叔和曰∶产后寸口洪疾不调者，死。沉微附骨不绝者，生。又曰∶沉小滑者生，实
大坚弦急者死。丹溪曰∶胎前脉当洪数，既产而脉仍洪数者，死。又曰∶胎前脉细小，
产后脉洪大者，多死，《产经》曰∶胎前之病，其脉贵实，产后之病，其脉贵虚，胎前
则顺气安胎，产后则补虚消瘀，此其要也。
临产气血动荡，胞胎迸裂，与常经离异，必有水先下，俗谓之胞浆，即养胎之液
也。水下则胞裂而产，既产则气血两虚，脉宜缓滑，缓则舒徐，不因气夺而急促，滑则
流利，不因血去而枯涩，均吉兆也。若实大弦牢，非产后气血两虚所宜，实为邪实，大
为邪进，弦为阴敛，宣布不能，牢为坚着，近于无胃，皆相逆之脉也。
凡产毕，饮热童便一盏，不得便卧，宜闭目而坐，须臾上床，宜仰坐，不宜侧坐，
宜竖膝，不宜伸足高倚，床头浓铺 褥，遮围四壁使无孔隙，免致贼风，以醋涂鼻，或
用醋炭，更烧漆器，轻轻以手从心按摩至脐，则恶露尽下，以杜血滑血逆，如此三
日。不问腹痛不痛，以童便和酒温服五七次，酒虽行血，能下恶露，行乳汁，然脏气
方虚，不可多饮，并不可产毕即饮，恐引血入四肢，能令血晕。如胃气弱者，里无火
者，童便亦宜禁之，恐伤胃气，惟频食白术薄粥，渐进丰肉、猪蹄少许。慎言语，戒七
情，勿勤梳头洗足，以百日为度。若气血弱者，不计月旦，否则患手足腰腿疼痛等症，
名曰蓐劳，最难治疗。产后不必问是男是女，恐因言语而泄气，或因爱憎而劳神。最
忌大喜、大怒，喜则气散，或生红污，怒则气逆，或生 瘕。不可独宿，恐致虚惊∶
不可刮舌，恐伤心气；不可刷齿，恐致血逆。须气血平复，方可治事，犯时微若秋
毫，成病重如山岳，可不慎欤！
乳乃血气所成，产后不可食盐，盐止血，令无乳汁，且发嗽难治。夏忌贪凉用
扇，及食冷物，切不可当风睡卧。儿生三日，相传洗三，谓不洗则长大皮粗起秕，但
夏月天热洗可，不洗可，至冬后切不可洗，恐风入脐中，脐风由此而起，屡见有不洗三
者，至老不闻皮粗起秕，有识者不洗三可也。且儿在胎，从母腹中温暖长养，一出胎
来，阳和之气全失，虽当暑月，必须衣服周密，勿见外风，故俗云亚无六月。儿生下，
欲断脐带，必以蕲艾为捻，香油浸湿，熏烧脐带，令焦方断，其束脐须用软帛，浓绵裹
束，勿令受风，及儿尿湿脐，此预防脐风第二要紧也。儿初生皮肤娇嫩，腠理不密，衣
服须用大人故绵，则勿耗损脉络精华，兼用布衣粗服，令其皮肤坚浓，一生受益无穷。
儿生次日，即看口中上 ，如有白泡子，即以银挖宜轻轻刮破其泡子，须刮出勿令落入
喉中，仍以京墨搽之。此泡一老，非为难刮，且儿不乳，变生撮口诸症。又看牙龈之
上，如有马牙，亦须挑破取出，血出不妨，以墨搽之。其藏胎衣，忌太岁方，三杀方，
宜用稍大平稳瓷瓶，器小令儿吐乳，安稳令儿不惊。母血衣不可日晒，儿湿衣不可夜
露，遇鸟以粪水染衣，能生毒疮，变成疳症。古以一月为小盈月，两月为大盈月，此
两月内不暴怒，少劳碌，禁淫欲，终身无病，而且多子。凡人累劫重修，方得人身，
一出胞胎，性命托于父母之保养，有因儿女，
太多，衣食缺乏，投溺水中者、大损天和，最宜禁戒。
产后诸证，不可概服补药，恐有瘀血凝滞也，非行血则邪不去。即诸虚症，亦须血
行其气乃复，但行之有方，不可过峻。凡产后危证，莫如三冲、三急，三冲者，败血冲
肺、冲心，冲胃也；三急者，新生产之呕吐、泄泻、多汗也。其用药则有三禁，禁佛
