程达庵四媳戴氏，产半月而腿疼。迎专科诊视曰虚，投以八珍汤，服十日，痛益甚。予
赴邑
候之召，道经其庐，达庵趋问∶产后半月而腿疼，何症？予曰∶两腿皆疼，独一疼也？达庵
曰∶右腿疼。予问疼处热否？曰∶热。予谓切不可认虚认风。此产后败血凝滞血海，流于经
络，不急治则血无从出、久必化脓成毒，或为肠痈，今腿痛是其征也。达庵默然而别。复迎
专科，又曰风也。但丹溪有云，产后须当大补气血，虽有他症，以末治之。投以十全大补汤
。痛转剧，大发寒热，小腹近胯果红肿出脓。外科又为生肌收口太早，致腰俞复发一毒，肿
痛寒热如初。十日后大溃脓而不收口，精神萎顿，肌肉陡削。饮食不进，恶心怯寒，奄奄一
息尔。外科曰∶不可为也。专科曰∶余但治胎前产后，今为肿毒所坏。皆辞去而不下药，达
庵始悔不听予言，以致误事。因急予，予往视。六脉濡大无力，疮口流清水而无脓。予曰∶
势棘矣，不暇治疾，速为保脾。盖五脏六腑皆藉脾土以为养。然非大剂人参、附子不可。始
以
人参、白术各五钱，甘草、干姜、大附子各一钱，黄 三钱，白芷、桂心各五分，以其能排
脓
止痛也。外科犹然阻曰∶白术作脓恐不可服。予曰∶脓不死人，饮食不入口则死人也。急进
之。四帖而神气回，饮食进，诸症悉减，疮口成脓。予语之曰∶生矣，改用参苓白术散，调
理一月而安。达庵叩予曰∶公何预知必为肿毒，当急治也？予曰∶《内经》所谓脏象。又云
∶现症腿疼而热，症已现矣。生于产后非败血所致而何？于时急为疏通，不留经络，何毒之
有？专科不察而补，是益其毒而助之溃也。外科不审虚实强弱，概以毒治之，奈何不使患者
几危哉？达庵曰∶专科之不足恃也。如此夫，虽然不如是，无以见公之高矣。
程达庵的四儿媳戴氏，产后半个月出现腿疼。请来专科医生诊治，说是虚证，给予八珍汤服用，服药十日后，疼痛反而加剧。
我正好去县城应候补官员之召，路过他家，达庵急忙跑来询问：“产后半个月腿疼，是什么病症？”我问：“是两条腿都疼，还是只有一条腿疼？”达庵说：“右腿疼。”我又问：“疼痛的地方发热吗？”回答说：“发热。”我说：“千万不可认定为虚证或风邪。这是产后败血凝滞于血海，流注于经络，如果不及时救治，血液无法排出，时间久了必然化脓成毒，或者形成肠痈，现在的腿痛就是征兆。”达庵沉默着告别了。
后来又请专科医生，又说这是风邪。但丹溪先生说过，产后必须大补气血，即使有其他症状，也要作为次要问题处理。于是投以十全大补汤。疼痛更加剧烈，大发寒热，小腹靠近胯部果然红肿并出脓。外科医生又因为过早使用生肌收口药，导致腰俞穴附近复发一个毒疮，肿痛寒热与之前一样。十日后大溃脓但不收口，精神萎靡，肌肉突然消瘦。饮食不进，恶心怕冷，奄奄一息。外科医生说：“没法治了。”专科医生说：“我只治胎前产后病，现在被肿毒搞坏了。”两人都辞去不再下药，达庵这才后悔没听我的话，以致误事。于是急忙请我，我去诊治。六脉濡大而无力，疮口流出清水而没有脓。我说：“形势危急了，没空治病，赶紧保脾。因为五脏六腑都依赖脾土来滋养。然而非大剂量人参、附子不可。”开始用人参、白术各五钱，甘草、干姜、大附子各一钱，黄芪三钱，白芷、桂心各五分，因为它们能排脓止痛。外科医生仍然阻拦说：“用白术恐怕会助长脓液，不可服用。”我说：“脓不会死人，饮食不入口才会死人。”急忙进服此药。四帖后神气恢复，饮食进入，诸症全部减轻，疮口成脓。我对他说：“有救了，改用参苓白术散，调理一个月而安。”达庵向我叩头问：“您怎么预知必定是肿毒，应当紧急治疗呢？”我说：“《内经》所说的脏象。又说：现症腿疼而热，症状已经显现了。生于产后，如果不是败血所致，那是什么呢？当时应该紧急疏通，不留滞于经络，哪里有毒素呢？专科医生不考察就进补，这是增加毒性并帮助它溃烂。外科医生不审察虚实强弱，一概以解毒治之，怎么能不让患者几乎危殆呢？”达庵说：“专科医生的不足依靠，像这样啊。虽然如此，不这样，也无法显示您的高明之处。”
Cheng Da'an's fourth daughter-in-law, Dai Shi, suffered from leg pain half a month after childbirth. A specialist was invited for diagnosis and treatment, who diagnosed it as deficiency (Xu) and prescribed Bazhen Tang (Eight Treasures Decoction). After ten days of taking the medicine, the pain intensified.
