〔全〕夫恶露不下者，由产后脏腑劳伤，气血虚损，或胞络挟于宿冷，或产后当风取
凉，风冷乘虚而搏于血，血则壅滞不宣，积蓄在内，故令恶露不下也。
〔薛〕前症若恶露不下，用失笑散。（见后心痛。）若气滞血凝，用花蕊石散。（胞衣不下。）
一产妇患前证，服峻厉之剂，恶露随下，久而昏愦，以手护其腹。余曰∶此脾气复伤作
痛，故用手护也。以人参理中汤加肉桂二剂，补之而愈。
《大全》疗产后三四日恶露不下。
芍药（十分） 知母（八分） 生姜 当归 蒲黄（各四分） 红花（二分）
荷叶中心蒂（七枚） 生地黄汁（二合）
上细切，以水二升，煎至七合，去滓服。
荷叶散 疗产后恶露不下，腹中疼痛，心神烦闷。
干荷叶（二两） 鬼箭羽 桃仁 刘寄奴 蒲黄（各一两）
上为粗末，每服三钱，以童便一大盏，姜二片，生地黄一分，捶碎同煎至六分，去滓，
无时热服。
《广济》疗产后恶露不多下方。
川牛膝 大黄（各二两） 牡丹皮 当归（各一两半） 芍药 蒲黄 桂心（各一两）
上为末，以生地黄汁调酒服方寸匕，日二服，血下愈。
没药丸 治产后恶露方行，而忽然断绝，骤作寒热，脐腹百脉，皆痛如锥刺非常，此
由冷热不调，或思虑动作，气所拥遏，血蓄经络。
当归（一两） 桂心 芍药（各半两） 桃仁（去皮尖，炒研） 没药（研，各二钱半） 虻虫（去
足翅，炒） 水蛭（炒焦，各三十枚）
上为末，醋糊丸如豌豆大，醋汤下三丸。
《千金》备急丹（见胞衣不下。）
《保命》治妇人恶血不下。
当归（炒） 芫花（炒等分）
上为细末，每服三钱，酒下。又方，用好墨醋 ，末，以童便酒下妙。
梅师治产后血不下。蒲黄三两，水三升，煮取一升，顿服。
《本事方》治产后血不下。益母草捣绞汁，每服一小盅，入酒一合，搅匀温服。
《千金》治产后血不去。麻子五升，酒一升，浸一宿，明旦去渣温服一升，不瘥再服
一升，不吐不下。不得与男子通，一月将养，如初瘥。
黑龙丸（见通用方内。）
生料五积散 治产后恶露不快，腹中疼痛，或腹内有块及发寒热，并加醋少许煎，通
口服。亦能疗血崩。
【全元起注】恶露不下的原因，是由于产后脏腑劳损受伤，气血虚弱亏损；或者是胞络夹杂有宿存的寒气；或者是产后吹风受凉，风冷之邪乘虚侵入并与血相搏结，导致血液壅滞不通，积蓄在体内，所以造成恶露不下。
【薛己按语】上述病症如果表现为恶露不下，使用失笑散。（参见后文心痛条。）如果是气滞血凝，使用花蕊石散。（参见胞衣不下条。）
有一位产妇患上述病症，服用峻烈猛烈的药剂后，恶露随即排出，但时间久了出现神志昏乱、意识模糊，并用手护住腹部。我说：这是脾气再次受损引起疼痛，所以用手护住腹部。用人参理中汤加入肉桂，服用两剂，补益脾气而痊愈。
《大全》记载治疗产后三四天恶露不下的方剂。
芍药（十分） 知母（八分） 生姜 当归 蒲黄（各四分） 红花（二分）
荷叶中心蒂（七枚） 生地黄汁（二合）
以上药材细切，用水二升，煎煮至七合，去渣服用。
荷叶散 治疗产后恶露不下，腹中疼痛，心神烦闷。
干荷叶（二两） 鬼箭羽 桃仁 刘寄奴 蒲黄（各一两）
以上药材制成粗末，每次服用三钱，用童子尿一大盏，生姜两片，生地黄一分，捣碎同煎至六分，去渣，随时热服。
《广济》记载治疗产后恶露不多的下方。
川牛膝 大黄（各二两） 牡丹皮 当归（各一两半） 芍药 蒲黄 桂心（各一两）
以上药材研为末，用生地黄汁调酒送服一方寸匕，每日两次，血下则愈。
没药丸 治疗产后恶露刚开始行经，却突然断绝，骤然发作寒热，脐腹及全身血脉，都痛如锥刺般剧烈，这是由于冷热不调，或者思虑过度、劳累动作，导致气机拥塞遏阻，血液蓄积在经络中。
当归（一两） 桂心 芍药（各半两） 桃仁（去皮尖，炒研） 没药（研，各二钱半） 虻虫（去足翅，炒） 水蛭（炒焦，各三十枚）
以上药材研为末，用醋糊制作成如豌豆大小的丸剂，醋汤送服三丸。
《保命》治疗妇人恶血不下。
当归（炒） 芫花（炒，等分）
以上药材研为细末，每次服用三钱，用酒送服。另一方法，用好墨加醋研磨成末，用童子尿和酒送服效果更佳。
梅师治疗产后血不下。蒲黄三两，水三升，煮取一升，一次性服下。
《本事方》治疗产后血不下。益母草捣烂绞取汁液，每次服用一小盅，加入酒一合，搅匀温服。
《千金》治疗产后血不去。麻子五升，酒一升，浸泡一夜，次日清晨去渣温服一升，若未痊愈再服一升，以不吐不泻为度。期间禁止与男子同房，一个月调养，如同病愈如初。
黑龙丸（参见通用方内。）
[Quan Yuanqi] The cause of lochia retention is due to the damage and injury of the Zang-Fu organs after childbirth, resulting in deficiency and depletion of Qi and Blood. Alternatively, it may be caused by the uterine collaterals harboring lingering cold pathogens, or by exposure to wind and cooling after childbirth. Wind-cold pathogens take advantage of the deficiency to invade and contend with the blood, causing blood stasis and obstruction, leading to accumulation within the interior, thus resulting in lochia retention.
