小柴胡汤 大承气汤（俱见《伤寒论》）
当归生姜羊肉汤
当归（三两） 生姜（五两） 羊肉（一斤）
上三味，以水八升，煮取三升，温服七合，日三服。
若寒多，加生姜成一斤；痛多而呕者，加橘皮二两、白术一两；加生姜者，亦如水五升，煮取三升二合服之。
歌曰∶腹痛胁疼（腹胁皆寒气作主，无复界限，里）急不堪，（是内之荣血不足，致阴气不能相荣而急。）羊斤姜五
蜀归三，于今豆蔻香砂法，可笑医盲授指南。
（次男元犀）按∶方中当归行血分之滞而定痛，生姜宣气分之滞而定痛，亦人所易晓也。妙在羊肉之多，羊肉为气
血有情之物，气味腥 浓浓，入咽之后，即与浊阴混为一家，旋而得当归之活血，而血中之滞通；生姜之利气，而气中
之滞通；通则不痛，而寒气无有潜藏之地，所谓发透之，而后攻之者也。苟病家以羊肉太补而疑之，是为流俗之说所囿，
其中盖有命焉，知几者即当婉辞而去。
枳实芍药散
枳实（炒令黑，勿太过） 芍药（等分）
上二味，杵为散，服方寸匕，日三服。并主痈脓，大麦粥下之。
歌曰∶满烦不卧腹疼频，枳实微烧芍等平；羊肉汤方应反看，（彼治不烦不满之虚痛，此治烦满之实痛。）散调大麦
（粥）稳而新。
（长男蔚）按∶枳实通气滞，芍药通血滞，通则不痛，人所共知也。妙在枳实烧黑，得火化而善攻停积；下以大麦
粥，和肝气而兼养心脾；是行滞中而寓补养之意，故痈脓亦主之。
下瘀血汤
大黄（三两） 桃仁（二十个） 虫（二十枚，去足，熬）
上三味末之，炼蜜和为四丸，以酒一斤，煮一丸，取八合顿服之，瘀血下如豚肝。（各本略异。）
歌曰∶脐中着痛瘀为殃，廿粒桃仁三两黄，更有 虫二十个，酒煎大下亦何伤？
（次男元犀）按∶产妇腹痛，服枳实、芍药而不愈者，为热灼血干，而为停瘀，其痛着于脐下，宜用此汤。方中大
黄、桃仁之推陈下瘀， 虫之善攻干血，人尽知之。妙在桃仁一味，平平中大有功力。盖血已败而成瘀，非得生气不能
流通，桃得三月春和之气，而花最鲜明似血，而其生气皆在于仁，而味苦又能开泄，故直入血中而和之散之，逐其旧而
不伤其新也。
阳旦汤 即桂枝汤倍桂增附。坊本谓加黄芩者，未知《伤寒论·太阳篇》中已明其方也。孙真人及各家俱误。
（桂枝汤见《伤寒论》。）
竹叶汤
竹叶（一把） 葛根（三两） 防风 桔梗 桂枝 人参 甘草（各一两） 附子（一枚，炮） 生姜（五两） 大
枣（十五枚，劈）
上十味，以水一斗，煎服二升半，分温三服，温复取微汗。头项强，用大附子一枚，破之如豆大，煎药，扬去沫；
呕者，加半夏半升洗。
歌曰∶喘热头疼面正红，（势欲成痉。一两）防桔桂草人参同；（同用一两。）葛根（三两）、生姜（五两）、附
枚一；枣十五枚竹叶（一把）充。
加减歌曰∶头项强者大附抵，以大易小不同体；若为气逆更议加，半夏半升七次洗。
程云来云∶症中未至背反张，而发热、面赤、头痛，亦风痉之渐。故用竹叶主风痉，防风治内痉，葛根疗刚痉，桂
枝治柔痉，生姜散风邪，桔梗除风痹，辛以散之之剂也。又佐人参生液以养筋，附子补火以致水，合之甘草以和诸药，
大枣以助十二经；同诸风济，则发中有补，为产后中风之大剂也。
竹皮大丸
生竹茹 石膏（各二分） 桂枝（一分） 白薇（一分） 甘草（七分）
上五味，末之，枣肉和丸，弹子大，饮服一丸，日三夜二服。有热倍白薇，烦喘者加柏实一分。
歌曰∶呕而烦乱乳中虚，（谓乳子之时，气虚火胜，内乱而上逆也。）二分石膏与竹茹，薇桂一分加草七，（分）枣丸
饮服效徐徐。
加减歌曰∶白薇退热绝神异，有热倍加君须记。柏得金气浓且深，叶叶西向归本位；实中之仁又镇心，烦喘可加一
分饵。（解见本论）
白头翁加甘草阿胶汤（汤见《伤寒论》。再加甘草、阿胶各二两是也。）师云∶产后下利虚极者，此主之。
歌曰∶白头汤已见前歌，二两阿胶甘草和；产后利虚成极症，滋（阿胶救其阴，）而且缓（甘草缓其急，）莫轻过。
（次男元犀）按∶凡产后去血过多，又兼下利亡其津液，且为阴虚无疑。兹云虚极，理宜大补，然归、芎、芍、地
则益其滑而下脱，参、术、桂、 则动其阳而上逆，皆为禁剂。须知此虚字，指阴虚而言，与少阴症阴气欲绝同义。少
阴症与大承气汤急下以救阴，与此症与白头翁汤大苦以救阴同义。此法非薛立斋、张景岳、李士材辈以甘温为主、苦寒
为戒者所可窥测。尤妙在加甘草之甘，合四味之苦，为苦甘化阴法；且久痢膏脂尽脱，脉络空虚，得阿胶之滋润，合四
味之苦以坚之，则源流俱清而痢自止。
千金三黄散
黄芩（一两） 苦参（二两） 干地黄（四两）
上三味，以水六升，煮取二升，温服一升。多利下虫。
千金内补当归建中汤
当归（四两） 桂枝 生姜（各三两） 芍药（六两） 甘草（二两） 大枣（十二枚）
上六味，以水一斗，煮取三升，分温三服，一日令尽。若大虚，加饴糖六两，汤成纳之于火上，暖令饴消；若去血
过多，崩伤内衄不止，加地黄六两、阿胶二两，合八味，汤成纳阿胶。若无当归，以川芎代之；若无生姜，以干姜代之。
门人问曰∶《金匮》外尚有可行之法否？
曰∶若能熟读而得其精微，任产后之病变百出，无难一举而安之。若逐症而分治之，即千百方尚有遗漏，如《嵩崖
尊生》、《东医宝鉴》，胪列可谓详矣，试问能愈一症否乎？然而钟期老矣，古调独弹奚为乎？不得已而从俗尚，遂于坊刻
各种，择出二十三种，虽云浅率，却不离经，亦姑录之于下。
王叔和曰∶产后脉，寸口洪疾不调者死，沉微附骨不绝者生。又曰∶沉小滑者生，实大坚弦急者死。朱丹溪曰∶胎
前脉当洪数，既产而脉仍洪数者死。又曰∶胎前脉细小，产后脉洪大者多死。《济生产经》曰∶胎前之病，其脉贵实；产
后之病，其脉贵虚；胎前则顺气安胎，产后则扶虚消瘀，此其要也。《脉要》曰∶欲产之脉，必见离经，或沉细而滑，夜
半觉痛，来朝日中必娩。新产之脉，缓滑为吉；若实大、弦急，近乎无胃凶危之候；或寸口涩疾不调，恶症立见；惟宜
沉细附骨不绝，虽剧无恙。《大全》曰∶产后饮热童便一盏，不得便卧，宜闭目而坐须臾，上床宜仰卧，不宜侧坐，宜竖
膝，不宜伸足，高倚床头，浓铺被褥，遮围四壁，使无孔隙，免致贼风；以醋熏鼻，或用醋炭，更烧漆器，频以手从心
至脐下以防血晕、血逆。如此三日，不问腹痛不痛，以童便和酒服五七次。酒虽行血，亦不可多，恐引血入四肢，能
令血晕。宜频食白粥，渐食羊肉、猪蹄少许，仍慎言语、七情、寒暑、梳头、洗足，以百日为度。若气血素弱者，不计
月日，否则患手、足、腰、腿酸痛等症，名曰褥劳，最难治疗。初产时，不可问是男是女，恐因言语而泄气，或以爱憎