手散，以川芎辛散，能发汗走泄也。禁四物汤，以生地寒冷，能作泻而凝血也，白芍酸
寒，伐生气也。禁小柴胡汤，以黄芩性凉，能阻恶露也。更有三禁，不可汗，不可下，
不可利小便。并勿犯胃及上下焦，虽有杂症，以未治之，大补气血为主。产后满百
日，方可会合，不尔至死，大概虚羸百疾，多从此而得。凡妇人患风气，脐下虚冷，莫
不由于早行房也。
产后诸疾，古方多用四物汤加减，而丹溪独谓芍药酸寒，伐生发之气，禁而不用，
何欤？盖新产之妇，血气俱虚，但存秋冬肃杀之气，而无春夏主发之机，故最忌寒凉，
大宜温热之药，以助资始资生之源也。先哲制四物汤，以芎归之辛温，佐以地芍之寒，
温寒适中，为女科诸疾妙剂。若用于产后，必取白芍以酒重复制炒，去其酸寒之性，但
存生血活血之能，或再加黑姜，则何不可用？且芍药性清微酸而收，最宜于阴气散失
之证，岂不为产后要药！先贤尚谆谆告戒，况寒凉酸削者乎！但知芍药酸寒而不究生地
更凉，且直走血分为害尤甚，必不得已，当以熟地代之，若概以四物治产后者、误人多矣。
产后以去败血为先，血滞不快，乃成诸病，夫产后元气既亏，营运失度，不免瘀血
停留，治者必先逐瘀，瘀消方可行补，此第一义也。但虚极不能姑待者，则以峻补之
中，加入温行之药，峻补则力大而可宣通，温行则流畅而不凝滞，即实症逐瘀，亦不可
用峻厉之药。产后元气大虚，恐血无主宰，一任药力，便为崩行不止，虚则易脱，犹覆
水难收矣，故莫若生化汤行中有补，补中有行，温则不滞，无伤胃气，为至当也。
产后元气大脱，新血未生，凡有头疼发热，恶心饱闷诸证，皆是虚中变现之假象，
慨以大补气血为主，如恶露未尽，补药中入行血药。如感冒风寒停滞，亦须补中兼以发
散消导，勿得泛用峻厉，有伤气血，因疑似之外邪，伤真切之元气，岂不误甚！
新产之后，虽无疾病，宜将息劳动，调理脾胃，进以美味饮食，则脏腑易于平复，
气血自然和调，百疾不生，但中气方虚，难于运化，勿得过多，反伤脾胃。
四物生地性凉而滞，大伤脾胃，芍药味酸而寒，易伐生气，产后常多误人，生化汤
除此二味，加以温中行血之剂。如产后儿枕作痛，世多用消块散血之剂，然后议补。又
有消与补混施，不知旧血虽当消化，新血亦当生养，若专攻旧，则新血转伤。世以回生
丹，攻血块，下胞衣，其元气甚多伤损，生化汤因药性功用而立名也，产后血块当消而
新血亦当生也，专消则新血不生，专生则旧血反滞，芎归桃仁三味善去旧血，骤生新
血，佐以黑姜、炙草，引三味入于肺肝，生血利气，行中有补，且得暖则血自流通，恶
露自尽，故无后患，实产后之圣药。（张）因其方，加人参、桂、牛膝、红花，更为产
前催生之神效。
胞衣不下有二，有因恶露入衣，胀而不能出，有因元气亏损，虚而不能出，恶露流
入衣中者，腹必胀痛，用夺命丹，或失笑散，以消瘀血，缓则不救。元气虚弱不能送
下者，腹中不胀痛，用保生无忧散，以固元气，然不若总以万全汤去人参，并可取效为至当也。
妇人百病，莫重于生产，产科之难，临产莫重于催生，既生莫重于胞衣不下，古方
用花蕊石散最为紧要，但恐石药非肠胃大虚者所宜，莫若生化万全二方，选而用之。
有川佛手散，加红花、益母草、香附、山楂、陈皮、牛膝稍煎成，冲重便服。更有一
法，产讫胞衣不下，停久非特产母疲倦，又恐血流胞中，必致危笃，宜急断脐带，以物
系坠，使血不潮入胞中，则胞衣自痿缩而下。只要产母安心以物系坠之时，尤宜用
