产后无得令虚，当大补气血为先。虽有杂证，以末治之。一切病多是血虚，皆
不可发表。产后不可用芍药，以其酸寒伐生发之气故也。产后血晕，因虚火载血上行，渐渐
晕
以韭叶细切，盛于有觜瓶中，以热醋沃之，急封其口，以觜塞产妇鼻中，可愈眩冒。产后中风
，切不可作风治，必大补气血为主，然后治痰，当以左右手之脉，分其气血多少而治。产后
中风，口眼 斜，切不可服小续命汤。产后水肿，必用大补气血为主，小佐苍术、茯苓，使水自
利。
产后大发热，必用干姜，轻者用茯苓，淡渗其热，一应寒苦并发表之药，皆不可用，产后发
热恶寒，皆属血虚。左手脉不足，补血药多于补气药。恶寒发热腹痛者，当去恶血，腹满
者
不是。产后发热，乳汁不通及膨者，无子当消，用麦 二两炒，研细末，
清汤调下，作四服
。有子者，用木通、通草、猪蹄煎服。凡产后有病，先固正气。前条云∶产后大热，必用干
姜。或曰∶用姜者何也？曰∶此热非有余之热，乃阴虚生内热耳。故以补阴药大剂服
之。且干姜能入肺和肺气，入肝分引血药生血，然不可独用，必与补阴药同用。此造化自
然
之妙，非天下之至神，孰能与于此乎？产后脉洪数，产前脉细小涩弱，多死。怀孕者脉主
洪数，已产而洪数不改者，多主死。
入方 产后补虚。
人参 白术（一钱） 茯苓 归身尾 陈皮 川芎（各半钱） 甘草（炙，三分）
有热，加黄芩一钱，生姜三片。
上以水煎服。
产后消血块方
滑石（三钱） 没药（二钱） 血竭（二钱，如无以牡丹皮代之）
上为末，醋糊丸。如恶露不下，以五灵脂为末，神曲丸、白术陈皮汤下。瓦楞子能消
又方
血竭 五灵脂
上为末。消产后血块，极好。
又方 治产后泄泻。
黄芩 白术 川芎 茯苓 干姜 滑石 陈皮 炒芍药 甘草（炙）
上 咀。水煎服。
又方 治产后恶露不尽，小腹作痛。
五灵脂 香附（一方加蛤粉）
上为末，醋糊丸。甚者入桃仁，不去尖用。
独行丸 治妇人产后血冲心动，及治男子血气心腹痛，有孕者忌服。
五灵脂（去土，半炒半生）
上为末，水丸，弹子大。每一丸，或酒或姜汤化下。
参术膏 治产后胞损成淋沥证。
人参（二钱半） 白术（二钱） 桃仁 陈皮（各一钱） 黄 （一钱半）茯苓（一钱） 甘草（炙，半钱
上 咀。水煎猪羊胞，后入药，作一服。
〔附录〕产后血晕者，皆由败血流入肝经，眼见黑花，头目旋晕，不能起坐，甚至昏闷不
省人事，谓之血晕。用酒调黑神散最佳，切不可作中风治之。凡血晕皆血乘虚逆上凑心，故
昏迷不省，气闭欲绝是也。古法有云∶产妇才分娩了，预烧秤锤，或江中黄石子，硬炭烧
令通赤，置器中，急于床前以醋沃之，得醋气可除血晕。或以好醋久涂口鼻，乃置醋于傍，使
闻
器亦可。
附方
清魂散 治血迷血晕。
泽兰叶 人参（各二钱半） 荆芥（一两） 川芎（半两） 甘草（二钱）
上为末。用温酒热汤各半盏，调一钱急灌之，下咽即开眼。
黑神散
黑豆（炒，半升） 熟地黄 当归 肉桂 干姜 甘草 白芍 蒲黄（各四两） 生地黄（别本
上为末。每服二钱，童便酒各半调服。一名乌金散。
产后调理的原则是绝不允许让产妇处于虚弱状态，应当以大补气血为首要任务。即使出现其他杂病，也应将其作为次要问题来处理。所有的疾病大多是由于血虚引起的，因此都不可使用发汗解表的方法。产后不能使用芍药，因为它的酸寒之性会损伤人体生发之气。
对于产后血晕（因失血过多或瘀血阻滞导致的头晕目眩甚至昏厥），是因为虚火携带血液上行所致，患者会逐渐感到头晕。可以用韭菜叶切成细丝，放入有嘴的瓶中，倒入热醋，迅速封住瓶口，将瓶嘴塞入产妇鼻孔中，利用醋气刺激，可以治愈眩晕冒昧的症状。
产后如果发生中风，切不可当作普通中风来治疗，必须以大补气血为主，然后再治疗痰证。应当根据左手和右手脉象的情况，分辨气血的多少来进行针对性治疗。产后中风出现口眼歪斜时，切不可服用小续命汤。
产后出现水肿，必须以大补气血为主，少量佐以苍术、茯苓，使水液自然排出。产后出现大发热，必须使用干姜；病情较轻的用茯苓，通过淡渗利湿来清热。所有寒凉苦味以及发汗解表的药物，都不可使用。产后发热伴恶寒，都属于血虚范畴。如果左手脉象不足，补血药的用量应多于补气药。如果是恶寒、发热且伴有腹痛，应当祛除恶露（产后余血）；如果是腹满胀，则不属于这种情况。
