临盆之时。专赖气血旺足。然后能生。此时惟有多服参 归桂。甘温重补。儿信一下。频频
服之。自无横生逆产胎衣不下之病矣。有不耐药气者。独参汤妙。服法于未下产时。用芎归参
。浓煎饮之。自然紧痛易产矣。儿下后即用前药。加肉桂一钱。煎服。自无血块痛之病矣。
产后血晕。用醋炭熏鼻法。好老酒和童便服。不可放倒。（产后败血不尽。血迷血晕。腹中胎
衣不下。至死心头暖者。急用花蕊石散一服。化水即出。其效如神。不可不知。）如气血脱而晕
者。必唇口手足厥冷无脉。此时间不容发。当以大剂参附回其阳。如认作血晕。而以前法治之。
则毙矣。
产后发热。乃气血大亏也。（亦有食物太早。气弱不能运而生热者。必兼恶心饱闷。治宜健
运为主。又有乳结不通作热者。宜通乳。）即有见识者。亦必曰发散固不可。且以轻剂疏通之。
此一句害人不浅。总之脉必浮数。与外感无辨。（外感而发热者。必兼头痛拘急等症。脉必浮数
有力。补中益气加芎苏热服。补以散之。切忌妄汗。）一时不敢骤补也。殊不知产后发热。吾不
管其是邪非邪。有脉无脉。一味八珍十全峻补之。有邪自然汗解。无邪自然竟退矣。（如此胆气。
庸工那得到此。然胆由于识。彼只缘见不透耳。见得透定干得来矣。有识自有胆矣。）如瘀血发热
者。（腹必痛。口必微渴。）四物汤加桃仁红花丹皮足矣。然俟腹痛口微渴一退。即以八珍汤与之。
血块痛不发热者。四物汤加桃仁牛膝青皮丹皮。服二三剂自除。除后以八珍汤与之。（凡妇人血
虚阻滞。不能流畅而痛极者。当以水济水。若江河一决。而积垢皆去。宜用熟地当归牛膝泽泻肉
桂乌药。随症加减治之。如呕恶加炒黑干姜。阴滞加附子。大便干燥加楂肉。甚加苁蓉。下焦痛
极加吴茱萸。气滞者加香附陈皮。血滞者加红花。如气虚者宜少用香附陈皮之类。甚者不用亦可
。此系景岳决津煎。乃以补为泻之神剂也。）产后泄泻。切不可利水。（产后泄泻。责在脾虚。若
再加利水。则脾肾皆虚。故不可也。）如有此等症。只一味补中益气汤。加白芍。（酒洗炒为妙）
如发热而渴。乃阴竭也。六味丸。另煎六君子汤。或人参汤下之。（泻多则亡阴。故症兼发热作
渴也。然因泻而热而渴。则原是由脾传肾。故须仍用六君参汤下六味丸。此亦标本兼治之义。）
产后不便。有至二十余日者。不足为病。然产妇急于便。必多努责。往往成玉门不闭。子宫
下坠之病。治之贵早。一味用八珍汤。加桃仁杏仁各二钱。多则三剂自下。（产后气血未有不虚者
。即此症亦属气虚不能推送。血虚不能濡润之故。八珍汤乃治气血两虚之的剂也。然用于此症。则
其妙处却在加桃仁杏仁两味。盖人第知桃仁能破血。而不知桃仁又能利血而滑肠。人第知杏仁
能润肺。而不知杏仁兼能润肠而利便。故单用八珍以养气补阴。燥矢亦未始不下。然产妇既急于
便。而不加此二味。以使之速下。则恐仍多努责之劳也。前辈立法。必准理揆情如此。）
子宫下
坠。乃劳力所伤也。补中益气汤加白芍。倍用参 白术。如下坠而痛。大剂归脾汤加白芍。如因
恼下坠而痛。此骤动肝火所致。归脾汤加丹皮山栀。然当治之于早。如子宫干枯。不能升矣。玉
门不闭治同。产后感风。率多成痉者。气血虚故也。刚痉由血虚。（无汗为刚痉）四物汤倍归地。加软柴胡钩藤钩柔痉
由
气虚。（有汗为柔痉）补中益气汤加软柴胡钩藤钩。如主去风燥血之剂。则筋挛而成痉矣。（双林许炳如
侄妇。产后三日。忽喑哑不语。手足痉搐。延予视之。曰此怒动肝火而血燥也。用加味逍遥散
加熟地钩藤。一剂而痉搐全愈。三剂而口酸身热腰痛胁痛诸症悉除。惟语言尚不能出。予于前方中
又加菖蒲钱许。一剂。睡至半夜。言语如常。）产后咳嗽。弱症之渐也。六味饮加人参主之。如
兼发热。归脾汤去木香加白芍麦冬五味。吞六味丸。然须于初起时。即用此药。或有可救者。如
经发散。用过凉药。不效。
分娩之时，完全依赖气血旺盛充足，然后才能顺利生产。此时应当多服用人参、当归、桂枝等药物，以甘温之性进行重补。胎儿一旦下降，便频频服用这些药物，自然就不会出现难产、胎衣不下等病症了。如果有不耐受药气的人，使用独参汤效果很好。服用方法是在胎儿未娩出前，用川芎、当归、人参浓煎后饮用，自然会使产程紧促疼痛并易于分娩。胎儿娩出后立即服用前面的药方，加入一钱肉桂，煎服，自然就不会出现血块疼痛的病症了。
