Library

(Ji Zhulinsi Chuan Mi Ben)

After childbirth, Qi and Blood suddenly become deficient; theoretically, major tonification is indicated. However, since lochia (postpartum discharge) has not yet cleared, the use of tonics requires caution: one must avoid stagnating blood, be capable of resolving stasis while generating new blood, break down masses without damaging Yuan Qi, and achieve tonification within the process of promoting circulation. Only then can it be considered flawless. The world commonly uses Siwu Tang (Four Substances Decoction), composed of Chuanxiong, Danggui, Baishao, and Dihuang, to manage postpartum conditions, which has misled many. This is because Dihuang is cold in nature, and Baishao is sour and astringent, leading to blood stagnation. When postpartum lochia forms clumps accompanied by pain, it is called "Erzhen" (Baby Pillow).

The world often specializes in methods to dissipate stasis first, and only then discusses tonification. Others apply dissipation and tonification simultaneously but ultimately achieve no effect. They do not realize that although old blood should be resolved, new blood must also be nourished. If one exclusively attacks old blood, new blood will not remain tranquil. People use Jikun Dan, also known as Huisheng Dan, to treat blood masses and expel the placenta. Although it shows rapid effects, it inevitably damages Yuan Qi. Even if peace is fortunately achieved, it is ultimately not a good formula. If used out of necessity to expel the placenta, only one pill should be taken, and it should not be overdosed. Shenghua Tang is named based on the properties and functions of its herbs. Postpartum blood masses should be eliminated, and new blood should be generated. Exclusive elimination makes new blood unstable; exclusive generation causes old blood to stagnate. Examining the herb properties, Chuanxiong, Danggui, and Taoren are excellent at breaking down evil blood and rapidly generating new blood. These three are assisted by Zhihei Ganjiang (Charred Dried Ginger) and Gancao (Licorice Root) to guide the three herbs into the Lung and Liver meridians, generating blood and regulating Qi. With these five ingredients forming the prescription, there is tonification within circulation, and generation within resolution. It is truly an essential medicine for postpartum care, hence the name Shenghua Tang.

All diseases arise from the decline of Qi and Blood and the deficiency of the Spleen and Stomach, with postpartum Qi and Blood deficiency being particularly severe. Therefore, Mr. Danxi argued in his discussions on childbirth that major tonification of Qi and Blood must come first. Even if other symptoms are present, they should be treated secondarily. These three statements summarize the main principles of treating obstetric conditions. If one can expand upon medication and prescription formulation, treating obstetric cases can be done without major errors. After childbirth, due to worry, fright, fatigue, and overwork, Qi and Blood become acutely deficient, making various syndromes prone to entering through this deficiency. If there is Qi stagnation, do not specialize in dispersing it; if there is food retention, do not specialize in digesting it. For heat patterns, do not use Huangqin (Scutellaria Root) and Lianzi (Lotus Plumule); for cold patterns, do not use Guizhi (Cinnamon Twig) and Fuzi (Aconite Root). Using cold herbs causes blood masses to stagnate; using hot herbs causes new blood to hemorrhage. Regarding exterior contraction in a deficient person, if many Yangming or Taiyang exterior symptoms are seen, sweating might seem appropriate. However, using Mahuang (Ephedra Herb) in postpartum patients would doubly exhaust Yang. If many Yin interior symptoms are seen, purgation might seem suitable. However, using Chengqi Tang (Gut-Clearing Decoction) in postpartum patients would doubly deplete Yin Blood. Deafness and hypochondriac pain are caused by the stagnation of evil blood in the Kidney and Liver; do not use Chaihu (Bupleurum Root). Delirium and sweating are symptoms of Yuan deficiency resembling pathogenic invasion; do not treat them as excess Heat in the Stomach. Jue (Cold Extremities/Reversal) is due to the decline of Yang Qi; regardless of cold or weakness, only major tonification can restore Yang and revive weakness. Bi syndrome is due to the deficiency of Yin Blood; regardless of rigidity or flaccidity, only nourishing Ying and Blood can relax tendons and activate collaterals. Additionally, alternating chills and fever occurring at regular intervals resemble Malaria. If treated as Malaria, the condition will linger and be difficult to cure. If the Spirit does not reside in its house, and speech is incoherent, the disease resembles possession. If treated as possession, death may follow quickly. Excessive blood loss leading to dry, constipated stool: adding Rongren (Cistanche Stem) to Shenghua Tang is superior to the purgative action of Runchang Chengqi Tang. Sweating excessively with scanty, difficult urination: Liu Junzi Tang (Six Gentlemen Decoction) with doubled Ginseng is necessary to generate fluids and assist liquids to promote diuresis. Frequent administration of Shenghua Tang with Ginseng can save critical postpartum cases. Changsheng Huoluo Fang (Longevity Collateral-Activating Formula) has been used repeatedly to save those who have stopped eating. Genital prolapse and rectal prolapse are mostly due to Qi deficiency sinking; Buzhong Yiqi Tang (Middle-Warming and Qi-Supplementing Decoction) is applicable. Trismus and clenched fists are due to Blood dryness resembling wind spasms; Shenghua Tang with Ginseng is suitable. Severe pain in the vagina due to wind invasion: Qianghuo Yangrong Fang (Notopterygium Nourishing Ying Decoction) is indicated. Coldness and laxity of the vulva: washing with Tusizi (Cuscuta Seed), Shanzhuyu (Cornus Fruit), and Liuhuang (Sulfur) is appropriate. Palpitations and fright: add Dingzhi Wan (Stabilizing Spirit Pill) to Shenghua Tang. Apparent spirit-like trance: Anshen Wan (Calming Spirit Pill) assists Guipi Tang (Restore the Spleen Decoction). Fullness, vexation, and irritability due to Qi stagnation: add Muxiang (Aucklandia Root) as an assistant to Shenghua Tang. Sour belching and aversion to food due to food retention: Liu Junzi Tang with Shenqu (Medicated Leaven) and Maiya (Germinated Barley) is excellent. Sumu (Sappan Wood) and Ezhu (Curcuma Rhizome) greatly break blood stasis. Qingpi (Green Tangerina Peel) and Zhishi (Immature Bitter Orange) best reduce distension. All agents that consume Blood and scatter Qi, as well as the use of sweating, vomiting, and purging methods, may be applied to young and strong individuals, but surely should not be used during pregnancy and childbirth. Generally, after recent delivery, one must first ask about the status of lochia. If there are painful masses, do not hastily add Baizhu (Atractylodes Macrocephala Rhizome). If abdominal pain stops, Buzhong Yiqi Tang is undoubtedly indicated. In cases of Yang collapse with sweating, and Qi deficiency with panting, frequent administration of Shenghua Tang with Ginseng is a temporary measure. In cases of Yin collapse with intense heat, and uterine bleeding with syncope, continuously decocting the original Shenghua Tang is an emergency rescue method. Wang Taipu said: "To treat the lower part, tonify the lower part; the prescription should follow urgency. If slow, the path is long and the force is weak; if urgent, the flavor is strong and the force is heavy." Therefore, treating obstetric conditions should follow Danxi's theories, and the method of taking tonic medicines should emulate Wang Taipu by frequent supplementation. Those skilled in miraculous life-saving arts must focus on rescuing the critically ill. To seek a clear conscience in all endeavors, one must sincerely intend to benefit beings. Although this does not detail every postpartum syndrome, prescribing based on symptoms draws upon local clinical experiences as evidence, offering perhaps some minor benefit.

