产后血块，是孕成余血之所积也，夫妇人血旺气衰，二七而天癸至，三旬一见，以象月
盈则亏，行之有常则曰经，有孕则经水不行，其余血注于胞中以护胎元。一月名胎胚，二月
名始膏，三月始成形而名胎，方受母血之荫庇。胎形尚小，虽食母血而尚有余汁，并前两月
之血积于胞中，日久成块，至产时当随儿下。或因产妇送儿送胞劳倦无力，或调护失宜，腹
欠温暖，致血块日久不散，疼痛拒按。并宜生化汤助血行血，外用热衣暖腹可也，慎勿轻服
峻剂，至崩脱不救。
凡产后晕、厥二证，皆由气血并竭，苟非急补，何能挽其将绝之元神，无庸疑议者也。
但晕在临盆，证急犹甚于厥，用药不及，急救法救之。如其人微虚者，则眼花头眩，或心下
满闷，神昏口噤，不知人事，少顷即苏。或因亡血过多，以致虚火乘虚泛上而神不清，身无
所主，其阴血暴亡，心神失养，心与胞络君相之火，得血则安，亡血则危。火上炽故令人昏
冒，火乘肺故瞑目不省人事，是阴血暴亡，不能镇抚也。《经》云∶病气不足，宜补不宜泻
。瞑目合眼，病悉属阴，暴去有形之血，则火上炽，均宜频灌生化汤，或从权急救。生化汤
二三帖，无补血分之亏，则块化血旺，神清而晕止。大虚者，其证面白眼闭，口开手冷，多
汗神昏，六脉微细之甚，是气随血脱而欲绝，当大剂人参方可回阳，恐势急而补阴不及，须
以气药兼之，此阳生阴长之理也。从权急救加参生化汤，或加参生化汤最效。如制药不及，
速用独参汤两许，煎汤急救之，但得下咽，即可望生。若少迟延，则无及矣。有人谓产后七
日，方可用参，此愚昧讹传，不知始自何人，万不可信。但晕发顷刻，而急救外治之法，又
不可缓，速宜轻轻扶坐，勿令卧倒。或烧红炭，沃之以醋；或烧旧漆器，令烟气透入口鼻即
苏；急捏人中，静以待之，元气渐复。不可乱动，致令神气散乱。或用韭菜一握，切碎入有
嘴瓷瓶内，将醋煮滚浇入瓶内，急盖口，以瓶嘴向妇鼻孔，令气透入鼻中即苏。但凡大病大
虚之人，皆能作晕，产后之晕因血去而名之曰血晕，实非因血而致晕也。若偏信古方，认晕
证为恶血抢心，而轻用苏木、牛膝、红花等类以及牡丹夺命等方，或认为痰水，而用调补消
痰之方，误之甚矣。俗治产妇或因死胎及胎衣恶血上逆，搐呕昏晕，用小便乘热灌之，但得
一口下咽即止。设遇胃气壮盛之妇，不畏臊气，获效者有之。然童便非能止晕回元，盖取其
下行旧路，降火消瘀。考之方书内云∶败血流入肝经，眼生黑花，头目昏晕，不省人事。此
血热乘虚逆上凑心，故昏迷不省，气闭欲绝也，服童便最好。此论但照管败血，全罔顾产虚
，且有气闭欲绝四字，岂童便可挽回元气欲绝乎？即有恶血上逆、血滞等证，亦莫若生化汤
温而行之，去瘀止晕之妙也。予见江南产科有用当归二钱，益母草一钱，人参二钱，红花六
分，炮姜八分，煎热冲童便服之以治晕，此方兼得之义，庶几近之。如妇人有血晕之证者，
不若于将产数日前，预煎择服八珍、十全、归脾等类调补气血，临产又用人参催生，补于未
产未虚之前，产后无虚可乘，无晕可发矣。
至于厥证，在分娩之后，因产时用力过多，劳倦伤脾，孤脏不能注于四旁，故手足逆冷
而发厥。《经》云∶阳气衰于下，则为寒厥，厥气上行，满脉去形。盖逆气上满于经络，则
神气浮越去身而散也。宜大补回阳，生化汤连用两服。俟血气旺而神复，厥证自止矣，又非
偏补血分之可得而愈也。若服药而口渴，另用参麦散以代茶，助津以救脏燥也。又有四肢逆
冷、泄痢，类伤寒阴证，不可用四逆汤，必生化汤倍参煎服，或加熟附子一片，则可以止逆
回阳，而见参、归之功矣。若血块痛止而厥，滋荣益气汤最效。
凡晕厥乃产后危急二证，若新产块痛未除，又未可遽加 、术，故急加人参，从权以救
之，俟晕止厥回，再去参以除块痛，此要诀也。
产后血块，是怀孕后残留血液积聚而成的。妇女气血旺盛时，十四岁天癸（促进生殖功能发育的物质）来潮，三十岁月经每月一次，如同月亮盈亏有常度，称为经；一旦怀孕，月经停止，剩余的血液注入胞宫以保护胎元。怀孕一个月叫胎胚，两个月叫始膏，三个月开始成形才叫胎，此时才接受母血的滋养庇护。胎儿形体尚小，虽然摄取母血但仍有剩余汁液，加上前两月的积血留在胞宫中，日久结成血块，到分娩时应随婴儿一起排出。如果因为产妇在送产、排胞过程中劳累无力，或者调护不当，腹部缺乏温暖，导致血块日久不散，引起疼痛且拒按。此时宜用生化汤帮助行血活血，外用热衣暖腹即可，千万不要轻易服用峻猛之剂，以免导致崩漏脱证无法救治。
凡是产后晕厥两种证候，都是由气血同时衰竭所致，如果不紧急进补，怎么能挽回将绝的元神呢？这是毫无疑问的。但是晕证发生在临盆之时，病情比厥证更为急迫，若用药来不及，需用急救法处理。如果是体质轻微虚弱的人，会出现眼花头晕，或者心下满闷，神志昏迷牙关紧闭，不知人事，过一会儿就能苏醒。或者因为失血过多，导致虚火乘虚上浮而神志不清，身体失去主宰，阴血突然亡失，心神失去滋养，心和胞络中的君火与相火，得到血液则安宁，失去血液则危险。火上炽盛所以令人昏冒，火邪侵犯肺脏所以闭目不省人事，这是因为阴血突然亡失，不能镇抚阳气。《内经》说：病气不足，适宜补益而不适宜泻法。闭目合眼，病症都属阴，突然失去有形的血液，则火势炽盛，都适宜频繁灌服生化汤，或者权宜采取急救措施。生化汤服用二三帖，如果没有补血分的亏损，那么血块化解、血液旺盛，神志清醒而晕止。对于极度虚弱者，其症状为面色苍白、眼睛闭合、口开手冷、多汗神昏，六脉极其微细，这是气随血脱而将要断绝，应当使用大剂量人参才能回阳，恐怕形势紧急而单纯补阴来不及，必须配合补气药，这是阳生阴长的道理。权宜急救可用加参生化汤，或者加参生化汤效果最好。如果来不及制药，迅速使用独参汤一两许，煎汤急救，只要能够咽下，就有希望生存。如果稍微迟延，就来不及了。有人声称产后七日才可以用人参，这是愚昧的错误传闻，不知道始于何人，万万不可相信。但是晕证发作顷刻之间，而急救的外治方法，又不可迟缓，应迅速轻轻扶起坐好，不要让其躺倒。或者烧红木炭，浇上醋；或者烧旧漆器，让烟气透入口鼻即能苏醒；急掐人中穴，安静等待，元气逐渐恢复。不可乱动，致使神气散乱。或者用韭菜一把，切碎放入有嘴的瓷瓶内，将醋煮滚倒入瓶内，急盖瓶口，将瓶嘴对准产妇鼻孔，让气体进入鼻中即能苏醒。但凡大病大虚之人，都能发生晕厥，产后因失血而发生的晕厥称为血晕，实际上并非因血而导致晕厥。如果偏信古方，认定晕证是恶血抢心，而轻率使用苏木、牛膝、红花等类药物以及牡丹夺命汤等方剂，或者认为是痰水，而使用调补消痰的方剂，误人甚深。民间治疗产妇有时因死胎及胎衣恶血上逆，抽搐呕吐昏晕，用小便趁热灌服，只要得一口咽下即停止。如果遇到胃气壮盛的妇人，不畏惧臊气，获得疗效的确实有。然而童便并非能止晕回元，大概是取其下行旧路，降火消瘀。考察方书内记载：败血流入肝经，眼生黑花，头目昏晕，不省人事。这是血热乘虚逆上凑心，所以昏迷不省，气闭欲绝，服用童便最好。这种论述只照顾到败血，完全不顾及产后体虚，且有“气闭欲绝”四字，难道童便可挽回元气欲绝吗？即使有恶血上逆、血滞等证，也不如用生化汤温通而行，具有去瘀止晕的妙处。我见到江南产科有用当归二钱，益母草一钱，人参二钱，红花六分，炮姜八分，煎热冲入童便服用以治疗晕厥，此方兼得义理，比较接近正确。如果妇人有血晕的证候，不如在分娩前几天，预先煎煮选择服用八珍汤、十全大补汤、归脾汤等类调补气血，临产时又用人参催生，在未产未虚之前进行补益，产后没有虚损可乘，也就不会发生晕厥了。
