丹溪云∶必须大补气血，然后治痰。当从左右手
脉分气血多少治之。切不可作中风治，用小续命汤治风之药。
薛立斋云∶产后腰背反张，肢体抽搐，因亡血过多，筋无所养使然。大补气血，多保无虞；若发表祛
风，百不全一。
武叔卿云∶寒主收引。背项强直，寒在太阳经也。诸家皆主续命汤，此古法也。郭氏不问产后虚实、邪
之有无，概用续命，似觉一偏。至薛氏专主亡血过多，非十全大补不可，是或一见。乃夷坚志谓以大豆紫汤、
独活汤而愈，亦主于风矣。是续命固不为妄也，但本方有麻黄、附子，气血两虚人，不可轻用。而郭氏论，
又嘱人速灌，取汗而解，偏不以麻黄为忌，何也？二说俱不可废，临诊时详之。
沈尧封曰∶仲景论腰背反张为痉。无汗者为刚痉，主以葛根汤；有汗者名柔痉，主以桂枝加葛根汤。桂
枝汤乃治中风主方，故有汗之痉属风；葛根汤中用麻黄，麻黄乃散寒主药，故无汗之痉属寒。仲景治少阴
伤寒，未见吐衄之里证者，用麻黄附子细辛汤、麻黄附子甘草汤微发汗。盖寒邪乘少阴之虚而欲入，急以
附子保坎中之阳，而以麻黄散外感之寒，真神方也。小
续命汤虽非仲景之制，方中用此二味，正见攻守相须之妙。而叔卿反云∶麻、附二味，气血两虚者，不可
轻用。假使除却麻黄，何以散客寒？除却附子，何以保真阳？特不可用于有汗之柔痉耳！有汗柔痉更有两
种∶一则因虚而受外来之风；一则血虚则筋急，并无外感之风。有风者，虽汗出，必然恶风，主以华元化
愈风散；只血虚而无风者，必不恶风，纯宜补血。
尧封又曰∶人身气血之外，更有真阳真阴，藏在坎中，亦立命之根基。胎系于肾，肾司二阴。产育之
时，下焦洞辟，坎中阴阳有不大损者乎？况背后夹脊四行，俱太阳经脉；太阳之里，即是少阴；脊里一
条是督脉，亦隶少阴，此脉急缩，与少阴大有关会。此用麻兼用附之深意也。使置此不讲，徒执气虚、血
虚以治产后百病，业医亦觉太易矣！
小续命汤 治产后中风，身体缓急，或顽痹不仁，或口眼 斜，牙关紧急，角弓反张。
防风（一钱） 麻黄（去节） 黄芩 白芍 人参 川芎 防己 肉桂（各七分） 附子（炮）
杏仁（各五分） 甘草（四分，炙）
加生姜，水煎服。
华佗愈风散 治产后中风，口噤，牙关紧闭，手足螈 ，如角弓状。亦治产后血晕，不省人事，
四肢强直；
或心眼倒筑，吐泻欲死。此药清神气血脉，其效如神。
荆芥略炒为末，每服三钱，黑豆淬酒调服，童便亦可。口噤揠开灌之，或吹鼻中。
李濒湖曰∶此方诸书盛称其妙。姚僧垣《集验方》以酒服，名如圣散，药下可立效。陈氏方名举卿
古拜散。萧存敬方用古老钱煎汤服，名一捻金。许叔微《本事方》云∶此药委有奇效。一产妇睡久，及醒
则昏昏如醉，不省人事，医用此药及交加散。云服后当睡，必以左手搔头。用之果然。昝殷《产宝方》云∶
此病多因怒气伤肝，或忧气内郁，或坐草受风而成，宜服此药。戴氏《证治要诀》名独行散。贾似道《悦生
堂随抄》呼为再生丹。《指迷方》加当归等分。
沈尧封曰∶丁丑三月，练塘金虞旬第四媳，产后变证，伊芳郎来请。先述病状云∶上年十月，生产甚健，
至十二月初旬，面上浮肿。驱风不应，加麻黄三帖，通身胀肿，小便不利；更用五皮杂治，反加脐凸；更用
肉桂五苓，小便略通，胀亦稍减；续用桂附八味，其肿渐消，惟右手足不减。忽一日口眼歪斜，右手足不
举，舌不能言，因作血虚治，变为俯不得仰。数日后吐黑血盈盂，吐后俯仰自如。旬余复不能仰，又吐黑
血而定，投以消瘀，忽然口闭自开如脱状。伊芳母一夜
煎人参三钱，灌之得醒，醒来索饭吃一小杯。近日又厥，灌人参不醒，已三昼夜矣。余遂往诊，右手无脉，
因肿极，不以为怪；左脉浮取亦无，重按则如循刀刃。余曰∶此是实证，停参可医。遂用胆星、半夏、石菖