而动气，皆能致病。不可独宿，恐致虚惊；不可刮舌，恐伤心气；不可刷齿，恐致血逆；须气血平复，方可治事。犯时
微若秋毫，成病重如山岳，可不戒哉？！《产宝新书》曰∶产后血气暴虚，理当大补，但恶露未尽，用补恐致滞血，惟生
化汤行中有补，能生又能化，其方因药性功用而立名也。产后血块当消，而又必随生其新血，若专用消，则新血受削；
专用生，则旧血反留。考诸药性，芎、归、桃仁三味，善攻旧血，骤生新血；佐以黑姜、炙草，引三味入于肺肝，生血
利气；五味共方，行中有补，实产后圣药也。
（长孙男心典禀）按∶产妇胞衣一破，速煎一贴，候儿头下地即服，不拘半产、正产，虽平安少壮妇无恙者，俱服
一二剂，以消血块而生新血，自无血晕之患。若胎前素弱，至产后见危症，不厌频服，病退即止；若照常日服一剂，可
扶将绝之气血也。如血块痛，加肉桂三分，红花三分，益母草五钱。如产后劳甚血崩，形色虚脱，加人参三、四钱。如
汗出气促，人参倍加。
《大全》曰∶产后血晕者，由败血流入肝经，眼生黑花，头目旋晕，不能起坐，昏闷不省人事，谓之血晕。此血热
乘虚，逆上凌心，故昏迷不省，气闭欲绝也，服童便最好。陈良甫曰∶产后瘀血崩心，因分娩后不食童便，以致虚火炎
上也。用鹿角烧灰，童便调下即醒，此物行血极效。又用五灵脂半生、半熟，名独行散；又用返魂丹，即益母丸也。崔
氏曰∶产妇分娩讫，将秤锤或黄石子入炭中，烧令通赤，置器中，于床前以醋沃之，可除血晕，时作为佳。或先取酿醋
以涂口鼻，仍置醋于旁，淬火炭使闻其气。又一法，烧干漆，令烟熏产母之面，即醒；如无干漆，旧漆器烧烟亦炒。单
养贤曰∶产后寒气上攻则心痛，下攻则腹痛。并血块者，宜服生化汤加桂末，止加吴茱萸、姜三片助血；若独用诸热药
攻寒，其痛难止，其血未免来多，以伤产母也。《产宝百问》曰∶产后四肢浮肿，由败血乘虚停积，循经流入四肢，留淫
日深，腐坏如水，故令面黄，四肢浮肿。医人不识此症，作水气治之，凡治水多用导水药，极虚人产后既虚，又以药虚
之，是谓重虚，多致大狂，服小调经散，行血肿消则愈。朱丹溪曰∶产后肿，必用大补气血为主，少佐苍术、茯苓，使
水自利。薛立斋曰∶前症若寒水侮土，宜养脾肺；若气虚浮肿，宜益脾胃；若水气浮肿，宜补中气。又曰∶产后浮肿或
兼喘咳，脉沉细无力，此命门火衰，脾土虚寒，八味丸主之。吴蒙斋曰∶新产后伤寒，不可轻易发汗。或产时有伤力发
热；去血过多发热；有恶露不去发热；有三日蒸乳发热；有因劳动、饮食停滞发热，状类伤食；要在仔细详辨，切不可
发汗。大抵产后大血空虚，汗之则变，筋惕肉 ，或郁冒昏迷，或搐搦，或便秘，其害非轻。凡有发热，宜与四物为君，
加柴胡、人参、炮姜最效。盖干姜辛热，能引血药入血分，气药入气分，且能去恶生新，有阳生阴长之道，以热治热，
深合《内经》之旨。朱丹溪曰∶产后发热，此热非有余之热，乃阴虚生内热耳，以补阴药大剂服之。必用干姜者何也？
曰∶干姜能入肺利气，入肝经引血药生血；然不可独用，与补阴药同用，此造化自然之妙。王节斋曰∶妇人产后阴虚，
阳无所根据，浮散于外，故热；以四物汤补血，以炙干姜之苦温从治，收其浮散之阳以归于阴也。赵养葵曰∶产后大失血，
阴血暴亡，必大发热，名阴虚发热。此阴字正谓气血之阴，若以凉药正治必毙，正所谓症象白虎，误服白虎必死。此时
偏不用四物，有形之血不能骤生，几希之气须当急护，宜用独参汤或当归补血汤，使无形生出有形来，阳生阴长之妙，
不可不知也。武叔卿曰∶产后阴虚、血弱发热，四物加茯苓，热甚加炮姜。此方全不用气药，是血虚气不虚也。加茯苓
者，使天气降而阴自生，阴生则热自退。热甚加炒干姜者，取从阳引阴，亦可从阴引阳。微乎！微乎！郭稽中曰∶产后
乍寒乍热者何？曰∶阴阳不和与败血不散，皆令乍寒乍热也。二者何以别之？曰∶时有剌痛者，败血也；但寒热无他症
者，阴阳不和也。薛立斋曰∶人所主者心，心所主者血，心血一虚，神气不守，惊悸所由来也，当补血气为主。《产宝百
问》曰∶产后虚羸，渐成蓐劳，皆由产下亏损血气所致。须慎起居，节饮食，调养百日，庶保无疾。若中年反难产者，
勿论日期，必须调养平复，方可动作；否则，气血复伤，虚羸之症作矣。薛立斋曰∶蓐劳，当扶养正气为主。多因脾胃
虚弱，饮食减少，致诸经疲惫，当补脾胃；饮食一进，精气生化，诸脏有所赖，其病自愈。《产乳集》曰∶产后小便不通，
腹胀如鼓，闷乱不醒，盖由未产前内积冷气，遂致产后尿胞受病。用盐于脐中填平，用葱白捣一指浓，安盐上，以艾炷
葱饼上灸之，觉热气入腹内，实时便通神验。朱丹溪曰∶有收生不谨，损破产妇尿脬，致病淋漓，用猪羊胞煎汤入药，
参、 为君，归、地为佐，桃仁、陈皮、茯苓为使，于极饥时饮之；令气血骤长，其胞自完，稍缓亦难成功也。《医暇
言》曰∶女子产育，哺养以乳，乳之体，居经络、气血之间也。盖自寅时始于手太阴肺经，出于云门穴（穴在乳上）；阴
阳继续以行，周十二经，至丑时归于足厥阴肝经，入于期门穴（穴在乳下）；出于上，入于下，肺领气，肝藏血，乳正居
于其间也。萧慎斋曰∶妇人以血用事，上为乳汁，下为月水；而血之所化，则本于脾胃，饮食之精微营运，而为乳、为
经。产后脾胃之气旺，则血旺而乳多，脾胃之气衰，则血减而乳少，此立斋通乳汁以壮脾胃滋化源为要也。若罔顾脾胃
以补气血，徒从事于通乳之剂，是犹求千金于乞丐而不可得矣。《达生篇》曰∶通乳用黄 一两，当归五钱，白芷、木通
小柴胡汤、大承气汤（均见于《伤寒论》）
当归生姜羊肉汤
当归（三两） 生姜（五两） 羊肉（一斤）
以上三味药，用水八升，煮取三升，每次温服七合，每日服用三次。
如果寒气重，将生姜加至一斤；如果疼痛剧烈且伴有呕吐，加橘皮二两、白术一两；若加了生姜，也需加水五升，煮取三升二合服用。
歌诀说：腹痛胁痛（腹胁部皆由寒气主导，界限模糊），拘急难忍（这是体内营血不足，导致阴气无法濡养而拘急）。一斤羊肉、五两生姜、三两蜀地当归，如今的豆蔻香砂疗法，可笑那些庸医以此作为指南。
（次子元犀）按语：方中当归能疏通血分的瘀滞以止痛，生姜能宣通气分的郁滞以止痛，这也是人们容易理解的。妙处在于大量使用羊肉，羊肉是气血有情之品，气味腥浓，咽下后，便与体内的浊阴融为一体，随即得到当归的活血作用，使血中的瘀滞得以通畅；生姜的利气作用，使气中的郁滞得以通畅；通则不痛，寒气便无处潜藏，这就是所谓先透发出来，然后再攻逐邪气的道理。如果病人因为羊肉过于滋补而产生疑虑，那就是被世俗的说法所局限，其中自有深意，懂得事物细微征兆的人应当婉言谢绝。
