新产之后。丹溪谓大补气血。虽有他症。以末治之。其说甚善。然此谓恶露
下尽而言则可。恶露未尽而言。则不可也。妊娠十月根据经而养。其精粹则
为孕育。其滓秽则为恶露。分娩之日。年壮气旺。恶露易行。以六七日为期
者有之。杂病相侵。或为阻滞。以一二十日未尽者有之。多产气弱。时行时
止。以一月淋沥者有之。故其为患也。两胁作疼。少腹胀满。儿枕成块。寒热
时作。甚至心神恍惚。发呕不食。败血流经等候。其害不一。故产后首重于
此。其自行者所不待言。一或有阻而致他病。或因他病而致凝阻。必须芎
归益母楂肉去瘀为主。而佐以他药。无论虚实。皆不可缺。而参 补气之
药。切勿早投。恐恶露上攻。变异顷刻。若去血过多。恶露已尽。腹无疼痛硬
满之处。半月一月以来。但见虚候。又须大补气血。兼温暖药。以复其生气。
则又何疑之有哉。
一产后恶露不下。少腹疼痛。用芎归益母楂肉香附陈皮玄胡索。或加桃
仁红花丹皮五灵脂。腰痛。加杜仲续断。外感。加紫苏。呕恶。加藿香半夏
茯苓甘草砂仁生姜。
一产后恶露少去。用四物汤加牛膝山楂杜仲益母茯苓陈皮香附。
一产后恶露未尽。脾气又虚。破血则碍脾。补脾则碍血。用二陈汤入川芎
益母香附木香。少加炒当归。或倍入车前子。
一产后恶露未止。血虚发热。四物汤加炮姜肉桂茯苓甘草广皮杜仲续断。
一产后脾虚。不进饮食或浮肿。用白术茯苓炙甘草炮姜。入芎归益母陈皮。
一产后心神恍惚。用远志茯神枣仁丹参木香及芎归益母杜仲甘草。
一产后外感。头痛身热。用荆防紫苏川芎陈皮香附山楂。仍入当归茯苓。
一产后停食。或因临产不化。用浓朴枳壳陈皮山楂青皮香附莱菔子木香等。以轻重加减。仍入芎归益母红花。
一产后疟疾。或因胎前所致。用白术茯苓甘草陈皮半夏。加芎归益母山楂。
一产后痢疾。或因胎前所致。用当归芍药川芎木香肉桂白术茯苓炙甘草广陈皮阿胶。
一产后诸症。恶露未尽。必须遵以上法万无一误。但寒凉之药。切不可用。恐伐其生生之气也。
一产后恶露已透。凡有杂症。随病制宜。血气亏损。或发寒热。十全大补汤。
补中益气汤。怔忡惊悸。自汗不寐。归脾汤。中气虚寒。饮食不进。六君子
加炮姜益智。或人参附子理中汤。血虚大便难。八珍汤加杜仲续断。或
六味汤加苁蓉牛膝。
一胎前脉洪大滑疾为顺。微小涩滞为逆。产后脉虚软柔弱为顺。弦大急
疾为逆。故胎前宜清热。而亦有用温药者。病之变也。产后宜温补。而亦
有用凉润者。亦病之变也。治者守其常。而达其变。则病无遁情矣。
一丹溪云。虽有他症。以末治之。非不治也。如实症多。则泻中带补。虚症多。
则补中带泻。如此则正气不脱。而邪气不炽矣。此用药之权衡也。
益母草汤 产后恶露未尽。腹疼痛者。
益母草（一钱五分） 当归（一钱） 杜仲（一钱盐水炒） 牛膝（一钱） 川芎（五分） 丹皮（一钱） 香附
（一钱醋炒） 茯苓（一钱） 山楂（一钱半） 广皮（一钱）
炒熟砂仁末一钱。姜一片。水煎。甚者加桃仁延胡红花。
黑神散 治产后发热。恶露不下。
黑豆（三钱） 黑姜（一钱） 牛膝（二钱） 当归（一钱） 川芎（五分） 熟地（二钱）
水煎。
加味六君子汤 治产后中气大虚。恶露不下。
人参（一钱） 白术（一钱土炒） 肉桂（一钱） 牛膝（一钱半） 茯苓（一钱） 炙甘草（三分） 半夏（一
钱） 广皮（一钱） 益母草（二钱）
砂仁末七分。姜一片。水煎。
远志汤 治产后心神恍惚。恶露未尽。
远志肉（一钱） 枣仁（一钱半） 茯神（一钱） 丹参（一钱） 石菖蒲（五分） 牛膝（一钱半） 广皮（一
钱） 杜仲（一钱） 益母草（一钱半）
桂圆肉五枚。姜一片。水煎。
黄 补气汤 治产后去血过多。自汗体倦。
黄 （一钱半蜜炙） 人参（二钱） 白术（一钱半土炒） 当归（一钱） 芍药（一钱） 炙甘草（三分） 茯
苓（一钱） 肉桂（五分） 附子（五分制）
枣二枚。煨姜一片。
贝母汤 治产后内热咳嗽。心神不宁。
川贝母（一钱半） 茯苓（一钱） 车前子（一钱半） 当归（一钱） 炙甘草（三分） 广陈皮（七分） 远志
肉（一钱） 枣仁（一钱） 钩藤钩（一钱） 牡丹皮（七分）
桂圆肉五枚。灯芯一握。
八珍汤 治产后气血两虚。四肢乏力。
人参（一钱） 白术（一钱土炒） 茯苓（一钱） 炙甘草（三分） 川芎（五分） 熟地（一钱） 当归（一钱）
白芍药（一钱酒炒） 杜仲（一钱盐水炒） 川续断（一钱酒炒）
枣二枚。姜一片。水煎。
八味汤 治产后阴虚发喘。气上逆者。
怀熟地（三钱） 山茱肉（二钱） 肉桂（五分） 熟附子（五分） 牡丹皮（一钱） 山药（二钱） 川牛膝（一
钱半） 茯苓（一钱） 泽泻（一钱）
水煎。如汗出不止。兼进生脉散。
After childbirth, Zhu Danxi advocated greatly tonifying Qi and Blood. Even if there are other symptoms, they should be treated as secondary issues. This theory is excellent. However, this applies only when the lochia (postpartum vaginal discharge) has been completely discharged; if stated when lochia remains, it is incorrect.
