（附∶初产十要 产后狂言 夜卧不安 产后不语 恶露下少）
丹溪云∶产后如有杂证相仍，以末治之，惟以大补气血为主。虽然先生一代之良师，一言之
下，后人亦当圆融。若恶露去尽，腹中不疼，手按脐至小腹，亦无梗碍，亦无风寒、头疼、发热
、伤食、胸满等证，惟是气血两虚，大补宜矣。如神气清爽，饮食可进，犹有腹中梗痛，败血未
尽，宜服行血之药，黑神散之类。如感风寒头疼骨痛，畏寒拘急，即当服散邪药，故必穿衣而起
。正气虚时，腿足微露，风寒易侵，古方用茯苓补心汤常不能速效，亦当伤寒冲和汤之类，取微
汗易愈。如伤饮食，胸膈胀闷 加山楂、麦芽、神曲之类。产后忌芍药，恐酸寒伐发生之气。如白
芍药酒炒，产后止腹痛之妙品；赤芍药加用，产后行败血之良药。可不用乎？
产妇坐靠床中。
一、人频覆脐腹，庶令恶露易下。大略一昼夜后 败血下尽，方才睡倒乃安。
二、房中伏侍宜老媪，曾有经历者。行步轻缓，语言低悄，百凡谨慎，细心安妥。忌少妇、幼婢，
轻举妄动，多言高声，致产妇动怒，变生不测。
三、床前置炭火炉，频烧干漆渣、破漆器，漆消败血，常令嗅其气味，不令恶血上逆。
四、宜备醋一碗，频令妇嗅，知醋味则无事，不知醋味，乃耳中闻如烹茶声，乃血运之候。
预以铁器烧炭内令红，仍置醋半壶，以韭菜一握，揉浸醋内。连作时，提起顶发，掐住人中，急
取赤铁投醋壶内，盖定口，令热气从壶嘴出，对鼻孔熏；取炭火醋沃熏面，肃静则神复而苏；若
惊慌叫哭，则不复矣。急灸关元（脐下三寸）、气海（脐下二寸。）
五、频与砂糖汤行恶血，兼与姜汤。天热与绿豆汤；心烦与白蜜调汤；腹中儿枕痛与山楂汤
。
六、预备清魂散治血运；益母返魂丹治百疾；保生锭镇心神；黑神散治胞衣不下。恶露不行
、腹痛及儿枕痛，用童便煮酒调下。
七、冬月床前多置火炉御寒，房中固密，勿有小隙入风。起身便溺，腿足勿露，虚时寒邪易
入，难治，多致危殆。
八、夏月床前勿置火炉，不可摇扇冒风，卧房楼上者尤热，多致血崩伤人，必当预移楼下，
床下多置水盆。
九、月内勿令洗浴，每见少妇欲净，因浴作劳，致病危笃。夏月七日后可浴。
十、产妇频与热粥汤，渐与薄粥，切戒腥酒。各方风俗，有产即食蛋二枚煮汤者，有食煮猪
血一碗者，多致伤食为病，皆不宜。尤不宜为产妇宰杀牲命及宴客，则母安子寿。
产后数日间，必探其血尽、腹软不痛为安。否此，即服行血药。多因失看，十数日忽然崩下不救。
次伤食冒寒，次恃健劳早。且产中成病，治亦难效，多成痼疾。更勿多饮酒，引败血流入遂道及
四肢关节，永久疼痛。古云∶产妇致患，微若秋毫，成病重如山岳。《地藏经》云∶杀生致母子
不安。俗云∶产亡者，受血湖地狱，此狱杀业重者受之。妇女预释其疑。
主方 （恶露下，少腹痛）当归尾 赤芍药 益母草 泽兰叶 玄胡索 焦姜 熟地黄
山楂（各一钱） 蒲黄（七分） 官桂（五分） 甘草（三分） 上加姜、枣煎成。用黑豆炒焦
，淋入好酒一杯，去豆用酒，并童便和服。
血不下加苏木、红花、丹皮、桃仁、香附、五灵脂、荆芥之类。败血去尽，腹不痛加补药。
血去多不止者，去归尾、玄胡、赤芍、蒲黄、官桂，加参、 、生地、阿胶、栀子（炒），乌
梅、荆芥（炒、）地榆，作血崩治。另以当归（五钱，）荆芥（炒，二钱），山楂（一两）煎服
，无他患。
黑神散 产后恶露不尽，胎死难产，胞衣不下，败血攻心，腹痛。
黑豆（半升，炒熟） 熟地黄 当归尾 肉桂（各二两） 干姜（炒焦，三两） 甘草（二
两） 赤芍药 蒲黄（生，二两）
为末，每服二钱。童便煮酒下，血尽止服。
益母丸 胎前产后百疾皆治。
益母草（端午日采取叶，阴干，八两，捣末） 蜜丸弹大，每服三丸，临产白汤、童便、酒
化下。加四物汤各二两尤效。捣绞汁炼膏服更佳。
乌玄汤 治恶露不下，腹痛，乍寒乍热，不时作运。
何首乌（二两） 玄胡索（一两） 荆芥（五钱）
上煎汁二碗，重滚热，用橘红（一两，）置碗中，热汁泡入，盖少时去橘红，取汁服，血行
痛止。
清魂散 产后血运昏迷。去瘀血，生新血。
川芎（二钱） 泽兰叶 荆芥（各四钱） 人参（一钱） 甘草（八分） 共为末，每二钱酒下。
夺命丸 血寒凝滞，胞衣不下。
丹皮（八钱） 当归尾 黑附子 干漆（炒，各五钱）
上为末，用大黄（为末，八钱），醋煮成膏，加鸡子白捣匀，和丸桐子大，酒吞五十丸即下。
归膝汤 治胞衣不下，服此即下。
归尾（二钱） 牛膝 木通 滑石（各五钱） 冬葵子（研，三钱半） 水煎服。
八味理中汤 产后气血俱虚，汗出，呕吐。
白术（一两） 炙甘草（七钱） 人参 茯苓 干姜（炒） 滑石 麦芽 神曲（各五钱）
为末，米糊丸桐子大，每五十丸，食前姜汤下。
返元汤 恶露上逆，神昏不省，二便不通，脉洪。
当归（五钱） 川芎（三钱） 五灵脂 桃仁（各钱半） 大黄（二钱） 芍药（一钱）
肉桂（六分） 人参（五分） 上水煎，加童便，砂糖、酒服。
保生锭 产后镇养心神。更以山楂（一两、）当归（五钱、） 荆芥（炒，二钱，）水煎
服。
辰砂（上好，水飞） 当归 川芎（等分）为末，蜜和，印定金银，煎汤化下。
归竭丸 产后血积腹中成块，单用五灵脂为末，每服二钱，酒下亦效。
当归 血竭 蓬术（煨） 白芍（酒炒，二两） 五灵脂（四两）
上为末，醋糊丸如梧桐子大。每服六十丸空心酒送下。
神昏气促自汗∶人参（二钱） 核桃肉 麦门冬（各五钱）上水煎服。
元气脱，血上逆∶人参（五钱） 苏木（一两） 上童便煎服。
血运∶荆芥（炒，五钱） 童便煎服。气虚加当归、人参；血虚，川芎各二钱。
胞衣不下∶最宜产时妇自发嚼，一呕而下，稍迟，败血入胞矣。
