Library

Xue Lizhai treated a postpartum woman who felt a mass in her abdomen, which sometimes caused pain and moved around. It was not painful upon pressure (indicating it was not an excess accumulation). Her complexion was sallow, she discharged leukorrhea when in pain, and her pulse was floating and choppy. This indicated deficiency of Liver Qi and weakness of Blood. The patient did not believe this and took blood-breaking and Qi-moving herbs, causing the pain to intensify and the mass to move irregularly. She then believed it was "blood leech" (a folk pathology concept) and specifically used blood-breaking and expelling drugs. The pain attacked both hypochondria, with the abdomen being particularly severe, further convincing her it was a leech. She indeed took vermifuge-like medicines, losing a large amount of Blood, becoming increasingly deficient in form and Qi. Small nodules formed in her joints, hidden within the flesh, which she thought were "leech offspring" fleeing the medicine. Xue said: "The Liver stores Blood to nourish the sinews. Here, Liver Blood has been damaged again, causing the sinews to dry up and spasm. The limbs, joints, chest, and neck all belong to the Gallbladder and Liver regions. By nurturing Spleen Earth, tonifying Lung Metal and Kidney Water to nourish Liver Blood, the sinews will naturally relax." He subsequently used Bazhen Tang (Eight-Treasure Decoction), Xiaoyao San (Free and Easy Wanderer Powder), and Guipi Tang (Restore the Spleen Decoction), modified as appropriate, leading to recovery.

Another postpartum woman suffered from lower abdominal pain and a mass, with a knotted and choppy pulse. She was treated with Siwu Tang (Four-Substance Decoction) plus Yanhusuo (Corydalis Rhizome), Honghua (Carthamus Flower), Taoren (Peach Seed), Niuxi (Achyranthes Root), and Muxiang (Aucklandia Root), resulting in recovery.

Xue Lizhai treated a postpartum woman with metrorrhagia (uterine bleeding), distending pain in the lower abdomen. After using Qi-breaking and Blood-moving agents, the bleeding became like a gush, accompanied by flaccidity of the four limbs, aversion to cold, vomiting, and frequent loose stools. Six Junzi Tang (Six-Gentleman Decoction) and Paojiang (Charred Ginger) were administered for four doses, bringing slight improvement. Subsequently, Shiquan Dabu Tang (Ten-Ingredient Great Tonifying Decoction) was given for over thirty doses, leading to full recovery.

Another postpartum woman experienced metrorrhagia due to anger. The blood gushed out, she collapsed, her jaw clenched, eyes deviated, and limbs convulsed. This was Wind generated from Blood exhaustion in the Liver Channel. One dose of Liuwei Wan (Six-Ingredient Pill) material eliminated all symptoms. However, due to poor appetite and afternoon fever, Sizijunzi Tang (Four-Gentleman Decoction) was supplemented with Chaihu (Bupleurum Root) and Danpi (Moutan Bark), leading to recovery.

Sun Wen Yuan treated Mrs. Huang, who had intercourse while drunk less than a month after childbirth. She suffered from flooding bleeding, fever, dizziness, and heat in urination and defecation. Her six pulses were surging and large. Zhuru (Bamboo Shavings), Puhuang (Typha Pollen), and Baishao (White Peony Root) at 1 qian each; Xiangfu (Cyperus Rhizome), Fuling (Poria), and Ce Bai Ye (Biota Tops) at 0.7 fen each; Gancao (Licorice Root), Paojiang (Charred Ginger), and Aye (Mugwort Leaf) at 0.3 fen each were prescribed. The bleeding stopped by more than half. Due to persistent waist pain and afternoon chest/epigastric fullness, the formula was changed to Chuanxiong (Ligusticum Rhizome) 0.5 fen, Danggui (Angelica Sinensis Root), Fuling (Poria), Buguzhi (Psoralea Fruit), Puhuang (Typha Pollen), and Xiangfu (Cyperus Rhizome) at 0.8 fen each; Jiangtan (Charred Ginger) and Gancao (Licorice Root) at 0.1 fen each; Chenpi (Tangerine Peel) 0.7 fen; and Renshen (Ginseng Root) 1 qian. This led to recovery.