产后发热，同时伴有乳汁不通及乳房肿胀者，若没有婴儿吸吮，应当消除乳汁。可用麦冬二两炒制后研成细末，用清汤调服，分四次服用。如果有婴儿哺乳，则使用木通、通草配合猪蹄煎服。凡是产后患病，首先要巩固正气。前文提到：“产后大热，必用干姜。”有人问：“为什么用姜呢？”回答说：“这种热不是实热有余，而是阴虚产生的内热。所以要用大剂量的补阴药服用。而且干姜能入肺经调和肺气，入肝经引导血药生血，但不能单独使用，必须与补阴药同用。这是造化自然的奥妙，如果不是天下最神妙的人，谁能理解其中的道理呢？”
产后脉象洪大而数，而产前脉象细小涩弱，预后多不良，主死。怀孕期间脉象主洪数是正常的，但分娩后洪数脉象如果不改变，也多主死亡。
以下列出相关方剂：
【产后补虚方】
人参、白术（一钱）、茯苓、当归身尾、陈皮、川芎（各半钱）、甘草（炙，三分）。
若有热象，加黄芩一钱，生姜三片。
以上药材用水煎服。
【产后消血块方】
滑石（三钱）、没药（二钱）、血竭（二钱，若无可用牡丹皮代替）。
以上研为细末，用醋糊制成丸剂。如果恶露不下，可用五灵脂研末，以神曲丸和白术陈皮汤送服。瓦楞子也能消散血块。
又方：
血竭、五灵脂。
以上研为细末。用于消除产后血块，效果极好。
又方：治产后泄泻。
黄芩、白术、川芎、茯苓、干姜、滑石、陈皮、炒芍药、甘草（炙）。
以上切碎，用水煎服。
又方：治产后恶露不尽，小腹疼痛。
五灵脂、香附（另一版本加蛤粉）。
以上研为细末，用醋糊制成丸剂。症状严重者加入桃仁，不去尖头直接使用。
独行丸：治妇人产后血冲心导致的心悸动乱，以及男子血气引起的心腹痛，孕妇忌服。
五灵脂（去土，一半炒一半生用）。
以上研为细末，用水泛丸，大小如弹子。每次服用一丸，用酒或姜汤化开送服。
参术膏：治产后胞宫受损导致的小便淋漓不尽证。
人参（二钱半）、白术（二钱）、桃仁、陈皮（各一钱）、黄芪（一钱半）、茯苓（一钱）、甘草（炙，半钱）。
以上切碎，用水煎煮猪羊胞，然后加入药物，一次服完。
〔附录〕产后血晕，都是由败血流入肝经所致，患者眼前出现黑花，头目旋转眩晕，不能起坐，甚至昏迷不省人事，这称为血晕。用酒调服黑神散最佳，切不可当作中风治疗。凡血晕都是血液乘虚逆上汇聚于心，导致昏迷不省，气闭欲绝。古法记载：产妇刚分娩完，预先烧红秤锤，或者江中的黄石子、硬炭，烧得通红，放入容器中，急于床前倒入醋，利用醋气可以消除血晕。或者用优质醋长时间涂抹口鼻，并将醋放在旁边让产妇闻其气味，容器也可以。
附方：
清魂散：治血迷血晕。
泽兰叶、人参（各二钱半）、荆芥（一两）、川芎（半两）、甘草（二钱）。
以上研为细末。用温酒和热汤各半盏，调服一钱并急灌下去，咽下后立即睁眼清醒。
黑神散：
黑豆（炒，半升）、熟地黄、当归、肉桂、干姜、甘草、白芍、蒲黄（各四两）、生地黄（另一版本有记载）。
以上研为细末。每次服用二钱，用童便和酒各半调服。又名乌金散。
Postpartum care dictates that the patient must never be allowed to remain in a deficient state; the primary approach should be massive supplementation of Qi and Blood. Even if other miscellaneous syndromes arise, they should be treated as secondary issues. Most diseases are caused by Blood deficiency, so releasing the exterior (inducing sweating) is contraindicated. *Shaoyao* (White Peony Root) should not be used postpartum because its sour and cold nature damages the body's generative Qi.