蒲、橘皮、天虫、地龙、紫草，水煎，入竹沥、姜汁。一剂知，四剂手足能举。不换方，十二剂能出外房诊
脉，诸病悉退，惟舌音未清，仍用前方而愈。金问奇病之源，余曰∶人身脏腑接壤，受胎后腹中遂增一物，
脏腑之机栝为之不灵，五液聚为痰饮，故胎前病痰滞居半，《千金》半夏茯苓汤，所以神也。至临产时，痰涎
与恶血齐出，方得无病；若止血而痰饮不下，诸病丛生。故产后理血不应，六神汤为要药。此证初起，不
过痰饮阻滞气道作肿，血本无病，用五苓、肾气肿减者，痰滞气道，得热暂开故也。久投不已，血分过热，
致吐血两次。至若半身不遂，口眼歪斜，舌络不灵，俱是痰滞经络见证，即厥亦是痰迷所致，并非虚脱。故
消痰通络，病自渐愈，何奇之有？
王孟英按∶此等卓识，皆从阅历而来。朱生甫令郎仲和之室，娩后患此，医治不能除根；再产亦然，延
已数年；继复怀妊，病发益频。余用大剂涤痰药，服月余，产后安然，病根竟刈。
沈尧封曰∶震泽一妇，产后十余日，延我师金大文诊视，余从。据述新产时，证似虚脱，服温补药数
剂，近日变一怪证∶左边冷，右边热，一身四肢尽然，前后中分，冷则如冰，热则如炭，鼻亦如之，舌色左
白，右黑。师问曰∶此是何病？用何方治？余曰∶书未曾载，目未曾睹，不知应用何方。师曰∶奇证当于
无方之书求之。经不云乎？左右者，阴阳之道路也；阴阳者，水火之征兆也。败血阻住阴阳升降道路，不能
旋转，阳盛处自热，阴盛处自寒，所以偏热偏寒。用泽兰、楂肉、刘寄奴、苏木、桃仁、琥珀等药两剂，病
热减半，继服不应。遂更医杂治，以致不起。由今思之，此证不但血阻，必兼痰滞。我师见及阻住阴阳升
降道路，病源已经识出，特跳不出产后消瘀圈子耳！倘通瘀不应，即兼化痰，或者如前案金妇得起，未可知
也。此时彭尚初学，我师见识过人，特未悟彻血滞一证，惜哉！
薛立斋案∶郭茂恂嫂金华君，产七日不食，始言头痛，头痛已又心痛作，既而目睛痛如割刺，更作更
止，相去无瞬息间。每头痛，欲取大石压，良久渐定；心痛作，则以十指抓胸，血流满掌；痛定目复痛，复
以两手自剜目。如是十日不已，众医无计。进黑龙丹半粒，疾少间。中夜再服，乃瞑日寝如平时。至清晨
下一行，约三升许，如蝗虫子，病减半。已刻又行如
前，痛尽除。
黑龙丹 治产难及胞衣不下，血迷血晕，不省人事，一切危急恶候垂死者，但灌药得下，无不全活。
当归 五灵脂 川芎 良姜 熟地（各二两锉碎，入炒锅内，纸筋盐泥固，济火 过） 百草霜（一两）
硫黄 乳香（各二钱） 琥珀 花蕊石（各一钱）
为细末，醋糊丸，如弹子大。每用一二丸，炭火 红，投入生姜自然汁中，浸碎，以童便合酒调灌下。
朱丹溪说：必须大补气血，然后才能治疗痰证。应当根据左右手脉象中气血的多少来辨证施治。切不可将其当作中风来治疗，而使用小续命汤等祛风药物。
薛立斋说：产后出现腰背反张、肢体抽搐，是因为失血过多，筋脉失去濡养所致。大补气血，大多能保全无虞；若用发表祛风的治法，百人中难保一人。
武叔卿说：寒邪主收引。背部和项部强直，是寒邪在太阳经的表现。各家都主张使用续命汤，这是古法。但郭氏不问产后体质的虚实、是否有外邪，一概使用续命汤，似乎有些偏颇。至于薛氏专门主张因亡血过多，非用十全大补汤不可，这或许只是一见之论。《夷坚志》记载用大豆紫汤、独活汤治愈，也是侧重于治风。由此可见，续命汤并非妄用，但该方中含有麻黄、附子，对于气血两虚的人，不可轻易使用。而郭氏的论述中，又嘱咐人快速灌药，取汗而解，偏偏不把麻黄列为禁忌，这是为什么呢？这两种说法都有可取之处，临诊时需详细斟酌。
