产后诸证,首必通瘀,然有不可以常理测者。表弟周鹤庭室,新产晕汗,目不能开,心若悬旌,毫无恶露。乃
父何君新之,按其脉有虚弦豁大之形,亟拉孟英图之。与以∶“三甲”石英 丹参 琥珀 甘草 小麦 绿豆衣等
药,覆杯即安,数服而愈。
或诘其何以知非瘀血为患?曰∶此阴虚之体,既产而营液大脱,风阳上冒。虽无恶露,胸腹皆舒,岂可误作瘀
冲,而妄投破血之药耶?
朱氏妇,产后恶露不行,而宿哮顿发,专是科者不能下手。孟英以∶丹参 桃仁 贝母 茯苓 滑石 花粉
桂枝 通草 蛤壳 苡仁 紫菀 山楂 旋复 琥珀 丝瓜子 茺蔚子等,出入为方,三日而愈。
予荆人娩后恶露不行。或劝服生化汤。适孟英枉顾,诊曰∶阴虚内热,天令炎蒸,虽赤砂糖,不可服也。
以∶生地 丹参 丹皮 豆卷 茺蔚子 茯苓 桃仁 山楂 栀子 泽兰 琥珀,投之即效。且无别恙而易健。可
见体质不齐,药难概用,况其致病之因不一,病机传变无穷。语云∶“量体裁衣”,而治病者,可不辨证而施
治耶?孟英尝曰∶凡产后,世俗多尚生化汤,是以一定之死方,疗万人之活病,体寒者固为妙法,若血热之人,
或兼感温热之气者,而一概投之,骤则变证蜂起,缓则蓐损渐成,人但知产后之常有,而不知半由生化汤之历阶
。此风最盛于越,方本传于越之钱氏,自景岳采入《八阵》,遂致流播四海,人之阴受其害者,数百年矣。
从无一人能议其非,今特为此长夜之灯,冀后人不致永远冥行,或可稍补于世。但景岳最偏于温补,而独于产
后一门,力辨丹溪大补气血为主之非,可谓此老之一隙微明,惜犹泥于产后宜温之谬说,盖由未入仲圣之宫墙也。
金亚伯廷尉之 室,产后恶露不行,渴、泻、痰多。孟英以∶北沙参 滑石 生薏苡 扁豆 蛤壳 豆卷 石
斛竹茹 枇杷叶 琥珀 茯苓等药,数剂而愈。
庚子春,戴氏妇产后恶露不多,用山楂、益母草酒煎,连服数日,遂发热自汗,口渴不饥,眩晕欲脱,彻
夜不眠。孟英视之,曰∶此素禀阴亏,血已随胎而去,虽恶露甚少,
但无胀痛之苦者,不可妄投药饵。酒煎益母草、山楂不特伤阴,且能散气。而汗泄口干,津液有立竭之势,即仲圣
所谓“无阳也”。盖人身天真之气谓之阳,阳根于津,阴化于液,津液既夺,则阳气无根而眩晕,阴血不生而
无寐,若补气生阴,则舍本求末,气血不能生津液也。唯有澄源洁流,使津液充而气血自复,庶可无忧。以∶西洋
参生黄 龙骨 牡蛎 玉竹 百合 甘草 麦冬 生苡仁 生扁豆 石斛 木瓜 桑叶 甘蔗浆,投之,一剂即
安,数日而愈。后以滋填阴分,服之乃健。
产后各种病症,首要原则是疏通瘀血,但其中也有不能仅凭常理推断的情况。我表弟周鹤庭的妻子,刚生产后出现晕厥、出汗,眼睛无法睁开,心中惊恐不安(如同悬挂的旗帜般飘摇不定),完全没有恶露排出。她的父亲何新之先生,诊察其脉象呈现虚弦且豁大的形态,急忙邀请孟英诊治。孟英开具了“三甲”散、石英、丹参、琥珀、甘草、小麦、绿豆衣等药物,患者喝完药汤即感安宁,服用几剂后痊愈。
有人质问孟英:您是如何知道这不是瘀血为患的呢?孟英回答说:这位患者体质属阴虚,分娩后营阴血液大量耗脱,导致风阳之气上冒。虽然她没有恶露排出,但胸腹部感觉舒畅,哪里可以误认为是瘀血冲逆,而胡乱投用破血攻下的药物呢?