砂仁（五钱，炒，研、） 当归尾（五钱，）水煎服。
血未尽，闷乱欲绝∶红花（一两）、酒二钟，乌梅汤二匙和服。
恶血未尽，腹痛∶当归、赤芍（各二钱、） 肉桂（一钱，） 姜三片，水煎服。
产后随处作痛∶当归、玄胡（为末、） 血竭、没药（另研、等分）。共末，每二钱酒下。
玉门不敛，阴户突出∶硫黄（二钱，） 菟丝子、吴茱萸、蛇床子（各一钱，）水煎洗。
简便方 子宫不合。
藿香、荆芥、臭椿根皮，煎汤熏洗。
难产数日不下，体俱冷∶椒橙叶煎汤一盆，小凳，令产妇坐盆中熏洗，良久腿腹热，气温血
行而产。
胞衣不下∶黑豆（一合，）炒熟入醋煮六、七沸、去豆，用醋三次，以热手摩妇小腹下。
又 取夫单衣盖井上。
又 泽兰叶浸酒中，铁锤烧热 饮。
产后百病血不下∶用血竭、没药为末，每二钱童便酒下。
血不止∶百草霜（二钱），童便、酒下，或桑白皮煎汤，入姜汁二匙饮。
一月血水不干∶竹纸、绵皮纸（各七张，烧灰，） 荆芥（一握，炒焦、） 半夏（五分，）
水、酒煎服。
子肠不收∶枳壳、诃子、五倍子、白矾，煎汤熏洗。或头顶心灸数壮，收。
(Attachment: Ten Essentials for First Birth, Postpartum Delirium, Restlessness at Night, Postpartum Aphasia, Scanty Lochia)
Zhu Danxi stated: If postpartum patients are accompanied by persistent miscellaneous syndromes, secondary treatments should be employed as adjuncts, with the primary focus being on greatly tonifying Qi and Blood. Although he was a distinguished master of his generation, later practitioners should interpret his words flexibly. If lochia has been completely discharged, the abdomen is painless, and palpation from the umbilicus to the lower abdomen reveals no obstruction, while there are no symptoms such as wind-cold, headache, fever, food stagnation, or chest fullness, but only Qi and Blood deficiency, then great tonification is appropriate. If the spirit is clear and appetite is present, yet abdominal distension and pain persist, indicating that retained blood (stasis) has not been fully expelled, blood-invigorating herbs such as Heishen San (Black Spirit Powder) should be administered. If wind-cold invasion causes headache, bone pain, aversion to cold, and stiffness, dispersing pathogenic factors is necessary; thus, one must dress warmly and move about. When Zhengqi (Upright Qi) is deficient, slight exposure of the legs and feet allows wind-cold to easily invade. Ancient formulas like Fuling Buxin Tang (Poria Heart-Tonifying Decoction) often fail to produce rapid effects; instead, formulas similar to Shanghan Chonghe Tang (Cold Damage Harmonizing Decoction) should be used to induce mild sweating for recovery. In cases of dietary injury causing chest and epigastric distension, add Hawthorn Fruit, Malt, and Medicated Leaven. Paeonia Root is contraindicated in the postpartum period due to its sour and cold nature, which may impair the body's generating Qi. However, if White Paeonia Root is stir-fried with wine, it becomes an excellent remedy for postpartum abdominal pain; Red Paeonia Root, when added, is a fine medicine for moving retained blood. Should these not be utilized?