至于厥证，在分娩之后，因为产时用力过多，劳累损伤脾气，孤脏之气不能灌注于四肢，所以手足逆冷而发生厥。《内经》说：阳气衰于下，则为寒厥，厥气上行，充满经脉而脱离形体。大概逆气上满于经络，则神气浮越离开身体而散失。适宜大补回阳，连续服用两服生化汤。等到血气旺盛而神志恢复，厥证自然停止，这又不是单纯补血分所能治愈的。如果服药后口渴，另用参麦散代替茶喝，辅助津液以救脏腑干燥。又有四肢逆冷、泄痢，类似伤寒阴证，不可用四逆汤，必须用生化汤加倍人参煎服，或者加熟附子一片，就可以止逆回阳，体现人参、当归的功效。如果血块痛止而出现厥证，滋荣益气汤效果最好。
凡是晕厥乃是产后危急的两个证候，如果新产后血块疼痛尚未消除，又不可以立即加入白术、苍术等燥湿药，所以紧急加入人参，权宜以救急，等到晕止厥回，再去掉参以除血块痛，这是关键诀窍。
Postpartum blood masses are accumulations of residual blood after pregnancy. In women, when Qi and Blood are abundant, Tian Gui (substances promoting reproductive development) arrives at age fourteen, and menstruation occurs monthly at age thirty, resembling the waxing and waning of the moon with regularity, termed Jing (menstruation). Once pregnant, menstruation ceases, and residual blood enters the Bao Gong (uterus) to protect the Tai Yuan (fetal origin). At one month of gestation, it is called Tai Pei (fetal embryo); at two months, Shi Gao (beginning paste); at three months, it begins to take form and is named Tai (fetus), only then receiving nourishment from maternal blood. The fetal form is still small; although it consumes maternal blood, surplus fluid remains. Combined with blood accumulated in the previous two months within the uterus, over time it forms blood masses. At delivery, these should be expelled along with the infant. If due to the mother's exhaustion during labor or expulsion of the placenta, or improper care leading to a lack of warmth in the abdomen, the blood masses may fail to dissipate for a long time, causing pain that rejects pressure. At this time, Sheng Hua Tang (Decoction for Generating New Blood) should be used to promote blood circulation, and external warming of the abdomen with hot garments is sufficient. One must not lightly administer harsh purgatives, lest they cause Bing Lou (flooding/bleeding) and Tuo Zheng (collapse) which cannot be saved.
Both Yun (fainting/dizziness) and Jue (syncope/cold extremities) postpartum arise from the simultaneous depletion of Qi and Blood. Without urgent tonification, how can the nearly extinct Yuan Shen (original spirit) be挽救ed? This is beyond doubt. However, Yun occurring during labor is more urgent than Jue. If medication is too slow, emergency rescue methods must be employed. For those with slight deficiency, symptoms include blurred vision and dizziness, fullness and oppression below the heart, coma with clenched jaws, loss of consciousness, followed by spontaneous recovery after a short while. Or, due to excessive blood loss, empty fire rises vacuously clouding the spirit, leaving the body without control. Sudden loss of Yin Blood deprives the Xin Shen (heart spirit) of nourishment. The Jun Huo (monarch fire) and Xiang Huo (minister fire) of the Heart and Bao Luo (pericardium/luteal