产后恶露不止，非如崩证暴下之多也。由于产时伤其经血，虚损不足，不能收
摄，或恶血不尽，则好血难安，相并而下，日久不止，渐成虚劳。当大补气血，使旧血得行，新血得
生。不可轻用固涩之剂，致败血聚为 瘕，反成终身之害。十全大补汤主之。如小腹刺痛者，蒲索四物
汤主之。如产后月余，经血淋沥不止，宜用升陷固血汤。《全书》云∶因血热者，宜保阴煎、清化饮。
因伤冲任之络而不止者，固阴煎加减用之。若肝脾气虚，不能收摄而血不止者，宜寿脾煎。若气血俱
虚，而淡血津津不已者，宜大补元煎。若怒火伤肝，而血不藏者，宜薛氏加味四物汤。若风热在肝，
而血下泄者，宜一味防风散。以上诸治法，与《济阴纲目》理同。血崩门亦可参看通治。
蒲索四物汤 治产后恶露不止。
当归（一钱五分） 川芎（八分） 熟地黄（二钱） 白芍（酒炒） 延胡索（醋炒。各一钱）
蒲黄（七分，炒） 干姜（五分，炒黑）
产后忌芍药，而此方用之，审恶露不止四字，则产日已久矣，故不忌也。
升陷固血汤 治产后月余，经血不止，陷下者举之。
当归 川芎 熟地 白芷 升麻 血余灰（各一钱）
水煎服。
保阴煎 治一切阴虚内热动血等证。
生地 熟地 芍药（各二钱） 山药 川续断 黄芩 黄柏（各一钱五分） 生草（一钱）
水二钟，煎七分，食远服。如小水多热，或兼怒火动血者，加焦栀子一二钱。如夜热身热，加地
骨皮一钱五分。如肺热多汗者，加去心麦冬、炒枣仁。如血热甚者，加酒炒黄连一钱五分。如血虚血滞，
筋骨肿痛者，加当归二三钱。如气滞而痛，去熟地，加陈皮、青皮、丹皮、香附之属。如血脱血滑，
及便血久不止者，加地榆一二钱，或乌梅一二个，或百药煎一二钱，醋炒文蛤亦可。如少年，或血
气正盛者，不必用熟地、山药。如肢节筋骨疼痛或肿者，加秦艽、丹皮各一二钱。此方芩、连、栀、
柏等类，当于产后日久，方可用之。
清化饮 治妇人产后，因火发热，及血热妄行，阴亏诸火不清等证。此方清凉，产后日久方可用之。
芍药 麦冬（去心。各二钱） 丹皮 茯苓 生地（各二三钱） 石斛（一钱）
水一钟半，煎七分，食远温服。如觉骨蒸多汗者，加地骨皮一钱五分。热甚而
渴，或头痛者，加 石膏一二钱。下热便涩者，加木通一二钱，或炒黄柏、炒栀
子皆可随证用之。如兼外邪发热，加柴胡一二钱。
以上保阴、清化二方，盖因产家或过慎太暖，或因年力方壮而饮食药饵大补过度，致火动病热，下
血日久不止。此产后间有之实证，故录是方以备用。
固阴煎 治阴虚滑泄，带浊淋遗，及因虚不固，此方专主肝肾。
人参（随宜） 熟地（三五钱） 山药（二钱，炒） 山茱萸（一钱五分，去核） 远志（七分，甘
草水泡去骨，炒用） 炙草（一二钱） 五味子（十四粒） 菟丝子（二三钱，炒香）
水二钟，煎七分，食远温服。如虚滑遗甚者，加金樱子肉二三钱，或醋文蛤一钱，或乌梅二个。如
阴虚微热而经血不固者，加制川续断肉二钱。如下焦阳气不足而兼腹痛溏泄者，加补骨脂、吴茱萸之类，
随宜用之。如肝肾血虚，小腹痛而血不归经者，加当归二三钱。如脾虚多湿，或兼呕恶者，加土炒白术一
二钱。如气陷不固者，加炒升麻一钱。如兼心虚不眠，或多汗者，加炒枣仁二钱。
寿脾煎 治脾虚不能摄血等证，及妇人无火崩淋。凡兼呕恶，犹为危候，速宜用此救脾，则统
血归源矣。若再用寒凉，胃气必脱，无不死者。
人参（随宜，一二钱。急者，用一两） 白术（二三钱） 当归（二钱） 山药（二钱） 枣仁（
一钱五分） 远志（三五分，制） 干姜（一二钱，炮黑） 炙草（一钱） 莲肉（二十粒，去心）
水二钟，煎服。如血未止，加乌梅二个。凡畏酸者，不可用。或加地榆一钱五分亦可。滑脱不禁者，
加醋炒文蛤一钱。下焦虚滑不禁，鹿角霜二钱为末，搅入药中服之。气虚甚者，加炙黄 二三钱。气陷
而坠者，加炒升麻五七分，或白芷亦可。兼溏泄者，加炒补骨脂一钱。阳虚畏寒者，加制附子一二钱。
血去过多，阴虚气馁，心跳不宁者，加熟地七八钱，或一二两。
大补元煎 治男妇血气大坏，精神失守，危剧等证。
人参（一二钱，多则用一二两） 山药（二钱，炒） 熟地（二三钱，多则用二三两） 杜仲（
二钱，盐水炒断丝） 当归（泄泻者去之） 枸杞（各二三钱） 山萸肉（如畏酸、吞酸者，去之）
炙草（各一钱）
水二钟，煎七分，食远温服。如元阳不足多寒者，加制附子、肉桂、炮姜之类，随宜用之。如气
分偏虚者，加炙黄 、土炒白术。若胃口多滞者，不必用。如血滞者，加川芎，去山茱萸。滑泻者，
加五味、炒故纸之属。
薛氏加味四物汤 养肝血，清肝火。
熟地 当归（各三钱） 芍药（二钱） 川芎 山栀（炒） 柴胡 丹皮（各一钱）
水二钟，煎服。
良方一味防风散（一名独圣散）
防风（去芦）
为末，每服二钱，空心，食前用酒煮白面清饮调下。治肝经有风，以致血得风而流不归经者极效。
十全大补汤（见上卷胎不长养门。）