产后血晕，采用醋炭熏鼻的方法，并用好老酒混合童便服用，不可让产妇平躺。（如果是产后败血未尽，导致血迷血晕，腹中胎衣不下，即使死亡但心头尚暖的，急需用花蕊石散一服，化水灌服，其效如神，不可不知道。）如果是气血脱失导致的晕厥，必然出现嘴唇、口角、手足厥冷且无脉象。此时时间紧迫，必须用大剂量的参附汤来回阳救逆。如果误认为是血晕，而用治疗血瘀的方法处理，患者就会死亡。
产后发热，是由于气血严重亏损所致。（也有因为进食过早，气弱不能运化食物而生热的，必然兼有恶心、饱闷的症状，治疗应以健运脾胃为主。又有因乳汁结滞不通引起发热的，宜通乳。）即使是见多识广的医生，也一定会说发散法绝对不可用，只能用轻剂疏通。这一句话害人不浅。总之，脉象必然浮数，与外感发热难以辨别。（外感引起的发热，必然兼有头痛、身体拘急等症状，脉象必然浮数有力，可用补中益气汤加川芎、紫苏热服，以补益兼疏散的方法治疗，切忌妄用发汗法。）一时不敢贸然进补。殊不知产后发热，我不管它是邪气还是非邪气，也不管有脉无脉，一味地用八珍汤或十全大补汤峻补。有邪气自然会通过汗液排出，没有邪气自然就会退热。（有这样的胆识，庸医怎么能做到呢？然而胆识源于见识，他们只是因为见解不透彻罢了。见解透彻了，行动自然就能做到。有见识自然就有胆量了。）如果是瘀血引起的发热，（腹部必然疼痛，口必然微渴），用四物汤加桃仁、红花、丹皮就足够了。然而等到腹痛和口微渴的症状消退后，立即给予八珍汤。如果是血块疼痛但不发热的，用四物汤加桃仁、牛膝、青皮、丹皮，服用二三剂自然消除。消除后给予八珍汤。（凡是妇人血虚阻滞，不能流畅运行而导致剧烈疼痛的，应当以水济水，就像江河决堤一样，积垢都会去除。适宜用熟地黄、当归、牛膝、泽泻、肉桂、乌药，随症状加减治疗。如有呕吐恶心加炒黑干姜，阴寒凝滞加附子，大便干燥加山楂肉，严重时加肉苁蓉，下焦疼痛剧烈加吴茱萸，气滞者加香附、陈皮，血滞者加红花。如果是气虚者，应少用香附、陈皮之类，严重时不用也可以。这是张景岳的决津煎，是以补为泻的神奇方剂。）产后泄泻，切不可利水。（产后泄泻，责任在于脾虚，如果再加以利水，则脾肾皆虚，所以不可以这样做。）如果有这些症状，只用一味补中益气汤，加白芍。（用酒洗炒制为好）如果发热且口渴，这是阴液枯竭的表现，用六味丸，另煎六君子汤，或者用人参汤送服六味丸。（腹泻过多会导致亡阴，所以症状兼有发热作渴。然而因为腹泻而发热口渴，原本是由脾传至肾，所以仍需先用六君子汤或人参汤送服六味丸，这也是标本兼治的意义。）
产后便秘，有的长达二十多天，这不算病。然而产妇急于排便，往往用力努责，常常导致玉门不闭、子宫下坠的病症。治疗贵在早，一味用八珍汤，加桃仁、杏仁各二钱，多则三剂自然排出。（产后气血没有不虚的，此症也属于气虚不能推送、血虚不能濡润的缘故。八珍汤是治疗气血两虚的确切方剂。然而用于此症，其妙处在于加了桃仁和杏仁这两味药。人们只知道桃仁能破血，却不知道桃仁又能利血滑肠；人们只知道杏仁能润肺，却不知道杏仁兼能润肠通便。所以单用八珍汤来养气补阴，燥屎也未尝不能排出。然而产妇既然急于排便，如果不加这两味药使其快速排出，恐怕仍会多有努责的劳累。前辈立法，必定合乎情理如此。）
子宫下坠，是由于劳力损伤所致。用补中益气汤加白芍，加倍使用人参、白术。如果下坠且疼痛，用大剂量归脾汤加白芍。如果是因恼怒导致下坠疼痛，这是骤然触动肝火所致，用归脾汤加丹皮、山栀。然而应当在早期治疗。如果子宫干枯，不能升举，玉门不闭的治疗方法相同。产后感风，大多形成痉病，是因为气血虚弱。刚痉由血虚引起（无汗称为刚痉），用四物汤加倍当归、地黄，加软柴胡、钩藤。柔痉由气虚引起（有汗称为柔痉），用补中益气汤加软柴胡、钩藤。如果使用主去风燥血的药剂，就会导致筋脉挛缩而成痉病。（双林许炳如的侄媳妇，产后三天，忽然失音不语，手足痉挛抽搐，请我去诊治。我说这是怒气触动肝火导致血燥。用加味逍遥散加熟地黄、钩藤，一剂后痉挛抽搐全愈，三剂后口酸、身热、腰痛、胁痛等各种症状全部消除，只有语言还不能发出。我在前方中又加入少许石菖蒲，一剂后，睡到半夜，言语恢复正常。）产后咳嗽，是虚弱的征兆。用六味饮加人参主治。如果兼有发热，用归脾汤去掉木香，加白芍、麦冬、五味子，吞服六味丸。然而必须在初起时就使用这些药物，或许还有可救的希望。如果经过发散治疗，用过凉药，无效。
