论曰。妇人童幼天癸未行之间。皆属少阴。天癸既行。皆从厥阴论之。天癸已绝。乃属太阴经也。治胎产
之病。从厥阴经者。是祖生化之源也。厥明与少阳相为表里。故治法无犯胃气。及上二焦。为三禁。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。荣卫和而寒热止矣。外则和于荣卫。内则调于清便。先将此法为之初治。次后详而论之。见证消息。同坏
证伤寒。为之缓治。或小便不利。或大便秘结。或积热于肠胃之间。或以成 。或散血气而为浮肿。盖产理多
门。故同伤寒坏证。如发渴用白虎。气弱则黄 。血刺痛而用以当归。腹中痛而加之芍药。以上例证。不犯三
禁。皆产后之久病也。凡产后暴病。禁犯不可拘也。如产后热入血室者。桃仁承气抵当汤之类是也。胃坚燥者。
大承气不可以泄药言之。产后世人多用乌金四物。是不知四时之寒热。不明血气之虚与实。盲然一概。用药如
此。而愈加增剧。是医人误之耳。大抵产病天行。从增损柴胡。杂证从加添四物。然春夏虽从柴胡。秋冬约同
四物。药性寒热。病证虚实。不可不察也。四物汤常病服饵。四时各有增损。今具增损于后。
春倍川芎。（一曰春二曰脉弦三曰头痛） 夏倍芍药。（一曰夏二曰脉洪三曰泄） 秋倍地黄。（一曰秋
二曰脉涩三曰血虚） 冬倍当归。（一曰冬二曰脉沉三曰寒而不食） 此常服顺四时之气。而有对证不愈者。
谓失其辅也。春防风四物。（加防风倍川芎） 夏黄芩四物。（加黄芩倍芍药） 秋天门冬四物。（加天门冬
倍地黄） 冬桂枝四物。（加桂枝倍当归） 此四时常服随证用之也。如血虚而腹痛。微汗而恶风。四物加术
桂。谓之腹痛六合。如风虚眩晕。加秦艽羌活。谓之风六合。如气虚弱。起则无力。匡然而倒。加浓朴陈皮。
谓之气六合。如发热而烦。不能安卧者。加黄连栀子。谓之热六合。如虚寒脉微。气难布息。不渴清便自调。
加干姜附子。谓之寒六合。如中湿身沉重无力。身凉微汗。加白术茯苓。谓之湿六合。此妇人常病。及产后病
通用之药也。治妇人虚劳。局方中谓之首尾六合者。如大圣散下熟干地黄丸。是治无热虚劳。专其养也。中道药
也。牡丹煎丸。空心食前。人
参荆芥散。临卧食后。是治有热虚劳药也。
治妇人怀胎腹胀。枳壳汤。
枳壳（三两炒） 黄芩（一两）
上为粗末。每服半两。水一盏半。煎一盏。去滓温服。
治产前胀满。身体沉重。枳壳汤中。加白术一两。
治产前寒热。小柴胡汤中。去半夏。谓之黄龙汤。
治怀孕胎漏。二黄散。
生地黄 熟地黄（各等分）
上为细末。加白术。枳壳汤调下一两。日二服。
治有孕胎痛。地黄当归汤。
当归（一两） 熟地黄（二两）
上为粗末。作一服。水三升。煎至升半。去滓顿服。
束胎丸
白术 枳壳（去穣炒等分）
上为末。烧饭为丸。如桐子大。每月一日食前服三五十丸。温熟水下。胎瘦易生也。服至产则已。
产间药
治胎衣不下。或子死腹中。或血冲上昏闷。或血暴下。及胞干而不能产者。宜服半夏汤。
半夏曲（一两半） 桂（七钱半去皮） 大黄（五钱） 桃仁（三十个去皮尖炒）
上为细末。先服四物汤三两服。次服半夏汤三钱。生姜三片。水一盏。煎去三分。食后。如未效。次服下
胎丸。
下胎丸
半夏（生） 白敛（各半两）
上为细末。滴水为丸。如桐子大。食后。用半夏汤下三二丸。续续加至五七丸。如有未效者。须广大其药。
榆白皮散主之。又不效大圣散主之。有宿热人。宜服人参荆芥散。
产后药
治产后经水适断。感于异证。手足牵搐。切牙昏冒。宜增损柴胡汤。
柴胡（八钱） 黄芩（四钱半） 人参（三钱） 半夏（三钱） 石膏（四钱） 知母（二钱） 黄 （五钱）
甘草（四钱炙）
上为粗末。每服半两。生姜五片。枣四个。水一盏半。煎至一盏。温服清。无时。
前证已去。次服秦艽汤。去其风邪。
秦艽（八钱） 人参（三钱） 防风（四钱半） 芍药（半两） 柴胡（八钱） 黄芩（四钱半） 半夏（三钱）
甘草（四钱炙）
上为粗末。每服五七钱。水一盏。煎至七分。温服清无时。二三日经水复行。前证退。宜服荆芥散。小柴
胡小料中。加荆芥穗五钱。枳壳五钱麸炒去穣。同小柴胡汤煎服。三二日后。宜正脾胃之气。兼除风邪。宜服
防风汤。
苍术（四两） 防风（三两） 当归（一两半） 羌活（一两半）
上为粗末。每服一二两。水三盏。煎至一盏半。取清。续续常服。无时。
凡胎前之药。无犯胎气。产后变化。并同伤寒坏证。尽从加减四物汤调治。
治产后腹大坚满。喘不能卧。白圣散。
樟柳根（三两） 大戟（二两半） 甘遂（一两炒）
上为极细末。每服二三钱。热汤调下。取大便宣利为度。此药主水气之胜药也。
治产后风气在表。面目四肢浮肿。宜加减局方中七圣丸。每服二十丸。白汤下。日加三四丸。以利为度。
如浮肿喘嗽。加木香槟榔倍之。谓气多浮则肿。如头目昏冒。加羌活川芎。谓多风也。如只浮肿。根据七圣丸本
方服之。
治产后日久虚劳。虽日久而脉浮疾者。宜服三元汤。
柴胡（八钱） 黄芩 人参 半夏（洗） 甘草（炙以上各三钱） 川芎 芍药 熟地黄 当归（各二钱半）
上为粗末。同小柴胡汤煎服。
治日久虚劳。微有寒热。脉沉而浮。宜柴胡四物汤。
川芎 熟地黄 当归 芍药（各一两半） 柴胡（八钱） 人参 黄芩 甘草 半夏曲（以上各三钱）
上为粗末。同四物煎服。
如日久虚劳。针灸小药俱不效者。宜服三分散。
白术 茯苓 黄 川芎 芍药 熟地黄 当归（各一两） 柴胡（一两六钱） 黄芩（六钱） 人参（一两六钱）
半夏（六钱） 甘草（六钱）
上为粗末。每服一两。水一盏。煎至半盏。温服清。日一服。
治产后虚劳不能食。宜十全散。
白术 茯苓 黄 （各二两） 人参 川芎 芍药 熟地黄 当归（各一两） 桂（一两半） 甘草（一两半炙）
上 如麻豆。每服半两。水一盏半。入生姜五片。枣三枚。同煎至七分。空心食前温服清。
凡虚损病者。浅深治有次第。虚损论中详论之。
治产后诸风。痿挛无力。血风汤。
秦艽 羌活 防风 白芷 川芎 芍药 当归 地黄 白术 茯苓（各等分）
上为细末。一半炼蜜丸如桐子大。一半散。温酒调下丸子五七十丸。甚妙。
治产后诸积不可攻。当养阴去热。其病自退。宜服芍药汤。
芍药（一斤） 黄芩 茯苓（各六两）
上三味为粗末。每服半两。水煎。日三服。去滓温服。
治产后儿枕大痛。黑白散。
乌金石（烧红醋淬七遍另为细末） 寒水石（烧存性末）
上二味各等分。另顿放。临服各抄末一钱半。粥饮汤下。痛止便不可服。未止再服。大效。
治产后不烦而渴。桃花散。
新锻石（一两） 黄丹（半钱）
上细末。渴时冷浆水。调一钱服。
治产后冲胀。胸中有物状。是噎气不降。紫金丹。
代赭石 砺石（各等分）
上为细末。醋糊为丸。如桐子大。每服三五十丸。酒下。胸中痛。加当归汤下。久服治血癖。
又方
代赭石（一两） 桃仁（三钱炒去皮尖） 大黄（五钱）
上为末。薄荷水为糊。丸如桐子大。每服三五十丸。温水下无时。
治脐腹痛不可忍。四物汤一两。加玄胡三钱半。
治血癖腹痛。及血刺腰痛。四物汤细末二两。加酒煮玄胡细末三两。每服三钱。酒调下。
治血运血结血聚于胸中。或偏于少腹。或连于肋胁。四物汤四两。倍当归川芎。加鬼箭红花玄胡各一两。
同为末。如四物汤煎服。取清调没药散服之。
没药散
虻虫（一钱去足羽炒） 水蛭（一钱炒） 麝香（一钱） 没药（三钱）
上为细末。煎前药调服。血下痛止。只服前药。
治产后头痛。血虚痰癖寒厥。皆令头痛。加减四物汤。
羌活 川芎 防风 香附子（炒） 白芷（以上各一两） 石膏（二两半） 细辛（二钱） 当归（五钱）
熟地黄（一两） 甘草（五钱） 苍术（一两六钱去皮）
上为粗末。每服一两。水煎服无时。如有汗者。是气弱头痛
也。方中加芍药三两。桂一两半。加生姜煎。如痰癖头疼。加半夏三两。茯苓一两半。加生姜煎。如热厥头痛。