枳实芍药散
枳实（炒至黑色，但不要过头） 芍药（等分）
以上两味药，捣碎过筛为散，每次服用一方寸匕，每日三次。同时也主治痈脓，用大麦粥送服。
歌诀说：腹胀烦闷不能入睡，腹部频繁疼痛，枳实微烧，芍药分量相等；当归生姜羊肉汤的方法应反过来看（彼方治疗没有烦满症状的虚性疼痛，此方治疗有烦满症状的实性疼痛）。散剂用大麦（粥）调服，稳妥而新鲜。
（长子蔚）按语：枳实能疏通气机郁滞，芍药能疏通血液瘀滞，通则不痛，这是人所共知的。妙处在于枳实炒黑，借助火化之力善于攻破停滞积聚；用大麦粥送服，能调和肝气并兼养心脾；这是在行滞之中蕴含补养之意，所以也主治痈脓。
下瘀血汤
大黄（三两） 桃仁（二十个） 䗪虫（二十枚，去足，熬制）
以上三味药研成粉末，用炼蜜和制成四丸，用酒一斤，煮一丸，取汁八合，一次性顿服，瘀血排出如猪肝状。（各版本略有差异。）
歌诀说：脐中固定疼痛是因为瘀血作祟，二十粒桃仁配三两大黄，还有䗪虫二十个，用酒煎煮大下瘀血又有什么伤害？
（次子元犀）按语：产妇腹痛，服用枳实、芍药后不愈的，是因为热邪灼伤血液干枯，形成停瘀，疼痛固定在脐下，适宜使用此汤。方中大黄、桃仁推陈出新、下泄瘀血，䗪虫善于攻破干血，人们都知道这些。妙处在于桃仁一味药，在平淡中大有功效。因为血液已经败坏成为瘀血，不得到生机就不能流通，桃树得三月春和之气，花朵最鲜明似血，而其生机都在果仁中，且味道苦又能开泄，所以直接入血中调和消散它，驱逐旧血而不损伤新血。
阳旦汤 即桂枝汤加倍桂枝并增加附子。坊间刻本说是加入黄芩的，不知道《伤寒论·太阳篇》中已经明确说明了这个方子。孙思邈及各家都搞错了。
（桂枝汤见《伤寒论》。）
竹叶汤
竹叶（一把） 葛根（三两） 防风 桔梗 桂枝 人参 甘草（各一两） 附子（一枚，炮制） 生姜（五两） 大枣（十五枚，劈开）
以上十味药，用水一斗，煎煮取二升半，分三次温服，服药后覆盖衣被使其微微出汗。如果头项强直，用大附子一枚，破开如豆大，煎药时扬去沫；如果呕吐，加半夏半升洗净。
歌诀说：气喘发热头痛面色正红（病情即将发展成痉病。一两），防风、桔梗、桂枝、甘草、人参同用（各用一两）。葛根（三两）、生姜（五两）、附子一枚；大枣十五枚、竹叶一把充数。
加减歌诀说：头项强直用大附子替代，以大换小性质不同；如果是气逆更建议添加，半夏半升洗七次。
程云来说：症状中尚未达到角弓反张，但出现发热、面赤、头痛，也是风痉的渐进表现。所以用竹叶主治风痉，防风治疗内痉，葛根治疗刚痉，桂枝治疗柔痉，生姜疏散风邪，桔梗祛除风痹，这是辛散之剂。又佐以人参生津液以滋养筋脉，附子补火以助水，配合甘草调和诸药，大枣辅助十二经；配合各种治风药物，则是发汗中有补益，是产后中风的大方。
竹皮大丸
生竹茹 石膏（各二分） 桂枝（一分） 白薇（一分） 甘草（七分）
以上五味药，研成粉末，用枣肉和丸，如弹子大小，饮水送服一丸，白天服三次，晚上服两次。如果有热，加倍白薇；如果烦闷气喘，加柏实一分。
歌诀说：呕吐而烦乱是由于乳中虚（指哺乳期间，气虚火旺，内部紊乱而上逆）。二分石膏与竹茹，白薇桂枝各一分加甘草七分，枣肉丸饮水送服效果徐徐显现。
加减歌诀说：白薇退热绝妙神奇，有热时加倍记住。柏实得金气浓厚深沉，叶子叶叶向西回归本位；果实中的仁又能镇心安神，烦喘可加一分服用。（解释见本论）
白头翁加甘草阿胶汤（汤方见《伤寒论》。再加甘草、阿胶各二两即是。）老师说：产后下利极度虚弱的，以此方为主治。
歌诀说：白头翁汤已在前面歌诀中提到，二两阿胶甘草调和；产后下利虚弱至极症，滋阴（阿胶救其阴）而且缓急（甘草缓其急），不要轻易放过。
（次子元犀）按语：凡是产后失血过多，又兼下利亡失津液，这无疑是阴虚。这里说“虚极”，按理应该大补，但是当归、川芎、芍药、地黄则会增加滑利而导致下脱，人参、白术、桂枝、干姜则会动阳气而上逆，这些都是禁忌药剂。须知这里的“虚”字，指的是阴虚而言，与少阴证阴气欲绝意义相同。少阴证用大承气汤急下以救阴，与此证用白头翁汤大苦寒以救阴意义相同。这种方法不是薛立斋、张景岳、李士材等人以甘温为主、忌讳苦寒的人所能窥测的。尤其妙在加入甘草的甘味，合四味药的苦味，构成苦甘化阴法；而且久痢导致膏脂尽脱，脉络空虚，得到阿胶的滋润，合四味药的苦味以坚敛，则源流俱清而痢疾自止。
千金三黄散
黄芩（一两） 苦参（二两） 干地黄（四两）
以上三味药，用水六升，煮取二升，温服一升。多用于下利有虫的情况。
千金内补当归建中汤
当归（四两） 桂枝 生姜（各三两） 芍药（六两） 甘草（二两） 大枣（十二枚）
以上六味药，用水一斗，煮取三升，分三次温服，一天内服完。如果非常虚弱，加饴糖六两，汤成后放在火上暖令饴糖融化；如果失血过多，崩漏或鼻衄不止，加地黄六两、阿胶二两，合为八味药，汤成后纳入阿胶。如果没有当归，用川芎代替；如果没有生姜，用干姜代替。
门人问：《金匮要略》之外还有可行的方法吗？
回答说：如果能熟读并掌握其精微之处，任凭产后病变百出，不难一举安定它。如果针对每个症状分别治疗，即使有成千上百个方子也会有遗漏，像《嵩崖尊生》、《东医宝鉴》，罗列可谓详细了，试问能治愈一个症状吗？然而知音已老，古调独弹有何意义呢？不得已而顺从世俗风尚，于是从坊间刻印的各种书籍中，选出二十三种，虽然说是浅显粗略，却不背离经典，也姑且记录在下面。
王叔和说：产后脉象，寸口洪大疾速不调者死，沉微按之不绝者生。又说：沉小滑者生，实大坚弦急者死。朱丹溪说：产前脉当洪数，分娩后脉仍洪数的死。又说：产前脉细小，产后脉洪大的多死。《济生产经》说：产前之病，脉象贵在实；产后之病，脉象贵在虚；产前则顺气安胎，产后则扶虚消瘀，这是要点。《脉要》说：临产之脉，必见离经脉，或沉细而滑，半夜觉得痛，第二天中午必定分娩。新产之脉，缓滑为吉；如果实大、弦急，近乎无胃气的凶危征候；或者寸口涩疾不调，恶症立即出现；只宜沉细按之不绝，虽然病重也无恙。《大全》说：产后饮一盏热童便，不得躺卧，宜闭目坐一会儿，上床宜仰卧，不宜侧坐，宜竖膝，不宜伸足，高倚床头，厚铺被褥，遮围四壁，使无孔隙，以免贼风侵袭；用醋熏鼻子，或用醋炭，再烧漆器，频繁用手从心向下至脐下按摩以防血晕、血逆。如此三天，不问腹痛不痛，用童便和酒服用五到七次。酒虽能行血，也不可多喝，恐怕引血入四肢，能导致血晕。宜频繁食用白粥，逐渐少量食用羊肉、猪蹄，仍慎言语、七情、寒暑、梳头、洗脚，以一百天为限度。如果气血素来虚弱，不计月日，否则患手、足、腰、腿酸痛等症状，名叫褥劳，最难治疗。初产时，不可问是男是女，恐怕因言语而泄气，或以爱憎而动气，都能致病。不可独宿，恐致虚惊；不可刮舌，恐伤心气；不可刷牙，恐致血逆；须气血平复，方可处理事务。犯禁时轻微如秋毫，成病重如山岳，能不戒慎吗？！《产宝新书》说：产后血气暴虚，理当大补，但恶露未尽，用补恐怕导致滞血，只有生化汤行中有补，能生又能化，其方名是因药性功用而立名的。产后血块应当消除，而又必须随之生成新血，如果专用消法，则新血受削损；专用生法，则旧血反而留存。考察诸药性，川芎、当归、桃仁三味，善于攻破旧血，迅速生成新血；佐以黑姜、炙甘草，引导这三味药进入肺肝，生血利气；五味共成一方，行中有补，实在是产后圣药。
