陈氏曰∶产后血崩者何？答曰∶产卧伤耗经脉，未得平复，劳役损动，致血暴崩，淋沥不
止，或因酸咸不节伤蠹，荣卫衰弱，亦变崩中。若小腹满痛，肝经已坏，为难治。急服固经丸
止之。陈无择评曰∶血崩不是轻病，产后有此，是谓重伤，恐不止酸咸不节而能致之，多因惊
忧恚怒，脏气不平，或产后服断血药早，致恶血不消，郁满作坚，亦成崩中。固经丸自难责
效，不若大料煮川芎汤加芍药，候定，续次随证诸药治之为得。
薛氏曰∶前证若血滞小腹胀满、用失笑散，血少小腹虚痞，川芎汤；肝火血妄行，加味
逍遥散，脾郁不统血，加味归脾汤；脾气虚不摄血，补中益气汤；浓味积热伤血，清胃散加
槐花；风热相搏伤血，四君子加防风、枳壳。
一产妇血崩，小腹胀痛，用破气行血之剂，其崩如涌，四肢不收，恶寒呕吐，大便频
泻，余用六君加炮黑干姜，四剂稍愈（见症在脾胃，故用六君加炮姜），又以十全大补三十
余剂而痊。
一产妇血崩因怒，其血如涌，仆地，口噤目斜，手足抽搐，此肝经血耗生风，余用六味
丸料一剂，诸证悉退，但食少晡热，佐以四君、柴胡、牡丹皮而愈。
芎归加芍药汤 治产后血崩，眩晕不知人事。
方见前恶露不绝。
加味四物汤 治产后血崩如豆汁，紫黑过多者。
方见前恶露不绝。
奇效四物汤 治产后血崩，素有热者。
方见血崩门。
干熟地黄散 治产后崩中，头目旋晕，神思昏迷，四肢烦乱，不知人事。（崩久虚脱者宜之）
干熟地黄 黄 伏龙肝 赤石脂（各一两） 当归（七钱半） 川芎 阿胶 艾叶 白术
人参 甘草（各半两）
上 咀，每服四钱，生姜三片，水煎温服。
阿胶丸 治产后崩中，下血不止，虚羸无力。
阿胶 赤石脂（各一两半） 续断 川芎 当归 丹参 甘草（各一两） 龙骨 鹿茸（酥炙）
乌贼鱼骨 鳖甲（炙，各一两）
上为细末，炼蜜丸，如桐子大，空心温酒二三十丸。（一派固血，不用补气，尤妙在鹿
茸，谓其能引血上升也）
瑞莲散 治产后恶血崩漏，状如涌泉。
瑞莲（一百枚，烧灰存性） 棕榈（烧存性） 当归（各一两） 官桂（半两） 槟榔（二枚）
川芎 鲤鱼鳞（各七钱半，亦烧灰用）
上为细末，每服三钱，煨生姜酒调服。如
未止，更进一服。或非时血崩，无药可治，但进三服即止。
固经丸 治产后血气未复，而有房事，及劳役伤损，致血暴崩，或淋沥不止。（温涩之
剂，固脱以暖下元）
艾叶 赤石脂（ ） 补骨脂（炒） 木贼（各半两） 附子（一枚，炮去皮）
上为细末，糊丸，如桐子大，每服二十丸，温酒或米饮下。
千金方 治产后崩中，下血不止。（此方惟心气郁者宜之）
菖蒲一两半锉，酒二盅煎一盅，去渣，分三服，食前下。
Chen stated: What is postpartum metrorrhagia? The answer is: Childbed rest consumes the meridians, which have not yet recovered; physical exertion damages and agitates them, causing sudden violent bleeding that drips continuously. Alternatively, immoderate consumption of sour and salty foods may damage the body, leading to weakness of Ying (Nutrient) and Wei (Defensive) Qi, also resulting in metrorrhagia. If there is fullness and pain in the lower abdomen, it indicates damage to the Liver Meridian, making it difficult to treat. One should urgently administer Gujing Wan (Solidify the Menses Pill) to stop the bleeding.
Chen Wuze commented: Metrorrhagia is not a mild disease. Its occurrence postpartum constitutes a severe injury. It is likely caused not merely by immoderate dietary habits but often by fright, worry, or anger, leading to imbalance in Zang-Fu Qi. Or, if blood-stopping medicines are taken too early postpartum, lochia fails to dissipate, becomes stagnant, distended, and hardened, also forming metrorrhagia. Relying solely on Gujing Wan is unlikely to be effective. It is better to use a large dose of Chuanxiong Decoction with added Shaoyao (Peony Root), wait for stabilization, and then sequentially treat according to symptoms with other formulas, which is more appropriate.
Xue stated: For the aforementioned conditions, if there is blood stasis causing lower abdominal fullness, use Shixiao San (Pain-Relieving Powder); if blood deficiency causes lower abdominal emptiness and bloating, use Chuanxiong Tang (Szechwan Lovage Root Decoction); if Liver Fire causes reckless blood flow, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder); if Spleen Stagnation fails to control blood, use Jiawei Guipi Tang (Modified Restore the Spleen Decoction); if Spleen Qi Deficiency fails to hold blood, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction); if rich flavors accumulate heat damaging blood, use Qingwei San (Clear the Stomach Powder) with Huaihua (Sophora Flower); if Wind-Heat combats and damages blood, use Sijunzi Tang (Four Gentlemen Decoction) with Fangfeng (Saposhnikovia Root) and Zhike (Aurantium Fruit).
