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：产后如果寸口脉象洪大急促且不调和，是死证；如果脉象沉微，但重按至骨仍有根气不绝，是生证。又说：脉象沉小滑利的为生证，脉象实大坚弦急的为死证。丹溪说：怀孕前脉象应当洪数，生产后脉象仍然洪数的，是死证。又说：怀孕前脉象细小，生产后脉象反而洪大的，大多死亡。《产经》说：怀孕期间的疾病，脉象以实大为贵；生产后的疾病，脉象以虚细为贵。怀孕期间要顺气安胎，生产后要补虚消瘀，这是关键要点。
临产时气血动荡，胞胎破裂，与平时的生理状态不同，必定有羊水先破流出，俗称“胞浆”，就是滋养胎儿的液体。羊水流出后胞胎破裂而分娩，生产后气血两虚，脉象适宜缓滑。缓脉表示从容不迫，不因气被夺而急促；滑脉表示流利，不因血液流失而枯涩，这都是吉兆。如果脉象实大弦牢，就不符合产后气血两虚的情况，实脉代表邪气盛，大脉代表邪气进逼，弦脉代表阴气收敛、宣发受阻，牢脉代表坚硬着位，接近无胃气的脉象，这些都是逆乱的脉象。
凡是分娩结束后，喝一盏热童子尿，不要立即躺下，应该闭目静坐，片刻后再上床，宜仰卧坐着，不宜侧卧，宜竖起膝盖，不宜伸直脚高靠，床头要厚铺褥子，四周遮挡墙壁不留缝隙，以免贼风（风寒邪气）侵入，用醋涂在鼻子上，或者用醋熏炭，再烧漆器，轻轻用手从心口按摩到肚脐，这样恶露就能排尽，以防止血滑或血逆，连续这样做三天。无论腹痛与否，用童子尿和酒温服五到七次。酒虽然能行血，能促使恶露排出，促进乳汁分泌，但脏腑之气刚刚虚弱，不可多饮，也不可在刚生产完就喝，恐怕引血进入四肢，导致血晕。如果胃气弱、体内无火的，也要禁止喝童子尿，恐怕损伤胃气，只能频繁食用白术薄粥，逐渐增加肥肉、猪蹄等少量食物。谨慎言语，戒除七情（喜、怒、忧、思、悲、恐、惊），不要勤快梳头洗脚，以一百天为限度。如果气血虚弱，不论月份多少，否则会出现手足腰腿疼痛等症状，名叫“蓐劳”，最难治疗。产后不必问是男孩还是女孩，恐怕因为言语而泄气，或因爱憎而劳神。最忌讳大喜、大怒，喜则气散，可能产生红色污物（出血）；怒则气逆，可能形成瘕聚（腹部包块）。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，一旦生病则严重如山岳，能不谨慎吗！
乳汁是由气血化生的，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，以及吃冷物，切不可对着风睡觉。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，脐风由此而起，多次见到不洗“三”的人，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。况且婴儿在胎内，从母腹中温暖生长养育，一出生，阳和之气完全丧失，即使在暑月，也必须衣服严密，不要见外风，所以俗语说“亚无六月”（意指婴儿怕风，即使六月也需保暖）。婴儿生下，要断脐带，必须以蕲艾做成捻子，用香油浸湿，熏烧脐带，烧焦了才断开，束脐带必须用软帛，厚绵包裹束缚，不要让受风，以及婴儿尿液弄湿脐部，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，衣服必须用大人穿过的旧绵，这样就不会耗损脉络精华，同时用布衣粗服，让他的皮肤坚固浓密，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泡子，必须刮出不要让它落入喉中，然后用京墨涂抹。这个泡子一旦变老，就很难刮，而且婴儿不吃奶，会变为撮口等症。再看牙龈之上，如果有马牙，也必须挑破取出，出血不妨碍，用墨涂抹。收藏胎盘，忌讳在太岁方和三杀方放置，宜用稍大平稳的瓷瓶，瓶子小会让婴儿吐乳，安稳放置让婴儿不惊吓。母亲的血衣不可日晒，婴儿的湿衣不可夜露，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，才得人身，一出胞胎，性命托付于父母的保养，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，不是行血则邪气不去。即使是各种虚症，也必须血行然后气才能恢复，但行血要有方法，不可过于峻猛。凡是产后危重证候，没有比“三冲”、“三急”更严重的。“三冲”是指败血冲肺、冲心、冲胃；“三急”是指新产妇人的呕吐、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，能致泻而凝血，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。还有三禁：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，才可以同房，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？大概新生产的妇女，气血都虚，只存有秋冬肃杀之气，而没有春夏主发的生机，所以最忌寒凉，大宜温热药物，以助资助生命之源。先哲制定四物汤，用川芎、当归的辛温，佐以地黄、芍药的寒凉，温寒适中，是妇科各种疾病的妙剂。