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On the Principle of Tonifying After Childbirth; Appendages: Taichan Jindan (Golden Pill for Fetal and Obstetric Conditions) and Huisheng Dan (Pill for Restoring Life)

The Heavenly Master said: The diseases occurring after childbirth are too numerous to enumerate, but treatment should ultimately focus on tonifying Qi and Blood. I am not incapable of prescribing a general formula to treat them all. After childbirth, one often experiences blood syncope (loss of consciousness due to blood loss), headache, fever, abdominal pain, or cold extremities with tetanic convulsions (muscle spasms). There may also be fullness in the heart and hypochondrium accompanied by vomiting, transformation into Yin-cold syndrome due to wind pathogen invasion, or direct occurrence of jue-ni (cold limbs extending to elbows and knees) due to chilling cold qi. These conditions can determine life or death within a day or night, becoming critical in an instant. If treated at this time as exterior syndromes, taking medicine would lead to immediate death; how can one not be cautious? The formula uses Ren Shen (Ginseng Radix et Rhizoma) 5 qian, Bai Zhu (Atractylodis Macrocephalae Rhizoma) 5 qian, Shu Di Huang (Rehmanniae Radix Praeparata) 1 liang, Dang Gui (Angelicae Sinensis Radix) 2 liang, Chuan Xiong (Ligustici Chuanxiong Rhizoma) 1 liang, and Jing Jie Mo (Schizonepetae Spica) stir-fried until black 2 qian. This formula serves as the main prescription: if wind pathogen is present, add Chai Hu (Bupleuri Radix) 6 fen; if cold pathogen enters, add Fu Zi (Aconiti Lateralis Radix Praeparata) 1 qian and Rou Gui (Cinnamomi Cortex) 1 qian. For other various symptoms, do not arbitrarily add herbs. Taking this formula yields miraculous effects without exception. One may reduce dosages appropriately but must not remove or substitute ingredients. Since a parturient woman has lost a vast amount of blood, her skin pores and interstices are as thin as paper; pathogens enter easily but also exit easily. Therefore, within a large-dose formula for tonifying Zheng Qi (Upright Qi), slightly adding dispelling-pathogen herbs with mild flavors allows pathogens to exit from the body shell. How can one treat them like healthy individuals, worrying that pathogens are hard to scatter and thus heavily using formulas to purge pathogens? The brilliance of this formula lies in its pure use of Qi- and Blood-tonifying substances, completely disregarding pathogens, focusing entirely on assisting Zheng Qi. Once Zheng Qi is abundant, pathogens naturally retreat. Moreover, the Jing Jie (Schizonepetae Spica) in the formula is a wonderful agent; it not only guides Qi and Blood back into the meridians but also guides pathogens out through the skin and hair. This is why the formula is so wondrous and divine. Only in cases of Er Zhen Tong (postpartum abdominal pain caused by retained lochia), where pressing reduces pain, one may add Shan Zha (Crataegi Fructus) 10 grains and Tao Ren (Persicae Semen) 5 pieces. Remove these two after one dose; other herbs must never be lightly added. Question: Can Shu Di Huang (Rehmanniae Radix Praeparata) be taken within three days postpartum? Answer: Why could it not be taken?

Master Zhang said: This postpartum formula is exquisitely determined; there is nothing more to transmit.

Master Hua said: This differs from my view, yet I transmit it together. For various postpartum symptoms, the principle is tonifying Qi and Blood. The formula uses Ren Shen (Ginseng Radix et Rhizoma) 3 qian, Dang Gui (Angelicae Sinensis Radix) 1 liang, Chuan Xiong (Ligustici Chuanxiong Rhizoma) 5 qian, Jing Jie (Schizonepetae Spica) stir-fried until black 1 qian, Yi Mu Cao (Leonuri Herba) 1 qian, decocted in water and taken orally. (Commentary: Qi and Blood Dual-Tonifying Decoction.) If wind is present, add Chai Hu (Bupleuri Radix) 5 fen; if cold is present, add Rou Gui (Cinnamomi Cortex) 1 qian; if lochia is not cleared, add Shan Zha (Crataegi Fructus) 10 grains; for blood syncope, add stir-fried black ginger slices 5 fen; for epistaxis, add Mai Dong (Ophiopogonis Tuber) 2 qian; for night fever, add Di Gu Pi (Lycii Cortex) 5 fen; if there is food stagnation, add Shan Zha (Crataegi Fructus) 5 grains and Gu Ya (Hordei Fructus Germinatus) 1 qian; if there is phlegm, add a small amount of Bai Jie Zi (Sinapis Semen) 5 fen. The rest must absolutely not be lightly added. This formula purely tonifies Qi and Blood without treating the exterior, which is its brilliance. I have personally treated postpartum cases with miraculous efficacy. I wonder why the Heavenly Master did not transmit this formula but instead transmitted another to Yuan Gong. Perhaps because his Qi count was thin, and this formula still lacked strength? Nevertheless, it can be transmitted for millennia.