The parturient should sit leaning against the bed.
1. People should frequently cover the umbilical and abdominal areas to facilitate the discharge of lochia. Generally, after one day and night, once the retained blood is fully expelled, lying down to sleep brings comfort.
2. Attendants in the room should be elderly women with childbirth experience. They should walk lightly, speak softly, exercise caution in all matters, and ensure careful and safe arrangements. Young women and young maidservants should be avoided, as their frivolous movements, excessive talking, and loud voices may anger the parturient, leading to unpredictable complications.
3. Place a charcoal stove near the bed and frequently burn dried lacquer residue or broken lacquerware. The dissolving effect of lacquer helps resolve retained blood. Allow the patient to frequently inhale the aroma to prevent the upward reversal of evil blood.
4. Prepare a bowl of vinegar and have the patient frequently sniff it. Awareness of the vinegar smell indicates safety; unawareness, accompanied by auditory hallucinations resembling boiling tea, signals impending syncope due to blood loss (Blood Yun). Preheat an iron tool until red-hot, place half a pot of vinegar inside, and soak a handful of Chinese chives in the vinegar. Repeat this process several times, lift the patient's scalp hair, press the Renzhong acupoint (GV26), and urgently throw the red-hot iron into the vinegar pot. Cover the mouth tightly so that hot steam exits through the spout and fumigates the nostrils. Alternatively, fumigate the face with hot vinegar and charcoal fire. Maintain silence to restore consciousness; panic and crying will hinder recovery. Urgently moxa Guanyuan (CV4, three cun below the umbilicus) and Qihai (CV6, two cun below the umbilicus).
5. Frequently administer sugar water to promote blood circulation and ginger water. In hot weather, provide mung bean soup; for irritability, provide white honey mixed with water; for "child pillow" pain (abdominal mass/pain), provide hawthorn soup.
