妇人疾莫大于产蓐仓猝为庸医所杀者多矣亦不素讲故也旧常见杜壬作医准一卷其平生治
人用药
之验其一记郝质子妇产四日螈 载眼弓背反张壬以为痤病与大豆紫汤独活汤而愈政和间余妻
才分娩犹在蓐中忽作此症头足反接相去几二尺家人惊骇以数婢强拗之不直适记所云而药囊有
独活乃急为之召医未至连进三剂遂能直医到即愈矣更不须用大豆紫汤古人处方神验类矣不可
不广告人二方在千金第三卷
凡产后运闷有四种有下血太多虚极运闷宜服羊肉汤兼黑神散有血下少血上逆于心亦令运
闷如
心腹刺痛宜服四物汤加桂黑神散芎 散有体中素多风疾因产损伤气血乘虚而运闷四物汤加防
风羌活热多者与独活柴胡汤并治风痰药有心气将温过度邪热上乘于心亦令人言语错乱运闷者
宜服镇心补心丹生姜生地黄散至宝丹桃奴丸
妇人冲任之脉起胞中为候之海手太阳小肠之经也手少阴心之经也二经为表里主下月水月
水来
如期谓之月信其不来者缘风冷伤本经故血结在内不通也或曾经唾血或吐血致血枯或醉以入室
劳伤肝气肝脏血竭于内俱令月水不通又胃气虚不能消化水谷使津液不生血气亦令月水不通其
候肠中鸣是也但益津液则经血自下久不通者血结为块若脾胃虚弱则变为水肿土不胜水故也其
月水来而断者由劳伤经脉波任气虚不能制经血也
妇女的疾病中，没有比在产褥期因仓促之间被庸医误治而致死的更多了，这也是因为平时没有预先学习了解的缘故。过去我曾见过杜壬所著的《医准》一卷，记录了他平生治疗病人用药有效的案例。其中有一条记载：郝质子之妻产后第四天出现抽搐（肢体拘挛、角弓反张），症状表现为眼球上翻、背部向后反折。杜壬认为这是痤病（一种以项背强直为特征的疾病），给予大豆紫汤和独活汤治疗后痊愈。
政和年间，我的妻子刚刚分娩，还在产褥期中，突然发作这种病症，头和脚向后反折对接，相距近二尺。家人惊恐骇怕，叫几个婢女强行掰直她的身体，但无法弄直。恰好我记起了书中所说的情况，药囊里又有独活，于是急忙为她配制药物，召请医生尚未到来时，连续服用了三剂药，身体就能伸直了。医生赶到后，病情随即痊愈，不再需要使用大豆紫汤。古人开方神效灵验，大抵如此，不可不告知世人。这两个方剂收录在《千金方》第三卷中。
凡是产后出现的晕闷（头晕目眩、意识模糊）有四种情况：一是恶露下血过多，导致极度虚弱而晕闷，适宜服用羊肉汤兼服黑神散；二是恶露下得少，血液上逆于心，也会导致晕闷，如果伴有心腹刺痛，适宜服用四物汤加桂枝的黑神散或川芎散；三是患者体质素来多风疾，因生产损伤气血，乘虚而入导致晕闷，可用四物汤加防风、羌活；四是热象较多者，与独活柴胡汤并治风痰的药物一起使用；五是心气将温补过度，邪热上乘于心，也令人言语错乱、晕闷，适宜服用镇心补心丹、生姜生地黄散、至宝丹或桃奴丸。
妇女的冲脉和任脉起于胞宫（子宫），是月经汇聚的海源。手太阳小肠经和手少阴心经互为表里，主管下部的月经。月经按时来潮称为“月信”。月经不来，是因为风寒损伤了本经，导致血液凝结在内，不通畅。或者曾经有过唾血、吐血，导致血枯；或者醉酒后行房事，劳伤肝气，肝脏内的血液枯竭，都会导致月经不通。另外，胃气虚弱不能消化水谷，使津液不生，气血不足，也会导致月经不通，其征候是肠鸣。只要补充津液，经血自然下行。如果久不通，血液凝结成块。如果脾胃虚弱，则转变为水肿，这是因为土（脾）不胜水（肾/湿）的缘故。
月经来潮却中断的，是由于劳伤经脉，冲任之气虚弱，不能固摄经血所致。
Among women's diseases, none are more fatal than those caused by incompetent physicians during the puerperium due to hasty treatment. This is often because such knowledge was not studied in advance. I once saw a volume titled *Yi Zhun* (Medical Standards) written by Du Ren, which recorded the efficacy of his medicinal prescriptions throughout his life. One entry records that the wife of Hao Zizhi experienced convulsions (limb spasms and opisthotonos) on the fourth day postpartum, characterized by upward rolling of the eyes and backward arching of the back. Du Ren diagnosed this as *Cuo Bing* (a disease characterized by stiffness and rigidity of the neck and back) and prescribed Da Dou Zi Tang (Soybean Purple Decoction) and Duhuo Tang (Angelica Pubescens Decoction), resulting in recovery.
