Library

Shuhe stated: If the Cun Kou (inch position) pulse after childbirth is surging, rapid, and unharmonious, it indicates a fatal condition; if the pulse is deep and faint but still has root qi when pressed to the bone, it indicates survival. He further stated: A deep, small, and slippery pulse indicates survival, while a full, large, firm, wiry, and urgent pulse indicates death. Danxi stated: During pregnancy, the pulse should be surging and rapid; if the pulse remains surging and rapid after childbirth, it indicates death. He also stated: If the pulse was fine and small during pregnancy but becomes surging and large after childbirth, death is likely. The *Chanjing* (Classic of Childbirth) stated: For diseases during pregnancy, a solid and large pulse is preferred; for diseases after childbirth, a deficient and thin pulse is preferred. During pregnancy, one should harmonize Qi and calm the fetus; after childbirth, one should tonify deficiency and resolve stasis; this is the key point.

During labor, Qi and Blood are turbulent, the fetal sac ruptures, deviating from normal physiological states, and amniotic fluid must break first, commonly known as "Baopang" (fetal membrane fluid), which is the fluid nourishing the fetus. After the fluid breaks and the sac ruptures leading to delivery, Qi and Blood become doubly deficient postpartum. The pulse should be slow and slippery. A slow pulse indicates composure, not急促 (urgent) due to Qi depletion; a slippery pulse indicates smoothness, not withered or rough due to blood loss. Both are auspicious signs. However, a full, large, wiry, and firm pulse is unsuitable for postpartum Qi and Blood deficiency. A full pulse represents excess pathogenic factors, a large pulse indicates pathogenic progression, a wiry pulse indicates Yin constriction and blocked dissemination, and a firm pulse indicates rigidity, approaching a stomach-less pulse. All these are contrary/rebellious pulses.

After delivery, drink a cup of hot urine from a young boy. Do not lie down immediately; instead, sit with eyes closed for a moment, then get into bed in a supine sitting position, not side-lying. Keep knees upright, not legs extended and high-supported. Place thick bedding at the head of the bed and block all walls to prevent gaps, avoiding "Thief Wind" (pathogenic wind). Apply vinegar to the nose, or use vinegar-fumed charcoal, or burn lacquerware. Gently massage from the heart to the navel with hands so that lochia discharges completely, preventing blood slipping or rebellious flow. Continue this for three days. Regardless of abdominal pain, take warm mixture of boy's urine and wine five to seven times. Although wine promotes blood circulation, expels lochia, and promotes lactation, the Zang-Fu Qi is just weakened, so do not drink too much, nor immediately after birth, lest it draws blood to the four limbs causing "Blood Fainting." If Stomach Qi is weak or there is no internal heat, boy's urine is also contraindicated to avoid damaging Stomach Qi. Instead, frequently eat thin congee made with Baizhu (Atractylodis Macrocephalae Rhizoma), gradually adding small amounts of fatty meat and pig trotters. Be cautious with speech, guard against the Seven Emotions, avoid frequent hair combing and foot washing, limiting this regimen to 100 days. If Qi and Blood are weak, regardless of months passed, otherwise symptoms like pain in hands, feet, waist, and legs may occur, named "Rulao" (Postpartum Consumption), which is difficult to treat. Postpartum, do not ask about the gender of the baby, lest speech depletes Qi or love/hate exhausts Shen (Spirit). Great joy and anger are strictly forbidden; joy scatters Qi, potentially causing bleeding; anger causes Qi rebellion, potentially forming Jia masses (abdominal lumps). Do not sleep alone, lest causing empty fright; do not scrape the tongue, lest hurting Heart Qi; do not brush teeth, lest causing blood rebellion. Only handle affairs after Qi and Blood have stabilized. Violating taboos initially seems slight as an autumn hair, but illness becomes heavy as a mountain. Can one not be cautious?

Milk is formed from Qi and Blood. Postpartum, salt should be avoided as it stops bleeding and prevents milk production, and induces difficult-to-treat coughs. In summer, avoid cooling fans and cold foods, and never sleep facing the wind. On the third day after birth, tradition dictates "Washing Three"; it is said that without washing, the skin becomes rough and scaly later. Washing is acceptable in hot summer weather, but absolutely forbidden in winter to prevent wind entering the umbilicus, causing "Umbilical Tetanus" (Qifeng). Many who did not wash "Three" remained healthy with good skin; knowledgeable people consider skipping "Washing Three" acceptable. Since the fetus grows in the warm maternal abdomen, upon birth, it loses Yang-warming Qi. Even in summer, clothing must be dense to exclude external wind, hence the saying "Ya Wu Liu Yue" (implying infants need protection even in June). To cut the umbilical cord, use Qiai (Artemisia argyi) twisted into a roll, soaked in sesame oil, burned until charred before cutting. Bind the umbilicus with soft cloth wrapped in thick cotton to prevent wind exposure and urine wetting, which is the second crucial step in preventing Umbilical Tetanus. Newborn skin is tender and pores loose; use old cotton from adults to preserve meridian essence, and coarse cloth clothes to toughen the skin, benefiting life long.