6. Prepare Qinghun San (Clear Soul Powder) for blood syncope; Yimu Fanhun Dan (Motherwort Soul-Returning Pill) for various diseases; Baosheng Ding (Life-Preserving Tablet) to calm the mind; and Heishen San for retained placenta. For stagnant lochia, abdominal pain, and child pillow pain, mix with child's urine and boiled wine.
7. In winter, place multiple charcoal stoves near the bed for warmth. Keep the room tightly sealed to prevent drafts. When rising to urinate or defecate, do not expose the legs and feet. Cold pathogens easily invade during weakness, making treatment difficult and often leading to critical conditions.
8. In summer, do not place charcoal stoves near the bed. Avoid fanning oneself in the wind. Rooms on upper floors are particularly hot and prone to causing severe postpartum hemorrhage; therefore, relocate to the ground floor and place multiple basins of water under the bed.
9. Do not allow bathing within the first month. It is common for young women, seeking cleanliness, to become critically ill due to exertion during bathing. Bathing may resume after seven days in summer.
10. Frequently give the parturient hot rice gruel, gradually transitioning to thin gruel. Strictly avoid raw/cold foods and alcohol. Local customs vary: some consume two boiled eggs immediately after birth, others eat a bowl of boiled pig's blood. These practices often lead to food stagnation and illness and are inadvisable. It is especially inappropriate to slaughter animals or host banquets for the parturient, as this ensures the mother's peace and the child's longevity.
Within the first few days postpartum, verify that bleeding has ceased and the abdomen is soft and pain-free for safety. Otherwise, administer blood-invigorating medicines. Neglect often leads to sudden, uncontrollable hemorrhage after ten or more days. Other causes include food stagnation, cold invasion, and premature overexertion. Diseases contracted during labor are difficult to treat and often become chronic. Advise against excessive alcohol consumption, which can draw retained blood into the vagina and limb joints, causing permanent pain. As the ancients said: Postpartum ailments start small as autumn hairs but become heavy as mountains. The *Ksitigarbha Sutra* states: Killing living beings causes unrest in mother and child. Folklore says: Women who die in childbirth suffer in the Lake of Blood Hell, a punishment for heavy killing karma. Women should dispel these doubts in advance.
Main Formula (For lochia discharge and lower abdominal pain): Radix Angelicae Sinensis Tail (Danggui Wei), Radix Paeoniae Rubra (Chishaoyao), Herba Leonuri (Yimucacao), Folium Euphrasiae (Zelan Ye), Rhizoma Corydalis (Yanhusuo), Scorched Ginger (Jiaojiang), Prepared Rehmannia Root (Shudihuang), Fructus Crataegi (Shanzha) (each 1 qian), Spore Poria (Puhuang) (0.7 qian), Cinnamon Twig (Guangui) (0.5 qian), Licorice Root (Gancao) (0.3 qian). Add fresh ginger and jujube, decoct. Charred black soybeans are fried, good wine is poured over them, beans are removed, and the wine is mixed with child's urine for administration.
If blood does not descend, add Subtree Wood (Sumu), Safflower (Honghua), Tree Peony Bark (Danpi), Peach Kernel (Taoren), Cyperus Rhizome (Xiangfu), Trogopterus Dung (Wulingzhi), Schizonepeta Spike (Jingjie), etc. Once retained blood is cleared and abdominal pain ceases, add tonifying medicines.
If bleeding is excessive and uncontrolled, remove Danggui Wei, Yanhusuo, Chishaoyao, Puhuang, and Guangui. Add Ginseng, [missing character], Rehmannia Root (Shengdi), Donkey-hide Gelatin (Ejiao), Gardenia (Zhizi, scorched), Mume Fruit (Wumei), Schizonepeta (Jingjie, scorched), and Sanguisorba Root (Diyu). Treat as metrorrhagia. Additionally, decoct Angelica (5 qian), scorched Schizonepeta (2 qian), and Hawthorn (1 liang) and take orally without other complications.
Heishen San (Black Spirit Powder): For postpartum incomplete lochia, fetal death/dystocia, retained placenta, retained blood attacking the heart, and abdominal pain.
