附、干姜僭热之剂。脏腑无寒。何处消受。若夫儿之初生。母腹烦冤。便啖鸡子。且吃火盐。不思鸡子难化火盐发热。
辗转为病。医者不识。每指他病。率尔用药。宁不误人。余每见产妇之无疾者。必教以却去黑神散。与夫鸡子火盐诸般
肉食。且与白粥将理。间以些少石首鲞煮令甘淡食之。至半月后方与少肉。彼富贵之家。骄恣之妇。卒有白带。头风。
气痛。膈满。痰逆。口干。经水不调。发脱体热。皆是阳胜阴虚之病。安知非此等谬妄启之耶。若五积散之治产后余血
作痛。以苍术为君。麻黄为臣。浓朴、枳壳为佐。虽有芍药当归之补血。仅及苍术三分之一。且其方中言妇人血气不调。
必腹撮痛。闭而不行。并宜服之。何不思产后之妇。有何寒耶。血气未充。似难发汗。借曰推陈致新。药性辛温。岂可
妄用麻黄之散。附以苍术、枳壳。虚而又虚。祸不旋踵。（此段专辨黑神散之非名论也）楼英曰。续命汤、大豆紫汤、举
轻古拜散。太阳厥阴药也。邪实脉浮弦有力者固宜。产后血气大虚之人。不宜轻发其表。但用防风当归散治之为妙。虞
抟曰。产后禁用酸寒。能伐生生之气也。先哲制四物。以芎、归之温。佐以芍地之寒。是以寒温适中。为妇人诸疾之妙
剂也。或用于产后。必取白芍。以酒重复制炒。去其酸寒之毒。但存生血活血之能。胡为其不可也。薛己曰。腹痛发热。
或胀满不食。水道滞涩。产后多有此症。薏苡仁汤。药品和平。其功且速。
产后要论 医宗金鉴曰。产后发热之故。非止一端。或饮食太过。或外感风寒。或瘀血停留。或亡血阴虚。或
产后劳乏。或三日乳蒸。当详其有余不足。或攻或补。或用凉药正治。或用温药反治。要在临症细细参考也。凡产后头
疼恶寒而发热者。属外感。不当作伤寒治。惟宜用四物加柴胡、葱白服之。若阴血暴亡。孤阳无附。而外感发热者。急
进参附汤。迟则必大汗大喘。是阳欲亡。虽药必无救矣。产后咳嗽。若感冒风寒。用旋复花汤。即荆芥穗、前胡、麻黄、
杏仁、半夏、茯苓、赤芍、五味子、甘草、旋复、姜、枣也。若因阴虚火炎。上烁肺金而嗽者。宜六味丸加麦冬、五味
子。名麦味地黄汤。滋其化源。若因瘀血上冲入肺而嗽者。宜佛手散加桃仁、红花、川贝、延胡索。以破其瘀。其嗽自
愈。凡一应伤胎。子死腹中者。须当急下。勿使上奔心胸。然必验其舌青面赤。肚腹胀大。腹冷如冰。久之口中有秽气
出者。方可议下。然犹必审其人之虚实寒热。随宜而施治之。
产后当知 保产要录曰。一、产后忌大喜大怒。未可便上床伸足侧卧。令血不行。宜用衣服靠住。曲膝仰卧。
以手从心下轻轻按摩至脐。日五七次。则恶血尽下。次日乃止。不问有无病痛。宜以益母草煎汤搀和童便。日服数次。
可免血疾及弱虚。童便须临时取用。亦须用清秀不吃韭蒜者。一、乳汁乃血气所成。产后不可多食盐。盐止血少乳。且
发嗽。夏月忌贪凉用扇。食冷物。当风睡。夏月房中。贮水一二缸解热气。冬月加火一二盆。取暖气。一儿生三日。相
传洗三。如冬寒切不可洗。恐洗时风入脐中。脐风由此而起。即初生亦戒浴。保全真元。一、儿生下时。欲断脐带。必
以蕲艾为燃。香油浸湿。熏洗脐带。至焦方断。其束脐须用软帛浓棉裹束。日间视之。勿令儿尿湿脐。此预防脐风。第
一要紧事。一、儿生次日三日。即看口中上 。如有白泡子。即以银挖耳轻轻刮破。将泡内白粒取出。勿令落入喉中。
仍以京墨搽之。如次日不取。则泡老难刮。误事。又有马牙在牙根处。亦须挑破取出。以墨搽之。一、子初生下。母即
昏晕不省者。此时即有药不能入口。迟则又不能救。其法即用柔软旧衣。谨闭产户。以知事女子。曲膝抵住。勿令下面
气泄。又一人一手挽住头发。一手扪住鼻口。勿令上面气泄。俟稍转。方用茶汤接气。如再晕。速换湿衣。照前为之。
一、母血衣不可日晒。儿湿衣不可夜露。夜有鸟粪。能生毒疮。一、盈月之期。一月为小盈月。两月为大盈月。此两月
内不暴怒。少劳碌。禁淫欲。终身无病。且多生子。一、临月不可洗头濯足。恐致难产。（以上各条并保儿之法亦详在内）
