《坤元是保》，宋·薛仲昂轩所着，历代女科书皆未之采，书中不乏精要之论，易简之
方，询为女科秘笈。咸丰丁巳，吴晓钲以重值购自吴门，借余录之，摘录数条于此。
妇人有疾，两乳不嫌其大，月水不嫌其多，乃生机也。治呕血及诸衄下血等候，用猪腰
具，童便二盏，陈三白酒一盏，贮新瓶内，密封泥口，日晚以慢火煨熟，至初更止，夜分后
，更以火温之，发瓶毕食，即病笃者，止一月效，平日瘦怯者，并宜服之，男女皆效，真以血养之良方也。
医书云∶先期为血热，后期为血寒，然有或前或后者，将忽寒忽热乎？大抵气者血之母
，气乱则经期亦乱，故调经以理气为先。
孕六七月，因争筑着子死腹中，恶露直下，痛不能胜而欲绝者，佛手散主之。（当归三
芎五钱，益母五钱，水酒各半碗煎服，停一二时再进一服。）若胎不损，则痛止而子母俱安
，既损则胎下而母全矣。
一胎不动而冷如冰，即非好胎。若以不动言之，好胎亦是伏而不动者，何可遂断其死胎也？
宜服顺气活血药。产后忌饮酒，但服童便可也，童便为临产仙药，晕眩败血中心，及血崩诸
症，仓卒不及备药，惟儿初下地时，即与童便一盏，庶免诸症之患。一月之内，日服一盏，
百病不生，他药皆不及此。
产后百病，三者最危∶呕吐、盗汗、泄泻是也。三者并见，其命必危。数症并作，治其
，见二凶多，一症轻者无害，产后阴血虚耗，阳浮散其外而靡所根据，故多发热，治法用四物
汤补阴，姜通神明，炮干姜能收浮散之阳，使合于阴，故兼用之。然产后脾胃虚损，有伤饮
食而发热者，误作血虚，则反伤矣。故必先问曾食何物，有无伤损。有恶血未净者，必腹痛
而发热，有感冒外邪者，必头痛而发热，若发热而饮食自调，绝无它症者，乃血虚也，可以
补血。若胸膈饱闷，嗳气恶食，泄泻等症，只随症治之。要知腹满而不痛者，断非恶血也，
产后用益母草锉一大剂三两，浓煎去渣，加芎、归末各二钱，陈酒、童便各一盏，服之至再
，则腹痛血晕之恶免，且大有补益，真治产之司总也。（此方又名夺命丹，为产后圣药。）
产后喜咸爱酸而致咳嗽者，必致痼疾，终身须自慎之，家传秘方有六，简易而神妙特奇
世宝之。种子丸，（五月五日拔益母草带根阴干为末，炼蜜为丸，如弹子大，每朝二丸，百
日必效。）固胎丸，（条芩、白术为末，每服三钱，砂仁汤下，连服数朝而胎可永安。）保安
丸，（五月五日取益母草去根晒干为末，炼蜜为丸，如弹子大，孕八九月每朝一丸，砂仁汤
下，服二三十朝必无倒产之逆。）催生丹，（益母草四两，焦白芷，炒滑石、百草霜各二两，
临产服四钱，芎归汤送下。）益母丹，（即产用山楂末三钱，浓煎益母草汤、陈酒和童便调下
，第一日三服，第二日二服，第三日一服，第四、第五日山楂末减半，第六、第七日去山楂
末，只服三味，第八日并三味一服，而百疾不生矣，历验。）坤元是保丹，（孕妇病则胎亦病
而坠，则多两亡，此方能却胎病使两无恙。青黛五钱，伏龙肝二两，二味研末，用井泥调匀
，涂脐上当孕处二寸许，干则再涂，此丹只可施于伤寒极热之症，不可概施者也，切记！
切记！慎之！慎之！）余家有佣妇叶姓，阴户坠下一物，如初生孩儿头，卧则入腹，立则坠于外
，行动不便，深以为苦，自云产后操作过早，屡至河埠踞而洗衣，致有此患，坠下后产一男
，仍不能收，俗名鱼袋，不知是否即子宫也。此症初起，若根据丹溪法，当或可疗，久则不能
丹溪治产妇阴户一物如帕垂下，俗名产颓，宜大补气以升提之，以参、 、术各一钱，
升麻
故随子而下，用升麻、当归、芎、 ，大剂服二次，后以五倍子作汤洗濯，皴其皮，觉一响而收入。
《坤元是保》，由宋代薛仲昂轩所著，历代妇科书籍均未收录此书。书中不乏精要的论述和简便的方剂，确实堪称妇科秘笈。咸丰丁巳年（1857年），吴晓钲以重金从苏州购得此书，借给我抄录，现在此摘录数条。
妇女若有疾病，但乳房不嫌其大，月经不嫌其多，这是生机旺盛的表现。治疗呕血及各种鼻衄、下血等症状，使用猪腰子一个，童子尿两盏，陈年三白酒一盏，装入新瓶中，用泥密封瓶口，傍晚时用慢火煨熟，直到初更时分停止，夜半之后，再用火温之，发开瓶子后空腹服用。即使是病情危重者，服药一个月也能见效。平时身体瘦弱怯懦的人，也适宜服用，男女皆有效，这确实是养血良方。
医书说：月经先期来潮是因为血热，后期来潮是因为血寒。然而，如果月经有时提前有时推后，难道要忽冷忽热地治疗吗？大概气是血之母，气机紊乱则经期也会紊乱，所以调理月经以理气为先。
