呕吐 呕吐恶露不行。二陈加当归、蓬术、肉桂、干姜。胸腹胀满。多是伤食。二陈加丁香。
不应。加人参、炮姜、泽兰、藿香。或抵圣散亦佳。如寒。理中汤加藿香。
呃逆 呃逆者。胃寒所生。产后气血俱虚。风冷搏气而逆上。乃胃气虚寒之极。最为恶候。
理中加丁香。古方以丁香、豆蔻、伏龙肝为末。用桃仁、吴茱萸煎汤。调下一钱匙。如人行五里
再服。未应。急投参、附。迟则不救。
饱闷 产后饱闷。恶露不行。多因血逆。宜行瘀血为主。如有块上升。饱闷欲吐者。二陈汤
加姜、桂、香附、炮楂、蓬术。块不散。积久愈坚。琥珀黑龙丹。若恶露已净而饱闷。受气也。
沉香降气散。若败血伤于脾胃而腹胀呕吐者。抵圣散加鲮鲤甲、肉桂。孕妇服安胎药过多。或正
产。或半产后。经一两月。恶露未净。此非败血之比。宜导气行血。若用止截误矣。饮食停滞。
六君子加木香、浓朴。大凡伤其脾胃者。当节饮食为主。
谵语 谵语多有血滞。亦有血虚着风而痰郁者。不可专以痰断。亦不可认为血逆。其发谵语。
必脉大有力。始与证合。然又与产后不宜。故多难治。去血少者。血滞也。实则桃仁承气、下瘀
血汤。虚则龙齿清魂散。或四乌汤用赤芍、归尾加桃仁、姜汁。去血多者。血虚也。盖血虚则心
神失守。故谵语。必先养血。不可用参、术峻补。当归内补建中汤、当归芍药散、胶艾汤选用。
着风兼痰郁者。心经虚。故风痰客之。导痰汤加钩藤钩、薄荷。又方。益母草为末。薄荷汤为丸。
童便服之。专治产后谵语。
如见鬼神 产后伤耗血脉。心气虚。则败血停积。上干于心。遂至心中烦躁。卧起不安。如
见鬼神。言语颠错。误作风治必殆。虚则四物汤换生地加桂心、炮姜、生蒲黄、石菖蒲。实则四
乌汤加川连。煎成入龙脑一捻。服后得睡即安。心悸恍惚。语言错乱者。千金远志汤。如内虚败
血攻心。狂言乱语者。龙齿清魂散。瘀积不行。腹胀喘急者。急用下瘀血汤攻之。庶或可救。稍
迟必难挽回。此证多有心脾血少者。宜八珍加炮姜。则痰清神自安矣。
不语 产后不语。多因停积败血。闭于心窍。神志不能明了。严氏清魂加苏木、丹参。若因
心肾气虚而不能通于舌。则舌强不语。辰砂七珍散。或人参、石菖蒲等分。不时煎服。肾虚风热。
地黄饮子。肝木太过。柴胡清肝散。或小柴胡加钩藤。脾受木侮。六君子加升麻、钩藤。气血俱
虚。八珍汤加菖蒲、远志。不应。独参汤加附子一片。峻补其气。而血自生。若竟用血药。则误矣。
发痉 产后发痉。因去血过多。元气亏极。或外邪相搏。或阴火内动所致。故伤寒汗下过多。
溃疡脓血大泄。多患此证须。大补气血。或保无虞。若攻风邪必死。其证牙关紧急。腰背反张。
四肢抽搐。两目连札。十全大补。有汗。加炮姜。多汗。加附子。不应。并加姜、附倍人参。多
服始应。尝治大虚之证。服参、 数斤。附子数枚方应。若汗拭不及。两手摸空者不治。
发热 妇人产后血虚。阳无所根据而浮散于外。故多发热。治宜四物补阴。而以炮姜之苦温从
治。收其浮散。使归于阴。若气血俱虚。恶寒发热。烦躁作渴。十全大补汤。若热愈甚。急加桂、
附。若血虚至夜发热。小腹腰胁作痛。四物加
黄五钱。肉桂一钱。若作渴面赤。当归补血汤。若误认为火证。投以凉药。祸在反掌。然产后
脾胃多虚。有过于饮食伤滞而发热者。慎勿误作血虚治。但遇产后发热。若胸膈饱闷。嗳气恶食
泄泻等证。只作伤食治之。若发热而饮食自调者。方用补血正法。产后大发热。必用炮姜同茯苓
淡渗其热。一应苦寒并发表之药。皆不可用。凡产后发热恶寒。皆属血虚。此热非有余之热。乃
阴虚生内热耳。故以补阴药加炮姜。大剂服之。且炮姜能入肺胃。散虚热。入肝脾。引血药生血。
然不可多用独用。必与补阴药同用。此造化自然之妙也。恶寒发热腹痛者。当去恶血。产后脉洪
数。胎前脉涩弱多死。怀孕者脉宜滑数。已产而滑数不改者。虽未必死。多费调理。
寒热 产后因气血虚弱。脾胃亏损而发寒热。皆不足证。经云。阳虚则恶寒。阴虚则寒热。
若兼大便不通。尤属气血枯槁。切禁发表降火。若寸口脉微为阳气不足。阴气上入阳中而恶寒。
补中益气汤加姜、枣发越之。尺部脉弦。为阴气不足。阳气下陷阴中而发热。六味丸加肉桂以收
摄之。若肌热大渴引饮。目赤面红。此血虚发热。当归补血汤。不可误认客邪而用表散药。下血
过多。寒热而小腹不痛者。此营卫亏损。阴阳不和。属虚。增损四物汤。若恶露未净。伤滞胞络。
寒热而小腹痛者。属实。轻则四乌汤。重则醋煎散。产后卧不如法。败血流入经络骨节间。寒热
腰股肿热。痛不可拊。局方调经散。有食消食。头痛骨疼寒热者。外感风寒也。参苏饮、增损
柴胡汤、柴胡四物汤选用。或兼泻及吐者。五积散。胸膈饱闷。前后心痛寒热者。伤气与食也。