Postpartum blood masses are accumulations of residual blood from conception. Women experience Blood consumption and Qi decline; at age fourteen, Tian Gui (Menstrual Essence) arrives. At thirty, menstruation occurs monthly, symbolizing the moon's waxing and waning. Regular flow is called Jing (Menses). During pregnancy, menses cease, and residual blood flows into the Baozhong (Uterus) to protect the Taiyuan (Fetal Origin). One month marks the Pei (Embryo), two months mark the Gao (Paste), and three months mark the Tai (Fetus) when form is established. Initially sheltered by the mother, the fetal shape is small, and maternal Blood consumption leaves surplus fluid. For the first two months, this accumulates in the uterus. Over time, it forms masses, which should descend with the infant at birth. Many postpartum women, exhausted from delivering the baby and placenta, lack strength, or suffer improper care, resulting in a cold abdomen. Consequently, blood mass pain persists for a long time without dissipating. Do not lightly administer harsh blood-breaking agents. Jiang (Ginger), Jiao (Pepper), Ai (Mugwort), and Jiu (Alcohol) are overly hot and may damage new Blood. The treatment method is to frequently take several doses of Shenghua Tang to assist Blood and move circulation, while externally warming the abdomen with hot clothing. Contemporary folk treatments for blood masses use Shengdi (Rehmannia Root) and Honghua (Carthamus Flower) to move blood, Sumu (Sappan Wood) and Niuxi (Achyranthes Root) to attack stasis. For Qi distension, Wuyao (Lindera Root) and Xiangfu (Cyperus Rhizome) are used to smooth Qi, Zhike (Bitter Orange Pericarp) and Houpo (Magnolia Bark) to relax. Some even use Qingpi (Green Tangerina Peel) and Zhishi (Immature Bitter Orange) to direct Qi downward and calm asthma. Huangqin (Scutellaria Root), Lianzi (Lotus Plumule), Zhizi (Gardenia Fruit), and Huangbai (Phellodendron Bark) are used to clear heat and relieve vexation. In cases of Blood dryness causing hard stools, using Chengqi Tang to purge leads to increased constipation. With excessive sweating and scanty urine, using Wuling San (Five Ingredient Powder with Poria) to promote urination leads to increased oppression. Those who are biased and ignorant of rooting the foundation... Or those who hesitate due to cost, or where ten doctors collude, misprescribing and causing premature death—these numbers are countless. Some claim Hawthorn (Shanzha) can dissolve blood masses, but it harms the weak. Frequent intake of two or three doses will certainly lead to death.

Shenghua Tang: For pregnant women at seven or eight months, prepare two or three doses in advance. Upon rupture of the membranes, quickly take one dose. Once the infant is born, take another. Regardless of normal delivery or miscarriage, even for young and strong postpartum women who are safe and sound, it is advisable to take two doses to resolve blood masses and generate new Blood.