During the ten months of pregnancy, the fetus is nourished by the mother's meridians. The essence and purity are used for gestation, while the dregs and turbid matter form the lochia. On the day of delivery, if the woman is young and her Qi is vigorous, the lochia flows easily, with a period of six to seven days being common. If complicated by other diseases causing obstruction, or if the lochia remains undischarged for ten to twenty days, this also occurs. In cases of multiple births leading to Qi deficiency, the lochia may stop and start intermittently, dripping on and off for a month. Therefore, complications arising from this include: pain in both hypochondriac regions, fullness and distension in the lower abdomen, formation of hard masses known as "Erzhen" (retained blood clots in the uterus), alternating chills and fever, and even mental confusion, vomiting, and inability to eat, or敗血 (decaying blood) entering the collaterals. The harms vary. Thus, postpartum treatment prioritizes this condition. If the lochia discharges naturally, no further comment is needed. However, if obstruction leads to other diseases, or if other diseases cause stagnation, one must primarily use Chuanxiong Rhizome (Chuanxiong), Angelicae Sinensis Radix (Danggui), Motherwort Herba (Yimucao), and Hawthorn Fruit (Shanzha) to remove stasis, assisted by other herbs. Regardless of deficiency or excess, these cannot be omitted. However, Qi-tonifying herbs like Ginseng Radix et Rhizoma (Renshen) must not be administered early, lest they cause the lochia to rush upward and lead to sudden changes. If excessive blood loss has occurred, the lochia is finished, and there is no painful hardness in the abdomen, and after half a month or a month only deficiency signs are seen, then one must greatly tonify Qi and Blood, combined with warming herbs, to restore vital energy. Is there any doubt about this?
In cases where postpartum lochia does not descend, causing lower abdominal pain, use Chuanxiong Rhizome (Chuanxiong), Angelicae Sinensis Radix (Danggui), Motherwort Herba (Yimucao), Hawthorn Fruit (Shanzha), Cyperi Rhizoma (Xiangfu), Citri Reticulatae Pericarpium (Chenpi), and Corydalis Rhizoma (Yanhusuo). Alternatively, add Peach Kernel (Taoren), Safflower Flos (Honghua), Moutan Cortex (Danpi), and Trogopteri Dung (Wulingzhi). For lower back pain, add Eucommiae Cortex (Duzhong) and Dipsaci Radix (Xuduan). For external contraction, add Perilla Folium (Zisu). For nausea and vomiting, add Patchouli Herb (Huoxiang), Pinellia Rhizoma (Banxia), Poria (Fuling), Glycyrrhizae Radix et Rhizoma (Gancao), Amomi Fructus (Sharen), and Zingiberis Rhizoma (Shengjiang).