怀孕六七月时，因争斗撞击导致胎儿死于腹中，恶露直下，疼痛难忍甚至昏厥，用佛手散主治。（当归三钱，川芎五钱，益母草五钱，水和酒各半碗煎服，停一二时辰后再进一服。）如果胎儿未受损，则疼痛停止而母子平安；如果胎儿已受损，则胎衣排出而母亲保全。
如果胎儿不动且冰冷如冰，这就不是好胎儿。如果说胎儿不动，正常的胎儿也是潜伏不动的，怎么能据此就断定是死胎呢？适宜服用顺气活血药。产后忌饮酒，只喝童子尿即可，童子尿是临产时的仙药，对于晕眩、败血攻心以及血崩等各种症状，在紧急来不及准备药物时，只要婴儿刚落地，立即给产妇灌服一盏童子尿，便可避免各种病症的发生。一个月内，每天服用一盏，百病不生，其他药物都比不上它。
产后百病中，有三种最危险：呕吐、盗汗、泄泻。这三种症状同时出现，性命必然危急。多种症状并发时，治疗需分主次，见两个凶险症状较多，一个症状较轻则无大碍。产后阴血虚耗，阳气浮散于外而无根基，所以多发热。治法用四物汤补阴，生姜通神明，炮干姜能收敛浮散的阳气，使其合于阴，所以兼用它们。然而产后脾胃虚损，有因饮食损伤而发热者，若误作血虚治疗，则会反而受伤。所以必须先问曾吃过什么食物，有无损伤。有恶血未净者，必定腹痛而发热；有感冒外邪者，必定头痛而发热；若发热而饮食正常，绝无其他症状者，才是血虚，可以补血。若胸膈饱闷、嗳气、恶食、泄泻等症状，只需随症治疗。要知道腹部胀满但不痛的，断然不是恶血。产后用益母草锉一大剂三两，浓煎去渣，加入川芎、当归末各二钱，陈酒、童子尿各一盏，连服多次，则可免除腹痛血晕之恶，且大有补益，这真是治疗产后病的总纲。（此方又名夺命丹，为产后圣药。）
产后因喜咸爱酸而导致咳嗽者，必致成痼疾，终身须自我谨慎。家传秘方有六个，简易而神妙奇特，世人应珍视。种子丸，（五月五日拔取带根益母草阴干研末，炼蜜为丸，如弹子大，每晨服二丸，百日必效。）固胎丸，（黄芩、白术为末，每服三钱，砂仁汤送下，连服数日胎可永安。）保安丸，（五月五日取益母草去根晒干为末，炼蜜为丸，如弹子大，怀孕八九月每晨一丸，砂仁汤送下，服二三十日必无倒产之逆。）催生丹，（益母草四两，焦白芷、炒滑石、百草霜各二两，临产时服四钱，用芎归汤送下。）益母丹，（即产后用山楂末三钱，浓煎益母草汤、陈酒和童子尿调下，第一日三服，第二日二服，第三日一服，第四、第五日山楂末减半，第六、第七日去山楂末，只服三味，第八日将三味同服，则百病不生矣，历经验证。）坤元是保丹，（孕妇生病则胎儿亦病而坠落，往往母子双亡，此方能去除胎病使母子无恙。青黛五钱，伏龙肝二两，两味研末，用井泥调匀，涂在脐上对应怀孕部位约二寸处，干了再涂，此丹只可施用于伤寒极热的症状，不可一概施用，切记！切记！慎之！慎之！）我家有个姓叶的佣妇，阴户坠下一物，像初生婴儿的头，躺着则进入腹内，站立则坠于体外，行动不便，深以为苦，自称产后过早劳作，多次到河边蹲着洗衣，导致有此患，坠下后生了一男婴，仍不能收回，俗名鱼袋，不知是否就是子宫。此症初起，若根据丹溪的方法，或许可以治疗，久了则不能。丹溪治疗产妇阴户有一物如帕垂下，俗名产颓，宜大补气以升提之，用人参、[缺字]、白术各一钱，升麻[缺字]，故随子而下，用升麻、当归、川芎、[缺字]，大剂服两次，后用五倍子作汤洗濯，使其皮皱缩，觉一声响而收入。
*Kun Yuan Shi Bao* was authored by Xue Zhong'angxuan of the Song Dynasty. It has not been included in gynecological books of successive generations. The book contains numerous essential discussions and simple prescriptions, truly serving as a secret manual for gynecology. In the Ding-Si year of the Xianfeng era (1857), Wu Xiaozheng purchased this book from Suzhou at a high price and lent it to me for copying. Here, I excerpt several entries.
