妇人病 四物良 与男子同,唯经前产后异耳。《济阴纲目》以四物汤加香附、炙草为
主,凡经前产后,俱以此出入加减。
月信准 体自康 经水一月一至,不愆其期,故名月信。经调则体自康。
渐早至 药宜凉 血海有热也,宜加味四物汤,加续断、地榆、黄芩、黄连之类。
渐迟至 重桂姜 血海有寒也,宜加味四物汤,加干姜、肉桂之类;甚,加附子。
错杂至 气血伤 经来或早或迟不一者,气血虚而经乱也,宜前汤加人参、白术、黄 之类。
归脾法 主二阳 《内经》云∶二阳之病发心脾,有不得隐曲,为女子不月。宜归脾汤。
兼郁结 逍遥长 郁气伤肝,思虑伤脾,宜加味逍遥散。
种子者 即此详 种子必调经,以归脾汤治其源,以逍遥散治其流,并以上诸法皆妙,
不必他求。唯妇人体肥浓者,恐子宫脂满,另用二陈汤,加川芎、香附为丸。
经闭塞 禁地黄 闭寒脉实,小腹胀痛,与二阳病为女子不月者不同。虽四物汤为妇科
所不禁,而经闭及积瘀实症,宜去地黄之濡滞,恐其护蓄,血不行也。加醋炒大黄二钱、桂
一钱、桃仁二钱,服五六剂。
孕三月 六君尝 得孕三月之内,多有呕吐、不食,名恶阻,宜六君子汤。俗疑半夏碍
胎,而不知仲师惯用之妙品也。高鼓峰云∶半夏合参术为安胎、止呕、进食之上药。
安胎法 寒热商 四物汤去川芎为主。热加黄芩、白术、续断,寒加艾叶、阿胶、杜仲
、白术。大抵胎气不安,虚寒者多。庸医以胎火二字惑人,误人无算。
难产者 保生方 横生倒产、浆水太早、交骨不开等症,宜保生无忧散。
开交骨 归芎乡 交骨不开,阴虚故也,宜加味芎归汤。
血大下 补血汤 胎,犹舟也。血,犹水也。水满则舟浮。血下太早,则干涸而胎阻矣
,宜当归补血汤加附子三钱。欲气旺则血可速生,且欲气旺而推送有力,加附子者取其性急
,加酒所以速 、归之用也。保生无忧散治浆水未行,此方治浆水过多,加味归芎汤治交骨
不开。三方鼎峙,不可不知。
脚小指 艾火炀 张文仲治妇人横产手先出,诸般符药不效,以艾火如小麦大,灸产妇
右脚小指头尖,下火立产。
胎衣阻 失笑匡 胎衣不下,宜以醋汤送失笑散三钱,即下。
产后病 生化将 时医相传云,生化汤加减,治产后百病。若非由于停瘀而误用之,则
外邪反入于血室,中气反因以受伤,危症蜂起矣。慎之,慎之!