Postpartum blood syncope (*Chanhout Xueyun*), characterized by dizziness progressing to fainting due to deficient fire carrying blood upward, can be treated by finely chopping chive leaves, placing them in a bottle with a spout, pouring hot vinegar into it, sealing the mouth tightly, and inserting the spout into the mother's nostril to utilize the vinegar vapor, which can resolve the vertigo.
If wind-stroke occurs postpartum, it must not be treated as typical wind-stroke; the main treatment must be massive supplementation of Qi and Blood, followed by treating phlegm. Treatment should be differentiated based on the degree of Qi and Blood deficiency indicated by the pulses at the left and right wrists. For postpartum wind-stroke presenting with deviation of the mouth and eye, *Xiao Xuming Tang* (Minor Continuation of Life Decoction) must absolutely not be administered.
For postpartum edema, the primary treatment must be massive supplementation of Qi and Blood, with minor adjuncts of *Cangzhu* (Atractylodis Rhizoma) and *Fuling* (Poria), allowing water to drain naturally. For severe fever postpartum, *Ganjiang* (Dried Ginger) must be used; for mild cases, *Fuling* (Poria) is used to clear heat through diuresis. All cold, bitter, and exterior-releasing herbs are contraindicated. Postpartum fever accompanied by aversion to cold belongs to Blood deficiency. If the left pulse is deficient, the dosage of Blood-nourishing herbs should exceed that of Qi-tonifying herbs. For symptoms of aversion to cold, fever, and abdominal pain, one should remove lochia (postpartum residual blood); however, abdominal fullness indicates this is not the case.
For postpartum fever accompanied by milk stasis and breast distension: if there is no infant to suckle, the milk should be suppressed using two liang of stir-fried *Maidong* (Ophiopogonis Radix), ground into fine powder and taken with clear soup in four divided doses. If there is an infant, use *Mutong* (Akebiae Caulis), *Tongcao* (Tetrapanacis Medulla), and pig trotters decocted together. In all postpartum illnesses, first consolidate the healthy Qi. The previous section stated: "Severe heat postpartum requires *Ganjiang*." One might ask, "Why use ginger?" The answer is: "This heat is not excess heat, but internal heat generated by Yin deficiency. Therefore, large doses of Yin-nourishing herbs should be taken. Furthermore, *Ganjiang* enters the Lung meridian to harmonize Lung Qi and enters the Liver branch to guide Blood herbs in generating Blood. However, it cannot be used alone; it must be combined with Yin-nourishing herbs. This is the profound mystery of natural creation; only the most divine among men could comprehend this."
A postpartum pulse that is surging and rapid, whereas the antenatal pulse was small, thin, choppy, and weak, often indicates death. A surging and rapid pulse is normal during pregnancy, but if it remains unchanged after delivery, it also often indicates death.
The following formulas are provided:
[Postpartum Deficiency-Supplementing Formula]
*Renshen* (Ginseng Radix et Rhizoma), *Baizhu* (Atractylodis Macrocephalae Rhizoma, 1 qian), *Fuling* (Poria), *Guishenwei* (Angelicae Sinensis Radix, body and tail), *Chenpi* (Citri Reticulatae Pericarpium), *Chuanxiong* (Ligusticum Chuanxiong Rhizoma, each half qian), *Gancao* (Licorice Root, honey-fried, 3 fen).
If heat is present, add *Huangqin* (Scutellariae Radix, 1 qian) and three slices of *Shengjiang* (Fresh Zingiberis Rhizoma).
Decoct in water and take orally.
[Postpartum Blood-Stasis-Resolving Formula]
*Huashi* (Talcum, 3 qian), *Moyao* (Myrrha, 2 qian), *Xuexie* (Dracaena Sanguinis, 2 qian; substitute with *Mudanpi* [Moutan Cortex] if unavailable).
Grind into powder, form pills with vinegar paste. If lochia does not discharge, administer *Wulingzhi* (Trogopteri Dung) powder with *Shenqu* (Massa Medicata Fermentata) pills and *Baizhu Chenpi Tang* (Baizhu and Chenpi Decoction). *Walengzi* (Arcaea Shell) can also resolve blood stasis.