如果用于产后，必须取白芍用酒反复炒制，去掉其酸寒的性质，只保留生血活血的功能，或者再加黑姜，那有什么不可以用的？况且芍药性清微酸而收敛，最适合阴气散失的证候，难道不是产后的要药！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研究生地更凉，且直走血分危害尤其严重，如果不得已，当用熟地代替，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，乃成各种病，既然产后元气亏损，营运失度，不免瘀血停留，治疗者必须先逐瘀，瘀血消除后方可行补，这是第一义。但如果虚极不能等待的，则在峻补之中，加入温行的药物，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，也不可用峻厉的药物。产后元气大虚，恐怕血无主宰，一任药力，就会崩漏不止，虚则易脱，如同覆水难收，所以不如生化汤行中有补，补中有行，温则不滞，无伤胃气，是最恰当的。
产后元气大脱，新血未生，凡有头疼发热、恶心饱闷诸证，都是虚中变现的假象，慨然以大补气血为主，如果恶露未尽，在补药中加入行血药。如果感冒风寒停滞，也必须补中兼以发散消导，不得泛用峻厉药物，有伤气血，因疑似之外邪，伤真切之元气，岂不误得很厉害！
新产之后，虽然没有疾病，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，生化汤除去这两味药，加上温中行血的药剂。如产后儿枕作痛，世人多用消块散血的药剂，然后议补。又有消与补混施，不知道旧血虽当消化，新血亦当生养，若专攻旧血，则新血转伤。世人用回生丹，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，川芎、当归、桃仁三味善去旧血，骤生新血，佐以黑姜、炙甘草，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，实为产后之圣药。（张元素）因此方，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，有因恶露进入胞衣，胀而不能出，有因元气亏损，虚而不能出。恶露流入胞衣中的，腹部必胀痛，用夺命丹，或失笑散，以消瘀血，缓则不救。元气虚弱不能送下的，腹部不胀痛，用保生无忧散，以固元气，然而不如总以万全汤去人参，并可取效为最恰当。
妇人百病，没有比生产更重要的，产科之难，临产没有比催生更重要的，既生没有比胞衣不下更重要的，古方用花蕊石散最为紧要，但恐怕石药非肠胃大虚者所宜，不如生化、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，产毕胞衣不下，停久不仅产母疲倦，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，不然胞上掩心而死，慎之。
Shuhe stated: If the Cun Kou (inch position) pulse after childbirth is surging, rapid, and unharmonious, it indicates a fatal condition; if the pulse is deep and faint but still has root qi when pressed to the bone, it indicates survival. He further stated: A deep, small, and slippery pulse indicates survival, while a full, large, firm, wiry, and urgent pulse indicates death. Danxi stated: During pregnancy, the pulse should be surging and rapid; if the pulse remains surging and rapid after childbirth, it indicates death. He also stated: If the pulse was fine and small during pregnancy but becomes surging and large after childbirth, death is likely. The *Chanjing* (Classic of Childbirth) stated: For diseases during pregnancy, a solid and large pulse is preferred; for diseases after childbirth, a deficient and thin pulse is preferred. During pregnancy, one should harmonize Qi and calm the fetus; after childbirth, one should tonify deficiency and resolve stasis; this is the key point.