Black Soybean (Ban sheng, roasted), Prepared Rehmannia Root, Radix Angelicae Sinensis Tail, Cinnamon Bark (each 2 liang), Dried Ginger (scorched, 3 liang), Licorice Root (2 liang), Radix Paeoniae Rubra, Raw Spore Poria (2 liang).
Grind into powder. Take 2 qian per dose, washed down with child's urine and boiled wine. Stop when lochia is complete.
Yimu Wan (Motherwort Pill): Treats all diseases before and after childbirth.
Herba Leonuri (Leaves collected on Dragon Boat Festival, shade-dried, 8 liang, ground). Honey-pilled to size of a bullet. Take 3 pills per dose. Before delivery, dissolve in warm water, child's urine, and wine. Adding Siwu Tang (Four Substances Decoction) components (each 2 liang) enhances efficacy. Extracting juice and refining into paste is even better.
Wuxuan Tang (Wu-Xuan Decoction): For retained lochia, abdominal pain, alternating chills and fever, and intermittent dizziness.
Polygonum Multiflorum (He Shou Wu) (2 liang), Rhizoma Corydalis (Yanhusuo) (1 liang), Schizonepeta Spike (Jingjie) (5 qian).
Decoct to yield two bowls of liquid. Re-boil until hot. Place Exocarpium Citri Reticulatae (Juhong, 1 liang) in a bowl, pour hot liquid over it, cover briefly, remove Juhong, and drink the juice. Blood circulation resumes, and pain stops.
Qinghun San (Clear Soul Powder): For postpartum blood syncoma and coma. Removes stasis, generates new blood.
Ligusticum Rhizome (Chuanxiong) (2 qian), Folium Euphrasiae (Zelan Ye), Schizonepeta Spike (Jingjie) (each 4 qian), Ginseng (1 qian), Licorice Root (Gancao) (0.8 fen). Grind into powder. Take 2 qian per dose with wine.
Duoming Wan (Life-Seizing Pill): For blood-cold stagnation and retained placenta.
Tree Peony Bark (Danpi) (8 qian), Radix Angelicae Sinensis Tail, Black Aconite Root (Heifuzi), Burnt Lacquer (Ganqi, roasted, each 5 qian).
Grind into powder. Use Rhubarb (Dahuang, powder, 8 qian), boil in vinegar to form a paste. Mix with egg white, pill to size of paulownia seeds. Swallow 50 pills with wine to expel placenta.
Guixi Tang (Angelica-Achyranthes Decoction): For retained placenta; effective upon ingestion.
Radix Angelicae Sinensis Tail (2 qian), Achyranthes Root (Niuxi), Akebia Caulis (Mutong), Talcum (Huashi) (each 5 qian), Abutilon Seed (Dongkuizi, ground, 3.5 qian). Decoct in water and take.
Bawei Lizhong Tang (Eight-Ingredient Lizhong Decoction): For postpartum dual deficiency of Qi and Blood, sweating, and vomiting.
Atractylodes Macrocephala Rhizome (Baizhu) (1 liang), Roasted Licorice Root (Zhigancao) (7 qian), Ginseng, Poria (Fuling), Dried Ginger (Jiang, roasted), Talcum (Huashi), Malt (Maiya), Medicated Leaven (Shenqu) (each 5 qian).
Grind into powder. Form pills with rice paste to size of paulownia seeds. Take 50 pills before meals with ginger water.
Fanyuan Tang (Return-to-Origin Decoction): For upward reversal of lochia, coma, inability to pass urine/feces, and surging pulse.
Radix Angelicae Sinensis (5 qian), Ligusticum Rhizome (Chuanxiong) (3 qian), Trogopterus Dung (Wulingzhi), Peach Kernel (Taoren) (each 1.5 qian), Rhubarb (Dahuang) (2 qian), Paeonia Root (Shaoyao) (1 qian), Cinnamon Bark (Rougui) (0.6 fen), Ginseng (0.5 fen). Decoct in water. Add child's urine, rock sugar, and wine before taking.
Baosheng Ding (Life-Preserving Tablet): Calms and nourishes the spirit postpartum. Additionally, decoct Hawthorn (1 liang), Radix Angelicae Sinensis (5 qian), and scorched Schizonepeta (2 qian) in water and take.
Cinnabar (Chensha, high quality, water-washed), Radix Angelicae Sinensis, Ligusticum Rhizome (Chuanxiong) (equal parts). Grind into powder. Mix with honey, stamp with gold/silver foil. Dissolve in decoction and take.