（长孙心典禀告）按语：产妇胞衣一破，迅速煎好一贴药，等候胎儿头部落地即服，不拘流产、足月产，即使是平安少壮妇女无恙者，也都服用一二剂，以消除血块而生新血，自然没有血晕的祸患。如果产前素来虚弱，到产后出现危症，不厌其烦地频繁服用，病退就停止；如果照常每天服一剂，可以扶持将绝的气血。如果有血块疼痛，加肉桂三分，红花三分，益母草五钱。如果产后劳损严重血崩，形色虚脱，加人参三、四钱。如果汗出气促，人参加倍。
《大全》说：产后血晕，是由败血流入肝经，眼生黑花，头目旋转眩晕，不能起坐，昏闷不省人事，叫做血晕。这是血热乘虚，逆上凌心，所以昏迷不省，气闭欲绝，服用童便最好。陈良甫说：产后瘀血崩心，因为分娩后不喝童便，以致虚火炎上。用鹿角烧灰，童便调下即醒，此物行血极有效。又用五灵脂半生、半熟，名叫独行散；又用返魂丹，就是益母丸。崔氏说：产妇分娩完毕，将秤锤或黄石子放入炭中，烧得通红，置于容器中，在床前用醋浇淋，可除血晕，经常制作为佳。或者先取酿醋涂于口鼻，仍将醋放在旁边，淬火炭使其闻其气味。又一法，烧干漆，让烟熏产妇的面部，即醒；如果没有干漆，烧旧漆器的烟也可以。单养贤说：产后寒气上攻则心痛，下攻则腹痛。并伴有血块的，宜服生化汤加桂末，只加吴茱萸、姜三片助血；如果单独用各种热药攻寒，其痛难止，其血未免增多，从而伤害产母。《产宝百问》说：产后四肢浮肿，由败血乘虚停积，循经流入四肢，留滞日久，腐坏如水，所以令面色黄，四肢浮肿。医生不认识此症，当作水气治疗，凡治水多用导水药，对于极虚之人，产后既已虚弱，又以药虚之，这叫重虚，多导致大狂，服用小调经散，行血肿消则痊愈。朱丹溪说：产后肿，必须用大补气血为主，少佐苍术、茯苓，使水自行排出。薛立斋说：前症如果是寒水侮土，宜养脾肺；如果是气虚浮肿，宜益脾胃；如果是水气浮肿，宜补中气。又说：产后浮肿或兼喘咳，脉沉细无力，这是命门火衰，脾土虚寒，八味丸主治。吴蒙斋说：新产后伤寒，不可轻易发汗。或者产时有伤力发热；去血过多发热；有恶露不去发热；有三日蒸乳发热；有因劳动、饮食停滞发热，状类伤食；要在仔细详辨，切不可发汗。大抵产后大血空虚，发汗则变生他症，筋惕肉瞤，或郁冒昏迷，或抽搐，或便秘，其害非轻。凡有发热，宜以四物汤为君药，加柴胡、人参、炮姜最效。盖干姜辛热，能引血药入血分，气药入气分，且能去恶生新，有阳生阴长之道，以热治热，深合《内经》之旨。朱丹溪说：产后发热，此热不是有余之热，乃是阴虚生内热耳，以补阴药大剂服用。必用干姜为什么呢？回答说：干姜能入肺利气，入肝经引血药生血；然不可独用，与补阴药同用，这是造化自然之妙。王节斋说：妇人产后阴虚，阳无所依，浮散于外，所以发热；以四物汤补血，以炙干姜之苦温从治，收其浮散之阳以归于阴。赵养葵说：产后大失血，阴血暴亡，必大发热，名叫阴虚发热。这个阴字正谓气血之阴，如果用凉药正治必死，正所谓症象白虎，误服白虎必死。此时偏不用四物，有形之血不能骤生，几希之气须当急护，宜用独参汤或当归补血汤，使无形生出有形来，阳生阴长之妙，不可不知。武叔卿说：产后阴虚、血弱发热，四物加茯苓，热甚加炮姜。此方全不用气药，是血虚气不虚也。加茯苓者，使天气降而阴自生，阴生则热自退。热甚加炒干姜者，取从阳引阴，亦可从阴引阳。微妙啊！微妙啊！郭稽中说：产后乍寒乍热是什么原因？回答说：阴阳不和与败血不散，都令乍寒乍热。二者如何区别？回答说：时有刺痛的是败血；但寒热无其他症状的是阴阳不和。薛立斋说：人所主者是心，心所主者是血，心血一虚，神气不守，惊悸由此而来，应当以补血气为主。《产宝百问》说：产后虚羸，渐成蓐劳，都是由产下亏损血气所致。须慎起居，节饮食，调养百日，庶保无疾。如果中年难产者，不论日期，必须调养平复，方可动作；否则，气血复伤，虚羸之症发作。薛立斋说：蓐劳，当扶养正气为主。多因脾胃虚弱，饮食减少，致诸经疲惫，当补脾胃；饮食一进，精气生化，诸脏有所赖，其病自愈。《产乳集》说：产后小便不通，腹胀如鼓，闷乱不醒，大概由于未产前内积冷气，遂致产后尿胞受病。用盐于脐中填平，用葱白捣一指厚，安盐上，以艾炷灸葱饼上，觉热气入腹内，实时便通神验。朱丹溪说：有收生不谨，损破产妇尿脬，致病淋漓，用猪羊胞煎汤入药，人参、黄芪为君，当归、地黄为佐，桃仁、陈皮、茯苓为使，于极饥时饮之；令气血骤长，其胞自完，稍缓亦难成功也。《医暇言》说：女子产育，哺养以乳，乳之体，居经络、气血之间也。盖自寅时始于手太阴肺经，出于云门穴（穴在乳上）；阴阳继续以行，周十二经，至丑时归于足厥阴肝经，入于期门穴（穴在乳下）；出于上，入于下，肺领气，肝藏血，乳正居于其间也。萧慎斋说：妇人以血用事，上为乳汁，下为月水；而血之所化，则本于脾胃，饮食之精微营运，而为乳、为经。产后脾胃之气旺，则血旺而乳多，脾胃之气衰，则血减而乳少，这是立斋通乳汁以壮脾胃滋化源为要也。如果罔顾脾胃以补气血，徒从事于通乳之剂，是犹求千金于乞丐而不可得矣。《达生篇》说：通乳用黄芪一两，当归五钱，白芷、木通
Xiao Chai Hu Tang (Minor Bupleurum Decoction) and Da Cheng Qi Tang (Major Order the Qi Decoction) (both seen in *Shang Han Lun* / Treatise on Cold Damage).