合诸说 俱平常 以上相沿之套法,轻病可愈,治重病则不效。
资顾问 亦勿忘 商治时不与众医谈到此法,反为其所笑。
精而密 长沙室 《金匮要略》第二十卷、第二十一卷、第二十二卷,义精而法密。
妊娠篇 丸散七 《妊娠篇》凡十方∶丸散居七,汤居三。盖以汤者,荡也。妊娠以安
胎为主,攻补俱不宜骤,故缓以图之,即此是法。
桂枝汤 列第一 此汤表症得之为解肌和营卫,内症得之为化气调阴阳,今人只知为伤
寒首方。此于《妊娠篇》列为第一方以喝醒千百庸医之梦,亦即是法。师云∶妇人得平脉
,阴脉小弱,其人渴不能食,无寒热,名妊娠,桂枝汤主之。注∶阴搏阳别为有子,今反云
阴脉弱小,是孕只两月,蚀下焦之气,不能作盛势也,过此则不然。妊娠初得,上下本无病
,因子室有凝,气溢上下,故但以芍药一味固其阴气,使不得上溢。以桂、姜、甘、枣扶上焦
之阳,而和其胃气,但令上焦之阳气充,能御相侵之阴气足矣。未尝治病,正所以治病也。
附半姜 功超轶 时医以半夏、附子坠胎不用,干姜亦疑其热而罕用之,而不知附子补
命门之火以保胎,半夏和胃气以安胎,干姜暖土脏使胎易长。俗子不知。
内十方 皆法律桂枝汤治妊娠,附子汤治腹痛少腹如扇,茯苓桂枝丸治三月余漏下、
动在脐上为 瘕,当归芍药散治怀妊腹中 痛,干姜人参半夏丸治妊娠呕吐不止,
当归贝母苦参丸治妊娠小便难,当归散妊娠常服,白术散妊娠养胎,方方超妙,用之如神。
惟妊娠有水气、身重、小便不利、恶寒、起即头眩,用葵子茯苓散不能无疑。
产后篇 有神术 共九方。
小柴胡 首特笔 妊娠以桂枝汤为第一方,产后以小柴胡汤为第一方,即此是法。新产
妇人有三病∶一者病痉,二者病郁冒,三者大便难。产妇郁冒、脉微弱、呕不能食、大便反
坚、但头汗出者,以小柴胡汤主之。
竹叶汤 风痉疾 《金匮》云∶产后中风、发热、面正赤、喘而头痛,竹叶汤主之。钱
院使注云∶中风之下,当有病痉者三字。按∶庸医于此症,以生化汤加姜、桂、荆芥、益母
草之类,杀人无算。
阳旦汤 功与匹 即桂枝汤增桂加附子,《活人》以桂枝汤加黄芩者误也。风乘火势,火
借风威,灼筋而成痉,宜竹叶汤。若数日之久,恶寒症尚在,则为寒风,宜此汤。二汤为一
热一寒之对子。师云∶产后风续续数十日不解,头微痛、恶寒、时时有热、心下闷、干呕,
汗出虽久,阳旦证续在者,可与阳旦汤。
腹痛条 须详悉 此下八句,皆言腹痛不同,用方各异。
羊肉汤 痛谧 痛者,痛之缓也,为虚症。
痛满烦 求枳实 满烦不得卧,里实也,宜枳实芍药散。二味无奇,妙在以麦粥下之。
着脐痛 下瘀吉 腹中有瘀血,着于脐下而痛,宜下瘀血汤。
痛而烦 里热窒 小腹痛虽为停瘀,而不大便、日晡烦躁、谵语,非停瘀专症也。血因
热裹而不行,非血自结于下,但攻其瘀而可愈也。《金匮》以大承气汤攻热。
攻凉施 毋固必 攻有大承气汤,凉有竹皮大丸、白头翁加甘草阿胶汤。《金匮》云∶
病解能食,七八日更发热者,此为胃实,大承气汤主之。又云∶妇人乳中虚,烦乱呕逆,安
中益气,竹皮大丸主之。又云∶产后下利虚极,白头翁加甘草阿胶汤主之。读此,则知丹溪
产后以大补气血为主,余以末治之说,为大谬也。
杂病门 还熟读 《金匮》云∶妇人之病,以因虚、积冷、结气六字为纲,至末段谓千
变万端,总出于阴阳虚实。而独以弦紧为言者,以经阻之始,大概属寒,气结则为弦,寒甚
则为紧,以此为主,而参之兼脉可也。
二十方 效俱速
随证详 难悉录
唯温经 带下服 十二 、九痛、七害、五伤、三痼共三十六种。因经致病,统名
