《金匮要略》曰∶产妇郁冒,其脉微弱,但头汗出。所以然者,血虚而厥,厥而必冒,
冒家欲解,必大汗出。以血虚下厥,孤阳上出,故头汗出。所以产妇喜汗出者,亡阴血虚,阳气独盛,故当汗
出,阴阳乃复。
徐忠可曰∶产妇郁冒,虚多邪少,故脉微弱,中气虚也。内虚,一身之阴阳不和,故身无汗,但头汗出。所
以头汗出者何?血虚下厥,则下之阴气尽,而阳为孤阳,阳孤则上出而头汗矣。然既头汗,仍喜其汗出而解
者何?盖阴不亡,则血未大虚,唯产妇血去过多而亡阴,则阳为孤阳,自阴较之,阳为独盛,所以喜其汗。损
阳就阴,则阴阳平,故曰乃复。
王海藏曰∶产妇头汗出,至颈而还,额上偏多。盖额为六阳之会,由虚热熏蒸而出也。
慎斋按∶以上四条,序产后有汗出之证也。经云∶夺血者无汗。汗与血类,产后去血过多,则阴不维阳,
阴虚而阳无所附,周身汗出不止,此为阴阳两虚,有亡阳之患,为危证。若身无汗,但头有汗,头为诸阳之会,
阴血暴亡,孤阳上越,阴虽虚,而阳气尚为有余,此时阴不胜阳,故头汗,额上偏多,心火上浮,逼阳于外,
急补其阴,而入以敛阳之药,则病自复。故产妇又喜其头汗出也。
《金匮要略》曰∶产后中风发热,面正赤,喘而头痛,竹叶汤主之。
徐忠可曰∶中风,发热头痛,表邪也。然面正赤,所谓面若朱妆,乃真阳上浮,加之以喘,气高不下也。
明是产后大虚,元阳不能自固,又杂以表邪,自宜攻补兼施。故以桂、甘、防、葛、桔梗、姜、枣,清在上之
邪,竹叶清胆腑之热,而以参、附培元气,返其欲脱之阳也。
The *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet) states: In postpartum women, Yu Mao (depression and dizziness caused by blood deficiency leading to Yang rebellion) occurs with a faint pulse, and sweating is confined only to the head. The reason for this is that blood deficiency leads to Jue (rebellion/cold extremities), and Jue inevitably leads to Mao (dizziness/confusion). For a patient suffering from Mao to recover, profuse sweating throughout the body must occur. Because blood deficiency causes rebellion in the lower part, the solitary Yang floats upward, hence sweating on the head. Therefore, postpartum women favor sweating because the loss of Yin blood leads to blood deficiency and excessive Yang; thus, sweating should occur to restore the balance of Yin and Yang.
Xu Zhongke stated: Postpartum Yu Mao involves much deficiency and little pathogenic factor, hence the pulse is faint due to deficiency of Middle Qi. Internal deficiency leads to disharmony of Yin and Yang in the whole body, so there is no sweating on the body, only on the head. Why is there sweating only on the head? Blood deficiency causes rebellion in the lower part, exhausting the Yin Qi below, leaving Yang as "solitary Yang." When Yang is solitary, it floats upward, causing sweating on the head. Since there is already head sweating, why is recovery favored through sweating? If Yin had not been lost, blood would not be severely deficient. Only when a postpartum woman loses too much blood and suffers from loss of Yin does Yang become solitary. Compared to Yin, Yang is excessively strong, hence the preference for sweating. By reducing excess Yang to align with Yin, Yin and Yang achieve equilibrium, hence it is said that they are restored.
Wang Haizang stated: Postpartum head sweating stops at the neck, with more sweat on the forehead. This is because the forehead is the meeting point of the six Yang meridians, and the sweating results from steaming by deficiency-heat.
Shen Zhai commented: The above four passages describe conditions of sweating after childbirth. The Classics state: "Those who lose blood do not sweat." Sweat and blood are of the same category. After childbirth, excessive blood loss means Yin cannot anchor Yang; Yin deficiency leaves Yang without attachment, resulting in continuous sweating over the whole body. This indicates deficiency of both Yin and Yang, carrying the risk of collapse of Yang, which is a critical condition. If there is no sweating on the body but only on the head, since the head is the meeting point of all Yang meridians, sudden loss of Yin blood causes solitary Yang to float upward. Although Yin is deficient, Yang remains relatively abundant. At this time, Yin cannot overcome Yang, hence sweating on the head, particularly on the forehead. Floating Heart Fire forces Yang outward. Urgent tonification of Yin, combined with herbs that astringe Yang, will naturally restore health. Thus, postpartum women also favor head sweating.
The *Jin Gui Yao Lue* states: Postpartum Wind Stroke with fever, bright red face, wheezing, and headache is primarily treated with Zhu Ye Tang (Bamboo Leaf Decoction).
Xu Zhongke stated: Wind Stroke with fever and headache indicates exterior pathogenic factors. However, a bright red face, described as "face like vermilion makeup," indicates floating True Yang. Accompanied by wheezing, where Qi rises high and does not descend, it clearly indicates severe deficiency after childbirth. Yuan Qi (Original Qi) and Yang cannot consolidate themselves, compounded by exterior pathogens. Therefore, simultaneous attack and tonification are appropriate. Thus, Gui Zhi (Cinnamon Twig), Gan Cao (Licorice Root), Fang Feng (Siler Root), Ge Gen (Kudzu Root), Jie Geng (Platycodon Root), Sheng Jiang (Fresh Ginger), and Da Zao (Jujube) are used to clear pathogens in the upper part; Zhu Ye (Bamboo Leaf) clears heat in the Gallbladder Fu-organ; while Ren Shen (Ginseng Root) and Fu Zi (Aconite Root) tonify Yuan Qi and rescue Yang that is about to collapse.