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Chen Liangfu stated: Postpartum blood dizziness (Chanhou Xueyun) has three causes: one is due to excessive exertion, another is due to excessive bleeding, and the third is due to insufficient bleeding. Although the manifestation of dizziness is the same, the treatment methods differ.

In cases where dizziness is caused by excessive bleeding, characterized merely by confusion and restlessness, one should use herbs that tonify blood and clear the heart. In cases where dizziness is caused by insufficient bleeding, often accompanied by the failure of lochia (Eluo) to discharge, with blood stasis rushing upward to the heart, causing fullness and urgency in the epigastrium, unconsciousness, and loss of consciousness, one should use herbs that break up blood stasis and promote blood circulation.

Commentary: Dizziness caused by excessive bleeding is termed "Blood Collapse" (Xuetuo). Large doses of Ginseng Radix et Rhizoma Rubra (Renshen) should be used to restore yang and rescue from collapse; how can it be said that tonifying blood and clearing the heart is appropriate? If dizziness is caused by insufficient bleeding, it is either blood stagnation or blood exhaustion; it is inappropriate to recklessly administer herbs that break up blood stasis. Chen Liangfu’s differentiation of syndromes was very clear, but his treatment methods were not entirely perfect.

Cui Shi stated: After childbirth, place a weight or a yellow stone into charcoal fire until it becomes red hot, put it in a vessel, and pour vinegar over it near the bed to alleviate postpartum blood dizziness; doing this frequently is better. Alternatively, apply thick vinegar to the mouth and nose, keep vinegar nearby, quench the hot charcoal, and allow the patient to inhale the fumes. Another method is to burn dried lacquer (Ganqi), letting the smoke熏 (xun) the parturient’s face to induce awakening. If dried lacquer is unavailable, burning old lacquerware vessels is also effective.

Shenzhai commented: The above two passages describe the treatment of postpartum blood dizziness based on the amount of bleeding. Postpartum blood dizziness generally results from sudden loss of yin blood and rising deficient fire. The Heart governs blood, and the Liver stores blood. When the Liver is deficient, the Hun (ethereal soul) has no attachment, leading to dizziness; when the Heart is deficient, the Shen (spirit) does not reside securely, allowing fire pathogens to invade. Li Dongyuan and Zhu Danxi had already grasped the essence of pathogenesis. Chen Liangfu further differentiated treatment based on the volume of bleeding. He stated that if lochia fails to discharge and rushes upward to cause dizziness, this condition commonly occurs in robust women shortly after delivery, and formulas that move and break blood stasis should be used. However, for individuals with Qi and Blood deficiency and excessive blood loss, the primary treatment should be massive tonification of Qi and Blood, such as using large doses of Xiong Gui Tang (Angelica and Ligusticum Decoction) or Sheng Hua Tang (Generation of Life Decoction) with added Ginseng Radix et Rhizoma Rubra (Renshen).

The Daquan stated: Failure of lochia to discharge is caused by damage to the Zang-Fu organs from postpartum labor, depletion of Qi and Blood, or cold pathogens lingering in the uterine collaterals. If the woman exposes herself to wind and cold after delivery, wind-cold may invade the deficiency and bind with blood, causing obstruction and stagnation within, thus preventing lochia discharge.

Lizhai commented: For the aforementioned syndrome of lochia retention, use Shixiao San (Pain-Relieving Powder); if there is Qi stagnation and blood coagulation, use Huarui Shi San (Flower-Marrow Stone Powder).

Shenzhai commented: The above passage describes the syndrome of postpartum lochia retention. Peng Yongguang said: When treating postpartum diseases, one must inquire about the presence and quantity of lochia. This is a crucial point. Fresh lochia consists of residual blood from pregnancy mixed with turbid fluids. If the newborn’s Qi and Blood are vigorous, lochia discharges naturally. If Qi and Blood are weak, obstruction in the lower abdomen leads to disease. Upward attack causes blood dizziness and fainting; accumulation of blood stasis causes “child pillow pain” (Erzhen Tong), abdominal pain, masses (Jia Ji), limb swelling, and bloody drum distension. The Daquan attributes this to wind-cold invading deficiency and binding with blood, which is common in autumn and winter. However, since the Daquan states that wind-cold binds with blood, why do formulas for lochia retention after three or four days exclusively include Paeoniae Radix Alba (Baishao) and Anemarrhenae Rhizoma (Zhimu)? Why does the Guangji Fang use Rhei Radix et Rhizoma (Dahuang), Paeoniae Radix Alba (Baishao), and juice of Rehmanniae Radix Recens (Shengdi)? Using cold-natured herbs to treat blood congealed by cold—does this make sense? The Zhunsuo cites this method first, which is inexplicable.