On the second day after birth, check the upper palate for white blisters ("mouth pearls"). Gently pop them with a silver spoon, ensuring they do not fall into the throat, then apply Jingmo (Beijing ink). If left untreated, they harden, cause refusal to nurse, and lead to conditions like "Suo Kou" (lockjaw). Check gums for "Horse Teeth" (epithelial pearls); puncture and remove them, applying ink afterward. Store the placenta in a stable, slightly large porcelain bottle; small bottles may cause infant regurgitation. Keep placenta safe to prevent infant startle. Do not sun-dry bloody maternity clothes; do not expose wet infant clothes to night dew. Bird droppings on clothes can cause toxic sores and turn into "Gan Syndrome" (infant malnutrition/parasitism). Ancient texts define one month as "Xiao Ying Yue" and two months as "Da Ying Yue." Avoiding rage, overwork, and sexual desire during these two months ensures lifelong health and fertility. Humans rarely attain human form after many kalpas; once born, life depends on parental care. Due to having too many children and lack of food/clothing, some drown infants, severely harming Heavenly Harmony; this must be strictly prohibited.

Various postpartum syndromes should not be treated generally with tonics, lest stasis coagulate. Without moving blood, pathogens remain. Even for deficiency syndromes, Qi recovers only after blood moves, but methods must be moderate, not overly harsh. Critical postpartum conditions include "Three Rushes" (Bai Xue Chong Fei/Xin/Stomai -敗血 rushing to Lung/Heart/Stomach) and "Three Urgencies" (Ou Tu/Xie Xie/Duo Han - vomiting, diarrhea, excessive sweating). Medications have three prohibitions: Forbidden is Foshou San because Chuanxiong (Chuanxiong Rhizoma) is acrid and dispersing, causing sweating and leakage. Forbidden is Siwu Tang because Shengdi Huang (Rehmanniae Radix) is cold, causing diarrhea and coagulating blood; Baishao (Paeoniae Radix Alba) is sour and cold, destroying vital Qi. Forbidden is Xiao Chai Hu Tang because Huangqin (Scutellariae Radix) is cool, obstructing lochia discharge. There are three more prohibitions: do not induce sweating, do not purge, do not promote urination. Do not violate the Stomach or Upper/Lower Jiao. Even with miscellaneous symptoms, prioritize major tonification of Qi and Blood. Coitus is permitted only after 100 days; otherwise, it leads to death. Most chronic deficiencies and diseases stem from early coitus. Women suffering from Wind patterns and cold below the umbilicus usually have this due to early sexual activity.

Ancient formulas often modify Siwu Tang for postpartum diseases, but Danxi prohibited Shaoyao (Paeoniae Radix) due to its sour-cold nature destroying growing Qi. Why? Because postpartum women have dual deficiency of Qi and Blood, retaining the肃杀 (killing/drying) energy of Autumn/Winter without the sprouting mechanism of Spring/Summer. Thus, cold-cooling herbs are taboo; warm-hot herbs are highly suitable to aid the source of life. Ancestors formulated Siwu Tang using Xiong Gui (Chuanxiong Rhizoma and Angelicae Sinensis Radix) for warmth/acridity, assisted by Di Shao (Shengdi Huang and Baishao) for coldness, achieving a balance suitable for gynecological diseases. For postpartum use, Baishao must be repeatedly fried with wine to remove sour-cold properties, retaining only blood-nourishing/moving functions, possibly adding Heijiang (Charred Zingiberis Rhizoma). Shaoyao is clear, slightly sour, and astringent, suitable for dissipating Yin Qi, making it a key postpartum herb! Ancestors warned against it, let alone other cold/astringent herbs! One knows Shaoyao is sour-cold but ignores that Shengdi is colder and directly harms the Blood level. If unavoidable, replace with Shudi (Prepared Rehmanniae Radix). Using Siwu Tang indiscriminately for postpartum cases has misled many.