指迷七气汤。虚人。局方七气合沉香降气散。如饱满寒热兼腹痛腰疼者。四乌汤。热而不寒。胸
烦自汗。与大病后虚烦相似。此去血过多。血虚生热也。逍遥散。若脐下热。非熟地不能治。如
大热。必用炮姜。日晡转甚者。非柴胡不能治。不应。必用肉桂。新产蒸乳发热。不必服药。
中风 产后类中风证。大多血虚。非真中也。或挟风。或挟痰。或挟气。证虽不一。治法莫
要于行血。芎归汤加荆芥穗。淋黑豆酒煎服。亦治角弓反张。手足螈 。脉来虚浮者。血晕四肢
强直。芎归汤加童便。或用荆芥穗微焙为末。豆淋酒调下二钱。或童便服之。口噤则抉齿灌之。
龈噤则灌入鼻中即苏。手足瘫痪。败血入经络也。用五积散。又有形盛气虚。产后痿废不起者。
但当补气药中兼行气为主。朝用香砂六君子。暮用越鞠丸。久服自效。
咳嗽 产后咳嗽。多因腠理不密。外邪所感而致。若因风寒所感。桔梗汤加葱白、香豉、生
姜。或小建中汤。虚。用异功散去术加山药、细辛、桂枝。阴虚兼感客邪者。六味丸去萸加桂枝、
细辛。阴虚水不制火而嗽。六味丸加麦冬、五味。干咳内热不寒。桔梗汤加葳蕤、麦冬、丹皮、
蜜煎姜、橘之类。盖干咳一证。有小儿食乳易治。无则成劳。
发喘 喘而痰声大作。此痰犯肺金也。豁其痰。喘自定。风则金匮旋复花汤加甘草、桔梗。
恶露未净。加炮姜、丹参。有食。加浓朴、陈皮。不嗽而喘。此肺为火迫。乃真喘也。难治。若
肺虚热。生脉散为主药。肺胃气虚。异功散加桔梗。兼外邪。加细辛。中气虚寒。前方加炮姜、
肉桂。阳气虚脱。更加附子。肾虚不能纳气归元。都气丸作汤送灵砂丹。兼气虚者。与异功散兼
进。大抵产后发喘。加以脉之虚大急疾。皆不可治。
螈 产后阴血去多。阳火炽盛。筋失营养。虚极生风而成此证。若见唇青肉冷。汗出目眩
神昏。命在须臾。四君子加芎、归、丹皮、钩藤。盖血生于至阴。至阴者脾土也。若肝经血虚。
逍遥散加钩藤。阳气虚败。十全大补加姜、附、钩藤钩。经云。脾之荣在唇。心之液为汗。若心
脾二藏虚极。而唇白多汗。急用参、附救之。若无力抽搐。戴眼反折。汗出如珠不流者。皆不可治。
颤振 产后颤振。乃气血亏损。虚火益盛而生风也。切不可以风为治。急用十全大补。温补
气血为主。如小产后半身肉颤。半身汗出。亦宜上法。若产后不省人事。口吐涎沫而颤振。或螈
者。当归补血汤加荆芥穗。豆淋酒煎服。妇人胎前产后颤振螈 。逍遥、归脾、小柴胡、补中皆可选用。
伤风 产后伤风。须问恶露净否。而后用药。若未净而小腹疼痛者。以行血理气为先。金匮
旋复花汤、四乌汤选用。若恶露已净。小腹不疼。但头痛身热足冷。自汗咳嗽。黄 建中汤。头重。
香苏散。若风寒并伤。营卫俱病。遍体痛无汗。败毒散。虚甚着风者。不可发散。逍遥去术加桂
枝。得效虽迟无失。
伤寒产后伤寒。不可遽用小柴胡。盖有黄芩在内。停滞恶血也。宜小建中汤、增损柴胡汤。
时疫。柴胡四物汤、香苏散。伏气发温。葱白香豉汤。感冒气食。香苏散。产后得热病。四肢暖
而脉息和平者生。四肢冷而脉沉涩。烦热甚而脉洪盛者。皆死证也。
疟 产后 疟。在初产时绝少。即胎前久疟淹缠。产后里气通达。无不霍然。间有微寒发热
不止者。此卫气向虚。营血骤伤之故。但与内补当归建中汤。热多。倍芍药。寒多。加黄 。夜
发。一倍当归。三倍黄 。不应。加生何首乌。虚热不止。大便不实。加炮姜、茯苓。恶露不行。
小腹结痛。另用炮黑山楂。熬枯黑糖。伏龙肝汤煎服。或有产后一月半月。感犯风暑而疟。小柴
胡、补中益气选用。风。加羌活、紫苏。暑。加香薷、浓朴。随证裁酌。但黄芩苦寒。无论恶露
净与未净。皆非所宜。
痢 产后下痢有三。一者因胎前患痢。产后不止。昔人以为七日必死之候。若元气未败。脉
有胃气。可进粥食者。
伏龙肝汤丸随证加减。多有得生者。一者因产后脐腹受冷。饮食不化。腹痛恶露不行。理中汤为
主。白。加吴萸、木香。赤。加桂心、茯苓。一者因产后误食生冷。或临产饮食过度。产后泄泻
下痢。亦宜理中汤。白。加枳实、茯苓、浓朴、木香。赤。加香附、炮楂熬糖。虚。加人参、肉
桂。间有热痢下重。白头翁加甘草阿胶汤清理之。恶露已净。痢久不止。腹痛后重。补中益气升
举之。大抵产后下痢。惟宜顾虑元神。调和血气。则积滞自下。恶露自行。非若妊娠之有胎息。
难于照顾也。
蓐劳 蓐劳者。因产理不顺。疲极筋力。忧劳心虑。或将养失宜。虚风客之。致令虚羸喘乏。
寒热如疟。百节烦疼。头痛自汗。肢体倦怠。咳嗽痰逆。腹中绞刺。当扶正气为主。六君子加当
归。若脾肺气虚。咳嗽口干。异功散加麦冬、五味。气虚头晕。补中益气倍用归、 。肝经血虚。