During labor, Qi and Blood are turbulent, the fetal sac ruptures, deviating from normal physiological states, and amniotic fluid must break first, commonly known as "Baopang" (fetal membrane fluid), which is the fluid nourishing the fetus. After the fluid breaks and the sac ruptures leading to delivery, Qi and Blood become doubly deficient postpartum. The pulse should be slow and slippery. A slow pulse indicates composure, not急促 (urgent) due to Qi depletion; a slippery pulse indicates smoothness, not withered or rough due to blood loss. Both are auspicious signs. However, a full, large, wiry, and firm pulse is unsuitable for postpartum Qi and Blood deficiency. A full pulse represents excess pathogenic factors, a large pulse indicates pathogenic progression, a wiry pulse indicates Yin constriction and blocked dissemination, and a firm pulse indicates rigidity, approaching a stomach-less pulse. All these are contrary/rebellious pulses.
After delivery, drink a cup of hot urine from a young boy. Do not lie down immediately; instead, sit with eyes closed for a moment, then get into bed in a supine sitting position, not side-lying. Keep knees upright, not legs extended and high-supported. Place thick bedding at the head of the bed and block all walls to prevent gaps, avoiding "Thief Wind" (pathogenic wind). Apply vinegar to the nose, or use vinegar-fumed charcoal, or burn lacquerware. Gently massage from the heart to the navel with hands so that lochia discharges completely, preventing blood slipping or rebellious flow. Continue this for three days. Regardless of abdominal pain, take warm mixture of boy's urine and wine five to seven times. Although wine promotes blood circulation, expels lochia, and promotes lactation, the Zang-Fu Qi is just weakened, so do not drink too much, nor immediately after birth, lest it draws blood to the four limbs causing "Blood Fainting." If Stomach Qi is weak or there is no internal heat, boy's urine is also contraindicated to avoid damaging Stomach Qi. Instead, frequently eat thin congee made with Baizhu (Atractylodis Macrocephalae Rhizoma), gradually adding small amounts of fatty meat and pig trotters. Be cautious with speech, guard against the Seven Emotions, avoid frequent hair combing and foot washing, limiting this regimen to 100 days. If Qi and Blood are weak, regardless of months passed, otherwise symptoms like pain in hands, feet, waist, and legs may occur, named "Rulao" (Postpartum Consumption), which is difficult to treat. Postpartum, do not ask about the gender of the baby, lest speech depletes Qi or love/hate exhausts Shen (Spirit). Great joy and anger are strictly forbidden; joy scatters Qi, potentially causing bleeding; anger causes Qi rebellion, potentially forming Jia masses (abdominal lumps). Do not sleep alone, lest causing empty fright; do not scrape the tongue, lest hurting Heart Qi; do not brush teeth, lest causing blood rebellion. Only handle affairs after Qi and Blood have stabilized. Violating taboos initially seems slight as an autumn hair, but illness becomes heavy as a mountain. Can one not be cautious?
Milk is formed from Qi and Blood. Postpartum, salt should be avoided as it 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 "Washing Three"; it is said that without washing, the skin becomes rough and scaly later. Washing is acceptable in hot summer weather, but absolutely forbidden in winter to prevent wind entering the umbilicus, causing "Umbilical Tetanus" (Qifeng). Many who did not wash "Three" remained healthy with good skin; knowledgeable people consider skipping "Washing Three" acceptable. Since the fetus grows in the warm maternal abdomen, upon birth, it loses Yang-warming Qi. Even in summer, clothing must be dense to exclude external wind, hence the saying "Ya Wu Liu Yue" (implying infants need protection even in June). To cut the umbilical cord, use Qiai (Artemisia argyi) twisted into a roll, soaked in sesame oil, burned until charred before cutting. Bind the umbilicus with soft cloth wrapped in thick cotton to prevent wind exposure and urine wetting, which is the second crucial step in preventing Umbilical Tetanus. Newborn skin is tender and pores loose; use old cotton from adults to preserve meridian essence, and coarse cloth clothes to toughen the skin, benefiting life long.