Appendage: Taichan Jindan (Golden Pill for Fetal and Obstetric Conditions). Treats various postpartum symptoms. For any postpartum condition, dissolve one pill in good wine and child's urine; various diseases will not arise. For postpartum wind exposure, dissolve one pill in Fang Feng Tang (Saposhnikoviae Root Decoction). For Er Zhen Tong (postpartum abdominal pain due to retained lochia), dissolve one pill in Shan Zha (Crataegi Fructus) and brown sugar soup. For deficiency and timidity, take one pill daily with Chuan Xiong Dang Gui Tang (Ligustici Chuanxiong and Angelicae Sinensis Decoction); recovery occurs in ten days. For infertility, take one pill with Chuan Xiong Dang Gui Tang (Ligustici Chuanxiong and Angelicae Sinensis Decoction) after menstruation, leading to conception. For the above symptoms, follow the formula for administration; it protects life and body, restores life from death, and its merits cannot be fully described.

Huisheng Dan (Pill for Restoring Life). Treats various postpartum symptoms. Within three days postpartum, when Qi and Blood are unsettled, blood returns to the Five Zang organs, rushing into the Liver, causing blood syncope, restlessness, and visualizing black spots; dissolve in boiling water to cure. Or seven days postpartum, when Qi and Blood are unsettled, food and blood knot in the chest, causing dry mouth, chest oppression, irritability, and thirst; swallow with hot water. Or postpartum emaciation, where blood enters Heart and Lung, heat enters Spleen and Stomach, presenting alternating chills and fever resembling malaria but not malaria; swallow with hot water. Or postpartum stagnant blood flowing to the Five Zang, filling the four limbs, stagnating and transforming into edema, with thirst and cold sensation in limbs—this is blood edema, not water edema; taking this cures it. Or postpartum stagnant blood reaching extreme heat, causing central irritability and delirious speech, not wind pathogen; swallow with boiling water. Or postpartum stagnant blood entering the heart orifice, causing aphonia due to blockage; decoct Gan Ju Hua (Chrysanthemi Flos) 3 fen and Jie Geng (Platycodonis Radix) 2 fen in water to dissolve the pill. Or within a month postpartum, mistakenly consuming sour, cold, and hard foods that clash with blood, flowing into Large Intestine, failing to digest, causing dysentery with pus and blood; dissolve in Shan Zha (Crataegi Fructus) decoction. Or during delivery, when joints open, blood enters meridians, stagnating for a long time causing distension and soreness—not dampness; dissolve in Su Geng (Perillae Caulis) decoction. Or mid-postpartum, irregular diet combined with anger, causing residual blood to flow into Small Intestine, blocking water passages, resulting in difficult urination and hematuria resembling chicken liver; dissolve in Mu Tong (Akebiae Caulis) decoction. Or again flowing into Large Intestine, blocking anus, causing difficult defecation with clots resembling chicken liver; dissolve in Guang Pi (Citri Reticulatae Pericarpium) decoction. Or when lochia is not cleared, diet冷热 (hot and cold) unharmonized, causing metrorrhagia resembling liver color, dampness, irritability, and stiffness in back and shoulders; dissolve in Bai Zhu (Atractylodis Macrocephalae Rhizoma) 3 fen and Guang Pi (Citri Reticulatae Pericarpium) 2 fen decoction. Or postpartum blood stagnating in Spleen and Stomach, causing distension and vomiting—not Fan Wei (regurgitation); dissolve in Chen Pi (Citri Reticulatae Pericarpium) decoction. Or postpartum stagnant blood entering Five Zang and Six Fu, spreading to skin and limbs, causing yellow complexion, dry mouth, epistaxis, and widespread macules—a critical condition; dissolve in aged wine. Or postpartum difficult urination, constipation, alternating chills and fever, appearing drunk or foolish; dissolve in boiling water. All above symptoms are caused by postpartum stagnant blood. Thus, this pill has unique merit. For all strange postpartum symptoms unrecognized by doctors and unprecedented by people, taking this pill brings immediate peace. If one pill fails, two or three pills will surely work; handle with utmost caution and respect.