Dang Gui Sheng Jiang Yang Rou Tang (Angelica Ginger Mutton Decoction).
Dang Gui (3 liang), Sheng Jiang (5 liang), Yang Rou (1 jin).
Take the above three ingredients, add 8 sheng of water, decoct to obtain 3 sheng. Take 7 ge warm each time, three times a day.
If cold is predominant, increase Sheng Jiang to 1 jin; if pain is severe accompanied by vomiting, add Ju Pi (2 liang) and Bai Zhu (1 liang); if Sheng Jiang is added, also add 5 sheng of water, decoct to obtain 3 sheng 2 ge, and take it.
The song states: Abdominal and hypochondriac pain (the abdomen and hypochondrium are both primarily caused by cold qi, with no clear boundary), unbearable urgency (this indicates insufficient Ying blood internally, causing Yin qi to fail to nourish and resulting in tension). One jin of mutton, five liang of ginger, three liang of Shu Dang Gui. The modern methods using Dou Kou (Cardamom) and Xiang Sha (Amomum and Aucklandia) are laughable as guides for blind physicians.
(Second son Yuan Xi) Commentary: In this formula, Dang Gui (Angelicae Sinensis Radix) moves stagnation in the Blood aspect to relieve pain, and Sheng Jiang (Zingiberis Rhizoma Recens) disseminates stagnation in the Qi aspect to relieve pain, which is easily understood by people. The brilliance lies in the large amount of Yang Rou (Mutton). Mutton is a substance with emotion containing Qi and Blood, with a strong fishy odor. After swallowing, it mixes with turbid Yin, and then, aided by Dang Gui's ability to invigorate blood, stagnation in the blood is unblocked; aided by Sheng Jiang's ability to promote Qi movement, stagnation in the Qi is unblocked. When there is free flow, there is no pain, and cold qi has no place to hide. This is what is meant by first venting it out, then attacking it. If the patient doubts the mutton because it is too tonifying, they are confined by vulgar views. There is profound meaning within; those who understand subtle signs should politely decline.
Zhi Shi Shao Yao San (Immature Bitter Orange and Peony Powder).
Zhi Shi (stir-baked until black, but not too much), Shao Yao (equal parts).
Crush the above two ingredients into a powder. Take one fang cun bi (square-inch spoonful) each time, three times a day. It also mainly treats carbuncles and pus. Administer with Barley Porridge.
The song states: Fullness, vexation, inability to sleep, frequent abdominal pain; Zhi Shi slightly burnt, Shao Yao equal in proportion; The method of the Mutton Decoction should be viewed oppositely (That one treats deficiency pain without fullness/vexation; this one treats excess pain with fullness/vexation). Powder mixed with Barley (Porridge) is steady and fresh.
