Infant’s Pillow and Sparrow’s Egg
Wáng Xùgāo’s Gynecology Chapter
As a sort of follow-up to last week’s post as well as knocking off another chunk of my ongoing project, I present the gynecology chapter of Wáng Xùgāo’s Yī Xué Chú Yán (Medical Ruminations, 1862). Wáng’s ever-pragmatic nature is well on display here. The chapter does run a little long and I’m always mindful of whether people are actually going to plod through 2500 words; so I will keep my commentary to a minimum.
第三十三章 婦人門
婦人之病與男子同，惟經帶胎產另立方法。（胎前宜清，產後宜溫）。
Chapter Thirty-Three: Women's Gate
The diseases of women and men are the same; only in menstruation, vaginal discharge, pregnancy, and parturition do the treatment methods stand apart. (In antepartum one should clear, in postpartum one should warm).
胎前
受胎二、三月，嘔惡者，以陽明之氣壅盛於上也，六君子湯加砂仁以和之，半夏不必顧忌。
胎前下血，名胎漏，氣不攝血也，補中益氣湯；如惱怒傷肝，加味逍遙散。
胎動不安，血不養胎也，四物湯去川芎，加白朮、杜仲；有火者加黃芩，有寒者加川椒（此味今人罕用，每易以炮姜。）
墮胎證，多屬氣血兩虛，參、耆、歸、芍、菟絲、杜仲、冬朮、川斷；有火加阿膠、黃芩，無火加鹿角膠、艾葉。
子腫，身體腫而小便不利，五皮飲加白朮。
子懸，四物湯去川芎，加茯苓、白朮、甘草。（按：其證胸脘滿悶，胎動不安。）
Antepartum
In the second and third months of pregnancy, for cases of nausea and vomiting from the congestion of yángmíng qì in the upper burner, use Liù Jūn Zǐ Tāng [Six Gentlemen Decoction] adding Shā Rén [Fr Amomi] to harmonize; one need not be apprehensive about Bàn Xià [Rz Pinelliae].
Antepartum descent of blood, called fetal spotting, is the qì not containing the blood, use Bǔ Zhōng Yì Qì Tāng [Center-Supplementing Qì-Boosting Decoction]; if anger injures the liver, use Jiā Wèi Xiāo Yáo Sàn [Augmented Free Wanderer Powder].
Stirring fetus: blood is not nourishing the fetus, use Sì Wù Tāng [Four Substance Decoction] removing Chuān Xiōng [Rz Chuanxiong] adding Bái Zhú [Rz Atractylodis Macrocephalae], Dù Zhòng [Cx Eucommiae]; in cases where there is fire, add Huáng Qín [Rx Scutellariae Baicalensis], in cases where there is cold, add Chuān Jiāo [Pc Zanthoxyli] (this ingredient people rarely use these days, it is often substituted with Pào Jiāng [Rz Zingiberis Praeparata].)
Miscarriage patterns, often categorized as dual vacuity of qì and blood, use [Rén] Shēn [Rx Ginseng], [Huáng] Qí [Rx Astragali], [Dāng] Guī [Rx Angelicae Sinensis], [Bái] Sháo [Rx Paeoniae], Tú Sī [Zǐ] [Sm Cuscutae], Dù Zhòng [Rx Eucommiae], Dōng Shù [Rz Atractylodes Macrocephalae Praeustum/ frostbitten Bái Zhú], Chuān Duàn [Rx Dipsaci]; if there is fire add Ē Jiāo [Colla Corii Asini], and Huáng Qín; if there is no fire add Lù Jiǎo Jiāo [Cornus Cervi Gelatinum], Ài Yè [Folium Artemisiae Argyi].
Swelling of pregnancy: there is bodily swelling as well as inhibited urination, use Wǔ Pí Yǐn [Five Peel Beverage], adding Bái Zhú.
Pregnancy suspension: use Sì Wù Tāng removing Chuān Xiōng and adding Fú Líng [Poria], Bái Zhú, and Gān Cǎo [Rx Glycyrrhizae] (Comment: This pattern includes fullness and oppression in the chest and stomach duct, with fetal stirring.)