At the time of delivery, success relies entirely on sufficient and vigorous Qi and Blood. Only then can birth occur. At this time, it is advisable to take multiple doses of Ren Shen (Ginseng), Dang Gui (Angelica Sinensis), and Gui Zhi (Cinnamon Twig) to provide heavy tonification with sweet-warm properties. Once the fetus descends, frequent administration of these medicines will naturally prevent complications such as dystocia, abnormal presentation, or retained placenta. For those who cannot tolerate strong medicinal odors, Du Shen Tang (Single Ginseng Decoction) is excellent. The method of administration is to decoct Xiong Gui Can (a mixture of Chuan Xiong, Dang Gui, and Ren Shen) thickly and drink it before the baby is born; this will naturally facilitate tight contractions and easier delivery. Immediately after the baby is born, administer the previous prescription with the addition of one qian of Rou Gui (Cinnamon Bark), decocted and taken orally; this will naturally prevent pain caused by blood stasis clots.
For postpartum syncope due to blood loss, use the method of fumigating the nose with vinegar-treated charcoal, and consume good aged wine mixed with children's urine. Do not lay the patient flat. (If postpartum lochia is incomplete, leading to blood confusion and syncope, with the placenta remaining in the abdomen, even if death appears imminent but the heart remains warm, urgently administer one dose of Hua Rui Shi San (Flower Pyrite Powder). Dissolve in water and administer; its efficacy is miraculous and must be known.) If syncope is caused by depletion of Qi and Blood, there will inevitably be coldness of the lips, mouth, hands, and feet, and absence of pulse. In this critical moment, large doses of Shen Fu Tang (Ginseng and Aconite Decoction) must be used to restore Yang. If mistaken for blood-stasis syncope and treated with methods for blood stasis, the patient will die.
