产后勿轻用乌药、香附、木香,及耗气、顺气等药,用之反增满闷,虽陈皮用不可过五分。
产后勿轻用青皮、浓朴、山楂、枳壳、陈皮消食药,多损胃减食,即枳壳、香砂等丸,亦多损气血。
产后勿用青皮、枳实、苏子以下气定喘,用之元气必脱。
产后浮麦伤胃耗气,五味能阻恶露,枣仁油滑致泻,均为禁忌。
产后身热,误用黄芩、黄连、黄柏、栀子。损胃增热,致不进饮食,且黄芩苦寒,无论恶露
净与不净,皆非所宜。
产后四日内,未服生化汤以消血块,勿先用人参、 、术,致块不除。
产后勿轻用牛膝、红花、苏木、枳壳等类以消块,犹忌多用、独用。至于三棱、莪术、枳实、
山楂等峻药,更不可用,若误用,旧血骤下,新血亦随之而损、祸不可测也。
产后勿轻用生地黄以滞血路。
产后不可用大黄、芒硝以通大便,反成臌胀。
产后不可用五苓以通小便,用之愈闭。
产后危症,莫如败血三冲。其人或歌舞谈笑,或怒骂坐卧,甚者逾墙上屋,口咬拳打,山腔野
调,号佛名神,此为败血冲心,多死。《医通》云∶花蕊石散最捷,琥珀黑丸丹亦效。如虽闷乱,
不致颠狂者,失笑散加郁金。予谓∶当于妄言妄见门参看治疗。
若其人饱闷呕恶、腹满胀痛者,为之冲胃,《医通》云∶用平胃散加姜、桂,往往获效;不
应,送来复丹。呕逆腹胀,血化为水者,《金匮》下瘀血汤。予谓∶当于饱胀呕逆等门参看治疗。
若其人面赤,呕逆欲死,为之冲肺。《医通》云∶二味
参苏饮,甚则加芒硝荡涤之。子谓∶当于口鼻黑衄门参看治疗。
大抵冲心者,十难救一;冲胃者,五死五生;冲肺者,十全一二。其《医通》所用金石及峻药等
治法,亦无可如何之思,与其视死,不若救生之意耳。予谓∶治此等症,宜用生化、失笑。抵圣等类
平稳药,当亦通神。
二味参苏饮 治恶露入胞,胀大不能出,及产后败血冲肺喘满,面赤几死者。
人参(二钱) 苏木(四钱碎)
水煎服。又有入童便热服,大便溏泄者禁用。
失笑散 治妇人心痛气刺不可忍,及产后儿枕蓄血,恶血上攻疼痛,并治小肠气痛,便治胞
衣由瘀血胀满不能出者。
五灵脂(生,酒研,澄去砂) 蒲黄(生,筛净)
为末,每服二、三钱,葱汤调末服之。一方用酒煎热服。按此方,如行血,各等分俱生用;如
止血,俱炒用。或五灵脂减半用。若用以止痛,蒲黄宜减半。又一方,蒲黄一半生,一半炒用。
抵圣汤(见气逆、呕吐不食门)
Postpartum women should not lightly use *Wuyao* (Linderae Radix), *Xiangfu* (Cyperus Rhizome), or *Muxiang* (Aucklandiae Radix), nor drugs that consume Qi or regulate Qi. Using them may instead increase chest and epigastric fullness and stuffiness. Even *Chenpi* (Citri Reticulatae Pericarpium) should not exceed a dosage of five fen.
Postpartum women should not lightly use digestive-resolving drugs such as *Qingpi* (Citri Reticulatae Viride Pericarpium), *Nongpo* (Magnoliae Officinalis Cortex), *Shanzha* (Crataegi Fructus), *Zhiqiao* (Aurantii Fructus), or *Chenpi*. These often damage the Stomach Qi and reduce appetite. Even pills containing *Zhiqiao* or *Xiangsha* often damage Qi and Blood.
Postpartum women should not use *Qingpi*, *Zhishi* (Immature Bitter Orange), or *Suzi* (Perilla Fructus) to descend Qi and calm asthma, as doing so will inevitably cause the collapse of Yuan Qi (Original Qi).
*Fumai* (Floating Wheat) damages the Stomach and consumes Qi postpartum; *Wuweizi* (Schisandrae Fructus) can obstruct the discharge of Lochia; *Zaoren* (Semen Ziziphi Spinosae) is oily and slippery, causing diarrhea. All are contraindicated.
If body heat occurs postpartum and one mistakenly uses *Huangqin* (Scutellariae Radix), *Huanglian* (Coptidis Rhizoma), *Huangbai* (Phellodendri Cortex), or *Zhizi* (Gardeniae Fructus), it will damage the Stomach and increase heat, leading to an inability to eat. Moreover, since *Huangqin* is bitter and cold, it is unsuitable regardless of whether Lochia has been cleared or not.