又加白芷三两。石膏三两。知母一两半。寒厥头痛。加天麻三两。附子一两半。生姜煎。
治产后风虚血眩。精神昏昧。荆芥散。
荆芥穗（一两三钱） 桃仁（五钱去皮尖炒）
上为细末。温水调服三钱。微喘加杏仁（去皮尖炒） 甘草（炒） 各三钱。
治产前证胎不动。如重物下坠。腹冷如冰。立效散。
川芎 当归（各等分）
上为粗末。每服秤三钱。水二盏。煎至一盏。去滓食前服。
治如人胎漏。及因事下血。枳壳汤。
枳壳（半两） 黄芩（半两） 白术（一两）
上为粗末。每服五七钱。水一盏。煎至七分。食前空心服。
治妇人筋骨痛。及头痛脉弦。憎寒如疟。宜服风六合汤。
四物汤四两。加羌活防风各一两。
治妇人血气上冲。心腹肋下闷。宜服治气六合汤。
四物四两。加木香槟榔各半两。
治妇人脐下冷。腹痛腰脊痛。宜服玄胡六合汤。
四物内加玄胡苦楝（炒）各一两。
治妇人气充经脉。月事频并。脐下痛。宜芍药六合汤。
四物内倍加芍药。
治妇人经事欲行。脐腹绞痛。宜服八物汤。
四物内。加玄胡苦楝各一两。槟榔木香各半两。
治妇人经水过多。别无余证。
四物内。加黄芩白术各一两。
治妇人经水涩少。
四物内。加葵花煎。
治妇人虚劳气弱。喘嗽胸满。宜气六合汤。
四物内。加浓朴一两。（制） 枳实半两。（炒）
以上煎法。并同四物服之。
四物主治法
熟地黄 补血。如脐下痛。非熟地黄不能除。此通肾经之药也。
川芎 治风。泻肝木。如血虚头痛。非芎不能除去。此通肝经之药也。
芍药 和血理脾。治腹痛非芍药不能除。此通脾经之药也。
当归 和血。如血刺痛。非当归不能除。此通心经之药也。
以上四味治法。如前一证。于四物汤中。各加二味用之。如少腹痛。四物汤四两。加玄胡苦楝各一两。经
水暴多。四物四两。加黄连黄芩各一两。如腹痛者只加黄连。如夏月用不去黄芩。经水如黑豆水。加黄连黄芩
各一两。如经水少而血色和者。四物四两。加熟地黄当归各一两。如经水适来适断。往来寒热者。先服小柴胡。
以去其寒热。后以四物汤调治之。如寒热不退。勿服四物。是谓变证。表邪犹存。不能效也。根据前论中变证。
随证用药调治之。
治妇人血积。增损四物汤。
四物内。加广术京三棱桂干漆。皆根据法制。各加一两。如四物煎服。
治妇人产后血昏血崩。月事不调。远年干血气。皆治之。名曰红花散。
干荷叶 牡丹皮 当归 红花 蒲黄（炒）
上各等分。为细末。每服半两。酒煎和滓温服。如衣不下。另末榆白皮。煎汤调半两立效。
治妇人恶物不下。
当归（炒） 芫花（炒）
上细末。酒调三钱。又好墨醋碎末之。小便酒调下妙。
又治胎衣不下。蛇退皮（炒焦）细末二钱。酒调下。
诸见血无寒。衄血下血吐血溺血。皆属于热。但血家证。皆宜服此药。生地黄散。
生地黄 熟地黄 枸杞子 地骨皮 天门冬 黄 芍药 甘草 黄芩
上各等分同 。每服一两。水一盏半。煎至一盏。去滓温服。脉微身凉恶风。每一两加桂半钱。吐血者多
有此证。
治衄血不止。麦门冬饮子。
麦门冬 生地黄
上等分 。每服一两。煎服。又衄血先朱砂蛤粉。次木香黄连。大便结下之。大黄芒硝甘草生地黄。溏软。
栀子黄芩黄连。可选用。
带下附
论曰。赤者热入小肠。白者热入大肠。原其本也。皆湿热结于脉。故津液涌溢。是为赤白带下。本不病。
缘五脉经虚。结热屈滞于带。故女子脐下 痛而绵绵。阴器中时下也。故经曰。任脉为病。男子内结七疝。女子
带下瘕聚。王注曰。任脉自胞上过带脉。贯于脐上。故男子内结七疝。女子带下。带脉起于季胁章门。如束带状。
今湿热冤结不散。故为病也。经曰。脾传之肾。病名曰疝瘕。少腹冤热而痛。出白。一名曰蛊。所以为带下冤
屈也。冤结也。屈滞而病热不散。先以十枣汤下之。后服苦楝丸大玄胡散调下之。热去湿除。病自愈也。如女子
不月。先泻心火。血自下也。内经曰。二阳之病发心脾。有不得隐曲。故女子不月。其传为风消。王注曰。大
肠胃发病也。心脾受之。心主血。心病则血不流。脾主味。脾病则味不化。味不化则精不足。精血不
论述说：妇女在童年及天癸（指月经）尚未来潮的时期，病证多归属于少阴经。当天癸已经到来，病证多从厥阴经进行辨证论治。当天癸枯竭绝止后，病证则归属于太阴经。治疗胎产方面的疾病，若从厥阴经论治，是因为这是生命化生和养育的根本源头。厥阴与少阳互为表里，因此治疗方法中不可损伤胃气，也不可攻伐上焦和中焦，这被称为“三禁”，即不可发汗、不可攻下、不可利小便。如果发汗，就会如同伤寒病误用早下法造成的坏证一样；如果通利大便，会导致脉数且扰动脾脏；如果利小便，会导致体内津液亡失，胃中干燥枯涸。制药用药的原则，如果不触犯上述三禁，那么营卫之气自然调和，营卫调和而寒热症状也就停止了。对外则能调和营卫，对内则能调理二便通畅。先将这种方法作为初步治疗，之后再详细论述。根据见证情况斟酌处理，如同对待伤寒坏证那样进行缓治。或者出现小便不利，或者大便秘结，或者肠胃间积热，或者形成痞块，或者散乱血气导致浮肿。因为产后病理变化多端，所以如同伤寒坏证。例如出现口渴用白虎汤，气虚用黄芪汤，血刺痛用当归，腹中痛加芍药。以上这些例子，都不触犯三禁，都是针对产后久病的治法。凡是产后突发的急症，禁忌不要拘泥于上述规则。例如产后热入血室者，可用桃仁承气汤或抵当汤之类。胃中坚硬燥结者，不能用大承气汤等泻下药来谈论治疗。产后世人多用乌金四物汤，这是不了解四季气候的寒热变化，不明白气血的虚实证候，盲目地一概而论，用药如此，反而使病情加重，这是医生误治所致。大致而言，产后感受时行邪气，应从增损柴胡汤加减；杂病则从加味四物汤加减。然而春夏季节虽以柴胡汤为主，秋冬季节则约同于四物汤。药物的寒热性质与病证的虚实关系，不可不仔细考察。四物汤常用于日常服用调理，四季各有增减变化。现将具体的增减方法列在后面：春季加倍川芎。（原因一曰春季，二曰脉弦，三曰头痛）夏季加倍芍药。（原因一曰夏季，二曰脉洪，三曰泄泻）秋季加倍地黄。（原因一曰秋季，二曰脉涩，三曰血虚）冬季加倍当归。（原因一曰冬季，二曰脉沉，三曰寒冷而不思饮食）这是常服以顺应四时之气的方法。如果有对证服药却不痊愈的情况，称为失去了辅助药物。春季用防风四物汤。（加防风，倍川芎）夏季用黄芩四物汤。（加黄芩，倍芍药）秋季用天门冬四物汤。（加天门冬，倍地黄）冬季用桂枝四物汤。（加桂枝，倍当归）这是四季常服并随证使用的方剂。如血虚而腹痛，微汗出且恶风，四物汤加白术、桂枝，称为腹痛六合汤。如风虚眩晕，加秦艽、羌活，称为风六合汤。如气虚弱，起身无力，突然昏倒，加厚朴、陈皮，称为气六合汤。如发热且烦躁，不能安卧，加黄连、栀子，称为热六合汤。如虚寒脉微，气息难续，口不渴，二便自调，加干姜、附子，称为寒六合汤。如中湿身体沉重无力，身凉微汗，加白术、茯苓，称为湿六合汤。这是妇人常发病及产后病通用的药物。治疗妇人虚劳，局方中称为首尾六合汤的，如大圣散下的熟干地黄丸，是治疗无热虚劳，专于滋养的。属于中和之药。牡丹煎丸，空腹食前服用；人参荆芥散，临睡前食后服用，这是治疗有热虚劳的药物。
治疗妇人怀孕腹胀，用枳壳汤。
枳壳（三两，炒） 黄芩（一两）
将上述药材捣成粗末。每次服用半两，加水一盏半，煎煮至一盏，去渣温服。
治疗怀孕胎漏（妊娠期阴道少量出血），用二黄散。
生地黄 熟地黄（各等分）
将上述药材研为细末，加入白术，用枳壳汤调服一两，每日两次。
治疗怀孕胎痛，用地黄当归汤。
当归（一两） 熟地黄（二两）
将上述药材捣成粗末，作一次服用量，加水三升，煎煮至一升半，去渣一次性服下。
束胎丸
白术 枳壳（去瓤，炒，等分）
将上述药材研为末，用米饭做丸，如梧桐子大。每月一日饭前服用三五十丸，温开水送下，可使胎儿瘦小易生。服至分娩即可停止。
产间药
治疗胎衣不下，或子死腹中，或血冲上致昏闷，或血暴下，以及胞干不能产者，宜服半夏汤。