心，先系然后截断，不尔胞上掩心而死，慎之。
叔和说：产后寸口脉象洪大急疾且不调和的，主死；脉象沉微、重按至骨仍有根气的，主生。又说：脉象沉小滑利的主生，脉象实大坚弦急的，主死。丹溪说：妊娠期间脉象应当洪数，分娩后脉象仍然洪数的，主死。又说：妊娠期间脉象细小，分娩后脉象反而洪大的，多主死亡。《产经》说：妊娠期间的疾病，脉象贵在充实有力；分娩后的疾病，脉象贵在虚弱柔和。妊娠期应当顺气安胎，分娩后应当补虚消瘀，这是治疗的要点。
临产时气血动荡，胞胎破裂，与常理不同，必然有羊水先破，俗称“胞浆”，即滋养胎儿的液体。羊水流出则胞胎破裂而分娩，分娩后气血两虚，脉象宜见缓滑之象。“缓”指从容舒缓，不因气脱而急促；“滑”指流利圆滑，不因血去而枯涩，这都是吉兆。如果脉象实大弦牢，不符合产后气血两虚的情况，“实”代表邪气盛，“大”代表邪气进犯，“弦”代表阴气收敛、宣发受阻，“牢”代表坚硬着滞，接近无胃气，这些都是逆证脉象。
凡是分娩结束，应饮一盏热童子尿，不能立即躺卧，适宜闭目静坐，片刻后再上床，宜仰卧或端坐，不宜侧卧，宜竖起膝盖，不宜伸直脚高靠床头。床头应厚铺褥子，四周遮挡墙壁不留缝隙，以免贼风侵袭。用醋涂在鼻子上，或用醋炭熏蒸，再烧漆器，轻轻用手从心口按摩至肚脐，使恶露排尽，以防止血滑、血逆，如此坚持三日。无论是否腹痛，都用童子尿调和酒温服五到七次。酒虽然能行血，能下恶露、通乳汁，但脏腑之气刚刚虚弱，不可多饮，也不可在分娩刚结束时饮用，恐怕引血流入四肢，导致血晕。如果胃气虚弱、体内无火的，也应禁止服用童子尿，恐怕损伤胃气，只宜频繁食用白术薄粥，逐渐增加肥肉、猪蹄等少量食物。慎言语，戒七情，不要勤梳头洗脚，以一百天为限度。如果气血虚弱，不论月份早晚，否则会出现手足腰腿疼痛等症状，名叫“蓐劳”，最难治疗。产后不必问是男是女，恐怕因言语泄气，或因爱憎劳神。最忌讳大喜、大怒，喜则气散，可能产生红污（出血）；怒则气逆，可能形成瘕块。不可独宿，恐怕导致虚惊；不可刮舌苔，恐怕伤心气；不可刷牙，恐怕导致血逆。必须等到气血平复，才可以处理事务，触犯禁忌时轻微如秋毫，成病后严重如山岳，能不谨慎吗！
乳汁是由血气化生的，产后不可吃盐，盐能止血，导致没有乳汁，且引发咳嗽难治。夏天忌讳贪凉用扇子，及吃冷物，切不可对着风睡卧。婴儿出生三天，相传要“洗三”，说不洗的话长大皮肤粗糙起皮屑，但夏天天气热可以洗，不洗也可以，到了冬天后切不可洗，恐怕风邪进入脐中，由此引起脐风。多次见到不洗三的，到老也没有皮肤粗糙起皮屑的现象，有见识的人认为不洗三是可以的。而且婴儿在胎内，从母腹中温暖长养，一出胎来，阳和之气全失，即使在暑月，也必须衣服周密，不见外风，所以俗话说不怕六月（指婴儿不怕热）。婴儿生下，要断脐带，必须以蕲艾做成捻子，香油浸湿，熏烧脐带，令其焦黑才切断。束脐须用软帛，厚绵包裹束缚，不要让受风，以及被婴儿尿液弄湿脐部，这是预防脐风的第二件要紧事。婴儿初生皮肤娇嫩，腠理不紧密，衣服须用大人穿过的旧棉絮，这样不会耗损脉络精华，兼用布衣粗服，使其皮肤坚实浓密，一生受益无穷。
