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Postpartum hematochezia (bleeding from the rectum) is caused by blood deficiency and intestinal heat. It is appropriate to use Siwu Tang (Four Substances Decoction) [see formula in the "Constipation" section above] with one qian of Huanglian (Coptidis Rhizoma).
Decoct in water and take orally.
If metrorrhagia (profuse uterine bleeding) persists, it is termed a severe injury. It is appropriate to use Buxue Yangxue Tang (Qi-Nourishing and Blood-Supplementing Decoction).

Buxue Yangxue Tang (Qi-Nourishing and Blood-Supplementing Decoction)
Renshen (Ginseng Radix et Rhizoma), Huangqin (Scutellariae Radix) [honey-fried], Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma) [honey-fried], Baishao (Paeoniae Radix Alba) [wine-fried], Aye (Colla Corii Asini), Chuanxiong (Ligustici Chuanxiong Rhizoma), Qingpi (Citri Reticulatae Pericarpium Viride), Xiangfu (Cyperi Rhizoma) [stir-fried], Sharen (Amomi Fructus), Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata) [each one qian].
Decoct in water and take orally.

This pill possesses the merit of reversing heaven and creating life; its application is extensive, yet its transmission is rare (worldwide circulated formulas such as Hainan Yiyi and Yangcheng Wuji Wan also primarily use aged ink, but they differ from this formula). Only Mr. Xu Lingtai briefly mentioned its outline in *Huixi Yi'an* (Cases of Huixi Clinic) [under the item "Blood Stasis Rushing Upward, Syncope Not Recovering"], stating that Heishen Wan (Black Spirit Pill) uses aged ink as the principal herb, assisted by herbs that resolve stasis and calm the heart and spirit. It is an essential formula for calming the spirit and stabilizing the soul after childbirth, removing stasis and generating new blood, yet the original formula was not disclosed. Now, having fortunately obtained the complete formula from Zhu Minggao's *Qiebing Jinang* (Silk Bag for Dispelling Illness), I urgently record and publish it to spread it widely. This medicine has been preserved by my family for generations; perhaps it may never be used, but if sought in an emergency, it cannot be obtained suddenly. Those with families should prepare it in advance according to the formula to benefit themselves and save others, ascending together to benevolence and longevity. This is indeed a contribution to the preservation of life! I hereby list the main formula and the guiding medicines for treating various syndromes below.

Chenmo (Aged Ink Stick) one stick (Must seek selected soot from the top, aged over a hundred years with fully detached gum properties. Wait for rainy days, catch rainwater in a clean porcelain vessel held in the air; this is called rootless water to wash the inkstone. Men should grind it into thick juice by hand, pour it into a clean fine large porcelain dish, dry it in the sun, scrape it down, and grind it finely for use. Each batch requires about four qian of pure ink powder. Ink juice spoils easily; do not add too much water, especially during prolonged rains and summer months. Do not use during damp/moldy rainy seasons).

Baicaoshuang (Soot from Hundred Herbs) two qian (Older is better. Must obtain soot collected from households near mountains or coasts burning various wild grasses. Before collecting soot, sweep away the fire first. Sweep down the accumulated soot on doors daily, sieve it clean, and grind it finely for use. Soot from burning cow dung is best. Do not use soot from burning single types of firewood, and do not mistake it for pot black).

Tianma (Gastrodiae Rhizoma) two qian (Use transparent slices. Soak in water, grind finely for use).

Huai Xiaomianfen (Flour of Huai Wheat) two qian (Available where wheat flowers are just blooming, thirty miles west of Huai'an Prefecture city. Sieve clean. Use half for the medicine, the other half to make paste for pills).

Zhuchi Da Jinbo (Pure Gold Leaf) fifty leaves (Grind forty leaves into the medicine; reserve the rest to coat the pills after formation). The above drugs should each be ground extremely finely, weighed accurately, then mixed and ground uniformly. Use Huai wheat flour paste to form pills (the boiling water for making paste must cool completely). Coat with gold leaf, dry until very hard, size like a Chinese quince seed. Each pill weighs approximately one fen. Seal externally with a wax shell for protection. Choose auspicious days such as Tianyi or Tianyuede for fasting and purification. Prepare in a strict, clean room, burn incense, and recite the Postpartum Protection Divine Mantra and other scriptures with devout repentance to the Dipper; this yields particularly miraculous results. Avoid contact with people with missing limbs, women in mourning clothes, all meat/fish/unclean items, and chickens/dogs. (Medicine makers must warn servants in advance, constrain all personnel, ensure all utensils are clean. When using this pill for inducing labor, avoid contact with individuals with "yin hands").