附录：干姜属于助热之剂。如果脏腑没有寒邪，身体何处能承受这种燥热？至于婴儿刚出生时，母亲腹部烦闷冤结，（此时）便给婴儿吃鸡蛋，并且喂火盐。不考虑鸡蛋难以消化、火盐容易发热，辗转导致生病。医生不认识这一点，常常指向其他疾病，草率用药，难道不会误人吗？我每次见到产妇没有疾病的，必定教导她们去除黑神散，以及鸡蛋、火盐等各种肉食，只给予白粥进行调养，偶尔用少许石首鱼鲞煮得甘淡食用。直到半个月后才给予少量肉类。那些富贵人家、骄纵的妇女，突然患有白带、头风、气痛、胸膈胀满、痰逆、口干、月经不调、脱发、身体发热等症状，这些都是阳胜阴虚的病证，怎么知道不是这些谬误妄为所引发的呢？
至于五积散治疗产后余血作痛，以苍术为君药，麻黄为臣药，厚朴、枳壳为佐药。虽然方中有芍药、当归来补血，但用量仅及苍术的三分之一。而且该方中说妇人血气不调，必然腹部撮痛，经闭不行，都适宜服用。为什么不思考产后妇女，有什么寒邪呢？血气未充盈，似乎难以发汗。假如说是为了推陈致新，药性辛温，岂可妄用麻黄的发散之力，再配合苍术、枳壳，使虚者更虚，祸患立刻就会到来。（这一段专门辨析黑神散的错误，名为论也）楼英说：续命汤、大豆紫汤、举轻古拜散，是治疗太阳经和厥阴经的药。邪气实盛、脉象浮弦有力的固然适宜。但对于产后血气大虚的人，不适宜轻易发散其表邪。只用防风当归散治疗才巧妙。虞抟说：产后禁用酸寒之品，因为会伐伤生生之气。先哲配制四物汤，用川芎、当归的温性，佐以芍药、地黄的寒性，因此寒温适中，是治疗妇人各种疾病的妙剂。或者用于产后，必须选用白芍，用酒反复蒸制炒熟，去掉其酸寒的毒性，只保留生血活血的功能，这有什么不可以的呢？薛己说：腹痛发热，或者胀满不食，水道滞涩，产后多有此症。薏苡仁汤，药品平和，功效迅速。
产后要论 《医宗金鉴》说：产后发热的原因，不止一端。或者是饮食太过，或者是外感风寒，或者是瘀血停留，或者是亡血阴虚，或者是产后劳乏，或者是三日乳蒸（乳汁分泌旺盛引起的发热），应当详细辨别有余还是不足，或者攻下或者补益，或者用凉药正治，或者用温药反治，关键在于临症时细细参考。凡是产后头疼恶寒而发热的，属于外感，不应当当作伤寒治疗。只适宜用四物汤加柴胡、葱白服用。如果是阴血突然大量流失，孤阳无所依附，而外感发热的，紧急进服参附汤，迟了就会大汗淋漓、大喘，这是阳气将要亡脱，即使用药也必无救了。产后咳嗽，如果是感冒风寒，用旋复花汤，即荆芥穗、前胡、麻黄、杏仁、半夏、茯苓、赤芍、五味子、甘草、旋复花、生姜、大枣组成。如果是因阴虚火炎，上灼肺金而咳嗽的，适宜六味丸加麦冬、五味子，名叫麦味地黄汤，滋养其化源。如果是因瘀血上冲入肺而咳嗽的，适宜佛手散加桃仁、红花、川贝母、延胡索，以破除瘀血，咳嗽自然痊愈。凡是所有伤胎，胎儿死在腹中的，必须当急下（使用下法排出死胎），不要让死胎上奔心胸。然而必须验证其舌青面赤，肚腹胀大，腹部冷如冰，久了口中有秽气出来的，才可以议定使用下法。然而还必须审察病人的虚实寒热，随宜施治。
产后当知 《保产要录》说：一、产后忌大喜大怒。不可立即上床伸足侧卧，令血液运行不畅。应用衣服靠住，曲膝仰卧，用手从心下轻轻按摩至脐部，每天五到七次，则恶血尽下。第二天才停止。不问有无病痛，适宜用益母草煎汤搀和童便，每天服用数次，可避免血疾及虚弱。童便须临时取用，也必须用清秀不吃韭蒜者的尿液。一、乳汁乃血气所成，产后不可多食盐。盐止血少乳，且引发咳嗽。夏季忌贪凉用扇，食冷物，当风睡。夏季房中，贮水一二缸解热气。冬季加火一二盆，取暖气。一、婴儿生下三天，相传洗三。如冬季寒冷切不可洗，恐怕洗时风入脐中，脐风由此而起。即使是初生婴儿也戒除洗浴，保全真元。一、婴儿生下时，欲断脐带，必须以蕲艾点燃，香油浸湿，熏洗脐带，至焦黑方才切断。其束脐须用软帛浓棉裹束，日间视之，勿令婴儿尿湿脐部。这是预防脐风，第一要紧的事。