(Elder son Wei) Commentary: Zhi Shi (Aurantii Fructus Immaturus) promotes the flow of Qi stagnation, and Shao Yao (Paeoniae Radix Alba/Rubra) promotes the flow of Blood stagnation. Free flow means no pain, which is common knowledge. The brilliance lies in Zhi Shi being charred black, utilizing fire transformation to effectively attack stagnant accumulation. Administering with Barley Porridge harmonizes Liver Qi and nourishes Heart and Spleen; thus, it contains the intention of nourishment within moving stagnation, so it also treats carbuncles and pus.
Xia Yu Xue Tang (Downward Discharge Stasis Decoction).
Da Huang (3 liang), Tao Ren (20 kernels), E Chong (20 pieces, feet removed, roasted).
Powder the above three ingredients. Mix with refined honey to form four pills. Boil one pill in 1 jin of wine, obtain 8 ge, and take it all at once. Stasis will discharge resembling pig liver. (Variations exist among editions.)
The song states: Fixed pain in the umbilicus is caused by stasis; twenty Tao Ren kernels and three liang Da Huang; plus twenty E Chong worms, why would boiling in wine and purging stasis cause harm?
(Second son Yuan Xi) Commentary: For postpartum abdominal pain that does not resolve after taking Zhi Shi and Shao Yao, it is due to heat scorching the blood causing dryness and stasis retention, with pain fixed below the umbilicus. This decoction is appropriate. People know that Da Huang (Rhei Radix et Rhizoma) and Tao Ren (Persicae Semen) push out old material and discharge stasis, while E Chong (Eupolyphaga/Steleophaga) excels at attacking dry stasis. The brilliance lies in Tao Ren alone, which has great efficacy despite appearing ordinary. Since blood has deteriorated into stasis, it cannot circulate without receiving vital energy. Peach trees receive the harmonious Qi of March spring, their flowers are most vivid like blood, and their vital energy resides in the kernel. Its bitter taste can open and drain, so it directly enters the blood to harmonize and scatter it, driving out the old without injuring the new.
Yang Dan Tang is Gui Zhi Tang (Cinnamon Twig Decoction) with doubled Gui Zhi and added Fu Zi (Aconiti Lateralis Radix Praeparata). Shop editions claim it adds Huang Qin (Scutellariae Radix), not knowing that *Shang Han Lun · Tai Yang Chapter* already clearly specifies this formula. Sun Simiao and other schools were mistaken.
(Gui Zhi Tang is seen in *Shang Han Lun*.)
Zhu Ye Tang (Bamboo Leaf Decoction).
Zhu Ye (one handful), Ge Gen (3 liang), Fang Feng, Jie Geng, Gui Zhi, Ren Shen, Gan Cao (each 1 liang), Fu Zi (one piece, processed), Sheng Jiang (5 liang), Da Zao (15 pieces, split).
Take the above ten ingredients, add 1 dou of water, decoct to obtain 2.5 sheng. Divide into three warm doses. Cover with blankets to induce slight sweating. If there is stiffness in the head and neck, use one large Fu Zi, break it into bean-sized pieces, decoct with the medicine, and skim off the foam. If there is vomiting, add Ban Xia (0.5 sheng, washed).
The song states: Panting, fever, headache, face red (condition about to become spasmodic. 1 liang); Fang Feng, Jie Geng, Gui Zhi, Gan Cao, Ren Shen used together (each 1 liang). Ge Gen (3 liang), Sheng Jiang (5 liang), one Fu Zi; fifteen Da Zao and one handful of Zhu Ye suffice.
Addition Song: For head and neck stiffness, substitute with large Fu Zi; using large instead of small changes the nature; if it is rebellious Qi, consider adding Ban Xia half a sheng washed seven times.
Cheng Yunlai said: The symptoms have not yet reached opisthotonos, but fever, red face, and headache are gradual signs of wind-spasm. Therefore, Zhu Ye is used to govern wind-spasm, Fang Feng treats internal spasm, Ge Gen treats rigid spasm, Gui Zhi treats flaccid spasm, Sheng Jiang disperses wind pathogen, Jie Geng removes wind-bi. These are acrid agents to disperse. Assisted by Ren Shen to generate fluids and nourish sinews, Fu Zi to tonify Fire to reach Water, combined with Gan Cao to harmonize herbs, and Da Zao to assist the twelve meridians; together with various wind-resolving agents, this is a major formula for postpartum wind-stroke where release includes tonification.
Zhu Pi Da Wan (Bamboo Skin Large Pill).
Sheng Zhu Ru (2 fen), Shi Gao (2 fen), Gui Zhi (1 fen), Bai Wei (1 fen), Gan Cao (7 fen).
Powder the above five ingredients. Mix with jujube flesh to form pills the size of an egg. Take one pill with water, three times during the day and twice at night. If there is heat, double Bai Wei; if there is vexation and panting, add Bai Shi (1 fen).
The song states: Vomiting with vexation and chaos is due to emptiness in the breast (referring to the time of nursing, when Qi deficiency leads to excessive Fire, causing internal disorder and upward rebellion). Two fen Shi Gao and Zhu Ru; one fen Bai Wei and Gui Zhi plus seven fen Gan Cao; taken as jujube pills with water, effect is gradual.
Addition Song: Bai Wei retreats heat with miraculous effect; remember to double it when there is heat. Bai Shi obtains Metal Qi, thick and deep, leaves facing west returning to origin; the kernel inside calms the Heart, add one fen for vexation and panting. (Explanation seen in this treatise.)
Bai Tou Weng Jia Gan Cao E Jiao Tang (Belleriphage Plus Licorice and Donkey-hide Gelatin Decoction) (Decoction seen in *Shang Han Lun*. Add Gan Cao and E Jiao, each 2 liang.) The Master said: For postpartum dysentery with extreme deficiency, this is the primary treatment.
The song states: Bai Tou Weng Decoction was mentioned in previous songs; two liang E Jiao and Gan Cao harmonize; Postpartum dysentery becoming extremely deficient syndrome; Nourishing (E Jiao saves Yin) and relieving urgency (Gan Cao relieves urgency), do not lightly pass over.
(Second son Yuan Xi) Commentary: Whenever postpartum blood loss is excessive, accompanied by dysentery losing body fluids, this is undoubtedly Yin deficiency. Here "extreme deficiency" logically suggests major tonification, but Dang Gui, Xiong, Shao, Di would increase slipperiness leading to prolapse; Ren Shen, Zhu, Gui, Jiang would move Yang leading to rebellion; these are all contraindicated. Note that the word "deficiency" here refers to Yin deficiency, synonymous with Shaoyin syndrome where Yin Qi is about to perish. Shaoyin syndrome uses Da Cheng Qi Tang for urgent purging to save Yin; this syndrome uses Bai Tou Weng Tang with great bitterness to save Yin. This method cannot be fathomed by figures like Xue Lizhai, Zhang Jingyue, Li Shicai who prioritize sweet-warm and forbid bitter-cold. Especially brilliant is adding Gan Cao's sweetness combined with the bitterness of the four ingredients, forming the method of "bitter-sweet transforming into Yin"; moreover, long-term dysentery depletes essence and empties collaterals; receiving E Jiao's moistening combined with the bitterness of the four ingredients to consolidate, the source and stream are cleared, and dysentery stops naturally.