朱姓妇女,产后恶露不通,导致旧有的哮喘病突然发作,专门治疗妇科的医生都不敢下手。孟英使用丹参、桃仁、贝母、茯苓、滑石、天花粉、桂枝、通草、蛤壳、薏苡仁、紫菀、山楂、旋覆花、琥珀、丝瓜子和茺蔚子等药物,根据病情加减变化组成方剂,三天后痊愈。
我的妻子分娩后恶露不行。有人劝她服用生化汤。恰逢孟英来访,诊察后说:患者阴虚内热,正值天气炎热蒸腾之时,即使是赤砂糖也不宜服用。孟英开具了生地、丹参、丹皮、豆卷、茺蔚子、茯苓、桃仁、山楂、栀子、泽兰、琥珀等药物,投药后立即见效,且没有其他并发症,身体很快恢复健康。由此可见,人的体质各不相同,药物难以一概而论,更何况致病原因不一,病机传变无穷无尽。俗话说:“量体裁衣”,治病的人,难道可以不辨证候而施治吗?孟英曾说道:凡是产后,世俗大多崇尚使用生化汤,这是用一定不变的死方,来治疗千万人变化的活病。体质寒凉者固然适合此法,但对于血热之人,或者兼感温热邪气者,如果一概投用,急则会导致各种变证蜂拥而起,缓则会导致产后虚损逐渐形成。人们只知道这是产后的常见现象,却不知道这大半是由生化汤造成的危害。这种风气在越地最为盛行,该方本传自越地的钱氏,自从张景岳将其采入《八阵图》后,便流传四海,数百年来人们暗中受其害的人数不胜数。却从无一人能指出它的错误,今天我特意写下这篇文字作为长夜中的明灯,希望后人不要永远盲目行事,或许可以对世人有所补益。但是张景岳最偏重于温补,唯独在产后这一门中,极力辩驳朱丹溪“大补气血为主”观点的错误,可以说是这位老先生的一个细微明智之处,可惜他仍然拘泥于“产后宜温”的错误说法,大概是因为没有进入仲景医学的正统殿堂吧。
金亚伯廷尉的妻子,产后恶露不行,伴有口渴、腹泻、痰多症状。孟英使用北沙参、滑石、生薏苡仁、扁豆、蛤壳、豆卷、石斛、竹茹、枇杷叶、琥珀、茯苓等药物,服用数剂后痊愈。
庚子年春天,戴姓妇女产后恶露不多,用山楂和益母草酒煎煮,连续服用数日,随后出现发热、自汗、口渴、不思饮食、眩晕欲脱、彻夜不眠的症状。孟英诊视后说:这位患者素体阴亏,血液已经随着胎儿娩出而流失,虽然恶露很少,但只要没有胀痛之苦,就不可以妄投药物。酒煎的益母草和山楂不仅损伤阴液,而且会耗散正气。现在汗出泄津、口干舌燥,津液有立即枯竭的趋势,这就是仲景所说的“无阳也”。所谓人身天真之气称为阳,阳气根源于津液,阴精化生于体液,津液既已夺失,则阳气失去根基而导致眩晕,阴血不生而导致失眠。如果此时补气以生阴,则是舍本逐末,因为气血本身不能直接生成津液。唯有澄清源头、洁净流道,使津液充盈,气血自然恢复,才可以无忧虑。孟英开具了西洋参、生黄芪、龙骨、牡蛎、玉竹、百合、甘草、麦冬、生薏苡仁、生扁豆、石斛、木瓜、桑叶、甘蔗浆等药物,投药后一剂即安,数日后痊愈。后来通过滋补填精阴分的方法调理,身体才完全康复。
Various conditions after childbirth must first address blood stasis, yet there are cases that cannot be judged by common reasoning. The wife of my cousin, Zhou Heting, experienced fainting and sweating immediately after delivery, with eyes unable to open and a heart feeling as if suspended (anxious palpitations), accompanied by an absence of lochia. Her father, Mr. He Xinzhi, felt her pulse which presented a deficiency, wiry, and large/open (Xu Xuan Huo Da) quality, and urgently invited Meng Ying for consultation. Meng Ying prescribed "San Jia" Powder (Three Shells Powder), Quartz (Shiying), Salvia Miltiorrhiza Radix et Rhizoma (Danshen), Amber (Hupo), Licorice Root (Gancao), Wheat (Xiaomai), and Mung Bean Coat (Lvdouyi). The patient was relieved upon finishing the cup of decoction and recovered after several doses.
When asked how he knew this was not caused by blood stasis, Meng Ying replied: This patient has a Yin-deficient constitution. After childbirth, the Ying-nutrient fluids were largely depleted, causing Wind-Yang to ascend and overwhelm. Although there was no lochia, her chest and abdomen felt comfortable. How could one mistakenly diagnose it as stasis rushing upward and recklessly administer blood-breaking drugs?
Mrs. Zhu suffered from obstructed lochia after childbirth, which triggered a sudden exacerbation of her chronic asthma. Specialists in gynecology dared not treat her. Meng Ying used Salvia Miltiorrhiza Radix et Rhizoma (Danshen), Peach Kernel (Taoren), Fritillaria Bulb (Beimu), Poria (Fuling), Talcum (Huashi), Trichosanthes Root (Huafen), Cinnamon Twig (Guizhi), Tetrapanax Medulla (Tongcao), Clam Shell (Geqiao), Coix Seed (Yiyiren), Aster Root (Ziwan), Hawthorn Fruit (Shanzha), Inula Flower (Xuanfu), Amber (Hupo), Luffa Seed (Siguazi), and Agnus Castus Fruit (Chongweizi) in varying combinations. She recovered in three days.
