凡妇人冲脉，为血脉之海。若血脉充足，流畅无滞，气血冲和，则关节清利而无病矣。至于产后
劳损脏腑，气血暴竭，百骸少血濡养，多有阴虚内热，热极生风。虽外证如风，实五内阴血不足，气无
所主。卒尔口噤牙紧，唇青肉冷汗出，或唇口 僻，手足筋脉挛搐。诸证类于中风者，或因血气耗损，
腠理不密，汗出过多，神无所主，致角弓反张，此乃厥阴虚极。类痉 者，在伤寒之家，虽有刚柔之分，而
产后无非血燥血枯之证，总宜养阴补血，血长而虚风自灭。任其痰火乘虚泛上，皆当以末治之，毋执偏
门而用治风消痰之方，以重虚产妇也。治初产，当服生化汤以生旺新血。如见危证，三帖后，即用人参
益气以救之。如有痰、有火，或少佐橘红、竹沥、姜汁，其黄连、芩、柏不可并用，胆星、苏子尤不宜
加。慎之慎之。如产已数日，腹无块痛，即用滋荣活络汤。如语涩、四肢不利，宜天麻汤。密斋治语言
蹇涩，加味生麦散。治汗多，口噤，背反，气微类 ，用止汗生血饮。治无汗筋挛，
用芎归枣仁汤。诸书所用，悉皆参附、十全、理阴、大补元煎之类，温养而峻补之，从未有以风痰治之者。
昔立斋用十全大补治口噤，挖开口灌之。如不得下，令侧其面出之，仍灌热者，又冷又灌，数次即能下
而苏矣。《医通》云∶口噤则抉齿灌之，断噤则灌入鼻中即苏。此古人救急灌法，不可不知。至于治口噤
不能为语，峻补之中少兼通心气之药治之。故密斋、《尊生》俱用七珍散，以通心气也。冯氏治产后螈
，用八珍加丹皮钩藤，以生阴血。不应，用四君子、芎、归、丹皮、钩藤补脾土。盖血生于至阴，至
阴者，脾土也。且气有生血之功耳。再此证如伤寒误汗亡液，误下亡阴，溃疡脓血大下之后，小儿吐泻
之后，悉多患之。故在产后亦惟去血过多，或大汗大泻而然，其为元气亏极，血液枯败可知。若肢体恶寒，
脉微细者，此为真状。若脉浮大，发热烦渴，此为假象，惟当固本为善。若至于无力抽搐，戴眼反折，
汗出如朱，两手撮空者，不治。《尊生》治产久拘挛不宜补者，用舒筋汤治之。
昔余奉差督运，亡室因胎前过月不生，忽患子痫证，误为医人认伤寒胎死，用承气调天水散下之，及
产后恶露即停止不行。此原非瓜熟自落，乃恶露随胎为药所
逐，则一时尽下，非有瘀滞不行也，所以腹无块痛。医者不明此理，不问块痛有无，用牡丹皮、泽兰等药，
以致有形之血不生，无形之气更伤，是以随变神脱，妄言妄见，虚火引痰上升。治者犹不知此孤阳浮越
之候，复不辨脉证，仍进逐瘀退热之剂，病势愈深。岂知产后大虚，再经辛散消克，则神愈亡而血愈竭。
是以心血竭而妄言愈甚，肝血竭而内虚生风成搐，肺气竭而发喘，鼻孔黑如烟煤，脾气竭而四肢不为
所用，胃中元气告匮不能散精，痰壅愈甚。治之者，仍不识为虚证，反用胆星、苏子以化痰降气，梨汁
以清痰降火，僵蚕、柴胡、天麻以止搐。诸如此等药类，杂进交攻，罔知顾本，遂致殒命，良可恸也。
滋荣活络汤 治产后口噤，项强，筋搐，类中风证。
人参（二钱或三钱） 川芎 茯神（各一钱） 当归（三钱，酒浸） 黄 （一二钱，蜜炙） 麦
冬（一钱二分，或一钱，去心） 天麻（八分或一钱） 熟地（二钱） 陈皮 荆芥 防风 羌活 炙草
（各四分） 黄连（三分，姜汁炒）
水煎服。有痰，加半夏七分，制，竹沥七分，姜汁少许。有肉食，加山楂、砂仁。
面食，加神曲、麦芽。大便秘，加肉苁蓉一钱五分，酒洗去泥。渴，加麦冬、干葛各八分。汗，加麻黄
根八分。惊悸，加酸枣仁一钱，去壳。
天麻汤 治产后中风恍惚，语涩四肢不利。
人参 枣仁（炒） 茯神 远志（净肉，制） 山药 柏子仁 麦冬（去心。各一钱） 当归（一二
钱） 石菖蒲 半夏曲 南星曲（各八分） 川芎 羌活（各七分） 天麻 防风（各五分） 细辛（四分）
或炼蜜为丸，珠砂为衣，淡姜汤送。
加味生脉散 治产后去血太多，心血虚弱不能上荣于舌，语言不清，含糊蹇涩。
人参 麦冬（去心） 归身 生地 炙草 石菖蒲（各一钱） 五味子（十三粒，捶碎）
猪心一个，劈开，水二盏，煎至一盏半，去心，入药煎七分，食后服。此方治怔忡甚效。
止汗生血饮 治产后汗出多，而口噤不开，背强而直，气息欲绝类 证，宜速治也。
当归（二钱，酒浸） 川芎 麻黄根（各一钱） 桂枝 羌活 防风 羚羊角 天麻（各六分） 附
子（制） 炙草（各四分）
水煎服。一方有人参一钱。
芎归枣仁汤 治产后无汗，筋脉拘挛类 证。
当归（二钱，酒洗） 川芎 防风（各一钱） 枣仁（五分，去壳，炒研）
水煎服。一方有羌活七分。
七珍散 治产后败血停积，闭于心窍，神志不明，盖心气通于舌，心气闭则舌强不语。
人参 石菖蒲（各一钱。为散各一两） 川芎（一钱。为散七钱五分） 生地（一钱。为散，
易炙甘草三钱） 细辛（二分。为散二钱五分） 薄荷（一分。为散，无此味） 防风（五分。
一方四分） 辰砂（五分，研细，水飞。为散三钱）
《尊生》合生化汤服。一方为散，薄荷汤调服三钱。
舒筋汤 治产后日久拘挛，不宜用补剂者。
羌活 姜黄 炙草（各二钱） 海桐皮 当归 赤芍（各一钱） 白术（一钱，土炒） 沉香（少许）
姜煎。参证治。
参附汤
人参 当归（酒浸。各二三钱） 肉桂（八分，或一钱） 黄 （蜜炙） 白术（土炒。各一钱
五分） 熟地（二钱）
制附子（四分，或六分） 炙草（四分）
生化汤（见本卷生化汤论后。） 加参生化汤（见本卷晕厥门。） 十全大补汤（见上
卷胎不长养门。） 理阴煎（见上卷恶阻门。） 大补元煎（见本卷恶露不止门。） 八
珍汤（见上卷诸痛门。） 四君子汤（见上卷胎逆上逼门。）
