产后腹有血块。是胎前余血之所积也。夫妇人以经脉为主。二七而天癸至。三旬一见。以象月盈则亏。行之有常。
名之曰经。有孕则经不行。其余血注于胞中。以护元。一月曰始胚。二月曰始膏。三月成形。而名胎。方受母血之荫。
胎形尚小。食母血故有留余。并前两月之血积于胞中。久而成块。至产时。随儿当下。亦有因产妇送儿劳倦。调护欠温。
以致块痛不散者。慎勿轻用攻血峻药。宜饮姜艾酒。多服生化汤。加以热衣暖腹。自然渐散。俗师有用红花生地以行之。
苏木牛膝以攻之。鲜有不至危亡者。
小腹有块作痛。名曰儿枕。世多专先消散。然后议补。或消补兼施。更为夹杂。殊不知旧血须当消化。新血尤当滋
生。若专主攻旧。新亦不能生矣。产后血气暴虚。理当大补。当恶露未净。用补须知无滞血。攻块不致损元气。行中兼
补。方是万全。世以四物汤理产。误人多矣。地黄性寒滞血。芍药酸寒伐肝。治产者察之。
产后七日内。未曾服生化汤。块痛未除。仍以生化汤治之。
暑月产后。内服生化汤以除块痛。外用热衣暖腹。方能消恶止痛。若失于盖暖。亦难取效。
产后一二日内。块痛未止。忽脱晕。汗多而厥。口气渐冷。即于生化汤中加用人参。黄 。以扶危急。日夜频服三
四剂必效。
产后七日内。因食冷物。血块凝结痛甚。宜于生化汤内加肉桂五七分。
产后三四日内。服生化汤三四剂。块痛未减。得按揉而稍安者虚也。可加参二三钱。
产后三日内。血块痛。人参当缓。如遇危症。从权加参救急可也。病势一转。则当减参。只服本方。自能取效。
Blood masses in the abdomen after childbirth are caused by the accumulation of residual blood from before pregnancy. Women's physiology is primarily governed by the meridians (Meridians and Collaterals). At age fourteen, Tian Gui (substances that promote reproductive function) arrives, and menstruation occurs approximately every thirty days, mirroring the waxing and waning of the moon, following a constant rhythm.
This is called Jing (Menstruation). During pregnancy, menstruation ceases, and residual blood flows into the Bao Zhong (Uterus) to nourish the fetus. In the first month, it is called Shi Pei (Initial Embryo); in the second month, Shi Gao (Initial Paste); in the third month, the form takes shape and is named Tai (Fetus), beginning to receive the protection of maternal blood.
Because the fetal form is still small, it consumes maternal blood, leaving residuals. Combined with the blood from the previous two months accumulating in the Bao Zhong, over time these coagulate into masses. At the time of delivery, they should be expelled along with the infant. However, due to maternal exhaustion during labor or inadequate warmth in care, the pain from these masses may not dissipate. One must never lightly use harsh drugs that aggressively break up blood stasis. It is advisable to drink Ginger and Mugwort Wine, take Shenghua Tang frequently, and keep the abdomen warm with hot clothing; naturally, the masses will gradually dissipate. Some folk practitioners use Red Flower (Hong Hua) and Rehmannia Root (Sheng Di Huang) to move blood, and Sappan Wood (Su Mu) and Achyranthes Root (Niu Xi) to attack stasis; few avoid reaching a critical or fatal state.
A mass in the lower abdomen accompanied by pain is called Er Zhen (Child Pillow). The world often specializes in dispersing first, then discussing tonification, or applying both methods simultaneously, leading to further complexity. Little do they know that old blood must be digested, and new blood especially needs to be generated. If one focuses solely on attacking old blood, new blood cannot be produced either. After childbirth, Qi and Blood are suddenly deficient, so major tonification is appropriate. However, when Lochia (postpartum discharge) is not yet clear, one must know how to tonify without stagnating blood, and how to attack masses without damaging Yuan Qi (Original Qi). Combining blood-moving with tonification is the most comprehensive approach. The world's use of Si Wu Tang for postpartum care has misled many. Di Huang (Rehmanniae Radix Preparata) is cold and causes blood stagnation; Bai Shao (Paeoniae Radix Alba) is sour and cold, damaging the Liver. Those treating postpartum conditions must observe this carefully.
Within seven days after childbirth, if Shenghua Tang has not been taken and the pain from blood masses persists, continue to treat with Shenghua Tang.
In summer, after childbirth, take Shenghua Tang internally to remove blood mass pain, and externally apply hot clothing to warm the abdomen; only then can lochia be eliminated and pain relieved. If neglecting warmth and covering, efficacy will be difficult to achieve.
Within one or two days after childbirth, if blood mass pain does not stop, and sudden syncope, profuse sweating, cold limbs, and gradually cooling breath occur, immediately add Ren Shen (Ginseng Radix et Rhizoma) and Huang Qi (Astragali Radix) to Shenghua Tang to support critical conditions. Taking three to four doses frequently day and night will surely be effective.
Within seven days after childbirth, if eating cold foods causes blood masses to coagulate with severe pain, add Rou Gui (Cinnamomi Cortex) five to seven fen to Shenghua Tang.
Three to four days after childbirth, after taking three to four doses of Shenghua Tang, if blood mass pain does not decrease but feels slightly relieved upon pressing and rubbing, this indicates deficiency. Add Ren Shen (Ginseng Radix et Rhizoma) two to three qian.
Within three days after childbirth, for blood mass pain, Ren Shen (Ginseng Radix et Rhizoma) should be used cautiously. In cases of critical illness, Ren Shen (Ginseng Radix et Rhizoma) may be added opportunistically for emergency rescue. Once the disease trend shifts, reduce the amount of Ren Shen (Ginseng Radix et Rhizoma) and take only the original formula; efficacy will naturally be achieved.