曰带下,言病在带脉,非近时赤白带下之说也。温经汤治妇人年五十,前阴下血、暮发热、
手掌烦热、腹痛、口干云云。其功实不止此也。
甘麦汤 脏躁服 《金匮》云∶妇人脏躁,悲伤欲哭,象如神灵所作,数欠伸,甘麦大枣汤主之。
药到咽 效可卜 闽中诸医,因余用此数方奇效,每缮录于读本之后,亦医风之将转也。余日望之。
道中人 须造福
妇女的疾病,四物汤是良方,其治疗原则与男子相同,只是在月经前和产后有所不同。《济阴纲目》以四物汤加入香附、炙甘草为主方,凡是月经前或产后的病症,都以此方为基础进行加减变化。
月经周期正常,身体自然健康。月经每月来潮一次,不违背其规律时间,所以称为“月信”。月经调顺,身体自然康健。
月经逐渐提前到来,用药宜用凉性药。这是血海有热所致,宜用加味四物汤,加入续断、地榆、黄芩、黄连等药物。
月经逐渐推后到来,重用桂枝、干姜。这是血海有寒所致,宜用加味四物汤,加入干姜、肉桂等药物;病情严重的,加入附子。
月经错杂不定(或早或迟),气血受损。月经来潮时间或早或迟不一,这是气血虚弱导致经血紊乱,宜用前方加入人参、白术、黄芪等药物。
运用归脾汤的方法,主治阳明经病变。《黄帝内经》说:阳明经的病变发于心脾,如果有难以启齿的隐情,会导致女子闭经。宜用归脾汤。
兼有郁结症状,逍遥散疗效长久。郁气损伤肝脏,思虑损伤脾脏,宜用加味逍遥散。
想要生育种子,就详细参考上述方法。想要受孕必须调理月经,用归脾汤治其本源,用逍遥散治其流变,以上各种方法都很精妙,不必另求他法。只有身体肥胖丰满的妇人,恐怕子宫被脂肪充满,另外使用二陈汤,加入川芎、香附制成丸药。
月经闭塞不通,禁用地黄。如果是寒凝且脉象实,小腹胀痛,这与因阳明病导致的女子闭经不同。虽然四物汤是妇科不禁用的方剂,但对于经闭及积瘀实证,应当去掉地黄这种滋腻停滞的药物,恐怕它会阻碍蓄积,使血液不能运行。加入醋炒大黄二钱、桂枝一钱、桃仁二钱,服用五六剂。
怀孕三个月内,常服六君子汤。怀孕三个月之内,多有呕吐、不想吃东西的症状,名叫恶阻,宜用六君子汤。世俗人怀疑半夏妨碍胎儿,却不知道这是张仲景惯用的妙品。高鼓峰说:半夏配合人参、白术,是安胎、止呕、进食的上等药物。
安胎的方法,需斟酌寒热属性。以四物汤去掉川芎为主方。热证加入黄芩、白术、续断,寒证加入艾叶、阿胶、杜仲、白术。大抵胎气不安,虚寒的情况居多。庸医以“胎火”二字迷惑人,误人无数。
难产的情况,用保生无忧方。横生倒产、羊水过早破裂、耻骨联合不开等症状,宜用保生无忧散。
打开耻骨(交骨),当归、川芎之乡。耻骨不开,是因为阴虚,宜用加味芎归汤。
阴道大量出血,用补血汤。胎儿就像船,血液就像水。水满则船浮。血液流失太早,就会干涸而导致胎儿阻滞,宜用当归补血汤加入三钱附子。想要气旺则血可快速生成,且想要气旺而推送有力,加入附子是取其药性急猛,加入酒是为了加速当归的作用。保生无忧散治疗羊水未行,此方治疗羊水过多,加味归芎汤治疗耻骨不开。三方鼎立,不可不知。
脚小指,用艾火灸烤。张文仲治疗妇人横产手先出的情况,各种符咒药物都不见效,用艾绒如小麦大小,灸产妇右脚小指指尖,点火后立即分娩。
胎衣阻塞,失笑散匡救。胎衣不下,宜用醋汤送服失笑散三钱,胎衣即可排出。
产后疾病,将生化汤作为主方。当时的医生相传,用生化汤加减,治疗产后百病。如果不是因为停瘀而误用此方,那么外邪反而进入血室,中气反而因此受伤,危重病症蜂拥而起。谨慎啊,谨慎啊!