Lu Dongzhuang treated his nephew's daughter-in-law who had a miscarriage. Lochia was scanty, with severe chest and abdominal distension. Her pulse was soft and rapid. Heavy use of Renshen (Ginseng Root) and Baizhu (Atractylodes Macrocephala Rhizome) was indicated; otherwise, collapse would occur. Due to financial hardship, she did not take them. Soon, she suffered uncontrollable hemorrhage, passing countless blood clumps the size of palms or bowls. Her spirit was confused, feet cold up to the lower abdomen, hands cold up to the shoulders, forehead and nose ice-cold, and head sweating profusely like oil. Her pulse was imperceptible even at the bone level. A large dose of Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with 1 liang of Renshen (Ginseng Root) was given but failed. (Note: Without 1 liang of Ginseng, Buzhong Yiqi Tang alone would cause immediate collapse.) Urgently, 1 liang of Renshen (Ginseng Root), 1 liang of Fuzi (Prepared Aconite Root), and 2 qian of Paojiang (Charred Ginger) were decocted thickly and administered. By evening, symptoms gradually subsided. He warned: "Stop the medicine once hands and feet are warm." By midnight, her limbs were fully warm, and bleeding stopped. The family forgot the warning and gave another dose. At dawn, her pulse was erratic, phlegm surged upward, preventing even water intake, causing vomiting, making even Dushen Tang (Single Ginseng Decoction) impossible to retain. He stated: "This is due to overdosing." He immediately prescribed Shengdi Huang (Rehmannia Root) 5 qian, Shudi Huang (Prepared Rehmannia Root) 1 liang, Danggui (Angelica Sinensis Root), Baishao (White Peony Root), and Gouqi (Goji Berry) at 3 qian each, and Gancao (Licorice Root) 1 qian, decocted thickly. The patient doubted taking medicine due to previous vomiting but was persuaded to try a small sip. After half a bowl, she felt comfortable, so the rest was given. Phlegm disappeared completely, and her spirit cleared instantly. In the afternoon, she developed body heat, which he attributed to Blood deficiency heat. She later recovered after conditioning with Shiquan Dabu Tang (Ten-Ingredient Great Tonifying Decoction). (Commentary: Although the Ginseng dose was heavy, collapse was avoided. The treatment method was largely flawed, yet his ability to adapt showed exceptional intelligence.)

Zhang Feichou treated the daughter-in-law of Chen Zinong. In August, difficult labor caused excessive blood loss. Postpartum lochia was scanty. Yi Mu Tang (Motherwort Decoction) failed to promote flow. She developed fever and bloody sweat. Obstetricians used dispersing and Blood-moving methods, worsening the condition. Self-administered banana sugar wine caused unbearable pain in meridians, massive loxia discharge, red face, upward deviation of eyes, bathing sweat, and indescribable heart pain (Sha Xue Xin Tong - Heart Pain from Blood Killing). This pain resulted from Heart malnourishment due to excessive blood loss. The Liver governs sinews and stores Blood; Liver malnourishment caused meridian pain. Sweating is a major taboo postpartum. Urgent Renshen (Ginseng Root) was needed to save her. Sizijunzi Tang (Four-Gentleman Decoction) combined with Baoyuan Tang (Preserve the Origin Decoction) plus Baishao (White Peony Root) and Wuweizi (Schisandra Fruit) stopped sweating in one dose. Due to delirium resembling possession, stasis was suspected, prompting desire for purgation. He noted: "Voice is weak and spiritless, indicating Zheng Sheng (deficiency muttering). Abdomen lacks stasis pain, so where is the stasis? This is scattered Spirit. Add Suanzaoren (Ziziphus Seed) and Longchi (Dragon Bone) to the previous formula." All symptoms calmed. Later, Dushen Tang (Single Ginseng Decoction) was taken until one month postpartum, ensuring stability.

Xue Lizhai treated a postpartum woman with irregular menstruation, internal heat, and dry thirst. Cold-natured herbs caused flooding bleeding, abdominal swelling/pain, alternating chills/fever, and vomiting with poor appetite. Liujunzi Tang (Six-Gentleman Decoction) for over twenty doses cured all symptoms. Jia Wei Xiaoyao San (Modified Free and Easy Wanderer Powder) conditioned her to health.

Another postpartum woman had amenorrhea for over a year, internal heat, and afternoon fever. Fenqi Wan (Qi-Separating Pill) caused continuous menstruation, aversion to cold, thirst, poor appetite, fatigue, chest fullness, and Qi obstruction. Morning: Jia Wei Xiaoyao San (Modified Free and Easy Wanderer Powder); Evening: Sizijunzi Tang (Four-Gentleman Decoction). After one month, symptoms resolved. Bazhen Tang (Eight-Treasure Decoction) was added for two months for complete recovery.

Ma Yuanyi treated Mrs. Jin, one month postpartum, with continuous bleeding, cold extremities, and incessant spontaneous sweating. Blood-nourishing and Yin-tonifying herbs failed. Pulse at both Chi positions was empty, large, and spiritless. He cited Chu Shi: "Blood is Yin, but its movement relies on Yang harmony." Current symptoms indicate weak True Yang in Spleen and Kidney, causing Blood to overflow without attachment ("Yang deficiency leads to Yin leakage"). Method: Greatly tonify True Yang to secure deficient Yin. Nourishing Blood/Yin might fail to generate Blood and damage Yang further. Renshen (Ginseng Root) 3 liang, Baizhu (Atractylodes Macrocephala Rhizome) 1 liang, Fuzi (Prepared Aconite Root) 3 qian, Fuling (Poria), and Zhi Gancao (Honey-fried Licorice Root) 1 qian each. Improvement in one dose, cure in two, several doses restored normal spirit.