On the second day after birth, check the upper palate for white blisters ("mouth pearls"). Gently pop them with a silver spoon, ensuring they do not fall into the throat, then apply Jingmo (Beijing ink). If left untreated, they harden, cause refusal to nurse, and lead to conditions like "Suo Kou" (lockjaw). Check gums for "Horse Teeth" (epithelial pearls); puncture and remove them, applying ink afterward. Store the placenta in a stable, slightly large porcelain bottle; small bottles may cause infant regurgitation. Keep placenta safe to prevent infant startle. Do not sun-dry bloody maternity clothes; do not expose wet infant clothes to night dew. Bird droppings on clothes can cause toxic sores and turn into "Gan Syndrome" (infant malnutrition/parasitism). Ancient texts define one month as "Xiao Ying Yue" and two months as "Da Ying Yue." Avoiding rage, overwork, and sexual desire during these two months ensures lifelong health and fertility. Humans rarely attain human form after many kalpas; once born, life depends on parental care. Due to having too many children and lack of food/clothing, some drown infants, severely harming Heavenly Harmony; this must be strictly prohibited.
Various postpartum syndromes should not be treated generally with tonics, lest stasis coagulate. Without moving blood, pathogens remain. Even for deficiency syndromes, Qi recovers only after blood moves, but methods must be moderate, not overly harsh. Critical postpartum conditions include "Three Rushes" (Bai Xue Chong Fei/Xin/Stomai -敗血 rushing to Lung/Heart/Stomach) and "Three Urgencies" (Ou Tu/Xie Xie/Duo Han - vomiting, diarrhea, excessive sweating). Medications have three prohibitions: Forbidden is Foshou San because Chuanxiong (Chuanxiong Rhizoma) is acrid and dispersing, causing sweating and leakage. Forbidden is Siwu Tang because Shengdi Huang (Rehmanniae Radix) is cold, causing diarrhea and coagulating blood; Baishao (Paeoniae Radix Alba) is sour and cold, destroying vital Qi. Forbidden is Xiao Chai Hu Tang because Huangqin (Scutellariae Radix) is cool, obstructing lochia discharge. There are three more prohibitions: do not induce sweating, do not purge, do not promote urination. Do not violate the Stomach or Upper/Lower Jiao. Even with miscellaneous symptoms, prioritize major tonification of Qi and Blood. Coitus is permitted only after 100 days; otherwise, it leads to death. Most chronic deficiencies and diseases stem from early coitus. Women suffering from Wind patterns and cold below the umbilicus usually have this due to early sexual activity.
Ancient formulas often modify Siwu Tang for postpartum diseases, but Danxi prohibited Shaoyao (Paeoniae Radix) due to its sour-cold nature destroying growing Qi. Why? Because postpartum women have dual deficiency of Qi and Blood, retaining the肃杀 (killing/drying) energy of Autumn/Winter without the sprouting mechanism of Spring/Summer. Thus, cold-cooling herbs are taboo; warm-hot herbs are highly suitable to aid the source of life. Ancestors formulated Siwu Tang using Xiong Gui (Chuanxiong Rhizoma and Angelicae Sinensis Radix) for warmth/acridity, assisted by Di Shao (Shengdi Huang and Baishao) for coldness, achieving a balance suitable for gynecological diseases. For postpartum use, Baishao must be repeatedly fried with wine to remove sour-cold properties, retaining only blood-nourishing/moving functions, possibly adding Heijiang (Charred Zingiberis Rhizoma). Shaoyao is clear, slightly sour, and astringent, suitable for dissipating Yin Qi, making it a key postpartum herb! Ancestors warned against it, let alone other cold/astringent herbs! One knows Shaoyao is sour-cold but ignores that Shengdi is colder and directly harms the Blood level. If unavoidable, replace with Shudi (Prepared Rehmanniae Radix). Using Siwu Tang indiscriminately for postpartum cases has misled many.
