《大全》曰∶产后血晕者,由败血流入肝经,眼生黑花,头目眩晕,不能起坐,昏闷不省人事,谓之血晕。
此血热乘虚,逆上凑心,故昏迷不省,气闭欲绝也,服童便最好。
陈良甫曰∶产后瘀血奔心,因分娩后,不饮童便,以致虚火炎上也。用鹿角烧灰,童便调下即醒,此物行血
极效。又用五灵脂,半生半熟,名独行散。又用返魂丹,即益母丸也。
《家居医录》曰∶产后元气亏损,恶露乘虚上攻,眼花头晕,或心下满闷,神昏口噤,或痰壅盛急,用失笑
散主之。若血下多而晕,或神昏烦乱,大剂芎归汤补之,加童便。
慎斋按∶以上三条,序产后血晕之属有余也。败血入肝,恶露上攻,此瘀血为患,当用行血逐瘀之药。
李东垣曰∶妇人分娩,昏冒瞑目,因阴血暴亡,心神无所养。心与包络,君火相火也。得血则安,亡血则危。
火上炽,故令人
昏冒。火乘肺,故瞑目,不省人事。是阴血暴亡,不能镇抚也。经云,病气不足,宜补不宜泻。瞑目合眼,病
悉属阴。暴去有形之血,则火上炽,但补其血,则神自安,心得血则能养,而神不昏迷矣。
郭稽中曰∶产后血晕者何?曰∶产后气血暴虚,未得安静,血随气上,迷乱心神,故眼前生花,或闷绝不省,
口噤神脱,但服清魂散即醒。
朱丹溪曰∶妇人产后血晕,乃虚火载血,渐渐上晕也。又崔氏云∶凡晕皆是虚热,血气奔送,腹中空虚所致。
慎斋按∶以上三条,序产后血晕之属于不足也。阴血暴亡,虚火上升,皆由腹中空虚所致,当用补血滋阴降
火之药。但滋阴不可用地、芍,降火不可用苦寒。
Quan Shu (General Collection) states: Postpartum blood dizziness is caused by failed blood entering the Liver meridian, resulting in black spots appearing before the eyes, dizziness of the head and eyes, inability to rise or sit, unconsciousness with a sense of suffocation, which is called blood dizziness.
This occurs when blood heat takes advantage of deficiency, counterflows upward to the Heart, causing coma and unconsciousness, and qi closure nearing extinction; drinking child's urine is most effective.
Chen Liangfu states: Postpartum stasis blood rushing to the Heart is due to not drinking child's urine after delivery, leading to the flare-up of deficient fire. Burning deer horn into ash and administering it mixed with child's urine can restore consciousness immediately; this herb is extremely effective in promoting blood circulation. Another prescription uses Trogopterus Dung (Wulingzhi), half raw and half processed, named Duxing San (Single-Traveling Powder). Another is Fanhun Dan (Soul-Returning Pill), which is also Yimu Wan (Motherwort Pill).
Jiaju Yilu (Medical Records for Home Living) states: Due to the depletion of primordial qi after childbirth, lochia attacks upward taking advantage of the deficiency, causing blurred vision and dizziness, or fullness and oppression below the heart, coma with clenched jaws, or excessive and urgent phlegm obstruction; Shixiao San (Pain-Stopping Powder) is the primary treatment. If dizziness results from excessive bleeding, or if there is coma with restlessness and confusion, a large dose of Xionggui Tang (Ligusticum and Angelica Decoction) should be used to tonify, added with child's urine.
Shenzhai notes: The above three passages describe postpartum blood dizziness belonging to excess patterns. Failed blood entering the Liver and lochia attacking upward are pathologies of stasis blood; one should use herbs that promote blood circulation and dispel stasis.
Li Dongyuan states: Women experiencing fainting and closed eyes during childbirth do so because sudden loss of yin blood leaves the Heart spirit without nourishment. The Heart and Pericardium correspond to Ministerial Fire and Sovereign Fire. They are calm when receiving blood and endangered when losing blood. When fire blazes intensely, it causes fainting. When fire invades the Lung, it causes closed eyes and unconsciousness. This is because the sudden loss of yin blood fails to suppress and soothe the fire. The Classics state: when disease qi is deficient, tonification is suitable, not purgation. Closed eyes indicate conditions belonging to Yin. Sudden loss of substantial blood causes fire to blaze intensely; only by tonifying blood will the spirit become calm. When the Heart receives blood, it is nourished, and the spirit does not become confused.
Guo Jizhong asks: What is postpartum blood dizziness? He answers: After childbirth, qi and blood are suddenly deficient. Without rest, blood follows qi upward, confusing the Heart spirit, causing black spots before the eyes, or suffocation and unconsciousness, clenched jaws, and dissipation of spirit; simply administering Qinghun San (Clear-Soul Powder) will restore consciousness.
Zhu Danxi states: Postpartum blood dizziness in women is caused by deficient fire carrying blood upward, gradually leading to dizziness. Additionally, Cui Shi states: All dizziness is caused by deficient heat, where qi and blood rush and transport, resulting from an empty abdomen.
Shenzhai notes: The above three passages describe postpartum blood dizziness belonging to deficiency patterns. Sudden loss of yin blood and the upward flare-up of deficient fire are both caused by abdominal emptiness; one should use herbs that tonify blood, nourish yin, and descend fire. However, for nourishing yin, Rehmanniae Radix (Dihuang) and Paeoniae Radix Alba (Baishao) should not be used; for descending fire, bitter-cold herbs should not be used.