Guijie Wan (Angelica-Kadophora Pill): For postpartum blood accumulation forming masses in the abdomen. Using only Trogopterus Dung powder (2 qian per dose with wine) is also effective.
Radix Angelicae Sinensis, Kadophora Resin (Xuejie), Curcuma Zedoaria Rhizome (Pengzhu, baked), White Paeonia Root (Shaoyao, wine-fried, 2 liang), Trogopterus Dung (Wulingzhi, 4 liang).
Grind into powder. Form pills with vinegar paste to size of paulownia seeds. Take 60 pills on an empty stomach with wine.
Coma, shortness of breath, spontaneous sweating: Ginseng (2 qian), Walnut Meat (Hetaorou), Ophiopogon Tuber (Mendong) (each 5 qian). Decoct in water and take.
Collapse of Yuan Qi, upward reversal of blood: Ginseng (5 qian), Subtree Wood (Sumu) (1 liang). Decoct in child's urine and take.
Blood Syncope: Scorched Schizonepeta (5 qian), decoct in child's urine. For Qi deficiency, add Angelica and Ginseng; for Blood deficiency, add Ligusticum Rhizome (each 2 qian).
Retained Placenta: Ideally, the parturient should chew it herself during delivery; vomiting will expel it. Delay allows retained blood to enter the uterus.
Amomum Fruit (Sharen, roasted, ground, 5 qian), Radix Angelicae Sinensis Tail (5 qian). Decoct in water and take.
Incomplete blood expulsion, severe agitation approaching death: Safflower (1 liang), two cups of wine, two spoons of Mume Soup. Mix and take.
Incomplete expulsion of evil blood, abdominal pain: Radix Angelicae Sinensis, Radix Paeoniae Rubra (Chishaoyao) (each 2 qian), Cinnamon Bark (Rougui) (1 qian), three slices of ginger. Decoct in water and take.
Postpartum pain anywhere: Radix Angelicae Sinensis, Rhizoma Corydalis (Yanhusuo, powder), Kadophora Resin (Xuejie), Myrrh (Moyao, separately ground, equal parts). Grind together. Take 2 qian per dose with wine.
Vaginal laxity, uterine prolapse: Sulfur (2 qian), Dodder Seed (Tusizi), Evodia Fruit (Wuzhuyu), Cnidium Fruit (Shechuangzi) (each 1 qian). Decoct in water for washing.
Simple Prescription for Uterine Inversion: Agastache Herb (Huoxiang), Schizonepeta Spike (Jingjie), Toona Root Bark (Chouchun Genpi). Decoct in water for fumigation and washing.
Dystocia lasting several days with cold body: Decoct Zanthoxylum Leaves (Jiaocheng Ye) in a basin of water. Provide a small stool. Let the parturient sit in the basin for fumigation and washing. After a long time, when legs and abdomen become warm, Qi warms and blood circulates, facilitating delivery.
Retained Placenta: Black Soybean (1 he), roasted and boiled in vinegar for six or seven boils. Remove beans. Use vinegar three times while rubbing the lower abdomen with hot hands.
Alternative: Place husband's single-layer garment over a well.
Alternative: Soak Folium Euphrasiae (Zelan Ye) in wine. Heat an iron hammer and drink the wine.
Postpartum myriad diseases due to non-descending blood: Kadophora Resin (Xuejie) and Myrrh (Moyao) ground into powder. Take 2 qian with child's urine and wine.
Unstoppable bleeding: Carbonized Grass (Baicaoshuang, 2 qian) with child's urine and wine. Or, decoct Mulberry Root Bark (Sangbaipi), add two spoons of ginger juice, and drink.
Lochia-like discharge persisting for a month: Bamboo paper and cotton paper (seven sheets each, burned to ash), Schizonepeta (one handful, scorched), Pinellia Tuber (Banxia, 0.5 fen). Decoct in water and wine and take.
Uterine Prolapse: Bitter Orange (Zhiqiao), Chebula Fruit (Hezi), Gallnut (Wubeizi), Alum (Baifan). Decoct in water for fumigation and washing. Or, moxa the vertex of the head several times to retract it.