一、婴儿生下次日或三日，即看口中上颚。如有白泡子，即以银挖耳轻轻刮破，将泡内白粒取出，勿令落入喉中。仍以京墨搽之。如次日不取，则泡老难刮，误事。又有马牙在牙根处，亦须挑破取出，以墨搽之。一、婴儿初生下，母亲即昏晕不省人事的，此时即有药不能入口，迟了又不能救。其法即用柔软旧衣，紧闭产户，由知事女子，曲膝抵住，勿令下面气泄。又一人一手挽住头发，一手扪住鼻口，勿令上面气泄。等到稍转醒，方用茶汤接气。如果再晕，速换湿衣，照前为之。一、母亲的血衣不可日晒，婴儿的湿衣不可夜露。夜晚有鸟粪，能生毒疮。一、盈月之期，一月为小盈月，两月为大盈月。这两个月内不暴怒，少劳碌，禁淫欲，终身无病，且多生子。一、临月不可洗头濯足，恐致难产。（以上各条并保儿之法亦详在内）
Appendix: Ganjiang (Dried Ginger) is a formula that promotes heat. If the Zang-Fu organs do not have cold pathogens, where can the body endure such dryness and heat? As for when an infant is first born, if the mother's abdomen feels stifled and resentful, [one] feeds the infant chicken eggs and fire salt. Failing to consider that chicken eggs are hard to digest and fire salt generates heat, this leads to illness through a chain of events. Physicians who do not understand this often misdiagnose other diseases and prescribe medications rashly; would this not harm people? Whenever I see postpartum women without disease, I instruct them to discard Heishen San (Black Divine Powder) and various meats like chicken eggs and fire salt, providing only white porridge for nourishment, occasionally eating some stonefish dried in a sweet and bland manner. Only after half a month should small amounts of meat be given. Those from wealthy families or indulgent women suddenly suffer from leukorrhea, wind-headache, Qi pain, chest fullness, rebellious Phlegm, dry mouth, irregular menstruation, hair loss, and body heat. These are all conditions of Yang excess and Yin deficiency. How could one know they were not triggered by such erroneous and reckless practices?