Miu Zhong Chun treated He Fanbo's son Zheng. After minor abortion, sudden violent Yin Blood hemorrhage caused dizziness, nausea, swollen gums, and sore throat with ceaseless crying day and night. He stated: "Excessive blood loss causes sudden Yin deficiency. Yang has no anchor, Fire rises in emptiness, flaming upward causing chest heat. This is Upper Excess and Lower Deficiency." Method: Descend Qi; descending Qi descends Fire. Fire descends, Qi returns to origin, upper jiao heat clears, gums swell less, throat pain stops, Yang joins Yin, diseases resolve. Su Zi (Perilla Seed) and Qing Hao Zi (Artemisia Seed) ground, 2.5 qian each; Maidong (Ophiopogon Tuber), Baishao (White Peony Root), Biejia (Turtle Shell), Niuxi (Achyranthes Root), Shengdi Huang (Rehmannia Root), Gouqi (Goji Berry) at 4 qian each; Wuweizi (Schisandra Fruit) 0.5 fen; Suanzaoren (Ziziphus Seed) 5 qian; Xuduan (Dipsacus Root), Juhong (Aged Tangerine Peel) 2 qian each; Pipaye (Loquat Leaf) 3 slices. Decocted in river water, add 1 large cup of Tongbian (Child Urine), 12 spoons of Yujin Zhi (Curcuma Juice). Take on empty stomach, occasionally sip Tongbian.

Wei Yuheng said: Lady Zhuxi, over 30 years old, suffered violent postpartum hemorrhage from Si to You hours, frequent yawning, closed eyes, open mouth, pale/grey complexion, incessant sweating soaking hair roots, six pulses vanished, impending collapse. Initial Tongbian (Child Urine) enemas and Leek/Vinegar fumigation failed. Shudi Huang (Prepared Rehmannia Root) 2 liang, Gouqi (Goji Berry), Suanzaoren (Ziziphus Seed) 1 liang each were decocted. Given slowly before thick concentration. One bell glass consumed, sweating stopped, eyes opened/closed, consciousness returned. Repeated dosing stopped bleeding, induced sleep, resumed porridge next morning. Next day, same formula, one dose daily, cured in four days. When urgently called, he left a drinking gathering, wrote prescription, and returned. Colleagues mocked: "Buying dried fish to release life? Who bears responsibility?" He smiled silently.

Song Shenfu's wife, pregnant several months, during midsummer, visited parents. Doctor diagnosed menstrual obstruction, gave four doses of Blood-breaking, acrid-hot herbs, causing miscarriage and profuse bleeding. Urgent consultation found profuse sweating, impending pulse collapse. She lay on desk, unable to reach bed due to violent bleeding. Only relative Zhu was present. Ordered mother to boil water, decoct herb quickly (over 100 boils), administer immediately, repeat. Urgently bought Shudi Huang (Prepared Rehmannia Root) 4 liang, Gouqi (Goji Berry), Suanzaoren (Ziziphus Seed) 2 liang each. Taken according to method, cured immediately.

Zhang Jiandong's wife, over 30, five months pregnant, chronic Liver disease. Minor discomfort treated by neighbor doctor with Jingjie (Schizonepeta), Fangfeng (Saposhnikovia), Guang Huo Xiang (Patchouli), Banxia (Pinellia), Xiangfu (Cyperus), Sharen (Amomum), Yujin (Curcuma), Yuanhu (Corydalis) for five doses. Resulted in spotting, sore/dragging waist/abdomen, shortness of breath, red face. Pulse discontinuous. He said: "Fetus hard to save. Nurture Three Yin to prevent collapse." Delivery expected at midnight. If waiting for collapse, too late. Prescribed in advance: Shudi Huang (Prepared Rehmannia Root) 2 liang, Gouqi (Goji Berry), Suanzaoren (Ziziphus Seed) 1 liang each. Advised: If face reddens or breathing worsens, blood will surge, drink immediately. Events unfolded as predicted, safely. Next day, halved dose, added Renshen (Ginseng Root) 1 qian, cured in two doses. Years later, pregnant again, fainted due to Liver deficiency. Used Shengdi Huang (Rehmannia Root) and Gouqi (Goji Berry), but she refused, leading to myriad complications, postpartum cough and diarrhea. Given Gouqi (Goji Berry), Shengdi Huang (Rehmannia Root), Shashen (Glehnia Root), Maidong (Ophiopogon Tuber), symptoms slightly improved. Next day, same formula, advised adding Lou Ren (Trichosanthes Seed) because prior excessive use of Renshen (Ginseng Root), Baizhu (Atractylodes Macrocephala Rhizome), Paojiang (Charred Ginger), Fuzi (Prepared Aconite Root) caused severe Heat stagnation, requiring this to resolve. She refused further visits. Later heard she continued taking Renshen (Ginseng Root), Baizhu (Atractylodes Macrocephala Rhizome), Fuzi (Prepared Aconite Root), ultimately dying. Are life and death merely fate?