Another Formula:
*Xuexie* (Dracaena Sanguinis), *Wulingzhi* (Trogopteri Dung).
Grind into powder. Excellent for resolving postpartum blood clots.
Another Formula: Treats postpartum diarrhea.
*Huangqin* (Scutellariae Radix), *Baizhu* (Atractylodis Macrocephalae Rhizoma), *Chuanxiong* (Ligusticum Chuanxiong Rhizoma), *Fuling* (Poria), *Ganjiang* (Zingiberis Rhizoma Recens), *Huashi* (Talcum), *Chenpi* (Citri Reticulatae Pericarpium), stir-fried *Shaoyao* (Paeoniae Radix Alba), *Gancao* (Licorice Root, honey-fried).
Cut into pieces, decoct in water, and take orally.
Another Formula: Treats incomplete expulsion of lochia postpartum with lower abdominal pain.
*Wulingzhi* (Trogopteri Dung), *Xiangfu* (Cyperi Rhizoma; another version adds *Ge Fen* [Arcae Testa]).
Grind into powder, form pills with vinegar paste. For severe cases, add *Taoren* (Persicae Semen), without removing the tips.
*Duxing Wan* (Solo Pill): Treats postpartum blood rushing to the heart causing palpitations and agitation, as well as qi-blood heart and abdominal pain in men. Contraindicated in pregnancy.
*Wulingzhi* (Trogopteri Dung, cleaned of earth, half stir-fried, half raw).
Grind into powder, make water pills the size of a bullet. Take one pill per dose, dissolved in wine or ginger soup.
*Shenzhu Gao* (Renshen and Baizhu Paste): Treats postpartum uterine damage leading to dribbling urination syndrome.
*Renshen* (Ginseng Radix et Rhizoma, 2.5 qian), *Baizhu* (Atractylodis Macrocephalae Rhizoma, 2 qian), *Taoren* (Persicae Semen), *Chenpi* (Citri Reticulatae Pericarpium, each 1 qian), *Huangqi* (Astragali Radix, 1.5 qian), *Fuling* (Poria, 1 qian), *Gancao* (Licorice Root, honey-fried, 0.5 qian).
Cut into pieces, decoct with pig or sheep uterus in water, then add the herbs. Take as one dose.
[Appendix] Postpartum blood syncope is caused by failed blood entering the Liver meridian. Symptoms include seeing black spots before the eyes, spinning vertigo, inability to sit up, and even coma and unconsciousness, termed "blood syncope." Administering *Heishen San* (Black Divine Powder) mixed with wine is best; it must absolutely not be treated as wind-stroke. All blood syncope results from blood riding on deficiency and counterflowing upward to gather at the Heart, causing coma and near-closure of Qi. Ancient methods state: Immediately after delivery, preheat a scale weight, yellow stones from a river, or hard charcoal until red-hot, place them in a vessel, and urgently pour vinegar onto them near the bed. The vinegar vapor can eliminate blood syncope. Alternatively, apply good vinegar to the mouth and nose for a long time, or place vinegar nearby for inhalation.
Attached Formulas:
*Qinghun San* (Clear Soul Powder): Treats blood confusion and syncope.
*Zelan Ye* (Leonuri Herba), *Renshen* (Ginseng Radix et Rhizoma, each 2.5 qian), *Jingjie* (Schizonepetae Spica, 1 liang), *Chuanxiong* (Ligusticum Chuanxiong Rhizoma, 0.5 liang), *Gancao* (Licorice Root, 2 qian).
Grind into powder. Mix one qian with half a cup of warm wine and half a cup of hot water, and force-feed urgently. The eyes will open immediately upon swallowing.
*Heishen San* (Black Divine Powder):
*Heidou* (Sojae Semen Nigrum, stir-fried, half sheng), *Shudihuang* (Rehmanniae Radix Praeparata), *Danggui* (Angelicae Sinensis Radix), *Rougui* (Cinnamomi Cortex), *Ganjiang* (Zingiberis Rhizoma Recens), *Gancao* (Licorice Root), *Baishao* (Paeoniae Radix Alba), *Puhuang* (Typhae Pollen, each 4 liang), *Shengdihuang* (Rehmanniae Radix; recorded in another edition).
Grind into powder. Take 2 qian per dose, mixed with half child's urine and half wine. Also known as *Wujin San* (Black Gold Powder).