凡产后因忿怒气逆,胸膈不舒,血块大痛,宜用生化汤,临服时磨木香一分在内服之,则血块
自化,怒气自散,并治而不悖也。若轻重气,偏用木香、香砂、乌药、枳壳、砂仁之剂,以散气行
块,则元气反损,而满闷反增,是重虚之,非善治产者也。又如怒后即食,胃弱停闷,当审何物所
伤。如肉物伤,加砂仁、神曲消之;如面饭伤,加神曲、麦芽消之。若伤物作痛,涩滞胁腹,宜加桂
枝、吴茱萸在生化汤中,以逐寒定痛,无有不安,慎勿用木香槟榔丸、顺气饮之方,以散气化食。
不然,则虚弱产妇,重虚之祸,有不可胜言者矣。
大抵产后患崩,血脱;短气似喘,气脱;妄言妄见,神脱。三症虽有血阴气阳之分,其精散神
去之促无异,此亦危症也。若非能浓药急方频服,失之者多矣。妄论气实痰火皆非也。如新产为块
痛,并用加参生化汤,行中当补之方,斯免血滞血虚之失也。其块痛止,宜用升举大补汤,少佐黄连
坠火,以治崩脱、宁血归经也。宜用倍参补中益气汤,少佐附子助参以治气脱,摄气归源也。宜用
滋荣益气复神汤,少佐痰剂以清心火,宁君主之官也。因人妄论气脱妄言之症,误用气实痰火之方药,
屡夭人年,故重复录告。倘执论气痰而愈重,必当识补救,方可活也。
In cases where postpartum anger causes qi rebellion, leading to discomfort in the chest and diaphragm, and severe pain from blood stasis (blood clots), Shenghua Tang (Life Generating Decoction) is appropriate. Before administration, grind one fen of Muxiang (Aucklandiae Radix) into the decoction for ingestion; this will naturally resolve the blood stasis and dissipate the anger, allowing both conditions to be treated simultaneously without conflict. If the condition is mild and primarily involves qi stagnation, using only agents such as Muxiang (Aucklandiae Radix), Xiangsha (Amomi Fructus with Aucklandiae Radix), Wuyao (Linderae Radix), Zhike (Aurantii Fructus), and Sharen (Amomi Fructus Rotundus) to move qi and disperse clots will反而 damage the Yuan Qi (Primary Qi), thereby increasing distension and fullness. This constitutes a "double deficiency" error and is not a skillful approach to treating postpartum disorders.
Furthermore, if eating immediately after an outburst of anger leads to weak stomach qi and food stagnation causing fullness, one must determine the specific offending food. For meat injury, add Sharen (Amomi Fructus Rotundus) and Shenqu (Massa Medicata Fermentata) to aid digestion; for grain or rice injury, add Shenqu (Massa Medicata Fermentata) and Maiya (Hordei Fructus Germinatus). If food injury causes pain accompanied by astringency and stagnation in the hypochondrium and abdomen, it is appropriate to add Guizhi (Cinnamomi Ramulus) and Wuzhuyu (Evodiae Fructus) to Shenghua Tang (Life Generating Decoction) to dispel cold and alleviate pain, ensuring stability. One must strictly avoid using formulas like Muxiang Binglang Wan (Aucklandia and Areca Nut Pill) or Shunqi Yin (Qi-Pacifying Drink) to move qi and digest food. Otherwise, applying these draining methods to a debilitated postpartum woman will cause severe additional deficiency, with consequences that are beyond description.
Generally speaking, postpartum metrorrhagia (flooding) indicates Blood Exhaustion; shortness of breath resembling asthma indicates Qi Exhaustion; delirious speech and visual hallucinations indicate Spirit Exhaustion. Although these three syndromes differ in their association with Yin/Blood and Yang/Qi, the urgency of essence scattering and spirit departing is identical, making them critical conditions. Unless thick medicinal preparations and urgent prescriptions are administered frequently, many errors occur. It is erroneous to attribute these symptoms to excess qi or phlegm-fire. For instance, in recent childbirth presenting with pain from blood clots, Jia Shen Shenghua Tang (Shenghua Tang with Added Ginseng) should be used uniformly. This formula moves blood while tonifying, thereby avoiding the pitfalls of blood stasis and blood deficiency.
Once the pain from blood clots subsides, Shengju Dabu Tang (Raising and Great Tonification Decoction) is appropriate, with a small addition of Huanglian (Coptidis Rhizoma) to descend fire, treating flooding and exhaustion while calming blood and guiding it back to its vessels. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with doubled Renshen (Ginseng Radix et Rhizoma) is appropriate, with a small addition of Fuzi (Aconiti Lateralis Radix Praeparata) to assist Renshen in treating Qi Exhaustion and gathering qi to its source. Zirong Yiqi Fushen Tang (Nourish Glory, Tonify Qi, and Restore Spirit Decoction) is appropriate, with a small addition of phlegm-resolving agents to clear Heart Fire and pacify the Monarch Organ (Heart). Because some erroneously interpret delirious speech caused by Qi Exhaustion as symptoms of excess qi and phlegm-fire, leading to the misuse of corresponding prescriptions and repeatedly shortening lives, this warning is recorded again. If one adheres rigidly to theories of qi and phlegm, worsening the condition, one must recognize the need for remedial measures to save the patient's life.