Postpartum fever is due to severe deficiency of Qi and Blood. (There are also cases where early consumption of food leads to heat generation because weak Qi cannot transform it; these cases necessarily include nausea and fullness/distension, and treatment should focus on strengthening and transforming the Spleen. There are also cases of fever caused by blocked lactation, which should be treated by promoting milk flow.) Even experienced physicians often say that dispersing methods are absolutely contraindicated and that only light agents for unblocking should be used. This statement causes significant harm. In general, the pulse will be floating and rapid, making it indistinguishable from exterior contraction fever. (Exterior contraction fever is accompanied by headache and stiffness/tightness, and the pulse is floating, rapid, and forceful; Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus Chuan Xiong (Szechwan Lovage Rhizome) and Zi Su (Perilla Leaf) should be taken hot, using a method of tonifying while dispersing. Profuse sweating must be strictly avoided.) One hesitates to tonify abruptly at first. However, one fails to realize that for postpartum fever, regardless of whether it is pathogenic or not, and regardless of the presence or absence of a pulse, one should simply use Ba Zhen Tang (Eight-Treasure Decoction) or Shi Quan Da Bu Tang (Ten-Ingredient Great Tonifying Decoction) for vigorous tonification. If there is pathogenic factor, it will resolve through sweating; if not, the fever will subside naturally. (Such courage stems from insight; how could mediocre practitioners achieve this? Courage comes from understanding. They fail because their insight is insufficient. With clear insight, action follows naturally. Insight brings courage.) If fever is caused by blood stasis, (there will necessarily be abdominal pain and slight thirst), Si Wu Tang (Four-Substance Decoction) plus Tao Ren (Peach Kernel), Hong Hua (Carthamus Flower), and Mu Dan Pi (Moutan Cortex) is sufficient. However, once the abdominal pain and slight thirst subside, immediately administer Ba Zhen Tang. If there is pain from blood clots without fever, Si Wu Tang plus Tao Ren (Peach Kernel), Niu Xi (Achyranthes Root), Qing Pi (Tangerine Peel), and Mu Dan Pi (Moutan Cortex) should be taken for two to three doses to eliminate the condition naturally. After elimination, administer Ba Zhen Tang. (In women with blood deficiency causing obstruction and inability to flow smoothly, resulting in extreme pain, it is appropriate to "use water to assist water," akin to a river bursting its banks, washing away accumulated filth. Suitable herbs include Shu Di Huang (Prepared Rehmannia Root), Dang Gui (Angelica Sinensis), Niu Xi (Achyranthes Root), Ze Xie (Alisma Rhizome), Rou Gui (Cinnamon Bark), and Wu Yao (Lindera Root), modified according to symptoms. Add Chao Hei Gan Jiang (Stir-fried Black Ginger) for vomiting/nausea; add Fu Zi (Aconite Lateral Root) for Yin stagnation/cold; add Zha Rou (Hawthorn Flesh) for dry stool; add Cong Rong (Cistanche Stem) for severe cases; add Wu Zhu Yu (Evodia Fruit) for extreme lower jiao pain. For Qi stagnation, add Xiang Fu (Cyperus Rhizome) and Chen Pi (Tangerine Peel); for Blood stagnation, add Hong Hua (Carthamus Flower). If Qi deficiency exists, use Xiang Fu and Chen Pi sparingly, or omit them in severe cases. This is Zhang Jingyue's Jue Jin Jian (Decoction for Crossing the Ford), a miraculous agent that uses tonification as purgation.)
For postpartum diarrhea, diuresis must never be used. (Postpartum diarrhea is attributed to Spleen deficiency; adding diuretics would further deplete both Spleen and Kidney, hence it is contraindicated.) If such symptoms occur, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) alone, plus Bai Shao (White Peony Root). (Washing with wine and stir-frying is ideal.) If accompanied by fever and thirst, this indicates exhaustion of Yin. Use Liu Wei Wan (Six-Ingredient Pill with Rehmannia), separately decocted Liu Jun Zi Tang (Six-Gentlemen Decoction), or administered via Ren Shen Tang (Ginseng Decoction). (Excessive diarrhea leads to loss of Yin, hence symptoms include fever and thirst. Since the fever and thirst arise from diarrhea, the pathology originally transmits from Spleen to Kidney; thus, Liu Wei Wan should still be administered via Liu Jun Zi Tang or Ren Shen Tang. This embodies the principle of treating both root and branch simultaneously.)