[Mulch comments: Wiseman (2022) says of pregnancy suspension: "stirring fetus with distension and fullness in the chest and heart due to liver depression, congestion of qì and phlegm, and fetal qì ascending counterflow."].
子嗽，二陳湯加桑皮、阿膠、麥冬、五味、乾薑、細辛。
子瀉，四君加砂仁、黃芩，或補中益氣湯。
臨產交骨不開，宜芎、歸加發灰、龜板。如血水大下而不產，是血乾而胎滯，氣虛推送無力也，當歸補血湯加人參、肉桂。
Cough in pregnancy, use Èr Chén Tāng [Two Aged Decoction], adding Sāng Pí [Cx Mori], Ē Jiāo, Mài Dōng [Tuber Ophiopogonis], Wǔ Wèi [Fr Schisandrae], Gán Jiāng [Rz Zingiberis], Xì Xīn [Hb Asari] .
Diarrhea in pregnancy, use Sì Jūn [Zǐ Tāng, Four Gentlemen Decoction], adding Shā Rén, Huáng Qín, or Bǔ Zhōng Yì Qì Tāng.
During childbirth, if the interlocking bones [i.e. the pelvic joints] do not open, it is good to use [Chuān] Xiōng and [Dāng] Guī, adding Fā Huī [Crinis Carbonisatus, a.k.a. Xuè Yú Tàn / charred hair], and Guī Bǎn [Plastrum Testudinis]. If there is a large downpour of watery blood but no parturition, it is blood dryness along with fetal stagnation; lack of strength in pushing to deliver is qì vacuity. Use Dāng Guī Bǔ Xuè Tāng [Chinese Angelica Blood-Supplementing Decoction], adding Rén Shēn, Ròu Guì [Cx Cinnamomi].
產後
產後血暈，用醋炭熏鼻，酒和童便飲之，不可臥倒，如氣血脫而暈者，必唇口手足厥冷，當歸補血湯，加參、附、淡姜以回陽。
Postpartum
Postpartum blood dizziness, use vinegar charcoal to fume the nose, mix with wine and Tóng Biàn [Urina Infantis /child’s urine]; [the patient] should not lie down, in cases where there is desertion of qì and blood as well as dizziness, there will be reversal cold of the lips, mouth, hands and feet, use Dāng Guī Bǔ Xuè Tāng, adding Rén Shēn, Fù [Zi] [Rx Aconiti Lateralis Praeparata], and Dàn [Gān] Jiāng [Rz Zingiberis] to return yáng.
[Mulch comments: Vinegar charcoal fumigation can be used to revive from fainting, to disinfect, or as an apotropaic to drive evil spirits from one's house, see reference below for 醋炭.]
胎衣不下，當歸五錢，川芎三錢，水煎服。如血入衣中，脹而不下，用陳酒送下失笑散。
產後發熱，有外感者，荊芥、防風；無外感，當歸、黃耆。
血塊痛，俗名兒枕痛，芎、歸、肉桂、牛膝、桃仁、楂炭，送下回生丹。
If there is retained placenta, take Dāng Guī 5 qián, and Chuān Xiōng 3 qián, decocted in water. If there is bleeding into the placenta and swelling along with retention, swallow Shī Xiào Sàn [Sudden Smile Powder] with some old wine. In cases of postpartum heat effusion with exterior contraction, Jīng Jiè [Hb Schizonepetae], Fáng Fēng [Rx Saposhnikoviae]; without exterior contraction, use Dāng Guī, Huáng Qí.
For pain due to a blood clot, commonly called infant's pillow pain, use [Chuān] Xiōng, [Dāng] Guī, Ròu Guì, Niú Xī [Rx Achyranthis Bidentatae], Táo Rén [Sm Persicae], [Shān] Zhā Tàn [Fr Crataegi Carbonisatus], swallow with Huí Shēng Dān [Return To Life Elixir].
