癸酉仲冬时在益郡署中。先室分娩受寒。胎衣不下血溃盈盆。越七日因怒呕血少止。复
暴崩
如涌。两眼瞑合。四肢冷厥。不省人事。脉六部沉代。势属危急。余即以人参二两为君。黄
归身附子炙草各二钱为佐。入山漆三钱。武火促煎。仍请蜀藩良医胡君商治。胡至胗视曰
。脾为统血之原。今肝木凌土。固中敛血。须加白术。余如言治之。药半晌。目转气舒。脉
复渐苏。至十三日肢体忽肿。又治以十全大补汤。去芎芍。加炮姜。七剂始退。再延胡君议
修
补养之剂。胡曰前症真阴暴绝。已入死法。今倘勤加调摄。勿辍良剂。亦可少延数年。自是
冬而历甲申季夏一十二载。经水断绝。盛暑犹着绵衣。暂离参数日。便病晕眩喘胀。计服过
人参十五斤有奇丸剂五十余斤。汤药千五百帖。而终不免于一死。只因数载以来。俯仰乏资
。参难裕置。至甲申仲夏。余缘洪江之行。复触事火升作渴。误嚼荸荠数枚。遂患格症
。
食入即吐。胃气遽绝。日只饮水碗许。绝谷四十九日而殁。殁时肌体丰润如生。可知参功累
积造命非小。每恨需参难继。 枉死。致令结发参商。哀肠寸断。余几无以为生矣。
癸未仲冬方天柱冢妇。系余妻妹。素劳郁。将产坐草寒。初数医所投。非辛发即平缓之剂
。渐增剧。越五日。延余治之。察其脉症寒热自汗。喘呕拒食。燥谵不寐。心腹胀痛。大便
里急后重。脉见结代。三至一歇。危笃濒死。投以参 归术桂附。加五味升麻炙草等味。彼
疑未用。复转质于内兄陈青云云亦知医。以为非此温补之剂。不能挽回。始信服不终剂而热
退
汗敛。静睡半日。醒知索粥。胀消痛减。脉渐复。再剂恶露始行。血块亦下。三剂脉仍结。
余曰。夜来莫非减参乎。渠云果只用五分。至四剂令加二钱。而诸症如失。夫前症寒热自汗
乃阴虚阳脱也呕喘拒食乃肺逆胃寒也燥谵不寐乃阴寒已极而阳暴越于上也心腹胀痛乃冲任受
寒瘀血停蓄也里急后重乃脾气下陷前医误以为痢则谬也脉见结代乃胃气暴虚不能接续也若谬
妄错治。能免虚虚之祸乎。故丹溪有云产后须大补气血为主。纵有他症。以末治之。如恶寒
发热者。乃血气虚弱之极也。须用大补汤治之。余每遵此法以温补疗产后。叠投叠中。先哲
法言。岂欺我哉。
癸酉年仲冬时节，我在益郡的官署中。我的妻子分娩时受寒，胎盘不下，出血满盆。过了七天，因为发怒而呕吐少量血液后暂时停止，随后又突然发生大出血，如涌出一般。双眼紧闭，四肢冰冷厥逆，不省人事。六部脉象均呈沉代脉，病情属于危急状态。我立即以人参二两为君药，当归身、附子、炙甘草各二钱为佐药，加入山漆三钱，用武火快速煎煮。同时请蜀王府的良医胡君共同诊治。胡君到来诊察后说：“脾是统摄血液的根本。如今肝木克制脾土，必须加固中气以收敛血液，需要加入白术。”我按照他的建议治疗。服药半个时辰后，患者眼睛转动，气息舒缓，脉象逐渐恢复生机。到了十三日，肢体忽然肿胀，又用十全大补汤治疗，去掉川芎、芍药，加入炮姜，服用七剂后肿胀才消退。再请胡君商议调理滋补的方剂。胡君说：“之前的病症是真阴突然衰竭，已经属于死证。如今如果勤加调养护理，不停止使用良药，也可以稍微延长几年寿命。”从那年冬天到甲申年的夏季，共十二年间，月经断绝，即使在盛夏也穿着棉衣，暂时离开人参几天，就会生病出现晕眩、气喘、腹胀。计算下来服用人参十五斤多，丸剂五十多斤，汤药一千五百帖，但最终还是不免于一死。只因为这几年以来，经济拮据，人参难以充足购置。到了甲申年仲夏，我因为去洪江办事，再次因事动火上升导致口渴，误吃了几颗荸荠，于是患上了噎膈症。食物吃进去就吐出来，胃气突然断绝，每天只喝一碗水左右，断绝谷物四十九天后去世。去世时身体肌肉丰满润泽如同生前，可知人参的功效积累救命作用不小。常常遗憾需要人参却难以持续供应，导致枉死，致使夫妻分离，哀肠寸断。我几乎无法生存了。
癸未年仲冬，方天柱家的长媳，是我的妻妹。平时劳累且抑郁，临产时坐在草垫上受寒。起初几位医生所用的药物，不是辛散发汗的就是平缓无力的药剂。病情逐渐加重。过了五天，请我去诊治。观察她的脉症，有寒热往来、自汗、气喘呕吐、拒绝进食、烦躁谵语、失眠、心腹胀痛、大便里急后重等症状。脉象呈现结代脉，每三次跳动歇息一次，病情危重濒临死亡。投以人参、当归、白术、桂枝、附子，加上五味子、升麻、炙甘草等药味。她怀疑没有使用这些药，又转而咨询内兄陈青云，陈青云也懂医术，认为如果不是这种温补的药剂，就不能挽回局面。这才信服，药还没吃完热退汗止，安静睡了半天，醒来知道索要粥喝，胀消痛减，脉象逐渐恢复。再服两剂恶露才开始下行，血块也排下。三剂后脉象仍然结代。我说：“昨晚是不是减少了人参用量？”她说果然只用了一钱五分。到第四剂时让她增加到二钱，各种症状消失。前面的病症寒热自汗是阴虚阳脱；呕喘拒食是肺逆胃寒；燥谵不寐是阴寒已极而阳气暴越于上；心腹胀痛是冲任受寒瘀血停蓄；里急后重是脾气下陷。前医误以为是痢疾那就错了。脉见结代是胃气突然虚弱不能接续。如果错误地胡乱治疗，能避免虚虚之祸吗？所以丹溪说产后必须以大大补气血为主，纵然有其他症状，也作为次要处理。如恶寒发热者，是血气虚弱到了极点，必须用大补汤治疗。我每次遵循此法用温补疗法治疗产后病，屡投屡效。先哲的法言，难道欺骗我吗？
In the mid-winter of the Guiyou year, I was in the official residence of Yijun. My wife contracted cold during childbirth. The placenta did not descend, and blood loss filled a basin. Seven days later, due to anger, she vomited a small amount of blood which temporarily stopped, but then suddenly suffered from massive hemorrhage (Bengle), gushing forth. Her eyes were closed shut, her four limbs were cold and inverted (Jue), and she was unconscious. The pulse in all six positions was deep and intermittent (Dai), indicating a critical condition. I immediately used two liang of Renshen (Ginseng Radix et Rhizoma) as the sovereign drug, with two qian each of Danggui Shen (Angelicae Sinensis Radix), Fuzi (Aconiti Lateralis Radix Praeparata), and Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata) as supporting drugs, adding three qian of Shanqi (Panacis Japonici Rhizoma). It was decocted rapidly over high heat. I also invited Hu Jun, a skilled physician from the Prince of Shu's mansion, to consult on the treatment. Upon examination, Hu Jun said: "The Spleen is the source that controls blood. Now Liver Wood is suppressing Spleen Earth; one must strengthen the middle jiao to consolidate and stop bleeding, requiring the addition of Baizhu (Atractylodis Macrocephalae Rhizoma)." I treated according to his advice. After half a day of taking the medicine, her eyes moved, her breath eased, and her pulse gradually revived. By the thirteenth day, her limbs suddenly swelled. She was treated with Shiquan Dabu Tang (Decoction for Complete Great Tonification), removing Chuanxiong (Ligustici Chuanxiong Rhizoma) and Shaoyao (Paeoniae Radix Alba), and adding Paojiang (Zingiberis Rhizoma Preparatum). After seven doses, the swelling subsided. Hu Jun was consulted again to discuss a tonic regimen. He said: "The previous condition was sudden exhaustion of True Yin, already entering a fatal pattern. If you now diligently care for her and do not cease good medicines, she may extend her life by a few years." From that winter through the summer of Jiashen, spanning twelve years, her menstruation ceased. Even in intense summer heat, she wore cotton clothes. If she stayed away from Renshen for a few days, she would suffer from dizziness, asthma, and distension. In total, she consumed more than fifteen jin of Renshen, over fifty jin of pills, and 1,500 prescriptions of decoctions, yet ultimately could not avoid death. This was because for several years, funds were lacking, and it was difficult to procure sufficient Renshen. In the mid-summer of Jiashen, due to a trip to Hongjiang, I again experienced fire rising from events, leading to thirst. I mistakenly chewed several water chestnuts (Biqie), and subsequently developed Gezheng (Regurgitation syndrome). Food was vomited immediately upon ingestion, and Stomach Qi abruptly failed. She drank only about a bowl of water per day, abstained from grain for forty-nine days, and died. At the time of death, her body was plump and lustrous as if alive. This shows that the cumulative effect of Renshen in saving lives is significant. I often regretted the inability to continuously supply Renshen, leading to premature death and causing our marriage to end in separation, breaking my heart into pieces. I nearly could not survive.
