产后暴崩为血脱。气短似喘为气脱，妄言妄见为神脱，
三症虽有气阳血阴之分，于精散神促无异，比前晕症，治可少缓，亦危症也。若非大药急方频服，
失之者多矣。倘误为气实痰火妄治，鲜有不殒生者。若势急，并宜用加参生化汤，补中寓行，免致
血虚之失。其血脱患崩一症，由冲任已伤，气血未复，或因劳役惊恐，或因恶露未尽，固涩太速，
以致停留，一旦复行，然经血大来。当审血气而辨血色之红紫，视形色之虚实。如血多紫色有块，
乃当去之，败血也，其少腹必胀满，按之而痛，止之反能作痛，或致淋沥，此不可言崩，只服生
化汤几帖自愈。如鲜红之血大来，乃惊伤心，不能主血；怒伤肝，不能藏血；劳伤脾，不能统血。
血不归经，血脏有伤，当以崩症治之。崩非经病，产妇得之，是为重虚，犹不可忽。故宜急治，
用荆芷治崩汤。若有血块痛而形色脱，或有汗，或气促，宜服加参生化止崩汤以益气，使阳生而
阴血自旺，非十灰散之可止者。如血块痛止，或产后半月外崩症者，又宜滋荣益气止崩汤，或升
举大补汤，少佐黄连坠火，宁血归经，或用曾生升举大补汤亦妙。亦有小腹空痛，不可误认有瘀，
察其下血少而无紫块者是也，当以崩治，宜重用熟地。若小腹满痛不已，而脉实大紧数者，此肝经
已竭，肝气随败矣，难治。《医通》有治产后崩中去血，赤白相兼，或如豆汁，用《千金》伏龙肝
汤治之。其气脱短气似喘一症，因产所下过多，荣血暴竭，卫气不能营运，独聚于肺，肝肾不接，
故令呼吸短促，语言不相接续，有似于喘，实非喘也。夫肺受脾气散精，生脉而通水道、呼吸，
所以清肃上下，调和荣卫而为平人。若值产后血亡气穷，浮脱于上，孤阳绝阴，无根将脱之兆，
最为危候。惟大进参、附，或可得生。世有妄论痰火实症，反用散气化痰之方，治之必死。有块
痛者，当用大补回阳生化汤，连二三服。世人多疑参助喘不用，致不救者多矣。况同芎、归、黑姜，不知 、术万无有
失。要知人生于气，气壮则根本固，而藏源者敛纳于下，营运者强健于中，何有为喘为胀之虞。考《全书》，
贞元饮亦治似喘妙药也。如无块痛，当用续气养荣汤最妙。或倍参补中益气汤，少佐熟附，助参以治
气脱，摄气归元亦可。如气虚兼寒者，宜大补元煎，或理阴煎主之。其神脱妄言妄见一症，因心
肝脾三阴血少，而神魂无根据也。然有谵语郑声之分，甚至发狂等症，统归于妄耳。其轻者，睡中呢喃；
重者，不睡亦语。或言日用寻常之事，或如见鬼状，昏不识人，语言不休，此谵语之谓也。若虚甚
而声转无力，言语不能接续，有头无尾，一两句即止，或重言叠语，说过又说，或如造字出于喉中，
若郑声之轻怯，此郑声之谓。其精气衰夺，更甚于谵语矣。若夫产后气血暴竭，而心神失守，故语
言无伦，肝魂无根据，则瞳 妄见。况心为五脏之主，目乃百脉之官，虚症见于心目，则十二官各
失其职可知矣。是以视听言动，皆成虚妄。当论产期块痛有无，先后施治，方为得法。若分娩儿下
之后，块痛未止者，宜服宁神生化汤。确知瘀血不行，合失笑散同服；如痛止者，则服宁心定魄
茯神汤，连进大补十数剂，生气养血，安神定志，服至元足，其病始愈矣。或以生地易熟地，而清心
火，宁君主之官亦可。
荆芷治崩汤 治产后血崩，其色鲜红。
川芎（一钱） 归身（四钱） 干姜（二分炙黑） 荆芥穗（六分炒黑） 炙草（四分） 白芷（五分）
枣，煎服。
加参生化止崩汤 治产后血块痛，鲜血崩，形色脱，或汗多，或气促。
人参（二三钱） 归身（四钱） 川芎（二钱） 干姜（炒黑） 炙草（各四分） 白芷
荆芥穗（炒黑各五分） 桃仁（十粒）
滋荣益气止崩汤 治产后无块痛，或半月外崩症。
人参 川芎 黄 （蜜炙，各一钱） 白术（土炒） 生地（各二钱） 当归（四钱酒洗） 陈皮
黄连 白芷 荆芥（炒） 升麻 炙草（各四分） 枣（二枚）
水煎，入童便温服。惊悸加柏子仁一钱，炒枣仁一钱，身热，倍加参、 ，去黄连。
升举大补汤 治产后日久，血崩不止，或崩如鸡蛋大，或去血片。宜大补脾胃，升举气血，
少加镇坠心火之剂，并治老壮妇人崩淋。
人参（二钱） 黄 （一钱蜜炙） 熟地（二钱） 白术（土炒） 当归（酒洗，各二三钱）
防风（三分） 荆芥（炒黑） 羌活 升麻 白芷 陈皮 黄连（炒） 黄柏（炒褐色） 炙草（各四分）
《千金》伏龙肝汤 治劳伤冲任，崩中去血，赤白相兼，或如豆汁，脐腹冷痛，口干食少。
伏龙肝（如弹子大，七枚） 生姜 生地（各一两五钱） 甘草 艾叶 赤石脂 桂心（各六钱）
分四服，日三夜一。
宁神生化汤 治产后块痛不止，妄言妄见，未可用 、术者。
人参（二钱） 当归（三钱酒洗） 干姜（炙黑） 炙草（各四分） 茯神 柏子仁 川芎（各一钱）
桃仁（十粒） 益智仁（八分） 陈皮（三分） 枣（二枚） 龙眼肉（五个）
水煎服。
产后突然大量出血称为血脱。呼吸短促类似喘息称为气脱，胡言乱语、幻觉妄见称为神脱。这三种病症虽然涉及气阳与血阴的区别，但在精气耗散、心神急促方面并无不同。与前文提到的晕厥症状相比，治疗可以稍微缓和，但也属于危重病症。如果不是使用大剂量药物和紧急方剂频繁服用，失治的患者很多。如果误认为是气实痰火而错误治疗，很少有不导致死亡的。如果病情紧急，都适宜使用加参生化汤，在补益中寓含行血之意，以免因血虚而导致其他损失。