In cases where postpartum lochia flow is scant, use Siwu Decoction (Four Substances Decoction) added with Achyranthis Bidentatae Radix (Niuxi), Hawthorn Fruit (Shanzha), Eucommiae Cortex (Duzhong), Motherwort Herba (Yimucao), Poria (Fuling), Citri Reticulatae Pericarpium (Chenpi), and Cyperi Rhizoma (Xiangfu).
In cases where postpartum lochia is not yet finished and Spleen Qi is deficient, blood-breaking herbs hinder the Spleen, while Spleen-tonifying herbs hinder blood circulation. Use Erchen Decoction (Two-Cured Decoction) added with Chuanxiong Rhizome (Chuanxiong), Motherwort Herba (Yimucao), Cyperi Rhizoma (Xiangfu), and Aucklandiae Radix (Muxiang). Add a small amount of stir-fried Angelicae Sinensis Radix (Danggui), or double the dose of Plantaginis Semen (Cheqianzi).
In cases where postpartum lochia has not stopped and there is heat due to Blood deficiency, use Siwu Decoction (Four Substances Decoction) added with Prepared Ginger Root (Paojiang), Cinnamon Twig (Rougui), Poria (Fuling), Glycyrrhizae Radix et Rhizoma (Gancao), Citri Reticulatae Pericarpium (Guangpi), Eucommiae Cortex (Duzhong), and Dipsaci Radix (Xuduan).
In cases of postpartum Spleen deficiency, leading to anorexia or edema, use Atractylodis Macrocephalae Rhizoma (Baizhu), Poria (Fuling), Honey-fried Glycyrrhizae Radix et Rhizoma (Zhigancao), and Prepared Ginger Root (Paojiang), added with Chuanxiong Rhizome (Chuanxiong), Angelicae Sinensis Radix (Danggui), Motherwort Herba (Yimucao), and Citri Reticulatae Pericarpium (Chenpi).
In cases of postpartum mental confusion, use Polygalae Radix (Yuanzhi), Poria Cum Radix Xyli (Fushen), Ziziphi Spinosae Semen (Suanzaoren), Salviae Miltiorrhizae Radix et Rhizoma (Danshen), Aucklandiae Radix (Muxiang), along with Chuanxiong Rhizome (Chuanxiong), Angelicae Sinensis Radix (Danggui), Motherwort Herba (Yimucao), Eucommiae Cortex (Duzhong), and Glycyrrhizae Radix et Rhizoma (Gancao).
In cases of postpartum external contraction with headache and fever, use Schizonepetae Spica (Jingjie), Saposhnikoviae Radix (Fangfeng), Perilla Folium (Zisu), Chuanxiong Rhizome (Chuanxiong), Citri Reticulatae Pericarpium (Chenpi), Cyperi Rhizoma (Xiangfu), and Hawthorn Fruit (Shanzha), still including Angelicae Sinensis Radix (Danggui) and Poria (Fuling).
In cases of postpartum food stagnation, possibly due to impaired digestion during labor, use Magnoliae Officinalis Cortex (Houpo), Aurantii Fructus (Zhike), Citri Reticulatae Pericarpium (Chenpi), Hawthorn Fruit (Shanzha), Tangerine Peel (Qingpi), Cyperi Rhizoma (Xiangfu), Raphani Semen (Laifuzi), and Aucklandiae Radix (Muxiang), adjusting dosages based on severity, while still including Chuanxiong Rhizome (Chuanxiong), Angelicae Sinensis Radix (Danggui), Motherwort Herba (Yimucao), and Safflower Flos (Honghua).
In cases of postpartum malaria, possibly originating from before birth, use Atractylodis Macrocephalae Rhizoma (Baizhu), Poria (Fuling), Glycyrrhizae Radix et Rhizoma (Gancao), Citri Reticulatae Pericarpium (Chenpi), Pinellia Rhizoma (Banxia), added with Chuanxiong Rhizome (Chuanxiong), Angelicae Sinensis Radix (Danggui), Motherwort Herba (Yimucao), and Hawthorn Fruit (Shanzha).
In cases of postpartum dysentery, possibly originating from before birth, use Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Shaoyao), Chuanxiong Rhizome (Chuanxiong), Aucklandiae Radix (Muxiang), Cinnamon Twig (Rougui), Atractylodis Macrocephalae Rhizoma (Baizhu), Poria (Fuling), Honey-fried Glycyrrhizae Radix et Rhizoma (Zhigancao), Citri Reticulatae Pericarpium (Guangchenpi), and Colla Corii Asini (Ejiao).