For women, the Chong Mai (Penetrating Vessel) is the sea of blood vessels. If blood and vessels are sufficient, flowing smoothly without stagnation, and Qi and Blood are harmonious, then joints will be clear and unobstructed, free from disease. However, postpartum labor damages the Zang-Fu organs, causing a sudden depletion of Qi and Blood. With insufficient blood to nourish the entire body, there is often Yin deficiency with internal heat; extreme heat generates wind. Although external symptoms resemble stroke (Zhong Feng), the reality is an insufficiency of Yin and Blood within the five internal organs, with Qi having no master. Suddenly, there is lockjaw (Kou Jin) and teeth clenching, cyan lips, cold sweat on muscles, or facial deviation, with spasms and convulsions of tendons and vessels in hands and feet. Various conditions resembling stroke may be due to consumption of Qi and Blood, loose interstices (Cou Li), excessive sweating, loss of mastery over the Spirit (Shen), leading to opisthotonos (Jiao Gong Fan Zhang); this indicates extreme deficiency of the Jue Yin channel. Conditions resembling spasm (Jing), although differentiated into rigid and flaccid types in Shang Han diseases, are essentially cases of dryness and exhaustion of Blood in postpartum women. The general principle should be to nourish Yin and tonify Blood; as Blood grows, deficient wind extinguishes itself. Regardless of Phlegm-Fire rising due to deficiency, treatment should follow this approach. Do not adhere to biased methods using formulas for expelling wind and resolving phlegm, which would further deplete the parturient. For initial postpartum care, Sheng Hua Tang (Birth Transformation Decoction) should be taken to generate and prosper new Blood. If critical signs appear, after three doses, Ren Shen (Ginseng Radix) should be used immediately to tonify Qi and rescue the condition. If there is Phlegm or Fire, small amounts of Ju Hong (Citri Reticulatae Pericarpium), Zhu Li (Bambusae Succus), and Jiang Zhi (Zingiberis Rhizoma Juice) may be added. Huang Lian (Coptidis Rhizoma), Huang Qin (Scutellariae Radix), and Huang Bai (Phellodendri Cortex) must not be used together, and Dan Xing (Arisaematis Cum Bile) and Su Zi (Perillae Fructus) are especially contraindicated. Exercise caution. If several days have passed since delivery and there is no abdominal mass pain, Zi Rong Huo Luo Tang (Nourishing Glory and Unblocking Collaterals Decoction) should be used immediately. If speech is slurred and limbs are immobile, Tian Ma Tang (Gastrodia Decoction) is appropriate. Mi Zhai treated language impediment with Jia Wei Sheng Mai San (Modified Generating Pulse Powder). For excessive sweating, lockjaw, back arching, and weak breath resembling epilepsy (Xian Zheng), Zhi Han Sheng Xue Yin (Stop Sweat and Generate Blood Infusion) is indicated. For