沈尧封说：张仲景论述腰背反张为痉病。无汗的称为刚痉，主治用葛根汤；有汗的称为柔痉，主治用桂枝加葛根汤。桂枝汤是治疗中风的主方，所以有汗的痉病属于风邪；葛根汤中使用麻黄，麻黄是发散寒邪的主药，所以无汗的痉病属于寒邪。张仲景治疗少阴伤寒，未见吐衄等里证者，使用麻黄附子细辛汤、麻黄附子甘草汤微发汗。这是因为寒邪乘少阴之虚欲入里，急用附子保护坎中的阳气，并用麻黄散发外感的寒邪，真是神妙的方剂。小续命汤虽然不是张仲景所制，但方中使用了这两味药，正体现了攻守相辅相成的妙处。而武叔卿反而说：麻黄、附子这两味药，气血两虚的人不可轻用。假如除去麻黄，用什么来散客寒？除去附子，用什么来保真阳？只是不可用于有汗的柔痉罢了！有汗的柔痉还有两种情况：一种是因为体虚感受外来风邪；一种是血虚导致筋脉拘急，并没有外感的风邪。有风邪的，虽然出汗，必然恶风，主治用华元化的愈风散；只有血虚而无风邪的，必然不恶风，纯粹宜于补血。
沈尧封又说：人身除了气血之外，还有真阳真阴，藏在坎中，这也是立命的根基。胎系于肾，肾主管二阴。分娩之时，下焦洞开，坎中的阴阳有不受到严重损伤的吗？况且背后夹脊的四行经脉，都是太阳经脉；太阳的里层，即是少阴；脊柱里面的一条是督脉，也隶属于少阴，这条经脉紧急收缩，与少阴大有关系。这就是使用麻黄兼用附子的深意啊。如果置此不讲，只执着于气虚、血虚来治疗产后百病，做医生也太容易了！
小续命汤：治疗产后中风，身体或缓或急，或顽痹麻木不仁，或口眼歪斜，牙关紧急，角弓反张。
防风（一钱） 麻黄（去节） 黄芩 白芍 人参 川芎 防己 肉桂（各七分） 附子（炮制） 杏仁（各五分） 甘草（四分，炙）
加生姜，水煎服。
华佗愈风散：治疗产后中风，口噤，牙关紧闭，手足抽搐，如角弓反张状。也治疗产后血晕，不省人事，四肢强直；或者心眼倒筑，呕吐腹泻欲死。此药能清神气血脉，其效如神。
荆芥略炒为末，每次服用三钱，用黑豆淬过的酒调服，童便也可以。口噤者撬开灌服，或吹入鼻中。
李濒湖说：此方在各书中盛称其奇妙。姚僧垣《集验方》用酒送服，名为如圣散，药下可立即见效。陈氏方名举卿古拜散。萧存敬方用古老钱煎汤服，名为一捻金。许叔微《本事方》说：此药确实有奇效。一位产妇睡久，醒来后昏昏如醉，不省人事，医生用此药及交加散。说服药后应当睡觉，必定要用左手搔头。用了果然如此。昝殷《产宝方》说：此病多因怒气伤肝，或忧气内郁，或坐草受风而成，宜服此药。戴氏《证治要诀》名为独行散。贾似道《悦生堂随抄》呼为再生丹。《指迷方》加当归等分。
沈尧封说：丁丑年三月，练塘金虞旬的第四位儿媳，产后出现变证，她的丈夫来请我诊治。先叙述病情说：去年十月，生产很顺利，到十二月初旬，脸上浮肿。驱风治疗无效，加用麻黄三帖，全身肿胀，小便不利；更用五皮饮杂治，反而加重脐凸；更用肉桂合五苓散，小便略通，胀稍减；续用桂附八味丸，其肿渐消，惟右手足不消肿。忽一日口眼歪斜，右手足不能举起，舌不能言，因此按血虚治疗，变为俯身不得仰起。数日后吐出黑血盈盂，吐后俯仰自如。旬余后又不能仰，又吐黑血而定，投以消瘀药，忽然口闭自开如解脱状。她母亲一夜煎人参三钱，灌之得醒，醒来索饭吃一小杯。近日又厥逆，灌人参不醒，已三昼夜了。我便前往诊视，右手无脉，因肿胀极甚，不以为怪；左脉浮取也无，重按则如循刀刃。我说：这是实证，停用人参可以医治。遂用胆星、半夏、石菖蒲、橘皮、天虫、地龙、紫草，水煎，入竹沥、姜汁。一剂知效，四剂手足能举。不换方，十二剂能出外房诊脉，诸病悉退，惟舌音未清，仍用前方而愈。金问奇病之源，我说：人身脏腑接壤，受胎后腹中遂增一物，脏腑之机栝为之不灵，五液聚为痰饮，故胎前病痰滞居半，《千金》半夏茯苓汤，所以神也。至临产时，痰涎与恶血齐出，方得无病；若止血而痰饮不下，诸病丛生。故产后理血不应，六神汤为要药。此证初起，不过是痰饮阻滞气道作肿，血本无病，用五苓、肾气肿减者，痰滞气道，得热暂开故也。久投不已，血分过热，致吐血两次。至若半身不遂，口眼歪斜，舌络不灵，俱是痰滞经络见证，即厥亦是痰迷所致，并非虚脱。故消痰通络，病自渐愈，何奇之有？
