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After delivery, if the patient sees black spots before her eyes, experiences dizziness and fainting, and loses consciousness: this is due to one of three causes: first, extreme fatigue leading to exhaustion of Qi and clouding of the spirit; second, massive blood loss leading to impending collapse of Qi; third, phlegm-fire rising due to deficiency, causing the spirit to lose its residence. One should immediately administer Er Sheng Tang (Two-Postpartum Decoction) for two or three doses. Externally, finely chop Chinese chive leaves, place them in a bottle with a spout, pour two cups of boiling vinegar into the bottle, and quickly fumigate the mother's nostrils to restore consciousness. If one blindly follows ancient prescriptions, attributing the condition to "evil blood snatching the heart" and lightly using blood-dispersing agents; or attributing it to epidemic fire and using formulas lacking tonifying, dissipating, or descending properties, this is a grave error.

If fainting occurs accompanied by clenched jaw, rapidly decoct Er Sheng Tang, pry open the mouth, probe the throat with a goose feather to induce vomiting, and administer the liquid from a wine cup. If the abdomen gradually warms after ingestion, do not rigidly adhere to the number of doses. Use warm hands to massage from the heart region down to the abdomen over single-layer clothing, keeping the area frequently hot and warm. After about one shichen (two hours), complete four doses of Er Sheng Tang, and the spirit will clear. Then, slightly reduce the medication dosage and begin consuming congee. After ten doses, the patient will be stable. Therefore, those suffering from this condition must be rapidly medicated and kept warm; do not abandon them without rescue. In winter, if the mother's body lacks warmth, indicating severe cold, one must pre-decoct Er Sheng Tang and pre-heat iron weights or hard stones before delivery. Once the child is born, administer two to three doses consecutively. Furthermore, placing the vinegar-chive fumigation method near the mother's pillow ensures no fainting will occur. Additionally, upon the birth of the child, the family must not focus solely on the joy of the child while neglecting the mother; the mother must not forget her fatigue due to concern for the child; nor should she lie down immediately after delivery, or become angry causing Qi rebellion. All these lead to blood-fainting. Be cautious, be cautious!

Jiawei Er Sheng Tang (Modified Two-Postpartum Decoction): Treats three types of postpartum blood-fainting.
Chuanxiong Rhizome (Sanqian / 3 qian), Danggui Radix (Liuqian / 6 qian), Heijiao Charred Ginger (Sifen / 4 fen), Taoren Peach Seed (Shili / 10 seeds), Zhi Gancao Prepared Licorice Root (Wufen / 5 fen), Jingjie Schizonepeta Spike (Sifen / 4 fen, stir-baked until black), Dazao Jujube Fruit. Decoct in water and take orally.

Rhyme: Postpartum blood-fainting renders one unaware,
Fatigue exhausts Qi, spirit clouds and sways.
Or due to blood loss, Qi nearly departs,
Phlegm-fire rises, spirit abandons its parts.
Blood-fainting Jiawei Er Sheng Tang,
Danggui, Chuanxiong, Jingjie, Gancao, Taoren, Jiang.
Chive leaves placed in a spouted bottle,
Boiling vinegar poured in to fumigate the nose.

For fainting due to extreme fatigue, as well as fainting due to blood flooding and Qi collapse, it is suitable to rapidly administer two doses. If the complexion is pale and form is depleted, or sweating leads to collapse, immediately take one dose, then add Renshen Ginseng Root (San-Siqian / 3-4 qian) (add Rougui Cinnamon Bark Sifen / 4 fen). Do not doubt that Renshen is tonifying and delay administration. For fainting caused by phlegm-fire rising due to deficiency, add Juhong Tangerinae Pericarpium Rubrum Sifen / 4 fen. For severe deficiency, add Renshen Ginseng Root Liang / 2 liang. Obese people often have phlegm; add Zhuli Bamboo Sap Qifen / 7 fen and a little Jiangzhi Ginger Juice. Overall, avoid formulas with Sanleng Sparganii Rhizoma and E Zhu Curcumae Rhizoma for breaking blood. If pain from blood clots is severe, concurrently administer Yimuwan Motherwort Pill, or Lujiaohui Deer Antler Ash, or Yuanhusan Corydalis Powder, or Dushengsan Single Victory Powder, above-mentioned blood-clot resolving formulas. One dose brings immediate effect; there is no need to change the formula; use this as an emergency measure.

Jia Shen Er Sheng Tang (Ginseng-Added Two-Postpartum Decoction): Treats postpartum fainting due to depletion of complexion and form, or fainting due to excessive sweating.
Renshen Ginseng Root (Sanqian / 3 qian, sometimes doubled to Wuqian / 5 qian), Chuanxiong Rhizome (Erqian / 2 qian), Danggui Radix (Wuqian / 5 qian), Zhi Gancao Prepared Licorice Root (Sifen / 4 fen), Taoren Peach Seed (Shili / 10 seeds), Paojiang Prepared Ginger (Sifen / 4 fen), Dazao Jujube Fruit. Decoct in water and take orally.

When pulse and form are depleted, indicating impending collapse, this formula must be taken. Add Renshen Ginseng Root Si-Wuqian / 4-5 qian and administer frequently. For postpartum blood flooding, blood-fainting, combined with excessive sweating, this formula is suitable. If there is no sweating and no collapse, only take the base formula without adding Renshen. If the Chi position on the left wrist shows depletion, also add Renshen Ginseng Root. This formula can be generally used for various critical postpartum conditions. Within one day and night, three to four doses must be taken. If taken like routine cases, how can it reconnect collapsing Qi and Blood, and support critical changes? During the first one or two days postpartum, even if pain from blood clots persists, if the mother's Qi and Blood are deficient and collapsing, presenting with fainting, syncope, excessive sweating, depletion of form, cooling breath, incessant irritability and thirst, or rapid breathing, regardless of clot pain, use Jia Shen Er Sheng Tang as an emergency measure. As the disease trend recedes, reduce the amount of Renshen and continue taking Er Sheng Tang.

Modifications: For severe pain from blood clots, add Rougui Cinnamon Bark Qifen / 7 fen; for thirst, add Maidong Ophiopogonis Radix Qian / 1 qian and Wuweizi Schisandrae Fructus Ten grains; for excessive sweating, add Mahuanggen Ephedrae Cauliculus Radix Qian / 1 qian. If blood clots do not hurt, add Zhi Huangqi Astragali Radix Qian / 1 qian to stop sweating; for injury from rice or wheat foods, add Chao Shenqu Fermented Wheat Mass Qian / 1 qian and Maiya Hordei Fructus Germinatus Wufen / 5 fen stir-fried; for injury from meat, add Shanzha Crataegi Fructus Five fruits and Sharen Amomi Fructus Qian / 4 qian stir-fried.

Rhyme: Pulse and form depleted, symptoms nearing end,
Blood flooding and fainting, with sweat profuse.
Various critical postpartum conditions,
Jia Shen Er Sheng Tang is safest.
Qi and Blood depletion, Er Sheng Tang,
Adding Renshen makes it excellent.
Severe clot pain adds Rougui,
Thirst adds Maidong and Wuweizi, sweat Mahuanggen.
Clots not painful, Zhi Huangqi,
Shenqu and Maiya treat food injury.
If meat injury, add Shanzha and Sharen,
Symptom-based modifications show greater efficacy.