In women with certain ailments, if the breasts are not considered too large and menstruation is not considered excessive, this indicates vigorous vitality. To treat hematemesis and various types of epistaxis or lower bleeding, use one pig kidney, two cups of urine from an uncircumcised boy (*Tongbian*), and one cup of aged Sanbai wine. Store them in a new bottle, seal the mouth tightly with mud, and simmer over low heat starting from dusk until the first watch of the night. After midnight, keep it warm with fire. Open the bottle and consume it on an empty stomach. Even in critical cases, efficacy can be seen within one month. Those who are naturally thin and weak should also take it; it is effective for both men and women. It is indeed an excellent prescription for nourishing blood.
Medical texts state: early menstruation is due to blood heat, while late menstruation is due to blood cold. However, if menstruation alternates between early and late, should one treat with alternating hot and cold methods? Generally, Qi is the mother of Blood; if Qi becomes disordered, the menstrual cycle will also be irregular. Therefore, regulating menstruation prioritizes regulating Qi.
During the sixth or seventh month of pregnancy, if a struggle or blow causes the fetus to die in the womb, resulting in direct discharge of lochia, unbearable pain, and near-fainting, *Foshou San* (Buddha's Hand Powder) is the primary treatment. (Composed of Danggui 3 qian, Chuanxiong 5 qian, and Yimucao 5 qian, decocted in half a bowl of water and half a bowl of wine. Take one dose, wait one to two hours, then take another.) If the fetus is undamaged, the pain stops and both mother and child remain safe; if the fetus is damaged, the placenta/fetus will be expelled while the mother survives.
If the fetus does not move and feels cold as ice, it is not a viable fetus. However, stating that "no movement" implies death is incorrect, as a healthy fetus is also latent and still. One cannot immediately diagnose it as a dead fetus based solely on lack of movement. It is appropriate to take Qi-regulating and blood-invigorating herbs. Alcohol is contraindicated postpartum; only urine from an uncircumcised boy (*Tongbian*) should be consumed. *Tongbian* is a miraculous medicine for childbirth. For symptoms such as vertigo, blood stasis attacking the heart, and metrorrhagia, when emergency medication is unavailable, immediately give one cup of *Tongbian* to the mother right after the infant is born to prevent these complications. Consuming one cup daily within the first month prevents myriad diseases; no other medicine compares.