关于血脱导致的崩漏这一症候，是由于冲任二脉已经受损，气血尚未恢复，或者因为劳累过度、惊恐刺激，或者因为恶露未尽，固涩止血太过迅速，导致血液停留，一旦再次流出，经血大量来潮。应当审察血气的虚实并辨别血色是红还是紫。如果血量多且呈紫色有血块，这是应当祛除的败血，患者小腹部必然胀满，按压时疼痛，强行止血反而会引起疼痛，或者导致淋漓不尽，这种情况不能称之为崩漏，只需服用几帖生化汤即可自愈。如果是鲜红色的血液大量来潮，这是因为惊吓伤心，心不能主血；愤怒伤肝，肝不能藏血；劳累伤脾，脾不能统血。血液不回归经脉，血脏受到损伤，应当按照崩漏症治疗。崩漏并非普通的月经病，产妇患上此症，属于双重虚弱，不可轻视。因此应当紧急治疗，使用荆芷治崩汤。如果有血块疼痛且面色苍白无华，或者有汗出，或者气促，适宜服用加参生化止崩汤以益气，使阳气生发而阴血自然旺盛，这不是十灰散所能止住的。如果血块疼痛停止，或者是产后半个月以后出现的崩漏症，又适宜使用滋荣益气止崩汤，或者升举大补汤，少量佐以黄连以降火，使血液安宁回归经脉，或者使用曾生的升举大补汤也很好。也有小腹空痛的情况，不可误认为是有瘀血，观察其下血量少且没有紫色血块的就是这种情况，应当按崩漏治疗，宜重用熟地黄。如果小腹胀痛不止，且脉象实大紧数，这是肝经已竭，肝气随之败坏，难以治疗。《医通》中有治疗产后崩漏去血，赤白相间，或者像豆汁一样的情况，使用《千金》伏龙肝汤治疗。
关于气脱导致的呼吸短促类似喘息这一症候，是因为生产时失血过多，营血突然枯竭，卫气不能正常运行，独自聚集于肺部，肝肾之气不相接续，所以导致呼吸短促，语言不能接续，看起来像喘息，实际上并不是喘息。肺接受脾气散布的精微物质，生成脉气并通调水道和呼吸，从而清肃上下，调和营卫成为健康人。如果遇到产后血亡气穷，浮脱于上，孤阳绝阴，这是无根将脱的征兆，最为危重。只有大剂量进服人参、附子，才可能得救。世上有人胡乱论述为痰火实证，反而使用散气化痰的方剂，治疗必死无疑。如果有血块疼痛，应当使用大补回阳生化汤，连续服用二三剂。世人多怀疑人参助喘而不使用，导致无法救治的人很多。况且配合川芎、当归、黑姜，再加上人参、白术，万无一失。要知道人生存依赖于气，气壮则根本稳固，藏纳之源在下收敛，营运之力在中强健，怎么会有喘息和胀满的忧虑呢？考证《全书》，贞元饮也是治疗类似喘息的妙药。如果没有血块疼痛，当使用续气养荣汤最好。或者加倍人参使用补中益气汤，少量佐以熟附子，助人参以治疗气脱，摄纳气归元也可以。如果气虚兼有寒邪，适宜使用大补元煎，或者理阴煎为主治。
关于神脱导致的胡言乱语、幻觉妄见这一症候，是因为心、肝、脾三脏阴血不足，导致神魂没有依托。然而有谵语和郑声的区别，甚至出现发狂等症状，都统归于妄语。轻度的，是在睡中喃喃自语；重度的，是不睡觉也说话。或者谈论日常寻常之事，或者像见到鬼怪一样，昏沉不认识人，语言不停，这叫做谵语。如果极度虚弱而声音转弱无力，言语不能接续，有头无尾，一两句就停止，或者重复言语，说过又说，或者像造字一样从喉咙中发出，如同郑声那样轻怯，这叫做郑声。精气衰败夺失，比谵语更严重。至于产后气血突然枯竭，心神失去守持，所以言语无序，肝魂没有依托，就会出现瞳孔异常和妄见。何况心是五脏之主，眼睛是百脉之官，虚证表现在心和目，那么十二官各失其职就可以知道了。因此视听言行，都成为虚妄。应当根据产期是否有血块疼痛，先后施治，这才是正确的方法。如果在分娩胎儿之后，血块疼痛仍未停止的，适宜服用宁神生化汤。确知瘀血不行，合用失笑散同服；如果疼痛停止的，则服用宁心定魄茯神汤，连续进服大补方剂十余剂，生气养血，安神定志，服药至元气充足，疾病才会痊愈。或者可以用生地黄代替熟地黄，以清心火，安宁君主之官也可以。
荆芷治崩汤：治疗产后血崩，血色鲜红。
川芎（一钱） 当归身（四钱） 干姜（二分，炙黑） 荆芥穗（六分，炒黑） 炙甘草（四分） 白芷（五分），大枣，煎服。
加参生化止崩汤：治疗产后血块疼痛，鲜血崩漏，面色苍白无华，或者汗多，或者气促。
人参（二三钱） 当归身（四钱） 川芎（二钱） 干姜（炒黑） 炙甘草（各四分） 白芷 荆芥穗（炒黑各五分） 桃仁（十粒）。
滋荣益气止崩汤：治疗产后无血块疼痛，或者半月以后的崩漏症。
人参 川芎 黄芪（蜜炙，各一钱） 白术（土炒） 生地黄（各二钱） 当归（四钱，酒洗） 陈皮 黄连 白芷 荆芥（炒） 升麻 炙甘草（各四分） 大枣（二枚）。水煎，加入童便温服。惊悸加柏子仁一钱，炒酸枣仁一钱，身体发热，加倍人参、黄芪，去掉黄连。
升举大补汤：治疗产后日久，血崩不止，或者崩漏如鸡蛋大，或者排出血片。适宜大补脾胃，升举气血，少量加入镇坠心火的药剂，并治疗老壮妇人崩漏淋证。
人参（二钱） 黄芪（一钱，蜜炙） 熟地黄（二钱） 白术（土炒） 当归（酒洗，各二三钱） 防风（三分） 荆芥（炒黑） 羌活 升麻 白芷 陈皮 黄连（炒） 黄柏（炒褐色） 炙甘草（各四分）。
