《史记》扁鹊传中称其过邯郸,闻赵贵妇人,遂为带下医,此女人科之所 乎?先生之《邯郸遗
稿》,此物此志也。妇女之病难治于男子,禀性阴柔,气血最多凝滞,且见症又诡变百出,往往误投一
剂即酿成沉 ,而世所称女科善本,如《济阴纲目》诸书,议病裁方不无畸重畸轻之弊。《邯郸遗稿》他
书引用颇多,其论胎产别开生面,实有发前人所未发者。惜无刻本行世,辛丑岁得抄本一帙,屡于临症时
师其大意,辄获奇效。藏诸家塾,借抄者踵相接也,恐转辗沿写,或滋亥豕鲁鱼之误,亟付梓人,以公同
好,庶先生一片苦心,其启牖靡涯欤!先生《医贯》一书,久经行世,以未化拘墟之见,故洄溪砭之,而
此书则简赅详明,能令读者耳目一新,较诸《医贯》,奚翅霄壤哉!想《医贯》着在学养未深之候,或根据草
附木者流捉刀所为,亦未可定。乌容执一以薄古人耶。先生赵氏,名献可,养葵其字也。
着述家每出一书,辄称翻刻必究,余甚惑焉,倘艺林中有同余好者,或嫌镌板未工,务期陆续刊发,
则先生之立言,尚其不朽乎千古。
嘉庆元年岁次丙辰春王月吴趋生吴升谨叙
凡妇女经事,谓之月水,又谓之潮水。曰月者一月一至也,曰潮者取其信也。上蓄为乳汁,下行为月
水。夫阴必从阳,故禀火色而红。血为气配,气寒则寒,气热则热,气降则降,气凝则凝,气滞则滞,气
行则行。平和之气,三旬一见,应月盈焉,其行有常,故名曰月经。贵调其气以行其血,血盛气聚是谓
之从,从则孕而无损,若将理失宜,变证百出,为病不浅。有枯闭不通者,有淋漓不止者,有不及期与过
期者,有先通而后止者,有错经而妄行者,有紫黑块而行痛者,有全白色而似鱼脑者,有黄绿色而似牛髓
者,有肥人痰多血海弥满而经闭者,有瘦人精气不聚子宫无血者,有因久患潮热消血者,有因久发盗汗耗
血者,有因脾弱不生血者,有因七情气结而经闭者,有泻痢失血者,有年久经不绝者,有一生经不至者,
有来时发谵语如见鬼状者,有临行遍身痛而浮肿者,或赤白淋浊,或崩中带下,或七疝八瘕,或聚或散,
乍有乍无,其余病证未能悉举。其将来而痛者血之滞也,块而下者气之凉也,来后作痛者气血俱虚也,色淡
者亦虚也,错经妄行者气乱也,色紫者气热也,黑者热甚也,参前者气热而速也,迟后者气滞而涩也,一
月两至者血热、故多也,两月一至者血冷、故少也,血得热则行,得冷则凝也,热用冷药,冷用热药,不
可一途而取明矣。
《史记·扁鹊仓公列传》中记载,扁鹊经过邯郸时,听说赵国重视妇女的健康,于是成为专门治疗妇科疾病的医生(带下医),这难道就是后世妇产科的源头吗?赵献可先生的《邯郸遗稿》,正是秉持着这种志向。妇女的疾病比男子更难治疗,因为女性禀赋阴柔,气血最容易凝滞,而且症状变化多端、诡谲异常,往往误服一剂药就会酿成严重的疾病。而世间所称道的妇科良书,如《济阴纲目》等书籍,在辨证论治和处方用药上,难免有偏重或偏轻的弊端。《邯郸遗稿》被其他书籍广泛引用,其关于胎产的理论别出心裁,确实有发挥前人未曾阐发的见解之处。可惜没有刻本流传于世,我在辛丑年得到了一部抄本,多次在临证时借鉴其大意,每每获得奇效。我将它藏在家塾中,借阅抄写的人络绎不绝,担心辗转传抄产生文字错误,于是急忙交付刻印,以与同道共享,希望先生的一片苦心,能开启后学无尽的智慧吧!先生的另一部著作《医贯》,早已流行于世,但因为其中未摆脱拘泥狭隘的见解,所以洄溪(徐大椿)对其进行了批评,而这本书则简明扼要、详尽清晰,能让读者耳目一新,与《医贯》相比,简直有天壤之别!想来《医贯》是在先生学识修养尚未深厚之时所著,或者是依据某些浅薄之人的草稿代笔所作,也未可知。怎么可以固执己见而轻视古人呢?先生姓赵,名献可,字养葵。
著述家每出一本书,就声称翻刻必究,我很对此感到困惑。倘若艺术界中有与我喜好相同的人,或者嫌弃雕版不够精美,务必期望陆续刊印发行,那么先生的立言,或许就能不朽于千古了。
嘉庆元年岁次丙辰春王月,吴趋生吴升谨序
凡是妇女的月经,称为“月水”,又称为“潮水”。叫“月”是因为每月来一次;叫“潮”是取像潮汐一样有信期的意思。血上行蓄积化为乳汁,下行排出则为月经。阴必须顺从阳,所以血液呈现红色。血需要气的配合,气寒则血寒,气热则血热,气降则血降,气凝则血凝,气滞则血滞,气行则血行。平和之气,三十天出现一次,对应月亮的盈亏,其运行有常规,所以称为月经。关键在于调理气机以推动血液运行,血盛气聚这就叫做“顺”,顺则受孕而无损伤;如果调护失当,变证百出,造成的疾病就不浅了。有的干枯闭经不通,有的淋漓不止,有的未到经期就来,有的过期不来,有的先通而后止,有的错经妄行,有的颜色紫黑有块且行经疼痛,有的全白色像鱼脑,有的黄绿色像牛髓,有的肥胖人痰多导致血海满溢而闭经,有的瘦人精气不聚、子宫无血,有的因长期患潮热消耗血液,有的因长期盗汗耗损血液,有的因脾弱不能生血,有的因七情气结导致闭经,有的因泻痢失血,有的年老经血不绝,有的终生月经不至,有的来时发谵语如见鬼状,有的临行遍身疼痛而浮肿,或者赤白淋浊,或者崩漏带下,或者七疝八瘕,或者聚散无常,乍有乍无,其余病证未能全部列举。将来月经前疼痛的是血滞,有血块下排的是气凉,经后作痛的是气血俱虚,颜色淡也是虚证,错经妄行的是气乱,颜色紫的是气热,黑色是热甚,参看前面的(指周期提前)是气热而快,迟后的是气滞而涩,一个月来两次的是血热所以量多,两个月来一次的是血冷所以量少,血得热则行,得冷则凝,这是显而易见的道理。热证用冷药,冷证用热药,不可走单一途径,这也明白了。