肢体作痛。四物加参、苓、术、桂。肝肾虚弱。自汗盗汗。往来寒热。六味丸加五味子。脾虚血
弱腹痛。月经不调。归脾汤倍木香。血虚有热。增损柴胡汤。骨蒸劳热。嗽痰有红者。异功散去
术加山药、丹皮、五味、阿胶、童便。热而无痰干咳。逍遥散用蜜煎姜、橘。蜜蒸白术。产后虚
损。不时寒热。或经一二载。元神不复。月事不转。先与千金当归芍药汤。后与乌骨鸡丸调补。
大抵此证多因脾胃虚弱。饮食减少。以致疲惫而成。当补脾胃。进饮食。则诸脏有所倚赖。病自愈矣。
虚烦 产后虚烦。皆气血亏损。虚火上泛所致。千金治产后内虚烦热短气。用甘竹茹汤。产
后乍寒乍热。手足身温。心胸烦满。用知母汤。产后虚烦头痛短气。闷乱不解。用淡竹茹汤。产
后烦满不安。用人参当归汤。俱孙真人法也。
惊悸 产后心悸。皆心虚所致。千金治产后冲悸。志意恍惚。言语错乱。用茯神汤。虚热口
燥。加麦门冬。虚。加人参。善忘。加远志、麦门冬。产后大虚心悸。志意不安。恍惚恐畏。虚
烦不眠少气。人参丸。吸吸乏气善忘。本方去薯蓣加远
志。亦孙真人法也。
多汗 产后血虚。身热自汗。逍遥散加熟枣仁、乌梅。不可用补气药。古方用麦煎散治产后
盗汗自汗。为害不可胜数。因外感而汗者。黄 建中汤。气血俱虚。十全大补汤。不应。加附子。
若汗多不止。必发柔痉。尤当前药。若头汗者。或因湿热。或因瘀血。当审虚实治之。半身汗出。
昔人用二陈合四物。治多不效。以血药助阴。闭滞经络也。此属气血不充。而有寒痰留滞。非大
补气血。兼行经豁痰不效。宜十全大补、人参养荣加星、半、川乌。肥人多加豁痰行气药。瘦人
气血本枯。夭之征也。
麻木产后麻瞀。宜生血补气。十全大补汤。去血过多。手足发麻。小腹大痛。则遍体麻晕欲
死。此非恶露凝滞。乃虚中挟痰。六君子加炮姜、香附、当归。曾治一妇。产后右半身麻瞀而昏
晕。不省人事。发即胸膈痞闷。下体重着。或时心神荡摇。若无心肺之状。顷则周身冷汗如漉。
大吐痰涎而苏。此产后经脉空虚。痰饮乘虚袭入之故。因与六君子加归、 、肉桂。随手而效。
复有一妇。产后左半身麻瞀昏晕。不省人事。发则周身大痛。筋脉螈 。肌肉 动。或时头面赤
热。或时腿上振振动摇。顷则蒸蒸汗出而苏。此产后营血大亏。虚风袭入之故。用十全大补汤治
之。诸证悉平。但麻瞀不止。后与地黄饮子而安。
大小便诸证 产后去血过多。大肠干涸。每至三五日后。甚至五七日而大便始通者。皆其常
也。或血虚火燥。不可计其日期。必待腹满觉胀。欲自去而不能者。乃结在直肠。宜用导法。蜜煎
导。或削酱姜酱瓜。皆可为导。惟猪胆汁导禁用。以其苦寒。误用每致发呃也。若用苦寒药攻通。
反伤中焦元气。或愈结难通。或通泻不止。必成败证。若属血
**Vomiting** Postpartum vomiting accompanied by the failure of lochia to discharge. Treat with Er Chen Tang (Two-Cured Decoction) added with Dang Gui (Radix Angelicae Sinensis), Peng Zhi (Rhizoma Curcumae), Rou Gui (Cortex Cinnamomi), and Gan Jiang (Radix Zingiberis Preparata). If accompanied by chest and abdominal distension and fullness, it is mostly due to food stagnation. Treat with Er Chen Tang added with Ding Xiang (Flos Caryophylli). If ineffective, add Ren Shen (Radix Ginseng), Pao Jiang (Radix Zingiberis Preparata), Ze Lan (Herba Lycopi), and Huo Xiang (Herba Agastaches). Alternatively, Di Sheng San (Decoction to Benefit the Holy One) is also excellent. If there is cold, treat with Li Zhong Tang (Regulate the Middle Decoction) added with Huo Xiang.