Qian Jin San Huang San (Thousand Gold Three Yellows Powder).
Huang Qin (1 liang), Ku Shen (2 liang), Gan Di Huang (4 liang).
Take the above three ingredients, add 6 sheng of water, decoct to obtain 2 sheng. Take 1 sheng warm. Used for dysentery with worms.
Qian Jin Nei Bu Dang Gui Jian Zhong Tang (Thousand Gold Internal Tonifying Angelica Building Middle Decoction).
Dang Gui (4 liang), Gui Zhi, Sheng Jiang (each 3 liang), Shao Yao (6 liang), Gan Cao (2 liang), Da Zao (12 pieces).
Take the above six ingredients, add 1 dou of water, decoct to obtain 3 sheng. Divide into three warm doses, consume within one day. If very deficient, add Yi Tang (6 liang); after decoction, place on fire to warm until Yi Tang dissolves. If blood loss is excessive, with metrorrhagia or epistaxis not stopping, add Di Huang (6 liang) and E Jiao (2 liang), making eight ingredients; after decoction, add E Jiao. If Dang Gui is unavailable, substitute Chuan Xiong; if Sheng Jiang is unavailable, substitute Gan Jiang.
Disciple asked: Are there feasible methods outside *Jin Gui*?
Answer: If one can read thoroughly and grasp the subtleties, regardless of how myriad postpartum pathologies arise, it is easy to pacify them with one move. If treating each symptom separately, even thousands of formulas may have omissions. Works like *Song Ya Zun Sheng* and *Dong Yi Bao Jian* list details exhaustively, yet ask if they can cure a single symptom? However, the connoisseur grows old, why play ancient tunes alone? Reluctantly yielding to popular trends, I selected twenty-three from various shop-printed books. Though shallow and rough, they do not depart from classics, and are recorded below for reference.
Wang Shuhe said: Regarding postpartum pulse, if Cun Kou is surging, rapid, and irregular, death ensues; if deep, faint, and unceasing upon pressing to the bone, life is preserved. He also said: Deep, small, and slippery pulses indicate survival; solid, large, firm, wiry, and rapid pulses indicate death. Zhu Danxi said: Prenatal pulse should be surging and rapid; if postpartum pulse remains surging and rapid, death ensues. He also said: Prenatal pulse small and fine; postpartum pulse surging and large often results in death. *Ji Chan Sheng Jing* said: For prenatal diseases, the pulse should be solid; for postpartum diseases, the pulse should be empty; prenatal care involves smoothing Qi and calming fetus, postpartum care involves supporting deficiency and resolving stasis; this is the key. *Mai Yao* said: Pulse before delivery must show Li Jing (departing from normal), or deep, fine, and slippery; pain felt at midnight ensures delivery by noon next day. Pulse after new delivery, slow and smooth is auspicious; if solid, large, wiry, rapid, it approaches the ominous sign of no Stomach Qi; or if Cun Kou is choppy, rapid, and irregular, evil symptoms appear immediately; only deep, fine, and unceasing upon pressing is safe, even if severe. *Da Quan* said: Drink a cup of hot child urine after delivery, do not lie down immediately, sit with eyes closed for a moment; when getting into bed, lie supine, not side-lying; keep knees upright, not extended; prop head high on bedhead, lay thick bedding, surround walls to prevent gaps avoiding thief wind; fumigate nose with vinegar or vinegar charcoal, burn lacquer ware frequently, rub hand from heart down to umbilicus to prevent blood dizziness and rebellion. For three days, whether abdominal pain exists or not, take five to seven times child urine mixed with wine. Wine moves blood but should not be drunk excessively, lest it draw blood to limbs causing dizziness. Frequently eat white porridge, gradually eat small amounts of mutton and pig trotters, still avoid speech, emotions, cold/heat, combing hair, washing feet, lasting one hundred days. If Qi and Blood are inherently weak, ignore months/days; otherwise, suffer soreness/pain in hands, feet, waist, legs, named "Bed Labor," hardest to treat. At initial delivery, do not ask gender, lest speech leak Qi, or love/hate move Qi, both causing disease. Do not sleep alone, lest cause deficiency fright; do not scrape tongue, lest damage Heart Qi; do not brush teeth, lest cause blood rebellion; only handle affairs after Qi and Blood stabilize. Violating rules initially minor as autumn hair, becomes illness heavy as mountain, can one not beware?! *Chan Bao Xin Shu* said: Postpartum Qi and Blood suddenly deficient,理应 major tonification, but lochia not finished, tonification fears stagnating blood; only Sheng Hua Tang moves with tonification, generating and transforming, named for its properties/functions. Postpartum blood clumps should dissolve, yet new blood must regenerate; solely using dissolution harms new blood; solely using generation retains old blood. Examining herb properties, Xiong, Dang Gui, Tao Ren excel at attacking old blood and rapidly generating new blood; assisted by Hei Jiang (charred ginger) and Zhi Gan Cao, guiding these three into Lung and Liver to generate blood and benefit Qi; five ingredients form a formula, moving with tonification, truly the holy medicine for postpartum.
(Grandson Xin Dian reported) Commentary: Once maternal sac ruptures, quickly decoct one dose, administer as soon as fetal head touches ground, regardless of miscarriage or term birth; even safe, young, strong women should take one or two doses to dissolve clumps and generate new blood, naturally avoiding blood dizziness. If prenatal constitution weak, presenting critical symptoms postpartum, do not tire of frequent administration, stop when disease recedes; if taken daily as usual, can support nearly perished Qi and Blood. If blood clump pain, add Rou Gui 3 fen, Hong Hua 3 fen, Yi Mu Cao 5 qian. If postpartum labor severe with blood collapse, pale/depleted appearance, add Ren Shen 3-4 qian. If sweating and shortness of breath, double Ren Shen.
