Library

Xue Lizhai stated: When a woman's qi and blood are abundant, her breasts may become distended. If the infant does not suckle, she may experience pain, swelling, aversion to cold, and fever. In such cases, use two or three liang of stir-fried malt, decocted in water and taken orally, which can rapidly resolve the symptoms. Malt has the effect of dissipating essence, thereby cutting off the source of milk. This demonstrates the strong dissipating power of malt; hence, *Bencao* (Compendium of Materia Medica) states that it can consume kidney qi. However, if breast swelling and pain are caused by excessive liver fire due to depression and anger, one should naturally soothe the liver, dissipate stagnation, and simultaneously nourish and harmonize the blood. In this way, liver yang will not be hyperactive, and the swelling will subside on its own. If the stagnation is severe, causing blood stasis and discomfort, compounded by milk accumulation leading to ulceration and pus formation, this becomes Ru Yong (Breast Abscess). At this stage, qi and blood are severely damaged, so heavy tonification is especially appropriate, with a slight addition of herbs to soothe the liver and detoxify. If one focuses solely on clearing heat and detoxifying, ulcers will struggle to granulate, and abscesses will struggle to heal.

Postpartum prolapse of the yin (vaginal prolapse) is mostly caused by excessive exertion during childbirth, leading to the descent of the yin and vaginal prolapse (Yin Ting), accompanied by pressing pain and swelling. Lifting heavy objects or sexual fatigue can also trigger this condition, often with continuous clear discharge and dribbling urination. Internal administration of lifting and tonifying formulas is indicated, while externally, sulfur, cuttlefish bone (Hai Piao Xiao), and Schisandra berry (Wu Wei Zi) ground into powder should be applied.

Failure of the vulva to close after delivery is due to inherent weakness of primordial qi and lack of proper care during pregnancy, resulting in the inability of qi and blood to consolidate. Shiquan Dabu Tang (Decoction for Complete Great Tonification) is used. In some primiparas, swelling of the labia or painful non-closure indicates deficiency heat in the Liver channel, treated with Jia Wei Xiao Yao San (Modified Free Wanderer Powder). If swelling persists without closure, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with added Wu Wei Zi is used. Even if swelling and heat are severe, cold and bitter herbs must be strictly avoided. Postpartum syndromes are fundamentally characterized by severe deficiency of qi and blood. How much more so for vaginal prolapse and failure of the vulva to close, which are caused by qi deficiency and blood collapse! Medical records from Danxi and Lizhai show that although symptoms vary, treatment invariably involves Ginseng, Angelica sinensis, and Rehmannia root, combined with lifting and astringent herbs. There was even a case of a pregnant woman with abdominal distension who delivered a stillborn fetus after two days; a piece of tissue resembling a pig's liver detached. She presented with sallow complexion, tidal fever, spontaneous sweating, anorexia, and fatigue. She was cured after taking Shiquan Dabu Tang for thirty doses.

The origins of postpartum syndromes are threefold: blood deficiency with fire agitation, reckless movement of foul blood, and dietary injury. How is this explained? Qi belongs to Yang, and Blood belongs to Yin. The *Neijing* states: "Yang deficiency generates external cold; Yin deficiency generates internal heat." Since postpartum hemorrhage leads to excessive blood loss, blood deficiency causes fire agitation, resulting in irritability and fever—this is the first cause. Blood is like water; flowing downward is its nature. However, splashing it can make it rise above the forehead, and agitating it can make it flow uphill. This is not the nature of water but the force acting upon it. Similarly, postpartum deficiency fire rises, and foul blood moves recklessly, causing dizziness and abdominal pain—this is the second cause. The *Neijing* says: "Mild fire generates qi; intense fire consumes qi." Li Dongyuan stated: "Fire is the thief of primordial qi; they cannot coexist, and when one prevails, the other declines." Postpartum, primordial qi is severely damaged, and the Spleen and Stomach are weak. Without the mother element (Kidney Water) to nourish the Earth element, digestion of grains is difficult. Dietary excess leads to epigastric fullness, vomiting, and diarrhea—this is the third cause. The treatment principles are: tonify if blood deficiency causes severe agitation; dissipate if foul blood moves recklessly; assist the Spleen and Stomach to digest if dietary injury occurs. Zhu Danxi said: "At the time of extreme postpartum qi and blood depletion, all treatments for various syndromes should focus on major tonification of qi and blood. Even if there are mixed syndromes, do not treat them immediately."

**Postpartum Regulation Decoction**
Treats qi and blood deficiency, lower back pain, alternating deficiency heat, dry throat, and sore throat, indicating impending Chulu Labor (Puerperal Fever/Labor).
Shu Di Huang (Rehmanniae Radix Praeparata, 5 qian, stir-fried dry), Mai Dong (Ophiopogonis Tuber, stir-fried dry), Bai Zhu (Atractylodis Macrocephalae Rhizoma, processed with milk and stir-fried, 2 qian each), Bai Shao (Paeoniae Radix Alba, 1.2 qian, wine-fried), Fu Ling (Poria, 1.5 qian), Du Zhong (Eucommiae Cortex, 2 qian, wine-mixed and stir-fried until yellow), Xu Duan (Dipsaci Radix, 1.5 qian), Ming Niu Xi (Cyathulae Root, 2 qian), Hei Jiang (Black Ginger/Zingiberis Rhizoma Carbonisatum, 0.6 qian). If lochia does not discharge, decoct in water and take warm.

