Library

Postpartum women have empty meridians and blood and qi throughout the body; it is inappropriate to use diaphoretic (sweat-inducing) treatments. Furthermore, remedies that are excessively cold or hot will damage and deplete blood and qi, further weakening an already deficient constitution. Even if other symptoms exist, the primary treatment principle should be regulating blood. If lochia remains incomplete accompanied by abdominal pain, use Danggui Tan (Charred Radix Angelicae Sinensis), Wulingzhi (Trogopterus Dung), Taoren (Peach Kernel), and Nipaojiang (Charred Dried Ginger). For dizziness, fainting, or collapse due to blood deficiency, use Danggui Tan, Baishao Tan (Charred Radix Paeoniae Alba), Qizi (Goji Berry), Chuanduan (Radix Dipsaci), Ejiao Zhu (Glue Ball of Donkey-hide Gelatin), Dancongroung (Cistanche), Danshen (Salvia Root), Xiangfu (Cyperus Rhizome), Taizishen (Pseudostellaria Root), and Chongweizi (Herba Leonuri). If wind pathogen is present, add Jingjie Tan (Charred Herba Schizonepetae), Jiegeng (Platycodon Root), and Chuanxiong (Ligusticum Rhizome). If cold pathogen is present, add Rougui (Cinnamon Bark). In cases of fever, thirst, and dry tongue, add Huangqin (Scutellaria Root), Maidong (Ophiopogon Tuber), and Danpi (Moutan Cortex). For loss of appetite, add Shihu (Dendrobium Stem), Guya (Sprouted Grain), and Chao Yiren (Stir-fried Coix Seed). Whenever miscellaneous conditions arise, one must exercise discretion, referring to various methods in gynecological texts to avoid errors.

When warm-heat pathogen first emerges, within two to three days the tongue becomes dry, cracked, and shrunk; speech is muttering and indistinct; consciousness is half-clear and half-obscured; drinking does not quench thirst, or there is thirst without desire to drink. Immediately administering Yin-nourishing and heat-clearing herbs fails to reduce the disease severity. This indicates impending exhaustion of Kidney Qi, with枯竭 (dryness) of Water failing to ascend moistening the upper jiao, and Heart Yang scattering outward without converging. Survival beyond one week (hou) is unlikely.

Upon observing a dry tongue with great thirst and desire to drink water, clinicians typically employ heat-clearing and Yin-nourishing methods. Although vexatious thirst may temporarily resolve, it returns shortly after; although the tongue momentarily regains moisture, it soon cracks and dries again; only high fever persists without sweating; and the pulse is restless and rapid. This signifies the exhaustion of the source of transformation and production, inability to guide pathogens outward, and virtually no chance of survival.

In the early stage of warm disease, the tongue coating is white, slippery, and resembles powder. By the sixth or seventh day, despite restlessness and coma, and thirst without desire to drink, the tongue coating remains non-dry. This indicates the pathogen directly invading the Pericardium (Xinbao) without affecting the Fu organs of the Yangming channel. Fewer than one or two out of ten patients can be saved. Only Shenmai San (Formula follows) may be used to seek a slim hope.

At the onset of illness, the tongue shows a mixture of yellow and white coatings that are slippery, or purely yellow but not dry, or white edges with a yellow center, or a white center with yellow edges, all without cracking or dryness. This represents Spleen dampness and turbid pathogens obscuring the Pericardium. The patient exhibits alternating periods of clarity and confusion, thirst with little intake of fluids, and carries a poor prognosis with more bad outcomes than good.

By the fifth or sixth day of warm disease, the tongue coating appears gray-white and moist, or gray-black mixed with yellow but not dry, accompanied by blurred consciousness. This indicates failure and exhaustion of Kidney Qi, with cold water overwhelming the Heart Monarch, presenting as "water extreme resembling fire." It is not merely fluid depletion failing to moisten. Using bitter-cold herbs to nourish Yin would hasten death. One might tentatively administer Zhigancao Tang (Formula follows) to do what is humanly possible.

After several days of illness, the tongue coating fluctuates between yellow and gray-black during peak pathogenic strength, then suddenly turns white and moist as the pathogen retreats, changing multiple times within a day. This occurs because righteous Qi is originally deficient, clashing with incoming pathogens, causing illusory manifestations on the tongue. The patient is comatose and unresponsive; although restless, there is no thirst. One may tentatively adopt a method of supporting righteous Qi and clearing pathogens, leaving the outcome to Heaven's will.

In certain epidemic diseases combined with other conditions, after a long duration, the patient’s spirit becomes clear, movement is possible, and there is no thirst. Suddenly, the tongue coating presents as tender yellow and glossy. This indicates impending exhaustion of Stomach Qi. Since the Stomach belongs to Central Earth, and yellow is the true color of Earth, the leakage of Middle Qi causes the true color to fail to remain internal. Death will occur within four to five days.