For various postpartum conditions where lochia is not yet finished, one must follow the above methods to ensure no errors. Cold-natured herbs must absolutely not be used, as they may damage the vital generating energy.
Once postpartum lochia has cleared, for any miscellaneous diseases, treatment should be tailored to the specific condition. For Qi and Blood deficiency, or alternating chills and fever, use Shiquan Dabu Decoction (Ten Ingredients Great Tonifying Decoction) or Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). For palpitations, fright, spontaneous sweating, and insomnia, use Guipi Tang (Restore the Spleen Decoction). For Middle Qi deficiency and cold, with anorexia, use Liujunzi Tang (Six Gentlemen Decoction) added with Prepared Ginger Root (Paojiang) and Alpiniae Oxyphyllae Fructus (Yizhi), or Renshen Fuzi Lizhong Tang (Ginseng, Aconite, and Centra Digestion Decoction). For Blood deficiency causing difficult defecation, use Bazhen Tang (Eight Treasures Decoction) added with Eucommiae Cortex (Duzhong) and Dipsaci Radix (Xuduan), or Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) added with Cistanche Caulis (Rongrongs) and Achyranthis Bidentatae Radix (Niuxi).
Before birth, a pulse that is surging, large, slippery, and rapid is favorable; one that is minute, small, choppy, and stagnant is unfavorable. After birth, a pulse that is deficient, soft, weak, and delicate is favorable; one that is wiry, large, urgent, and rapid is unfavorable. Therefore, before birth, clearing heat is appropriate, though warming herbs are sometimes used due to pathological variations. After birth, warming and tonifying are appropriate, though cooling and moistening herbs are sometimes used due to pathological variations. The practitioner should adhere to the constant principles while understanding the variations, so that no disease can hide its true nature.
Danxi said, "Even if there are other symptoms, treat them as secondary," which does not mean ignoring them. If excess syndromes predominate, tonification is included within purgation; if deficiency syndromes predominate, purgation is included within tonification. In this way, healthy Qi will not collapse, and pathogenic Qi will not flourish. This is the balance of medication.
[Yi Mu Cao Tang] Motherwort Decoction: For postpartum lochia not yet finished with abdominal pain.
Ingredients: Motherwort Herba (Yimucao, 1.5 qian), Angelicae Sinensis Radix (Danggui, 1 qian), Eucommiae Cortex (Duzhong, 1 qian, stir-fried with salt water), Achyranthis Bidentatae Radix (Niuxi, 1 qian), Chuanxiong Rhizome (Chuanxiong, 0.5 qian), Moutan Cortex (Danpi, 1 qian), Cyperi Rhizoma (Xiangfu, 1 qian, stir-fried with vinegar), Poria (Fuling, 1 qian), Hawthorn Fruit (Shanzha, 1.5 qian), Citri Reticulatae Pericarpium (Guangpi, 1 qian).
Preparation: Stir-fried Amomi Fructus powder (Sharen, 1 qian), one slice of Zingiberis Rhizoma (Shengjiang). Decoct in water. For severe cases, add Peach Kernel (Taoren), Corydalis Rhizoma (Yanhu), and Safflower Flos (Honghua).
[Hei Shen San] Black Spirit Powder: For postpartum fever and lochia not descending.
Ingredients: Soybean (Heidou, 3 qian), Black Ginger (Heijiang, 1 qian), Achyranthis Bidentatae Radix (Niuxi, 2 qian), Angelicae Sinensis Radix (Danggui, 1 qian), Chuanxiong Rhizome (Chuanxiong, 0.5 qian), Prepared Rehmanniae Radix (Shudi, 2 qian).
Preparation: Decoct in water.
[Jiawei Liujunzi Tang] Modified Six Gentlemen Decoction: For postpartum severe Middle Qi deficiency and lochia not descending.
Ingredients: Ginseng Radix et Rhizoma (Renshen, 1 qian), Atractylodis Macrocephalae Rhizoma (Baizhu, 1 qian, stir-fried with soil), Cinnamon Twig (Rougui, 1 qian), Achyranthis Bidentatae Radix (Niuxi, 1.5 qian), Poria (Fuling, 1 qian), Honey-fried Glycyrrhizae Radix et Rhizoma (Zhigancao, 0.3 qian), Pinellia Rhizoma (Banxia, 1 qian), Citri Reticulatae Pericarpium (Guangpi, 1 qian), Motherwort Herba (Yimucao, 2 qian).
Preparation: Amomi Fructus powder (Sharen, 0.7 qian), one slice of Zingiberis Rhizoma (Shengjiang). Decoct in water.
