Library

The *Daquan* states: Postpartum blood dizziness (Xue Yun) is caused by failed blood entering the Liver meridian, resulting in blacking out of the eyes, vertigo, inability to rise or sit, and even coma with loss of consciousness, which is termed "blood dizziness." It is best treated by mixing Heishen San (Black Divine Powder) with a small amount of wine. Treating it as an obscure wind or stroke would be a mistake. However, there are three causes for this condition: dizziness due to excessive mental exertion and physical labor; dizziness due to excessive postpartum bleeding; and dizziness due to insufficient postpartum bleeding. Although the symptom of dizziness is the same, the treatment differs, so careful examination is required. For dizziness accompanied by excessive bleeding, characterized by lethargy and restlessness, tonifying blood and clearing the Heart should be used. For dizziness with insufficient bleeding, where lochia fails to discharge and rebellious qi rushes upward to the Heart, causing fullness and urgency below the heart, coma, locked jaw, and complete unconsciousness, blood-breaking and blood-moving herbs should be used. Generally, when heat in the blood rises counterflow due to deficiency and disturbs the Heart, leading to coma, loss of consciousness, and impending closure of Qi, drinking child's urine (Tong Bian) is most effective, or fumigating the nose with vinegar-heated charcoal is also acceptable (vinegar helps to astringe and restore spirit).

Zhang Zhongjing stated: In postpartum depression and vertigo (Yu Mao), the pulse is faint, there is vomiting and inability to eat, constipation, and only sweating on the head. The reason for this is that blood deficiency leads to Jue (reversal cold), and Jue inevitably leads to Mao (vertigo/coma). For Mao to resolve, there must be profuse sweating throughout the body. Because blood deficiency causes lower Jue, and solitary Yang floats upward and outward, only the head sweats. Therefore, postpartum patients who sweat excessively experience Yin depletion; blood deficiency allows Yang to stand alone in excess, hence sweating occurs. When Yin and Yang are restored, constipation and vomiting/inability to eat may occur. Xiao Chai Hu Tang (Minor Bupleurum Decoction) is the primary formula. If the patient recovers and can eat, but develops fever again after seven or eight days, this indicates Stomach excess (Yangming Fu syndrome), and Da Cheng Qi Tang (Major Order the Qi Decoction) is the primary formula.

Commentary: Yu Mao refers to dizziness/vertigo. From this discussion, it is evident that postpartum blood dizziness involves three methods: diaphoresis (sweating), purgation (downward draining), and harmonizing. These should be applied according to the differentiation of exterior/interior and deficiency/excess.