Regarding Wuji San (Five Accumulations Powder) treating postpartum abdominal pain due to residual blood, it uses Cangzhu (Atractylodis Rhizoma) as the Sovereign herb, Mahuang (Ephedrae Herba) as the Minister herb, Houpo (Magnoliae Officinalis Cortex) and Zhike (Aurantii Fructus) as the Assistant herbs. Although it contains Shaoyao (Paeoniae Radix Alba/Rubra) and Danggui (Angelicae Sinensis Radix) to tonify blood, their dosage is only one-third of Cangzhu. Furthermore, the formula states that for women with irregular Blood and Qi, causing abdominal cramping pain and amenorrhea, it is suitable for use. Why not consider that postpartum women have what kind of cold? Their Blood and Qi are not yet充盈 (full), so sweating methods seem difficult to apply. Even if the goal is to eliminate the old and generate the new, given the acrid-warm nature of the drugs, how can one recklessly use the dispersing power of Mahuang, combined with Cangzhu and Zhike, making the deficient even more deficient, bringing disaster swiftly? (This section specifically refutes the use of Heishen San). Lou Ying said: Xuming Tang (Continuing Life Decoction), Da Douzi Tang (Soybean Purple Decoction), and Juqing Gubai San are formulas for Taiyang (Greater Yang) and Jueyin (Terminal Yin) meridians. They are indeed suitable for cases where pathogenic factors are substantial and the pulse is floating, wiry, and forceful. However, for those with massive postpartum Blood and Qi deficiency, it is inappropriate to lightly disperse the exterior. Using Fangfeng Danggui San (Saposhnikoviae and Angelica Powder) is the superior approach. Yu Tun said: Sour and cold substances are contraindicated postpartum as they damage the vital generating energy. The ancients formulated Siwu Tang (Four Substances Decoction) using the warmth of Xiong (Ligustici Chuanxiong Rhizoma) and Gui (Angelicae Sinensis Radix), assisted by the coldness of Shao (Paeoniae Radix) and Di (Rehmanniae Radix), thus achieving a balance of cold and warmth, making it an excellent remedy for women's diseases. When used postpartum, one must select Baishao (White Peony Root), steamed and fried repeatedly with wine to remove its sour-cold toxicity, retaining only its ability to generate and invigorate blood. Why is this not acceptable? Xue Ji said: Abdominal pain with fever, or distension with anorexia, and obstructed urination are common postpartum symptoms. Yiyiren Tang (Coix Seed Decoction) consists of mild herbs and acts quickly.
Essential Discussion on Postpartum Conditions: *Yizong Jinjian* (Golden Mirror of Medicine) states: The causes of postpartum fever are manifold. They may result from excessive diet, external contraction of Wind-Cold, retention of Stasis, hemorrhage leading to Yin deficiency, postpartum fatigue, or "breast steam" (fever associated with lactation onset). One must carefully distinguish between Excess and Deficiency, deciding whether to purge or tonify, whether to treat directly with cooling agents or inversely with warming agents. This requires careful reference during clinical practice. For postpartum headache, aversion to cold, and fever, this belongs to External Contraction and should not be treated as Shanghan (Cold Damage). It is appropriate to use Siwu Tang (Four Substances Decoction) added with Chaihu (Bupleuri Radix) and Congbai (Allii Fistulosi Bulbus). If Yin Blood has suddenly been lost, leaving Floating Yang unanchored, resulting in fever from external contraction, Shenfu Tang (Ginseng and Aconite Decoction) must be administered urgently; delay will lead to profuse sweating and severe panting, indicating impending Yang collapse, which cannot be saved even with medication. For postpartum cough due to Wind-Cold invasion, Xuanshenhua Tang (Inula Flower Decoction) is used, composed of Jingjie Sui (Schizonepetae Spica), Qianhu (Peucedani Radix), Mahuang (Ephedrae Herba), Xingren (Armeniacae Semen Amarum), Banxia (Pinelliae Rhizoma), Fuling (Poria), Chishao (Paeoniae Radix Rubra), Wuweizi (Schisandrae Fructus), Gancao (Glycyrrhizae Radix et Rhizoma), Xuanshen (Inulae Flos), Shengjiang (Zingiberis Rhizoma Recens), and Dazao (Jujubae