Library

Zhang Sanxi treated a woman who had become emotionally distressed during her menstrual period. Her constitution was naturally prone to phlegm-dampness, and she presented with migrating arm pain and swelling in both feet. Initially misdiagnosed as deficiency, treatment with Ginseng Radix (Renshen) and Angelicae Sinensis Radix (Danggui) exacerbated the pain, leading to nausea and mental confusion.

Subsequently, it was treated as depression-phlegm stagnation using Er Chen Tang (Two-Cured Decoction) and Yue Ju Wan (Pill of Resolving Depression), modified with Gentianae Macrophyllae Radix (Qinjiao) and Moutan Cortex (Danpi). After two doses, symptoms slightly decreased. However, bowel movements were absent for four to five days. A Feng Search Pill (Sofeng Wan) was administered, followed by a regimen to resolve phlegm and regulate qi, comprising Er Chen Tang, Atractylodis Rhizoma (Cangzhu), Atractylodis Macrocephalae Rhizoma (Baizhu), Scutellariae Radix prepared with wine (Jiu Huangqin), Phellodendri Cortex prepared with wine (Jiu Huangbai), Akebia Caulis (Mutong), Alisma Rhizoma (Zexie), and Cyperi Rhizoma (Xiangfu). The patient recovered after regulation.

Lu Yangyu treated Lady Ling Yi quan, who was nearly seven months pregnant when she suddenly developed weakness and flaccidity in both lower limbs, unable to stand or walk. Symptoms resolved immediately after delivery but recurred one month later, accompanied by chest and hypochondriac pain and night fever. Some physicians prescribed Si Wu Tang (Four-Substance Decoction) modified with Achyranthis Bidentatae Radix (Niuxi), Chaenomelis Fructus (Mugua), Panthera Ossis (Hugu), and Cervi Cornu Colla (Lujiao), resulting in intermittent improvement. Later, based on the theory that "the Spleen governs the four limbs," Ren Shen and Atractylodis Rhizoma (Baizhu) were given to tonify Qi, causing severe distending pain and suffocation. Blood-nourishing herbs were then used, but progress was stagnant for a year. Upon examination, her diet and muscle mass were normal, but calves were edematous. Chest and hypochondriac tenderness was mild upon palpation, otherwise feeling stifling and distended. The pulse was deep, slow, and slippery. This indicated damp-phlegm accumulating in the chest and flowing into the limbs, causing pain and flaccidity. Yin-nourishing methods did not worsen the condition, but Qi-tonifying methods aggravated it. Er Chen Tang was modified with Cangzhu, Sparagmi Radix (Weilingxian), Phellodendri Cortex (Huangbai), and Brassicae Semen Album (Baijiezi). After several doses, pain ceased and fever subsided. Coicis Semen (Yiren) was added, and after ten doses, walking ability returned to normal.

Xue Lizhai treated a postpartum woman presenting with body and abdominal pain, fever, anorexia, restlessness, insomnia, spontaneous sweating, and hypochondriac pain. Administration of exterior-releasing and blood-invigorating herbs caused frequent episodes of delirium; the six pulses were surging yet forceless. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was modified with processed Zingiberis Rhizoma (Paojiang) and Pinelliae Tuber (Banxia). After one dose, symptoms improved by two or three tenths; after another dose, appetite improved. However, back stiffness and pain persisted. She was regulated with Ba Zhen San (Eight-Treasure Powder) and Shi Quan Da Bu Tang (Ten-Absolutely Great Tonifying Decoction) until stable.

Another postpartum woman suffered from generalized and vertex headache, fever, and anorexia with a floating-tight pulse, indicating Wind-Cold syndrome. Wu Ji San (Five Accumulations Powder) was administered, and after one dose inducing sweating, she recovered. Subsequent fatigue and fever indicated that pathogenic factors had departed but True Qi was deficient. Ba Zhen Tang (Eight-Treasure Decoction) was used for regulation, leading to recovery.

Zhou Shenzhai treated a woman who contracted Dampness postpartum, resulting in generalized body pain. Physicians treated her with Wind-dispelling herbs, which led to bedridden status and wasting of the limbs. This occurred because postpartum Qi and Blood were deficient, and Wind herbs further depleted them. Treatment required substantial tonification of Qi and Blood using Ginseng Radix (Renshen) and Astragali Radix (Huangqi) each at 1.5 qian, plus Stephaniae Tetrandrae Radix (Fangji) at 0.5 qian, decocted and taken orally, resulting in cure.

Another postpartum woman suffered from generalized pain, unable to sit or lie down for two months, with excessive phlegm and reduced appetite. Previous treatments failed. Renshen and Danggui each at 1 liang, and Aucklandiae Radix (Muxiang) at 1 qian were powdered, decocted in wine, and divided into nine doses, leading to recovery.

