夫产后月水不调者，由产伤动血气，虚损未复，而风邪冷热之气客于经络，乍冷乍热，
冷则血结，热则血消。故令血或多或少，或在月前，或在月后，故名不调也。
治产后经脉不调，四肢烦疼，饮食全少，日渐羸瘦。琥珀散。
琥珀 牛膝 生干地黄 当归（各一两） 桃仁 赤芍药（各半两）
上为粗末，每服三钱。水一盏，姜三片，煎至六分，去滓温服。
治产后虚乏，不足，胸心短气，腹内紧急，腰背疼痛，月水不调，食少烦渴，四肢无力
。姜黄散。
姜黄 当归 熟地黄 牡丹皮 浓朴 桂心 川芎 续断 桃仁 白术（各一两） 赤
芍药 木香（各三分） 羚羊角屑（一分）
上为细末，炼蜜丸如梧桐子大。食前，温酒下三十丸。
（无方）
论曰∶夫产伤动于血气，其后虚损未复而为风冷所伤。血之为性，得冷则凝结。故风冷
伤于经，血结于胞络之间，故令月水不通也。凡血结月水不通，则血结成瘕，水血相并，复
遇脾胃衰弱、肌肉虚者，则为水肿也。（但于第一卷，第六、七论中求方）
夫妇人冲任之脉，为经络之海，皆起于胞内。而手太阳小肠之经、手少阴心之经也，此
二经上为乳汁，下为月水。若产后月水不通者，盖新产之后劳伤气血，或去血过多，乳汁
通行，自是不通。若新产之后或一岁之内，而月经不行，此是常候，即非病也，何必通之。
谚云奶假是也。若半岁而行者，或四、五个月便经行者，皆是少壮血盛之人，注受极易，产
乳必众。其子失乳，必四肢 羸，肚大青筋，头大发焦，好啖泥土，病名无辜。若经血有
余者，不可以药止之。若产后一、二岁，月经不通而无疾苦，何必服药。或劳伤气血，冲任
脉虚，气血衰少而不能行者，但服健脾胃、资气血之药自然通行。若以牛膝、红花、苏木、
干漆、虻虫、水蛭等药以通之，则为害滋大。经水枯竭，则无以滋养，其能行乎？初虞世所
谓譬犹索万金于乞丐之手，虽捶楚并下，而不可得也。后之学人，更宜详审而疗之。（自明
补注）
产后月经失调，是由于分娩时损伤了气血，身体虚弱尚未恢复，风邪和冷热之气侵入经络，导致时而发冷、时而发热。寒冷则使血液凝结，热则使血液消散。因此导致经量或多或少，经期或提前或推后，所以称为月经不调。
治疗产后经脉不调，四肢烦痛，饮食极少，日渐消瘦的方剂：琥珀散。
药材：琥珀、牛膝、生干地黄、当归（各一两）、桃仁、赤芍药（各半两）。
将上述药材捣成粗末，每次服用三钱。加水一盏，生姜三片，煎至六分，去渣温服。
治疗产后虚乏无力，气短，心胸憋闷，腹部拘急疼痛，腰背疼痛，月经不调，食少烦渴，四肢无力的方剂：姜黄散。
药材：姜黄、当归、熟地黄、牡丹皮、浓朴、桂心、川芎、续断、桃仁、白术（各一两）、赤芍药、木香（各三分）、羚羊角屑（一分）。
将上述药材研为细末，用炼蜜制成梧桐子大小的丸药。饭前，用温酒送服三十丸。
（此处无方剂）
论述说：分娩损伤气血，之后因虚弱未复而受风冷侵袭。血的性质是遇冷则凝结。因此风冷伤及经脉，血液在胞络之间凝结，导致月经不通。凡是血结导致的月经不通，血液会结成瘕块（腹内结块），水与血相互搏结，如果再遇到脾胃衰弱、肌肉虚弱的情况，就会形成水肿。（相关方剂请查阅第一卷第六、七篇论述）。
女性的冲脉和任脉，是经络之海，都起于胞宫内部。手太阳小肠经和手少阴心经，这两条经脉上行化为乳汁，下行化为月经。如果产后月经不通，大概是因为新产之后劳伤气血，或者失血过多，导致乳汁通行顺畅，而月经自然不通。如果在刚生产后或一年内，月经不来，这是正常现象，并非疾病，何必强行通经。谚语所说的“奶假”（指哺乳期停经）就是这个道理。如果半年后来月经，或者四、五个月就来月经的，都是年轻体壮、气血旺盛的人，受孕极易，生育哺乳次数必然很多。如果孩子失去母乳，必定四肢消瘦，肚子大且青筋暴露，头发干枯焦黄，喜欢啃食泥土，这种病名叫“无辜病”。如果经血有余，不可以用药强行止住。如果产后一两年，月经不通但没有病痛，何必服药。如果是劳伤气血，冲任脉虚弱，气血衰少而不能行经的，只要服用健脾胃、滋养气血的药物，月经自然会通畅。如果用牛膝、红花、苏木、干漆、虻虫、水蛭等药物来强行通经，危害就太大了。经血枯竭，就没有东西可以滋养，怎么能行得通呢？初虞世所说的比喻就像向乞丐索要万金，即使鞭打拷问，也是得不到的。后来的学医者，更应当详细审察后再进行治疗。（陈自明补注）
Postpartum irregular menstruation arises from the injury to Qi and Blood during childbirth, leaving the body in a state of deficiency that has not yet recovered. Pathogenic factors of wind, cold, and heat invade the meridians, causing alternating sensations of cold and heat. Cold causes blood to coagulate, while heat dissipates blood. Consequently, menstrual flow may be either excessive or scanty, occurring either before or after the expected time, hence termed "irregular menstruation."