Among the hundred diseases postpartum, three are most critical: vomiting, night sweats, and diarrhea. If all three appear together, life is in danger. When multiple symptoms occur simultaneously, treatment must prioritize the most urgent ones; having two severe symptoms and one mild one is less dangerous. Postpartum, Yin blood is depleted, causing Yang Qi to float outward without foundation, leading to fever. The treatment method uses *Siwu Tang* (Four Substances Decoction) to nourish Yin. Shengjiang (Fresh Ginger) unblocks the spirit, and Paoganjiang (Prepared Dried Ginger) consolidates floating Yang, integrating it with Yin, so both are used. However, postpartum Spleen and Stomach deficiency may cause fever due to dietary injury. Mistaking this for blood deficiency would cause further harm. Thus, one must first ask what food was consumed and if there was dietary injury. Fever accompanied by abdominal pain indicates retained evil blood; fever accompanied by headache indicates external pathogenic invasion. If there is fever but digestion is normal and no other symptoms exist, it is blood deficiency, and blood tonification is appropriate. For symptoms like chest fullness, belching, anorexia, and diarrhea, treat according to the specific symptoms. Abdominal distension without pain definitely does not indicate retained blood. Use a large dose (3 liang) of chopped Yimucao (Motherwort Herb), decoct strongly, strain, and add 2 qian each of Chuanxiong and Danggui powder, along with one cup each of aged wine and *Tongbian*. Repeated doses prevent abdominal pain and blood-stasis syncope and provide significant tonification; this is the general principle for treating postpartum conditions. (This formula is also known as *Duoming Dan* (Life-Rescuing Pill), a sacred medicine for postpartum care.)
Cough caused by a postpartum preference for salty and sour foods will likely become a chronic disease; lifelong caution is required. There are six family-secret formulas, which are simple yet miraculous and should be treasured by the world. *Zhongzi Wan* (Seed-Planting Pill): Harvest Yimucao with roots on the fifth day of the fifth lunar month, dry in shade, powder it, and make pills with refined honey the size of a bullet. Take two pills every morning; efficacy is guaranteed within 100 days. *Gutai Wan* (Fetus-Stabilizing Pill): Powder Huangqin (Scutellaria Root) and Baizhu (Atractylodes Rhizome). Take 3 qian per dose, washed down with Shaoren (Amomum Fruit) decoction. Continuous intake for several days ensures fetal stability. *Bao'an Wan* (Security-Peace Pill): On the fifth day of the fifth lunar month, harvest Yimucao, remove roots, dry, powder, and make honey pills the size of a bullet. Take one pill every morning during the eighth and ninth months of pregnancy, washed down with Shaoren decoction. Taking it for 20-30 days prevents breech presentation. *Cuisheng Dan* (Labor-Delivery Pill): Yimucao 4 liang, Jiaobaizhi (Charred Angelica Dahurica Root), Chaohuashi (Calcined Talcum), and Baicaoshuang (Herbal Ash) each 2 liang. Take 4 qian at labor onset, delivered with *Xiongui Tang* (Angelica and Chuanxiong Decoction). *Yimu Dan* (Motherwort Pill): Postpartum, mix 3 qian of Shanzha (Hawthorn Fruit) powder with strong Yimucao decoction, aged wine, and *Tongbian*. Day 1: 3 doses; Day 2: 2 doses; Day 3: 1 dose; Days 4-5: halve Shanzha powder; Days 6-7: omit Shanzha, take only the three liquids; Day 8: combine all three ingredients into one dose. This prevents myriad diseases and has proven effective through experience. *Kun Yuan Shi Bao Dan*: When a pregnant woman falls ill, the fetus suffers and may abort, often resulting in the death of both mother and child. This formula treats fetal illness to ensure safety. Qingdai (Indigo Naturalis) 5 qian, Fulonggan (Dragon's Liver/Drained Earth) 2 liang. Grind into powder, mix with well mud, and apply to the umbilicus corresponding to the fetal position (about 2 cun area). Reapply when dry. This formula is only applicable to extreme heat syndromes from Cold Damage; do not use indiscriminately. Remember! Remember! Be cautious! Be cautious!
My household had a servant surnamed Ye who had a mass prolapsing from the vagina, resembling the head of a newborn. It retracted when lying down and protruded when standing, causing inconvenience and suffering. She claimed it resulted from premature labor after childbirth, specifically squatting by the river to wash clothes repeatedly. After the mass prolapsed, she gave birth to a son, but the mass did not retract. Commonly called "fish bag," it is unknown if this is the uterus. If treated early according to Danxi's method, it might be curable; if prolonged, it becomes incurable. Danxi treated a case where a woman had a cloth-like mass hanging from the vagina, commonly called "Chantui" (Postpartum Prolapse). He recommended greatly tonifying Qi to lift and raise it, using Renshen (Ginseng Radix), [missing character], and Baizhu each 1 qian, Shengma (Cimicifugae Rhizoma) [missing character]. Since it descended with the child, he used Shengma, Danggui, Chuanxiong, [missing character] in a large dose, administered twice. Afterwards, he washed the area with Wubeizi (Chinese Gall) decoction to shrink the skin. Upon hearing a snap, it retracted.