[Mulch comments: Huí Shēng Dān is a formula from Wàn Bìng Huí Chūn (Return to Spring from Myriad Diseases, 1587). It consists of Dà Huáng, Sū Mù, Hóng Huā, Hēi Dòu, Dāng Guī, Chuān Xiōng, Shú Dì, Huáng Bái, Fú Líng, Cāng Zhú, Xiāng Fù, Wū Yào, Xuán Hú Suǒ, Táo Rén, Pú Huáng, Niú Xī, Bái Sháo, Gān Cǎo, Chén Pí, Mù Xiāng, Sān Léng, Wǔ Líng Zhī, Qiāng Huó, Dì Yú, Shān Yú, Rén Shēn, Bái Zhú, Qīng Pí, Mù Guā, Liáng Jiāng, Rǔ Xiāng, Mò Yào. The prescription is prepared, ground into a powder, mixed with rhubarb paste and rolled into marble-sized pills.]
產後泄瀉，不可利水，用補中益氣湯。
產後大便不通，宜八珍加桃仁、杏仁。
子宮下垂，乃勞力所傷也，補中益氣加附子；玉門不閉治同。
產後瘀血不行，腹痛者，宜生化湯，川芎二錢，當歸四錢，桃仁七枚，炙草一錢，炮姜一錢，水、酒各半煎服。
產後痙、口噤、角弓反張、無汗者，名剛痙，宜荊芥穗一兩，童便煎服之；或桂枝湯加葛根。有汗為柔痙，宜桂枝湯加花粉。凡二種痙屬虛者，以十全大補湯加鉤藤、竹瀝、薑汁；汗多加附子。
For postpartum diarrhea, one must not disinhibit urination, use Bǔ Zhōng Yì Qì Tāng.
Postpartum constipation, it is good to use Bā Zhēn [Eight Gem Decoction], adding Táo Rén, Xìng Rén [Sm Armeniacae].
Uterine prolapse is due to physical taxation injury. Use Bǔ Zhōng Yì Qì Tāng adding Fù Zǐ. Non-closure of the Jade Gate [vaginal opening] is treated in the same way.
In cases of postpartum retention of static blood with abdominal pain, it is good to use Shēng Huà Tāng [Generate and Transform Decoction]: Chuān Xiōng 2 qián, Dāng Guī 4 qián, Táo Rén 7 pieces, Zhì Cǎo [Rx Glycyrrhizae Praeparata] 1 qián, Pào Jiāng 1 qián, decoct in half water / half wine, and take.
Cases of postpartum tetany with clenched jaw, arched-back rigidity, and lack of sweating are called hard tetany [gāng jìng]. It is good to use Jīng Jiè Suì [Spica Schizonepetae] 1 liǎng, fry in Tóng Biàn and take; or use Guì Zhī Tāng [Cinnamon Twig Decoction] adding Gé Gēn [Rx Puerariae]. If there is sweating it is soft tetany [róu jìng], its good to use Guì Zhī Tāng adding Huā Fěn [Rx Trichosanthis]. In vacuity-type cases of the two kinds of tetany, use Shí Quán Dà Bǔ Tāng [Ten Great Supplementing Decoction], adding Gōu Téng [Ramulus Uncariae Cum Uncis], Zhú Lì [Succus Bambusae In Taeniam], Jiāng Zhī [Succus Zingiberis]; if there is profuse sweating add Fù Zǐ.
Postpartum panting, if the mouth and nose begin to assume a blackened color, it is because of static blood entering the lung and cannot be cured. Perhaps use Rén Shēn 1 liǎng, Sū Mù [Lignum Sappan] 3 qián, decoct in water and take. If there is reversal cold and spontaneous sweating, one must use Tōng Mài Sì Nì Tāng [Vessel Freeing Counterflow Cold Decoction]; cases where the reversal turns back around are curable.