婴儿出生的第二天，就看口中上颚，如果有白泡子，就用银挖匙轻轻刮破其泡子，须刮出勿令落入喉中，仍以京墨涂抹。这个泡子一旦变老，就难以刮除，且婴儿不吃奶，变生撮口诸症。又看牙龈之上，如果有马牙，也须挑破取出，出血不妨碍，用墨涂抹。收藏胎盘，忌讳太岁方、三杀方，宜用稍大平稳的瓷瓶，瓶子小会让婴儿吐乳，安稳不让婴儿受惊。母体血衣不可日晒，婴儿湿衣不可夜露，遇到鸟粪水染衣，能生毒疮，变成疳症。古时候以一个月为小盈月，两个月为大盈月，这两个月内不暴怒，少劳碌，禁淫欲，终身无病，而且多子。凡人累劫重修，方得人身，一出胞胎，性命托于父母之保养，有的因为儿女太多，衣食缺乏，投溺水中的，大损天和，最宜禁戒。
产后各种病症，不可一概服用补药，恐怕有瘀血凝滞，非行血则邪气不去。即使是各种虚症，也必须血行然后气才能恢复，但行之要有方法，不可过于峻猛。凡产后危重证候，莫过于三冲、三急。三冲者，败血冲肺、冲心、冲胃；三急者，新产后的呕吐、泄泻、多汗。其用药有三禁：禁佛手散，因为川芎辛散，能发汗走泄；禁四物汤，因为生地寒冷，能作泻而凝血，白芍酸寒，伐伤生气；禁小柴胡汤，因为黄芩性凉，能阻碍恶露排出。更有三禁：不可发汗，不可攻下，不可利小便。并且不要侵犯胃及上下焦，虽然有杂症，也以未治之，以大补气血为主。产后满百日，方可同房，不然至死，大概虚羸百病，多从此而得。凡妇人患风气，脐下虚冷，无不由于早行房事。
产后各种疾病，古方多用四物汤加减，而丹溪唯独认为芍药酸寒，伐伤生发之气，禁止不用，为什么呢？盖因新产的妇女，血气俱虚，只有秋冬肃杀之气，而没有春夏主发之机，所以最忌寒凉，大宜温热之药，以助资始资生之源。先哲制定四物汤，以川芎、当归的辛温，佐以地黄、芍药的寒凉，温寒适中，为妇科诸疾妙剂。若用于产后，必取白芍以酒重复制炒，去掉其酸寒之性，只保留生血活血的功能，或者再加黑姜，有什么不可以用的？况且芍药性清微酸而收，最适合阴气散失的证候，难道不是产后要药！先贤还谆谆告诫，何况那些寒凉酸削的药物呢！只知道芍药酸寒而不考究生地更凉，且直走血分为害尤甚，万不得已，当以熟地代替，如果一概用四物汤治疗产后病，误人太多了。
产后以去除败血为先，血滞不快，乃成诸病。夫产后元气既亏，营运失度，不免瘀血停留，治病者必先逐瘀，瘀消方可行补，这是第一义。但如果虚极不能等待的，则在峻补之中，加入温行之药，峻补则力大而可宣通，温行则流畅而不凝滞，即使是实证逐瘀，也不可峻厉。产后元气大虚，恐怕血无主宰，一任药力，便为崩行不止，虚则易脱，犹覆水难收矣，所以不如生化汤行中有补，补中有行，温则不滞，无伤胃气，最为妥当。
产后元气大脱，新血未生，凡有头疼发热，恶心饱闷诸证，皆是虚中变现之假象，概以大补气血为主，如恶露未尽，补药中加入行血药。如感冒风寒停滞，亦须补中兼以发散消导，不得泛用峻厉，有伤气血，因疑似之外邪，伤真切之元气，岂不误甚！
新产之后，虽无疾病，宜将息劳动，调理脾胃，进以美味饮食，则脏腑易于平复，气血自然和调，百疾不生，但中气方虚，难于运化，不得过多，反伤脾胃。
四物汤中生地性凉而滞，大伤脾胃，芍药味酸而寒，易伐生气，产后常多误人。生化汤除去这两味，加上温中行血之剂。如产后儿枕作痛，世人多用消块散血之剂，然后议补。又有消与补混施，不知旧血虽当消化，新血亦当生养，若专攻旧，则新血转伤。世以回生丹，攻血块，下胞衣，其元气甚多伤损。生化汤因药性功用而立名也，产后血块当消而新血亦当生也，专消则新血不生，专生则旧血反滞。芎归桃仁三味善去旧血，骤生新血，佐以黑姜、炙草，引三味入于肺肝，生血利气，行中有补，且得暖则血自流通，恶露自尽，故无后患，实产后之圣药。（张）因其方，加人参、桂枝、牛膝、红花，更为产前催生之神效。