半夏曲（一两半） 桂枝（七钱半，去皮） 大黄（五钱） 桃仁（三十个，去皮尖，炒）
将上述药材研为细末。先服四物汤三两，再服半夏汤三钱，加生姜三片，水一盏，煎煮去三分之一，饭后服用。如果未见效，接着服下胎丸。
下胎丸
半夏（生） 白敛（各半两）
将上述药材研为细末，滴水为丸，如梧桐子大。饭后，用半夏汤送下二三丸，逐渐增加至五六七丸。如果仍未见效，必须扩大药力，用榆白皮散主治。如果仍无效，用大圣散主治。有宿热的人，宜服人参荆芥散。
产后药
治疗产后经水突然中断，感于异证，手足抽搐，咬牙昏冒，宜服增损柴胡汤。
柴胡（八钱） 黄芩（四钱半） 人参（三钱） 半夏（三钱） 石膏（四钱） 知母（二钱） 黄芪（五钱） 甘草（四钱，炙）
将上述药材捣成粗末。每次服用半两，加生姜五片，大枣四个，水一盏半，煎煮至一盏，温服清汁，不拘时候。
前述证候已去，接着服秦艽汤，以祛除风邪。
秦艽（八钱） 人参（三钱） 防风（四钱半） 芍药（半两） 柴胡（八钱） 黄芩（四钱半） 半夏（三钱） 甘草（四钱，炙）
将上述药材捣成粗末。每次服用五七钱，水一盏，煎煮至七分，温服清汁，不拘时候。二三日后经水复行，前述证候退去，宜服荆芥散。在小柴胡汤小料中，加荆芥穗五钱，枳壳五钱（麸炒，去瓤）。同小柴胡汤煎服。三二日后，宜正脾胃之气，兼除风邪，宜服防风汤。
苍术（四两） 防风（三两） 当归（一两半） 羌活（一两半）
将上述药材捣成粗末。每次服用一二两，水三盏，煎煮至一盏半，取清汁，持续常服，不拘时候。
凡胎前之药，不可触犯胎气。产后变化，均如同伤寒坏证，尽从加减四物汤调治。
治疗产后腹大坚满，喘促不能卧，用白圣散。
樟柳根（三两） 大戟（二两半） 甘遂（一两，炒）
将上述药材研为极细末。每次服用二三钱，热开水调下。以大便通畅为度。此药主治水气盛行之证。
治疗产后风气在表，面目四肢浮肿，宜用加减局方中的七圣丸。每次服用二十丸，白开水送下。每日增加三四丸，以利为度。
如浮肿喘嗽，加木香、槟榔并加倍使用，这是因为气多浮则肿。如头目昏冒，加羌活、川芎，这是因为风多。如只浮肿，依七圣丸本方服用。
治疗产后日久虚劳，虽然日久但脉浮疾者，宜服三元汤。
柴胡（八钱） 黄芩 人参 半夏（洗） 甘草（炙，以上各三钱） 川芎 芍药 熟地黄 当归（各二钱半）
将上述药材捣成粗末，同小柴胡汤煎服。
治疗日久虚劳，微有寒热，脉沉而浮，宜服柴胡四物汤。
川芎 熟地黄 当归 芍药（各一两半） 柴胡（八钱） 人参 黄芩 甘草 半夏曲（以上各三钱）
将上述药材捣成粗末，同四物汤煎服。
如日久虚劳，针灸和小药均无效者，宜服三分散。
白术 茯苓 黄芪 川芎 芍药 熟地黄 当归（各一两） 柴胡（一两六钱） 黄芩（六钱） 人参（一两六钱） 半夏（六钱） 甘草（六钱）
将上述药材捣成粗末。每次服用一两，水一盏，煎煮至半盏，温服清汁，每日一服。
治疗产后虚劳不能食，宜服十全散。
白术 茯苓 黄芪（各二两） 人参 川芎 芍药 熟地黄 当归（各一两） 桂枝（一两半） 甘草（一两半，炙）
将上述药材捣碎如麻豆大小。每次服用半两，水一盏半，入生姜五片，大枣三枚，同煎至七分，空腹食前温服清汁。
治疗产后诸风，痿挛无力，用血风汤。
秦艽 羌活 防风 白芷 川芎 芍药 当归 地黄 白术 茯苓（各等分）
将上述药材研为细末。一半炼蜜为丸，如梧桐子大；一半为散剂。温酒调下丸子五七十丸，效果甚妙。
治疗产后诸积不可攻伐，应当养阴去热，病自然消退，宜服芍药汤。
芍药（一斤） 黄芩 茯苓（各六两）
将上述三味药捣成粗末。每次服用半两，水煎，每日三次，去渣温服。
治疗产后儿枕大痛，用黑白散。
乌金石（烧红醋淬七遍，另研为细末） 寒水石（烧存性，研末）
将上述两味药各等分，分别存放。临服时各取末一钱半，粥饮汤送下。痛止便不可再服，未止可再服，效果极大。
治疗产后不烦而渴，用桃花散。
新锻石（一两） 黄丹（半钱）
将上述药材研为细末，渴时用冷浆水调服一钱。
治疗产后冲胀，胸中有物状感，是噎气不降，用紫金丹。
代赭石 砺石（各等分）
将上述药材研为细末，醋糊为丸，如梧桐子大。每次服用三五十丸，酒送下。胸中痛，加当归汤送下。久服治血癖。
又一方
代赭石（一两） 桃仁（三钱，炒去皮尖） 大黄（五钱）
将上述药材研为末，薄荷水为糊，丸如梧桐子大。每次服用三五十丸，温水送下，不拘时候。
治疗血癖腹痛，及血刺腰痛，用四物汤细末二两，加酒煮玄胡索细末三两。每次服用三钱，酒调下。
治疗血运、血结、血聚于胸中，或偏于少腹，或连于肋胁，用四物汤四两，倍加当归、川芎，加鬼箭羽、红花、玄胡索各一两。同为末，按四物汤法煎服，取清汁调没药散服之。
没药散
虻虫（一钱，去足翅，炒） 水蛭（一钱，炒） 麝香（一钱） 没药（三钱）
将上述药材研为细末，煎前药调服。血下痛止，只服前药。
治疗产后头痛，血虚痰癖寒厥，皆令头痛，用加减四物汤。
羌活 川芎 防风 香附子（炒） 白芷（以上各一两） 石膏（二两半） 细辛（二钱） 当归（五钱） 熟地黄（一两） 甘草（五钱） 苍术（一两六钱，去皮）
将上述药材捣成粗末。每次服用一两，水煎服，不拘时候。如有汗者，是气弱头痛，方中加芍药三两，桂枝一两半，加生姜煎。如痰癖头疼，加半夏三两，茯苓一两半，加生姜煎。如热厥头痛，又加白芷三两，石膏三两，知母一两半。寒厥头痛，加天麻三两，附子一两半，生姜煎。
治疗产后风虚血眩，精神昏昧，用荆芥散。
荆芥穗（一两三钱） 桃仁（五钱，去皮尖，炒）
将上述药材研为细末，温水调服三钱。微喘加杏仁（去皮尖，炒）、甘草（炒）各三钱。
治疗产前证见胎不动，如重物下坠，腹冷如冰，用立效散。
川芎 当归（各等分）
将上述药材捣成粗末。每次称取三钱，水二盏，煎煮至一盏，去渣食前服。
治疗如人胎漏，及因事下血，用枳壳汤。
枳壳（半两） 黄芩（半两） 白术（一两）
将上述药材捣成粗末。每次服用五七钱，水一盏，煎煮至七分，食前空心服。
治疗妇人筋骨痛，及头痛脉弦，憎寒如疟，宜服风六合汤。
四物汤四两，加羌活、防风各一两。
治疗妇人血气上冲，心腹肋下闷，宜服治气六合汤。
四物汤四两，加木香、槟榔各半两。
治疗妇人脐下冷，腹痛腰脊痛，宜服玄胡六合汤。
四物汤内加玄胡索、苦楝（炒）各一两。
治疗妇人气充经脉，月事频并，脐下痛，宜服芍药六合汤。
四物汤内倍加芍药。
治疗妇人经事欲行，脐腹绞痛，宜服八物汤。
四物汤内，加玄胡索、苦楝各一两，槟榔、木香各半两。
治疗妇人虚劳气弱，喘嗽胸满，宜服气六合汤。
四物汤内，加厚朴一两（制），枳实半两（炒）。
以上煎法，并同四物汤服之。
四物主治法
熟地黄：补血。如脐下痛，非熟地黄不能除。此通肾经之药也。
川芎：治风，泻肝木。如血虚头痛，非川芎不能除去。此通肝经之药也。
芍药：和血理脾。治腹痛非芍药不能除。此通脾经之药也。
当归：和血。如血刺痛，非当归不能除。此通心经之药也。
以上四味治法，如前一证，于四物汤中，各加二味用之。如少腹痛，四物汤四两，加玄胡索、苦楝各一两。经水暴多，四物汤四两，加黄连、黄芩各一两。如腹痛者只加黄连。如夏月用不去黄芩。经水如黑豆水，加黄连、黄芩各一两。如经水少而血色和者，四物汤四两，加熟地黄、当归各一两。如经水适来适断，往来寒热者，先服小柴胡汤，以去其寒热，后以四物汤调治之。如寒热不退，勿服四物汤，是谓变证，表邪犹存，不能效也。根据前论中变证，随证用药调治之。
治疗妇人血积，用增损四物汤。
四物汤内，加莪术、京三棱、桂枝、干漆。皆依法炮制，各加一两。如四物汤煎服。
治疗妇人产后血昏血崩，月事不调，远年干血气，皆治之，名曰红花散。
干荷叶 牡丹皮 当归 红花 蒲黄（炒）