Postpartum lochia that does not stop is not as profuse and sudden as in the case of metrorrhagia (uterine bleeding). It occurs because the meridians and blood vessels are injured during childbirth, leading to deficiency and insufficiency, which fails to control the blood. Alternatively, if retained evil blood is not completely expelled, healthy blood cannot settle peacefully, and flows down together with the old blood. If this persists for a long time, it gradually develops into consumptive disease (Xu Lao). Treatment should focus on greatly tonifying Qi and Blood, allowing the old blood to move and new blood to generate. One must not lightly use astringent agents, lest they cause stagnant blood to accumulate and form masses (Jia), resulting in lifelong harm. The principal formula is Shiquan Dabu Tang (Ten Complete Tonifying Decoction). If there is stabbing pain in the lower abdomen, Pusuo Siwu Tang (Yanhusuo Four Substances Decoction) is the principal formula. If more than a month has passed postpartum and menstrual blood continues to drip incessantly, Shengxian Guxue Tang (Lifting Depressed Qi and Consolidating Blood Decoction) is appropriate. *Quan Shu* states: For cases caused by Blood Heat, Baoyin Jian (Protect Yin Decoction) and Qinghua Yin (Clear Transformation Infusion) are suitable. For bleeding due to injury of the Chong and Ren vessel collaterals, Guyin Jian (Consolidate Yin Decoction) modified is used. For cases where Liver and Spleen Qi deficiency fails to consolidate blood, Shoupi Jian (Longevity Spleen Decoction) is indicated. For cases of combined Qi and Blood deficiency with thin, continuous leakage of blood, Dabu Yuanjian (Greatly Tonify the Source Decoction) is indicated. For cases where anger-fire injures the Liver causing blood to fail to be stored, Xueshi Jiawei Siwu Tang (Dr. Xue’s Modified Four Substances Decoction) is indicated. For Wind-Heat in the Liver causing downward discharge of blood, Yiwei Fangfeng San (Single Herb Saposhnikovia Powder) is indicated. The above treatment methods align with the principles in *Ji Yin Gang Mu* (General Principles of Women's Medicine). The section on Metrorrhagia may also be consulted for general treatments.
