Library

(Postpartum wheezing and urgency, extremely critical with high mortality)

Ji Zhong stated: Ying (Nutritive Qi) is blood, Wei (Defensive Qi) is qi. Ying circulates within the vessels, while Wei circulates outside the vessels. They move up and down together, which is referred to as Ying-Wei harmony. Due to excessive blood loss during childbirth, Ying blood is suddenly depleted, causing Wei qi to lose its master. It gathers exclusively in the lungs, thus inducing wheezing. This condition is named "Lone Yang and Absolute Yin" and is difficult to treat. If lochia (postpartum discharge) does not flow smoothly, and stagnant blood coagulates, ascending to smolder in the lungs, it also causes wheezing and urgency. Simply administering Duoming Dan will allow the blood to clear, and the wheezing will naturally subside.

Chen Wuyue said: For the aforementioned symptoms, if they are caused by stagnant blood ascending to smolder in the lungs, Duoming Dan is appropriate. If Ying blood is suddenly exhausted, a large-dose decoction is appropriate; Xiong Tang (Szechwan Lovage Root Decoction) can also be used. For injuries caused by wind-cold, Xuanfuhua Tang (Inula Flower Decoction) is suitable. For emotional depression leading to qi stagnation and rebellion, Xiaotiaojing San (Minor Regulation of Menses Powder) is suitable, administered with a decoction of Sangbai Pi (Morus Alba Bark) and Xingren (Apricot Seed). For food retention, Jianni Wan (See-Naked Pill) or Wuji San (Five Accumulations Powder) is suitable.

Postpartum diarrhea arises from the deficiency and weakness of the intestines and stomach, making them susceptible to invasion by cold pathogens. This may result from drinking cold beverages or exposing oneself to wind, allowing cold to invade and remain in the abdomen and hypochondrium, causing paroxysmal abdominal pain. Or, cold may flow into the large intestine, failing to digest water and grain, resulting in watery diarrhea and borborygmus. Or, there may be passage of red and white mucus, distension in the hypochondrium, or wandering pain. In such cases, urgently administering Tiaozhong Tang will lead to immediate recovery.

Commentary: The aforementioned symptoms are not limited to a single cause; treatment should be adjusted according to the specific etiology. If Liver Wood insults Spleen Earth, Liu Jun Zi Tang (Six Gentlemen Decoction) combined with Chai Hu (Bupleurum Root) and Pao Jiang (Prepared Ginger) should be used. If cold and water insult Earth, Qian Shi Yihuang San (Dr. Qian's Yellow Fortifying Powder) should be used. For chronic diarrhea or sinking of Yuan Qi (Primal Qi), Buzhong Yiqi Tang (Middle-Boosting and Qi-Invigorating Decoction) should be added to raise and generate Yang Qi. For deficiency-cold of Spleen Earth, Liu Jun Zi Tang combined with Mu Xiang (Aucklandia Root), Sheng Jiang (Fresh Ginger), and Gui Zhi (Cinnamon Twig) should be used. For deficiency-cold of both Spleen and Kidney, Buzhong Yiqi Tang and Sishen Wan (Four Miracles Pill) should be used. If Mingmen Fire Decline leads to deficiency-cold of Spleen Earth, Ba Wei Wan (Eight-Ingredient Pill) should be used to tonify the mother of Spleen Earth (Kidney). If urine is scanty and difficult to pass, or accompanied by wheezing and cough, Jin Gui Shenqi Wan (Golden Cabinet Kidney Qi Pill) should be used to tonify Spleen and Kidney and promote water metabolism. If Kidney Qi deficiency leads to edema of the four limbs, treating the edema must primarily focus on tonifying Spleen and Stomach. If the condition persists for a long time without healing, or is not caused by dietary injury, it belongs to Kidney Qi depletion, requiring the use of Sishen Wan, Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia), and Ba Wei Wan to tonify the Kidney. Using diuretic and water-draining agents would further deplete the deficiency; therefore, treatment should still refer to the management of antepartum diarrhea.