王孟英按语：这种卓越的见识，都是从阅历中得来的。朱生甫令郎仲和的妻子，娩后患此病，医治不能除根；再产亦然，延已数年；继复怀妊，病发益频。我用大剂涤痰药，服月余，产后安然，病根竟刈。
沈尧封说：震泽一位妇女，产后十余日，延请我的老师金大文诊视，我跟随。据述新产时，证似虚脱，服温补药数剂，近日变一怪证：左边冷，右边热，一身四肢尽然，前后中分，冷则如冰，热则如炭，鼻亦如之，舌色左白，右黑。老师问曰：这是什么病？用何方治？我说：书未曾载，目未曾睹，不知应用何方。老师说：奇证当于无方之书求之。经不云乎？左右者，阴阳之道路也；阴阳者，水火之征兆也。败血阻住阴阳升降道路，不能旋转，阳盛处自热，阴盛处自寒，所以偏热偏寒。用泽兰、楂肉、刘寄奴、苏木、桃仁、琥珀等药两剂，病热减半，继服不应。遂更医杂治，以致不起。由今思之，此证不但血阻，必兼痰滞。我师见及阻住阴阳升降道路，病源已经识出，特跳不出产后消瘀圈子耳！倘通瘀不应，即兼化痰，或者如前案金妇得起，未可知也。此时彭尚初学，我师见识过人，特未悟彻血滞一证，惜哉！
薛立斋医案：郭茂恂嫂金华君，产七日不食，始言头痛，头痛已又心痛作，既而目睛痛如割刺，更作更止，相去无瞬息间。每头痛，欲取大石压，良久渐定；心痛作，则以十指抓胸，血流满掌；痛定目复痛，复以两手自剜目。如是十日不已，众医无计。进黑龙丹半粒，疾少间。中夜再服，乃瞑日寝如平时。至清晨下一行，约三升许，如蝗虫子，病减半。已刻又行如前，痛尽除。
黑龙丹：治疗产难及胞衣不下，血迷血晕，不省人事，一切危急恶候垂死者，但灌药得下，无不全活。
当归 五灵脂 川芎 良姜 熟地（各二两锉碎，入炒锅内，纸筋盐泥固，济火煅过） 百草霜（一两） 硫黄 乳香（各二钱） 琥珀 花蕊石（各一钱）
为细末，醋糊丸，如弹子大。每用一二丸，炭火煅红，投入生姜自然汁中，浸碎，以童便合酒调灌下。
Zhu Danxi stated: It is essential to greatly tonify Qi and Blood before treating Phlegm. Treatment should be differentiated based on the relative abundance or deficiency of Qi and Blood as indicated by the pulses at the left and right wrists. One must absolutely not treat it as Wind-Stroke (Zhong Feng, a condition caused by external wind pathogen invading the meridians) and use Wind-dispelling medicines such as Xiao Xuming Tang (Minor Continuation Life Decoction).