**Hiccough** Hiccough arises from stomach cold. In the postpartum period, both Qi and Blood are deficient; wind-cold combats with Qi causing it to rebel upwards, which is an extreme deficiency-cold of Stomach Qi and represents a most ominous sign. Treat with Li Zhong Tang added with Ding Xiang. Ancient formulas use Ding Xiang, Dou Kou (Fructus Cardamomi), and Fu Long Gan (Calamina) ground into powder, taken with a decoction of Tao Ren (Semen Persicae) and Wu Zhu Yu (Fructus Evodiae), one qian spoonful at a time. Re-administer after walking for five li. If ineffective, urgently administer Ren Shen and Fu Zi (Radix Aconiti Preparata); delay means no salvation.
**Distension and Fullness** Postpartum distension and fullness with failure of lochia discharge is mostly due to blood rebellion. The primary treatment should be to move blood stasis. If masses rise upward causing distension and urge to vomit, use Er Chen Tang added with Sheng Jiang (Rhizoma Zingiberis Recens), Rou Gui, Xiang Fu (Rhizoma Cyperi), Pao Zha (Fructus Crataegi Preparatus), and Peng Zhi. If the mass does not dissipate and becomes harder over time, use Hu Po Hei Long Dan (Amber Black Dragon Pill). If lochia has cleared but distension persists, it is due to Qi constraint; use Chen Xiang Jiang Qi San (Aquilaria Descending Qi Powder). If retained blood damages the Spleen and Stomach causing abdominal distension and vomiting, use Di Sheng San added with Ling Li Jia (Squama Manis) and Rou Gui. If a pregnant woman took too many fetal-calming medicines, or during normal delivery or miscarriage, if lochia remains unclean after one or two months, this is not comparable to retained blood; guide Qi and move Blood. Using astringents would be a mistake. For food stagnation, use Liu Jun Zi Tang (Six-Gentlemen Decoction) added with Mu Xiang (Radix Aucklandoniae) and Hou Po (Cortex Magnoliae Officinalis). Generally, for those whose Spleen and Stomach are damaged, regulating diet is paramount.
**Delirium** Delirium is mostly caused by blood stasis, or sometimes by blood deficiency attracting wind leading to phlegm constraint. Do not judge it solely as phlegm, nor assume it is blood rebellion. When delirium occurs, the pulse must be large and forceful to match the syndrome. However, this conflicts with the principle that postpartum patients should not be purged, making it difficult to treat. Those who lost little blood have blood stasis; in excess cases, use Tao Ren Cheng Qi Tang (Peach Kernel Order the Qi Decoction) or Xia Yu Xue Tang (Descend Blood Decoction). In deficiency cases, use Long Chi Qing Hun San (Dragon Tooth Calming Soul Powder). Or use Si Wu Tang (Four-Substance Decoction) with Chi Shao (Radix Paeoniae Rubra), Gui Wei (Cauda Radicis Angelicae Sinensis), added with Tao Ren and Jiang Zhi (Jucius Zingiberis). Those who lost much blood have blood deficiency; since blood deficiency causes the Heart Spirit to lose its residence, resulting in delirium, one must first nourish Blood. Do not use Ren Shen and Bai Zhu (Rhizoma Atractylodis Macrocephalae) for vigorous tonification. Selectively use Dang Gui Nei Bu Jian Zhong Tang (Dang Gui Internal Nourishing Middle-Jiao Decoction), Dang Gui Shao Yao San (Dang Gui and Peony Powder), or Jiao Ai Tang (Collage and Mugwort Decoction). For wind attacking with phlegm constraint due to Heart Meridian deficiency, use Dao Tan Tang (Guide Out Phlegm Decoction) added with Gou Teng Gou (Uncaria Rhynchophylla Hook) and Bo He (Herba Menthae). Another formula: Yi Mu Cao (Herba Leonuri) ground into powder, made into pills with Bo He decoction, taken with infant urine; specifically treats postpartum delirium.
**Seeing Spirits** Postpartum consumption of Blood vessels leads to Heart Qi deficiency, causing retained blood to accumulate and harass the Heart, resulting in inner restlessness, inability to lie down or sit still calmly, seeing spirits, and confused speech. Mistaking this for wind treatment will surely lead to danger. For deficiency, use Si Wu Tang replacing Shu Di Huang (Radix Rehmanniae Preparata) with Sheng Di Huang (Radix Rehmanniae), adding Gui Xin (Medulla Cinnamomi), Pao Jiang, Sheng Pu Huang (Spolium Pollinis Typhae), and Shi Chang Pu (Rhizoma Acori Tatarinowii). For excess, use Si Wu Tang added with Chuan Lian (Fructus Meliae). After decocting, add Long Nao (Borneolum Syntheticum) a pinch; sleep after taking indicates peace. For palpitations,恍惚 (fluctuation), and disordered speech, use Qian Jin Yuan Zhi Tang (Thousand Gold Yuan Zhi Decoction). For internal deficiency with retained blood attacking the Heart causing wild speech, use Long Chi Qing Hun San. For stasis retention with abdominal distension and wheezing urgency, urgently use Xia Yu Xue Tang to purge; perhaps salvageable, but delay makes recovery difficult. This syndrome often involves Heart and Spleen Blood deficiency; use Ba Zhen Tang (Eight-Treasure Decoction) added with Pao Jiang so that phlegm clears and Spirit calms naturally.