《千金》伏龙肝汤：治疗劳伤冲任，崩漏去血，赤白相间，或者像豆汁，脐腹冷痛，口干食少。
伏龙肝（如弹子大小，七枚） 生姜 生地黄（各一两五钱） 甘草 艾叶 赤石脂 桂心（各六钱）。分四服，日三夜一。
宁神生化汤：治疗产后血块疼痛不止，胡言乱语、幻觉妄见，尚未可用人参、白术者。
人参（二钱） 当归（三钱，酒洗） 干姜（炙黑） 炙甘草（各四分） 茯神 柏子仁 川芎（各一钱） 桃仁（十粒） 益智仁（八分） 陈皮（三分） 大枣（二枚） 龙眼肉（五个）。水煎服。
Postpartum sudden massive bleeding is called Blood Collapse (Xue Tuo). Shortness of breath resembling asthma is called Qi Collapse (Qi Tuo), and delirious speech with hallucinations is called Spirit Collapse (Shen Tuo). Although these three conditions differ in terms of Qi-Yang and Blood-Yin, they are no different in terms of scattered essence and hurried spirit. Compared to the preceding fainting syndrome, treatment can be slightly delayed, but it is still a critical condition. If large-dose medicines and urgent prescriptions are not taken frequently, many patients will suffer from mismanagement. If mistakenly treated as excess Qi and phlegm-fire, few will survive without fatal consequences. If the situation is urgent, Jia Shen Sheng Hua Tang (Ginseng-Added Decoction for Generating Blood) should be used for all cases; it contains blood-invigorating properties within tonification, preventing complications arising from blood deficiency.
Regarding the metrorrhagia caused by Blood Collapse, it occurs because the Chong and Ren vessels have been damaged, and Qi and Blood have not yet recovered. This may be due to overexertion or fright, or because lochia has not fully cleared and astringent hemostatics were used too quickly, causing blood stagnation. Once this stagnant blood flows again, menstrual blood comes in large amounts. One must examine the Qi and Blood status and distinguish whether the blood color is red or purple. If there is a large amount of dark purple blood with clots, this is retained bad blood that should be expelled. The lower abdomen will necessarily be distended and painful upon pressure; forcing hemostasis will instead cause pain or lead to dripping discharge. This condition should not be termed metrorrhagia; taking a few doses of Sheng Hua Tang (Decoction for Generating Blood) will