将上述药材各等分，为细末。每次服用半两，酒煎和滓温服。如衣不下，另研榆白皮末，煎汤调半两，立效。
治疗妇人恶物不下。
当归（炒） 芫花（炒）
将上述药材研为细末，酒调三钱。又好墨醋碎末之，小便酒调下妙。
诸见血无寒，衄血、下血、吐血、溺血，皆属于热。但血家证，皆宜服此药，生地黄散。
生地黄 熟地黄 枸杞子 地骨皮 天门冬 黄芪 芍药 甘草 黄芩
将上述药材各等分同煎。每次服用一两，水一盏半，煎煮至一盏，去渣温服。脉微身凉恶风，每一两加桂枝半钱。吐血者多有此证。
治疗衄血不止，用麦门冬饮子。
麦门冬 生地黄
将上述药材等分同煎。每次服用一两，煎服。又衄血先朱砂蛤粉，次木香黄连，大便结下之，大黄芒硝甘草生地黄，溏软，栀子黄芩黄连，可选用。
带下附
论述说：赤色带下是热入小肠，白色带下是热入大肠。推究其本源，皆是湿热结于脉道，故津液涌溢，是为赤白带下。本不病，缘五脉经虚，结热屈滞于带脉，故女子脐下痛而绵绵，阴器中时下也。故经曰：任脉为病，男子内结七疝，女子带下瘕聚。王注曰：任脉自胞上过带脉，贯于脐上，故男子内结七疝，女子带下。带脉起于季胁章门，如束带状。今湿热冤结不散，故为病也。经曰：脾传之肾，病名曰疝瘕，少腹冤热而痛，出白，一名曰蛊。所以为带下冤屈也。冤结也。屈滞而病热不散，先以十枣汤下之，后服苦楝丸大玄胡散调下之。热去湿除，病自愈也。如女子不月，先泻心火，血自下也。内经曰：二阳之病发心脾，有不得隐曲，故女子不月。其传为风消。王注曰：大肠胃发病也。心脾受之。心主血，心病则血不流。脾主味，脾病则味不化。味不化则精不足，精血不
Discussion states: During the period of childhood and before the onset of Tian Gui (menstruation) in women, diseases generally belong to the Shaoyin channel. Once Tian Gui has arrived, diseases are discussed from the perspective of the Jueyin channel. When Tian Gui is exhausted and ceases, diseases belong to the Taiyin channel. In treating diseases related to pregnancy and childbirth, discussing them from the Jueyin channel is because this is the source of life generation and nourishment. Jueyin and Shaoyang are exterior-interior counterparts; therefore, treatment methods must not damage Stomach Qi, nor attack the Upper and Middle Jiao. This is known as the "Three Prohibitions": no sweating, no purgation, and no promoting urination. Sweating would cause harm similar to the adverse effects of premature purgation in Cold Damage diseases. Purging the bowels would lead to a rapid pulse and disturb the Spleen. Promoting urination would result in the loss of body fluids and dryness in the Stomach. The principle of preparing medicines is that if these three prohibitions are not violated, Ying and Wei Qi will harmonize naturally, and when Ying and Wei Qi harmonize, chills and fever will cease. Externally, this harmonizes Ying and Wei Qi; internally, it regulates bowel movements and urination. This method should be used as initial treatment, followed by detailed discussion. Based on clinical manifestations, treatment should be gentle, similar to managing adverse conditions in Cold Damage diseases. Symptoms may include difficulty urinating, constipation, accumulation of heat in the intestines and stomach, formation of masses, or blood stasis causing edema. Since postpartum pathology is complex, it resembles adverse conditions in Cold Damage. For example, thirst is treated with Baihu Tang, Qi deficiency with Huangqi Tang, stabbing blood pain with Danggui, and abdominal pain with added Shaoyao. These examples do not violate the three prohibitions and are treatments for chronic postpartum conditions. However, for acute postpartem illnesses, one should not rigidly adhere to these rules. For instance, heat entering the Blood Chamber after childbirth can be treated with Taoren Chengqi Tang or Didang Tang. If the Stomach is hard and dry, Dachenqi Tang should not be used as a purgative. People often use Wuji Siwu Tang after childbirth, which shows a lack of understanding of seasonal cold and heat variations and the deficiency or excess of Qi and Blood. Blindly applying such medications exacerbates