陈良甫曰∶产后血晕，其由有三，有使力过多而晕，有下血多而晕，有下血少而晕。其晕虽同，治之则异。
如下血多而晕者，但昏闷烦乱，当以补血清心药。如下血少而晕者，多恶露不下，上抢于心，心下满急，神
昏不省，当以破血行血药。
按∶下血多而晕，名为血脱，当大剂人参，可以回阳，何云补血又加清心。若下血少而晕，非血滞即属血
竭，未便以破血行血为妄投也。良甫晰证最明，治法尤未尽善。
崔氏曰∶产妇分娩讫；将秤锤或黄石子入炭中，烧令通赤，置器中，于床前以醋沃之，可除血晕，时作为佳。
或先取酽醋，以涂口鼻，仍置醋于旁，淬火炭，使闻其气。又一法，烧干漆，令烟熏产母之面即醒。如无
干漆，旧漆器烧烟亦妙。
慎斋按∶以上二条，序产后血晕分血之多少，而用治法也。产后血晕，总属阴血暴亡，虚火上炎所致。夫
心主血，肝藏血，肝虚则魂无所附而目晕，心虚则神不守而火乘。东垣、丹溪已悉病机之要，若良甫又分血下
多少为治。如云恶露不下，上抢心而晕，此在壮实妇人新产下，恒有此患，当用行血破血之剂。若气血虚弱人，
血脱过多，当大补气血为主，如大剂芎归汤、生化汤，加人参服之可也。
《大全》曰∶恶露不下，由产后脏腑劳伤，气血虚损，或胞络挟于宿冷，或产后当风取凉，风冷乘虚而抟
于血，壅滞不宣，积蓄在内，故不下也。
立斋按∶前证若恶露不下，用失笑散；气滞血凝，用花蕊石散。
慎斋按∶以上一条，序产后恶露不下之证也。彭用光有云∶凡看产后病，须问恶露多少有无。此要语也。
夫新产恶露，属养胎余血，杂浊浆水。儿既产，如气血旺者，恶露随之而下。如气血弱者，阻碍小腹为病。上
攻则为血晕闷绝，蓄瘀则为儿枕痛，心腹痛， 瘕积聚，四肢肿满，血鼓诸证。《大全》以风冷乘虚，抟血不
宣所致。此在秋冬寒月，多有犯之。但《大全》既云风冷抟血矣，何疗三四日，恶露不下，方中独加芍药、知母，
《广济方》内更用大黄、芍药、生地汁。夫以寒药治寒凝之血，有是理乎？《准绳》独首载之，不可解。
陈良甫说：产后血晕，其成因有三种：有因用力过度而致晕的，有因下血量多而致晕的，有因下血量少而致晕的。虽然晕厥的表现相同，但治疗方法却不同。
如果是下血量多而致晕者，仅表现为昏闷烦乱，应当使用补血清心的药物。如果是下血量少而致晕者，多是恶露不下，瘀血上冲于心，导致心下胀满急迫，神志昏迷不省人事，应当使用破血行血的药物。
按语：下血量多而致晕，名为“血脱”，应当用大剂量人参，可以回阳救逆，怎么能说补血又加清心呢？如果下血量少而致晕，不是血滞就是血竭，不宜随意妄投破血行血的药物。陈良甫辨析证候最为清晰，但治疗方法尤其未尽完善。
崔氏说：产妇分娩完毕后；将秤锤或黄石子放入炭火中，烧得通红，置于容器中，在床前用醋浇在上面，可以消除血晕，经常这样做效果更佳。或者先取浓醋，涂抹于口鼻处，仍将醋放在旁边，淬火炭，使其气味被闻到。另一种方法，烧干漆，让烟熏产母的面部即可苏醒。如果没有干漆，烧旧漆器的烟也很好。
慎斋按语：以上两条，叙述了产后血晕根据下血量的多少而采用不同的治疗方法。产后血晕，总属于阴血突然亡失，虚火上炎所致。心主血，肝藏血，肝虚则魂无所依附而目眩，心虚则神不守舍而火邪乘虚而入。李东垣、朱丹溪已经透彻掌握了病机的关键，若陈良甫又根据下血量的多少来区分治疗。如果说恶露不下，上冲于心而晕，这在身体壮实的妇女新产后，常有此患，应当使用行血破血的方剂。如果是气血虚弱的人，血脱过多，应当以大补气血为主，如大剂量芎归汤、生化汤，加入人参服用即可。
《大全》说：恶露不下，是由于产后脏腑劳损受伤，气血虚损，或者胞络夹杂宿有的寒气，或者产后当风受凉，风冷乘虚侵入并与血搏结，壅滞不通，积蓄在内，所以恶露不下。
立斋按语：前述证候，如果恶露不下，使用失笑散；如果是气滞血凝，使用花蕊石散。
慎斋按语：以上一条，叙述了产后恶露不下的证候。彭用光曾说：凡是诊治产后病，必须询问恶露的多少和有无。这是关键的话。新生的恶露，属于养胎的余血，混杂浊浆水。胎儿既已产出，如果气血旺盛者，恶露随之而下。如果气血虚弱者，阻碍小腹而致病。向上攻冲则导致血晕闷绝，蓄积瘀血则导致儿枕痛、心腹痛、瘕积聚、四肢肿满、血鼓等各种证候。《大全》认为是风冷乘虚，搏结血液导致不通所致。这在秋冬寒冷月份，多有发生。但是《大全》既然说是风冷搏结血液，为什么治疗三四天后恶露不下，方剂中唯独加入芍药、知母，《广济方》内更使用大黄、芍药、生地汁？用寒凉药物治疗寒凝之血，有这样的道理吗？《准绳》单独首载此法，令人不解。
Chen Liangfu stated: Postpartum blood dizziness (Chanhou Xueyun) has three causes: one is due to excessive exertion, another is due to excessive bleeding, and the third is due to insufficient bleeding. Although the manifestation of dizziness is the same, the treatment methods differ.
