宝鉴曰宋褚澄疗师尼寡妇别制方盖有为也此二种寡居独阴无阳欲心萌而多不遂是以阴阳
交争
乍寒乍热全类温疟久则为劳史记仓公传载济北王侍人韩女病腰背痛寒热众医多以为寒热仓公
曰病得之欲男子不可得也何以知诊得其脉肝脉弦出寸口是以知之盖男子以精为主妇人以血为
主男子精盛以思室女人血盛以怀胎也如厥阴脉弦出寸口又上鱼际则阴盛可知故知褚氏之言有
谓矣
病机机要云治胎产之病从厥阴经论之无犯胃气及上二焦为之三禁不可汗不可下不可利小
便发
汗者同伤寒下早之证利大便则脉数而已动于脾利小便则内亡津液胃中枯燥制药之法能不犯三
禁
则荣卫自和而寒热止矣如发渴而白虎气弱则黄 血刺痛而用当归腹中痛而加之芍药大抵产病
天行从增损柴胡杂证从增损四物宜详察脉证而用之
谨按以上云胎产禁例大抵主于元气本病为要至于病体所因不同学人又必当处于权变也且
胎
前之证良方悉具但每证治例殊少如胎漏胎痛子烦子肿等证出方皆是治本病之例设所因不同或
有
所兼之证如胎漏下血亦有气虚血热腹痛亦有湿热者或形志苦药不一七情所动气动血病胎气即
损虽治例未能以尽其变然欲学人临证自推充而行之尔今于诸证未能一一悉具聊以证治数例附
于后云
《宝鉴》记载：宋代褚澄为尼姑、寡妇专门制定方剂，是有其深意的。这两种人寡居独处，体内只有阴而无阳，欲望萌动却多不能遂愿，因此导致阴阳交争，出现忽冷忽热的症状，完全类似于温疟。如果日久不愈，就会演变为虚劳病。《史记·仓公传》中记载，济北王的侍女韩女患有腰背疼痛、忽冷忽热的病证，许多医生都认为是寒热之邪所致。仓公说：“这个病是因为想要男子而不可得造成的。”凭什么知道呢？诊察发现她的脉象是肝脉弦急，且出现在寸口部位，所以据此判断。大概来说，男子以精气为主，女子以血液为主；男子精气旺盛则思虑房事，女子血液充盈则容易怀孕。如果厥阴脉弦急且出现在寸口，甚至上达鱼际部位，就可以知道这是阴气过盛的表现。因此可以知道褚氏的说法是有道理的。
《病机机要》云：治疗胎产疾病，应从厥阴经进行论述，不要损伤胃气以及上、中、下三焦，这被称为“三禁”，即不可发汗、不可攻下、不可利小便。发汗会导致类似伤寒误下早的证候；通利大便会使脉数并扰动脾脏；通利小便会耗伤体内津液，导致胃中干燥。制药的方法如果不触犯这三项禁忌，那么营卫自然调和，寒热症状也就停止了。如出现口渴，可用白虎汤；若气弱，则用黄芪（原文缺字，据语境补）；若血刺痛，则用当归；若腹中痛，则加芍药。大抵产后病兼有外感时，应在增损柴胡汤基础上加减；杂证则在增损四物汤基础上加减。应当详细诊察脉证后使用。
谨按：以上所说的胎产禁忌，大体上以元气本病为关键。至于病因不同，学习者又必须懂得权变。况且产前诸证，《良方》中已有完备记载，但每个证候的治疗法则很少涉及。例如胎漏、胎痛、子烦、子肿等证，所出方剂都是治疗本病的法则。如果病因不同，或者兼有其他证候，比如胎漏下血也有因气虚或血热引起的，腹痛也有因湿热引起的，或者形体与情志受苦，用药不一，七情所动导致气动血乱，胎气随即受损。虽然治疗法则未能穷尽所有变化，但希望学习者能临证自行推演扩充并施行。如今在诸证方面未能一一详尽列出，仅附几个证治例子在后面。
*Baojian* records: Song Dynasty physician Chu Cheng formulated special prescriptions for nuns, Buddhist nuns, and widows, which was purposeful. These two groups live in seclusion, possessing Yin without Yang; their desires arise but are often unfulfilled, leading to a conflict between Yin and Yang. This manifests as alternating chills and fever, closely resembling warm malaria (Wen Nue). If prolonged, it evolves into consumptive disease (Lao). The *Records of the Grand Historian* (*Shiji*), in the biography of Cang Gong, records that Han Nu, a maid-servant of King Jibei, suffered from lower back pain and alternating chills and fever. Many physicians attributed this to pathogenic cold-heat. Cang Gong said, "This illness arises from desiring a man but being unable to obtain one." How did he know? Upon pulse diagnosis, he found the Liver pulse (Gan Mai) was wiry (Xian) and emerged at the Cun Kou position. Thus, he deduced this. Generally speaking, men are governed by Essence (Jing), while women are governed by Blood (Xue). When men's Essence is abundant, they desire sexual intercourse; when women's Blood is abundant, they conceive. If the Jueyin pulse is wiry and emerges at the Cun Kou, extending even to the Yu Ji area, it indicates an excess of Yin. Therefore, it can be understood that Chu's statements were well-founded.
*Bingji Yaojiao* states: In treating diseases related to pregnancy and childbirth, one should discuss them according to the Jueyin Meridian (Jueyin Jing), without violating Stomach Qi (Wei Qi) or the Upper, Middle, and Lower Jiao (San Jiao). This constitutes the "Three Prohibitions" (San Jin): no sweating (Han), no purgation (Xia), and no diuresis (Li Di Xiao Bian). Sweating induces conditions similar to premature purgation in Cold Damage (Shang Han); purging affects the Spleen (Pi) causing rapid pulse; diuresis depletes internal fluids, leading to dryness in the Stomach. If herbal preparation avoids these three prohibitions, Ying and Wei (Nutritive and Defensive Qi) will harmonize naturally, and chills and fever will cease. For thirst, Bai Hu Tang (White Tiger Decoction) may be used; if Qi is weak, Huang Qi (Astragali Radix) is added; for stabbing blood pain, Dang Gui (Angelicae Sinensis Radix) is used; for abdominal pain, Shao Yao (Paeoniae Radix Alba) is added. Generally, postpartum diseases complicated by epidemic pathogens are treated by modifying Chai Hu Tang (Bupleurum Decoction); miscellaneous disorders are treated by modifying Si Wu Tang (Four Substance Decoction). One must carefully observe pulses and symptoms before application.
Respectfully noted: The aforementioned prohibitions for pregnancy and childbirth primarily emphasize the importance of the root Qi (Yuan Qi) and underlying pathology. Since etiologies vary, practitioners must employ flexibility. Although *Liangfang* covers prenatal conditions comprehensively, specific treatment protocols for each syndrome are scarce. For instance, formulas for fetal leakage (Tai Lou), fetal pain (Tai Tong), maternal irritability (Zi Fan), and edema (Zi Zhong) generally treat the primary pathology. However, if etiologies differ or complications exist—such as fetal bleeding caused by Qi deficiency or Blood heat, or abdominal pain due to damp-heat—or if physical and mental distress leads to varied medication, where emotional disturbances cause Qi stagnation and Blood chaos, damaging Fetal Qi—even though treatment protocols cannot cover every variation—the hope is that practitioners will deduce and adapt based on clinical presentation. Herein, not all conditions are exhaustively listed; only a few examples of syndrome differentiation and treatment are appended below.