the condition, which is due to medical error. Generally, postpartum diseases caused by epidemic pathogens should be treated with Zengsun Chaihu Tang, while miscellaneous diseases should be treated with Jiawei Siwu Tang. Although Chaihu Tang is primary in spring and summer, Siwu Tang is more appropriate in autumn and winter. The cold and hot properties of herbs and the deficiency and excess of symptoms must be carefully observed. Siwu Tang is commonly used for daily regulation, with modifications for each season. The specific modifications are listed below: In spring, double the amount of Chuanxiong (Reasons: 1. Spring season, 2. Wiry pulse, 3. Headache). In summer, double the amount of Shaoyao (Reasons: 1. Summer season, 2. Surging pulse, 3. Diarrhea). In autumn, double the amount of Dihuang (Reasons: 1. Autumn season, 2. Choppy pulse, 3. Blood deficiency). In winter, double the amount of Danggui (Reasons: 1. Winter season, 2. Deep pulse, 3. Cold and anorexia). This follows the Qi of the four seasons. If symptoms persist despite correct diagnosis, it indicates a lack of auxiliary herbs. Spring: Fangfeng Siwu Tang (add Fangfeng, double Chuanxiong). Summer: Huangqin Siwu Tang (add Huangqin, double Shaoyao). Autumn: Tianmendong Siwu Tang (add Tianmendong, double Dihuang). Winter: Guizhi Siwu Tang (add Guizhi, double Danggui). These are for regular seasonal use based on symptoms. For blood deficiency with abdominal pain, slight sweating, and aversion to wind, add Baizhu and Guizhi to Siwu Tang, called Abdominal Pain Liuhe Tang. For dizziness due to wind deficiency, add Qinjiao and Qianghuo, called Wind Liuhe Tang. For Qi deficiency with weakness upon standing and sudden collapse, add Houpo and Chenpi, called Qi Liuhe Tang. For fever with irritability and inability to lie down, add Huanglian and Zhizi, called Heat Liuhe Tang. For deficiency-cold with faint pulse, difficult breathing, no thirst, and normal bowel/urine, add Ganjiang and Fuzi, called Cold Liuhe Tang. For dampness with heavy body, weakness, cool skin, and slight sweating, add Baizhu and Fuling, called Dampness Liuhe Tang. These are common remedies for gynecological and postpartum conditions. For deficiency consumption, Ju Fang's Shouwei Liuhe Tang includes Shu Gan Dihuang Wan from Dasheng San, which treats non-heat deficiency consumption by nourishing. It is a moderate medicine. Mudan Jian Wan is taken empty-stomach before meals; Renshen Jingjie San is taken after meals before sleep, treating heat-related deficiency consumption.
For abdominal distension during pregnancy, use Zhike Tang.
Zhike (3 liang, stir-fried), Huangqin (1 liang).
Grind into coarse powder. Take 0.5 liang per dose, decoct in 1.5 cups of water until 1 cup remains. Strain and take warm.
For pre-partum distension and heavy body, add Baizhu (1 liang) to Zhike Tang.
For pre-partum chills and fever, remove Banxia from Xiaochaihu Tang, called Huanglong Tang.
For threatened miscarriage (vaginal bleeding during pregnancy), use Erhuang San.
Sheng Dihuang, Shu Dihuang (equal parts).
Grind into fine powder. Add Baizhu. Mix with Zhike Tang decoction, take 1 liang per dose, twice daily.