In cases where dizziness is caused by excessive bleeding, characterized merely by confusion and restlessness, one should use herbs that tonify blood and clear the heart. In cases where dizziness is caused by insufficient bleeding, often accompanied by the failure of lochia (Eluo) to discharge, with blood stasis rushing upward to the heart, causing fullness and urgency in the epigastrium, unconsciousness, and loss of consciousness, one should use herbs that break up blood stasis and promote blood circulation.
Commentary: Dizziness caused by excessive bleeding is termed "Blood Collapse" (Xuetuo). Large doses of Ginseng Radix et Rhizoma Rubra (Renshen) should be used to restore yang and rescue from collapse; how can it be said that tonifying blood and clearing the heart is appropriate? If dizziness is caused by insufficient bleeding, it is either blood stagnation or blood exhaustion; it is inappropriate to recklessly administer herbs that break up blood stasis. Chen Liangfu’s differentiation of syndromes was very clear, but his treatment methods were not entirely perfect.
Cui Shi stated: After childbirth, place a weight or a yellow stone into charcoal fire until it becomes red hot, put it in a vessel, and pour vinegar over it near the bed to alleviate postpartum blood dizziness; doing this frequently is better. Alternatively, apply thick vinegar to the mouth and nose, keep vinegar nearby, quench the hot charcoal, and allow the patient to inhale the fumes. Another method is to burn dried lacquer (Ganqi), letting the smoke熏 (xun) the parturient’s face to induce awakening. If dried lacquer is unavailable, burning old lacquerware vessels is also effective.
Shenzhai commented: The above two passages describe the treatment of postpartum blood dizziness based on the amount of bleeding. Postpartum blood dizziness generally results from sudden loss of yin blood and rising deficient fire. The Heart governs blood, and the Liver stores blood. When the Liver is deficient, the Hun (ethereal soul) has no attachment, leading to dizziness; when the Heart is deficient, the Shen (spirit) does not reside securely, allowing fire pathogens to invade. Li Dongyuan and Zhu Danxi had already grasped the essence of pathogenesis. Chen Liangfu further differentiated treatment based on the volume of bleeding. He stated that if lochia fails to discharge and rushes upward to cause dizziness, this condition commonly occurs in robust women shortly after delivery, and formulas that move and break blood stasis should be used. However, for individuals with Qi and Blood deficiency and excessive blood loss, the primary treatment should be massive tonification of Qi and Blood, such as using large doses of Xiong Gui Tang (Angelica and Ligusticum Decoction) or Sheng Hua Tang (Generation of Life Decoction) with added Ginseng Radix et Rhizoma Rubra (Renshen).
The Daquan stated: Failure of lochia to discharge is caused by damage to the Zang-Fu organs from postpartum labor, depletion of Qi and Blood, or cold pathogens lingering in the uterine collaterals. If the woman exposes herself to wind and cold after delivery, wind-cold may invade the deficiency and bind with blood, causing obstruction and stagnation within, thus preventing lochia discharge.
Lizhai commented: For the aforementioned syndrome of lochia retention, use Shixiao San (Pain-Relieving Powder); if there is Qi stagnation and blood coagulation, use Huarui Shi San (Flower-Marrow Stone Powder).
Shenzhai commented: The above passage describes the syndrome of postpartum lochia retention. Peng Yongguang said: When treating postpartum diseases, one must inquire about the presence and quantity of lochia. This is a crucial point. Fresh lochia consists of residual blood from pregnancy mixed with turbid fluids. If the newborn’s Qi and Blood are vigorous, lochia discharges naturally. If Qi and Blood are weak, obstruction in the lower abdomen leads to disease. Upward attack causes blood dizziness and fainting; accumulation of blood stasis causes “child pillow pain” (Erzhen Tong), abdominal pain, masses (Jia Ji), limb swelling, and bloody drum distension. The Daquan attributes this to wind-cold invading deficiency and binding with blood, which is common in autumn and winter. However, since the Daquan states that wind-cold binds with blood, why do formulas for lochia retention after three or four days exclusively include Paeoniae Radix Alba (Baishao) and Anemarrhenae Rhizoma (Zhimu)? Why does the Guangji Fang use Rhei Radix et Rhizoma (Dahuang), Paeoniae Radix Alba (Baishao), and juice of Rehmanniae Radix Recens (Shengdi)? Using cold-natured herbs to treat blood congealed by cold—does this make sense? The Zhunsuo cites this method first, which is inexplicable.