产后最宜将护。一曰倚坐。上床以被褥靠之。暑月以橙靠之。不可遽然睡倒。须至十日后。方
可平睡。常以手从心摩至脐下。俾瘀露下行。二曰择食。初生后宜专食粥。半月后方可食打
开鸡蛋。盈月后可食羊肉、猪蹄等物。三曰避风。养神。少言语。大忌梳头濯足。恐招风湿。四曰
服药。初产毕。即用生化汤或归姜汤。以驱瘀血。自然安吉。其有变生他症者。随症治之。
产后血晕者。瘀血上攻。胸腹胀痛拒按。宜归芎汤下失笑丸。若去血过多。心慌自汗。用归姜饮加人参。
甚则加熟附子。
产后不语者。由心肾不交。气血虚弱所致。七珍散、归脾汤并主之。若虚火上炎。六味地黄丸。
产后发热者。若无风寒表邪之象。则血虚也。四物汤加黑姜补之。或加童便为引更效。如有脾虚伤食。
用异功散加神曲、麦芽。大凡风寒发热。昼夜不退。若血虚与伤食发热。则晡热晨退。然伤食更必吞酸
嗳腐满闷。以此为别。更有气血大虚。阴躁作渴者。乃阳随阴散之危候。十全大补汤救之。
狂言如见鬼神者。有败血上冲。胸腹胀痛。宜泽兰汤并失笑丸。若血虚神不守舍。则心慌自
汗。宜安神定志丸加人参、归、芎治之。归脾汤亦得。
心神惊悸者。心血空虚也。七福饮、秘旨安神丸之类。
汗多变痉者。阳气大虚也。十全大补汤主之。
产后身痛。若遍身手按更痛者。瘀血凝滞也。四物汤加黑姜、桃仁、红花、泽兰化之。若身
痛喜按者。血虚也。四物汤加黑姜、参、术补之。若兼风寒。必头痛鼻塞恶寒。宜古拜散加当归、
川芎、秦艽、黑姜散之。
产后腰痛。若上连脊背。下连腿膝者。风也。独活寄生汤主之。若专腰痛者。虚也。八珍汤
加杜仲、续断、肉桂。若恶露不尽。痛如锥剌者。速用桃仁汤化之。免作痈肿。
产后心腹诸痛。受风寒者。口鼻气冷。停食者。吞酸嗳腐。俱用二香散。惟瘀血作痛。若刀锥之刺。失笑丸
主之。其中气虚寒。腹中冷痛。得热则止者。理中汤加桂心。若小腹痛处有块。不可手按者。此名
儿枕痛。瘀滞也。失笑丸主之。
恶露不绝者。因肝气不和。用逍遥散。因脾不统血。用归脾汤。若因瘀滞而新血不得归经。
必腹痛拒按。归芎汤下失笑丸。
蓐劳者。寒热食少头胀肢痛。最难调治。八珍汤养之。
喘促者。荣血暴竭。卫气无根据。最为难治。六味地黄汤加人参。若脾肺两虚。四君子汤加黑姜、
当归。若瘀血入肺。口鼻起黑气及鼻衄者。此肺胃将绝之候。急服参苏饮。如厥冷自汗。更加附
子。间有得生者。
产后乳少。由元气虚弱。八珍汤主之。若乳房 胀。是未通也。速宜吮通。服王不留行汤。若
为儿口吹气。壅肿不通。不急治即成乳痈。速服栝蒌乳香散。敷香附饼。若儿饮不尽。留乳作肿
者。亦如前法。亦有郁怒而乳肿者。于栝蒌乳香散内加柴胡、赤芍、橘叶、甘草。
乳痈初起。由胆胃热毒。服栝蒌乳香散。敷香附饼即消。如已成脓。则以神仙太乙膏贴之。
吸尽脓则愈矣。
乳岩初起。内结小核。不赤不痛。渐大而溃。形如熟榴。内溃深洞。此脾肺郁结。气血亏损。
最为难治。初起用加味逍遥散、加味归脾汤。二方间服。亦可内消。及其病势既成。虽有卢扁。
亦难为力。
乳卸者。乳头拖下一二尺。此肝经风热发泄。用小柴胡汤加羌防主之。蓖麻子四十九粒。麝香
一分。研涂顶心。俟乳头收上。即洗去。
Postpartum care is of utmost importance. The first aspect is posture: when getting into bed, use quilts or cushions to prop up the body; in summer months, an orange wood backrest may be used. One must not lie down flat immediately; it is necessary to wait until after ten days before lying supine. Regularly massage from the heart region down to below the umbilicus with the hand, to facilitate the downward discharge of lochia (postpartum vaginal discharge). The second aspect is diet: immediately after childbirth, one should consume only congee (rice porridge); after half a month, beaten eggs may be eaten; after one full month, nourishing foods such as mutton and pig's trotters may be consumed. The third aspect is daily life: avoid wind, nurture the spirit, and speak little. Combing hair and washing feet are strictly prohibited, lest wind-dampness pathogens be attracted. The fourth aspect is medication: immediately after delivery, Shenghua Tang (Decoction for Generating New Blood) or Guijiang Tang (Decoction of Angelica and Ginger) should be taken to expel blood stasis, ensuring natural peace and safety. If other complications arise, treat according to the specific syndrome.