Xue Lizhai stated: Postpartum opisthotonos (back arching) and limb convulsions are caused by excessive blood loss, leading to a lack of nourishment for the sinews. Greatly tonifying Qi and Blood will mostly ensure safety; however, if one uses methods to release the exterior and dispel Wind, fewer than one in a hundred will survive.
Wu Shuqing stated: Cold pathogen causes contraction and pulling. Stiffness and rigidity of the back and neck indicate Cold in the Taiyang Meridian (Taiyang Channel). Various schools advocate the use of Xuming Tang, which is an ancient method. However, Ms. Guo indiscriminately applies Xuming Tang without considering the postpartum constitution's deficiency or excess, or the presence or absence of pathogens, which seems biased. As for Mr. Xue, who specifically advocates that excessive blood loss requires Shiquan Dabu Tang (Ten Complete Tonifying Decoction), this might be a limited observation. *Yijian Zhi* records cures using Dadou Zi Tang (Soybean Purple Decoction) and Duhuo Tang (Angelica Pubescens Decoction), which also focus on treating Wind. Thus, Xuming Tang is not necessarily misused, but since the formula contains Mahuang (Ephedrae Herba) and Fuzi (Aconiti Lateralis Radix Praeparata), it should not be used lightly in patients with dual deficiency of Qi and Blood. Yet, in her discussion, Ms. Guo advises rapid administration to induce sweating for resolution, seemingly ignoring the contraindication of Mahuang. Why is this? Both perspectives have merit and require careful consideration during clinical practice.