[Xue Ji's Commentary] For the aforementioned symptoms manifesting as lochia retention, use Shixiao San (Pain-Relieving Powder). (See Heartache section below.) If the condition involves Qi stagnation and Blood coagulation, use Huarui Shi San (Flower-Millet Stone Powder). (See Retained Placenta section below.)
A certain puerperal patient suffered from the aforementioned condition. After taking harsh and drastic medicines, her lochia was discharged immediately, but later she developed mental confusion and unconsciousness, holding her abdomen with her hands. I stated: "This is pain caused by further injury to the Spleen Qi, which is why she holds her abdomen." She was treated with Renshen Lizhong Tang (Ginseng and Atractylodes Decoction) added with Rougui (Cinnamon Twig), administered for two doses. The Spleen Qi was tonified, and she recovered.
*Daquan* records a prescription for treating lochia retention occurring three to four days postpartum.
Shaoyao (Peony Root) (10 fen), Zhimu (Anemarrhena Rhizome) (8 fen), Shengjiang (Fresh Ginger), Danggui (Angelica Sinensis), Puhuang (Lycopodium Spore) (each 4 fen), Honghua (Safflower) (2 fen), Hetayou Zhongxin Di (Lotus Leaf Center Stalk) (7 pieces), Shengdihuang Zhi (Fresh Rehmannia Juice) (2 he).
Cut the herbs finely. Add 2 sheng of water, decoct until reduced to 7 he. Strain and administer.
Heye San (Lotus Leaf Powder) treats postpartum lochia retention, abdominal pain, and mental restlessness.
Gan Heye (Dried Lotus Leaf) (2 liang), Guijianyu (Tetracentron Sinense Branch), Taoren (Peach Kernel), Liujinu (Artemisia Annua Herb), Puhuang (Lycopodium Spore) (each 1 liang).
Grind into coarse powder. Take 3 qian per dose. Add one large cup of Tongbian (Child Urine), 2 slices of Shengjiang (Fresh Ginger), and 1 fen of Shengdihuang (Fresh Rehmannia Root). Crush them together and decoct until reduced to 6 fen. Strain and take hot at any time.
*Guangji* records a lower prescription for treating scanty lochia postpartum.
Chuan Niuxi (Achyranthes Bidentata Root), Dahuang (Rhubarb Root) (each 2 liang), Mudanpi (Moutan Cortex), Danggui (Angelica Sinensis) (each 1.5 liang), Shaoyao (Peony Root), Puhuang (Lycopodium Spore), Guixin (Cinnamon Twig) (each 1 liang).
Grind into powder. Mix with Shengdihuang Zhi (Fresh Rehmannia Juice) and wine. Administer one Fangcunbi (a measure approx. 1 cubic inch) per dose, twice daily. Recovery occurs when blood is discharged.
Meyao Wan (Myrrh Pill) treats the sudden cessation of lochia shortly after it begins postpartum, accompanied by abrupt onset of chills and fever. Pain throughout the umbilical-abdominal region and all meridians feels like needle pricks. This is caused by imbalance of cold and heat, or excessive thinking and physical exertion, leading to Qi obstruction and Blood accumulation in the meridians.
Danggui (Angelica Sinensis) (1 liang), Guixin (Cinnamon Twig), Shaoyao (Peony Root) (each 0.5 liang), Taoren (Peach Kernel) (dehulled, de-pitted, fried and ground), Meyao (Myrrha) (ground, each 2.5 qian), Mengchong (Blatta Orientalis) (legs and wings removed, fried), Shuizhi (Hirudo) (fried until scorched, each 30 pieces).
Grind into powder. Make pills using vinegar paste, sized like pea seeds. Take 3 pills with vinegar-infused water.
*Qianjin* Beijidan (Emergency Pill) (See Retained Placenta section).
*Baoming* treats retained evil blood in women.
Danggui (Angelica Sinensis) (fried), Yuanhua (Genkwa Flower) (fried, equal parts).
Grind into fine powder. Take 3 qian per dose with wine. Another method: Grind high-quality ink with vinegar into powder, administer with child urine and wine for better effect.
Master Mei treats postpartum blood retention. Use 3 liang of Puhuang (Lycopodium Spore) and 3 sheng of water. Boil to obtain 1 sheng. Take in one dose.
*Baoshi Fang* treats postpartum blood retention. Crush and juice Yimucao (Leonurus Japonicus Herb). Take one small cup per dose, add 1 he of wine, mix well, and take warm.
*Qianjin* treats postpartum blood stasis. Soak 5 sheng of Mazi (Cannabis Seed) in 1 sheng of wine overnight. Next morning, strain and take 1 sheng warm. If not cured, take another 1 sheng. Do not induce vomiting or diarrhea. Abstain from sexual intercourse with men. Rest and nourish for one month until fully recovered.
Heilong Wan (Black Dragon Pill) (See General Prescriptions section).
Shengliao Wuji San (Raw Material Five Accumulations Powder) treats sluggish lochia discharge postpartum, abdominal pain, intra-abdominal masses, and alternating chills and fever. Add a little vinegar during decoction. Take orally. It can also treat metrorrhagia (blood flooding).