The "Biography of Bian Que" in the *Records of the Grand Historian* (*Shiji*) records that when Bian Que passed through Handan, hearing that the State of Zhao valued women's health, he became a physician specializing in gynecological diseases (Dai Xia Yi), which might be considered the origin of later obstetrics and gynecology. Mr. Zhao Xianke's work, *Handan Yigao* (Manuscripts from Handan), embodies this very aspiration. Women's diseases are more difficult to treat than men's because women possess a yin-soft constitution, and their qi and blood are most prone to stagnation. Moreover, symptoms appear in myriad and unpredictable ways; often, a single misprescribed dose can lead to severe illness. The so-called authoritative texts on gynecology in the world, such as *Jiyin Gangmu* (General Outline of Nourishing Yin), inevitably suffer from biases in overemphasizing or underemphasizing certain aspects when discussing diseases and prescribing formulas. *Handan Yigao* is widely cited by other books; its theories on pregnancy and childbirth are innovative and indeed elucidate insights not previously explored by predecessors. Unfortunately, no printed edition circulated. In the Xin Chou year, I obtained a manuscript copy. Frequently borrowing its general principles during clinical practice, I often achieved remarkable effects. I kept it in my family school, and those who borrowed it for copying came in a continuous stream. Fearing that repeated copying might introduce textual errors (such as confused characters like 'hai' and 'shi', or 'lu' and 'yu'), I hastened to have it engraved and printed to share with fellow enthusiasts, hoping that Mr.'s painstaking effort would endlessly enlighten future generations. Mr.'s other work, *Yi Guan* (Medical Canon), has long been in circulation. However, because it did not break free from narrow-minded views, Xu Dacun (courtesy name Huixi) criticized it. In contrast, this book is concise yet comprehensive, detailed and clear, refreshing the reader's mind and senses. Compared to *Yi Guan*, the difference is as vast as heaven and earth! It is likely that *Yi Guan* was written when Mr.'s scholarly cultivation was not yet profound, or perhaps ghostwritten based on drafts by superficial scholars; this cannot be ruled out. How can one be dogmatic and belittle the ancients? Mr. surnamed Zhao, named Xianke, with the courtesy name Yangkui.