vessels) are calm with blood but endangered without it. Intense fire causes coma; fire invading the Lung leads to closed eyes and unconsciousness. This is because sudden Yin Blood loss fails to anchor Yang. The *Jing* (Classic) states: When disease Qi is insufficient, tonification is suitable, not purgation. Closed eyes indicate Yin pathology. Sudden loss of有形 (formative) blood intensifies fire. Frequent administration of Sheng Hua Tang is appropriate, or ad hoc emergency measures. After 2-3 doses of Sheng Hua Tang, if the deficiency of the Blood aspect is not addressed, the mass will dissolve, blood will flourish, spirit will clear, and fainting will stop. For severe deficiency, symptoms include pale face, closed eyes, open mouth, cold hands, profuse sweating, coma, and extremely fine and minute pulses in all six positions. This indicates Qi following Blood loss towards extinction. Large doses of Renshen (Ginseng Root) are required to restore Yang. Fearful that rapid Yin tonification is insufficient, Qi-tonifying herbs must be combined, following the principle of Yang generating Yin. For emergency rescue, Sheng Hua Tang with Ginseng is most effective. If decoction is unavailable, use Dushen Tang (Single Ginseng Decoction) rapidly; once swallowed, survival is possible. Delay renders it futile. Some claim Ginseng should only be used seven days postpartum; this is an ignorant rumor and must not be believed. Since Yun strikes instantly, external emergency treatments cannot be delayed. Quickly assist the patient to sit gently, do not let her lie down. Alternatively, heat charcoal until red and pour vinegar on it; or burn old lacquerware so smoke enters the nose and mouth to induce revival. Press Renzhong (GV26) urgently and wait quietly for Yuan Qi to recover. Do not move randomly to avoid scattering Shen Qi (spiritual energy). Another method: chop a handful of Chinese chives, place them in a spouted porcelain bottle, boil vinegar, pour into the bottle, cover tightly, and direct the spout to the nostrils to allow gas entry for revival. Any person with major illness or severe deficiency can experience fainting. Postpartum fainting due to blood loss is named Xue Yun (Blood Fainting), but it is not actually caused by blood per se. Blindly trusting ancient formulas to diagnose Yun as E Xue Qiang Xin (Evil Blood Snatching the Heart) and lightly using drugs like Sumu (Calamus Rhizome), Niuxi (Achyranthes Root), Honghua (Safflower), or formulas like Mudan Duoming Tang, or diagnosing it as Phlegm-Water and using phlegm-resolving formulas, is a grave error. Folk remedies sometimes treat postpartum convulsions, vomiting, and fainting caused by retained dead fetus or placenta blood by pouring warm urine. If swallowed, it stops. In women with strong Stomach Qi who tolerate the odor, efficacy is seen. However, Tong Bian (child's urine) does not stop fainting or restore