Postpartum syncope due to blood loss is caused by blood stasis attacking upward, manifesting as distension and pain in the chest and abdomen that refuses pressure. It is suitable to administer Shixiao Wan (Pills for Pain Relief) with Guiqiong Tang (Decoction of Angelica and Ligusticum). If excessive blood loss leads to palpitations and spontaneous sweating, Guijiang Yin (Infusion of Angelica and Ginger) with Ginseng is used; in severe cases, Prepared Aconite Root (Shu Fuzi) is added.
Postpartum aphasia is caused by the failure of communication between the Heart and Kidney, and deficiency of Qi and Blood. Zhizhen San (Powder of Seven Treasures) and Guipi Tang (Decoction for Replenishing the Spleen) are both indicated. If deficient fire flares upward, Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) is used.
Postpartum fever: if there are no signs of exterior pathogenic wind-cold, it is due to Blood deficiency. Siwu Tang (Four-Substance Decoction) with Heijiang (Charred Ginger) is used to tonify; adding child's urine as a guiding drug may enhance efficacy. If there is Spleen deficiency with food stagnation, Yigong San (Powder for Extra Assistance) with Shenqu (Medicated Leaven) and Maiya (Sprouted Barley) is used. Generally, wind-cold fever persists day and night without abatement. In contrast, fever due to Blood deficiency or food stagnation occurs in the late afternoon and subsides in the morning. However, food stagnation is distinguished by symptoms of acid regurgitation, belching of rotten food, and fullness. Furthermore, severe deficiency of Qi and Blood leading to yin restlessness and thirst is a critical sign of Yang dissipating with Yin; Shiquan Dabu Tang (Decoction for Tenfold Great Tonification) is used for rescue.
Delirium resembling seeing ghosts and spirits is caused by foul blood rushing upward, with distension and pain in the chest and abdomen. Zelan Tang (Decoction of Langsdorffia Root) combined with Shixiao Wan is indicated. If the spirit fails to reside due to Blood deficiency, causing palpitations and spontaneous sweating, Anshen Dingzhi Wan (Pills for Calming the Spirit and Stabilizing Will) with Ginseng, Danggui (Angelica Sinensis), and Chuanxiong (Ligusticum) is used; Guipi Tang is also effective.
Palpitations and fright indicate emptiness of Heart Blood. Qifu Yin (Infusion of Seven Blessings) or Mizhi Anshen Wan (Pills for Calming the Spirit according to Secret Principles) are appropriate.
Excessive sweating leading to tetany indicates severe deficiency of Yang Qi. Shiquan Dabu Tang is the primary treatment.
Postpartum body pain: if pain is widespread and worsens upon pressure, it is due to coagulation and stagnation of blood stasis. Siwu Tang with Heijiang, Taoren (Peach Kernel), Honghua (Safflower), and Zelan is used to resolve stasis. If body pain prefers pressure, it is due to Blood deficiency. Siwu Tang with Heijiang, Renshen (Ginseng), and Baizhu (Atractylodes Macrocephala) is used to tonify. If complicated by wind-cold, accompanied by headache, nasal congestion, and aversion to cold, Guyai San (Ancient拜 Powder) with Danggui, Chuanxiong, Qinjiao (Gentiana Macrophylla), and Heijiang is used to disperse.
