产后血晕由产前素虚，产时亡血过多，以致虚火泛上，身无所主，以致昏晕。张按∶大病、大虚之症，皆有之，名
为血晕，实非因血而致晕也。方书尽曰，败血流入肝经，眼生黑花，头目旋晕不能起坐，昏闷不省人事，谓之血晕。此
血热乘虚逆上凑心，故昏迷不省，气闭欲绝也，服童子便最好。此论但照管败血，全不照管大虚，但云气闭欲绝。服童
便，岂童便可挽回元气欲绝乎。一方∶用当归二钱、益母草一钱，人参二钱、红花六分、黑姜八分，冲热童便服，此方
兼得之矣。张每遇产妇向有血晕之症者，于将产数日预服十全、归脾、养荣，调补气血。临产，人参一、二两煎服，补
于未产、未虚之前，产后无虚可乘，无晕可发矣。
妇人分娩昏冒瞑目，因阴血暴亡，心神失养。心与包络君火相火也，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，但补其血，则神自安，心得血则能养而神不昏迷矣。然甚者，更当以补气药兼之，恐势急而补阴不
及，且气能生血也。
下血多而晕，名为血脱，当大剂人参，可以回阳。若下血少而晕，非血滞、或属血竭，滞者温而行之，竭者浊而补
之，切勿以破血、行血妄投也。
产后血晕，宜轻轻扶坐，烧炭沃醋，或烧旧漆器，令烟入口鼻即苏。急捏人中，静以待之，元气渐复，不可乱动，
益令神气散乱矣。
产后血晕是由于产前身体素来虚弱，分娩时失血过多，导致虚火上炎，身体失去主宰，从而出现昏晕。张氏按语：大病、大虚的病症中都会出现这种情况，虽然名为血晕，但实际上并非因为瘀血而导致昏晕。医书中都说，败血流入肝经，眼前出现黑花，头目眩晕不能起身坐立，昏迷不醒人事，这叫做血晕。这种观点认为，这是血热乘虚逆上冲心，所以昏迷不醒，气机闭塞欲绝，服用童子便（童尿）最好。这种论述只顾及了败血，完全不顾及大虚，只说气闭欲绝。难道童子便能挽回元气将绝的局面吗？一方：用当归二钱、益母草一钱、人参二钱、红花六分、黑姜八分，冲入热童子便服用，这个方子兼顾了上述两方面。张氏每次遇到产妇以往有血晕症状的，在分娩前数日预先服用十全大补汤、归脾汤、养荣汤，以调补气血。临产时，用人参一两至二两煎服，在未生产、未虚弱之前进行补益，产后就没有虚证可乘，也就不会发生血晕了。
妇女分娩时昏冒闭眼，是因为阴血突然大量亡失，心神失去滋养。心和心包络分别对应君火和相火，得到血液则安宁，失去血液则危险，火气炽盛，所以令人昏冒；火气侵犯肺脏，所以闭眼不醒人事，这是因为阴血突然亡失，不能镇抚火气。经文说：病气不足，应当补益，不宜泻法。闭眼合目，病症都归属于阴，突然失去有形的血液，则火气炽盛，只要补益血液，神志自然安宁，心得到血液就能滋养而神志不昏迷。然而病情严重的，更应当配合补气药一起使用，恐怕形势紧急而补阴药来不及见效，而且气能生血。
下血量多而昏晕，名为血脱，应当用大剂量人参，可以回阳救逆。如果下血量少而昏晕，不是血滞，或者属于血竭（血液枯竭），血滞的用温通的方法引导运行，血竭的用滋浊厚味的方法补益，千万不要妄投破血、行血的药物。
产后血晕，宜轻轻扶起让患者坐定，烧炭浇醋，或烧旧漆器，让烟熏入口鼻即可苏醒。急捏人中穴，安静等待，元气逐渐恢复，不可乱动，否则会使神气更加散乱。
Postpartum blood syncope (Xue Yun) is caused by inherent deficiency before delivery and excessive blood loss during delivery, leading to the floating upward of deficient fire, loss of bodily control, and resulting in fainting. Zhang’s commentary: This condition occurs in severe illnesses and states of extreme deficiency. Although named "blood syncope," it is actually not caused by blood stasis leading to fainting. Medical texts state that when敗血 (decayed blood) flows into the Liver meridian, causing black spots to appear before the eyes, dizziness preventing one from rising or sitting, and unconsciousness, it is called blood syncope. This theory posits that heat in the blood surges upward against the Heart due to deficiency, causing coma and a sense of qi closure nearing extinction, suggesting that drinking urine from an uncircumcised boy (Tongzi Bian) is best. This argument only considers the decayed blood and completely ignores the state of extreme deficiency, merely stating qi closure and near extinction. Can urine from an uncircumcised boy really restore nearly extinct primordial qi? A prescription: Use Dang Gui (Angelicae Sinensis Radix) 2 qian, Yimucao (Leonuri Herba) 1 qian, Renshen (Ginseng Radix et Rhizoma) 2 qian, Honghua (Carthami Flos) 6 fen, and Heijiang (Zingiberis Rhizoma Carbonisatum) 8 fen, mixed with hot Tongzi Bian for ingestion. This formula addresses both aspects. Whenever Zhang encounters parturients with a history of blood syncope, he prescribes Shiquan Dabu Tang (Decoction for Ten Significant Tonifications), Guipi Tang (Spleen-Restoring Decoction), and Yangrong Tang (Nourishing the Vigor Decoction) several days before delivery to regulate and tonify qi and blood. At the time of delivery, 1 to 2 liang of Renshen (Ginseng Radix et Rhizoma) is decocted and ingested to tonify before birth and before depletion occur; thus, postpartum there is no deficiency for pathogenic factors to exploit and no syncope to develop.
When a woman faints and closes her eyes during childbirth, it is because sudden massive loss of yin blood causes the heart-mind (Shen) to lose nourishment. The Heart and Pericardium correspond to Ministerial Fire and Sovereign Fire; they are calm when nourished by blood and endangered when blood is lost. With fire blazing intensely, one becomes faint; with fire invading the Lung, one closes the eyes and loses consciousness, as the sudden loss of yin blood fails to suppress the fire. The Classics state: When disease qi is insufficient, tonification is indicated, not purgation. Closing the eyes indicates the pathology belongs to Yin. Sudden loss of有形之血 (concrete blood) causes fire to blaze; tonifying blood allows the spirit to settle naturally. When the Heart receives blood, it is nourished, and the spirit does not become confused. However, in severe cases, qi-tonifying herbs should be added concurrently, lest the urgent condition outpace the effect of yin-tonifying herbs, given that qi generates blood.
Profuse bleeding accompanied by syncope is named blood exhaustion (Xue Tuo); large doses of Renshen (Ginseng Radix et Rhizoma) can restore yang. If bleeding is scant yet syncope occurs, it is either due to blood stasis or blood exhaustion. For stasis, warm methods should be used to promote circulation; for exhaustion, thick, turbid tonics should be used. One must never recklessly administer blood-breaking or blood-moving agents.
For postpartum blood syncope, gently assist the patient into a sitting position. Burn charcoal and pour vinegar on it, or burn old lacquerware, allowing the smoke to enter the nose and mouth to induce recovery. Urgently press Renzhong (GV26, Philtrum) acupoint and wait quietly. As primordial qi gradually recovers, avoid unnecessary movement, which would further scatter the spirit and qi.