**Aphasia** Postpartum aphasia is mostly due to retained retained blood closing the Heart orifices, preventing clear consciousness. Use Yan Shi Qing Hun Tang (Yan’s Calming Soul Decoction) added with Su Mu (Santalum Album) and Dan Shen (Radix Salviae Miltiorrhizae). If due to Heart and Kidney Qi deficiency failing to connect to the tongue causing stiff tongue and aphasia, use Chen Sha Qi Zhen San (Cinnabar Seven Treasures Powder). Or use equal parts Ren Shen and Shi Chang Pu, decocted and taken intermittently. For Kidney deficiency with wind-heat, use Di Huang Yin Zi (Rehmannia Elixir). For Liver Wood excess, use Chai Hu Qing Gan San (Bupleurum Clearing Liver Powder) or Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Gou Teng. For Spleen受 (affected) by Liver Wood oppression, use Liu Jun Zi Tang added with Sheng Ma (Rhizoma Cimicifugae) and Gou Teng. For combined Qi and Blood deficiency, use Ba Zhen Tang added with Chang Pu and Yuan Zhi (Radix Polygalae). If ineffective, use Du Shen Tang (Single Ginseng Decoction) added with one slice of Fu Zi to vigorously tonify Qi, allowing Blood to generate spontaneously. Using only Blood-tonifying herbs would be a mistake.
**Convulsions** Postpartum convulsions result from excessive blood loss leading to extreme Yuan Qi depletion, or combat with external pathogens, or internal movement of Yin fire. Thus, excessive sweating and purging in Shang Han (Cold Damage), or massive drainage of pus and blood from ulcers, often cause this syndrome. One must vigorously tonify Qi and Blood to ensure safety. Attacking wind pathogens will cause death. Symptoms include locked jaws, opisthotonos, limb twitching, and eye blinking. Use Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction). With sweating, add Pao Jiang. With profuse sweating, add Fu Zi. If ineffective, add Ginger and Aconite, doubling Ren Shen. Frequent administration is needed for effect. I once treated severe deficiency cases where several jin of Ren Shen and several pieces of Fu Zi were required for effect. If sweat cannot be wiped away and hands feel for empty space, it is untreatable.
**Fever** Women postpartum have Blood deficiency, leaving Yang without foundation to float and scatter externally, hence frequent fever. Treatment should use Si Wu Tang to nourish Yin, using the bitter-warm nature of Pao Jiang to guide and collect the floating Yang, returning it to Yin. If both Qi and Blood are deficient with aversion to cold, fever, restlessness, and thirst, use Shi Quan Da Bu Tang. If heat intensifies, urgently add Gui and Fu Zi. If Blood deficiency causes night fever with lower abdomen, waist, and hypochondriac pain, use Si Wu Tang added with Huang Qi (Radix Astragali) 5 qian and Rou Gui 1 qian. If thirsty with red face, use Dang Gui Bu Xue Tang (Dang Gui Tonifying Blood Decoction). Mistaking this for Fire syndrome and administering cooling drugs brings disaster instantly. However, postpartum Spleen and Stomach are often deficient; fever due to dietary injury and stagnation must not be mistaken for Blood deficiency. Whenever postpartum fever presents with chest/diaphragm fullness, belching, anorexia, or diarrhea, treat as food stagnation. Only if fever occurs with normal appetite should the correct method of tonifying Blood be used. For severe postpartum fever, Pao Jiang must be used with Fu Ling (Poria) to leach out heat gently. All bitter-cold and exterior-releasing drugs are contraindicated. All postpartum fever with aversion to cold belongs to Blood deficiency; this heat is not excess heat, but internal heat generated by Yin deficiency. Therefore, use Yin-nourishing drugs added with Pao Jiang in large doses. Pao Jiang enters Lung and Stomach to scatter deficiency heat, and enters Liver and Spleen to guide Blood herbs to generate Blood. However, it should not be used alone or in excess; it must be used with Yin-nourishing drugs, which is the wonder of natural creation. For aversion to cold, fever, and abdominal pain, one must remove bad blood. Postpartum pulse rapid and flooding, antepartum pulse choppy and weak often indicates death. Pregnancy pulse should be slippery and rapid; if postpartum pulse remains slippery and rapid, although not necessarily fatal, it requires extensive conditioning.
