川芎 当归 熟地 白芍(各二钱) 香附(钱半) 桃仁 枳壳(各七分) 缩砂 紫苏(各一
钱)
痛阵未紧。交骨未开。虽胞水来。不可临盆。 若胞水来久。交骨犹未开。宜服大料参归汤
。并补助气血饮食。 产户开。儿头未正。不可服催生丸散。 服催生药。不可用败血、耗
气、香窜等剂。 儿下胞停。不可卧倒。宜频服生化汤。 胞下后。不可令寒气入腹。更紧
防贼风入产户。 产毕。将烧红秤锤入醋瓶。以瓶嘴向产母鼻孔熏之。可免血晕。并解秽气
。产后月内。宜戒怒气。勿受惊恐。勿劳神力。谨慎饮食。
妇人病倍男子。以胎产之症偏多也。在胎前虽宜慎谨。然时日尚宽。苟非危急症。犹可渐渐挽
回。且不至终身受累。若夫产后。少有不谨。或医治失宜。祸同反掌。即幸不至损命。目前
受苦非小。终身得病恒多。故特列章首。普告产妇。并事产者郑重自持。庶几彼此不至后悔
产后血块。产科所当首重。毋视为轻症而忽之。盖因孕成余血。若产妇壮旺而产易。则儿下
后。亦随而俱下。必不至久停作痛。多由产母送儿送胞劳倦之甚。或调护失宜。或腹欠温暖
所致。若不加意调理。变症百出。论治此症。在古方偏用苏木。棱术。以迅攻之。在时俗多
用生地。红花。以急行之。或用苏木。牛膝。以大破之。此三者重虚产妇。非徒无益。并致
产后危急大症。无异操刀杀人。盖产后血块虽宜消。新血亦宜生。必须行中带补。化中有生
者。方称善治。是则生化汤一方。能使块消而痛止。神清而气复。实新产之至宝也。即世用
山楂、砂糖消块。姜椒、艾、酒定痛。亦能致淋、崩、昏、晕等症。皆非良剂。又如气胀用
乌药。香附。以顺之。枳壳浓朴。以舒之。甚有用青皮。枳实。苏子。以下气定喘。芩。连
。栀。柏。以退热除烦若夫血枯便实。反用承气汤下之而愈结。汗多小便涩短。反用五苓散
通之而愈秘。此则更无足论。盖产后诸症。总以生化汤为君。其余不过随症加减。治产后者
。慎毋执偏门。遵古方。予于此条下。分症立方。可考而用也。
川芎、当归、熟地黄、白芍（各二钱），香附（一钱半），桃仁、枳壳（各七分），缩砂、紫苏（各一钱）。
如果产痛阵势尚未紧密，骨盆交骨（耻骨联合）尚未张开，即使羊水已破，也不可以立即接生分娩。如果羊水流出时间较长，但骨盆交骨仍未张开，适宜服用大料参归汤，并补充气血及饮食营养。如果产门已开，但胎儿头部位置不正，不可以服用催产丸散。服用催产药物时，不可使用破血、耗气、辛香走窜等性质的药剂。胎儿娩出后胎盘滞留，不可以仰卧倒卧，适宜频繁服用生化汤。胎盘排出后，不可让寒气侵入腹部，更要严防贼风（外感风寒邪气）从产户进入。分娩结束后，将烧红的秤锤放入醋瓶中，用瓶口对着产妇鼻孔熏蒸，可以避免血晕，并能解除秽浊之气。产后一个月内，应当戒除愤怒情绪，不要受到惊恐，不要从事体力劳动，谨慎注意饮食。
妇女的疾病比男子多，因为胎产相关的病症偏多。在妊娠期间虽然应当谨慎，但时间尚宽裕，如果不是危急重症，还可以逐渐挽回，且不至于终身受累。至于产后，稍有疏忽，或者治疗不当，祸患就会迅速发生。即使侥幸不危及生命，眼前所受的痛苦也非常大，终身患病的情况也往往很多。因此特别列出这一章作为开头，普遍告诫产妇以及从事接生工作的人要郑重自持，这样或许彼此都不会后悔。
产后血块，是产科应当首要重视的，不要将其视为轻症而忽视。这是因为怀孕形成的余血，如果产妇体质强壮旺盛且生产顺利，那么胎儿娩出后，余血也会随之排出，必定不会久留体内导致疼痛。大多是因为产妇送儿送胞（分娩过程）过于劳累，或者调护不当，或者腹部缺乏温暖所致。如果不加以细心调理，变证百出。论述治疗此症，古代方剂偏向使用苏木、三棱、莪术来迅猛攻逐；当时世俗多用生地黄、红花来急行活血；或者使用苏木、牛膝来大力破血。这三种方法都会严重虚损产妇，不仅无益，反而会导致产后危急重症，无异于拿刀杀人。大概产后血块虽然应当消除，但新血也应当生成，必须做到行血中带补益，化瘀中兼有生新，才称得上是善治。这就是生化汤一方，能使血块消除而疼痛停止，神志清醒而元气恢复，确实是新产后的至宝。即使用山楂、砂糖来消块，姜、椒、艾、酒来定痛，也会导致淋证、崩漏、昏厥、眩晕等症状，都不是良剂。又如气胀使用乌药、香附来顺气，枳壳、厚朴来舒理，甚至有用青皮、枳实、苏子来降气定喘，黄芩、黄连、栀子、黄柏来退热除烦。至于血枯便秘，反而用承气汤泻下而导致结滞更甚；汗多小便短涩，反而用五苓散通利而导致更加秘结。这些就更不值得讨论了。大概产后诸症，总以生化汤为君药，其余不过是随症状加减。治疗产后病，千万不要执着于旁门左道，遵循古方。我在此条下，分症状设立方剂，可以参考并使用。
Chuanxiong (Rhizoma Chuanxiong), Danggui (Radix Angelicae Sinensis), Shudi (Radix Rehmanniae Preparata), Baishao (Radix Paeoniae Alba) (each 2 qian), Xiangfu (Rhizoma Cyperi Rotundati) (1.5 qian), Taoren (Semen Persicae), Zhike (Fructus Aurantii Immaturum) (each 7 fen), Suosha (Fructus Amomi Rotundus), Zisu (Folium Perillae) (each 1 qian).