lead to self-healing. If bright red blood flows in large amounts, it indicates that fear has injured the Heart, which fails to govern blood; anger has injured the Liver, which fails to store blood; and fatigue has injured the Spleen, which fails to control blood. When blood does not return to its vessels and the Blood Zang organs are damaged, it should be treated as metrorrhagia. Metrorrhagia is not a regular menstrual disorder; when postpartum women suffer from it, it represents severe double deficiency and cannot be ignored. Therefore, urgent treatment is required using Jing Zhi Zhi Beng Tang (Atractylodes and Angelica Decoction for Stopping Metrorrhagia). If there are blood clots with pain, pallor, sweating, or shortness of breath, Jia Shen Sheng Hua Zhi Beng Tang (Ginseng-Added Sheng Hua Decoction for Stopping Metrorrhagia) should be taken to tonify Qi, allowing Yang to generate and Yin-Blood to flourish naturally; this cannot be stopped by Shi Hui San (Ten Ash Powder). If the pain from clots subsides, or if metrorrhagia occurs more than half a month after delivery, Zi Rong Yi Qi Zhi Beng Tang (Nourishing and Tonifying Decoction for Stopping Metrorrhagia) or Sheng Ju Da Bu Tang (Great Tonifying and Elevating Decoction) should be used, with a small addition of Huang Lian (Coptis Rhizome) to descend fire and calm blood to return to its vessels. Alternatively, Zeng Sheng's Sheng Ju Da Bu Tang is also excellent. There are cases of empty pain in the lower abdomen that should not be mistaken for blood stasis; observing that the bleeding is scanty and lacks purple clots confirms this. It should be treated as metrorrhagia, with heavy use of Shu Di Huang (Prepared Rehmannia Root). If lower abdominal fullness and pain persist, and the pulse is solid, large, tight, and rapid, this indicates exhaustion of the Liver Channel and failure of Liver Qi, making it difficult to treat. *Yi Tong* records treating postpartum metrorrhagia with mixed red and white discharge or bean-juice-like fluid using Qian Jin Fu Long Gan Tang (Thousand Gold Dragon Soil Decoction).