I was on my way to the county town to attend an appointment for a waiting official when I passed by his house. Da'an hurriedly came to ask: "Leg pain half a month after childbirth, what syndrome is this?" I asked: "Do both legs hurt, or only one?" Da'an replied: "The right leg hurts." I asked: "Is the painful area hot?" He answered: "It is hot." I said: "You must absolutely not diagnose it as deficiency or wind pathogen. This is caused by retained blood (Bai Xue) stagnating in the Blood Sea (Xue Hai) after childbirth, flowing into the meridians. If not treated urgently, the blood will have no outlet; over time, it will transform into pus and toxin, potentially leading to intestinal abscess (Chang Yong). The current leg pain is a sign of this." Da'an silently took his leave.
Later, another specialist was invited, who again diagnosed it as wind pathogen. However, Danxi stated that postpartum cases require substantial tonification of Qi and Blood; even if other symptoms exist, they should be treated secondarily. Consequently, Shiquan Dabu Tang (Ten Complete Tonifying Decoction) was administered. The pain became severe, accompanied by alternating chills and fever. Indeed, the lower abdomen near the hip joint became red, swollen, and suppurated. The surgical physician had applied topical agents for tissue regeneration too early, causing a recurrence of a toxic sore at the Yaoshu point (BL23), with swelling, pain, chills, and fever similar to before. Ten days later, there was profuse suppuration without healing, mental exhaustion, sudden emaciation, loss of appetite, nausea, aversion to cold, and a critical condition. The surgical physician said: "It cannot be saved." The specialist said: "I only treat prenatal and postpartum conditions; now it is ruined by the toxic sore." Both resigned and ceased medication. Da'an finally regretted not listening to me, realizing his mistake. He urgently summoned me, and I went to examine her. The six pulses were soggy, large, and powerless. The wound exuded clear fluid without pus. I said: "The situation is critical. There is no time to treat the disease directly; prioritize protecting the Spleen. All five Zang and six Fu organs rely on Spleen Earth for nourishment. Therefore, large doses of Renshen (Ginseng Radix) and Fuzi (Aconiti Lateralis Radix Praeparata) are indispensable." Initially, I prescribed Renshen (Ginseng Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma) 5 qian each, Gancao (Licorice Root), Ganjiang (Zingiberis Rhizoma), and Dafuzi (Aconiti Lateralis Radix Praeparata) 1 qian each, Huangqi (Astragali Radix) 3 qian, Baizhi (Angelicae Dahuricae Radix), and Guixin (Cinnamomi Cortex) 0.5 fen each, because they can drain pus and relieve pain. The surgical physician still objected, saying: "Using Baizhu (Atractylodis Macrocephalae Rhizoma) might promote pus formation; it should not be taken." I said: "Pus does not kill people; inability to eat and drink kills people." Administered urgently. After four doses, spiritual energy returned, appetite improved, all symptoms decreased, and the wound formed pus. I told him: "She will survive. Switch to Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) for conditioning for one month, and she will recover." Da'an kowtowed to me and asked: "How did you foresee it would definitely be a toxic sore requiring urgent treatment?" I said: "As stated in the *Neijing* regarding Zang-Xiang (Visceral Manifestations). It also says: 'Current symptoms include leg pain and heat; the signs are already manifest.' Occurring postpartum, if not caused by retained blood, then what? At that time, urgent dredging was needed to prevent stagnation in the meridians; how could toxins remain? The specialist failed to investigate and used tonification, thereby increasing toxicity and aiding ulceration. The surgical physician failed to assess excess/deficiency and strength/weakness, treating everything as a toxin. How could this not endanger the patient?" Da'an said: "Specialists are unreliable indeed. Nevertheless, without such events, your high medical skill would not have been revealed."