**Alternating Chills and Fever** Postpartum alternating chills and fever due to Qi and Blood weakness and Spleen/Stomach damage are all deficiency syndromes. The Classics state: Yang deficiency causes aversion to cold; Yin deficiency causes alternating chills and fever. If accompanied by constipation, it especially indicates exhaustion of Qi and Blood; strictly forbid exterior-releasing and fire-draining methods. If Cun Kou (inch position) pulse is faint, it indicates insufficient Yang Qi, with Yin Qi entering Yang causing aversion to cold; use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) added with Ginger and Jujube to vent it. If Chi position (cubit position) pulse is wiry, it indicates insufficient Yin Qi, with Yang Qi sinking into Yin causing fever; use Liu Wei Wan (Six-Ingredient Pill) added with Rou Gui to gather and secure it. If skin feels hot with great thirst and drinking, red eyes and face, this is Blood deficiency fever; use Dang Gui Bu Xue Tang. Do not mistake it for external pathogen and use exterior-releasing drugs. After excessive bleeding, with chills/fever but no lower abdominal pain, this is Ying and Wei damage and Yin-Yang disharmony, belonging to deficiency; use Zeng Sun Si Wu Tang (Modified Four-Substance Decoction). If lochia is not clean, damaging the uterine collaterals, with chills/fever and lower abdominal pain, this is excess; mild cases use Si Wu Tang, severe cases Cu Jian San (Vinegar-Boiled Powder). If lying improperly postpartum, retained blood flows into meridians and joints causing chills/fever, swollen/hot waist and thighs, painful to touch, use Ju Fang Tiao Jing San (Standard Formula Regulating Menstruation Powder). For food stagnation with headache, bone pain, and chills/fever, it is external wind-cold; select Shen Su Yin (Ginseng and Perilla Drink), Zeng Sun Chai Hu Tang (Modified Bupleurum Decoction), or Chai Hu Si Wu Tang (Bupleurum Four-Substance Decoction). If accompanied by diarrhea and vomiting, use Wu Ji San (Five Accumulations Powder). For chest/diaphragm fullness, anterior/posterior heart pain with chills/fever, it is Qi and Food injury; use Zhi Mi Qi Qi Tang (Pointing to Mystery Seven Qi Decoction). For deficient persons, use Ju Fang Qi Qi combined with Chen Xiang Jiang Qi San. For fullness, chills/fever with abdominal and back pain, use Si Wu Tang. Heat without cold, chest irritability and spontaneous sweating, similar to post-illness deficiency irritability, is due to excessive blood loss generating heat; use Xiao Yao San (Free and Easy Wanderer Powder). For heat below the umbilicus, only Shu Di can treat it. For severe heat, Pao Jiang is essential. Worsening at dusk (Shen hour) requires Chai Hu; if ineffective, Rou Gui is necessary. Fever from new lactation needs no medicine.
**Wind Strike** Postpartum pseudo-stroke is mostly Blood deficiency, not true stroke. It may involve Wind, Phlegm, or Qi. Although symptoms vary, the key treatment is moving Blood. Use Xiong Gui Tang (Ligusticum and Angelica Decoction) added with Jing Jie Sui (Pteridii Spori prepared with Schizonepeta), decocted in black soybean wine; also treats opisthotonos and limb spasms. For floating deficiency pulse with blood晕 (fainting) and limb stiffness, use Xiong Gui Tang added with Tong Bian (Infant Urine). Or roast Jing Jie Sui slightly, grind to powder, take with Dou Lin Jiu (Black Soybean Wine) 2 qian, or with infant urine. For locked jaw, pry teeth open and pour in. For gum locking, instill into nose for revival. For limb paralysis due to retained blood entering meridians, use Wu Ji San. For those with robust body but deficient Qi, unable to rise postpartum due to flaccidity, tonify Qi primarily while moving Qi. Morning: Xiang Sha Liu Jun Zi Tang; Evening: Yue Ju Wan (Pill to Resolve Six Stagnations); long-term use yields results.
**Cough** Postpartum cough is mostly due to loose pores inviting external pathogens. If due to wind-cold, use Jie Geng Tang (Platycodon Decoction) added with Cong Bai (Scallion White), Xiang Chi (Fermented Soybean), and Sheng Jiang. Or Xiao Jian Zhong Tang (Minor Construct the Middle Decoction). For deficiency, use Yi Gong San (Benefit the Work Powder) removing Bai Zhu, adding Shan Yao (Rhizoma Dioscoreae), Xi Xin (Radix Asari), and Gui Zhi (Ramulus Cinnamomi). For Yin deficiency with external pathogen, use Liu Wei Wan removing Yu Zhu, adding Gui Zhi and Xi Xin. For Yin deficiency with Water failing to control Fire causing cough, use Liu Wei Wan added with Mai Dong (Radix Ophiopogonis) and Wu Wei Zi (Fructus Schisandrae). For dry cough with internal heat but no cold, use Jie Geng Tang added with Wei Rui (Rhizoma Polygonati), Mai Dong, Dan Pi (Cortex Moutan), Honey-fried Ginger, and Orange peel. Dry cough is easy to treat if breastfeeding; otherwise, it becomes consumption.
**Wheezing** Wheezing with loud phlegm sounds indicates Phlegm invading Lung Metal. Expel the phlegm, and wheezing settles. Due to Wind, use Jin Kui Xuan Fu Hua Tang (Golden Cabinet Inula Decoction) added with Gan Cao (Radix Glycyrrhizae) and Jie Geng. If lochia is not clean, add Pao Jiang and Dan Shen. If food stagnation, add Hou Po and Chen Pi (Pericarpium Citri Reticulatae). Wheezing without cough indicates Lung forced by Fire, a true wheezing, difficult to treat. For Lung deficiency heat, use Sheng Mai San (Generate Pulse Powder) as main drug. For Lung-Stomach Qi deficiency, use Yi Gong San added with Jie Geng. With external pathogen, add Xi Xin. for Middle Qi deficiency-cold, add Pao Jiang and Rou Gui to previous formula. for Yang Qi collapse, add Fu Zi. for Kidney deficiency failing to grasp Qi, use Du Qi Wan (Nine-Ingredient Pill) as decoction sending Ling Sha Dan (Cinnabar and Sulphur Pill). With Qi deficiency, advance concurrently with Yi Gong San. Generally, postpartum wheezing with large, rapid, deficient pulse is untreatable.