胞衣不下有两种情况，有因恶露入衣，胀而不能出，有因元气亏损，虚而不能出。恶露流入衣中者，腹必胀痛，用夺命丹，或失笑散，以消瘀血，缓则不救。元气虚弱不能送下者，腹中不胀痛，用保生无忧散，以固元气，然不若总以万全汤去人参，并可取效为至当也。
妇人百病，莫重于生产，产科之难，临产莫重于催生，既生莫重于胞衣不下。古方用花蕊石散最为紧要，但恐石药非肠胃大虚者所宜，莫若生化万全二方，选而用之。有川佛手散，加红花、益母草、香附、山楂、陈皮、牛膝稍煎成，冲重便服。更有一法，产讫胞衣不下，停久非特产母疲倦，又恐血流胞中，必致危笃，宜急断脐带，以物系坠，使血不潮入胞中，则胞衣自痿缩而下。只要产母安心以物系坠之时，尤宜用心，先系然后截断，不尔胞上掩心而死，慎之。
Shuhe stated: If the Cun (inch) pulse at the wrist is surging, rapid, and irregular after childbirth, it indicates death. If the pulse is deep, faint, yet still palpable with heavy pressure to the bone, it indicates life. He further stated: A deep, small, and slippery pulse indicates life; a full, large, firm, wiry, and urgent pulse indicates death. Danxi stated: During pregnancy, the pulse should be surging and rapid; if it remains surging and rapid after delivery, it indicates death. He also stated: If the pulse is fine and small during pregnancy but becomes surging and large after delivery, it mostly indicates death. The *Chanjing* (Classic of Childbirth) states: For diseases during pregnancy, the pulse should ideally be substantial; for diseases after childbirth, the pulse should ideally be deficient. During pregnancy, one should soothe Qi and secure the fetus; after childbirth, one should tonify deficiency and resolve stasis. This is the key principle.