Authors usually declare that unauthorized reprinting will be prosecuted. I find this puzzling. If there are connoisseurs in the literary and medical circles who share my appreciation, or if they find the engraving imperfect, I earnestly hope they will publish it in successive installments. Then, Mr.'s words may remain immortal for eternity.
Prefaced by Wu Sheng, styled Wuchusheng, in the first month of spring in the Bing Chen year of the first year of Jiaqing.
Women's menstruation is called "Yue Shui" (Monthly Water) or "Chao Shui" (Tidal Water). "Yue" (Moon) indicates it occurs once a month; "Chao" (Tide) implies reliability and regularity like the tides. Blood flowing upward accumulates to become milk; flowing downward becomes menstrual blood. Yin must follow Yang, hence blood appears red. Blood requires Qi as its companion: if Qi is cold, blood is cold; if Qi is hot, blood is hot; if Qi descends, blood descends; if Qi stagnates, blood stagnates; if Qi moves, blood moves. Under normal conditions, with balanced Qi, menstruation occurs every thirty days, corresponding to the waxing and waning of the moon, following a regular pattern, thus named "Menstrual Period." The key lies in regulating Qi to promote Blood circulation. When Blood is abundant and Qi gathers, it is termed "Harmonious" (Cong); harmony leads to conception without harm. If care and regulation are improper, myriad complications arise, causing significant disease. Conditions include dry amenorrhea (obstruction), dripping metrorrhagia, early onset, delayed onset, cessation after initial flow, irregular erratic flow, purple-black clots with dysmenorrhea, pure white discharge resembling fish brain, yellow-green discharge resembling ox marrow, amenorrhea in obese individuals due to excessive phlegm filling the Sea of Blood, amenorrhea in thin individuals due to lack of essence gathering in the uterus, blood consumption due to prolonged tidal fever, blood depletion due to chronic night sweats, inability to generate blood due to weak Spleen, amenorrhea due to emotional Qi stagnation, blood loss due to diarrhea and dysentery, perpetual bleeding in old age, lifelong absence of menstruation, delirium resembling hallucinations during menstruation, generalized pain and edema preceding menstruation, red-white turbid discharge, metrorrhagia and leukorrhea, seven types of hernias and eight types of masses, fluctuating presence or absence, and countless other symptoms too numerous to list. Pain before menstruation indicates Blood stagnation; passage of clots indicates Cold Qi; pain after menstruation indicates deficiency of both Qi and Blood; pale color also indicates deficiency; erratic flow indicates Chaotic Qi; purple color indicates Hot Qi; black color indicates extreme Heat; early occurrence indicates rapid flow due to Heat; late occurrence indicates sluggish flow due to Qi stagnation. Twice-monthly menstruation indicates Heat in Blood leading to excess volume; bimonthly menstruation indicates Cold in Blood leading to scanty volume. Blood flows when heated and coagulates when cooled; this principle is clear. Heat patterns require cold herbs, and cold patterns require hot herbs; treatment cannot rely on a single approach. This is evident.