(周 论并在其中)
论曰∶凡妇人生产毕,且令饮童子小便一盏,不得便卧,且宜闭目而坐,须臾方可扶上
床仰卧,不得侧卧,宜立膝,未可伸足。高倚床头,浓铺茵褥,遮围四壁,使无孔隙,免被
贼风。兼时时令人以物从心 至脐下,使恶露不滞,如此三日可止。仍不可令多卧,如卧
多,看承之人宜频唤醒。旧说产妇分娩了,三日方可上床。若三日上床则必就地睡卧,又岂
可令产妇近地气乎?才生产毕,不得问是男是女,且先研醋墨三分服之。一法云不可服醋墨
,有伤肺经成咳嗽之戒,诚过虑也。然醋墨本破凝结之血,然不可用太酽之醋,仍不可太
多,即不至伤肺。然所在皆同,亦有不吃者。更产后三日内,令产妇尝闻醋炭气,或烧干漆
烟。若无干漆,以破旧漆器烧之,以防血逆、血迷、血运不省之患。夏月宜于房门外烧砖,
以醋沃之置于房中。(夏月房中不须着大火及煮粥、煎药之类。)分娩之后,须臾且食白粥一
味,不可令太饱,频少与之为妙,逐日渐增之。煮粥时须是煮得如法,不用经宿者。又不可
令温冷不调,恐留滞成疾,仍时与童子小便一盏饮之。(亦须先备小便,若遇夏月以薄荷养
之。)新产后不问腹痛不痛,有病无病,以童子小便以酒和半盏温服,五七服妙。一腊(七
日也)之后,方可少进醇酒并些小盐味。一法才产不得与酒,缘酒引血迸入四肢,兼产母脏
腑方虚,不禁酒力,热酒入腹,必致昏闷。七日后少进些酒,不可多饮。如未出月,间欲酒
吃或服药者,可用净黑豆一升,炒令烟出,以无灰酒五升浇淋之,仍入好羌活一两(洗净拍
破)同浸尤妙。当用此酒下药,或时时饮少许,可以避风邪、养气血、下恶露、行乳脉也。
如产妇素不善饮酒,或夏月之间,亦不须强饮。一腊之后,恐吃物无味,可烂煮羊肉或雌鸡
汁,略用滋味,作粥饮之。或吃烂煮猪蹄肉,(忌母猪及白脚猪肉)不可过多,(今江浙间产
妇多吃熟鸡子,亦补益,亦风俗也)三月之后,方可少食温面,(食面早,成肿疾)凡吃物
过多,恐成积滞。若未盈月,不宜多语、喜笑、惊恐、忧惶、哭泣、思虑、恚怒、强起离床
行动、久坐;或作针线,用力工巧,恣食生冷、粘硬果菜、肥腻鱼肉之物;及不避风寒,脱
衣洗浴,或冷水洗濯。当时虽未觉大损,盈月之后即成蓐劳。手脚及腰腿酸重冷痛,骨髓间
飕飕如冷风吹,继有名医亦不能疗。大都产妇将息,须是满百日方可平复。大慎!触犯此,
多致身体强直如角弓反张,名曰蓐风,遂致不救。又不得夜间独处,缘去血心虚,恐有惊悸,
切宜谨之。所有血衣洗濯,不得于日中晒曝,免致邪祟侵伤。又不得濯足,恐血气攻下。又
不得刮舌、(伤心)刷齿及就下低头,皆成血逆、血运,此产家谨护之常法也。盈月之后,
尤忌任意饮食、触冒风寒、恣意喜怒、梳头用力、高声、作劳工巧、房欲(详见产后通用方
第一),及上高厕便溺之类。如此节养,摄至百 ,始得血气调和,脏腑平复,自然安帖。
设不根据此,即致产后余疾矣。小可虚羸,失于将补,便成大患,终身悔而不及。或有诸疾,
不论巨细,后并有方药医疗,不得信庸医妄投药饵。经云妇人非止临产须忧,产后大须将理,
慎不得恃身体和平取次为之。乃纵心恣意,无所不为。若有触伤,便难整理。犯时微若秋毫,
感病重如山岳,知命者可不谨之。
难产的情况既然已经阐明,必须了解产后疾病,因此接着论述。
(周氏的论述包含在其中)
