陈良甫曰∶产后元气大脱，新血未生，概以大补气血为主。如恶露未尽，补药中入行血药。如感冒风寒停滞，
亦须先补，然后发散消导，勿得泛用峻厉伤气血之药。
何松庵曰∶产后气血大损，诸事必须保重，切不可恃健劳碌，致内伤外感六淫七情诸证，为患莫测。故产
后证，先以大补气血为主。虽有他证，以末治之。或欲去邪，必兼补剂为当，不宜专用峻厉，再损血气。
慎斋按∶以上四条，序治产后有攻补之法也。子和之论，专主攻邪。丹溪之论，专主补虚。两贤之法，各自
有见，而丹溪之说为长。故必合《良方》、正宗二说以参之，乃攸当也。
虞天民曰∶或问产后证，丹溪云当大补气血为主，虽有杂证，以末治之。又云产后中风，切不可作中风治，
用风药。然则产后不问诸证，悉宜大补气血乎。曰∶详主末二字，其义自明。虚而无他证者，合宜大补气血自
愈。或因虚而感冒风寒者，补气血药带驱风之剂。或因脾虚而食伤太阴者，补气血药，加消导之剂。或因瘀血恶
露未尽，而恶寒发热者，必先逐去瘀血，然后大补。经曰∶有本而标之者，有标而本之者。又曰∶急则治标，缓
则治本。丹溪主末二字，即标本之
意也。
叶以潜曰∶或问产后气血大虚，纵有杂证，以末治。又谓产后须以去恶露为主。二者孰是？不知古人之言，
各有攸当。假如产后去血过多，有血晕之状，脉必弦浮大散。乃阴血既亡，阳无所根据。宜大剂芎、归，加熟
附、干姜，顿服补虚。或有滞血作痛，兼用行血药。此大补为本，他证为末也。若产后三四日，余瘀卒止，腰
腹疼痛，渐生潮热咳嗽，脉洪实而数，乃是败血停积，上冲心肺，恶露与血相抟，留结不行，非用行血破气以
消瘀，何以得安。若徒知当补不当泻，病必益剧。故产后虽为不足，亦有有余之证，不当泥产后无热，胎前无
虚之说。如胎前恶阻，少食腹胀，二便清滑，经水时下，胎动不安，不用温补，何以起病？非胎前亦有虚乎？如
产后伤寒热病，烦渴秘结，不用苦寒，何以解利？非产后亦有热乎？今人但见产后，六脉浮洪弦紧，便说有热，
不知产后脉与别病脉不同。产后洪大，是气血耗散，内无存蓄，故显是脉。如用凉剂，杀人反掌，不可不知也。
慎斋按∶以上二条，序产后辨攻补之法也。产后用药攻补，最难调剂，虚则补，实则攻，其定法也。唯虚证
而兼实邪，在产后见之者甚多。丹溪之论，专为世医罔顾产后大虚，唯务攻邪者立诫也。岂知守丹溪之法，亦不
无峻补之害，此虞天民、叶以潜两论所宜急玩也。
陈良甫说：产后元气大量脱失，新血尚未生成，治疗应以大补气血为主。如果恶露没有排尽，在补药中加入行血药物。如果因感冒风寒导致气机停滞，也必须先进行补益，然后再发散表邪、消导积滞，不得随意使用猛烈伤及气血的药物。
何松庵说：产后气血严重亏损，所有事情都必须小心保重，切不可倚仗身体强健而过度劳累，导致内伤或外感六淫七情等各种病证，其危害难以预测。因此产后病症，首先以大补气血为主。即使有其他病证，也作为次要问题处理。如果想要祛除邪气，必须兼用补益药剂才恰当，不宜专门使用猛烈药物，再次损伤血气。
慎斋按语：以上四条内容，阐述了治疗产后疾病有攻法与补法。张子和的论述，专门侧重于攻逐邪气。朱丹溪的论述，专门侧重于补益虚损。两位贤者的方法，各自都有见解，但朱丹溪的说法更为妥当。所以必须结合《良方》（指陈良甫的观点）与正宗（指朱丹溪的观点）两种说法来参考参详，才是恰当的。
虞天民说：有人问产后病症，朱丹溪说应当以大补气血为主，即使有杂症，也作为次要问题处理。又说产后中风，切不可当作普通中风治疗，使用祛风药物。那么产后不论什么病症，都适宜大补气血吗？回答说：详细考察“主”和“末”这两个字，其中的含义自然明了。只有虚损而没有其他病证的，适宜大补气血，病自然会痊愈。如果是因虚损而感冒风寒的，在使用补气血药时带上驱风药剂。如果是因脾虚而饮食损伤太阴经的，在使用补气血药时，加上消食导滞的药剂。如果是因瘀血恶露没有排尽，而出现恶寒发热的，必须先驱逐瘀血，然后才能大补气血。医经说：有先治本后治标的情况，也有先治标后治本的情况。又说：紧急时治标，缓和时治本。朱丹溪所说的“主”和“末”，就是“本”和“标”的意思。
叶以潜说：有人问产后气血极度虚弱，纵然有杂症，也作为次要问题处理。又说产后必须以去除恶露为主。这两种说法哪个正确？不知道古人的言论，各有其适用的情境。假如产后失血过多，出现血晕的症状，脉象必定弦、浮、大、散。这是阴血已经亡失，阳气无所依附。宜用大剂量的川芎、当归，加入熟附子、干姜，一次性服用以补虚。如果有瘀血阻滞引起疼痛，兼用行血药物。这是以大补为本，其他病证为末。如果产后三四天，残留的瘀血突然停止，腰部腹部疼痛，逐渐产生潮热咳嗽，脉象洪大、实而数，这是败血停积，上冲心肺，恶露与血液相互搏结，停留凝结不流通，如果不使用行血破气的药物来消除瘀血，怎么能安宁呢？如果只知道应当补而不应当泻，病情必定更加严重。所以产后虽然属于不足之证，也有有余（实证）的病证，不应当拘泥于“产后无热”、“胎前无虚”的说法。比如胎前恶阻，少食腹胀，二便清滑，月经时下，胎动不安，不使用温补药物，怎么能治愈疾病？不是胎前也有虚证吗？比如产后伤寒热病，烦渴便秘，不使用苦寒药物，怎么能解利？不是产后也有热证吗？现在的人只要见到产后，六脉浮洪弦紧，就说有热，不知道产后的脉象与其他疾病的脉象不同。产后脉象洪大，是气血耗散，内部没有存蓄，所以显现出这种脉象。如果使用凉性药剂，杀人只在反掌之间，不可不知道这一点。