lack of sweating and tendon cramping, Xiong Gui Zao Ren Tang (Ligusticum and Angelica Seed Decoction) is used. Texts generally employ formulas such as Shen Fu Tang (Ginseng and Aconite Decoction), Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction), Li Yin Jian (Regulating Yin Decoction), and Da Bu Yuan Jian (Great Tonifying Origin Decoction) to warm-nourish and strongly tonify. It has never been treated by addressing wind-phlegm. Previously, Li Zhai treated lockjaw with Shi Quan Da Bu Tang, prying open the mouth to administer it. If it could not be swallowed, the patient was turned to the side to allow drainage, while hot decoction was still poured in; alternating hot and cold administration several times allowed it to go down and the patient to revive. *Yi Tong* states: for lockjaw, pry teeth and pour in; for jaw dislocation, pour into the nose for immediate revival. This ancient emergency pouring method must be known. For treating lockjaw preventing speech, strong tonification should be slightly combined with herbs that unblock Heart Qi. Thus, both Mi Zhai and *Zun Sheng* use Qi Zhen San (Seven Treasures Powder) to unblock Heart Qi. Feng Shi treated postpartum convulsions with Ba Zhen Tang (Eight Precious Decoction) plus Mu Dan Pi (Moutan Cortex) and Gou Teng (Uncaria Ramulus) to generate Yin Blood. If ineffective, Si Jun Zi Tang (Four Gentlemen Decoction), Chuan Xiong (Ligustici Rhizoma), Dang Gui (Angelicae Sinensis Radix), Mu Dan Pi, and Gou Teng were used to tonify Spleen Earth. Since Blood is generated from Extreme Yin, and Extreme Yin is Spleen Earth, Qi also possesses the function of generating Blood. Furthermore, this condition often occurs after erroneous sweating in Shang Han causing fluid loss, erroneous purging causing Yin loss, massive bleeding from ulcerative suppurative conditions, or after infant vomiting and diarrhea. In postpartum cases, it is caused by excessive blood loss or severe sweating/diarrhea, indicating extreme deficiency of Yuan Qi and exhaustion of Blood. If limbs feel aversion to cold and pulse is faint and fine, this is a true cold presentation. If pulse is floating and large with fever, irritability, and thirst, this is a false heat presentation; only consolidating the root is advisable. If weakness, convulsions, upward rolling of eyes, opisthotonos, crimson-colored sweat, and grasping at empty air occur, the condition is untreatable. *Zun Sheng* treats long-standing postpartum stiffness unsuitable for tonification with Shu Jin Tang (Unbind Tendons Decoction).