论述说:凡是妇女生产完毕,先让她喝一盏童子尿,不要立刻躺下,应当闭目坐着,过了一会儿才能扶上床仰卧,不能侧卧,宜保持膝盖弯曲直立的状态,暂时不要伸直双腿。头部要高枕倚靠床头,褥子要铺得厚实,四周墙壁遮挡严密,不留缝隙,以免受到贼风侵袭。同时不时让人用手从心口按揉至脐下,使恶露不致停滞,这样三天即可停止。仍然不可让产妇多躺卧,如果躺卧过多,看护的人应频繁唤醒她。旧的说法认为产妇分娩后,三天才可以上床。如果三天后才上床,那就只能睡在地上,又怎么能让产妇靠近地气呢?刚生产完毕,不要问是男孩还是女孩,先研碎三分醋墨服用。另一种说法认为不可服用醋墨,有损伤肺经导致咳嗽的禁忌,这实在是过分担忧了。然而醋墨本来能破除凝结的血块,只是不可用太浓的醋,也不可用太多,就不会损伤肺脏。各地情况虽有不同,也有不服用的。另外在产后三日内,让产妇时常闻醋炭的气味,或者烧干漆产生的烟。如果没有干漆,可以用破旧的漆器燃烧来代替,以防血逆、血迷、血运不省等祸患。夏季适宜在房门外烧红砖,浇上醋放在房中。(夏季房中不需要生大火以及煮粥、煎药之类。)分娩之后,一会儿吃一味白粥,不可吃得过饱,少量多次喂食最为巧妙,逐日逐渐增加。煮粥时必须煮得合乎法度,不用隔夜的米。也不可让温度冷热不调,恐怕滞留体内成疾,仍不时给产妇喝一盏童子尿。(也须提前备好小便,如果遇到夏季用薄荷养护小便。)新产后不问是否腹痛,有病无病,用童子尿加酒调和半盏温服,服用五到七次效果很好。过了七天(一腊),才可以少量饮用纯酒并加少许盐味。另一种说法认为刚生产时不可饮酒,因为酒会引血奔入四肢,加上产母脏腑刚刚虚弱,承受不住酒力,热酒入腹,必然导致昏闷。七日后少量进些酒,不可多喝。如果在未满月的期间,偶尔想喝酒或服药,可用净黑豆一升,炒至冒烟,用无灰酒五升浇淋浸泡,再放入好羌活一两(洗净拍破)一同浸泡尤其好。应当用此酒送服药物,或时时饮少许,可以避风邪、养气血、下恶露、通乳脉。如果产妇平时不善饮酒,或者在夏季,也不必勉强饮用。过了七天之后,恐怕食物无味,可以烂煮羊肉或雌鸡汤,略加调味,做成粥饮用。或者吃烂煮猪蹄肉,(忌食母猪及白脚猪肉),不可过多,(现在江浙一带产妇多吃熟鸡蛋,也是补益,也是风俗)。三个月之后,才可以少量食用温性的面食,(吃面过早,会形成肿疾)。凡吃东西过多,恐怕形成积滞。如果未满月,不宜多说话、喜笑、惊恐、忧惶、哭泣、思虑、愤怒、强行起床离床行动、久坐;或者做针线活,用力精巧,恣意食用生冷、粘硬果菜、肥腻鱼肉之物;以及不避风寒,脱衣洗浴,或用冷水洗涤。当时虽然未觉得大损,满月之后就会形成蓐劳。手脚及腰腿酸重冷痛,骨髓间飕飕如冷风吹,继而有名医也不能治疗。大体上产妇调养,必须满百日才可以平复恢复。非常谨慎!触犯这些禁忌,多导致身体强直如角弓反张,名叫蓐风,于是导致无法救治。又不得夜间独处,因为失血导致心虚,恐怕有惊悸,务必谨慎。所有血衣洗涤,不得在中午晒曝,以免邪祟侵伤。又不得洗脚,恐怕血气攻下。又不得刮舌、(伤心)刷牙及低头弯腰,都会造成血逆、血运,这是产家谨慎护理的常规方法。满月之后,尤其忌讳任意饮食、触冒风寒、恣意喜怒、用力梳头、高声喊叫、做精细手工、房事(详见产后通用方第一),以及上高处厕所大小便之类。如此节制保养,摄养至百日,始得血气调和,脏腑平复,自然安适。如果不依据这些,就会导致产后余疾。轻微的身体虚弱羸瘦,失于调养进补,就会成为大患,终身后悔莫及。如果有各种疾病,不论大小,后面都有方药医疗,不得相信庸医妄投药饵。经书说妇人不仅临产需要忧虑,产后更需要调理,千万不要仗着身体平和就随意行事。于是放纵心意恣意行为,无所不为。如果有触犯损伤,就很难整理恢复。犯禁时微小如秋毫,感病沉重如山岳,知命的人能不谨慎吗?
Since the difficulties of difficult labor have been clarified, one must understand postpartum diseases; therefore, they are discussed next.
(The discussions by Zhou are included within.)