During labor, Qi and Blood are in turmoil, the fetal sac ruptures, deviating from normal conditions. Amniotic fluid must break first, commonly known as "Baopang" (fetal membrane fluid), which is the fluid nourishing the fetus. Once the fluid flows out, the sac ruptures and birth occurs. After delivery, both Qi and Blood are severely deficient, so the pulse should appear slow and slippery. "Slow" implies leisurely and relaxed, not hurried due to Qi depletion; "slippery" implies smooth and fluent, not withered and rough due to Blood loss. Both are auspicious signs. However, a full, large, wiry, or firm pulse is unsuitable for postpartum Qi and Blood deficiency. "Full" indicates excess pathogen; "large" indicates pathogenic advance; "wiry" indicates Yin constriction and failure of dissemination; "firm" indicates rigidity and stagnation, approaching a lack of Stomach Qi. All these are adverse pulses.
Upon completion of delivery, drink a cup of hot urine from a male child under ten years old ("Tongbian"). Do not lie down immediately; instead, sit quietly with eyes closed, then get into bed after a short while. One should lie on the back or sit upright, not on the side; knees should be bent, not legs extended high against the headboard. The headboard should be padded thickly with mats, and walls should be sealed without gaps to prevent "thief wind" (drafts). Apply vinegar to the nose, use vinegar charcoal fumigation, or burn lacquerware. Gently massage from the heart area down to the navel with the hand to ensure complete expulsion of lochia, preventing blood slipping or counterflow. Continue this for three days. Regardless of abdominal pain, take five to seven doses of Tongbian mixed with wine, warmed. Although wine promotes blood circulation, helps expel lochia, and stimulates lactation, the Zang-Fu organs are currently weak, so it should not be consumed excessively or immediately after delivery, lest it draw blood into the four limbs causing "blood vertigo" (syncope due to blood loss). If Stomach Qi is weak or there is internal cold, Tongbian should also be prohibited to avoid damaging Stomach Qi. Instead, frequently consume thin congee made with Baizhu (Atractylodis Macrocephalae Rhizoma), gradually adding small amounts of fatty meat and pig trotters. Guard speech, regulate the Seven Emotions, avoid frequent hair combing and foot washing, limiting these practices to 100 days postpartum. If Qi and Blood are weak, regardless of the month, otherwise symptoms such as pain in hands, feet, waist, and legs may occur, named "Rulao" (postpartum consumption), which is difficult to treat. There is no need to ask whether the baby is male or female after birth, as conversation may leak Qi, and love/hate may strain the Spirit. Great joy and anger are strictly forbidden. Joy causes Qi to scatter, potentially leading to abnormal bleeding; anger causes Qi to rebel, potentially forming masses ("Jia"). Do not sleep alone, lest it cause empty fright; do not scrape the tongue coating, lest it damage Heart Qi; do not brush teeth, lest it cause blood rebellion. Only when Qi and Blood have stabilized should one resume daily affairs. Violating taboos initially seems slight as an autumn hair, but the resulting illness can be heavy as a mountain. Can one not be cautious?