综合各种说法,都是平常之法。以上这些沿袭下来的套路方法,轻症可以治愈,治疗重症则无效。
作为顾问参考,也不要忘记。如果在诊治时不与众医生谈到这些方法,反而会被他们嘲笑。
精微而严密,属于长沙(张仲景)的学术体系。《金匮要略》第二十卷、第二十一卷、第二十二卷,义理精微而法则严密。
妊娠篇,丸散占七成。《妊娠篇》共十方,其中丸散占七方,汤剂占三方。大概因为汤剂的作用是荡涤,妊娠以安胎为主,攻补都不宜骤进,所以用缓和方法图之,这就是其中的法则。
桂枝汤列为第一。此汤对于表证,得到它就能解肌调和营卫;对于里证,得到它就能化气调和阴阳,现在的人只知道它是伤寒的首方。此书在《妊娠篇》将其列为第一方,以喝醒千百庸医的美梦,这也是其中的法则。老师说:妇人诊得平和之脉,阴脉小而弱,其人口渴不能食,无寒热症状,名为妊娠,用桂枝汤主治。注解说:阴脉搏动明显而与阳脉有别是有孕的表现,现在反而说阴脉弱小,说明怀孕只有两个月,蚀伤了焦之气,不能形成旺盛之势,过了这个阶段就不是这样了。妊娠初期,上下原本没有病,因为子室有凝滞,气溢于上下,所以只用芍药一味药固摄其阴气,使其不得上溢。用桂枝、生姜、甘草、大枣扶持上焦之阳气,调和胃气,只要令上焦阳气充足,能抵御相侵的阴气就够了。未曾治病,这正是治病的方法。
附子、半夏、干姜,功效超群。当时的医生认为半夏、附子会坠胎而不使用,干姜也被怀疑性热而很少使用,却不知道附子能补命门之火以保胎,半夏能和胃气以安胎,干姜能暖土脏使胎儿容易生长。世俗之人不知道这一点。
内部十方,都是法律准则。桂枝汤治疗妊娠,附子汤治疗腹痛少腹如扇状寒冷,茯苓桂枝丸治疗怀孕三个多月漏下、脐上有瘕块,当归芍药散治疗怀孕腹中疼痛,干姜人参半夏丸治疗妊娠呕吐不止,当归贝母苦参丸治疗妊娠小便困难,当归散妊娠常服,白术散妊娠养胎,方方超妙,使用如神。只有妊娠有水气、身重、小便不利、恶寒、起身即头晕眩,使用葵子茯苓散不能不有疑问。
产后篇,有神妙之术。共九方。
小柴胡汤,首先特别提及。妊娠以桂枝汤为第一方,产后以小柴胡汤为第一方,这就是其中的法则。新产下的妇人有三病:一是病痉,二是病郁冒,三是大便难。产妇出现郁冒、脉微弱、呕吐不能食、大便反而坚硬、只有头部出汗的,用小柴胡汤主治。
竹叶汤,治疗风痉疾。《金匮要略》说:产后中风、发热、面色正红、喘促而头痛,用竹叶汤主治。钱院使注解说:在中风之下,应当有“病痉”这三个字。按:庸医对此症,用生化汤加入姜、桂、荆芥、益母草之类,杀人无数。
阳旦汤,功效与之匹敌。即桂枝汤增加桂枝并加入附子,《活人书》中以桂枝汤加黄芩是错误的。风乘火势,火借风威,灼伤筋脉而成痉,宜用竹叶汤。如果数日之久,恶寒症状仍在,则为寒风,宜用此汤。这两方是一热一寒的对子。老师说:产后风邪持续数十日不解,头微痛、恶寒、时不时有热、心下闷、干呕,出汗虽久,阳旦证仍在的,可与阳旦汤。
羊肉汤,用于痛势缓和者。“谧”意为痛势缓和,属虚证。
痛且满烦,求枳实。腹部胀满烦躁不得卧,属里实证,宜用枳实芍药散。两味药并不奇特,妙处在于用麦粥送服。
痛着于脐部,下瘀血吉。腹中有瘀血,附着于脐下而痛,宜用下瘀血汤。
痛且烦,里热窒塞。小腹痛虽然是停瘀,但如果伴有大便不通、傍晚烦躁、谵语,就不是停瘀的专症。血液因热裹挟而不能运行,不是血自己结于下部,只需攻逐其瘀即可痊愈。《金匮要略》用大承气汤攻热。
攻下与凉泻施用,不要固执必守。攻下有方大承气汤,凉泻有方竹皮大丸、白头翁加甘草阿胶汤。《金匮要略》说:病解能食,七八日后又发热的,此为胃实,大承气汤主治。又说:妇人哺乳期中气虚,烦乱呕逆,安中益气,竹皮大丸主治。又说:产后下利极度虚弱,白头翁加甘草阿胶汤主治。读到这里,就知道丹溪主张产后以大补气血为主,其余以末治的说法,是大谬误。
杂病门,还要熟读。《金匮要略》说:妇人的病,以因虚、积冷、结气六个字为纲领,到最后一段说千变万端,总出于阴阳虚实。而唯独强调弦紧脉,是因为经阻之初,大概属寒,气结则为弦脉,寒甚则为紧脉,以此为主,参合兼脉即可。
二十方,疗效都迅速。
随证详细分析,难以全部记录。
唯有温经汤,带下病服用。十二瘕、九痛、七害、五伤、三痼共三十六种。因经致病,统名曰带下,意思是病在带脉,不是近时所说的赤白带下。温经汤治疗妇人五十岁,前阴下血、傍晚发热、手掌烦热、腹痛、口干等等。它的功效实际上不止于此。
甘麦大枣汤,脏躁病服用。《金匮要略》说:妇人脏躁,悲伤欲哭,像神灵所作所为,频繁打哈欠伸懒腰,用甘麦大枣汤主治。
药到咽下,疗效可预见。福建地区的各位医生,因为我用这几首方子效果奇佳,每每抄录在读本之后,这也是医风将要转变的迹象。我日日盼望这一天。
同道中人,必须造福世人。
Women's diseases, Siwu Tang (Four Substances Decoction) is an excellent formula; its treatment principles are the same as those for men, with differences only occurring before menstruation and after childbirth. *Jiyin Gangmu* (Outline of Gynecology) uses Siwu Tang added with Xiangfu (Cyperus Rhizome) and Zhi Gancao (Honey-fried Licorice Root) as the main formula. For conditions before menstruation or after childbirth, modifications are made based on this formula.