For treating postpartum meridian irregularities accompanied by vexing pain in the four limbs, significantly reduced appetite, and progressive emaciation: Hu Po San (Amber Powder).
Ingredients: Hu Po (Amber), Niu Xi (Achyranthis Bidentatae Radix), Sheng Gan Di Huang (Raw Rehmanniae Radix), Dang Gui (Angelicae Sinensis Radix) [each 1 liang]; Tao Ren (Persicae Semen), Chi Shao Yao (Paeoniae Radix Rubra) [each 0.5 liang].
Grind the above ingredients into a coarse powder. Take 3 qian per dose. Add 1 zhan of water and 3 slices of fresh ginger, decoct until 0.6 zhan remains, strain, and take warm.
For treating postpartum deficiency and exhaustion, shortness of breath in the chest and heart, abdominal tension and pain, lower back and back pain, irregular menstruation, poor appetite with irritability and thirst, and weakness in the four limbs: Jiang Huang San (Curcumae Longae Rhizoma Powder).
Ingredients: Jiang Huang (Curcumae Longae Rhizoma), Dang Gui (Angelicae Sinensis Radix), Shu Di Huang (Prepared Rehmanniae Radix), Mu Dan Pi (Moutan Cortex), Hou Po (Magnoliae Officinalis Cortex), Gui Xin (Cinnamomi Ramulus), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Xu Duan (Dipsaci Radix), Tao Ren (Persicae Semen), Bai Zhu (Atractylodis Macrocephalae Rhizoma) [each 1 liang]; Chi Shao Yao (Paeoniae Radix Rubra), Mu Xiang (Aucklandiae Radix) [each 0.3 fen]; Ling Yang Jiao Xie (Saiga Tataricae Cornu) [0.1 fen].
Grind the above ingredients into a fine powder. Mix with refined honey to form pills the size of Sophora japonica seeds. Take 30 pills before meals, washed down with warm wine.
(No formula provided here)
Discussion: Childbirth injures Qi and Blood; subsequently, due to unresolved deficiency, the body is injured by wind-cold. The nature of blood is to coagulate when exposed to cold. Therefore, when wind-cold invades the meridians, blood coagulates between the uterine collaterals, resulting in amenorrhea. Whenever blood coagulation causes amenorrhea, blood may form masses (Jia). If water and blood bind together, and this is compounded by weak spleen and stomach and deficient muscles, edema may develop. (Please refer to the formulas in Chapters 6 and 7 of Volume 1.)
The Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel) are the seas of the meridians and originate within the uterus. The Hand-Taiyang Small Intestine Meridian and the Hand-Shaoyin Heart Meridian both transform upward into breast milk and downward into menstrual blood. If menstruation does not resume after childbirth, it is generally because labor has injured Qi and Blood, or excessive blood loss has occurred, allowing breast milk to flow freely while menstruation naturally ceases. If menstruation does not occur shortly after delivery or within one year, this is a normal physiological state, not a disease, and there is no need to forcibly induce menstruation. This aligns with the proverb regarding "lactational amenorrhea." If menstruation resumes at six months, or even at four or five months, these individuals are young and vigorous with abundant Qi and Blood, conceiving easily, and likely having many pregnancies and lactations. If such infants lose breast milk, they may exhibit emaciated limbs, distended abdomen with visible veins, dry and brittle hair, and pica (geophagia); this condition is named "Wu Gu" (Innocent Disease). If menstrual blood is abundant, it should not be suppressed with medication. If menstruation is absent for one or two years postpartum without discomfort, medication is unnecessary. However, if Qi and Blood are injured, and the Chong and Ren vessels are deficient, leading to insufficient Qi and Blood to drive menstruation, one should administer herbs that strengthen the Spleen and Stomach and nourish Qi and Blood; menstruation will naturally resume. Using herbs such as Niu Xi (Achyranthis Bidentatae Radix), Hong Hua (Carthami Flos), Su Mu (Sappan Lignum), Gan Qi (Drymopteridis Rhizoma), Meng Chong (Blatta), and Shui Zhi (Hirudo) to forcibly unblock menstruation causes significant harm. If menstrual blood is exhausted, there is nothing to nourish the channels, so how can flow occur? Chu Yushi compared this to demanding ten thousand gold pieces from a beggar; even under torture, it cannot be obtained. Future practitioners must examine cases carefully before treatment. (Supplementary note by Chen Ziming)