典藏书目

When a pregnant woman is ill, the primary principle is to stabilize the fetus; this is known to all. However, people do not realize that the reason for fetal instability is the disease itself. If the pathogenic factor is not eliminated, the fetus will remain unstable, and even daily use of fetal-stabilizing medicines will be ineffective. Therefore, those who wish to stabilize the fetus must first examine the origin of the disease and eliminate it. Once the disease is gone, the fetus becomes stable, with very rapid results. These are not merely "fetal-stabilizing" drugs, but rather formulas that stabilize the fetus; some substances considered harmful to the fetus may actually achieve the effect of stabilizing it. Can such insights be understood by those with superficial knowledge? For instance, Magnoliae Officinalis Cortex (Houpo), Aurantii Fructus Immaturus (Zhiqiao), and Pinelliae Rhizoma Preparatum (Banxia) are all contraindicated for pregnant women. Yet, for patients with dampness obstruction and rebellious Qi, there is no alternative but to use these herbs. Even more so, Radix Rhei Preparata (Dahuang), Natrii Sulfas (Mangxiao), Aurantii Fructus (Zhishi), Zingiberis Rhizoma (Ganjiang), Cinnamomi Ramulus (Guizhi), and Aconiti Lateralis Radix Praeparata (Fuzi) are generally unsuitable for pregnancy. However, for conditions involving heat closure and cold stagnation, treatment is impossible without them. In the past, the Yellow Emperor asked Qibo: "How should toxic medicines be used in pregnant women?" Qibo replied: "If there is a cause (pathology), there will be no destruction (to the mother or fetus)." Large accumulations and masses can be treated with aggressive methods. Stop when the pathology has diminished by more than half. "If there is a cause, there is no destruction" means that because there is an existing pathology, the medicine does not harm the fetus. "Nor is there destruction" means it does not harm the mother either. Generally, because there is pathology, the pathology absorbs the drug's force; although the drug may have toxicity, it does not damage the fetus nor the mother. However, these should only be administered for large accumulations and masses, and one should stop when half the effect is achieved, avoiding overdose which would damage healthy Qi. Why do practitioners not follow the great principles of Xuanyuan (Yellow Emperor) and Qibo, but instead hesitate due to fear of contraindications, waiting until the disease deepens beyond cure, ultimately resulting in fetal death!

Postpartum chills and fever occur in 20-30% of cases due to exogenous wind-cold invasion, and in 70-80% due to deficiency of both Qi and Blood. Qi deficiency leads to Yang decline and external cold; Blood deficiency leads to Yin exhaustion and internal heat. Alternating chills and fever, spontaneous movement of deficient Wind, and continuous spasms or convulsions characterize the latter group. If it is indeed exogenous wind-cold, symptoms must include headache, distending brain pain, stiffness in the neck and back, aversion to wind, absence of sweating, and altered taste perception. One should add Herba Schizonepetae (Jingshen) and Folium Perillae (Zisu) to Siwu Tang (Four Substances Decoction) in appropriate doses to dispel cold and expel wind, avoiding heavy diaphoretic agents. If it is Qi and Blood deficiency mistakenly diagnosed as wind-cold and treated with diaphoresis, the patient will inevitably suffer from sweating, palpitations, insomnia, and worsening condition. Sweat is the fluid of the Heart, and the Heart is generated by Blood. The more sweat is lost, the more Blood is depleted. Without sufficient Blood to nourish the Heart, how can one avoid palpitations and insomnia? This is why myriad diseases arise. So what should be done? If lochia is not clear, abdominal pain with palpable masses upon pressure, the treatment should focus on removing stasis and generating new blood. Shenghua Tang, Foshou San, and Jiawei Xionggui Tang are the principal formulas. Once lochia is cleared, and if the patient experiences alternating chills and fever, abdominal comfort, normal taste, pale white tongue coating, deep and fine pulse, pale face like paper, colorless lips, spontaneous and night sweats, dizziness, tinnitus, palpitations, and insomnia, these are all signs of deficiency. Without substantial tonification of Qi and Blood, recovery is difficult. Bazhen Tang (Eight Treasures Decoction) and Shiquan Dabu Tang (Ten Significant Tonifying Decoction), supplemented with Os Draconis (Longgu), Concha Ostreae (Muli), Jujubae Fructus (Dazao), and Poria (Fuling), are the principal formulas. In summary, if stasis remains, the priority is to move stasis; if stasis is cleared, the priority is to tonify Blood. Formulas for tonifying Blood must also tonify Qi, because Qi is the commander of Blood. Ancients stated: "To treat Wind, first treat Blood; to tonify Blood, first tonify Qi." This explains why Huangqi (Astragali Radix) is heavily used in Buxue Tang (Blood-Tonifying Decoction). When Qi moves, Blood moves, and stasis is resolved. Therefore, for deficient constitutions requiring stasis removal, one must first tonify Qi and Blood. Danxi argued that postpartum women should not be allowed to remain deficient; tonifying Qi and Blood should be the priority. Even if other complications exist, they should be treated secondarily. This grasps the essential principle.

Bing notes: Wu Jutong said: "The elderly, postpartum women, infants, and deficient persons are like an army without provisions; speed in battle is advantageous." However, having sharp eyes and quick hands—how easy is that to achieve?