Removing defeated blood (lochia/stasis) is paramount postpartum. Stagnant blood causes various diseases. Since Yuan Qi is depleted and transport is disordered, stasis inevitably remains. Treaters must first expel stasis; only after stasis clears can tonification proceed. This is the primary principle. However, if deficiency is extreme and cannot wait, add warming-moving herbs to strong tonification. Strong tonification provides power for circulation; warming movement ensures flow without stagnation. Even for excess syndromes requiring stasis removal, harsh drugs are forbidden. Postpartum Yuan Qi is greatly deficient; fearing blood lacks control, relying solely on drug force may cause unstoppable hemorrhage. Deficiency easily leads to collapse, like spilt water. Therefore, Shenghua Tang is best: it moves while tonifying, tonifies while moving, is warm without stagnation, and does not hurt Stomach Qi. It is most appropriate.

When postpartum Yuan Qi is largely depleted and new blood not yet generated, symptoms like headache, fever, nausea, and fullness are false manifestations of deficiency. Generally, major tonification of Qi and Blood is used. If lochia is not finished, add blood-moving herbs to tonics. If complicated by Wind-Cold stagnation, combine tonification with dispersing and digesting agents. Do not indiscriminately use harsh drugs that damage Qi and Blood, injuring true Yuan Qi with suspected exterior pathogens. How mistaken would this be!

After new birth, even without disease, rest and labor management, spleen-stomach regulation, and delicious diet help organs recover and Qi-Blood harmonize, preventing diseases. But Zhong Qi (Middle Qi) is weak and digestion difficult; do not overeat, lest damaging Spleen-Stomach.

Siwu Tang contains Shengdi (cool/stagnant, damaging Spleen-Stomach) and Shaoyao (sour/cold, destroying vital Qi), often misleading in postpartum cases. Shenghua Tang removes these two, adding warming-moving-blood agents. For "Erzhen" (afterbirth mass) pain, people often use blood-breaking/stasis-resolving formulas before tonifying. Some mix breaking and tonifying, not realizing old blood should dissolve but new blood must grow. Attacking only old blood damages new blood. Huisheng Dan attacks blood masses and expels placenta, severely damaging Yuan Qi. Shenghua Tang is named for its function: resolving postpartum masses while generating new blood. Solely resolving prevents new blood generation; solely generating causes old blood stagnation. Xiong Gui Tao Ren (Chuanxiong Rhizoma, Angelicae Sinensis Radix, Persicam Semen) effectively remove old blood and rapidly generate new blood. Assisted by Heijiang and Zhi Gancao (Roasted Glycyrrhizae Radix et Rhizoma), they enter Lung/Liver, generate blood, benefit Qi, move while tonifying. Warmth ensures blood flows, lochia ends, leaving no aftereffects. It is truly the sage medicine for postpartum. Zhang Yuansu added Renshen (Ginseng Radix), Guizhi (Cinnamomi Ramulus), Niuxi (Achyranthis Bidentatae Radix), Honghua (Carthami Flos) to this formula, making it miraculous for inducing labor prenatally.

Placenta retention has two types: one due to lochia entering the sac causing distension preventing expulsion; the other due to Yuan Qi deficiency failing to push it out. If lochia enters the sac, the abdomen is painful and distended. Use Mingdan (Dingming Dan) or Shixiao San (Shixiao Powder) to resolve stasis; delay is fatal. If Yuan Qi weakness fails to send it down, the abdomen is not painful/distended. Use Baosheng Wuyou San (Baosheng Wuyou Powder) to secure Yuan Qi. However, using Wanquan Tang (Wanquan Decoction) without Renshen is considered most appropriate.

Among women's diseases, none is heavier than childbirth. In obstetrics, nothing is harder than inducing labor; after birth, nothing is heavier than placenta retention. Ancient formulas favor Huarui Shi San (Flower Manganese Stone Powder), but stone medicines are unsuitable for severe intestinal/stomach deficiency. Better to select Shenghua Tang and Wanquan Tang. Another option: Chuan Foshou San plus Honghua, Yimucao (Leonuri Herba), Xiangfu (Cyperi Rhizoma), Shanzha (Crataegi Fructus), Chenpi (Citri Reticulatae Pericarpium), Niuxii, lightly decocted, taken with concentrated urine. Another method: If placenta remains after birth, prolonged retention fatigues the mother and risks blood flowing into the sac, causing critical danger. Quickly cut the umbilical cord, tie it, and hang something heavy to prevent blood flooding the sac, allowing the placenta to shrink and descend naturally. The mother must remain calm. Tie first, then cut. Otherwise, the placenta may rise and crush the heart, causing death. Be cautious.