Yimu Wan (Motherwort Pill), Cuisheng Wansan (Delivery-inducing Pills and Powders), Lu Jiao Hui (Ash of Deer Antler), Da Liao Shen Gui Tang (Large-dose Ginseng and Angelica Decoction), Shenghua Tang (Transformation of Stasis Decoction).
If the labor pains are not yet intense, and the pubic symphysis (Jiaogu) has not opened, even if the amniotic fluid has ruptured, delivery should not be attempted immediately. If the amniotic fluid has been flowing for a long time but the pubic symphysis remains unopened, it is appropriate to administer Da Liao Shen Gui Tang (Large-dose Ginseng and Angelica Decoction), along with nutritional support to tonify Qi and Blood. If the birth canal is open but the fetal head is malpositioned, delivery-inducing pills and powders should not be used. When administering drugs to induce labor, preparations that break Blood, consume Qi, or contain pungent aromatic substances that circulate rapidly should not be used. After the fetus is delivered but the placenta is retained, the mother should not lie flat; she should frequently take Shenghua Tang (Transformation of Stasis Decoction). After the placenta is expelled, cold pathogens must be prevented from entering the abdomen, and special care must be taken to prevent "thief wind" (external pathogenic Wind-Cold) from entering the birth canal. After childbirth, place a red-hot weight into a vinegar bottle and fumigate the mother's nostrils with the bottle's mouth; this can prevent syncope due to blood loss (Xue Yun) and dispel foul odors. Within one month postpartum, anger should be avoided, fright should be prevented, strenuous physical labor should be eschewed, and diet should be managed carefully.
Women suffer from diseases more than men because pregnancy and childbirth-related conditions are prevalent. During pregnancy, although caution is advised, there is ample time; unless it is a critical condition, recovery can often be gradual, avoiding lifelong burden. However, in the postpartum period, any negligence or improper medical treatment can lead to rapid disaster. Even if death is avoided, the immediate suffering is severe, and chronic illnesses are common thereafter. Therefore, this chapter is placed at the beginning to universally admonish mothers and midwives to exercise utmost prudence, so that neither party will regret later.
Postpartum blood stasis masses (Xue Kuai) are of primary importance in obstetrics and should not be dismissed as minor conditions. This occurs because residual blood from pregnancy, if the mother is robust and delivery is smooth, is expelled along with the fetus, preventing prolonged retention and pain. It mostly results from excessive fatigue during delivery, improper nursing, or lack of warmth in the abdomen. Without careful regulation, various complications may arise. Regarding treatment, ancient formulas tended to use Sumu (Lignum Sappan), Sanleng (Rhizoma Sparganii), and Ezhu (Rhizoma Curcumae) for aggressive expulsion; contemporary folk practices often used Shengdi (Radix Rehmanniae Recens), Honghua (Flos Carthami) for rapid blood activation; or Sumu (Lignum Sappan) and Niuxi (Radix Achyranthis Bidentatae) for strong blood-breaking. These three approaches severely deplete the postpartum woman, offering no benefit and potentially causing critical postpartum syndromes, akin to killing with a knife. Although postpartum blood stasis should be resolved, new Blood must also be generated; effective treatment requires promoting circulation while tonifying, and resolving stasis while generating new tissue. Thus, Shenghua Tang (Transformation of Stasis Decoction) is the supreme treasure for the immediate postpartum period, as it eliminates stasis and stops pain, clarifies the mind, and restores Qi. Even remedies like Shan Zha (Fructus Crataegi), sugar to resolve masses, and ginger, pepper, mugwort, wine to stop pain, can lead to strangury, metrorrhagia, fainting, or vertigo; they are not good agents. Similarly, using Wuyao (Radix Linderae), Xiangfu (Rhizoma Cyperi Rotundati) to regulate Qi, Zhike (Fructus Aurantii Immaturum), Houpo (Cortex Magnoliae Officinalis) to soothe, or Qingpi (Pericarpium Citri Reticulatae Viride), Zhishi (Fructus Aurantii Immaturum), Suzi (Fructus Perillae) to descend Qi and calm asthma, Huangqin (Radix Scutellariae), Huanglian (Rhizoma Coptidis), Zhizi (Fructus Gardeniae), Huangbai (Cortex Phellodendri) to clear heat and relieve irritability—these are discussed. As for constipation due to Blood dryness, using Chengqi Tang (Major Order the Qi Decoction) to purge leads to worse accumulation; for profuse sweating and scanty dark urine, using Wuling San (Five-Ingredient Powder with Poria) to promote urination leads to greater retention. These are hardly worth discussing. Generally, for all postpartum conditions, Shenghua Tang (Transformation of Stasis Decoction) serves as the sovereign remedy, with other prescriptions merely modified according to symptoms. When treating postpartum disorders, do not adhere to eccentric methods or blindly follow ancient formulas. I have formulated specific prescriptions under this section based on symptoms for reference and use.