产后阴血骤下，阳无所附，孤阳外越，每多发热，此乃阴虚生热，切勿作外感而表散。生化汤
善能退热，以其内有姜、草，所谓甘温能除大热也。故产后虽有表症，一切风药性升，不可用，
恐载血上行，令人发晕。且虑重竭其阳，必至汗脱而死，即佛手散中川芎辛散，能发汗走泄，亦
须临时因症审酌用之。产后阴血既亏，津液自少，况临产劳倦气虚，虚则传化自迟，二肠枯燥，势所必然，久则自复。
或用生化汤养血，兼生津助液亦可。故产后虽二便暂有不甚通利，然于下利等药，必须禁用，非特硝、黄、五苓难于轻
试。即四物汤中生地、芍药，纯阴而伐生气，且作泻而凝血。五苓利水伤阴，愈通之而愈枯结。若误用而
重亡其阴，难免孤阳无辅而走脱矣。故《机要》有云∶胎产之病从厥阴，无犯胃气及上下二焦，
不可汗，不可下，不可利小便也。
凡治产后，三审不可缺也。一审少腹痛与不痛，以征恶露之有无；二审大便通与不通，以
征津液之盛衰；三审乳汁行与不行，及饮食多少，以征胃气之充馁。大抵常产之妇，开合有权，
产后子宫即闭，儿枕随气攻注，碎作小块，续续而下，所以延绵日期。又有由于难产，过伤子
宫，关闸废弛，不能收敛，或下血块，大小形色与茄无异，此名儿枕是也。全块顿出，自无淋
沥之患，即有余血，尽归溲便，如皂荚汁，少腹略无痛苦。切勿认为产后瘀尚未行，妄行攻下，
误人性命。产后又有似乎儿枕痛者，摸之亦有块，按之亦微拒手，人皆指为儿枕宿血，此大不
然。夫胎胞俱去，血亦岂能独留？盖子宫蓄子既久，忽尔相离，血海陡虚，所以作痛，胞门受
伤，必致壅肿，所以亦若有块，而实非正块。肿既未消，所以亦颇拒按。治此者，当安养其脏，
不久自愈。若有瘀服药，生化汤对最，殿胞煎或四神散亦可。若误用苏木、红花、元胡、青皮
之属，反损脏气，必增虚病，慎之，慎之！
殿胞煎 治产后儿枕疼痛等症如神。
当归（五钱） 川芎（一钱） 茯苓（一钱） 炙草（一钱） 肉桂（五分） 水一盅。
煎八分，热服。如脉细而寒或呕者，加干姜（炒黄色）一钱；如血热多火者，去肉桂，加酒炒芍
药一钱。
四神散（见腹痛门）。
产后阴血突然大量流失，阳气失去依附，导致孤阳向外浮越，常常出现发热的症状，这是阴虚产生的内热，千万不要当作外感表证而使用解表发散的方法。生化汤善于退热，因为方中含有干姜、甘草，这就是所谓的“甘温能除大热”的道理。所以，产后即使有表证，一切具有升散性质的风药都不可使用，恐怕会载着血液上行，使人头晕目眩。并且担心这会再次耗竭阳气，必然导致汗出亡阳而死。即使是佛手散中的川芎，因其辛散之性能够发汗走泄，也必须根据当时的具体情况审慎斟酌后使用。
产后阴血已经亏损，津液自然减少，况且分娩时劳累疲倦导致气虚，气虚则脏腑传化功能自然迟缓，大小肠干燥枯涩，这是势所必然的，时间久了自然会恢复。或者使用生化汤养血，兼以生津助液也是可以的。所以，产后虽然二便暂时不太通利，但是像泻下等药物必须禁用，不仅仅是芒硝、大黄、五苓散难以轻易尝试。即使是四物汤中的生地黄、芍药，性质纯阴会损伤生气，且会导致腹泻并凝固血液。五苓散利水伤阴，越是通利小便，身体反而越加干枯结滞。如果误用这些药物导致阴液再次严重亡失，难免出现孤阳无依而脱散的危象。所以《兰室秘藏·机要》中说：胎产疾病多与厥阴经有关，不要损伤胃气及上、中、下三焦，不可发汗，不可攻下，不可利小便。
凡是治疗产后病，三审诊法是不可缺少的。一审少腹部是否疼痛，以此推断恶露是否有残留；二审大便是否通畅，以此推断津液的盛衰情况；三审乳汁是否通畅以及饮食量的多少，以此推断胃气的充盛或虚弱。大致而言，正常生产的妇女，子宫开合有度，产后子宫立即闭合，儿枕（产后瘀血凝聚形成的块状物）随气机攻注，碎裂成小块，陆续排出，所以持续时间较长。又有因难产过度损伤子宫，导致关闸松弛，不能收敛，排出的血块大小形状与茄子无异，这叫做儿枕。如果是整块一次性排出，自然没有淋漓不尽的忧患，即使有余血，也全部归于大小便排出，如皂荚汁般，小腹几乎没有痛苦。千万不要认为是产后瘀血尚未行尽，妄用攻下药物，这会误人性命。
产后又有似乎儿枕痛的情况，触摸也有块状物，按压时也略有抗拒感，人们都指为儿枕宿血，这大错特错。既然胎胞都已去除，血液又怎能单独留下？大概是因为子宫蓄养胎儿日久，忽然分离，血海骤然空虚，所以产生疼痛；胞门受伤，必然导致壅肿，所以看起来好像有块状物，但实际上并非真正的瘀血块。肿胀既然没有消退，所以按压时也比较抗拒。治疗这种情况，应当安养脏腑，不久自然痊愈。如果有瘀血需要服药，生化汤最为对症，殿胞煎或四神散也可以。如果误用苏木、红花、元胡、青皮这类药物，反而会损伤脏气，必定增加虚损病症，务必谨慎，务必谨慎！
殿胞煎：治疗产后儿枕疼痛等症状效果神奇。
当归（五钱） 川芎（一钱） 茯苓（一钱） 炙甘草（一钱） 肉桂（五分） 用水一盅。
煎至八分，热服。如果脉细且有寒象或呕吐的，加炒黄色的干姜一钱；如果血热火旺的，去掉肉桂，加酒炒芍药一钱。
四神散（见腹痛门）。
After childbirth, Yin-blood is suddenly and heavily lost, leaving Yang without attachment. Solitary Yang floats outward, often causing fever. This is heat generated by Yin deficiency; it must not be mistaken for an external contraction treated with surface-releasing methods. Shenghua Tang (Blood-Generating Decoction) is effective in reducing fever because it contains dried ginger (Ganjiang) and licorice (Gancao), illustrating the principle that "sweet and warm herbs can eliminate severe heat." Therefore, even if exterior symptoms are present after childbirth, all wind-dispelling herbs with ascending properties should not be used, as they may carry blood upward, causing dizziness. Furthermore, there is a risk of further exhausting Yang, which could lead to death from sweating collapse. Even Chuanxiong (Chuanxiong Rhizome) in Foshou San (Hand-Holding Powder), due to its acrid and dispersing nature that induces sweating and leakage, must be used only after careful consideration based on the specific condition at that time.