After my wife delivered, her lochia did not flow. Someone advised taking Shenghua Decoction (Biomorphic Decoction). At that time, Meng Ying happened to visit. Upon diagnosis, he said: The patient has Yin deficiency with internal heat, and the weather is hot and humid. Even Red Sugar Rock Candy should not be taken. He prescribed Rehmannia Root (Shengdi), Salvia Miltiorrhiza Radix et Rhizoma (Danshen), Moutan Bark (Danpi), Fermented Soybean (Douban), Agnus Castus Fruit (Chongweizi), Poria (Fuling), Peach Kernel (Taoren), Hawthorn Fruit (Shanzha), Gardenia Fruit (Zhizi), Lonicera Stem (Zelan), and Amber (Hupo). The effect was immediate, with no other complications arising, and she regained health easily. This demonstrates that constitutions vary, and medicines cannot be applied uniformly. Moreover, causes of disease differ, and pathogenesis changes infinitely. As the saying goes, "Tailor the clothes to the body"; does not treating illness require syndrome differentiation?
Meng Ying once said: Regarding postpartum conditions, the public often favors Shenghua Decoction (Biomorphic Decoction). Using a fixed, rigid formula to treat the dynamic diseases of thousands of people is flawed. For those with cold constitutions, it is indeed a good method; but for those with blood heat or concurrent warm-heat pathogens, indiscriminate use can cause acute variations or chronic postpartum damage over time. People only know these as common postpartum issues, unaware that half are caused by the misuse of Shenghua Decoction. This trend is most prevalent in Yue. The formula originated from the Qian family in Yue and was included in Zhang Jingyue's *Ba Zhen Tu* (Eight Arrays Diagram), leading to its spread across the world. For centuries, countless people have secretly suffered from its harm, yet no one has dared to criticize it. I write this as a lamp in the long night, hoping future generations will not walk blindly forever, perhaps offering some benefit to the world. However, while Zhang Jingyue generally favored warming and tonifying, he uniquely refuted Zhu Danxi's emphasis on major Qi and Blood tonification for postpartum care, showing a glimmer of wisdom. Unfortunately, he remained stuck in the fallacy that "postpartum requires warmth," likely because he had not entered the orthodox school of Zhang Zhongjing.
The wife of Jin Yabo, Tingwei, suffered from obstructed lochia accompanied by thirst, diarrhea, and excessive phlegm. Meng Ying prescribed Glehnia Root (Beishashen), Talcum (Huashi), Raw Coix Seed (Shengyiyi), Lablab Bean (Biandou), Clam Shell (Geqiao), Fermented Soybean (Douban), Dendrobium Stem (Shihu), Bamboo Shavings (Zhuru), Loquat Leaf (Pipaye), Amber (Hupo), and Poria (Fuling). She recovered after several doses.
In the spring of Gengzi year, Mrs. Dai had little lochia after childbirth. She took decoctions of Hawthorn Fruit (Shanzha) and Motherwort Herb (Yimucao) brewed in wine for several consecutive days. Subsequently, she developed fever, spontaneous sweating, thirst, loss of appetite, dizziness threatening collapse, and insomnia throughout the night. Meng Ying examined her and said: This patient has a congenital Yin deficiency. Blood has been lost with the fetus. Although lochia is scant, as long as there is no distension or pain, one should not recklessly administer drugs. Wine-brewed Motherwort Herb (Yimucao) and Hawthorn Fruit (Shanzha) not only injure Yin but also scatter Qi. Now, sweating depletes fluids, and dry mouth indicates a tendency toward immediate exhaustion of Jin-Ye (body fluids). This is what Zhang Zhongjing called "absence of Yang." The innate Qi of the human body is called Yang, which roots in Jin-Ye, while Yin transforms from Ye (thick fluids). Once Jin-Ye is deprived, Yang loses its root causing dizziness, and Yin-blood fails to generate causing insomnia. If one tonifies Qi to generate Yin at this stage, it is seeking the branch and neglecting the root, as Qi and Blood cannot directly generate Jin-Ye. One must clear the source and purify the flow, replenishing Jin-Ye so that Qi and Blood naturally recover. Meng Ying prescribed American Ginseng (Xiyangshen), Raw Astragalus Root (Sheng Huangqi), Dragon Bone (Longgu), Oyster Shell (Muli), Polygonatum Rhizome (Yuzhu), Lily Bulb (Baihe), Licorice Root (Gancao), Ophiopogon Tuber (Maidong), Raw Coix Seed (Sheng Yiyiren), Raw Lablab Bean (Sheng Biandou), Dendrobium Stem (Shihu), Quince (Mugua), Mulberry Leaf (Sangye), and Sugarcane Juice (Ganzhe Jiang). One dose brought relief, and she recovered in a few days. Later, she took formulas to nourish and fill the Yin aspect, achieving robust health.