經帶雜病
婦人經水不調屬虛者，衝任之血不足也，宜歸脾湯二十劑，加烏賊骨四兩、茜草一兩，以雀卵為小丸，空心以鮑魚湯送下三錢。如無雀卵，以雞肝代之。
經水不調屬實者，自有實證可憑，宜四物湯加醋炒大黃、香附、桃仁、丹皮、青皮、紅花。
經水不調因鬱而致者，加味逍遙散。
婦人肥而不孕，乃子宮脂滿，宜芎、歸、芍、香附、半夏、貝母、益母膏為丸。 如瘦而不孕，乃氣血兩虛，宜八珍湯加菟絲、杜仲、鹿茸、川椒。
婦人帶下，多因中土虧損，濕熱下陷，帶脈失固，宜六君子加炮姜，更以補中益氣湯提之；或以椿根皮、黃柏、白芍、牡蠣、醋糊丸以澀之。
Menstruation, Vaginal Discharge and Miscellaneous Diseases
In vacuity-type cases of women whose menstrual flow is not regulated, the blood of the chōng and rèn [vessels] is insufficient, it’s good to use Guī Pí Tāng [Spleen-Returning Decoction] 20 doses, adding Wū Zéi Gǔ [Os Sepiae] 4 liǎng, Qiàn Cǎo [Rx Rubiae] 1 liǎng, as well as Què Luǎn [ovum passeris / sparrow’s egg] and make into small pills; on an empty stomach swallow 3 qián along with some abalone soup. If there are no sparrow eggs, use chicken liver as a substitute.
Repletion-type cases of unregulated menstrual flow will have repletion pattern [manifestations] one can lean on, it is good to use Sì Wù Tāng adding cù chǎo [vinegar-fried] Dà Huáng [Rx Et Rz Rhei Praeparatum], Xiāng Fù [Rz Cyperi], Táo Rén, Dān Pí [Cx Moutan], Qīng Pí [Pc Citri Reticulatae Viride], Hóng Huā [Flos Carthami].
Cases of unregulated menstrual flow caused by depression, use Jiā Wèi Xiāo Yáo Sàn.
In women who are overweight as well as infertile, the uterus is full of fat. It is good to make [Chuān] Xiōng, [Dāng] Guī, [Bái] Sháo, Xiāng Fù, Bàn Xià, Bèi Mǔ [Bulbus Fritillariae Cirrhosae], and Yì Mǔ Gāo [Hb Leonuri Pasta] into pills. If they are thin as well as infertile, this is a dual vacuity of qì and blood. Use Bā Zhēn Tāng, adding Tú Sī, Dù Zhòng, Lù Róng [Cornu Cervi Pantotrichum], Chuān Jiāo.
Women's vaginal discharge is frequently caused by center-earth depletion, downward fall of damp heat, and impaired securing of the dài mài. It is good to use Liù Jūn Zǐ adding Pào Jiāng, alternating with Bǔ Zhōng Yì Qì Tāng to raise. Or perhaps use Chūn Gēn Pí [Cx Ailanthi], Huáng Bǎi [Cx Phellodendri], Bái Sháo, Mǔ Lì [Concha Ostreae], with vinegar paste in pills to astringe.
That’s all for now. Thanks as always for reading, and for your support of the mulch.
Note: this publication is for information purposes only and is not intended as medical advice. Please seek the opinion of a health care professional for any specific medical issues you may have.
References
Baike.Baidu.com. (n.d.). 醋炭 (Cù tàn). Retrieved January 9, 2024 from https://baike.baidu.com/item/%E6%89%93%E9%86%8B%E7%82%AD/1315472
Wáng, X. (1862). 醫學芻言 (Yī xué chú yán). https://jicheng.tw/tcm/book/%E9%86%AB%E5%AD%B8%E8%8A%BB%E8%A8%80/index.html
Wiseman, N. (2022). Chinese-English Dictionary of Chinese Medical Terms. Paradigm Publications.
ZYBD.com. (n.d.). 回生丹 (Huí shēng dān). Retrieved January 9, 2024 from http://zhongyaofangji.com/h/huishengdan.html#14550