典藏书目

The *Xin Dian* states: "Blood deficiency leads to sweating, causing the sinews and vessels to lose nourishment; when wind pathogen invades, it exacerbates stiffness, which is a disease of the sinews. Massive loss of yin blood results in blood deficiency, causing yang qi to rebel (Jue), and cold pathogen to stagnate within, leading to dizziness and blurred vision, which is a disease of the spirit (Shen). The Stomach stores body fluids and irrigates the Yang meridians; loss of body fluids causes Stomach dryness, leading to lack of lubrication in the Large Intestine and difficult defecation, which is a disease of fluids. Although these three conditions differ, they all stem from blood loss and fluid injury, thus they are all diseases that may occur postpartum." From this, one can infer that any syndrome of blood deficiency postpartum can be understood through intuitive comprehension. Regarding the aforementioned three major syndromes, they can all be treated with Sanjia Fumai Decoction (Three-Shell Pulse-Replenishing Decoction), Da Dingfeng Zhu (Great Wind-Calming Pearl) or Xiao Dingfeng Zhu (Small Wind-Calming Pearl), and Zhuanxi Gao (Zhuanxi Paste). This is because these six formulas can all moisten the sinews, calm the spirit, and replenish fluids, differing only in the depth and sequence of their action. If there are no other illnesses postpartum, but only difficulty in defecation, Zengye Tang (Fluid-Increasing Decoction) may be administered (formula notes are found in the Middle Jiao Chapter on Warm Heat). The above seven formulas are suitable for patients with postpartum blood deficiency and shortness of fluids; even if there is a slight exterior contraction, or the exterior contraction has been largely resolved, presenting as less pathogen and more deficiency, they can be selected for use without waiting for the complete resolution of the exterior contraction. Furthermore, if postpartum errors involve the misuse of wind-dispelling herbs or acrid-warm rigid-dry substances, causing injury to body fluids, the aforementioned seven formulas can be used judiciously for rescue. I formulated these seven formulas based on my understanding of the original text of the *Jingui Yaolue*; they have proven effective upon use, so I dare to share them with future practitioners.

Zhang Shiwan stated: "Postpartum primordial qi is depleted, allowing lochia to attack upward due to deficiency. Symptoms include visual disturbances and dizziness, epigastric fullness and oppression, coma with locked jaw, or excessive phlegm-saliva accumulation. In such cases, hot child urine should be urgently administered. For fainting due to excessive bleeding, or coma with restlessness, Xionggui Tang (Peony and Angelica Decoction) added with Renshen (Ginseng), Zelan (Lycopus Herb), and child urine can be used to tonify and dissipate simultaneously (This point requires careful consideration. Fainting due to heavy bleeding indicates blood deficiency; how can one use acrid, dispersing, and moving herbs like Chuanxiong, Danggui, and Zelan that travel through the blood and qi levels, thereby worsening the deficiency? This formula relies entirely on Renshen to secure the upright qi. However, Renshen is currently difficult to obtain, and the formula itself is flawed. It would be better to use Sanjia Fumai Decoction or Da/Xiao Dingfeng Zhu. Wise individuals should realize this). Additionally, there are three types of敗血 (stagnant blood) rushing upward: singing, dancing, talking, and laughing; angry cursing, sitting, and lying restlessly; or even climbing walls and roofs. This is stagnant blood rushing to the Heart, often resulting in death; Huashishi San (Flower Coral Stone Powder) or Hupo Heilong Dan (Amber Black Dragon Pill) should be used. If there is restlessness but not mania, Shixiao San (Instant Success Powder) added with Yujin (Curcuma Rhizome) is indicated. If there is fullness, bloating, nausea, vomiting, abdominal distension, and pain, this is stagnant blood rushing to the Stomach; Wuji San (Five Accumulations Powder) or Pingwei San (Calm the Stomach Powder) added with Shengjiang (Fresh Ginger) and Rougui (Cinnamon Bark) should be used. If ineffective, Songlaifu Dan (Songlaifu Pill) is sent. If vomiting and rebounding distension occur, and blood transforms into water, Xiayuxue Tang (Drain Stagnant Blood Decoction) from the *Jingui Yaolue* is used. If the face is red, vomiting and retching are severe, or breathing is rapid and urgent, this is stagnant blood rushing to the Lung; Renshen (Ginseng) and Sumu (Pterocarpus Wood) are used, and in severe cases, Mangxiao Tang (Mirabilite Decoction) to purge. Generally, those with heart rush have a mortality rate where ten out of ten die; stomach rush has a 50% mortality rate; lung rush has a survival rate of only one or two out of ten. Additionally, if black color appears around the mouth and nose postpartum accompanied by epistaxis, it indicates failure of Stomach qi and blood stasis. Urgent administration of Renshen and Sumu is required; delay means non-survival." I observe that Zhang's discussion on postpartum stagnant blood rushing upward is detailed. Postpartum stagnant blood excess syndromes must present with abdominal pain that refuses pressure. If the painful area refuses pressure, Shenghua Tang (Generate New Decoction) is best for mild cases, and Huisheng Dan (Regenerate Life Pill) for severe cases. Huisheng Dan uses vinegar-boiled Dahuang (Rhubarb Root), which targets the pathology without damaging other organs; it contains many animal-derived blood-resolving ingredients and Ginseng to protect the upright qi. How can such a formula fail to break stasis or harm the upright qi? Recently, I have seen physicians treating postpartum abdominal pain without asking whether the patient prefers pressure or rejects it, uniformly applying Shenghua Tang. Even families do not consult doctors, routinely administering over ten doses of Shenghua Tang after every birth, leading to Yin-deficiency consumptive diseases, which is truly lamentable! I saw in the ancient edition of *Dasheng Pian* that the note under Shenghua Tang states: "Specifically treats postpartum stagnant blood abdominal pain and 'child pillow' pain, capable of resolving stasis and generating new blood." The formula matches the disease, with solid basis. Recent printed editions simply state: "Treats various postpartum diseases," with some annotations saying "take immediately after delivery," which is extremely illogical, detestable, and hateful. Furthermore, while the main theme of *Dasheng Pian* teaches tranquility and reliance on natural processes, which is wonderful, its prescribed formulas cannot be fully trusted. For instance, under Dasheng Tang, it says: "Take after the ninth month of pregnancy; more is better." This is akin to saying "there is no trouble in the world, yet commoners worry themselves." Is there any logic in prescribing medication to pregnant women regardless of their physical condition and pulse? If the pulse is deep and choppy, taking Dasheng Tang might be acceptable. But if the pulse is slippery, forceful, and slippery (Hong-Hua), indicating abundant qi in the blood and warm blood, how can one again use acrid herbs that move qi? This would inevitably lead to excessive postpartum bleeding and convulsions. Such illogical statements are too numerous to refute, leaving only with a long sigh!