It is stated: Whenever a woman has completed childbirth, she should first be given a cup of urine from a young boy (Tongzi Xiaobian). She must not lie down immediately but should sit with her eyes closed. After a short while, she may be helped onto the bed to lie supine. She must not lie on her side; instead, her knees should be kept bent and upright, and her legs should not be extended straight for the time being. Her head should be propped high against the headboard, the mattress should be thickly padded, and the four walls should be covered tightly without gaps to prevent exposure to "thief wind" (drafts). Simultaneously, attendants should frequently massage from the heart area down to below the navel to ensure that lochia does not stagnate. Following this practice for three days will stop the bleeding. The mother must not lie in bed too much; if she does, the caregiver should wake her frequently. Old theories suggest that a parturient should not get into bed until three days after delivery. If she waits three days to get into bed, she would have to sleep on the floor, which is certainly not advisable as it exposes her to earthy qi. Immediately after delivery, do not ask whether the baby is male or female; instead, grind three fen of vinegar-ink and administer it orally. Another method advises against taking vinegar-ink, citing a warning that it damages the Lung Meridian and causes coughing; this is considered an excessive worry. However, vinegar-ink naturally breaks up congealed blood. As long as the vinegar is not too strong and the dosage is not excessive, it will not harm the lungs. Practices vary by region, and some do not take it. Additionally, during the first three days postpartum, let the mother smell the fumes of charcoal soaked in vinegar, or burn dried lacquer (Gan Qi). If dried lacquer is unavailable, burn broken lacquered vessels as a substitute to prevent complications such as blood reversal (Xue Ni), blood confusion (Xue Mi), or fainting due to blood disturbance (Xue Yun). In summer, it is appropriate to heat bricks outside the room door, pour vinegar on them, and place them in the room. (In summer, there is no need for large fires in the room, nor for cooking porridge or decocting herbs.) Shortly after delivery, consume a simple white porridge. Do not eat too much; small, frequent servings are best, increasing gradually each day. The porridge must be cooked properly, using fresh rice, not overnight leftovers. Ensure the temperature is neither too hot nor too cold to avoid retention and illness. Continue to give a cup of urine from a young boy occasionally. (Prepare the urine in advance; in summer, keep it preserved with mint.) Regardless of abdominal pain or other conditions, shortly after birth, mix half a cup of urine from a young boy with wine and take it warm. Taking it five to seven times is excellent. After seven days (one La), one may slowly introduce pure wine and a small amount of salt flavor. Another view holds that alcohol should not be given immediately after birth because wine draws blood into the limbs, and since the mother's zang-fu organs are newly deficient, they cannot withstand the alcohol. Hot wine entering the stomach will inevitably cause dizziness and confusion. After seven days, a small amount of wine may be taken, but not excessively. If the mother desires wine or medicine before the end of the first month, take one sheng of clean black beans, stir-fry until smoke appears, pour five sheng of non-ashy wine over them, and soak them together with one liang of good Qianghuo (Notopterygii Rhizoma et Radix, washed and crushed). This is especially effective. Use this wine to administer medication or drink small amounts occasionally to ward off wind-pathogens, nourish qi and blood, expel lochia, and promote milk flow. If the mother is not accustomed to drinking alcohol, or if it is summer, there is no need to force consumption. After seven days, food may seem tasteless; one can boil mutton or hen broth thoroughly, add slight seasoning, and drink it as porridge. Alternatively, eat thoroughly boiled pig trotters (avoid sow meat and pork with white hooves), but not in excess. (Currently, in Jiangsu and Zhejiang regions, it is customary and beneficial for postpartum women to eat many boiled eggs.) After three months, warm wheat noodles may be eaten in small quantities. (Eating noodles too early can lead to edema.) Eating too much may cause food stagnation. Within the first month, one should avoid talking excessively, laughing, being startled, worrying, crying, overthinking, anger, forcing oneself out of bed to walk, or sitting for long periods. One should also avoid needlework requiring fine effort, consuming raw/cold, sticky/hard fruits/vegetables, or rich/fatty fish/meat; avoiding wind-cold exposure, undressing for bathing, or washing with cold water. Although significant damage may not be felt initially, after the full month, it may develop into "Chulao" (postpartum consumptive disease). Symptoms include soreness, heaviness, coldness, and pain in the hands, feet, waist, and legs, with a sensation like cold wind blowing through the bone marrow. Even famous doctors may find it incurable. Generally, postpartum recuperation requires a full hundred days to return to normal. Extreme caution is advised! Violating these rules often leads to body stiffness resembling opisthotonos (Jiaogong Fanzhang), known as "Chufeng" (postpartum wind), leading to untreatable conditions. One must not stay alone at night, as blood loss causes heart deficiency and fear of palpitations; strict vigilance is required. Blood-stained clothes should not be sun-dried at noon to avoid invasion by evil spirits. One must not wash feet, lest blood and qi descend improperly. One must not scrape the tongue (which harms the heart), brush teeth vigorously, or bow low, as these can cause blood reversal or fainting. These are the standard precautions for postpartum care. After the full month, one must strictly avoid arbitrary eating/drinking, exposure to wind-cold, emotional extremes, vigorous hair combing, loud shouting, strenuous manual labor, sexual intercourse (see General Postpartum Formulas Part 1), and climbing high places to use the toilet. By observing these restrictions and nurturing the body for a hundred days, qi and blood will harmonize, zang-fu organs will recover, and peace will naturally ensue. Failure to follow these guidelines results in residual postpartum diseases. Minor weakness and emaciation, if neglected and not tonified, can become major crises, causing lifelong regret. For any illnesses, regardless of severity, formulas and medicines are provided later; do not trust quacks who prescribe blindly. The Classics state that women need not only worry about labor but also require careful management postpartum. One must not rely on a feeling of health to act recklessly. Indulging desires without restraint leads to injuries that are difficult to rectify. A violation may seem insignificant as an autumn hair, but the resulting illness can be heavy as a mountain. Those who value life must be cautious.