**Spasms** Postpartum Yin Blood loss leads to blazing Yang Fire, tendons losing nourishment, extreme deficiency generating Wind causing this syndrome. If lips turn blue, flesh cold, sweating, dizzy, and unconscious, life hangs in balance; use Si Jun Zi Tang (Four-Gentlemen Decoction) added with Xiong, Gui, Dan Pi, and Gou Teng. Blood is born from Supreme Yin, which is Spleen Earth. For Liver Meridian Blood deficiency, use Xiao Yao San added with Gou Teng. for Yang Qi deficiency and collapse, use Shi Quan Da Bu Tang added with Ginger, Aconite, and Gou Teng. The Classics say: Spleen manifests in lips; Heart fluid is sweat. If Heart and Spleen are extremely deficient with white lips and profuse sweating, urgently use Ren Shen and Fu Zi to rescue. If powerless spasms, eyes rolling back, opisthotonos, and bead-like non-flowing sweat occur, it is untreatable.
**Tremor** Postpartum tremor is due to Qi and Blood loss, with increasing deficiency fire generating Wind. Do not treat as Wind; urgently use Shi Quan Da Bu Tang, focusing on warming and tonifying Qi and Blood. For half-body muscle tremor and sweating after minor abortion, use the above method. For postpartum unconsciousness, salivation, tremor, or spasms, use Dang Gui Bu Xue Tang added with Jing Jie Sui, decocted in Dou Lin Jiu. For women with pre/postpartum tremor/spasms, Xiao Yao, Gui Pi, Xiao Chai Hu, and Bu Zhong Zhong Yi are all selectable.
**Wind Injury** Postpartum wind injury requires asking if lochia is clean before prescribing. If not clean with lower abdominal pain, prioritize moving Blood and regulating Qi; select Jin Kui Xuan Fu Hua Tang or Si Wu Tang. If lochia is clean and no lower abdominal pain, but with headache, body heat, cold feet, spontaneous sweating, and cough, use Huang Qi Jian Zhong Tang. For heavy head, use Xiang Su San (Perilla Powder). If wind and cold jointly injure, affecting Ying and Wei, causing whole-body pain and no sweat, use Bai Du San (Eliminate Toxins Powder). For severe deficiency with wind, do not release exterior; use Xiao Yao removing Bai Zhu, adding Gui Zhi; effect may be slow but safe.
**Cold Damage** Postpartum cold damage should not immediately use Xiao Chai Hu Tang because Huang Qin (Radix Scutellariae) inside can stagnate bad blood. Use Xiao Jian Zhong Tang or Zeng Sun Chai Hu Tang. For seasonal epidemics, use Chai Hu Si Wu Tang or Xiang Su San. For latent Qi causing warmth, use Cong Bai Xiang Chi Tang. For Qi/Food cold, use Xiang Su San. Postpartum heat disease with warm limbs and peaceful pulse survives; cold limbs with deep/choppy pulse, or severe irritability with flooding pulse, are death signs.
**Malaria** Postpartum malaria is rare initially. Even if chronic malaria persisted antepartum, postpartum interior Qi flow usually cures it suddenly. Occasionally, slight chills/fever persist due to defensive Qi deficiency and sudden Ying/Blood injury. Use Nei Bu Dang Gui Jian Zhong Tang. More heat: double Shao Yao. More cold: add Huang Qi. Night onset: double Dang Gui, triple Huang Qi. If ineffective, add Sheng He Shou Wu (Polygonum Multiflorum). Persistent deficiency heat with loose stool: add Pao Jiang and Fu Ling. Retained lochia with knotted lower abdominal pain: separately use charred Shan Zha (Crataegus), boiled dark brown sugar, decocted in Fu Long Gan Tang. If malaria contracted one month postpartum from wind-summerheat, select Xiao Chai Hu or Bu Zhong Yi Qi. Add Qiang Huo (Radix Notopterygii) and Zi Su (Folium Perillae) for wind; add Xiang Ru (Herba Elsholtziae) and Hou Po for summerheat. Adjust per syndrome. Huang Qin is bitter-cold and unsuitable regardless of lochia status.
**Dysentery** Postpartum dysentery has three types. First, dysentery starting antepartum continuing postpartum; ancients deemed fatal within seven days. If Yuan Qi is intact, pulse has Stomach Qi, and porridge can be eaten, use Fu Long Gan Tang Wan adjusted per syndrome; many survive. Second, cold invading navel/abdomen postpartum, undigested food, abdominal pain, lochia retention; Li Zhong Tang is main. White dysentery: add Wu Yu and Mu Xiang. Red dysentery: add Gui Xin and Fu Ling. Third, eating raw/cold or overeating at delivery causing postpartum diarrhea/dysentery; also use Li Zhong Tang. White: add Zhi Shi (Fructus Aurantii), Fu Ling, Hou Po, Mu Xiang. Red: add Xiang Fu and charred Shan Zha with sugar. Deficiency: add Ren Shen and Rou Gui. Occasionally, heat dysentery with heaviness uses Bai Tou Weng Tang added with Gan Cao and E Jiao (Colla Corii Asini) to clear. If lochia clean, chronic dysentery with abdominal pain/tenesmus, use Bu Zhong Yi Qi to lift. Generally, postpartum dysentery requires guarding Yuan Shen and harmonizing Qi/Blood so stagnation passes and lochia moves naturally, unlike pregnancy where fetal breath complicates care.