After recovery from taking the medicine, one should perform good deeds according to one's ability to thank the spirits. For the guiding medicines listed later, if urgent cases arise and purchase is impossible, use urine from a healthy child (Tongbian) or plain boiled water to dissolve and administer. For mild syndromes, take one pill; for severe syndromes, take two or three pills (peel off the wax shell before use). All post-abortal syndromes are treated similarly to postpartum syndromes.

For transverse or breech presentation and all difficult labors, dissolve in yellow wine or urine from a healthy child and administer.
If extreme heat in the maternal organs steams and causes fetal death in the uterus, causing the fetus to descend below the umbilicus, symptoms include cyanotic/black nails, red face, and blue tongue (this is evidence of fetal death), cold limbs, foaming at the mouth. Urgently use one cup of urine from a healthy child, or dissolve in yellow wine and administer. (If continuing treatment, adding Dongkuizi (Malvae Semen) one liang and Huainiu Xi (Cyathulae Radix) three qian, decocted in water, is even better. If one dose is ineffective, it can be taken again or up to three times).

For retained placenta, use yellow wine or urine from a healthy child to dissolve and administer one pill. If it still does not pass, mix several fen of Baicaoshuang (Soot from Hundred Herbs) with cool boiled water, then administer another pill to expel it.

Sudden spasms of the four limbs, locked jaw, and shaking head after childbirth (commonly known as postpartum convulsions, caused by excessive blood loss leading to internal stirring of liver wind). Use Gouteng (Uncariae Ramulus cum Uncis) [add later], Jingjie (Schizonepetae Herba) each five fen, Danpi (Moutan Cortex) one qian, Shouwuteng (Polygoni Multiflori Caulis) two qian. Decoct in water, add urine from a healthy child, dissolve the pills, and administer. (Avoid fishy smells. Convulsions can also be caused by external pathogens; if there were chills and fever several days prior, seek different treatment methods, do not err).

Sudden syncope, unconsciousness, manic laughter/crying, and strange mental confusion within seven days after childbirth. (These syndromes all belong to foul blood rushing to the heart, representing an extremely dangerous and severe condition). Urgently dissolve in urine from a healthy child, take two pills first. Then decoct Zhenming Hupo (Clear Amber) five fen (ground to powder) first, add Sheng Puhuang (Typhae Pollen), Wulingzhi (Trogopterori Faeces), Guang Yujin (Curcumae Radix) each eight fen. Decoct in water, add one cup of urine from a healthy child, dissolve one pill, and administer. (If chills and fever appeared gradually several days prior, rather than sudden syncope/manic behavior, it is an external pathogen syndrome; seek different treatment. For all postpartum foul blood rushing upward syndromes, it is suitable to quickly place a large basin of rice vinegar near the mother's head, quench hot charcoal in it, allowing the vinegar vapor to enter the nose and mouth. This method is very stable and wonderful; it can be used even if there is an external pathogen).

Abdominal distension and hypochondriac pain, coughing and wheezing, sweating like oil after childbirth. This is foul blood counter-rushing to the heart and lungs. Urgently use Tongcao (Tetrapanacis Medulla) five fen, Zhen Honghua (Carthami Flos) and Sangbaipi (Morus Cortex) each one qian. Decoct in water, add three spoons of rice vinegar, dissolve and administer. (Adding Xuanfuhua (Inulae Flos) one qian 5 fen, wrapped in linen cloth for decoction, is even better).

Postpartum throat swelling and wheezing, urgent sound like a cat, or chattering teeth due to cold shivers (also foul blood rushing to the heart and lungs). Urgently use Sangbaipi (Morus Cortex) one qian, decoct in water, dissolve and administer. (Sangbaipi may be weak in potency; adding Taoren (Persicae Semen) and Xingren (Armeniacae Semen) each one qian as guiding agents is even better).

Postpartum blood syncope with dim vision or blindness, or chattering teeth due to cold shivers, caused by foul blood flowing into the five zang organs and accumulating in the liver. Urgently use Honghua (Carthami Flos) eight fen, decoct in water, add one cup of urine from a healthy child, dissolve and administer.

Postpartum blackening of the nose and epistaxis, with scattered qi and blood and deficient heat in all meridians. Urgently use Sangbaipi (Morus Cortex) one qian, decoct in water, dissolve and administer. (Adding Digupi (Lycii Cortex) and Maocaogen (Imperatae Rhizoma) each two qian is even better).

Postpartum inability to speak and paralysis of limbs, caused by open pores allowing wind-cold invasion, or by foul blood rushing to the heart. Use Doulun Jiu (Bean-Dripping Wine) to dissolve and administer. (Note: Doulun Jiu is made by stir-frying one he of black soybeans [Wumao Dou] until hot, soaking in boiling wine for a moment, removing the beans, and using only the wine).