Milk is formed from Qi and Blood. Postpartum women should not eat salt, as salt stops bleeding and prevents milk production, and induces difficult-to-treat coughs. In summer, avoid cooling fans and cold foods, and never sleep facing the wind. On the third day after birth, tradition dictates a "Third-Day Bath." It is said that without it, the skin will become rough and scaly later in life. In summer heat, bathing is optional; however, after winter, bathing is strictly prohibited to prevent wind entering the umbilicus, causing "umbilical tetanus" (Qifeng). Many who skip the bath grow up with healthy skin. Wise people consider skipping the bath acceptable. Since the fetus grows in the warm maternal abdomen, upon birth, it loses Yang warmth. Even in summer, clothing must be thorough to exclude external wind. Hence the saying, "No fear of June" (referring to infants tolerating heat well if protected). To cut the umbilical cord, use moxa twine soaked in sesame oil, burn it until charred, then cut. Bind the stump with soft cloth wrapped in thick cotton to prevent wind exposure and urine contamination, which is crucial for preventing umbilical tetanus. Newborn skin is tender and pores are open; use worn adult cotton for clothes to preserve meridian essence, and coarse cloth to toughen the skin, benefiting the child for life.
On the second day, inspect the infant's mouth roof. If white blisters ("mouth pearls") appear, gently puncture them with a silver spoon, ensuring they are removed and not swallowed, then apply Peking ink. If left untreated, they harden, preventing feeding and leading to "mouth closure" syndromes. Also check the gums for "horse teeth" (epstein pearls); pierce them if necessary, allow slight bleeding, and apply ink. Store the placenta in a stable porcelain bottle of appropriate size; small bottles may cause infant regurgitation. Keep maternal blood-stained clothes out of direct sun, and wet infant clothes out of night dew. Bird droppings on clothes can cause toxic sores and malnutrition syndromes ("Gan"). Ancient texts define the first month as the "small full moon" and the second as the "great full moon." Avoiding rage, overwork, and sexual desire during these two months ensures lifelong health and fertility. Human life is precious; abandoning children due to poverty or overcrowding harms Heavenly Harmony and is strictly forbidden.
Postpartum syndromes should not be treated generally with tonics, lest blood stasis remain. Pathogens cannot be expelled without promoting blood circulation. Even in deficiency syndromes, Qi recovery depends on Blood movement, but methods must be moderate, not overly harsh. Critical postpartum conditions include "Three Rushes" (Bai Xue Chong Fei, Chong Xin, Chong Wei -敗血 rushing to Lung, Heart, Stomach) and "Three Urgencies" (vomiting, diarrhea, excessive sweating). Medications are subject to three prohibitions: 1. Foshou San, because Chuanxiong is acrid and dispersing, causing sweat and leakage. 2. Siwu Tang, because Shengdi is cold, causing diarrhea and coagulating blood; Baishao is sour and cold, damaging vital Qi. 3. Xiaochaihu Tang, because Huangqin is cool, obstructing lochia discharge. Additionally, three therapies are prohibited: diaphoresis (sweating), purgation (downward draining), and diuresis. Do not violate the Stomach or Upper/Middle/Lower Jiao. Treat miscellaneous symptoms by primarily tonifying Qi and Blood. Sexual intercourse is prohibited until 100 days postpartum; otherwise, it leads to death or chronic weakness and myriad diseases. Women suffering from wind patterns and lower abdominal coldness often do so due to early resumption of sexual activity.
Ancient formulas for postpartum diseases often modify Siwu Tang. However, Danxi prohibited Baishao because its sour-cold nature damages rising Qi. Why? Because postpartum women have dual deficiency of Qi and Blood, possessing only the withering energy of Autumn/Winter, lacking the sprouting energy of Spring/Summer. Thus, cold-cool herbs are taboo, and warm-hot herbs are preferred to support the source of generation. Ancestors formulated Siwu Tang using Xionggui (acrid-warm) to offset Dishaodi (cold), achieving balance for gynecological disorders. For postpartum use, Baishao must be stir-fried with wine repeatedly to remove its sour-cold nature, retaining only blood-nourishing and moving properties. Adding Heijiang (charred ginger) makes it suitable. Baishao is slightly sour and astringent, ideal for dissipating Yin Qi, making it a key postpartum herb. Ancestors warned against cold-sour herbs, yet many ignore that Shengdi is even colder and directly harms the Blood level. If necessary, replace Shengdi with Shudi. Blindly using Siwu Tang for postpartum cases has misled many.