Pusuo Siwu Tang: Treats postpartum lochia that does not stop.
Dang Gui (Angelicae Sinensis Radix) 1.5 qian, Chuan Xiong (Chuanxiong Rhizoma) 0.8 qian, Shu Di Huang (Rehmanniae Radix Praeparata) 2 qian, Bai Shao (Paeoniae Radix Alba, stir-fried with wine), Yan Hu Suo (Corydalis Rhizoma, stir-fried with vinegar) each 1 qian, Pu Huang (Typhae Pollen) 0.7 qian (stir-fried), Gan Jiang (Zingiberis Rhizoma, stir-fried until black) 0.5 qian.
Although Piao Yao (Bai Shao) is usually contraindicated postpartum, it is used here because the phrase "lochia that does not stop" implies that some time has passed since delivery, so the contraindication does not apply.
Shengxian Guxue Tang: Treats postpartum menorrhagia lasting over a month; for sinking conditions, lifting methods are employed.
Dang Gui, Chuan Xiong, Shu Di, Bai Zhi, Sheng Ma, Xue Yu Hui (Carbonized Human Hair) each 1 qian.
Decoct in water and take orally.
Baoyin Jian: Treats all syndromes of Yin deficiency with internal heat disturbing blood.
Sheng Di Huang (Rehmanniae Radix) 2 qian, Shu Di Huang 2 qian, Shao Yao (Paeoniae Radix) 2 qian, Shan Yao (Dioscoreae Rhizoma), Chuan Xu Duan (Dipsaci Radix), Huang Qin (Scutellariae Radix), Huang Bo (Phellodendri Cortex) each 1.5 qian, Sheng Gan Cao (Glycyrrhizae Radix et Rhizoma) 1 qian.
Decoct two zhong of water to seven-tenths; take after meals. If urine is frequent and hot, or if anger-fire disturbs blood, add Jiao Zhi Zi (Carbonized Gardeniae Fructus) 1-2 qian. If there is night fever or body heat, add Di Gu Pi (Lycii Cortex) 1.5 qian. If Lung heat causes excessive sweating, add Mai Dong (Ophiopogonis Radix, heart removed) and Chao Zao Ren (Ziziphi Spinosomi Semen, stir-fried). If Blood heat is severe, add Jiu Chao Huang Lian (Coptidis Rhizoma, wine-stir-fried) 1.5 qian. If Blood deficiency with stasis causes swelling and pain in bones and joints, add Dang Gui 2-3 qian. If Qi stagnation causes pain, remove Shu Di and add Chen Pi (Citri Reticulatae Pericarpium), Qing Pi (Citri Reticulatae Pericarpium Viride), Dan Pi (Moutan Cortex), and Xiang Fu (Cyperi Rhizoma). If blood loss leads to slipping blood, or if hematochezia persists for a long time, add Di Yu (Sanguisorbae Radix) 1-2 qian, or Wu Mei (Mume Fructus) 1-2 pieces, or Bai Yao Jian (Fermented Medicated Leaven) 1-2 qian; Cu Chao Wen Ge (Veneris Concha, vinegar-stir-fried) is also acceptable. For adolescents or those with robust Qi and Blood, Shu Di and Shan Yao are unnecessary. If limb joints and bones hurt or swell, add Qin Jiao (Gentianae Macrophyllae Radix) and Dan Pi each 1-2 qian. Herbs such as Huang Qin, Huang Lian, Zhi Zi, and Huang Bo in this formula should only be used when the postpartum period has been prolonged.
