35.产后阴虚阳气盛, 微微自汗却无妨, 头汗阴虚阳上越, 周身大汗
是亡阳.
【注】产后血去过多则阴虚, 阴虚则阳盛. 若微微自汗, 是荣卫调和
,故虽汗无妨. 若周身无汗, 独头汗出者, 乃阴虚阳气上越之象也.
若头身俱大汗不止, 则恐有亡阳之虑矣.
当归六黄汤 黄耆汤
36.虚热上蒸头汗出, 治用当归六黄汤, 黄芩连柏炒黑用, 归耆生熟
二地黄. 自汗黄耆汤牡蛎, 耆术苓甘麦地防, 大汗不止阳外脱, 大剂
参附可回阳.
【注】产后亡血阴虚, 阳热上蒸, 头上汗出至项而还者, 宜当归六黄
汤,即黄连, 黄芩, 黄柏, 当归, 黄耆, 生地, 熟地也. 内芩, 连,
柏,三味俱炒黑用. 若自汗太甚, 宜黄耆汤, 即牡蛎粉, 黄耆, 白术
,茯苓, 甘草, 麦冬, 熟地, 防风也. 若阴血大脱, 孤阳外越, 大汗
不止, 非大剂参附, 不能回阳也.
37.产后中风惟大补, 火气风痰末治之, 十全大补为主剂, 临证详参
佐使宜.
【注】产后气血大虚, 虽患中风, 惟宜大补. 即有火热, 风痰, 气闭
,亦当末治. 总以十全大补汤主之, 临证详参其火气, 风痰, 而佐使
之.
十全大补汤 方见首卷
35. 产后阴血亏虚而阳气偏盛，出现微微自汗并无妨碍；若仅头部出汗，是阴虚导致阳气上浮外越的表现；若周身大汗淋漓，则是亡阳（阳气极度衰竭）的危象。
【注释】产后失血过多则导致阴血亏虚，阴血亏虚则阳气相对偏盛。如果是微微自汗，说明营卫（营气与卫气）调和，因此虽然出汗但无大碍。如果全身无汗，唯独头部出汗，这是阴血亏虚、阳气上浮外越的征象。如果头身都大汗不止，恐怕有亡阳的危险了。
36. 虚热上蒸导致头部出汗，治疗应使用当归六黄汤；方中黄芩、黄连、黄柏需炒黑使用，当归、黄芪用生品和熟品，以及生地、熟地。自汗可用黄耆汤加牡蛎，方含黄芪、白术、茯苓、甘草、麦冬、地黄、防风；若大汗不止导致阳气外脱，可用大剂量的参附（人参、附子）来回阳救逆。
【注释】产后失血导致阴血亏虚，阳热之气上蒸，头上出汗至颈部而止者，适宜用当归六黄汤，即由黄连、黄芩、黄柏、当归、黄芪、生地、熟地组成。其中黄芩、黄连、黄柏三味药都要炒黑使用。如果自汗过于严重，适宜用黄耆汤，即由牡蛎粉、黄芪、白术、茯苓、甘草、麦冬、熟地、防风组成。如果阴血大量脱失，孤阳外越，大汗不止，非大剂量的人参、附子不能挽回阳气。
37. 产后中风只宜大补气血，不可先治火气、风痰；以十全大补汤为主方，临证时详细参考并酌情添加佐使药。
【注释】产后气血严重虚弱，即使患中风，也只宜大补气血。即便伴有火热、风痰、气闭等症状，也应将其作为次要矛盾处理。总以十全大补汤为主方，临证时详细辨别其火热、风痰的情况，从而加入相应的佐使药进行调理。
十全大补汤 方见首卷
35. After childbirth, yin deficiency leads to an excess of yang; slight spontaneous sweating is harmless. Head sweating indicates that yin deficiency causes yang to float upward and outward; profuse sweating over the entire body signifies Yang collapse (critical depletion of Yang qi).
[Note] Excessive blood loss after childbirth results in Yin deficiency, which in turn leads to relative Yang excess. If there is only slight spontaneous sweating, it indicates harmonious Ying and Wei (Nutritive and Defensive Qi), so although sweating occurs, it is not harmful. If the body has no sweat but only the head sweats, this is a sign of Yin deficiency with floating and outward surging of Yang. If both the head and body sweat profusely without stopping, there is a danger of Yang collapse.
Danggui Liu Huang Tang (Angelica Six-Huang Decoction) | Huangqi Tang (Astragalus Decoction)
36. When deficient heat steams upward causing head sweating, treat with Danggui Liu Huang Tang; Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), and Huangbai (Phellodendri Cortex) should be used charred; Danggui (Angelicae Sinensis Radix) and Huangqi (Astragali Radix) are used in both raw and prepared forms, along with Shengdi Huang (Rehmanniae Radix) and Shudi Huang (Prepared Rehmanniae Radix). For spontaneous sweating, use Huangqi Tang with Oyster Shell (Concha Ostreae); the formula contains Huangqi (Astragali Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Gancao (Glycyrrhizae Radix et Rhizoma), Maidong (Ophiopogonis Tuber), Dihuang (Rehmanniae Radix), and Fangfeng (Saposhnikoviae Radix). If profuse sweating continues due to Yang escaping outward, large doses of Renshen (Ginseng Radix et Rhizoma) and Fuzi (Aconiti Lateralis Radix Praeparata) can restore Yang.
[Note] Postpartum blood loss causes Yin deficiency, allowing Yang-heat to steam upward; if sweating occurs on the head up to the neck and then stops, Danggui Liu Huang Tang is appropriate. This consists of Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Huangbai (Phellodendri Cortex), Danggui (Angelicae Sinensis Radix), Huangqi (Astragali Radix), Shengdi Huang (Rehmanniae Radix), and Shudi Huang (Prepared Rehmanniae Radix). The three herbs Huangqin, Huanglian, and Huangbai must be used charred. If spontaneous sweating is excessive, Huangqi Tang is suitable, consisting of Concha Ostreae (Oyster Shell), Huangqi (Astragali Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Gancao (Glycyrrhizae Radix et Rhizoma), Maidong (Ophiopogonis Tuber), Shudi Huang (Prepared Rehmanniae Radix), and Fangfeng (Saposhnikoviae Radix). If massive loss of Yin-blood leads to lone Yang escaping outward and profuse sweating without cessation, only large doses of Renshen (Ginseng Radix et Rhizoma) and Fuzi (Aconiti Lateralis Radix Praeparata) can restore Yang.
37. For postpartum wind-stroke, only major tonification is indicated; do not treat fire, wind-phlegm as primary concerns. Use Shiquan Dabu Tang (Ten-Tonifying Decoction) as the main formula, and carefully consider adding assistant and guiding herbs based on clinical presentation.
[Note] Postpartum Qi and Blood are severely deficient; even if wind-stroke occurs, major tonification is the only appropriate approach. Even if symptoms of fire, wind-phlegm, or Qi stagnation are present, they should be treated as secondary. Shiquan Dabu Tang (Ten-Tonifying Decoction) should be used as the principal formula, with assistant and guiding herbs added according to a detailed assessment of the specific manifestations of fire, wind, and phlegm.
Shiquan Dabu Tang (Ten-Tonifying Decoction) Formula appears in the first volume.