Shen Yaofeng stated: Zhang Zhongjing discussed opisthotonos as Jing disease (Spasm). Those without sweating are called Gang Jing (Yang Spasm), treated primarily with Gegen Tang (Kudzu Root Decoction); those with sweating are called Rou Jing (Yin Spasm), treated primarily with Guizhi Jia Gegen Tang (Cinnamon Twig plus Kudzu Root Decoction). Guizhi Tang (Cinnamon Twig Decoction) is the main formula for treating Wind-Strike (Zhong Feng, a condition characterized by susceptibility to wind due to Wei Qi deficiency), so spasms with sweating belong to Wind; Gegen Tang uses Mahuang, which is the primary herb for dispersing Cold, so spasms without sweating belong to Cold. When treating Shaoyin Shanghan (Cold Damage to the Shaoyin channel) without interior signs such as hematemesis or epistaxis, Zhang Zhongjing used Mahuang Fuzi Xixin Tang (Ephedra, Prepared Aconite, and Asarum Decoction) or Mahuang Fuzi Gancao Tang (Ephedra, Prepared Aconite, and Licorice Decoction) to induce slight sweating. This is because the Cold pathogen takes advantage of Shaoyin deficiency to enter; urgently using Fuzi protects the Yang in Kan (the Kidney/Water element), while Mahuang disperses the external Cold. This is truly a divine prescription. Although Xiao Xuming Tang was not formulated by Zhang Zhongjing, its use of these two herbs perfectly illustrates the synergy between attacking and defending. Wu Shuqing, conversely, claimed that Mahuang and Fuzi should not be used lightly in cases of dual Qi and Blood deficiency. If Mahuang were removed, how would one disperse the invading Cold? If Fuzi were removed, how would one preserve True Yang? They are simply contraindicated in Rou Jing with sweating! There are two types of Rou Jing with sweating: one is due to deficiency allowing external Wind invasion; the other is sinew tension due to Blood deficiency without external Wind. In cases with Wind, despite sweating, there is aversion to wind, treated primarily with Hua Yuanhua’s Yufeng San (Wind-Peace Powder). In cases of pure Blood deficiency without Wind, there is no aversion to wind, and treatment should purely focus on nourishing Blood.
Shen Yaofeng further stated: Beyond Qi and Blood, the human body possesses True Yang and True Yin hidden in Kan, which form the foundation of life. The fetus is connected to the Kidneys, which govern the lower orifices. During childbirth, the lower Jiao opens widely; can the Yin and Yang in Kan remain undamaged? Moreover, the four rows of meridians along the spine are all Taiyang channels; the interior of Taiyang is Shaoyin; the single meridian within the spine is the Du Mai (Governing Vessel), which also belongs to Shaoyin. The urgency and contraction of this meridian are closely related to Shaoyin. This reveals the profound intention behind using Mahuang together with Fuzi. If this principle is ignored and one merely clings to treating Qi and Blood deficiency for all postpartum diseases, medical practice becomes too simplistic!
Xiao Xuming Tang: Treats postpartum Wind-Strike, with body stiffness or flaccidity, numbness and anesthesia, deviation of the mouth and eyes, trismus (lockjaw), and opisthotonos.
Fangfeng (1 qian), Mahuang (devoid of joints), Huangqin, Baishao, Renshen, Chuanxiong, Fangji, Rougui (each 0.7 qian), Fuzi (prepared), Xingren (each 0.5 qian), Gancao (0.4 qian, honey-fried).
Add fresh ginger, decoct in water, and take orally.
Hua Tuo’s Yufeng San: Treats postpartum Wind-Strike, trismus, lockjaw, convulsions of hands and feet resembling opisthotonos. Also treats postpartum Blood Syncope with loss of consciousness, limb rigidity; or sensation of organs reversing, severe vomiting and diarrhea threatening death. This medicine clears the Spirit, Qi, Blood, and vessels, with miraculous efficacy.
Jingjie (Schizonepetae Spica), slightly fried and powdered. Take 3 qian per dose, mixed with wine infused with black soybeans; child’s urine may also be used. For trismus, pry open the mouth and administer, or insufflate into the nose.
Li Shizhen stated: This formula is highly praised in various texts. Yao Sengyuan’s *Jiyan Fang* administers it with wine, naming it Rusheng San (Like-Sage Powder), taking effect immediately upon ingestion. Chen’s formula is named Juqing Gubai San. Xiao Cunjing’s formula uses ancient copper coins decocted in water, named Yinnian Jin. Xu Shumi’s *Benshi Fang* states: This medicine indeed has miraculous effects. A puerperal woman slept for a long time; upon waking, she was dizzy as if drunk and unconscious. The physician used this medicine and Jiaojiao San. He predicted she would sleep after taking it and must scratch her head with her left hand. It happened exactly as predicted. Zan Yin’s *Chanbao Fang* states: This illness is often caused by anger injuring the Liver, sorrow causing internal stagnation, or catching wind during labor; this medicine is suitable. Dai Shi’s *Zhengzhi Yaojue* names it Duxing San. Jia Sidao’s *Yueshengtang Suichao* calls it Zaisheng Dan. *Zhimi Fang* adds Danggui in equal parts.