Yuan; it works by descending via old pathways, clearing heat, and resolving stasis. Formulas record:敗血 (failed blood) flowing into the Liver Meridian causes black spots in vision, dizziness, and unconsciousness. This is blood-heat rising vacuously to the Heart, causing coma and Qi closure approaching extinction. Taking Tong Bian is best. This view only considers failed blood, ignoring postpartum deficiency. With "Qi closure approaching extinction," can Tong Bian really restore near-extinct Yuan Qi? Even with evil blood reversal or blood stasis, Sheng Hua Tang warmed and circulated is superior for removing stasis and stopping fainting. I have seen Jiangnan obstetricians use Danggui (Angelica Sinensis Root) 2 qian, Yimucao (Motherwort Herb) 1 qian, Renshen 2 qian, Honghua 6 fen, Paojiang (Prepared Ginger) 8 fen, decocted hot and mixed with Tong Bian to treat fainting. This formula captures the essence well. For women prone to Xue Yun, it is better to pre-decoct and take Bazhen Tang (Eight-Treasure Decoction), Shiquan Dabu Tang (Ten-Tonifying Decoction), or Guipi Tang (Restore the Spleen Decoction) days before delivery to tonify Qi and Blood. Use Renshen to facilitate delivery at term. Tonifying before birth and before deficiency allows no deficiency to exploit postpartum, thus preventing fainting.
As for Jue syndrome, occurring after delivery, it results from excessive effort during labor damaging the Spleen Qi. The isolated Zang organ cannot irrigate the four limbs, causing cold extremities and Jue. The *Jing* states: Yang Qi declining below leads to Cold Jue; Jue Qi ascending fills the meridians and separates from the form. Rebellious Qi filling the meridians causes Shen Qi to float away and scatter. Profound tonification and Yang restoration are indicated. Two doses of Sheng Hua Tang consecutively. When Blood and Qi flourish and Spirit returns, Jue stops. This cannot be cured by merely tonifying the Blood aspect. If thirst occurs after medication, Shenmai San (Ginseng and Ophiopogon Powder) taken as tea assists Jin Ye (body fluids) to save Zang dryness. Cases with cold extremities and dysentery resemble Cold Syndrome of Shaoyin in Shanghan (Cold Damage); Sibii Tang (Decoction for Four Reversals) is contraindicated. Instead, use Sheng Hua Tang with doubled Renshen, or add one slice of Shufuzi (Prepared Aconite Root) to stop rebellion, restore Yang, and demonstrate the merit of Renshen and Danggui. If blood mass pain ceases but Jue persists, Zirong Yiqi Tang (Nourish Glory and Tonify Qi Decoction) is most effective.
Yun and Jue are critical postpartem emergencies. If postpartum blood mass pain remains, Baidu (Atractylodes Macrocephala) and Baizhu (Atractylodes Lancea) should not be added abruptly. Therefore, urgently add Renshen for ad hoc rescue. Once Yun stops and Jue reverses, remove Renshen to resolve blood mass pain. This is the key principle.