慎斋按语：以上两条内容，阐述了产后辨别攻法与补法的原则。产后用药攻补，最难调剂，虚证则补，实证则攻，这是固定的法则。唯独虚证兼夹实邪的情况，在产后见到者很多。朱丹溪的论述，专门是为了告诫世医不顾产后大虚，只致力于攻逐邪气的弊端。哪里知道遵守朱丹溪的方法，也不无峻猛补益的危害，这就是虞天民、叶以潜两篇论述所应当急切玩味研究的。
Chen Liangfu stated: After childbirth, the primordial Qi (vital energy) is severely depleted, and new blood has not yet been generated; treatment should primarily focus on significantly tonifying Qi and Blood. If lochia (postpartum uterine discharge) has not fully cleared, blood-invigorating herbs should be added to the tonifying prescription. If wind-cold pathogenic factors cause stagnation due to a common cold, tonification must be performed first, followed by releasing the exterior and resolving stagnation; one must not casually use harsh medicines that damage Qi and Blood.
He Song'an stated: Postpartum Qi and Blood are severely damaged, and all matters require careful protection. One must not rely on physical robustness to engage in overwork, leading to internal injury or external contraction of the Six Excesses (pathogenic factors) and Seven Emotions, causing unpredictable harm. Therefore, for postpartum conditions, the primary approach is to significantly tonify Qi and Blood. Even if other symptoms exist, they should be treated as secondary. If one wishes to eliminate pathogens, it is appropriate to combine them with tonifying agents; one should not exclusively use harsh medicines that further deplete Qi and Blood.
Shenzhai commented: The above four points outline the methods of attacking (purging) and tonifying for treating postpartum conditions. Zhang Hezi's discussion focuses specifically on attacking pathogens. Zhu Danxi's discussion focuses specifically on tonifying deficiency. The methods of these two sages each have their own insights, but Zhu Danxi's theory is superior. Therefore, one must integrate the views from *Liangfang* (referring to Chen Liangfu) and the orthodox school (referring to Zhu Danxi) for reference, which is the appropriate approach.