Removing defeated blood (lochia/stasis) is paramount postpartum. Stagnant blood causes various diseases. Since Yuan Qi is depleted and transport is disordered, stasis inevitably remains. Treaters must first expel stasis; only after stasis clears can tonification proceed. This is the primary principle. However, if deficiency is extreme and cannot wait, add warming-moving herbs to strong tonification. Strong tonification provides power for circulation; warming movement ensures flow without stagnation. Even for excess syndromes requiring stasis removal, harsh drugs are forbidden. Postpartum Yuan Qi is greatly deficient; fearing blood lacks control, relying solely on drug force may cause unstoppable hemorrhage. Deficiency easily leads to collapse, like spilt water. Therefore, Shenghua Tang is best: it moves while tonifying, tonifies while moving, is warm without stagnation, and does not hurt Stomach Qi. It is most appropriate.
When postpartum Yuan Qi is largely depleted and new blood not yet generated, symptoms like headache, fever, nausea, and fullness are false manifestations of deficiency. Generally, major tonification of Qi and Blood is used. If lochia is not finished, 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, injuring true Yuan Qi with suspected exterior pathogens. How mistaken would this be!
After new birth, even without disease, rest and labor management, spleen-stomach regulation, and delicious diet help organs recover and Qi-Blood harmonize, preventing diseases. But Zhong Qi (Middle Qi) is weak and digestion difficult; do not overeat, lest damaging Spleen-Stomach.
Siwu Tang contains Shengdi (cool/stagnant, damaging Spleen-Stomach) and Shaoyao (sour/cold, destroying vital Qi), often misleading in postpartum cases. Shenghua Tang removes these two, adding warming-moving-blood agents. For "Erzhen" (afterbirth mass) pain, people often use blood-breaking/stasis-resolving formulas before tonifying. Some mix breaking and tonifying, not realizing old blood should dissolve but new blood must grow. Attacking only old blood damages new blood. Huisheng Dan attacks blood masses and expels placenta, severely damaging Yuan Qi. Shenghua Tang is named for its function: resolving postpartum masses while generating new blood. Solely resolving prevents new blood generation; solely generating causes old blood stagnation. Xiong Gui Tao Ren (Chuanxiong Rhizoma, Angelicae Sinensis Radix, Persicam Semen) effectively remove old blood and rapidly generate new blood. Assisted by Heijiang and Zhi Gancao (Roasted Glycyrrhizae Radix et Rhizoma), they enter Lung/Liver, generate blood, benefit Qi, move while tonifying. Warmth ensures blood flows, lochia ends, leaving no aftereffects. It is truly the sage medicine for postpartum. Zhang Yuansu added Renshen (Ginseng Radix), Guizhi (Cinnamomi Ramulus), Niuxi (Achyranthis Bidentatae Radix), Honghua (Carthami Flos) to this formula, making it miraculous for inducing labor prenatally.
Placenta retention has two types: one due to lochia entering the sac causing distension preventing expulsion; the other due to Yuan Qi deficiency failing to push it out. If lochia enters the sac, the abdomen is painful and distended. Use Mingdan (Dingming Dan) or Shixiao San (Shixiao Powder) to resolve stasis; delay is fatal. If Yuan Qi weakness fails to send it down, the abdomen is not painful/distended. Use Baosheng Wuyou San (Baosheng Wuyou Powder) to secure Yuan Qi. However, using Wanquan Tang (Wanquan Decoction) without Renshen is considered most appropriate.
Among women's diseases, none is heavier than childbirth. In obstetrics, nothing is harder than inducing labor; after birth, nothing is heavier than placenta retention. Ancient formulas favor Huarui Shi San (Flower Manganese Stone Powder), but stone medicines are unsuitable for severe intestinal/stomach deficiency. Better to select Shenghua Tang and Wanquan Tang. Another option: Chuan Foshou San plus Honghua, Yimucao (Leonuri Herba), Xiangfu (Cyperi Rhizoma), Shanzha (Crataegi Fructus), Chenpi (Citri Reticulatae Pericarpium), Niuxii, lightly decocted, taken with concentrated urine. Another method: If placenta remains after birth, prolonged retention fatigues the mother and risks blood flowing into the sac, causing critical danger. Quickly cut the umbilical cord, tie it, and hang something heavy to prevent blood flooding the sac, allowing the placenta to shrink and descend naturally. The mother must remain calm. Tie first, then cut. Otherwise, the placenta may rise and crush the heart, causing death. Be cautious.