凡产后脏腑劳伤，气血虚损，或胞络挟于宿冷，或当风取凉，风冷乘虚而搏于血，壅滞不宣，积
蓄在内，故不下也。宜温暖活血，则血自行。此必小腹胀满刺痛无时，宜用血证黑神散。予每治此证，
用生化汤倍桃仁，调失笑散，生新行瘀，频以黑沙糖冲滚汤，少滴无灰酒服之。如素不饮，或恐发晕，
即不加酒亦可，每每获效。又或因脾胃素弱，中气本虚，败血亦少，气乏血阻，不能尽下，其证乍痛
乍止，痛亦不甚，不可用大黄等药攻之，反增别病，加减八珍汤主之，或生化汤多服数帖亦效。薛氏
止用失笑散治之，《尊生》、《锦囊》均用四味散治效。一产妇患前证，服峻厉之剂，恶露随下，久
而昏愦，以手护其腹。此脾气复伤作痛，故用手护也。以人参理中汤，加肉桂二剂，补之而愈。
加减八珍汤
人参（八分或一钱） 白术（土炒） 茯苓（各一钱） 归身（二钱） 川芎 赤芍（各八分）
熟地（一钱五分） 延胡索（炒） 制香附（各七八分） 炙草（五分）
姜枣引，水煎，食前服。
四味散 治瘀血不下，及疗才分娩一切诸疾。
当归 延胡 血竭 没药（各五分）
为末，用热童便半钟，调服。
血证黑神散（见上卷谵语门。） 生化汤（见本卷生化汤论后。） 失笑散（见中
卷胞衣不下门。）
凡是产后脏腑因劳累而受伤，气血虚弱亏损，或者胞络夹杂有宿存的寒气，或者在受风时贪凉，导致风冷之邪乘虚侵入并与血液搏结，致使血液壅滞不通，积聚在体内，所以恶露不下。治疗应当采用温暖血脉、活血通经的方法，血液自然能够运行通畅。这种情况必然表现为小腹胀满且伴有随时发作的刺痛，适宜使用血证黑神散。我每次治疗这种病症，使用生化汤并加倍桃仁用量，配合调服失笑散，以生新血、行瘀血，频繁地用滚烫的黑砂糖水冲服，滴入少许无灰酒送下。如果患者平时不饮酒，或者担心引起头晕，也可以不加酒，往往都能获得疗效。另外，有的因为脾胃素来虚弱，中气本来不足，败血也少，气乏血阻，不能全部排出，其症状是疼痛时而发作时而停止，疼痛也不剧烈，不可使用大黄等药物进行攻下，否则反而会增加其他疾病，应以加减八珍汤为主治方，或者多服用几帖生化汤也有效。薛氏只用失笑散来治疗此病，《尊生》和《锦囊》均使用四味散治疗且见效。有一位产妇患上述病症，服用峻烈猛厉的药物后，恶露随即下行，但时间久了出现神志昏乱迷糊，用手护住腹部。这是因为脾气再次受损导致疼痛，所以用手护住腹部。用人参理中汤，加入肉桂，服用两剂，通过补益而痊愈。
加减八珍汤
人参（八分或一钱） 白术（土炒） 茯苓（各一钱） 当归身（二钱） 川芎 赤芍（各八分）
熟地黄（一钱五分） 延胡索（炒） 制香附（各七八分） 炙甘草（五分）
生姜、大枣为引，加水煎煮，饭前服用。
In general, after childbirth, the Zang-Fu organs are injured by overwork, and Qi and Blood are deficient and depleted. Alternatively, the uterine collaterals may harbor chronic cold, or exposure to wind while seeking coolness allows Wind-Cold pathogens to invade due to deficiency and contend with the blood. This causes blood stagnation and obstruction, accumulating internally, thus preventing the discharge of lochia. The treatment should involve warming the vessels and invigorating blood circulation, so that blood flows naturally. This condition is invariably characterized by distension and fullness in the lower abdomen accompanied by stabbing pain at any time; Xuezheng Heishen San (Black Divine Powder for Blood Disorders) is appropriate. In my practice, when treating this syndrome, I utilize Shenghua Tang (Decoction for Generating New Blood) with doubled Tao Ren (Peach Kernel), combined with Shixiao San (Powder That Makes One Smile). This combination generates new blood and dispels stasis. It is frequently administered by dissolving dark brown sugar in boiling water, with a few drops of unadulterated wine added. If the patient does not usually consume alcohol or if dizziness is feared, the wine may be omitted; this method often yields effective results. Furthermore, some cases arise from inherent weakness of the Spleen and Stomach and a fundamental deficiency of Middle Qi, resulting in scanty retained blood. Due to Qi exhaustion and blood obstruction, the lochia cannot be fully discharged. The symptoms present as intermittent pain that is not severe. In such cases, purgatives like Da Huang (Rhubarb) must not be used, as they may induce other diseases. Instead, Jiajian Bazhen Tang (Modified Eight-Treasure Decoction) should be the primary formula, or prolonged administration of Shenghua Tang is also effective. Master Xue employed only Shixiao San to treat this condition, while *Zunsheng* and *Jinnang* both utilized Siwei San (Four-Ingredient Powder) with good efficacy. A certain puerpera suffered from the aforementioned syndrome; after administering harsh and drastic agents, her lochia was discharged, but she later became confused and delirious, holding her abdomen with her hands. This indicated that the Spleen Qi had been re-injured causing pain, hence the hand guarding the abdomen. She was treated with Renshen Lizhong Tang (Ginseng Decoction for Regulating the Middle) plus Rou Gui (Cinnamon Bark), administered over two doses, and recovered through tonification.
Jiajian Bazhen Tang (Modified Eight-Treasure Decoction)
Renshen (Ginseng Radix et Rhizoma) (8 fen or 1 qian) Baizhu (Atractylodis Macrocephalae Rhizoma, stir-fried with earth) Fuling (Poria) (each 1 qian) Danggui Shen (Angelicae Sinensis Radix, root portion) (2 qian) Chuanxiong (Ligusticum Chuanxiong Rhizoma) Chishao (Paeoniae Rubra Radix) (each 8 fen)
Shudi (Rehmanniae Radix Praeparata) (1.5 qian) Yanhusuo (Corydalis Rhizoma, stir-fried) Zhixiangfu (Cyperi Rhizoma, processed) (each 7-8 fen) Zhigancao (Glycyrrhizae Radix et Rhizoma, honey-fried) (5 fen)
Use Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus) as guides, decoct in water, and take before meals.
Siwei San (Four-Ingredient Powder) Treats retention of blood stasis and all sorts of ailments occurring immediately after delivery.
Danggui (Angelicae Sinensis Radix) Yanhu (Corydalidis Rhizoma) Xuexie (Draco Sanguis) Moyao (Myrrha) (each 5 fen)
Grind into powder, mix with half a cup of hot Tongbian (Infant Urine), and take orally.
Xuezheng Heishen San (See Volume Upper, Mania Gate.) Shenghua Tang (See Volume Current, Discussion on Shenghua Tang.) Shixiao San (See Volume Middle, Retained Placenta Gate.)