Regular menstrual cycles indicate natural health. Menstruation occurs once a month without deviation from its schedule, hence it is called "Yuexin" (Monthly Trust). When menstruation is regulated, the body remains healthy.
Menstruation arriving progressively earlier requires cooling herbs. This is due to heat in the Blood Sea (Chong and Ren meridians), and Jiawei Siwu Tang (Modified Four Substances Decoction) should be used, adding Xuduan (Dipsacus Root), Diyü (Sanguisorba Root), Huangqin (Scutellaria Root), and Huanglian (Coptis Rhizome).
Menstruation arriving progressively later requires Cinnamon Twig and Dried Ginger. This is due to cold in the Blood Sea, and Jiawei Siwu Tang should be used, adding Ganjiang (Dried Ginger) and Rougui (Cinnamon Bark); in severe cases, Fuzi (Aconite Lateral Root) is added.
Irregular menstruation damages Qi and Blood. When menstruation arrives at varying times, either early or late, it indicates deficiency of Qi and Blood leading to menstrual disorder. The previous formula should be used with Renshen (Ginseng Root), Baizhu (Atractylodes Macrocephala Rhizome), and Huangqi (Astragalus Root) added.
The method of using Guipi Tang (Restore the Spleen Decoction) targets disorders of the Yangming channels. The *Neijing* states: "Disorders of the Yangming channels originate in the Heart and Spleen; if there are hidden grievances, it leads to amenorrhea in women." Guipi Tang is indicated.
When accompanied by stagnation, Xiaoyao San (Free Wanderer Powder) provides long-lasting effects. Stagnant Qi injures the Liver, and overthinking injures the Spleen; Jiawei Xiaoyao San (Modified Free Wanderer Powder) is indicated.
For conception, refer to the details above. To conceive, one must regulate menstruation. Use Guipi Tang to treat the root cause, and Xiaoyao San to treat the branch manifestations. All the aforementioned methods are excellent; no other search is necessary. However, for obese women, whose uteruses may be filled with fat, Erchen Tang (Two Aged Things Decoction) added with Chuanxiong (Ligusticum Rhizome) and Xiangfu (Cyperus Rhizome) should be processed into pills.