**Shenghua Tang (Life Generation Decoction)**
Generates new blood and removes stasis postpartum; miraculous efficacy.
Dang Gui (Angelicae Sinensis Radix, 3 qian), Chuan Xiong (Ligustici Chuanxiong Rhizoma, 1 qian), Tao Ren (Persicae Semen, 13 grains), Hei Jiang (Black Ginger, 1 qian), Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Preparata, 0.8 fen). Decoct in water and take.

**Duoming Dan (Life-Seizing Pill)**
Treats postpartum blood entering the uterus (retained placenta/stasis), causing distension rushing to the heart, persisting for a long time.
Fu Zi (Aconiti Lateralis Radix Praeparata, processed, skin and umbilicus removed), Mu Dan Pi (Moutan Cortex, 1 liang each). Grind into powder. Use 1 sheng of sour vinegar, add 1 liang of Da Huang (Rhei Radix et Rhizoma) powder, boil into a paste, mix with the powder to form pills the size of Sophora seeds. Take 50 pills with warm wine.

**Another Formula**
Treats postpartum rectal prolapse. Use Zhi Ke (Aurantii Fructus, 2 liang), decoct in water for warm immersion. After a while, it reduces.

**Another Formula**
Treats uterine prolapse.
Jing Jie (Schizonepetae Herba, medium grade), Huo Xiang Ye (Agastaches Folium, medium grade), Chou Chun Pi (Toosendan Cortex, superior grade). Decoct for fumigation and washing; the uterus will reduce.

**Another Formula**
Treats retained placenta and fetal death in the womb. Use Xia Yan (Natrii Sulfas, 2 qian), mix with hot child's urine and drink. It will expel immediately.

**Siwei Tang (Four-Ingredient Decoction)**
Treats all diseases immediately after delivery.
Dang Gui, Yan Hu Suo (Corydalis Rhizoma), Xue Jie (Dragon's Blood), Mo Yao (Myrrha). (Each 0.5 fen). Another formula adds Hong Hua (Carthami Flos). Grind into powder, mix with half a zhong of hot child's urine and take.

**Danggui Xuejie Wan (Angelica and Dragon's Blood Pill)**
Treats postpartum foul matter retention, forming masses, chest oppression, and hard pain in the hypochondrium.
Dang Gui (stir-fried), Xue Jie, Peng Ze (Curcumae Rhizoma), Shao Yao (each 1 qian). Another formula includes Ling Zhi Zhi (Trogopterori Faex). Grind into powder, make pills with vinegar paste, size of Sophora seeds. Take 50-60 pills per dose with warm wine before meals on an empty stomach.

**Ruilian San (Ruilian Powder)**
Treats postpartum foul blood flooding and leakage, resembling a spring.
Rui Lian (100 pieces, burned to ash retaining nature), Zong Lu Tan (Palmae Fructus Carbonisatus), Dang Gui (each 1 liang), Guan Gui (Cinnamomi Ramulus, 5 qian), Bing Lang (Arecae Semen, 1 piece), Li Yu Lin (Cyprini Squama, stir-fried), Chuan Xiong (each 0.75 qian). Grind into powder. Take 3 qian per dose, mixed with ginger-warmed wine. If bleeding does not stop, take another dose. For flooding, this astringent medicine stops it after three consecutive doses.

**Qianjin San (Thousand-Gold Powder, i.e., Shiquan Dabu Tang ingredients)**
Treats postpartum deficiency labor with inability to eat.
Bai Zhu, Fu Ling, Huang Qi (each 1 liang), Ren Shen, Chuan Xiong, Shu Di Huang, Shao Yao, Dang Gui (each 1 liang), Rou Gui (1.5 liang), Gan Cao (stir-fried, 5 qian). Chop, take 1 liang per dose, decoct with ginger and jujube in water, take warm on an empty stomach.

**Ren Shen Tang (Ginseng Decoction)**
Treats postpartum general deficiency, fever, and night sweats.
Gui Shen (Angelicae Sinensis Radix radix part), Ren Shen (equal parts). Grind into powder. Use one pig kidney, remove membrane, slice. Boil with 3 sheng of water, half he of glutinous rice, and two stems of scallion white until cooked. Strain to get one zhong of clear juice. Add 2 qian of powder, decoct until 0.8 zhong remains, then take.