For fetal pain during pregnancy, use Dihuang Danggui Tang.
Danggui (1 liang), Shu Dihuang (2 liang).
Grind into coarse powder. One dose, decoct in 3 sheng of water until 1.5 sheng remains. Strain and take at once.
Shutai Wan
Baizhu, Zhike (remove pith, stir-fried, equal parts).
Grind into powder. Make pills with rice paste, size of wisteria seeds. Take 30-50 pills on the first day of each month before meals with warm water. This makes the fetus smaller and easier to deliver. Stop taking when delivery begins.
Medicines for Labor
For retained placenta, dead fetus in utero, blood rushing up causing coma, severe hemorrhage, or dry uterus preventing delivery, use Banxia Tang.
Banxia Qu (1.5 liang), Guizhi (7.5 qian, peeled), Dahuang (5 qian), Taoren (30 kernels, peeled, de-seeded, stir-fried).
Grind into fine powder. First take 3 liang of Siwu Tang, then take 3 qian of Banxia Tang with 3 slices of Shengjiang. Decoct in 1 cup of water until 1/3 is lost. Take after meals. If ineffective, proceed to Xiatai Wan.
Xiatai Wan
Banxia (raw), Bailian (each 0.5 liang).
Grind into fine powder. Make pills with water drops, size of wisteria seeds. After meals, take 2-3 pills with Banxia Tang, gradually increasing to 5-7 pills. If ineffective, expand treatment using Yubai Pi San. If still ineffective, use Dasheng San. Patients with residual heat should take Renshen Jingjie San.
Postpartum Medicines
For sudden cessation of lochia with convulsions, teeth grinding, and coma due to external pathogens, use Zengsun Chaihu Tang.
Chaihu (8 qian), Huangqin (4.5 qian), Renshen (3 qian), Banxia (3 qian), Shigao (4 qian), Zhimu (2 qian), Huangqi (5 qian), Gancao (4 qian, honey-fried).
Grind into coarse powder. Take 0.5 liang per dose with 5 slices of Shengjiang and 4 dates. Decoct in 1.5 cups of water until 1 cup remains. Take warm clear liquid anytime.
After previous symptoms resolve, take Qinjiao Tang to expel wind pathogen.
Qinjiao (8 qian), Renshen (3 qian), Fangfeng (4.5 qian), Shaoyao (0.5 liang), Chaihu (8 qian), Huangqin (4.5 qian), Banxia (3 qian), Gancao (4 qian, honey-fried).
Grind into coarse powder. Take 5-7 qian per dose. Decoct in 1 cup of water until 0.7 cup remains. Take warm clear liquid anytime. After 2-3 days, if menstruation resumes and symptoms subside, take Jingjie San. Add Jingjie Sui (5 qian) and Zhike (5 qian, bran-fried, de-pithed) to small dosage Xiaochaihu Tang. Decoct and take. After 2-3 days, strengthen Spleen and Stomach Qi and expel wind by taking Fangfeng Tang.
Cangzhu (4 liang), Fangfeng (3 liang), Danggui (1.5 liang), Qianghuo (1.5 liang).
Grind into coarse powder. Take 1-2 liang per dose. Decoct in 3 cups of water until 1.5 cups remain. Take warm clear liquid continuously anytime.
All prenatal medicines must not harm fetal Qi. Postpartum changes resemble adverse conditions in Cold Damage and should be regulated using modified Siwu Tang.
For postpartum abdominal distension, hardness, and dyspnea preventing lying down, use Baisheng San.
Zhangliugen (3 liang), Daji (2.5 liang), Gansui (1 liang, stir-fried).
Grind into very fine powder. Take 2-3 qian mixed with hot water. Stop when bowels move freely. This medicine treats excessive water qi.