The priority in postpartum care is eliminating stale blood. Stagnant blood causes various diseases. Since Yuan Qi is depleted and transport is impaired, stasis inevitably remains. Physicians must first expel stasis before tonifying. This is the primary principle. If deficiency is extreme and cannot wait, add warming-moving herbs to strong tonics. Strong tonics provide power for circulation; warming herbs ensure flow without stagnation. Even for excess syndromes requiring stasis removal, harsh drugs are contraindicated. Postpartum Yuan Qi is greatly deficient; without control, blood may hemorrhage uncontrollably under drug influence. Deficiency leads to collapse, irreversible like spilled water. Therefore, Shenghua Tang is best: it moves while tonifying, tonifies while moving, is warm without stagnation, and does not harm Stomach Qi.
Postpartum Yuan Qi is largely depleted, and new blood has not yet formed. Headache, fever, nausea, and fullness are false manifestations of deficiency. Primarily tonify Qi and Blood. If lochia is incomplete, add blood-moving herbs to tonics. If complicated by wind-cold stagnation, combine tonification with dispersing and digesting agents. Do not indiscriminately use harsh drugs that damage Qi and Blood, mistaking exterior pathogens for true Qi injury.
After delivery, even without disease, rest and labor management are essential. Regulate Spleen and Stomach, consume delicious food to stabilize Zang-Fu and harmonize Qi and Blood, preventing disease. However, Middle Qi is weak and digestion is poor; do not overeat, lest it damage Spleen and Stomach.
Siwu Tang contains Shengdi (cool/stagnant) and Baishao (sour/cold), which damage Spleen/Stomach and vital Qi, often harming postpartum women. Shenghua Tang removes these, adding warm-moving blood herbs. For "Zhenmao" (afterbirth mass) pain,世人 often use blood-breaking formulas before tonifying. Mixing breaking and tonifying is wrong; old blood must be resolved, but new blood must be nourished. Attacking only old blood damages new blood. Huisheng Dan breaks blood masses and expels placenta but severely damages Yuan Qi. Shenghua Tang is named for its function: resolving old blood while generating new blood. Pure resolution stops new blood generation; pure generation traps old blood. Xiong, Gui, and Taoren remove old blood and generate new blood rapidly. Heijiang and Zhigancao guide these into Lung and Liver, generating blood, benefiting Qi, moving while tonifying. Warmth ensures free flow, complete lochia discharge, and no sequelae. It is the sacred medicine for postpartum. Zhang added Renshen, Guizhi, Niuxi, and Honghua to this formula, making it highly effective for inducing labor prenatally.
Placenta retention has two types: distension due to lochia entering the sac, or deficiency unable to expel it. If lochia enters the sac, the abdomen distends and hurts; use Mingdan or Shixiao San to resolve stasis. Delay is fatal. If Yuan Qi is too weak to expel it, the abdomen does not distend/pain; use Baosheng Wuyou San to secure Yuan Qi. However, Wanquan Tang (without Renshen) is most appropriate.
Childbirth is the most critical event in women's diseases. In obstetrics, induction is hardest during labor, and placenta retention is hardest after birth. Ancient texts prioritize Huarui Shi San, but stone minerals are unsuitable for severe intestinal/stomach deficiency. Shenghua Tang and Wanquan Tang are better choices. Another option is Chuan Foshou San plus Honghua, Yimucao, Xiangfu, Shanzha, Chenpi, and Niuxi, decocted lightly, taken with concentrated urine. Another method: if placenta is retained long after birth, risking maternal exhaustion and blood flooding the uterus, urgently cut the umbilical cord and tie a weight to it to prevent blood flowing back into the uterus, causing the placenta to shrink and fall. The mother must remain calm. Tie first, then cut. Otherwise, the uterus may rise and crush the heart, causing death. Be extremely cautious.