Previously, while I was dispatched to supervise transport, my late wife, whose pregnancy had exceeded the term without delivery, suddenly suffered from eclampsia (Zi Xian). Physicians mistakenly diagnosed it as fetal death due to Shang Han and administered Cheng Qi Tang (Order the Qi Decoction) mixed with Tian Shui San (Heavenly Water Powder) to purge. Consequently, lochia stopped immediately after delivery. This was not a natural ripening and falling, but rather lochia accompanying the fetus was driven out by the medicine, resulting in sudden complete expulsion, not due to stasis. Hence, there was no abdominal mass pain. Physicians ignorant of this principle, regardless of the presence of mass pain, used Mu Dan Pi and Ze Lan, failing to generate tangible Blood and further injuring intangible Qi. This led to Spirit detachment, delusions, and false fire drawing Phlegm upward. Practitioners failed to recognize this sign of floating solitary Yang, did not differentiate pulse and symptoms, and continued administering blood-invigorating and heat-clearing agents, deepening the illness. They did not realize that postpartum great deficiency, compounded by acrid-dispersing and consuming drugs, causes further Spirit loss and Blood exhaustion. Thus, Heart Blood exhaustion worsens delusions; Liver Blood exhaustion leads to internal deficiency generating wind and convulsions; Lung Qi exhaustion causes asthma with black nostrils like soot; Spleen Qi exhaustion renders limbs useless; Stomach Yuan Qi fails to distribute essence, worsening Phlegm obstruction. Practitioners, still failing to recognize this as a deficiency syndrome, used Dan Xing and Su Zi to resolve Phlegm and descend Qi, Pear Juice to clear Phlegm and reduce Fire, Jiang Can (Bombyx Batryticatus), Chai Hu (Bupleuri Radix), and Tian Ma to stop convulsions. Such miscellaneous medicines were administered together, ignoring the root, leading to death—a truly mournful event.
**Zi Rong Huo Luo Tang** treats postpartum lockjaw, neck stiffness, tendon cramping, and stroke-like syndromes.
Ren Shen (2-3 qian), Chuan Xiong, Fu Shen (1 qian each), Dang Gui (3 qian, soaked in wine), Huang Qi (1-2 qian, honey-fried), Mai Dong (1.2 qian or 1 qian, heart removed), Tian Ma (0.8 or 1 qian), Shu Di (2 qian), Chen Pi, Jing Jie, Fang Feng, Qiang Huo, Zhi Gan Cao (0.4 qian each), Huang Lian (0.3 qian, stir-fried with ginger juice).
Decoct in water and drink. If Phlegm is present, add Ban Xia (0.7 qian, processed), Zhu Li (0.7 qian), and a little Jiang Zhi. If meat diet is consumed, add Shan Zha and Sha Ren. If grain diet is consumed, add Shen Qu and Mai Ya. If constipation, add Rou Cong Rong (1.5 qian, washed with wine). If thirsty, add Mai Dong and Ge Gen (0.8 qian each). If sweating, add Ma Huang Gen (0.8 qian). If palpitations/fright, add Suan Zao Ren (1 qian, husked).
**Tian Ma Tang** treats postpartum wind-stroke with mental confusion, slurred speech, and limb immobility.
Ren Shen, Zao Ren (fried), Fu Shen, Yuan Zhi (clean flesh, processed), Shan Yao, Bai Zi Ren, Mai Dong (heart removed, 1 qian each), Dang Gui (1-2 qian), Shi Chang Pu, Ban Xia Qu, Nan Xing Qu (0.8 qian each), Chuan Xiong, Qiang Huo (0.7 qian each), Tian Ma, Fang Feng (0.5 qian each), Xi Xin (0.4 qian).
