典藏书目

Diseases during pregnancy, such as *Ezu* (pregnancy-induced nausea and vomiting), *Baozu* (abdominal pain during pregnancy), *Tailou* (spotting during pregnancy), and *Tuotai* (miscarriage), are detailed in gynecological texts and need not be repeated here. However, the most critical point is that medication must be used with extreme caution during both pregnancy and the postpartum period.

When treating diseases during pregnancy, one must protect the fetus. Although ancient texts state, "If there is a cause (pathogen), there will be no destruction to the mother or the fetus; large accumulations and masses may be attacked, but stop when half of the pathogen has been eliminated," modern practitioners often rigidly adhere to the phrase "if there is a cause, there will be no destruction." Upon encountering internal accumulation, they recklessly use purgative methods, often injuring either the fetus or the mother. This is likely due to neglecting the instruction to "stop when half of the pathogen has been eliminated."

I speculate that once pathogens occupy the space within the womb, attacking the pathogens damages the fetus, while protecting the fetus hinders the elimination of pathogens. After careful consideration, it is advisable to combine fetal protection measures within the formula used for attacking pathogens. This does not contradict the *Huangdi Neijing* (Yellow Emperor's Inner Canon); rather, it reflects that contemporary constitutions are far inferior to those of the ancients.

Moreover, caution is required not only for severe illnesses but also for minor ailments. For instance, *Banxia* (Pinelliae Rhizoma) for resolving phlegm, *Shenqu* (Massa Medicata Fermentata) for digesting food, *Houpo* (Magnoliae Officinalis Cortex) for relieving distension, *Huaihua* (Flos Sophorae) for clearing the intestines, *Danpi* (Moutan Cortex) and *Maogen* (Imperatae Rhizoma) for cooling blood, *Ganjiang* (Zingiberis Rhizoma), *Guizhi* (Cinnamomi Ramulus), and *Fuzi* (Aconiti Lateralis Radix Praeparata) for dispelling cold, *Yiyiren* (Coicis Semen), *Tongcao* (Tetrapanacis Medulla), and *Huashi* (Talcum) for promoting diuresis, and *Caoguo* (Tsao-ko Fructus) and *Changshan* (Dichroae Radix) for arresting malaria, are all substances that can harm the fetus. They are easily misused; should physicians not be vigilant and fearful?

Regarding postpartum diseases, I have observed physicians failing to distinguish between deficiency and excess syndromes, invariably prescribing *Shenghua Tang* (Decoction for Generating Blood). If the patient suffers from exogenous pathogens, heavy reliance on ancient formulas (such as *Baibai*, potentially referring to specific strong formulations or a textual error for a specific herb/formula contextually implying harsh treatment) may be acceptable for robust individuals, but for deficient patients, using attack methods further depletes the interior, and using dispersal methods further weakens the exterior. The disaster of "depleting the deficient" occurs immediately!

Furthermore, there are cases where patients believe themselves to be deficient, and doctors blindly prescribe tonics, ignoring the distinction between deficiency and excess. They cite Zhu Danxi’s methods for postpartum care, frequently using heavy tonification of Qi and Blood. While this might suit truly deficient bodies, if exogenous pathogens are present, tonification exacerbates the condition; if lochia (postpartum discharge) remains internally, tonification causes the pathogen to linger. With dual complications arising, the physician fails to recognize the fault of using tonics.

In summary, during pregnancy, one must step-by-step protect the fetus; during the postpartum period, treatment must differentiate between deficiency and excess. A discrepancy of a hair's breadth concerns life and death. I hope colleagues, when encountering conditions during pregnancy or the postpartum period, will avoid rash medication practices. Exercise utmost caution!