During the Zhenghe era, my wife had just given birth and was still in the puerperium when she suddenly developed these symptoms: her head and feet bent backward to meet each other, with a distance of nearly two chi between them. Her family was terrified and called several maidservants to forcibly straighten her body, but they could not succeed. Recalling the record I had read, and finding Duhuo (Angelica Pubescens) in my medicine pouch, I hastily prepared the prescription. Before the physician arrived, she took three doses consecutively and was able to straighten her body. When the physician arrived, she recovered completely, without needing to use Da Dou Zi Tang. The efficacy of ancient prescriptions is indeed miraculous; this should be shared with others. These two formulas are found in Volume 3 of *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold).
Postpartum faintness and dizziness (yun men) can be categorized into four types:
1. Excessive lochia discharge leading to extreme deficiency and faintness: suitable for Yang Rou Tang (Mutton Decoction) combined with Hei Shen San (Black Divine Powder).
2. Scanty lochia discharge with blood reversing upward to affect the Heart, also causing faintness: if accompanied by stabbing pain in the heart and abdomen, suitable for Si Wu Tang (Four Substances Decoction) added with Gui Zhi (Cinnamon Twig) in Hei Shen San, or Xiong Xin San (Ligusticum Chuanxiong Powder).
3. Patients with a constitutional predisposition to wind disorders, where childbirth damages Qi and Blood, allowing pathogenic factors to enter through the deficiency and cause faintness: treat with Si Wu Tang added with Fang Feng (Saposhnikovia Root) and Qiang Huo (Notopterygium Rhizome).
4. Cases with significant heat signs: treat with Duhuo Chai Hu Tang (Angelica Pubescens and Bupleurum Decoction) along with herbs for dispelling wind and resolving phlegm.
5. Over-warming tonification of Heart Qi, allowing pathogenic heat to ascend to the Heart, causing confused speech and faintness: suitable for Zhen Xin Bu Xin Dan (Heart-Calming and Tonifying Pill), Sheng Jiang Sheng Di Huang San (Fresh Ginger and Rehmannia Powder), Zhi Bao Dan (Precious Treasure Pill), or Tao Nu Wan (Peach Bud Pill).
The Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel) originate from the Bao Gong (Uterus) and serve as the sea of menstruation. The Hand-Taiyang Small Intestine Meridian and the Hand-Shaoyin Heart Meridian are exterior-interior pairs, governing menstruation. Menstruation arriving on schedule is called "Yue Xin" (Monthly Trust). Amenorrhea occurs when Wind-Cold injures the primary meridians, causing blood to coagulate internally and obstruct flow. It may also result from previous hematemesis or spitting blood leading to Blood exhaustion, or from sexual intercourse while intoxicated, damaging Liver Qi and depleting Liver Blood. Additionally, Spleen-Stomach Qi deficiency failing to transform food and fluids prevents the generation of Jin Ye (Body Fluids) and Qi-Blood, also causing amenorrhea, manifested by borborygmus (intestinal rumbling). If Body Fluids are replenished, menses will naturally resume. Prolonged amenorrhea leads to blood coagulation forming masses. If Spleen-Stomach deficiency persists, it may transform into edema, as Earth (Spleen) fails to control Water.
Menorrhagia that stops abruptly is caused by injury to the meridians and deficiency of Chong-Ren Qi, failing to contain the menstrual blood.