Alternatively, make pills with refined honey, coat with Cinnabar, and swallow with light ginger soup.
**Jia Wei Sheng Mai San** treats excessive postpartum blood loss, Heart Blood deficiency failing to nourish the tongue, resulting in unclear, hesitant, and slurred speech.
Ren Shen, Mai Dong (heart removed), Dang Gui Shen, Sheng Di, Zhi Gan Cao, Shi Chang Pu (1 qian each), Wu Wei Zi (13 grains, crushed).
One pig heart, split, boiled with two cups of water until one and a half cups remain, discard the heart, add herbs, boil until seven-tenths remain, take after meals. This formula is very effective for palpitations.
**Zhi Han Sheng Xue Yin** treats excessive postpartum sweating, lockjaw, stiff straight back, and near-death breath resembling epilepsy; urgent treatment is required.
Dang Gui (2 qian, wine-soaked), Chuan Xiong, Ma Huang Gen (1 qian each), Gui Zhi, Qiang Huo, Fang Feng, Ling Yang Jiao, Tian Ma (0.6 qian each), Fu Zi (processed), Zhi Gan Cao (0.4 qian each).
Decoct in water and drink. One variation includes Ren Shen (1 qian).
**Xiong Gui Zao Ren Tang** treats postpartum lack of sweating and tendon/collarateral cramping resembling epilepsy.
Dang Gui (2 qian, wine-washed), Chuan Xiong, Fang Feng (1 qian each), Zao Ren (0.5 qian, husked, fried and ground).
Decoct in water and drink. One variation includes Qiang Huo (0.7 qian).
**Qi Zhen San** treats postpartum stagnant evil blood accumulating and closing the Heart orifice, causing unclear spirit. Since Heart Qi connects to the tongue, closure of Heart Qi results in stiff tongue and inability to speak.
Ren Shen, Shi Chang Pu (1 qian each; for powder, 1 liang each), Chuan Xiong (1 qian; for powder, 0.75 liang), Sheng Di (1 qian; for powder, replace Zhi Gan Cao with 3 qian), Xi Xin (0.2 qian; for powder, 0.25 liang), Bo He (0.1 qian; for powder, omit if unavailable), Fang Feng (0.5 qian; one variation 0.4 qian), Chen Sha (0.5 qian, finely ground, water-flowered; for powder, 3 qian).
Take with Sheng Hua Tang according to *Zun Sheng*. Alternatively, take as powder mixed with Bo He soup, 3 qian per dose.
**Shu Jin Tang** treats long-standing postpartum stiffness unsuitable for tonifying agents.
Qiang Huo, Jiang Huang, Zhi Gan Cao (2 qian each), Hai Tong Pi, Dang Gui, Chi Shao (1 qian each), Bai Zhu (1 qian, earth-fried), Chen Xiang (small amount).
Decoct with ginger. Refer to syndrome differentiation for treatment.
**Shen Fu Tang**
Ren Shen, Dang Gui (wine-soaked, 2-3 qian each), Rou Gui (0.8 or 1 qian), Huang Qi (honey-fried), Bai Zhu (earth-fried, 1.5 qian each), Shu Di (2 qian), Zhi Fu Zi (0.4 or 0.6 qian), Zhi Gan Cao (0.4 qian).
**Sheng Hua Tang** (see discussion of Sheng Hua Tang later in this volume). **Jia Shen Sheng Hua Tang** (see Syncope section in this volume). **Shi Quan Da Bu Tang** (see Fetal Malnutrition section in previous volume). **Li Yin Jian** (see Morning Sickness section in previous volume). **Da Bu Yuan Jian** (see Profuse Lochia section in this volume). **Ba Zhen Tang** (see Various Pains section in previous volume). **Si Jun Zi Tang** (see Fetal Reversal section in previous volume).