Postpartum masses appearing all over the body, caused by forcing oneself out of bed within three to four days, injuring the birth canal, or anger rushing and injuring the five zang organs. If initially presenting with gritty eyes and locked jaw, use Doulun Jiu (Bean-Dripping Wine) to dissolve and administer.

Postpartum inability to rise or lie down after three to four days, blurred vision, dry mouth, mental confusion and unconsciousness. Use Bohe (Menthae Haplocalycis Herba) [a small amount], decoct in water, add urine from a healthy child, dissolve and administer. Or, if qi and blood are unsettled, and excessive consumption of hot foods causes chest oppression, dry mouth, fever, and fullness, use Honghua (Carthami Flos) two or three fen, decoct in water, dissolve and administer.

Postpartum lower back pain and limb pain, caused by the opening of all vessels, with foul blood circulating with qi and scattering into the four limbs. If initially experiencing abdominal heat and waist cold upon onset, use iron scale weight charcoal, heated red and quenched in hot wine, to dissolve the medicine and administer while warm.

Postpartum wind-stroke, open mouth (or closed mouth),急促 breathing, hemiplegia, headache, chills, and fever. All should be administered by dissolving in urine from a healthy child. (This item is similar to the "inability to speak and limb paralysis" item above. Because there is急促 breathing, Doulun Jiu is not used because it is disliked for its ascending nature).

Postpartum metrorrhagia, headache, dry mouth, and mental panic. Use Haipiaoxiao (Sepiae Endoconcha) one qian stir-fried with vinegar, Ziwei Hua (Bignoniae Flos) five fen. Decoct in water, dissolve and administer. Or, if lochia forms clots with much stasis, change to Zhen Honghua (Carthami Flos) five fen, decoct in water, dissolve and administer. If metrorrhagia has slowed but headache, dry mouth, and mental confusion persist, change to one raw egg yolk (Jizi Huang), decoct in clear soup, dissolve and administer. (The egg yolk should be decocted whole so the juice is clear and not viscous).

Postpartum unbearable abdominal pain, relieved by pressure. Use equal parts wine and water to decoct, use Jiuchao Baishao (Paeoniae Radix Alba Prepared with Wine) one qian, dissolve and administer. If pain worsens with pressure, change to Yuanhusuo (Corydalis Rhizoma) one qian, decoct in equal parts wine and water, dissolve and administer. (Reduce wine if the patient does not drink; use water decoction if the patient has chronic liver qi stagnation). If pain is accompanied by masses, refer to the following two items.

Postpartum masses forming in the abdomen with intermittent pain, constantly gathering and not dispersing, caused by early sexual intercourse, eating hard foods, or lying on cold surfaces. Use Danggui (Angelicae Sinensis Radix) one qian, decoct in wine, dissolve and administer. It is also advisable to continuously take Fuke Huisheng Zhibao Dan (Gynecological Life-Returning Precious Pill) [available in major pharmacies in Hangzhou]. If masses appear only when painful and disperse when pain stops (belonging to qi level), change to Qingpi (Citri Reticulatae Pericarpium Viride) five fen, Chuanshan Lianzi (Toosendan Fructus) one qian, decoct in water, dissolve and administer (do not use wine-decocted Danggui).

Postpartum abdominal mass pain within several days (commonly known as "child pillow pain"), due to obstructed lochia or scanty flow. Use Shanzhutan (Crataegi Fructus Carbonized) one qian stir-fried until dark black, Sha Tang (Saccharum) four qian. Decoct in water, add half a cup of urine from a healthy child, dissolve and administer. (Refer to the previous two items for comparison).

Postpartum heart pain due to excessive consumption of cold foods. Use Huixiang (Foeniculi Fructus) and Zhen Honghua (Carthami Flos) each five fen. Decoct in water, dissolve and administer.

Postpartum yellow edema, headache, and heavy limbs, caused by consuming cold foods which agitate foul blood, transmitting to the spleen and stomach, changing into swelling. Patients present with dry mouth and fatigue. Use Jingjie (Schizonepetae Herba), Huaijiao (Staphyleae Fructus), Jizhen (Zanthoxyli Spina), and Zhen Honghua (Carthami Flos) each three fen. Decoct in wine, dissolve and administer. (Avoid fishy smells). The above syndromes treated by this pill have been tested repeatedly with miraculous efficacy. The only difference lies in the guiding medicines. At the time of administration, one must strictly match the syndrome according to this text, investigate carefully and accurately, and not be careless. This is crucial.