Menstrual obstruction contraindicates Rehmannia Root. If the condition is cold with excess pulse, accompanied by lower abdominal distension and pain, it differs from amenorrhea caused by Yangming disease. Although Siwu Tang is not contraindicated in gynecology, for menstrual obstruction and excess stasis patterns, Dihuang (Rehmannia Root) should be removed due to its cloying nature, which might hinder blood circulation. Add Cu Chao Dahuang (Vine-processed Rhubarb Rhizome) 2 qian, Guizhi (Cinnamon Twig) 1 qian, and Taoren (Peach Seed) 2 qian; take for five to six doses.
During the first three months of pregnancy, Liujunzi Tang (Six Gentlemen Decoction) is often used. Within the first three months of pregnancy, vomiting and loss of appetite are common, known as "Ezu" (Morning Sickness). Liujunzi Tang is indicated. Laypeople suspect that Banxia (Pinellia Tuber) harms the fetus, unaware that it is a wonderful herb frequently used by Zhang Zhongjing. Gao Gufeng stated: Banxia combined with Renshen and Baizhu is a superior herb for calming the fetus, stopping vomiting, and promoting appetite.
Methods for calming the fetus require considering heat and cold. The base is Siwu Tang minus Chuanxiong. For heat patterns, add Huangqin (Scutellaria Root), Baizhu (Atractylodes Macrocephala Rhizome), and Xuduan (Dipsacus Root); for cold patterns, add Aiye (Mugwort Leaf), Ejiao (Donkey-hide Gelatin), Duzhong (Eucommia Bark), and Baizhu. Generally, fetal unrest is mostly due to deficiency and cold. Quack doctors confuse people with the term "Fetal Fire," causing countless errors.
For difficult labor, use Baosheng Wuyou San (Preserve Life and Peace of Mind Powder). Conditions such as transverse presentation, premature rupture of membranes, and failure of the pubic symphysis to open are treated with Baosheng Wuyou San.
To open the pubic symphysis, use Angelica and Ligusticum. Failure of the pubic symphysis to open is due to Yin deficiency; Jiawei Xionggui Tang (Modified Ligusticum and Angelica Decoction) is indicated.
Profuse bleeding requires Bu Xue Tang (Tonify Blood Decoction). The fetus is like a boat, and blood is like water. When water is full, the boat floats. If blood is lost too early, it dries up, obstructing the fetus. Bu Dang Gui Bu Xue Tang (Danggui Tonify Blood Decoction) with 3 qian of Fuzi (Aconite Lateral Root) is indicated. To promote Qi abundance so that blood generates quickly, and to ensure strong pushing power, Fuzi is added for its rapid action, and wine is added to accelerate the effect of Danggui (Angelica Sinensis Root). Baosheng Wuyou San treats premature membrane rupture; this formula treats excessive amniotic fluid; Jiawei Xionggui Tang treats pubic symphysis non-opening. These three formulas stand together; one must know them.
The little toe of the foot is treated with moxa. Zhang Wenzhong treated a case of transverse presentation with hand protrusion where various charms and medicines failed. He applied moxa the size of a wheat grain to the tip of the产妇's right foot little toe; upon ignition, delivery occurred immediately.
Placental retention is rescued by Shixiao San. Retained placenta is treated by sending down 3 qian of Shixiao San (Laughing Away Powder) with vinegar broth; the placenta will then be expelled.
Postpartum diseases rely on Shenghua Tang. Contemporary physicians claim that Shenghua Tang (Generate New and Transform Old Decoction) with modifications treats all postpartum diseases. If misused for conditions not caused by retained stasis, external pathogens may enter the Blood Chamber, and Middle Qi may be injured, leading to numerous critical conditions. Be cautious, be cautious!
Synthesizing these theories reveals they are ordinary methods. The above traditional routine methods can cure mild illnesses but are ineffective for severe ones.
As a reference, do not forget. If one discusses these methods during consultations, one may be laughed at by other physicians.
Refined and rigorous, belonging to the Changsha school (Zhang Zhongjing). Volumes 20, 21, and 22 of *Jinkui Yaolue* (Essential Prescriptions of the Golden Cabinet) possess profound meaning and strict methodology.
