夫产伤动血气,虚损未复,而风邪冷热之气客于经络,乍冷乍热,冷则血结,热则血消
,故令血或多或少,乍在月前,乍在月后,故为不调也。
夫产伤动血气,其后虚损未平复,为风冷所伤。血之为性,得冷则凝结。故风冷伤经,
血结于胞络之间,故令月水不通也。凡血结月水不通,则变成血瘕,水血相并,后遇脾胃衰
弱,肌肉虚者,变水肿也。
带下之病,由任脉虚损。任脉为经络之海。产后血气劳损未平复,为风冷所乘,伤于任
脉,冷热相交,冷多则白多,热多则赤多也,相兼为带下也。
又云∶带下有三门,一曰胞门,二曰龙门,三曰玉门。产后属胞门,谓因产伤损胞络故
也。
产伤于经血,其后虚损未平复,或劳役损动,而血暴崩下,遂因淋沥不断时来,故为崩
中恶露不尽。
风崩中,若小腹急满,为内有瘀血,不可断之;断之终不断,而加小腹胀满,为难矣。
若无瘀血,则可断,易治也。
产后虚损未平复而起早,伤于风冷,风冷乘虚入于大肠,肠虚则泄,故令痢也。产后痢
若变为血痢,则难治,世谓之产子痢也。
因产劳伤荣卫,脾胃虚弱,风冷乘之,水谷不结,大肠虚则泄成利也。痢而肿者,脾主
土,候肌肉,土性本克水,今脾气衰微,不能克消于水,水气流溢,散在皮肤,故令肿也。
妇女分娩时损伤了血气,虚损状态尚未恢复,此时风邪及冷热之气侵入经络,导致身体忽冷忽热。寒气会使血液凝结,热气会使血液消散,因此月经量或多或少,有时在月经期前,有时在月经期后,这就称为月经不调。
妇女分娩损伤血气之后,若虚损未能平复,被风冷之邪所伤。血的性质是遇到寒冷就会凝结。因此风冷侵袭经脉,血液凝结在胞络之间,导致月经不通畅。凡是血液凝结导致月经不通的,会演变成血瘕(腹部结块病),水与血相互搏结,如果随后脾胃功能衰弱、肌肉虚弱,就会转变为水肿。
带下病,是由于任脉虚损所致。任脉是经络之海。产后血气劳损尚未恢复,被风冷之邪乘虚而入,损伤任脉,冷热之气交争,寒多则白带多,热多则赤带多,两者兼夹即为带下病。
又说:带下病分为三门,一是胞门,二是龙门,三是玉门。产后带下属于胞门范畴,是因为分娩损伤了胞络的缘故。
分娩损伤经血,之后虚损未平复,或因劳累过度导致气血再次受损,血液突然大量崩漏下行,淋漓不断,时常发作,这就称为崩中恶露不尽。
如果是风邪引起的崩中,若小腹部拘急胀满,说明体内有瘀血,不可强行止血;如果强行止血,终究止不住,反而加重小腹胀满,这就难以治疗了。
如果没有瘀血,则可以止血,容易治愈。
产后虚损未平复就过早起床劳作,遭受风冷之邪侵袭,风冷乘虚进入大肠,肠道虚弱则发生泄泻,从而导致痢疾。产后的痢疾如果转变为血痢,则难以治疗,世人称之为产子痢。
因为分娩劳累损伤了营卫之气,加上脾胃虚弱,风冷之邪乘虚而入,导致饮食水谷不能正常运化,大肠虚弱则泄泻形成痢疾。患痢疾并出现浮肿的,是因为脾属土,主司肌肉,土的本性是克制水的。现在脾气衰微,不能克制和消除水湿,水流溢散漫于皮肤之间,所以导致浮肿。
After childbirth, the blood and qi are injured, and the deficiency is not yet restored. Wind-cold and wind-heat pathogens invade the meridians, causing alternating cold and heat sensations. Cold causes blood to coagulate, while heat causes blood to dissipate; thus, menstrual flow may be either excessive or scanty, occurring sometimes before or after the expected time, which is termed irregular menstruation (Yue Shui Bu Tiao).
Following childbirth, if the blood and qi remain deficient and unbalanced, they are susceptible to wind-cold injury. The nature of blood is to coagulate upon exposure to cold. Therefore, when wind-cold invades the meridians, blood coagulates within the uterine collaterals (Bao Luo), leading to amenorrhea (Yue Shui Bu Tong). If blood coagulation results in amenorrhea, it may transform into a blood mass (Xue Jia). When water and blood bind together, and subsequently the spleen and stomach become weak with muscle atrophy, edema (Shui Zhong) may develop.
Leukorrhea (Dai Xia) arises from the deficiency of the Ren Mai (Conception Vessel). The Ren Mai is the sea of the meridians. After childbirth, due to labor-induced damage to blood and qi that has not yet recovered, wind-cold pathogens invade and injure the Ren Mai. The interaction of cold and heat determines the discharge: excess cold leads to white discharge, while excess heat leads to red discharge; their combination constitutes leukorrhea.
It is further stated that leukorrhea involves three gates: the Bao Men (Uterine Gate), Long Men (Dragon Gate), and Yu Men (Jade Gate). Postpartum leukorrhea belongs to the Bao Men category, caused by injury to the uterine collaterals during delivery.
Childbirth injures the menstrual blood. If postpartum deficiency remains unresolved, or if physical exertion aggravates the condition, sudden severe bleeding (Beng Zhong) may occur, characterized by persistent dripping and intermittent flow, known as incomplete expulsion of lochia (E Lu Bu Jin).
In cases of wind-induced Beng Zhong, if there is urgency and fullness in the lower abdomen, it indicates the presence of static blood (Yu Xue) internally. Hemostasis should not be forced; attempting to stop it will fail and exacerbate abdominal distension, making treatment difficult. If no static blood is present, hemostasis can be applied, and the condition is easy to treat.
If a woman rises too early after childbirth while still deficient and unbalanced, she may be exposed to wind-cold. These pathogens enter the large intestine through the deficiency, causing intestinal weakness and diarrhea, resulting in dysentery (Li). If postpartum dysentery transforms into bloody dysentery (Xue Li), it becomes difficult to treat and is commonly referred to as postpartum dysentery (Chan Zi Li).
Childbirth labor damages the Ying (Nutritive) and Wei (Defensive) Qi, leading to spleen and stomach weakness. Wind-cold pathogens invade, preventing the proper transformation of food and fluids. Large intestine weakness leads to diarrhea and dysentery. In cases of dysentery accompanied by edema, since the Spleen governs Earth and muscles, and Earth naturally controls Water, the current decline of Spleen Qi fails to control and eliminate water dampness. Consequently, water flows excessively and disperses into the skin, causing edema.