Within four days postpartum, if *Shenghua Tang* (Decoction for Generating New Blood) has not been taken to resolve blood clots, do not first use *Renshen* (Ginseng Radix et Rhizoma) or *Baizhu* (Atractylodis Macrocephalae Rhizoma), lest the clots fail to be eliminated.
Postpartum women should not lightly use drugs like *Niuxi* (Achyranthis Bidentatae Radix), *Honghua* (Carthami Flos), *Sumu* (Pterocarpus Santalinus Lignum), or *Zhiqiao* to eliminate clots. It is especially taboo to use them in large amounts or exclusively. Harsh drugs such as *Sanleng* (Sparganii Rhizoma), *Ezhu* (Curcumae Rhizoma), *Zhishi*, and *Shanzha* must not be used at all. If mistakenly used, old blood will suddenly flow down, and new blood will also be damaged, resulting in unpredictable disaster.
Postpartum women should not lightly use *Shengdihuang* (Rehmanniae Radix Preparata) because it stagnates the blood vessels.
Postpartum women must not use *Dahuang* (Rhei Radix et Rhizoma) or *Mangxiao* (Natrii Sulfas) to unblock the bowels, as this may instead result in abdominal distension (Gu Zhang).
Postpartum women must not use *Wuling San* (Five-Ingredient Powder with Poria) to promote urination, as using it will worsen urinary retention.
Among critical postpartum conditions, none is more severe than the "Three Rushes" caused by failed blood (Lochia stasis). The patient may sing, dance, talk, and laugh, or curse, sit, and lie down angrily. In severe cases, they may climb over walls or roofs, bite, punch, make wild noises, and call out Buddha names or deity names. This is "Failed Blood Rushing to the Heart," which is mostly fatal. *Yitong* (Essential Prescriptions for Gynaecology) states: *Huairushi San* (Stony Coral Stone Powder) is the most rapid remedy, and *Hupo Hei Wan Dan* (Amber Black Pill) is also effective. If the patient is merely restless and confused but not manic, *Shixiao San* (Laughing Dispersal Powder) added with *Yujin* (Curcumae Longae Rhizoma) should be used. I suggest referring to the treatment methods in the section on "Delusions and Hallucinations."
If the patient feels fullness, oppression, nausea, vomiting, abdominal distension, and pain, this is "Failed Blood Rushing to the Stomach." *Yitong* states: Use *Pingwei San* (Peaceful Stomach Powder) added with Shengjiang (Fresh Ginger Rhizome) and Rougui (Cinnamon Bark), which often yields results. If ineffective, switch to *Songfu Dan*. If there is vomiting, acid reflux, abdominal distension, and the blood transforms into water, *Jinkui Yaolue* advocates using *Xiayuxue Tang* (Decoction to Drain Down Blood Stasis). I suggest referring to the treatment methods in the sections on "Fullness, Distension, Nausea, and Vomiting."
If the patient's face is red, and they experience vomiting and retching to the point of near death, this is "Failed Blood Rushing to the Lung." *Yitong* states: Use *Erwei Renshen Su Mu Yin* (Two-Ingredient Ginseng and Pterocarpus Decoction); in severe cases, add *Mangxiao* to purge the pathogen. I suggest referring to the treatment methods in the section on "Black Nasal Bleeding from Mouth and Nose."
Generally speaking, for Failed Blood Rushing to the Heart, one in ten survives; for Rushing to the Stomach, five die and five survive; for Rushing to the Lung, only one or two in ten survive. The treatments in *Yitong* using mineral stones and harsh drugs are measures of last resort, reflecting an intent to save lives rather than accept death. I believe that treating such conditions with stable formulas like *Shenghua Tang*, *Shixiao San*, and *Dasheng Tang* should also yield miraculous results.
**Erwei Renshen Su Mu Yin** treats lochia entering the uterus, causing swelling and inability to expel, as well as postpartum failed blood rushing to the lung causing asthma, fullness, facial redness, and near-death states.
*Renshen* (2 qian) *Sumu* (4 qian, crushed)
Decoct in water and take orally. Another method involves adding child's urine and taking it hot; it is contraindicated for those with loose stools.
**Shixiao San** treats unbearable heart pain and stabbing qi pain in women, as well as postpartum "child pillow" blood stasis, pain caused by evil blood attacking upward, intestinal qi pain, and inability to expel the placenta due to blood stasis and fullness.
*Wulingzhi* (Raw, ground in wine, clarified to remove sand) *Puhuang* (Raw, sifted clean)
Grind into powder. Take 2-3 qian per dose, mixed with scallion decoction. Another method is to decoct in wine and take hot. Note: For moving blood, use all ingredients raw in equal parts; for stopping bleeding, use all fried. Alternatively, halve the dose of *Wulingzhi*. For relieving pain, halve the dose of *Puhuang*. Another formula uses half raw and half fried *Puhuang*.
**Dasheng Tang** (See section on "Qi Reversal, Vomiting, and Anorexia")