The Pregnancy Chapter contains seven pills and powders. There are ten formulas in the *Pregnancy Chapter*: seven are pills/powders, and three are decoctions. Decoctions act to sweep away pathogens. Since pregnancy focuses on calming the fetus, both purgative and tonifying actions should not be abrupt; thus, a slow approach is taken. This is the method.
Guizhi Tang (Cinnamon Twig Decoction) is listed first. This formula resolves the muscle layer and harmonizes Ying and Wei for exterior syndromes, and transforms Qi and harmonizes Yin and Yang for interior syndromes. Modern practitioners only know it as the primary formula for Cold Damage. Listing it first in the *Pregnancy Chapter* serves to awaken thousands of quacks from their dreams; this is also a method. The Master said: "If a woman has a normal pulse, with the Yin pulse slightly weak, and experiences thirst, inability to eat, without chills or fever, it is named pregnancy, and Guizhi Tang governs it." Commentary: "Yin pulse beating distinctly different from Yang indicates pregnancy. Here, the Yin pulse being weak suggests pregnancy is only two months old, eroding Lower Jiao Qi, preventing a vigorous state. After this stage, it is different." In early pregnancy, there is originally no disease above or below. Due to condensation in the uterus, Qi overflows upward and downward. Therefore, only Shaoyao (Peony Root) is used to secure Yin Qi, preventing it from overflowing upward. Guizhi, Shengjiang (Fresh Ginger), Gancao (Licorice Root), and Dazao (Jujube Fruit) support Upper Jiao Yang Qi and harmonize Stomach Qi. As long as Upper Jiao Yang Qi is sufficient to resist invading Yin Qi, it is enough. Not treating disease directly is precisely how disease is treated.
Fuzi, Banxia, and Ganjiang have transcendent merits. Contemporary physicians avoid Banxia and Fuzi fearing they cause miscarriage, and rarely use Ganjiang fearing it is too hot. They do not know that Fuzi supplements Mingmen Fire to preserve the fetus, Banxia harmonizes Stomach Qi to calm the fetus, and Ganjiang warms the Earth Organ to facilitate fetal growth. Laypeople do not understand this.
The internal ten formulas are all legal standards. Guizhi Tang treats pregnancy; Fuzi Tang treats abdominal pain with cold sensation in the lower abdomen like a fan; Fuling Guizhi Wan (Poria and Cinnamon Twig Pill) treats leakage after three-plus months of pregnancy with masses above the umbilicus; Danggui Shaoyao San (Angelica and Peony Powder) treats abdominal pain during pregnancy; Ganjiang Renshen Banxia Wan (Dried Ginger, Ginseng, and Pinellia Pill) treats persistent vomiting in pregnancy; Danggui Beimu Kushen Wan (Angelica, Fritillaria, and Sophora Pill) treats difficult urination in pregnancy; Danggui San (Angelica Powder) is commonly taken during pregnancy; Baizhu San (Atractylodes Powder) nourishes the fetus during pregnancy. Every formula is superb, effective as if divine. Only for pregnancy with water qi, heaviness, difficulty urinating, aversion to cold, and dizziness upon rising, the use of Kuizi Fuling San (Abutilon and Poria Powder) raises doubts.
The Postpartum Chapter has divine efficacy. It contains nine formulas.
Xiao Chaihu Tang (Minor Bupleurum Decoction) is specifically highlighted first. Guizhi Tang is the first formula for pregnancy; Xiao Chaihu Tang is the first formula for postpartum conditions; this is the method. New mothers have three diseases: one is Jing (spasms), two is Yumao (depression and vertigo), three is difficult defecation. For postpartum Yumao, weak pulse, vomiting, inability to eat, hard stool, and sweating only on the head, Xiao Chaihu Tang is indicated.
Zhuye Tang (Bamboo Leaf Decoction) treats wind-induced spasms. *Jinkui* states: "Postpartum wind strike, fever, red face, wheezing, and headache are treated with Zhuye Tang." Dean Qian annotated: "Under 'wind strike,' the words 'and spasm' should be present." Note: Quacks treat this condition with Shenghua Tang added with Jiang, Gui, Jingjie, and Yimucao, killing countless people.