Qinghua Yin: Treats postpartum women with fever due to fire, reckless bleeding due to Blood heat, and various fires remaining unclear due to Yin deficiency. This formula is cooling and should only be used when the postpartum period has been prolonged.
Shao Yao 2 qian, Mai Dong (Ophiopogonis Radix, heart removed) 2 qian, Dan Pi (Moutan Cortex), Fu Ling (Poria), Sheng Di Huang (Rehmanniae Radix) each 2-3 qian, Shi Hu (Dendrobii Caulis) 1 qian.
Decoct one and a half zhong of water to seven-tenths; take warm after meals. If bone-steaming fever and sweating occur, add Di Gu Pi 1.5 qian. If heat is severe with thirst or headache, add Shi Gao (Gypsum Fibrosum) 1-2 qian. If lower jiao heat causes difficult urination, add Mu Tong (Akebiae Caulis) 1-2 qian, or Chao Huang Bo and Chao Zhi Zi as appropriate. If external pathogenic factors cause fever, add Chai Hu (Bupleuri Radix) 1-2 qian.
These two formulas, Baoyin Jian and Qinghua Yin, are likely prescribed because mothers were either overly cautious about keeping warm, or because their strong constitution led to excessive tonic food and medicine, causing fire to arise and illness to develop with prolonged bleeding. These are occasional excess syndromes postpartum, so these formulas are recorded for backup use.
Guyin Jian: Treats Yin deficiency with slippery discharge, turbid leukorrhea, dribbling, and enuresis due to insecurity from deficiency. This formula specifically targets the Liver and Kidney.
Ren Shen (Ginseng Radix et Rhizoma) as needed, Shu Di Huang (Rehmanniae Radix Praeparata) 3-5 qian, Shan Yao (Dioscoreae Rhizoma, stir-fried) 2 qian, Shan Zhu Yu (Corni Fructus, pitted) 1.5 qian, Yuan Zhi (Polygalae Radix, soaked in Licorice water, bone removed, stir-fried) 0.7 qian, Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried) 1-2 qian, Wu Wei Zi (Schisandrae Fructus) 14 grains, Tu Si Zi (Cuscutae Semen, stir-fried until fragrant) 2-3 qian.
Decoct two zhong of water to seven-tenths; take warm after meals. If deficiency slipping and seminal emission are severe, add Jin Ying Zi (Chrysanthemi Fructus) meat 2-3 qian, or Cu Wen Ge 1 qian, or Wu Mei 2 pieces. If Yin deficiency with slight heat causes insecure menstrual blood, add Zhi Chuan Xu Duan (Prepared Dipsaci Radix) 2 qian. If lower jiao Yang Qi deficiency accompanies abdominal pain and loose stools, add Bu Gu Zhi (Psoraleae Fructus) and Wu Zhu Yu (Evodiae Fructus) as appropriate. If Liver-Kidney Blood deficiency causes lower abdominal pain and blood failing to return to its vessels, add Dang Gui 2-3 qian. If Spleen deficiency with dampness or accompanying nausea/vomiting occurs, add Tu Chao Bai Zhu (Atractylodis Macrocephalae Rhizoma, earth-stir-fried) 1-2 qian. If Qi sinks and fails to consolidate, add Chao Sheng Ma (Cimicifugae Rhizoma, stir-fried) 1 qian. If accompanied by Heart deficiency insomnia or excessive sweating, add Chao Zao Ren (Ziziphi Spinosomi Semen, stir-fried) 2 qian.
Shoupi Jian: Treats Spleen deficiency failing to control blood, and non-fire metrorrhagia/leukorrhea in women. Whenever accompanied by nausea and vomiting, it is a critical condition; this formula should be used urgently to save the Spleen, thereby restoring blood control. If cold-natured herbs are used again, Stomach Qi will collapse, leading to death.