Regarding the shortness of breath resembling asthma caused by Qi Collapse: excessive blood loss during childbirth causes sudden depletion of Ying-Blood, preventing Wei-Qi from circulating normally. Qi gathers alone in the Lungs, and the Kidney and Liver energies fail to connect, resulting in short breathing and disjointed speech, resembling asthma but not being true asthma. The Lung receives refined essences dispersed by the Spleen, generates Mai-Qi, regulates water passages, and controls respiration, thereby clearing the upper and lower jiao and harmonizing Ying and Wei to maintain health. However, in postpartum blood loss and Qi exhaustion, floating collapse upwards leads to isolated Yang and severed Yin, signaling rootless impending collapse, which is the most critical prognosis. Only large doses of Ren Shen (Ginseng Root) and Fu Zi (Aconite Root) can save the patient. Some wrongly diagnose this as phlegm-fire excess and use Qi-scattering and phlegm-resolving formulas, which will certainly cause death. If there are clots and pain, Da Bu Hui Yang Sheng Hua Tang (Great Tonifying and Returning Yang Sheng Hua Decoction) should be used for two or three doses. People often doubt that Ren Shen promotes asthma and avoid it, leading to many untreatable cases. Combined with Xiong Gui (Ligusticum and Angelica roots) and Hei Jiang (Charred Ginger), along with Ren Shen and Bai Zhu (Atractylodes Macrocephala Rhizome), there is no risk. One must know that life depends on Qi; strong Qi secures the foundation, allowing storage sources to gather below and operational forces to strengthen in the middle, eliminating worries of asthma or distension. According to *Quan Shu*, Zhen Yuan Yin (True Origin Drink) is also an excellent remedy for asthma-like symptoms. If there are no clots or pain, Xu Qi Yang Rong Tang (Continuing Qi and Nourishing Blood Decoction) is best. Alternatively, doubling the dose of Ren Shen in Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) with a small addition of Shu Fu Zi (Prepared Aconite) helps Ren Shen treat Qi Collapse by grasping Qi and returning it to its origin. For Qi deficiency combined with cold, Da Bu Yuan Jian (Great Tonifying Source Decoction) or Li Yin Jian (Regulating Yin Decoction) should be used.
Regarding delirious speech and hallucinations caused by Spirit Collapse: this is due to insufficient Yin-Blood in the Heart, Liver, and Spleen, leaving the Hun and Shen without support. There is a distinction between Chan Yu (Delirium) and Zheng Sheng (Mumbling), extending even to mania, all categorized under delirious speech. Mild cases involve muttering in sleep; severe cases involve speaking while awake. Patients may discuss daily matters or appear to see ghosts, becoming confused and unrecognizable, with incessant speech; this is Chan Yu. If extremely deficient with weak voice, speech is disjointed, lacking beginning or end, stopping after one or two sentences, or repeating words, or sounding like characters formed in the throat with a timid quality, this is Zheng Sheng. Essence and Qi depletion here is worse than in Chan Yu. Postpartum sudden exhaustion of Qi and Blood causes the Heart-Mind to lose its hold, leading to incoherent speech; the Liver-Hun lacks support, causing pupillary abnormalities and hallucinations. Since the Heart is the master of the five Zang organs and the eyes are the officials of the hundred vessels, deficiency manifesting in the Heart and eyes implies dysfunction of all twelve officials. Thus, vision, hearing, speech, and movement become false. Treatment must consider the presence or absence of clots and pain relative to the delivery period. If clots and pain persist after fetal delivery, Ning Shen Sheng Hua Tang (Calming Spirit Sheng Hua Decoction) should be taken. If blood stasis is confirmed to be unexpelled, combine with Shi Xiao San (Pain-Stopping Powder); if pain has stopped, take Ning Xin Ding Po Fu Shen Tang (Calming Heart and Stabilizing Soul Poria Decoction), administering several doses of great tonics to generate Qi and nourish Blood, calming the Spirit and stabilizing Will, until Yuan-Qi is sufficient for recovery. Alternatively, replace Shu Di Huang with Sheng Di Huang (Raw Rehmannia Root) to clear Heart-Fire and calm the Monarch organ.