Yangdan Tang matches its merit. It is Guizhi Tang with increased Guizhi and added Fuzi. *Heren* incorrectly used Guizhi Tang with Huangqin. Wind rides fire, fire borrows wind strength, scorching tendons to cause spasms; Zhuye Tang is indicated. If after several days chills persist, it is cold wind; Yangdan Tang is indicated. These two formulas are a pair of heat and cold. The Master said: "Postpartum wind lingering for dozens of days, slight headache, chills, intermittent fever, chest oppression, dry vomiting, prolonged sweating, yet Yangdan syndrome persists, Yangdan Tang can be given."
The Abdominal Pain section requires detailed knowledge. The following eight lines discuss different types of abdominal pain requiring different formulas.
Rouyang Tang is for dull pain. "Mi" means dull/slow pain, indicating a deficiency pattern.
Pain with fullness and irritability seeks Zhi Shi. Fullness, irritability, and inability to lie down indicate interior excess; Zhishi Shaoyao San (Immature Bitter Orange and Peony Powder) is indicated. The two ingredients are not extraordinary; the brilliance lies in taking them with oatmeal gruel.
Pain fixed at the navel benefits from expelling stasis. Blood stasis in the abdomen fixed below the navel causing pain is treated with Xiayuxue Tang (Expel Blood Stasis Decoction).
Pain with irritability indicates interior heat obstruction. Lower abdominal pain may be due to stasis, but if accompanied by constipation, evening irritability, and delirium, it is not solely a stasis pattern. Blood is trapped by heat and cannot move; it is not self-coagulated in the lower part. Attacking the stasis alone can cure it. *Jinkui* uses Dachengqi Tang (Major Order the Yellow Decoction) to attack heat.
Use purging and cooling methods; do not be rigid. Purging includes Dachengqi Tang; cooling includes Zhupi Dawan (Bamboo Peel Large Pill) and Baitouweng Jia Gancao Ejiao Tang (Baitouweng Decoction plus Licorice and Donkey-hide Gelatin). *Jinkui* states: "After recovery, if able to eat, but fever returns after seven to eight days, this is Stomach Excess, governed by Dachengqi Tang." Also: "In women nursing, with deficiency causing irritability, vomiting, and reversal, Anzhong Yiqi (Nourish Middle and Boost Qi) is governed by Zhupi Dawan." Also: "Postpartum dysentery with extreme deficiency is governed by Baitouweng Jia Gancao Ejiao Tang." Reading this, one knows that Danxi's view that postpartum treatment should focus mainly on greatly tonifying Qi and Blood, and his dismissal of other treatments, is a major error.
The Miscellaneous Disease section requires careful study. *Jinkui* states: "Women's diseases are summarized by six characters: Deficiency, Accumulated Cold, and Stagnant Qi." At the end, it says changes are endless but total in Yin-Yang and Deficiency-Excess. Emphasizing Xian (Wiry) and Jin (Tight) pulses is because initial menstrual obstruction is generally cold; Qi stagnation makes the pulse wiry, severe cold makes it tight. Take this as primary and combine with concurrent pulses.
Twenty formulas, all effective quickly.
Detailed analysis by syndrome cannot be fully recorded.
Only Wenjing Tang is taken for Dai Xia (Leukorrhea). The twelve masses, nine pains, seven harms, five injuries, and three chronic diseases total thirty-six types. Diseases caused by menstruation are collectively called Dai Xia, meaning the disease is in the Dai Mai (Girdle Vessel), not the modern concept of red and white leukorrhea. Wenjing Tang (Warm the Meridian Decoction) treats a fifty-year-old woman with vaginal bleeding, evening fever, palm heat, abdominal pain, and dry mouth. Its efficacy is actually far greater than this.
Ganmai Dazao Tang is taken for Zang Zao (Visceral Agitation). *Jinkui* states: "Visceral agitation in women, characterized by sadness and desire to cry, acting like possessed by spirits, frequent yawning and stretching, is governed by Ganmai Dazao Tang (Licorice, Wheat, and Jujube Decoction)."
Once the medicine reaches the throat, efficacy is predictable. Physicians in Fujian, seeing my miraculous results with these few formulas, copy them after the readings. This indicates a shift in medical ethics. I look forward to this day.
Those in the Dao must benefit humanity.