A parturient woman suffered from metrorrhagia with lower abdominal distension and pain. After using qi-breaking and blood-moving agents, her bleeding surged like a fountain, her limbs became flaccid and unresponsive, she experienced aversion to cold and vomiting, and frequent diarrhea. I used Liujunzi Tang (Six Gentlemen Decoction) with Pao Hei Ganjiang (Charred Dried Ginger). After four doses, she improved slightly (since the symptoms manifested in the Spleen and Stomach, Liujunzi Tang with Charred Ginger was used). She subsequently took over thirty doses of Shiquan Dabu Tang (Perfect Great Tonifying Decoction) and recovered.
Another parturient suffered from metrorrhagia due to anger. Her blood gushed out, she collapsed, her jaw locked, eyes deviated, and hands and feet convulsed. This was wind generated from Liver Blood depletion. I administered one dose of Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) ingredients. All symptoms subsided, but she had poor appetite and afternoon fever. I supplemented with Sijunzi Tang, Chaihu (Bupleurum Root), and Mudanpi (Tree Peony Bark), and she recovered.
Xionggui Jia Shaoyao Tang (Ligusticum and Angelica Decoction with Added Peony): Treats postpartum metrorrhagia with dizziness and loss of consciousness.
Formula see previous entry "Lochia Non-stop".
Jiawei Siwu Tang (Modified Four Substances Decoction): Treats postpartum metrorrhagia resembling bean curd juice, excessively purple and black.
Formula see previous entry "Lochia Non-stop".
Qixiao Siwu Tang (Miraculous Efficacy Four Substances Decoction): Treats postpartum metrorrhagia in patients who habitually have internal heat.
Formula see "Metrorrhagia" section.
Gan Shudihuang San (Dried Prepared Rehmannia Powder): Treats postpartum metrorrhagia with vertigo, coma, limb restlessness, and loss of consciousness. (Suitable for cases of prolonged bleeding leading to collapse).
Gan Shudihuang (Dried Prepared Rehmannia Root), Huangqi (Astragalus Root), Fulonggan (Stove Earth), Chishizhi (Red Halloysite) (each 1 liang), Danggui (Angelica Sinensis Root) (7 qian 5 fen), Chuanxiong (Ligusticum Chuanxiong Rhizome), Ejiao (Donkey-hide Gelatin), Aye (Mugwort Leaf), Baizhu (Atractylodes Macrocephala Rhizome), Renshen (Ginseng Root), Gancao (Licorice Root) (each 0.5 liang).
Crush the herbs. Take 4 qian per dose, add 3 slices of fresh ginger, decoct in water, and take warm.
Ejiao Wan (Donkey-hide Gelatin Pill): Treats postpartum metrorrhagia with continuous bleeding, weakness, and emaciation.
Ejiao, Chishizhi (each 1.5 liang), Xuduan (Dipsacus Root), Chuanxiong, Danggui, Danshen (Salvia Miltiorrhiza Root), Gancao (each 1 liang), Longgu (Fossilized Bones), Lurong (Deer Antler, processed with butter), Oubieyu Gu (Cuttlefish Bone), Biejia (Tartar Testudinis, roasted) (each 1 liang).
Grind into fine powder, mix with refined honey to make pills the size of paulownia seeds. Take 20-30 pills with warm wine on an empty stomach. (This formula focuses on securing blood without tonifying Qi; its brilliance lies in Lurong, which guides blood upward.)
Ruilian San (Sacred Lotus Powder): Treats postpartum lochia metrorrhagia resembling a gushing spring.
Ruilian (100 pieces, burned to ash retaining nature), Zonglv (Date Palm Spadix, burned to ash), Danggui (each 1 liang), Guangui (Cinnamon Bark) (0.5 liang), Binglang (Areca Seed) (2 pieces), Chuanxiong, Liyulin (Carp Scales) (each 7 qian 5 fen, also burned to ash).
Grind into fine powder. Take 3 qian per dose, mixed with wine and baked fresh ginger. If bleeding does not stop, take another dose. For irregular metrorrhagia where no medicine is available, three doses will suffice to stop it.
Gujing Wan (Solidify the Menses Pill): Treats postpartum metrorrhagia or dripping bleeding caused by sexual intercourse before Qi and Blood recovery, or by physical exertion. (This is a warming and astringent formula to secure collapse and warm the Lower Yuan).
Aye, Chishizhi (vinegar-fried), Buguzhi (Psoralea Fructus, fried), Muzei (Equisetum Hiemale) (each 0.5 liang), Fuzi (Aconite Lateralis Radix Praeparata, one piece, roasted and peeled).
Grind into fine powder, bind with paste to make pills the size of paulownia seeds. Take 20 pills with warm wine or rice water.
Qianjin Fang (Thousand Gold Formula): Treats postpartum metrorrhagia with continuous bleeding. (This formula is suitable only for those with Heart Qi stagnation).
Shichangpu (Acorus Tatarinowii Rhizome) 1.5 liang, chopped. Decoct in 2 zhong of wine until 1 zhong remains. Strain, divide into three doses, take before meals.