[Yuanzhi Tang] Polygala Decoction: For postpartum mental confusion and lochia not yet finished.
Ingredients: Polygalae Radix (Yuanzhi Rou, 1 qian), Ziziphi Spinosae Semen (Suanzaoren, 1.5 qian), Poria Cum Radix Xyli (Fushen, 1 qian), Salviae Miltiorrhizae Radix et Rhizoma (Danshen, 1 qian), Pogostemonis Rhizoma (Shichangpu, 0.5 qian), Achyranthis Bidentatae Radix (Niuxi, 1.5 qian), Citri Reticulatae Pericarpium (Guangpi, 1 qian), Eucommiae Cortex (Duzhong, 1 qian), Motherwort Herba (Yimucao, 1.5 qian).
Preparation: Five fruits of Dimocarpus Longan Aril (Guiyuanrou), one slice of Zingiberis Rhizoma (Shengjiang). Decoct in water.
[Huangqi Bqi Tang] Astragalus Qi-Tonifying Decoction: For postpartum excessive blood loss, spontaneous sweating, and fatigue.
Ingredients: Astragali Radix (Huangqi, 1.5 qian, honey-fried), Ginseng Radix et Rhizoma (Renshen, 2 qian), Atractylodis Macrocephalae Rhizoma (Baizhu, 1.5 qian, stir-fried with soil), Angelicae Sinensis Radix (Danggui, 1 qian), Paeoniae Radix Alba (Shaoyao, 1 qian), Honey-fried Glycyrrhizae Radix et Rhizoma (Zhigancao, 0.3 qian), Poria (Fuling, 1 qian), Cinnamon Twig (Rougui, 0.5 qian), Prepared Aconiti Lateralis Radix (Fuzi, 0.5 qian, processed).
Preparation: Two jujubes, one slice of baked ginger.
[Beimu Tang] Fritillaria Decoction: For postpartum internal heat cough and restless mind.
Ingredients: Fritillariae Thunbergii Bulbus (Chuanbeimu, 1.5 qian), Poria (Fuling, 1 qian), Plantaginis Semen (Cheqianzi, 1.5 qian), Angelicae Sinensis Radix (Danggui, 1 qian), Honey-fried Glycyrrhizae Radix et Rhizoma (Zhigancao, 0.3 qian), Citri Reticulatae Pericarpium (Guangchenpi, 0.7 qian), Polygalae Radix (Yuanzhi Rou, 1 qian), Ziziphi Spinosae Semen (Suanzaoren, 1 qian), Uncariae Ramulus cum Uncis (Goutenggou, 1 qian), Moutan Cortex (Mudanpi, 0.7 qian).
Preparation: Five fruits of Dimocarpus Longan Aril (Guiyuanrou), a handful of Junci Medulla (Dengxin).
[Bazhen Tang] Eight Treasures Decoction: For postpartum dual deficiency of Qi and Blood, weakness of limbs.
Ingredients: Ginseng Radix et Rhizoma (Renshen, 1 qian), Atractylodis Macrocephalae Rhizoma (Baizhu, 1 qian, stir-fried with soil), Poria (Fuling, 1 qian), Honey-fried Glycyrrhizae Radix et Rhizoma (Zhigancao, 0.3 qian), Chuanxiong Rhizome (Chuanxiong, 0.5 qian), Prepared Rehmanniae Radix (Shudi, 1 qian), Angelicae Sinensis Radix (Danggui, 1 qian), White Peony Root (Baishaoyao, 1 qian, wine-fried), Eucommiae Cortex (Duzhong, 1 qian, salt-water fried), Dipsaci Radix (Chuanduan, 1 qian, wine-fried).
Preparation: Two jujubes, one slice of Zingiberis Rhizoma (Shengjiang). Decoct in water.
[Bawei Tang] Eight-Ingredient Decoction: For postpartum Yin deficiency causing asthma and rebellious Qi.
Ingredients: Prepared Rehmanniae Radix (Shudi, 3 qian), Corni Fructus (Shanzhuyu, 2 qian), Cinnamon Twig (Rougui, 0.5 qian), Prepared Aconiti Lateralis Radix (Shufuzi, 0.5 qian), Moutan Cortex (Mudanpi, 1 qian), Dioscoreae Rhizoma (Shanyao, 2 qian), Achyranthes Bidentatae Radix (Chuanniuxi, 1.5 qian), Poria (Fuling, 1 qian), Alisma Rhizoma (Zexie, 1 qian).
Preparation: Decoct in water. If sweating persists, concurrently administer Shengmai San (Generate the Pulse Powder).