Jing Zhi Zhi Beng Tang: Treats postpartum metrorrhagia with bright red blood.
Chuan Xiong (1 qian) Dang Gui Shen (4 qian) Gan Jiang (2 fen, charred black) Jing Jie Sui (6 fen, stir-fried black) Zhi Cao (4 fen) Bai Zhi (5 fen), decoct with dates.
Jia Shen Sheng Hua Zhi Beng Tang: Treats postpartum clot pain, bright red metrorrhagia, pallor, profuse sweating, or shortness of breath.
Ren Shen (2-3 qian) Dang Gui Shen (4 qian) Chuan Xiong (2 qian) Gan Jiang (stir-fried black) Zhi Cao (4 fen each) Bai Zhi Jing Jie Sui (5 fen each, stir-fried black) Tao Ren (10 grains).
Zi Rong Yi Qi Zhi Beng Tang: Treats postpartum metrorrhagia without clot pain, or occurring more than half a month after delivery.
Ren Shen Chuan Xiong Huang Qi (honey-fried, 1 qian each) Bai Zhu (earth-fried) Sheng Di Huang (2 qian each) Dang Gui (4 qian, wine-washed) Chen Pi Huang Lian Bai Zhi Jing Jie (stir-fried) Sheng Ma Zhi Cao (4 fen each) Dates (2 pieces). Decoct, take warm with child urine. Add Bai Zi Ren (1 qian) and Chao Zao Ren (1 qian) for palpitations; double Ren Shen and Huang Qi, remove Huang Lian for fever.
Sheng Ju Da Bu Tang: Treats prolonged postpartum metrorrhagia, large clots like eggs, or blood fragments. Suitable for greatly tonifying Spleen and Stomach, elevating Qi and Blood, with minor sedatives for Heart-Fire; also treats metrorrhagia and leukorrhea in older or robust women.
Ren Shen (2 qian) Huang Qi (1 qian, honey-fried) Shu Di Huang (2 qian) Bai Zhu (earth-fried) Dang Gui (wine-washed, 2-3 qian each) Fang Feng (3 fen) Jing Jie (charred black) Qiang Huo Sheng Ma Bai Zhi Chen Pi Huang Lian (stir-fried) Huang Bo (stir-fried brown) Zhi Cao (4 fen each).
Qian Jin Fu Long Gan Tang: Treats Chong-Ren injury from labor, metrorrhagia with mixed red/white discharge or bean-juice consistency, umbilical/abdominal cold pain, dry mouth, and poor appetite.
Fu Long Gan (size of a bullet, 7 pieces) Sheng Di Huang (1 liang 5 qian each) Gan Cao Ai Ye Chi Shi Zhi Gui Xin (6 qian each). Divide into four doses, taken three times day and once night.
Ning Shen Sheng Hua Tang: Treats persistent postpartum clot pain, delirium, and hallucinations, where Ren Shen and Bai Zhu are not yet suitable.
Ren Shen (2 qian) Dang Gui (3 qian, wine-washed) Gan Jiang (charred black) Zhi Cao (4 fen each) Fu Shen Bai Zi Ren Chuan Xiong (1 qian each) Tao Ren (10 grains) Yi Zhi Ren (8 fen) Chen Pi (3 fen) Dates (2 pieces) Long Yan Rou (5 pieces). Decoct and take.