For postpartum wind pathogen in the exterior causing facial and limb edema, use Jiajian Ju Fang Zhong Qisheng Wan. Take 20 pills with warm water. Increase by 3-4 pills daily until bowels move.
If edema and cough worsen, add Muxiang and Binglang and double the dose, as excessive floating Qi causes swelling. If head and eyes are dizzy, add Qianghuo and Chuanxiong, indicating excess wind. If only edema occurs, follow the original Qisheng Wan formula.
For long-term postpartum deficiency consumption with floating and rapid pulse, use Sanyuan Tang.
Chaihu (8 qian), Huangqin, Renshen, Banxia (washed), Gancao (honey-fried, each 3 qian), Chuanxiong, Shaoyao, Shu Dihuang, Danggui (each 2.5 qian).
Grind into coarse powder. Decoct with Xiaochaihu Tang.
For long-term deficiency consumption with mild chills and fever, deep yet floating pulse, use Chaihu Siwu Tang.
Chuanxiong, Shu Dihuang, Danggui, Shaoyao (each 1.5 liang), Chaihu (8 qian), Renshen, Huangqin, Gancao, Banxia Qu (each 3 qian).
Grind into coarse powder. Decoct with Siwu Tang.
If long-term deficiency consumption does not respond to acupuncture or minor medicines, use Sansan San.
Baizhu, Fuling, Huangqi, Chuanxiong, Shaoyao, Shu Dihuang, Danggui (each 1 liang), Chaihu (1.6 liang), Huangqin (6 qian), Renshen (1.6 liang), Banxia (6 qian), Gancao (6 qian).
Grind into coarse powder. Take 1 liang per dose. Decoct in 1 cup of water until 0.5 cup remains. Take warm clear liquid once daily.
For postpartum deficiency consumption with inability to eat, use Shiquan San.
Baizhu, Fuling, Huangqi (each 2 liang), Renshen, Chuanxiong, Shaoyao, Shu Dihuang, Danggui (each 1 liang), Guizhi (1.5 liang), Gancao (1.5 liang, honey-fried).
Crush like hemp seeds. Take 0.5 liang per dose with 1.5 cups of water, 5 slices of Shengjiang, and 3 dates. Decoct until 0.7 cup remains. Take warm clear liquid empty-stomach before meals.
Treatment of deficiency consumption follows a sequence from superficial to deep, detailed in the Treatise on Deficiency Consumption.
For postpartum wind syndromes with flaccidity, spasms, and weakness, use Xuefeng Tang.
Qinjiao, Qianghuo, Fangfeng, Baizhi, Chuanxiong, Shaoyao, Danggui, Dihuang, Baizhu, Fuling (equal parts).
Grind into fine powder. Half make honey pills size of wisteria seeds; half keep as powder. Take 50-70 pills with warm wine. Very effective.
For postpartum accumulations that cannot be attacked, nourish Yin and clear heat; the disease will recede. Use Shaoyao Tang.
Shaoyao (1 jin), Huangqin, Fuling (each 6 liang).
Grind into coarse powder. Take 0.5 liang per dose. Decoct in water, three times daily. Strain and take warm.
For severe postpartum abdominal pain (lochia retention), use Heibai San.
Wujinshi (red-hot quenched in vinegar 7 times, ground separately), Hanshuishi (calcined to retain nature, ground).
Mix equal parts, store separately. Before use, take 1.5 qian of each powder mixed with congee soup. Stop if pain ceases; repeat if not. Highly effective.
For postpartum thirst without irritability, use Taohua San.
Xin Duanshi (1 liang), Huangdan (0.5 qian).
Grind into fine powder. Take 1 qian mixed with cold Jiangshui (fermented rice water) when thirsty.
For postpartum chest distension and sensation of obstruction due to failing descending Qi, use Zijin Dan.
Daizheshi, Lishi (equal parts).
Grind into fine powder. Make pills with vinegar paste, size of wisteria seeds. Take 30-50 pills with wine. If chest pain, take with Danggui decoction. Long-term use treats blood masses.
Another prescription:
Daizheshi (1 liang), Taoren (3 qian, stir-fried, peeled, de-seeded), Dahuang (5 qian).
Grind into powder. Make pills with mint water paste, size of wisteria seeds. Take 30-50 pills with warm water anytime.
For unbearable umbilical abdominal pain, take 1 liang of Siwu Tang plus 3.5 qian of Yuanhu.
For blood mass abdominal pain and stabbing lower back pain, take 2 liang of fine Siwu Tang powder plus 3 liang of wine-boiled Yuanhu powder. Take 3 qian mixed with wine.
For blood stagnation, clots, or pooling in the chest, lower abdomen, or ribs, take 4 liang of Siwu Tang, double Danggui and Chuanxiong, add Guijianyu, Honghua, and Yuanhu (1 liang each). Grind into powder. Decoct like Siwu Tang. Take clear liquid mixed with Moyao San.
Moyao San
Mengchong (1 qian, feet/wings removed, stir-fried), Shuizhi (1 qian, stir-fried), Shexiang (1 qian), Moyao (3 qian).
Grind into fine powder. Decoct previous medicine and mix to take. Bleeding stops pain. Continue with previous medicine.
For postpartum headache due to blood deficiency, phlegm-masses, or cold-jue, use Jiajian Siwu Tang.
Qianghuo, Chuanxiong, Fangfeng, Xiangfu (stir-fried), Baizhi (each 1 liang), Shigao (2.5 liang), Xixin (2 qian), Danggui (5 qian), Shu Dihuang (1 liang), Gancao (5 qian), Cangzhu (1.6 liang, peeled).
Grind into coarse powder. Take 1 liang per dose. Decoct in water, anytime. If sweating occurs, it is Qi-deficiency headache; add Shaoyao (3 liang) and Guizhi (1.5 liang) with Shengjiang. If phlegm-mass headache, add Banxia (3 liang) and Fuling (1.5 liang) with Shengjiang. If heat-jue headache, add Baizhi (3 liang), Shigao (3 liang), and Zhimu (1.5 liang). If cold-jue headache, add Tianma (3 liang) and Fuzi (1.5 liang) with Shengjiang.
For postpartum wind-blood dizziness and mental confusion, use Jingjie San.
Jingjie Sui (1.3 liang), Taoren (5 qian, peeled, de-seeded, stir-fried).
Grind into fine powder. Take 3 qian mixed with warm water. If slight panting, add Xingren (peeled, de-seeded, stir-fried) and Gancao (stir-fried) each 3 qian.
For pre-partum signs of fetal immobility, heavy bearing-down sensation, and ice-cold abdomen, use Lixiao San.
Chuanxiong, Danggui (equal parts).
Grind into coarse powder. Weigh 3 qian per dose. Decoct in 2 cups of water until 1 cup remains. Strain and take before meals.
