Library

In cases where the placenta fails to be expelled after childbirth, it is indeed a matter of grave concern. This is often due to lochia (stagnant blood) filling and distending the placenta, obstructing the birth canal. It is imperative to use medication to assist its expulsion; one must absolutely avoid having unskilled women attempt to extract it by hand, as this frequently results in damage to the Liver and Stomach. This aspect requires utmost caution. Zhu Danxi stated: "After childbirth, the primary treatment should be massive tonification of Qi and Blood. Even if other miscellaneous disorders are present, they should not be treated initially." This is indeed an unchanging principle for all generations.

Originally, during pregnancy, the mother's Yuan Qi (Original Qi) nourishes the fetus, so her constitution is not particularly robust. Furthermore, childbirth causes a massive depletion of Qi and Blood, resulting in a state of "deficiency upon deficiency." How can massive tonification not be necessary? However, this represents the standard approach described by Zhu Danxi. If specific pathological variations occur, is it not necessary to adapt the treatment accordingly? Or should one rigidly adhere to the standard method of tonification? The *I Ching* states: "Transformation and adaptation depend on flexibility; divine understanding depends on the individual."

Once the fetus is delivered, the accumulated foul blood must be completely discharged. If it is not fully expelled and abdominal hardness and pain occur, formulas such as Huase Tang (Slippery-Astringent Decoction) or Heishen San (Black Divine Powder) should be used to break up stasis and promote movement. Only after the lochia has been entirely cleared should tonifying agents be administered. Subsequently, the placenta is washed to remove impurities, processed into pills, and presumptuously named Huanyuan Dan (Return to Origin Pill). Taking this formula postpartum is truly sufficient to tonify the True Yuan. Those who do not comprehend the profound mysteries of creation cannot possibly understand this!

If I encounter wind-cold invasion due to postpartum deficiency, wind-dispelling herbs may be added to the tonifying base. If fever arises from food stagnation, digestive-promoting herbs may also be added to the tonifying base. Other scenarios can be inferred by analogy. After delivery, one should first drink infant urine (Tongbian), take one pill of Fanhun Dan (Soul-Returning Pill), and must not lie flat immediately. Instead, one should sit leaning back with eyes closed for a moment, keep the knees firm and chest expanded. While lying supine, someone should massage from the heart region down to below the navel to prevent blood stasis. The mother should be awakened frequently; she must not fall into deep sleep or indulge in sexual activity. Within three days, smoke from burning dry lacquer (Ganqi) and charcoal quenched with vinegar should be used regularly so that the puerpera inhales the aroma, thereby preventing syncope due to blood loss (Xueyun) and coma.

For the month following childbirth, emotions such as worry, thought, anger, and joy, as well as activities like walking, standing, sitting, and lying, should be kept moderate and excessive exertion avoided. One should not recklessly consume raw, cold, roasted, fried, sticky, hard, or indigestible foods. Furthermore, one must not let guard down simply because one feels slightly healthy, nor ignore protection against wind and cold, nor engage in strenuous bathing. Although symptoms may not appear immediately, latent diseases may develop later, potentially causing significant lifelong harm. Wise individuals should take this as a warning.