Ren Shen (Ginseng Radix et Rhizoma) as needed, 1-2 qian (use 1 liang for emergencies), Bai Zhu (Atractylodis Macrocephalae Rhizoma) 2-3 qian, Dang Gui (Angelicae Sinensis Radix) 2 qian, Shan Yao (Dioscoreae Rhizoma) 2 qian, Zao Ren (Ziziphi Spinosomi Semen) 1.5 qian, Yuan Zhi (Polygalae Radix, prepared) 0.3-0.5 qian, Gan Jiang (Zingiberis Rhizoma, roasted black) 1-2 qian, Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried) 1 qian, Lian Rou (Nelumbinis Semen, heart removed) 20 grains.
Decoct two zhong of water and take orally. If bleeding does not stop, add Wu Mei 2 pieces. Those who fear sour flavors should not use this. Alternatively, add Di Yu 1.5 qian. For uncontrolled slipping, add Cu Chao Wen Ge 1 qian. For lower jiao deficiency slipping, Lu Jiao Shuang (Deer Antler Glue Residue) 2 qian powdered can be mixed into the decoction. For severe Qi deficiency, add Zhi Huang Qi (Astragali Radix, honey-fried) 2-3 qian. For sinking Qi with prolapse, add Chao Sheng Ma 0.5-0.7 qian, or Bai Zhi is also acceptable. For accompanying loose stools, add Chao Bu Gu Zhi 1 qian. For Yang deficiency with aversion to cold, add Zhi Fu Zi (Aconiti Lateralis Radix Praeparata) 1-2 qian. For excessive blood loss leading to Yin deficiency, Qi exhaustion, and palpitations, add Shu Di Huang 7-8 qian or 1-2 liang.
Dabu Yuanjian: Treats severe damage to Qi and Blood in men and women, loss of spirit, and critical conditions.
Ren Shen (Ginseng Radix et Rhizoma) 1-2 qian (up to 1-2 liang), Shan Yao (Dioscoreae Rhizoma, stir-fried) 2 qian, Shu Di Huang (Rehmanniae Radix Praeparata) 2-3 qian (up to 2-3 liang), Du Zhong (Eucommiae Cortex, salt-water stir-fried until fibers break) 2 qian, Dang Gui (Angelicae Sinensis Radix, omit if diarrhea), Gou Qi (Lycii Fructus) each 2-3 qian, Shan Yu Rou (Corni Fructus, omit if sour aversion or acid regurgitation), Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried) each 1 qian.
Decoct two zhong of water to seven-tenths; take warm after meals. If Yuan Yang deficiency causes coldness, add Zhi Fu Zi, Rou Gui (Cinnamomi Cortex), and Pao Jiang (Zingiberis Rhizoma Praeparata) as appropriate. If Qi deficiency is predominant, add Zhi Huang Qi and Tu Chao Bai Zhu. If the stomach appetite is sluggish, do not use. If Blood stasis exists, add Chuan Xiong and remove Shan Yu Rou. For slippery diarrhea, add Wu Wei Zi and Chao Gu Zhi (Psoraleae Fructus).
Xueshi Jiawei Siwu Tang: Nourishes Liver Blood and clears Liver Fire.
Shu Di Huang (Rehmanniae Radix Praeparata) 3 qian, Dang Gui (Angelicae Sinensis Radix) 3 qian, Shao Yao (Paeoniae Radix) 2 qian, Chuan Xiong (Chuanxiong Rhizoma), Shan Zhi (Gardeniae Fructus, stir-fried), Chai Hu (Bupleuri Radix), Dan Pi (Moutan Cortex) each 1 qian.
Decoct two zhong of water and take orally.
Liangfang Yiwei Fangfeng San (also known as Dusheng San)
Fang Feng (Saposhnikoviae Radix, remove root tip).
Grind into powder. Take 2 qian per dose, on an empty stomach before meals, mixed with clear rice wine decoction. Highly effective for Liver channel Wind causing blood to flow freely and fail to return to its vessels.
Shiquan Dabu Tang (See Volume I, Section on Failure of Fetal Growth.)