For threatened miscarriage and bleeding due to exertion, use Zhike Tang.
Zhike (0.5 liang), Huangqin (0.5 liang), Baizhu (1 liang).
Grind into coarse powder. Take 5-7 qian per dose. Decoct in 1 cup of water until 0.7 cup remains. Take empty-stomach before meals.
For bone and joint pain, headache with wiry pulse, and aversion to cold resembling malaria, use Feng Liuhe Tang.
Siwu Tang 4 liang, add Qianghuo and Fangfeng (1 liang each).
For blood and Qi rushing upward causing chest, abdomen, and rib hypochondriac fullness, use Zhiqi Liuhe Tang.
Siwu Tang 4 liang, add Muxiang and Binglang (0.5 liang each).
For cold below the umbilicus, abdominal pain, and lower back/spine pain, use Yuanhu Liuhe Tang.
Add Yuanhu and Kulian (stir-fried) 1 liang each to Siwu Tang.
For Qi filling meridians, frequent menstruation, and lower abdominal pain, use Shaoyao Liuhe Tang.
Double Shaoyao in Siwu Tang.
For impending menstruation with colicky abdominal pain, use Bawu Tang.
Add Yuanhu and Kulian 1 liang each, Binglang and Muxiang 0.5 liang each to Siwu Tang.
For excessive menstrual flow without other symptoms.
Add Huangqin and Baizhu 1 liang each to Siwu Tang.
For scanty, difficult menstrual flow.
Add Kuihua Jian to Siwu Tang.
For deficiency consumption with weak Qi, wheezing, cough, and chest fullness, use Qi Liuhe Tang.
Add Houpo (processed) 1 liang and Zhishi (stir-fried) 0.5 liang to Siwu Tang.
Decoction methods above are same as Siwu Tang.
Main Actions of Siwu Tang:
Shu Dihuang: Nourishes Blood. Essential for relieving lower abdominal pain. Enters Kidney channel.
Chuanxiong: Expels Wind, drains Liver Wood. Essential for relieving blood-deficiency headache. Enters Liver channel.
Shaoyao: Harmonizes Blood, regulates Spleen. Essential for relieving abdominal pain. Enters Spleen channel.
Danggui: Harmonizes Blood. Essential for relieving stabbing blood pain. Enters Heart channel.
For the above four herbs, add two auxiliary herbs to Siwu Tang based on symptoms. For lower abdominal pain, add Yuanhu and Kulian (1 liang each) to 4 liang Siwu Tang. For sudden heavy menstruation, add Huanglian and Huangqin (1 liang each) to 4 liang Siwu Tang. If abdominal pain exists, add only Huanglian. In summer, do not remove Huangqin. If menstrual blood looks like black bean water, add Huanglian and Huangqin (1 liang each). If flow is scanty but color is healthy, add Shu Dihuang and Danggui (1 liang each) to 4 liang Siwu Tang. If menstruation starts and stops with alternating chills and fever, first take Xiaochaihu Tang to resolve chills and fever, then regulate with Siwu Tang. If chills and fever persist, do not take Siwu Tang, as this is a changed syndrome with lingering exterior pathogen; it will be ineffective. Follow the previous discussion on changed syndromes and treat according to symptoms.
For blood accumulations in women, use Zengsun Siwu Tang.
Add Ezhu, Sanleng, Guizhi, and Ganqi (processed according to standard methods, 1 liang each) to Siwu Tang. Decoct and take like Siwu Tang.
For postpartum blood coma, metrorrhagia, irregular menstruation, and old dry blood qi, use Honghua San.
Gan Heye, Mudanpi, Danggui, Honghua, Puhuang (stir-fried).
Equal parts, grind into fine powder. Take 0.5 liang per dose, decoct with wine, take sediment and liquid warm. If placenta does not descend, separately decoct Yubai Pi powder (0.5 liang) for immediate effect.
For expulsion of foul lochia.
Danggui (stir-fried), Yuanhua (stir-fried).
Grind into fine powder. Take 3 qian mixed with wine. Alternatively, mix with ink and vinegar, take with wine via urine route.
Another prescription for retained placenta: She Tui Pi (charred), 2 qian fine powder, take with wine.
Hemorrhagic syndromes without cold, including epistaxis, hematochezia, hematemesis, and hematuria, all belong to heat. Patients with blood disorders should take this medicine, Shengdihuang San.
Sheng Dihuang, Shu Dihuang, Gouqizi, Digupi, Tianmendong, Huangqi, Shaoyao, Gancao, Huangqin.
Equal parts, decoct together. Take 1 liang per dose. Decoct in 1.5 cups of water until 1 cup remains. Strain and take warm. If pulse is faint, body cool, and aversion to wind, add Guizhi (0.5 qian) per 1 liang. Common in hematemesis cases.
For persistent epistaxis, use Maidong Yinzi.
Maidong, Sheng Dihuang.
Equal parts, decoct together. Take 1 liang per dose. For epistaxis, first use Zhusha and Ge Fen, then Muxiang and Huanglian. If constipated, purge with Dahuang, Mangxiao, Gancao, Sheng Dihuang. If loose stools, use Zhizi, Huangqin, Huanglian. Select as needed.
Appendix on Leukorrhea
Discussion states: Red leukorrhea indicates heat entering the Small Intestine; white leukorrhea indicates heat entering the Large Intestine. Fundamentally, both are due to damp-heat binding in the vessels, causing fluid overflow, resulting in red and white discharge. The root is deficiency of the five vessel channels, with constrained heat stagnating in the Dai Mai, causing continuous lower abdominal pain and vaginal discharge. As stated in the Classics: Disease of Ren Mai causes seven types of hernia in men and leukorrhea/masses in women. Wang Bing notes: Ren Mai passes over Dai Mai through the umbilicus. Dai Mai originates at Zhangmen in the flank, encircling like a belt. Now, damp-heat binds and does not disperse, causing disease. As stated: Spleen transmitting to Kidney causes hernia/masses, lower abdominal heat/pain, and white discharge, also called Gu. This explains the constrained nature of leukorrhea. Constrained heat does not disperse. First purge with Shizao Tang, then take Kelian Wan and Da Yuanhu San. Once heat clears and dampness removes, the disease heals itself. For amenorrhea, first drain Heart Fire, and blood will flow naturally. The Inner Classic states: Diseases of Yangming originate in Heart and Spleen. Due to hidden distress, women experience amenorrhea. It transmits into Wind Xiao. Wang Bing notes: This is a disease of Large Intestine and Stomach. Heart and Spleen are affected. Heart governs Blood; Heart disease causes blood stagnation. Spleen governs Taste; Spleen disease causes failure to transform taste. Failure to transform taste leads to insufficient Essence. Essence and Blood...