Ma Yuanyi treated a relative of the Bu family who suffered from postpartum chest pain so severe it was unbearable, even prompting suicidal thoughts. Treatments failed for five months until the condition became critical. Pulses were wiry and choppy with little spirit in both hands; she could not turn over or speak. Ma stated: "The chest is the domain governed by Yang Qi. Now, Yin pathogens have invaded, and Yin and Yang are battling, causing pain. Previous physicians attempted to break Qi, harmonize Blood, warm and tonify, and suppress rebellion, failing to realize that when Yin and Yang are knotted, tonification is useless and attack worsens the knot. Suppressing methods only inhibit vital Yang and obstruct pathogens. Only the method of 'communication' can open Yang entering Yin and connect upper and lower, allowing Yin to govern below and Yang above, leaving the Tai Xu (Great Void) cavity clear, thus resolving chest pain." Ren Shen (3 qian) and Cinnamomi Ramulus (Rougui, 1 qian) were combined with Zhang Zhongjing's Huang Lian Tang (Coptis Decoction). Pain decreased after one dose and vanished after two to three doses. Jia Gui Li Zhong Tang (Modified Cinnamon and Ginger Decoction to Regulate the Middle) was then administered, curing the patient after several doses.

Note: This syndrome is Xiong Bi (Chest Bi), hence included in the Tong Bi (Painful Bi) section.

Miao Zhongchun treated Lady Wang Shanchang, who suffered from postpartum leg pain, inability to walk or stand, progressive anorexia, and extreme exhaustion. Diagnosis indicated insufficient Spleen Yin. Since the Spleen governs the four limbs, Yin insufficiency manifested in the lower body. Previous medications were drying and bitter, failing to nourish Yin. Dendrobii Caulis (Shihu), Chaenomelis Fructus (Mugua), Achyranthis Bidentatae Radix (Niuxi), Paeoniae Radix Alba (Baishao), and Ziziphi Spinosae Semen (Suanzaoren) were used as principal herbs; Rehmanniae Radix (Shengdi), Lycii Fructus (Gouqi), Poria (Fuling), and Phellodendri Cortex (Huangbai) as assistant herbs; Licorice Root (Gancao) and Plantaginis Seed (Cheqianzi) as guide herbs. Improvement was seen after one dose, and she could rise after four doses.

Lai Tianpei treated the wife of Pan Luduan, approximately forty years old, suffering from numbness and pain in the head, body, hands, and feet. Postpartum exposure to Wind, combined with overwork, allowed Wind to enter the collaterals, forming Tong Feng (Gout-like Syndrome). History confirmed onset after childbirth last year. Angelicae Sinensis Radix (Guishen) and Carthami Flos (Honghua) nourished Blood; Uncariae Ramulus cum Uncis (Gouteng) and Gentianae Macrophyllae Radix (Qinjiao) unblocked collaterals; Scutellariae Radix (Huangqin) and Lonicerae Japonicae Flos (Yinhua) cleared Heat; Notopterygii Rhizoma et Radix (Qianghuo) traversed all joints; Chuanxiong Rhizoma (Chuanxiong) addressed headache; Acori Tatarinowii Rhizoma (Changpu) benefited the intestines and reduced fullness; Licorice Root (Gancao) alleviated pain; Zingiberis Pericarpium (Jiangpi) reached the skin and opened interstices. Headache resolved and abdominal distension decreased after two doses, but fever and body pain persisted, along with mental agitation and insomnia. The pulse became slightly harmonious. Exterior symptoms had retreated, but interior Heat remained. Formula was changed to include Shengdi, Danggui, Baishao, Bupleuri Radix (Chaihu), Corticis Lycii (Digupi), Dipsaci Radix (Xuduan), Gouteng, Massae Fermentatae Medicinalis (Banxia Qu), Aurantii Fructus Immaturus (Zhike), Suanzaoren, and Nelumbinis Plumula (Jianlian). All symptoms resolved after two doses. However, swelling and pain in the inner knees required a cane. This indicated Wind entering the Three Yin meridians, signaling impending recovery. The previous formula was modified by removing Chaihu, Digupi, Banxia Qu, and Zhike, adding Moutan Cortex (Danpi), Red Peony Root (Chishao), Honghua, Weilingxian, Sinomenii Caulis (Qingfengteng), Fangji, Niuxi, Acanthopanacis Cortex (Wujiapi), and Gancao. Cure was achieved after three to four doses.

Xue Lizhai treated a postpartum woman in June who sweated excessively and felt fatigued, fearing to uncover herself. Sweat accumulated under the covers, cooling and soaking the body, leading to Wind-Damp invasion and body pain. Qianghuo Xuduan Tang (Notopterygium and Dipsacus Decoction) was administered, curing her after several doses. (Not selected.)