無或曰::初產之婦,好血已虧,瘀血尚留,黑神散非要藥歟。予曰:至哉坤元,萬物資生,理之常也,初產之婦,好血未必虧,污血未必積,臟腑必未寒,何藥為?飲食起居,勤加調護,何病之有,誠有污血體怯而寒,與之數帖亦自簡便,或有他病,當求病起何因,病在何經,氣病治氣,血病治血,寒者溫之,熱者清之,凝者行之,虛者補之,血多者止之,何用海製,此方不恤,無病生病,彼黑神散者,用乾薑當歸之溫熱,黑豆之甘熟,地黃之微寒,以補血之虛,佐以炒蒲黃之甘,以防出血之多,芍藥之酸寒,有收有散,以為四藥之助,官桂之大辛熱,以行滯氣,推凝血,和以甘草之緩,其為取用,似乎精密,然驅逐與補益似難同方施治,設有性急者,形瘦者,本有怒火者,夏月坐蓐者,時有火令,薑桂皆為禁藥,論語未達之戒,不知誰執其咎,至於將護之法,尤為悖理,肉汁發陰經之火,易成內傷之病,先哲具有訓戒,胡為羊雞濃汁作糜,而又常服當歸丸,當歸建中湯,四順理中丸,雖是滋補,悉犯桂附乾薑僣熱之劑,臟腑無寒,何處消受,若夫兒之初生,母腹頓寬,便啖雞子,且喫火鹽,不思雞子難化,火鹽發熱,展轉為病,醫者不識,每指他證,率爾用藥,寧不誤人,余每見產婦之無疾者,必教以郤去黑神散,與夫雞子火鹽,諸般肉食,且與白粥,將理間以些少石首魚,煮令甘淡,食之至半月以後,方與少肉,若雞子亦須豁開淡煮,大能養胃郤疾,彼富貴之家,驕恣之婦,卒有白帶,頭風氣痛,膈滿痰逆,口乾經水不調,髮脫體熱,皆是陽勝陰虛之病,天生血氣本自和平,曰勝曰虛,又焉知非此等繆妄有以啟之耶。局方發揮終。
有人问:刚分娩的妇女,好血(正常血液)已经亏损,瘀血尚存,黑神散不是必要的药物吗?我说:坤元(大地生育万物的本源)至为重要,万物依靠它生长,这是常理。但初产妇女的好血未必亏损,污血(恶露)未必积聚,脏腑必定没有受寒,用什么药呢?在饮食起居方面,勤加调护,会有什么病呢?确实如果有污血滞留、体质虚弱且伴有寒象的情况,给她服用几帖也是简便之法。但如果患有其他疾病,应当探究病因,判断病在何经,气病治气,血病治血,寒者温之,热者清之,凝滞者行之,虚者补之,血多者止之,何必拘泥于海藏(张元素,号海藏)所制的这个方子而不顾惜?此方不顾患者实际情况,会导致无病生有病。那黑神散,用干姜、当归的温热,黑豆的甘熟,地黄微寒,来补血之虚;辅以炒蒲黄的甘味,以防出血过多;芍药的酸寒,具有收敛和发散的作用,作为上述四药的辅助;官桂的大辛大热,以行滞气,推动凝血;调和以甘草的缓急。其取用似乎精密,然而驱邪与补益似乎难以在同一方剂中施治。假设有性情急躁者、形体消瘦者、本有怒火者、夏季分娩者,此时常有火令,干姜、官桂都是禁忌药物。《论语》中有“未达”(不懂装懂或理解偏差)的告诫,不知谁该承担过错。至于产后护理的方法,更是违背常理。肉汁会引发阴经之火,容易形成内伤疾病,先哲已有训诫,为何还要喝羊鸡浓汤做粥,并且常服当归丸、当归建中汤、四顺理中丸?虽然这些是滋补之品,但都犯了桂枝、附子、干姜等僭热(过于燥热)药剂的忌讳。脏腑没有寒邪,哪里承受得住?至于婴儿刚出生,母亲腹部顿时变宽,就吃鸡蛋,且吃火盐(一种含盐调料),却不考虑鸡蛋难消化,火盐易发热,辗转导致生病。医者不识此理,往往指向其他证候,贸然用药,难道不害人吗?我每次见到没有疾病的产妇,必定教导她们摒弃黑神散以及鸡蛋、火盐和各种肉食,只给白粥,护理期间偶尔给予石首鱼(黄鱼),煮得甘淡,食用直到半个月以后,才给少量肉类。如果吃鸡蛋也必须敲开淡煮,这非常能养胃并预防疾病。那些富贵之家、骄纵的妇女,突然患上白带、头风、气痛、胸膈满闷、痰逆、口干、月经不调、脱发、身体发热,这些都是阳胜阴虚的病。天生气血本自和平,所谓“胜”和“虚”,又怎知不是这些谬误妄行所引发的呢?《局方发挥》结束。
Some asked: "In women who have just given birth, the good blood (normal blood) is already deficient, and the stasis blood remains. Is Heishen San not an essential medicine?" I replied: "The Kun Yuan (the creative power of Earth that generates all things) is profound; all things rely on it for life, which is the constant principle. However, in women who have just given birth, the good blood may not necessarily be deficient, the foul blood (lochia) may not necessarily accumulate, and the Zang-Fu organs are certainly not cold. What medicine should be used? By diligently caring for diet and daily life, what illness would there be? Indeed, if there is retained foul blood, physical weakness, and cold signs, administering a few doses is also a simple method. But if other diseases exist, one must seek the cause of the illness, determine which meridian is affected, treat Qi disorders by regulating Qi, treat Blood disorders by regulating Blood, warm the cold, clear the heat, move stagnation, tonify deficiency, and stop excessive bleeding. Why cling to the formula prepared by Haicang (Zhang Yuansu, styled Haicang) without regard for the patient's condition? This formula disregards the actual situation, potentially causing disease where none exists. That Heishen San uses the warming properties of Ganjiang (Dried Ginger) and Danggui (Angelica Sinensis), the sweet and cooked nature of Heidou (Black Soybean), and the slightly cold nature of Dihuang (Rehmannia Root) to tonify Blood deficiency; assists with the sweetness of Chaopuhuang (Stir-fried Spore of Lygodium Sporangium) to prevent excessive bleeding; utilizes the sour and cold nature of Shaoyao (Peony Root) for its astringent and dispersing effects as an aid to the aforementioned four herbs; employs Guigui (Cinnamon Twig) for its acrid and hot nature to move stagnant Qi and push out coagulated blood; and harmonizes with Gancao (Licorice Root) for its moderating effect. Its composition seems precise. However, expelling pathogens and tonifying deficiency seem difficult to treat simultaneously in one formula. Suppose there are those with irritable temperaments, thin constitutions, pre-existing fire-anger, or those giving birth in summer when fire regulations are prevalent; Ganjiang and Guigui are then contraindicated medicines. The warning in the Analects regarding 'not understanding' applies; who will bear the blame? As for postpartum care methods, they are even more contrary to reason. Meat broth can ignite fire in the Yin meridians, easily leading to internal injury diseases, as warned by ancient sages. Why consume thick broths of mutton and chicken as porridge, and constantly take Danggui Wan (Angelica Pill), Danggui Jianzhong Tang (Angelica Decoction to Build the Middle), and Sishun Lizhong Wan (Four Smooth Decoction to Warm the Middle)? Although these are nourishing agents, they all violate the principles by using overly heating agents like Guizhi (Cinnamon Twig), Fuzi (Prepared Aconite Root), and Ganjiang (Dried Ginger). If the Zang-Fu organs are not cold, how can they tolerate this? Regarding the newborn, when the mother's abdomen suddenly expands after birth, eating eggs and Huoyan (fire salt) immediately is unwise. One fails to consider that eggs are hard to digest and Huoyan promotes heat, leading to illness through progression. Physicians, failing to recognize this, often misdiagnose other syndromes and prescribe rashly, do they not harm people? Whenever I see postpartum women without illness, I instruct them to discard Heishen San, eggs, Huoyan, and various meat foods, providing only white rice porridge. During nursing, occasionally offer Shishouyu (Croaker fish), boiled until mild and bland, continuing this for half a month before introducing small amounts of meat. If eggs are consumed, they must be cracked and boiled plainly, which greatly nourishes the Stomach and prevents disease. Those from wealthy families or indulgent women who suddenly develop leukorrhea, Toufeng (head wind/headache), Qi pain, chest fullness, phlegm rebellion, dry mouth, irregular menstruation, hair loss, and body heat—all these are diseases of Yang excess and Yin deficiency. Naturally, Qi and Blood are originally balanced. How do we know that 'excess' and 'deficiency' are not triggered by such absurd and reckless practices? Thus ends Ju Fang Fa Hui."