Since Yin-blood is already deficient after childbirth, body fluids are naturally scant. Moreover, labor fatigue leads to Qi deficiency; when Qi is deficient, digestive transformation slows down, inevitably leading to dryness of the large and small intestines. This will recover naturally over time. Alternatively, using Shenghua Tang to nourish blood and assist in generating fluids is also appropriate. Thus, although bowel movements and urination may be temporarily obstructed after childbirth, purgative or draining herbs must be strictly prohibited. It is not only that Mangxiao (Natrii Sulfas), Dahuang (Rhei Radix et Rhizoma), and Wuling San (Five-Ingredient Powder with Poria) should not be lightly tried. Even Shengdihuang (Rehmanniae Radix) and Shaoyao (Paeoniae Radix) in Siwu Tang (Four-Substance Decoction) are purely Yin in nature, damaging the vital Qi, causing diarrhea, and coagulating blood. Wuling San promotes diuresis but injures Yin; the more one promotes urination, the more dryness and constipation worsen. If mistakenly used, causing a second loss of Yin, solitary Yang without support may flee, leading to collapse. Therefore, *Jiyao* (Essentials) states: Diseases related to pregnancy and childbirth involve the Jueyin channel; one must not violate Stomach Qi or the Upper, Middle, and Lower Jiaos. One must not induce sweating, purge, or promote diuresis.
In treating postpartum conditions, the "Three Examinations" are indispensable. The first examination checks for pain in the lower abdomen to determine the presence or absence of lochia discharge. The second examination assesses whether stool is unobstructed to gauge the abundance or depletion of body fluids. The third examination evaluates whether lactation is flowing and the amount of food intake to determine whether Stomach Qi is robust or deficient. Generally, women who have normal deliveries have regulated uterine opening and closing. After birth, the uterus closes immediately. Erzhen (Placental Blood Stasis Mass), driven by Qi, breaks into small pieces and is discharged continuously, hence the prolonged duration. In cases of difficult labor, excessive injury to the uterus causes the "gate" to relax and fail to contract, resulting in the expulsion of blood clumps as large and shaped like eggplants; this is called Erzhen. If the entire mass is expelled at once, there is no worry of dripping discharge. Any remaining blood goes into urine and stool, resembling soap pod juice, with little to no lower abdominal pain. Do not mistakenly assume that postpartum blood stasis has not yet moved and recklessly use purgatives, which can be fatal.
There are postpartum cases that resemble Erzhen pain, where a mass can be felt and slight resistance occurs upon pressure. People often attribute this to residual blood from Erzhen, which is greatly mistaken. Since the fetal sac has been expelled, how can blood remain alone? The uterus housed the fetus for a long time; its sudden separation causes the Sea of Blood to become suddenly empty, resulting in pain. Injury to the uterine gate causes congestion and swelling, making it appear as if there is a mass, though it is not a true solid mass. Because the swelling has not subsided, it resists pressure. Treatment should focus on calming and nourishing the organs, and recovery will occur soon. If blood stasis requires medication, Shenghua Tang is most suitable; Dianbao Jian (Placenta-Clearing Decoction) or Sishen San (Four-God Powder) are also acceptable. If herbs such as Sumu (Sappan Wood), Honghua (Carthami Flos), Yuanhu (Corydalis Rhizoma), and Qingpi (Aurantii Fructus Pericarpium) are mistakenly used, they will damage organ Qi and exacerbate deficiency conditions. Be extremely cautious!
Dianbao Jian: Highly effective for postpartum Erzhen pain and similar symptoms.
Danggui (Angelicae Sinensis Radix, 5 qian), Chuanxiong (Chuanxiong Rhizome, 1 qian), Fuling (Poria, 1 qian), Zhi Gancao (Prepared Licorice Root, 1 qian), Rougui (Cinnamomi Cortex, 0.5 qian). Add one cup of water.
Decoct until reduced to eight-tenths, and take hot. If the pulse is fine and cold signs are present, or if vomiting occurs, add fried Huangqi Ganjiang (Fried Dried Ginger, 1 qian). If there is excess blood heat and fire, remove Rougui and add Jiuchao Shaoyao (Wine-fried White Peony Root, 1 qian).
Sishen San (See section on Abdominal Pain).