产后危证，莫如败血三冲。其人或歌舞谈笑，或怒骂坐卧，甚者逾墙上屋，口咬拳打，山腔野
调，号佛名神，此为败血冲心，多死。《医通》云∶花蕊石散最捷，琥珀黑龙丹亦效。如虽闷乱不致
癫狂者，失笑散加郁金。予谓当于妄言妄见门参看治疗。
若其人饱闷呕恶，腹满胀痛者，为之冲胃。《医通》云∶用平胃散加姜、桂，往往获效。不应，送
来复丹。呕逆腹胀血化为水者，金匮下瘀血汤。予谓当于饱胀呕逆等门参看治疗。
若其人面赤呕逆欲死，为之冲肺。《医通》云∶二味参苏饮，甚则加芒硝荡涤之。
予谓当于口鼻黑衄门参看治疗。
大抵冲心者，十难救一。冲胃者，五死五生。冲肺者，十全一、二。其《医通》
所用金石及峻药等治法，亦无可如何之思，与其视死，不若救生之意耳。予谓治此等证，宜用生化、失
笑、抵圣等类平稳药，当亦通神。至来复、黑龙等丹，花蕊、平胃等散，及下瘀血汤，均未敢轻用，
姑录之以备参考耳。
来复丹 治上盛下虚，里寒外热，及伏暑泄泻如水。
硫黄（同硝石为末，银石器内慢火炒，柳木搅之。不可猛火以伤药力） 硝石 太阴玄 精石
（水飞） 青皮（去穣） 陈皮（去白。各一两） 五灵脂（二两，水飞去沙石，澄定晒干）
上为末，古法以醋和丸，米饮下。因醋易冲坏，今改用米饮糊丸如梧子大。每服三十丸，空心醋汤下。
二味参苏饮 治恶露入胞，胀大不能出，及产后败血冲肺，喘满面赤几死者。
人参（二钱） 苏木（四钱，碎）
水煎服。又有入童便热服。一方，人参一两为末，苏木二两捶碎，水碗半，煎苏木水一碗，去
渣，调人参末，随时加减服。大便溏泄者禁用。
花蕊石散失笑散（俱见中卷胞衣不下门。） 琥珀黑龙丹（见中卷催生门。） 平胃散
金匮下瘀血汤（俱见上卷诸痛门。） 生化汤（见本卷生化汤论后。） 抵圣汤（见本卷气逆呕吐不食门。）
产后危重证候，没有比败血三冲更严重的了。患者有的能歌舞谈笑，有的愤怒辱骂、坐卧不宁，严重的甚至翻墙爬屋，咬人口拳打，发出山野怪异的调声，呼喊佛神名号，这是败血冲心，大多死亡。《医通》说：花蕊石散效果最快，琥珀黑龙丹也有效。如果虽然烦闷扰乱但未至癫狂的，用失笑散加郁金。我认为应当在“妄言妄见”门类中参看治疗方法。
如果患者感到饱胀闷痛、呕吐恶心、腹部满胀疼痛的，这是败血冲胃。《医通》说：用平胃散加生姜、肉桂，往往获得疗效。如果无效，送来复丹。如果呕吐逆气、腹胀且血液化为水湿的，用《金匮要略》的下瘀血汤。我认为应当在“饱胀呕逆”等门类中参看治疗方法。
如果患者面色红赤、呕吐逆气痛苦欲死，这是败血冲肺。《医通》说：用二味参苏饮，严重的加芒硝以荡涤邪气。我认为应当在“口鼻黑衄”门类中参看治疗方法。
大抵而言，败血冲心的，十个人中难得救活一个；冲胃的，五死五生；冲肺的，十个人中能救活一两个。《医通》所用的金石类药物及峻猛药物等治法，也是无可奈何时的想法，与其看着病人死亡，不如挽救生命的意图罢了。我认为治疗这类证候，宜用生化汤、失笑散、抵圣汤等平稳的药物，应当也能取得神奇疗效。至于来复丹、黑龙丹，花蕊石散、平胃散，以及下瘀血汤，都不敢轻易使用，暂且记录它们以备参考而已。
来复丹：治疗上盛下虚，里寒外热，以及伏暑泄泻如水样。
硫黄（与硝石研为细末，在银器或石器内用慢火炒制，用柳木棍搅拌。不可用猛火以免损伤药力）、硝石、太阴玄精石（用水飞法研磨）、青皮（去瓤）、陈皮（去白，各一两）、五灵脂（二两，用水飞法去除沙石，澄清后定形晒干）。
以上药物研为细末，古法用醋调和制成丸剂，米汤送服。因为醋容易冲坏药效，现在改用米糊制成梧桐子大小的丸剂。每次服用三十丸，空腹时用醋汤送服。
二味参苏饮：治疗恶露进入胞宫，胀大无法排出，以及产后败血冲肺，气喘面赤几乎死亡的证候。
人参（二钱）、苏木（四钱，捣碎）。
加水煎煮服用。又有加入童便热服的方子。另一方法，将人参一两研为细末，苏木二两捶碎，用水一碗半，煎取苏木水一碗，去渣，调入人参细末，根据情况随时加减服用。大便溏泄者禁用。
花蕊石散、失笑散（均见于中卷胞衣不下门）。琥珀黑龙丹（见于中卷催生门）。平胃散。
金匮下瘀血汤（均见于上卷诸痛门）。生化汤（见于本卷生化汤论后）。抵圣汤（见于本卷气逆呕吐不食门）。
Critical postpartum syndromes are most severe in the case of Three Rushing (San Chong) caused by Ruined Blood (Bai Xue). The patient may be able to sing, dance, talk, and laugh; or become angry, curse, sit, and lie restlessly. In severe cases, they may climb over walls and roofs, bite people, and punch with fists, making wild and strange noises, calling out the names of Buddhas and deities. This is called Ruined Blood Rushing to the Heart (Bai Xue Chong Xin), and it is mostly fatal. *Yi Tong* states: Huarui Shi San (Huarui Stone Powder) acts most swiftly, and Hupo Heilong Dan (Amber Black Dragon Pill) is also effective. If the patient is troubled and restless but not yet manic, Shixiao San (Joyless Powder) with Yujin (Curcuma Aromatica Rhizome) should be used. I believe treatment methods should be consulted in the section on "Delusions and Hallucinations."