Yu Tianmin stated: Someone asked about postpartum conditions. Zhu Danxi said that the primary approach should be significantly tonifying Qi and Blood, and even if there are miscellaneous symptoms, they should be treated secondarily. He also stated that postpartum wind-stroke should never be treated as ordinary wind-stroke using wind-dispelling drugs. Then, regardless of the symptoms, is it always appropriate to significantly tonify Qi and Blood? I reply: By examining the characters "primary" (Zhu) and "secondary" (Mo), the meaning becomes clear. In cases of deficiency without other symptoms, it is appropriate to significantly tonify Qi and Blood, and the disease will heal itself. If the deficiency leads to wind-cold contraction, wind-dispelling agents should be included alongside Qi and Blood tonics. If Spleen deficiency leads to dietary injury affecting the Taiyin channel, digestive-resolving agents should be added to the Qi and Blood tonics. If chills and fever occur because blood stasis and lochia have not fully cleared, the blood stasis must first be expelled before significantly tonifying Qi and Blood. The Classics state: There are cases where the root is treated first and the branch second, and cases where the branch is treated first and the root second. It also states: In emergencies, treat the branch; when stable, treat the root. Zhu Danxi's use of "primary" and "secondary" corresponds to the concepts of "root" (Ben) and "branch" (Biao).
Ye Yiqian stated: Someone asked: Postpartum Qi and Blood are extremely deficient; even if there are miscellaneous symptoms, they are treated secondarily. Yet it is also said that postpartum treatment must prioritize removing lochia. Which is correct? One must understand that ancient texts each have their specific applicability. For example, if excessive blood loss occurs after childbirth, resulting in syncope (blood fainting), the pulse will likely be wiry, floating, large, and scattered. This indicates that Yin Blood has been exhausted, leaving Yang Qi without support. Large doses of Chuanxiong Rhizome (Chuanxiong) and Angelicae Sinensis Radix (Danggui), added with Prepared Aconite Lateralis Radix Preparate (Fuzi) and Dried Ginger (Ganjiang), should be administered at once to tonify deficiency. If pain is caused by stagnant blood, blood-invigorating medicines should be used concurrently. This prioritizes significant tonification as the root and other symptoms as the branch. However, if three or four days after childbirth, residual stasis suddenly stops, accompanied by lower back and abdominal pain, gradually developing tidal fever and cough, with a surging, full, and rapid pulse, this indicates that foul blood has accumulated and rushed upward to affect the Heart and Lungs. The lochia and blood have clumped together and remain stagnant. Without using blood-invigorating and Qi-moving medicines to resolve the stasis, how can peace be restored? If one only knows that tonification is necessary and purging is forbidden, the illness will inevitably worsen. Therefore, although postpartum conditions are generally characterized by deficiency, there are also excess conditions. One should not rigidly adhere to the sayings that "there is no heat after childbirth" or "there is no deficiency before childbirth." For instance, during pregnancy, morning sickness, poor appetite, abdominal distension, clear and loose stools, menstrual bleeding, and restless fetus do not respond to warming and tonifying medicines; how else could the condition be cured? Does this not prove that deficiency exists before childbirth? Similarly, postpartum cold damage and febrile diseases involving irritability, thirst, and constipation do not respond to bitter-cold medicines; how else can they be resolved? Does this not prove that heat exists after childbirth? Nowadays, people see floating, surging, wiry, and tight pulses after childbirth and immediately claim there is heat. They do not know that postpartum pulses differ from those of other diseases. A surging and large pulse after childbirth indicates the dispersion of Qi and Blood and a lack of internal retention, hence manifesting such a pulse. Using cooling prescriptions in this context can kill instantly; this must not be ignored.
Shenzhai commented: The above two points outline the principles for distinguishing between attacking and tonifying methods in postpartum care. Balancing attacking and tonifying therapies in postpartum medicine is the most difficult task. Tonifying for deficiency and purging for excess are fixed rules. However, cases where deficiency coexists with excess pathogens are very common in postpartum conditions. Zhu Danxi's discussion was specifically established to warn physicians against ignoring severe postpartum deficiency while solely focusing on attacking pathogens. Little do they realize that strictly adhering to Zhu Danxi's methods also carries the risk of harm from overly vigorous tonification. This is why the discussions by Yu Tianmin and Ye Yiqian should be urgently studied and pondered.