In the mid-winter of the Guiwei year, Fang Tianzhu's eldest daughter-in-law, who was my wife's younger sister, had been suffering from chronic fatigue and depression. She contracted cold while sitting on grass during labor. The initial physicians prescribed either acrid-releasing or mild and ineffective formulas. Her condition gradually worsened. Five days later, I was called to treat her. Observing her pulse and symptoms, she presented with alternating chills and fever, spontaneous sweating, asthma and vomiting, refusal to eat, dryness and delirium, insomnia, abdominal fullness and pain, and tenesmus (Li Ji Hou Zhong). The pulse showed Jie Dai (knotted and intermittent), pausing after every three beats. The condition was critical and near death. I administered a formula containing Renshen, Danggui, Baizhu, Guizhi (Cinnamomi Ramulus), Fuzi, along with Wuweizi (Schisandrae Fructus), Shengma (Cimicifugae Rhizoma), and Zhigancao. She suspected the omission of these ingredients and consulted her elder brother-in-law Chen Qingyun, who also knew medicine. Chen agreed that without such warming and tonifying agents, recovery was impossible. She finally accepted the treatment. Before finishing the dose, her fever subsided, sweat stopped, and she slept quietly for half a day. Upon waking, she asked for porridge, her distension resolved, pain decreased, and her pulse gradually recovered. After two more doses, the lochia began to flow, and blood clots were expelled. After three doses, the pulse remained knotted. I asked, "Did you reduce the dosage of Renshen last night?" She replied, "Indeed, I used only five fen." For the fourth dose, I instructed her to increase it to two qian, whereupon all symptoms disappeared. Regarding the previous symptoms: alternating chills and fever with spontaneous sweating indicate Yin deficiency and Yang collapse; vomiting, asthma, and food refusal indicate Lung rebellion and Stomach cold; dryness, delirium, and insomnia indicate extreme Yin cold with Yang violently floating upward; abdominal fullness and pain indicate Cold invading the Chong and Ren vessels with stasis accumulation; tenesmus indicates Spleen Qi sinking. The previous physicians mistook this for dysentery, which was erroneous. The knotted and intermittent pulse indicates sudden deficiency of Stomach Qi unable to connect continuously. If treated erroneously, how could one avoid the disaster of 'deficiency making deficiency worse'? Thus, Danxi stated that postpartum conditions require major tonification of Qi and Blood as the primary approach. Even if other symptoms exist, they should be treated secondarily. For example, aversion to cold and fever indicate extreme weakness of Qi and Blood, requiring Da Bu Tang (Great Tonifying Decoction). I have always followed this method, using warming and tonifying therapies for postpartum conditions, achieving consistent success. Do not the words of the sages deceive us?