Postpartum constipation may last over twenty days and is not necessarily pathological. However, because postpartum women are anxious to defecate, they often strain excessively, frequently leading to prolapse of the vaginal opening (Yu Men) and uterus. Early treatment is crucial. Use Ba Zhen Tang (Eight-Treasure Decoction) alone, plus Tao Ren (Peach Kernel) and Xing Ren (Apricot Seed), each 2 qian. Within three doses, relief will naturally occur. (Qi and Blood are invariably deficient postpartum; this symptom is also due to Qi deficiency failing to push and Blood deficiency failing to moisten. Ba Zhen Tang is the precise formula for dual Qi and Blood deficiency. Its efficacy here lies in the addition of Tao Ren and Xing Ren. People know Tao Ren breaks blood but do not know it also promotes blood flow and lubricates the intestines; people know Xing Ren moistens the Lungs but do not know it also moistens the intestines and facilitates bowel movements. Thus, using Ba Zhen Tang alone to nourish Qi and Yin might eventually pass dry stools. However, since the patient is anxious to defecate, without these two herbs to accelerate passage, excessive straining may persist. Ancient masters established laws based on reason and human nature.)
Uterine prolapse is caused by labor injury. Use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus Bai Shao (White Peony Root), doubling the dosage of Ren Shen (Ginseng) and Bai Zhu (Atractylodes Macrocephala Rhizome). If prolapse is accompanied by pain, use a large dose of Gui Pi Tang (Restore the Spleen Decoction) plus Bai Shao (White Peony Root). If prolapse and pain are triggered by anger, this is due to sudden stirring of Liver Fire; use Gui Pi Tang (Restore the Spleen Decoction) plus Mu Dan Pi (Moutan Cortex) and Shan Zhi (Gardenia Fruit). Treatment should begin early. If the uterus becomes dry and cannot ascend, the treatment for Yu Men non-closure (vaginal laxity/prolapse) is the same. Postpartum wind invasion often results in spasms due to Qi and Blood deficiency. Gang Spasm (rigid spasm) is caused by Blood deficiency (characterized by absence of sweat); use Si Wu Tang (Four-Substance Decoction) with doubled Dang Gui (Angelica Sinensis) and Shu Di Huang (Prepared Rehmannia Root), plus Ruan Chai Hu (Bupleurum Root) and Gou Teng (Uncaria Rhynchophylla). Rou Spasm (flaccid spasm) is caused by Qi deficiency (characterized by presence of sweat); use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus Ruan Chai Hu (Bupleurum Root) and Gou Teng (Uncaria Rhynchophylla). If one uses formulas primarily aimed at expelling wind and drying blood, muscle convulsions leading to spasm will result. (Case: The niece-in-law of Xu Bingru from Shuanglin developed aphasia and limb spasms three days postpartum. I examined her and diagnosed Liver Fire agitation causing Blood dryness. I prescribed Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) plus Shu Di Huang (Prepared Rehmannia Root) and Gou Teng (Uncaria Rhynchophylla). After one dose, spasms resolved completely; after three doses, acid taste in mouth, body heat, lower back pain, and hypochondriac pain all disappeared, except for speech. I added a small amount of Shi Chang Pu (Acorus Rhizome) to the previous formula. After one dose, she slept until midnight and spoke normally.)
Postpartum cough is a sign of declining health. Treat with Liu Wei Yin (Six-Ingredient Decoction) plus Ren Shen (Ginseng). If accompanied by fever, use Gui Pi Tang (Restore the Spleen Decoction) minus Mu Xiang (Aucklandia Root), plus Bai Shao (White Peony Root), Mai Dong (Ophiopogon Tuber), and Wu Wei Zi (Schisandra Berry), swallowing Liu Wei Wan (Six-Ingredient Pill with Rehmannia). However, these medications must be used at the onset; otherwise, rescue may be impossible. If dispersing methods have been used and cooling agents administered without effect...