*Da Quan* said: Postpartum blood dizziness is caused by failed blood flowing into Liver Meridian, seeing black flowers in eyes, spinning dizziness of head and eyes, inability to rise/sit, coma/unconsciousness, called blood dizziness. This is blood heat taking advantage of deficiency, rebelling upward to overwhelm Heart, causing coma/unconsciousness, Qi closure/near death; drinking child urine is best. Chen Liangfu said: Postpartum stasis blood flooding heart, due to not drinking child urine after delivery, causing deficient Fire flaming upward. Use Lu Jiao (burnt to ash), mix with child urine to swallow, wakes immediately; this substance moves blood extremely effectively. Also use Wu Ling Zhi half raw, half cooked, named Du Xing San; also use Fan Hun Dan, which is Yi Mu Wan. Cui Shi said: After delivery, place hammer or yellow stone in charcoal, burn red-hot, put in vessel, pour vinegar in front of bed to remove blood dizziness, make frequently. Or first apply brewed vinegar to mouth/nose, keep vinegar nearby, quench charcoal to smell smoke. Another method: burn Gan Qi (dry lacquer), let smoke fumigate mother's face, wakes immediately; if no dry lacquer, smoke from old lacquer ware works. Shan Yangxian said: Postpartum cold Qi attacking upward causes heart pain, downward causes abdominal pain. With blood clumps, take Sheng Hua Tang plus Gui Mo; only add Wu Zhu Yu, 3 slices ginger to assist blood; if solely using hot medicines to attack cold, pain hard to stop, blood inevitably increases, harming mother. *Chan Bao Bai Wen* said: Postpartum limb edema is caused by failed blood taking advantage of deficiency to accumulate, flowing along meridians to limbs, lingering deeply, rotting like water, causing yellow face, limb edema. Physicians not recognizing this treat as water qi, using mostly draining water medicines; for extremely deficient person, postpartum already deficient, further deficiencing with medicine is double deficiency, often leading to mania; take Xiao Tiao Jing San, moving blood, swelling dissipates, then heals. Zhu Danxi said: Postpartum swelling must primarily use major Qi and Blood tonification, slightly assist with Cang Zhu, Fu Ling, letting water drain naturally. Xue Lizhai said: If previous symptom is cold water insulting Earth, nourish Spleen/Lung; if Qi deficiency edema, benefit Spleen/Stomach; if water qi edema, tonify Middle Qi. Also said: Postpartum edema with panting/cough, pulse deep/fine/weakless, this is Ming Men Fire decline, Spleen Earth deficiency cold, Ba Wei Wan governs. Wu Mengzhai said: New postpartum cold damage, do not lightly induce sweat. Or injury during delivery causing fever; excessive blood loss causing fever; lochia not leaving causing fever; three-day milk steaming causing fever; labor/diet stagnation causing fever resembling food stagnation; must carefully distinguish, absolutely do not induce sweat. Generally postpartum Great Blood empty, sweating causes transformation: muscle twitching, or depression/coma, or convulsions, or constipation, harm is not light. Any fever, use Si Wu Tang as sovereign, add Chai Hu, Ren Shen, Pao Jiang most effective. Gan Jiang acrid-hot, guides blood herbs into Blood aspect, Qi herbs into Qi aspect, removes evil generates new, has principle of Yang generating Yin, treating heat with heat, deeply conforming to *Nei Jing*. Zhu Danxi said: Postpartum fever, this heat is not excess heat, but Yin deficiency generating internal heat, take major dose of Yin-nourishing medicine. Why must Gan Jiang be used? Answer: Gan Jiang enters Lung to benefit Qi, enters Liver Meridian to guide blood herbs to generate blood; but cannot be used alone, must be used with Yin-nourishing medicine, this is natural wonder of creation. Wang Jiezai said: Woman postpartum Yin deficiency, Yang has no root, floats/scatters externally, thus fever; use Si Wu Tang to tonify blood, use Zhi Gan Jiang bitter-warm to follow-treat, gather floating/scattered Yang back to Yin. Zhao Yangkui said: Postpartum massive blood loss, Yin blood suddenly perishes, must have high fever, named Yin deficiency fever. This "Yin" refers precisely to Qi/Blood Yin; if treating with cooling medicines directly, death ensues, exactly as syndrome resembles Bai Hu, mistakenly taking Bai Hu Tang causes death. At this time, specifically do not use Si Wu Tang, tangible blood cannot be generated suddenly, slight Qi must be urgently protected, use Du Shen Tang or Dang Gui Bu Xue Tang, making intangible generate tangible, wonder of Yang generating Yin, must know. Wu Shuqing said: Postpartum Yin deficiency, blood weakness fever, Si Wu plus Fu Ling, severe heat add Pao Jiang. This formula uses no Qi herbs, indicating Blood deficiency but not Qi deficiency. Adding Fu Ling makes Heaven Qi descend and Yin self-generate, Yin generates then heat self-retreats. Severe heat add stir-fried Gan Jiang, taking lead Yin from Yang, or lead Yang from Yin. Subtle! Subtle! Guo Jizhong said: What causes alternating chills and fever postpartum? Answer: Yin/Yang disharmony and failed blood not scattering both cause alternating chills/fever. How to distinguish? Answer: Occasional stabbing pain is failed blood; only chills/fever without other symptoms is Yin/Yang disharmony. Xue Lizhai said: What humans master is Heart, what Heart masters is Blood, once Heart Blood is deficient, Spirit/Qi does not stay, palpitations/fright originate here, should primarily tonify Blood/Qi. *Chan Bao Bai Wen* said: Postpartum emaciation gradually becomes Bed Labor, all caused by depletion of Blood/Qi during delivery. Must guard起居 (daily routine), regulate diet, nourish/rest for one hundred days, thereby ensuring no disease. If difficult delivery in middle age, regardless of date, must nourish/rest to recover before movement; otherwise, Qi/Blood injured again, emaciation syndrome arises. Xue Lizhai said: Bed Labor, should primarily support/nourish Righteous Qi. Often due to Spleen/Stomach weakness, reduced diet, causing exhaustion of all meridians, should tonify Spleen/Stomach; once diet enters, Essence/Qi transforms/generates, all organs rely on it, disease self-heals. *Chan Ru Ji* said: Postpartum urinary retention, abdomen distended like drum, confused/unconscious, likely due to internal accumulated cold Qi before delivery, causing bladder disease postpartum. Fill navel flat with salt, crush Cong Bai (white part of green onion) to finger-thickness, place on salt, moxa cone on onion cake, feel heat entering abdomen, urination passes instantly, miraculous. Zhu Danxi said: Midwife careless, damaging mother's bladder, causing dripping disease, use pig/sheep bladder decoction with medicine, Ren Shen/Huang Qi as sovereign, Dang Gui/Di Huang as minister, Tao Ren/Chen Pi/Fu Ling as envoy, drink when extremely hungry; let Qi/Blood suddenly grow, bladder self-completes, delay slightly makes success difficult. *Yi Xia Yan* said: Women childbirth, nurse with milk, milk's body resides between meridians and Qi/Blood. Starting from Yin hour at Hand Taiyin Lung Meridian, exiting Yunmen Acupoint (point above breast); Yin/Yang continue circulating, traversing twelve meridians, returning to Foot Jueyin Liver Meridian at Chou hour, entering Qimen Acupoint (point below breast); exiting up, entering down, Lung commands Qi, Liver stores Blood, milk resides precisely between them. Xiao Shenzhai said: Woman uses Blood for affairs, upper becomes milk, lower becomes menstruation; Blood transformation originates in Spleen/Stomach, essence/qi of diet circulates, becoming milk/menses. Postpartum Spleen/Stomach Qi vigorous, then Blood vigorous and milk abundant; Spleen/Stomach Qi declines, then Blood decreases and milk scarce, this is Lizhai's key to promoting milk by strengthening Spleen/Stomach and nourishing source. If ignoring Spleen/Stomach to tonify Qi/Blood, merely engaging in milk-promoting agents, is like seeking thousand gold from beggar, impossible. *Da Sheng Pian* said: Promote milk using Huang Qi 1 liang, Dang Gui 5 qian, Bai Zhi, Mu Tong