Shen Yaofeng stated: In March of the Dingchou year, the fourth daughter-in-law of Jin Yuxun from Liantang suffered postpartum complications, and her husband invited me to consult. He first described the symptoms: In October last year, delivery was healthy. By early December, facial edema appeared. Wind-dispelling treatments failed; adding three doses of Mahuang resulted in generalized swelling and oliguria; treating with Wupi Yin (Five-Bark Decoction) worsened umbilical protrusion; using Rougui combined with Wuling San slightly improved urination and reduced swelling; continuing with Guifu Dihuang Wan gradually reduced edema, except in the right hand and foot. Suddenly, one day, deviation of the mouth and eyes occurred, the right hand and foot could not move, and speech was impaired. Treating as Blood deficiency led to inability to extend the back. Days later, a basinful of black blood was vomited; afterward, flexion and extension returned to normal. After ten days, inability to extend recurred, followed by vomiting black blood again; administering blood-resolving herbs caused the closed mouth to suddenly open as if relieved. Her mother decocted 3 qian of Renshen overnight and administered it, restoring consciousness; she then asked for food and drank a small cup. Recently, she experienced syncope; Renshen infusion did not revive her, and this had persisted for three days and nights. I went to examine her. The right pulse was absent, likely due to extreme edema, so I did not find it strange; the left pulse was imperceptible on superficial palpation but felt like touching a blade on deep pressure. I said: This is an Excess pattern; stopping Renshen allows for curable treatment. I prescribed Danshen (Arisaematis Cum Bile), Banxia (Pinelliae Rhizoma Preparatum), Shichangpu (Acori Tatarinowii Rhizoma), Chuanpi (Citri Reticulatae Pericarpium), Tianchong (Mylabris), Dilong (Pheretima), and Zicao (Arnebiae Radix seu Lithospermi Radix), decocted in water, with Zhuli (Bamboo Sap) and Jiangzhi (Fresh Ginger Juice) added. Improvement was seen after one dose; limbs could move after four doses. Without changing the formula, after twelve doses, she could leave the inner room for pulse diagnosis, with all ailments subsiding, except unclear speech, which resolved with the same formula. When Jin asked about the origin of this strange disease, I said: Human viscera are adjacent; after conception, a mass increases in the abdomen, disrupting visceral mechanisms. The five fluids gather into Phlegm-Fluids; thus, half of prenatal diseases involve Phlegm stagnation. Banxia Fuling Tang (Pinellia and Poria Decoction) from *Qianjin* is therefore miraculous. At parturition, Phlegm-saliva and lochia exit together, resulting in health; if bleeding is stopped but Phlegm-Fluids do not descend, various diseases arise. Therefore, if regulating Blood postpartum fails, Liushen Tang (Six-God Decoction) is the key medicine. This case began with Phlegm-Fluids obstructing the airway causing edema; Blood was originally unaffected. The reduction of swelling with Wuling San and Shenqi Wan was because Phlegm obstruction in the airway temporarily opened due to heat. Prolonged use overheated the Blood level, causing two episodes of hematemesis. Regarding hemiplegia, deviation of the mouth and eyes, and tongue dysfunction, these are all manifestations of Phlegm stagnating in the collaterals. Even syncope here was caused by Phlegm confusing the mind, not Deficiency collapse. Thus, resolving Phlegm and unblocking collaterals leads to gradual recovery. What is strange about this?