Postpartum lower back pain: if pain extends upwards to the spine and downwards to the legs and knees, it is due to wind. Duhuo Jisheng Tang (Decoction for Expelling Wind and Nourishing the Liver and Kidneys) is indicated. If the pain is localized solely to the waist, it is due to deficiency. Bazhen Tang (Eight-Treasure Decoction) with Duzhong (Eucommia Bark), Xuduan (Dipsacus Root), and Rougui (Cinnamon Bark) is used. If lochia does not cease and pain feels like needle pricking, Taoren Tang (Decoction of Peach Kernel) should be used urgently to resolve stasis, preventing the formation of abscesses.
Various pains in the heart and abdomen postpartum: those caused by wind-cold present with cold breath from mouth and nose; those caused by food stagnation present with acid regurgitation and belching of rotten food. Both are treated with Erxiang San (Two-Fragrance Powder). Only pain due to blood stasis, feeling like knife or needle pricks, is treated with Shixiao Wan. For middle-jiao Qi deficiency and cold, presenting as cold abdominal pain relieved by warmth, Lizhong Tang (Decoction for Regulating the Middle) with Guixin (Cinnamon Wood) is used. If there is a mass in the lower abdomen that cannot be pressed, this is named "Eryao Tong" (Baby Pillow Pain), caused by stagnation, and treated with Shixiao Wan.
Continuous lochia discharge: if due to disharmony of Liver Qi, Xiaoyao San (Free and Easy Wanderer Powder) is used. If due to Spleen failing to control blood, Guipi Tang is used. If due to stasis preventing new blood from returning to its vessels, accompanied by abdominal pain refusing pressure, Guiqiong Tang with Shixiao Wan is administered.
Chastity labor (Rulao) presents with alternating chills and fever, poor appetite, head distension, and limb pain; it is difficult to treat. Bazhen Tang is used for nourishment.
Panting and shortness of breath: due to sudden depletion of Ying (Nutritive) Blood and lack of foundation for Wei (Defensive) Qi, this is the most difficult to treat. Liuwei Dihuang Tang with Ginseng is used. If both Spleen and Lung are deficient, Sijunzi Tang (Four-Gentlemen Decoction) with Heijiang and Danggui is used. If blood stasis enters the Lung, presenting with black qi around the mouth and nose and epistaxis, this is a sign of impending failure of Lung and Stomach; Shenqi Yin (Infusion of Ginseng and Perilla) should be taken urgently. If cold extremities and spontaneous sweating occur, Fuzi (Aconite) is added; survival is occasionally possible.
Scanty lactation postpartum is due to weakness of Yuan (Original) Qi, treated with Bazhen Tang. If breasts are distended and painful, milk ducts are blocked; suckling should be performed urgently to clear them, and Wangbuliuxing Tang (Decoction of Myrrh Flower Seed) is taken. If blockage and swelling are caused by infant's breath blowing into the ducts, urgent treatment is required to prevent mastitis; Gualou Rushen San (Powder of Trichosanthes and Myrrh) is taken, and Xiangfu Bing (Cyperus Cake) is applied externally. If retained milk causes swelling because the infant did not finish feeding, the same method is used. Swelling due to depression and anger is treated by adding Chaihu (Bupleurum), Chishao (Red Peony Root), Juye (Tangerine Leaf), and Gancao (Licorice) to Gualou Rushen San.
Early-stage mastitis is caused by heat-toxin in the Gallbladder and Stomach. Taking Gualou Rushen San and applying Xiangfu Bing will cause resolution. If pus has formed, apply Shenyen Taiyi Gao (Divine Immortal Taiyi Plaster); once the pus is fully drained, recovery occurs.
Breast cancer (Luyan) initially presents as small internal nodules, non-red and non-painful, gradually enlarging and ulcerating, resembling a ripe pomegranate with deep internal cavities. This is due to constraint of Spleen and Lung and deficiency of Qi and Blood, making it very difficult to treat. Initially, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) and Jiawei Guipi Tang (Modified Replenishing Spleen Decoction) are taken alternately, which may lead to internal resolution. Once the disease progresses, even physicians like Lu Yi and Bian Que would find it difficult to help.
Nipple inversion/prolapse (Ruxie) involves the nipple dragging down one or two chi. This is due to wind-heat exuding from the Liver Meridian. Xiao Chaihu Tang (Minor Bupleurum Decoction) with Qianghuo (Notopterygium) and Fangfeng (Saposhnikovia) is used. Forty-nine seeds of Castor Bean (Bimazi) and one fen of Musk (Shexiang) are ground and applied to the top of the head; once the nipple retracts, it is washed off.