**Fu Ling San (Poria Powder)**
Treats postpartum Chulu Labor due to early postpartum exertion, causing cold pain in limbs, chills, fever, and malaria-like symptoms.
Fu Ling (1 liang), Dang Gui, Chuan Xiong, Gui Xin (Cinnamomi Ramulus), Bai Shao, Huang Qi, Ren Shen, Shu Di Huang (each 5 qian). Use 2 zhong of water, add one pair of pig kidneys (removed of fat membrane), finely ground. Add 3 slices of ginger and 2 jujubes. Decoct to 1 zhong. Remove kidneys, ginger, and jujube. Add 0.5 fen of Mo Yao. Boil to obtain 0.7 zhong. Strain and eat/drink, divided into two warm doses.

**Rensu Yin (Ginseng and Perilla Drink)**
Treats postpartum blood entering the lungs, causing red face, panting, and near-death state.
Ren Shen (1 liang, ground into powder), Su Mu (Sappan Lignum, 2 liang, crushed). Use 2 bowls of water, decoct Su Mu to 1 bowl. Strain, mix in Ren Shen powder. Adjust dosage as needed.

**Maren Wan (Hemp Seed Pill)**
Treats postpartum blood loss and fluid exhaustion causing constipation.
Ma Zi Ren (Cannabis Fructus, separately ground), Zhi Ke (Aurantii Fructus, bran-stir-fried), Ren Shen (medium grade). Grind into powder, make pills with honey, size of Sophora seeds. Take 50 pills with warm wine.

**Another Formula**
Treats postpartum excessive exertion causing vulvar protrusion. Use Siwu Tang (Four-Substance Decoction) decocted. Add a small amount of Long Gu (Fossilia Ossis Mastodi) powder. Take two doses consecutively on an empty stomach. Fumigate and wash with sesame oil soup to reduce.

**Zhuti Tang (Pig Trotter Decoction)**
Treats lactating women with declining strength, sluggish pulse, and blocked milk secretion.
Zhuti (one pig trotter), Tong Cao (Tetrapanacis Medulla, 5 liang). Clean the trotter, boil in 1 dou of water to make a soup/congee, and eat.
A lactating woman with low milk supply accidentally ate boiled red beans and soup at home. That night, her milk flowed like a spring. Subsequent uses were effective.

**Yongquan San (Surging Spring Powder)**
For scant milk due to qi deficiency.
Qu Mai Sui (Dianthi Herba spike), Mai Men Dong (Ophiopogonis Tuber), Wang Bu Liu Xing (Vaccariae Semen), Chuan Shan Jia (Manis Squama, fried yellow), Zi Long Gu (Fossilia Ossis Mastodi, equal parts). Grind into powder. Take 1 qian per dose with hot wine. Eat pig trotter soup first, then take the medicine. Comb the breast over thirty times with a wooden comb. Take three times a day. Proverb: "Chuan Shan Jia and Wang Bu Liu Xing; women who eat them have constant milk flow."

**Fanhun Dan (Soul-Returning Pill)**
Treats various birth syndromes; dead fetus, foul lochia, retained placenta, malpresentation. Clears heat and nourishes blood prenatally; promotes elimination of old and generation of new postnatally. Effective for both.
Ye Da Ma (One name: Yi Mu Cao/Leonuri Herba, harvest flowers and leaves in April-May when purple flowers bloom, shade-dry, 0.5 jin), Chi Shao Yao (Red Peony Root, 6 qian), Dang Gui (7 qian), Mu Xiang (Aucklandiae Radix, 5 qian). Grind into powder, make pills the size of a bullet with honey. Dissolve one pill in child's urine with wine, or mint tea, or rice water, or Guizhi Tang, or jujube soup, or Qin Jiao Tang, according to the patient's preference.

**Danggui Yangrou Tang (Angelica and Mutton Decoction)**
Treats postpartum fever, spontaneous sweating, and limb pain, named Chulu Labor.
Huang Qi (1 liang), Ren Shen, Dang Gui (7 qian), Sheng Jiang (5 qian), Fei Yang Rou (Fat Mutton, 1 jin). Boil to extract juice, remove meat, add previous herbs and decoct.
If lochia does not cease, add Gui (Cinnamon), which is acrid and hot, naturally promoting blood circulation.

**Chentong San (Pain-Chasing Powder)**
Treats postpartum blood stasis, tendon spasm, stiff back and waist, and generalized body pain.
Huang Qi, Dang Gui (wine-soaked), Guan Gui (Cinnamomi Ramulus, avoid direct fire), Bai Zhu, Du Huo (Angelicae Pubescentis Radix), Sheng Jiang (5 qian), Chuan Niu Xi (Cyathi Radix, wine-soaked, 5 qian), Zhi Gan Cao (roasted, 3 qian), Xie Bai (Allii Macrostemonis Bulbus, 3.5 qian). Chop, take 4 qian per dose, decoct in water. Adding Sang Ji Sheng (Taxilli Caulis, 0.5 liang) is especially good. For Chuan Niu Xi, choose thick, plump, moist, bright yellow ones. In the North, black ones are mistaken for Chuan Niu Xi, while yellow ones are Huai Niu Xi. *Bencao Gangmu* notes: Black ones are female Niu Xi, hard and brittle with little efficacy, so Southerners generally do not use them in medicine.