**Childbed Consumption** Childbed consumption (Ru Lao) results from difficult labor exhausting sinews/strength, worry stressing mind, or improper nursing allowing deficiency wind to invade, causing emaciation, panting, malaria-like chills/fever, joint pain, headache, sweating, fatigue, cough with reverse phlegm, and cramping abdomen. Primary treatment is supporting Righteous Qi; use Liu Jun Zi Tang added with Dang Gui. For Spleen-Lung Qi deficiency with cough/dry mouth, use Yi Gong San added with Mai Dong and Wu Wei Zi. for Qi deficiency dizziness, use Bu Zhong Yi Qi doubling Dang Gui and Huang Qi. for Liver Blood deficiency with limb pain, use Si Wu Tang added with Shen, Ling, Zhu, and Gui. for Liver-Kidney weakness with spontaneous/night sweats and alternating chills/fever, use Liu Wei Wan added with Wu Wei Zi. for Spleen deficiency/Blood weakness with abdominal pain/menstrual irregularity, use Gui Pi Tang doubling Mu Xiang. for Blood deficiency with heat, use Zeng Sun Chai Hu Tang. for bone-steaming consumption with bloody sputum, use Yi Gong San removing Zhu, adding Shan Yao, Dan Pi, Wu Wei Zi, E Jiao, and Tong Bian. for heat without phlegm/dry cough, use Xiao Yao San with honey-fried Ginger/Orange and honey-steamed Bai Zhu. for postpartum deficiency with intermittent chills/fever lasting years, unrecovered Yuan Shen, and amenorrhea, first give Qian Jin Dang Gui Shao Yao Tang, then Wu Gu Ji Wan (Black Bone Chicken Pill) for regulation. Generally, this syndrome stems from Spleen-Stomach weakness and reduced intake causing exhaustion. Tonify Spleen-Stomach and promote intake so organs rely on them, curing the disease.
**Deficiency Irritability** Postpartum deficiency irritability is caused by Qi/Blood loss and deficiency fire rising. Qian Jin treats internal deficiency heat/shortness of breath with Gan Zhu Ru Tang. For alternating chills/fever, warm extremities, chest fullness, use Zhi Mu Tang. For headache/shortness of breath/confusion, use Dan Zhu Ru Tang. For fullness/restlessness, use Ren Shen Dang Gui Tang. All are Sun Simiao’s methods.
**Palpitations** Postpartum palpitations are due to Heart deficiency. Qian Jin treats rushing palpitations with恍惚/disordered speech using Fu Shen Tang. for deficiency heat/dry mouth, add Mai Men Dong. for deficiency, add Ren Shen. for forgetfulness, add Yuan Zhi and Mai Men Dong. for severe Heart deficiency with palpitations, anxiety, fear, insomnia, shortness of breath, use Ren Shen Wan. for gasping/forgetfulness, remove Yu Zhu from base formula, add Yuan Zhi. Also Sun Simiao’s methods.
**Excessive Sweating** Postpartum Blood deficiency with body heat and spontaneous sweating: use Xiao Yao Tang added with Shu Zao Ren (Semen Ziziphi Spinosae Preparatum) and Wu Mei (Fructus Mume). Do not use Qi-tonifying drugs. Ancient formulas use Mai Jian San for night/spontaneous sweating, causing countless harms. For sweating due to external pathogen, use Huang Qi Jian Zhong Tang. for combined Qi/Blood deficiency, use Shi Quan Da Bu Tang. If ineffective, add Fu Zi. If sweating persists, soft convulsions will develop; continue previous meds. For head sweating, determine if damp-heat or blood stasis and treat based on deficiency/excess. Half-body sweating: ancients used Er Chen combined with Si Wu, often ineffective because Blood herbs aid Yin, blocking meridians. This is Qi/Blood insufficiency with cold-phlegm retention; requires vigorous Qi/Blood tonification plus meridian-moving/phlegm-expelling. Use Shi Quan Da Bu or Ren Shen Yang Rong Tang added with Tian Nan Xing (Rhizoma Arisaematis), Ban Xia (Rhizoma Pinelliae), and Chuan Wu (Radix Aconiti Carminopolii). Fat people need more phlegm-expelling/Qi-moving herbs. Thin people have inherent Blood/Q exhaustion, a sign of premature death.
**Numbness** Postpartum numbness/blindness requires generating Blood and tonifying Qi; use Shi Quan Da Bu Tang. Excessive blood loss with limb numbness and severe lower abdominal pain causing whole-body numbness/fainting is not lochia stasis, but deficiency with phlegm; use Liu Jun Zi Tang added with Pao Jiang, Xiang Fu, and Dang Gui. Case: Woman with right-side numbness/fainting/unconsciousness, chest oppression, heavy lower body, heart fluctuation, cold sweat, vomiting phlegm upon waking. Due to empty meridians allowing phlegm-fluid invasion. Given Liu Jun Zi Tang with Dang Gui, Huang Qi, Rou Gui; effective immediately. Another case: Left-side numbness/fainting/unconsciousness, whole-body pain, spasms, muscle twitching, facial heat, leg trembling, sweating upon waking. Due to severe Ying/Blood loss and deficiency wind invasion. Treated with Shi Quan Da Bu Tang; symptoms resolved. For persistent numbness, later used Di Huang Yin Zi for stability.
**Urination and Defecation Syndromes** Postpartum excessive blood loss dries Large Intestine; bowel movements every 3-5 days, even up to 7 days, are normal. If Blood deficiency with fire dryness, do not count days; wait until abdominal fullness/bloating with urge but inability to pass, indicating rectal blockage. Use guiding methods: Honey suppository or sliced pickled ginger/cucumber. Pig bile enema is forbidden due to bitter-cold nature causing hiccough if misused. Using bitter-cold purgatives damages Middle Jiao Yuan Qi, leading to harder blockage or uncontrolled diarrhea, resulting in failure syndromes. If due to Blood...