Fructus). If the cough is caused by Yin deficiency with Fire flaming upward, scorching Lung Metal, Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) added with Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Fructus), named Maiwei Dihuang Tang (Ophiopogon and Schisandra Rehmannia Decoction), should be used to nourish the source of transformation. If the cough is caused by Stasis rushing up into the Lungs, Foshou San (Buddha's Hand Powder) added with Taoren (Persicae Semen), Honghua (Carthami Flos), Chuanbei (Fritillariae Cirrhosae Bulbus), and Yanhusuo (Corydalis Rhizoma) should be used to break up the Stasis, and the cough will heal itself. In all cases of fetal injury where the fetus dies in the uterus, purgative methods must be employed urgently to prevent the dead fetus from ascending to the heart and chest. However, one must verify signs such as a blue tongue, red face, abdominal distension, abdomen cold as ice, and foul breath after some time, before considering purgation. One must still assess the patient's Excess/Deficiency and Cold/Heat patterns and treat accordingly.
What to Know About the Postpartum Period: *Baochan Yaolu* (Essential Record for Safe Delivery) states: 1. Avoid extreme joy and anger postpartum. Do not lie on the bed immediately with legs extended or side-sleeping, as this impedes blood flow. Use clothing for support, lie supine with knees bent, and gently massage from below the heart down to the umbilicus five to seven times daily until lochia is fully expelled. Stop the next day. Regardless of symptoms, it is advisable to drink Yi Mucao (Leonuri Herba) decoction mixed with Tongbian (Child's Urine) several times a day to avoid blood disorders and weakness. Tongbian should be freshly collected from a healthy person who does not eat garlic or leeks. 2. Milk is formed from Blood and Qi; do not consume too much salt postpartum. Salt stops bleeding and reduces milk production, and induces coughing. In summer, avoid fans, cold food, and sleeping in drafts. Store water jars in the room to cool the air in summer; add heating stoves in winter for warmth. 3. On the third day after birth, tradition dictates bathing the baby ("Washing Three"). In winter cold, absolutely do not bathe, as wind entering the umbilicus can cause Umbilical Wind (Neonatal Tetanus). Even newborns should avoid bathing to preserve True Yuan (Original Qi). 4. To cut the umbilical cord, burn Qiai (Artemisiae Argyi Folium) soaked in sesame oil to fumigate and wash the cord until charred before cutting. Bind the umbilicus with soft silk and thick cotton. Check it daily to ensure the baby does not wet it. This is the most critical step in preventing Umbilical Wind. 5. On the second or third day, check the infant's palate for white blisters. Gently scrape them open with a silver ear pick, remove the white particles inside, ensuring they do not fall into the throat, and apply Beijing ink. If not removed the next day, the blisters become tough and difficult to scrape, causing errors. Also, check for "Horse Teeth" (Epstein pearls) at the gum roots; pierce and remove them, applying ink. 6. If the mother faints immediately after birth, medicines cannot be taken orally, and delay makes rescue impossible. The method is to tightly close the vaginal opening with soft old clothes. Have a knowledgeable woman press her knees against the area to prevent Qi leakage from below. Another person holds the hair with one hand and covers the nose and mouth with the other to prevent Qi leakage from above. Once consciousness returns slightly, offer tea soup to restore Qi. If she faints again, change to wet clothes and repeat. 7. Mother's bloody garments should not be sun-dried; infant's wet garments should not be exposed to night dew. Bird droppings at night can cause toxic sores. 8. The "Full Month" period: one month is the Small Full Month, two months is the Large Full Month. During these two months, avoiding rage, overwork, and sexual desire ensures lifelong health and fertility. 9. Do not wash hair or feet near term, as it may cause dystocia. (The above items also include detailed methods for protecting the infant.)