If the patient feels fullness, oppression, nausea, vomiting, abdominal distension, and pain, this is called Ruined Blood Rushing to the Stomach (Bai Xue Chong Wei). *Yi Tong* states: Use Pingwei San (Pingwei Powder) added with Shengjiang (Fresh Ginger) and Guirou (Cinnamon Bark), which often yields results. If there is no response, Laifu Dan (Laifu Pill) should be administered. If there is vomiting, reverse flow, abdominal distension, and blood transforms into water-dampness, Xiayuxue Tang (Decoction for Draining Stasis from the Golden Cabinet) should be used. I believe treatment methods should be consulted in the sections on "Fullness, Distension, Nausea, and Reverse Flow."
If the patient has a red face, vomiting, reverse flow, and suffers to the point of wanting to die, this is called Ruined Blood Rushing to the Lung (Bai Xue Chong Fei). *Yi Tong* states: Use Erwei Renshen Suye Yin (Two-Ingredient Ginseng and Spatholobus Decoction); in severe cases, Mangxiao (Mirabilite) should be added to purge the pathogen. I believe treatment methods should be consulted in the section on "Black Nasal Epistaxis."
Generally speaking, in cases of Ruined Blood Rushing to the Heart, one in ten can be saved; in cases of Rushing to the Stomach, five die and five survive; in cases of Rushing to the Lung, only one or two in ten can be saved. The treatments using mineral stones and harsh drugs mentioned in *Yi Tong* are measures of last resort, reflecting an intention to save lives rather than watch them perish. I believe that treating such syndromes requires mild and stable medicines such as Shenghua Tang (Shenghua Decoction), Shixiao San (Joyless Powder), and Disheng Tang (Disheng Decoction), which should also yield miraculous results. As for Laifu Dan, Heilong Dan, Huari Shi San, Pingwei San, and Xiayuxue Tang, I dare not use them lightly; they are recorded here merely for reference.
Laifu Dan (Laifu Pill): Treats excess above and deficiency below, interior cold with exterior heat, and summerheat retention diarrhea resembling water.
Liu Huang (Sulfur, ground together with Xiaoshi (Niter) into powder, slowly fried in silver or earthenware vessels, stirred with willow wood. Do not use strong fire to avoid damaging medicinal potency), Xiaoshi (Niter), Taiyin Xuanjing Shi (Taiyin Mysterious Essence Stone, prepared by water levigation), Qingpi (Green Tangerine Peel, pith removed), Chenpi (Aged Tangerine Peel, white pith removed, each 1 liang), Wulingzhi (Trogopterus Dung, 2 liang, prepared by water levigation to remove sand and stones, clarified, settled, and dried).
Grind all ingredients into powder. According to ancient methods, mix with vinegar to form pills and take with rice drink. Because vinegar may easily impair efficacy, current practice uses rice paste to form pills the size of mulberry seeds. Take 30 pills per dose, on an empty stomach with vinegar water.
Erwei Renshen Suye Yin (Two-Ingredient Ginseng and Spatholobus Decoction): Treats lochia entering the uterus, causing distension and inability to expel, as well as postpartum Ruined Blood Rushing to the Lung, characterized by asthma, red face, and near-death state.
Renshen (Ginseng Radix et Rhizoma, 2 qian), Sumu (Spatholobi Caulis, 4 qian, crushed).
Decoct in water and take orally. Another method adds Tongbian (Child's Urine) and takes hot. Another prescription: Grind 1 liang of Renshen (Ginseng Radix et Rhizoma) into powder, crush 2 liang of Sumu (Spatholobi Caulis), add half a bowl of water, decoct Sumu until one bowl remains, strain, mix in Renshen powder, and adjust dosage according to circumstances. Contraindicated in patients with loose stools.
Huarui Shi San (Huarui Stone Powder) and Shixiao San (Joyless Powder) (both see Volume Middle, Section on Retained Placenta). Hupo Heilong Dan (Amber Black Dragon Pill) (see Volume Middle, Section on Facilitating Labor). Pingwei San (Pingwei Powder).
Jinkui Xiayuxue Tang (Decoction for Draining Stasis from the Golden Cabinet) (see Volume Upper, Section on Various Pains). Shenghua Tang (Shenghua Decoction) (see Post-Shenghua Decothesis Discussion in this Volume). Disheng Tang (Disheng Decoction) (see Volume, Section on Qi Reversal, Vomiting, and Anorexia).