Wang Mengying commented: Such profound insights come from experience. Zhu Shengfu’s son Zhonghe’s wife suffered this after delivery; medical treatment could not eradicate the root; it recurred after subsequent deliveries, persisting for years; upon re-pregnancy, attacks became more frequent. I used large doses of Phlegm-draining medicines for over a month; postpartum she was safe, and the root cause was eradicated.
Shen Yaofeng stated: A woman from Zhenze, more than ten days postpartum, consulted my teacher Jin Dawen, with me accompanying. She reported that at delivery, symptoms resembled Deficiency collapse, and several doses of warming-tonifying medicines were taken. Recently, a strange syndrome developed: the left side is cold, the right side is hot, affecting the whole body and limbs, divided front-to-back. Cold feels like ice, heat feels like charcoal, even the nose reflects this; the tongue coating is white on the left and black on the right. My teacher asked: What disease is this? Which formula should be used? I said: It is not recorded in books, nor have I seen it with my own eyes; I do not know which formula to apply. My teacher said: Strange syndromes should be sought in books without formulas. Does the Classic not say: Left and right are the pathways of Yin and Yang; Yin and Yang are the omens of Water and Fire. Retained Blood blocks the pathways of Yin and Yang ascending and descending, preventing rotation. Where Yang is abundant, it naturally heats; where Yin is abundant, it naturally chills, hence the偏热偏寒 (bias toward heat and cold). Two doses of Zelán (Leonuri Fructus), Zharon (Crataegi Fructus), Liuji Nu (Josephinae Herba), Sumu (Pterocarpus Santalinus), Taoren (Persicae Semen), and Hupo (Amber) reduced the heat by half, but subsequent doses were ineffective. Physicians changed and treated杂乱ly, leading to death. Reflecting now, this syndrome involved not only Blood stasis but also Phlegm stagnation. My teacher identified the blockage of Yin-Yang pathways and recognized the source of the disease, but he remained trapped in the circle of postpartum blood-resolving. If blood-resolving failed, combining Phlegm-resolving might have revived her like the previous case of Mrs. Jin. At that time, Peng was just beginning his studies; my teacher’s insight was outstanding, but he had not fully comprehended Blood stasis syndromes. Regrettably!
Xue Lizhai Medical Case: Sister-in-law of Guo Maoxun, Lady Jinhua, did not eat for seven days postpartum, then complained of headache. After the headache ceased, heart pain arose, followed by eye pain like cutting or stabbing, recurring intermittently without pause. Whenever the headache occurred, she desired a heavy stone to press on her head; after a long while, it gradually settled. When heart pain arose, she scratched her chest with ten fingers, filling her palms with blood. When pain subsided, eye pain returned, and she dug at her eyes with both hands. This continued for ten days without relief; physicians had no plan. Administering half a pill of Heilong Dan (Black Dragon Pill) alleviated the disease slightly. Taken again at midnight, she slept soundly until morning. Upon rising, she passed stool, approximately three sheng, resembling locust larvae; the disease halved. At the Si hour, she passed stool again as before, and pain was completely eliminated.
Heilong Dan: Treats difficult labor and retained placenta, Blood confusion and syncope, loss of consciousness, and any critical emergency conditions nearing death. As long as the medicine is swallowed, survival is assured.
Danggui (Angelicae Sinensis Radix), Wulingzhi (Trogopterori Faeces), Chuanxiong (Ligustici Chuanxiong Rhizoma), Liangjiang (Galangal Rhizome), Shudi (Rehmanniae Radix Preparata) (each 2 liang, chopped, placed in a stir-fry pan, sealed with paper paste and salt mud, calcined over fire), Baicaoshuang (Herba Artemisiae Argyi Carbonis) (1 liang), Liuhuang (Sulfur), Ruxiang (Olibanum) (each 2 qian), Hupo (Amber), Huaruishi (Pyritum) (each 1 qian).
Grind into fine powder, make pills with vinegar paste, size of a bullet. Use 1-2 pills per dose, calcine until red-hot on charcoal fire, immerse in fresh ginger juice until dissolved, mix with child’s urine and wine, and administer orally.