丁 因疟小产，瘀凝未尽，冲任受伤，少腹结瘕，上攻疼痛，大便常溏，内热不已，迄今半载。不渴不
嗽，病在下焦。通补冲任、和营化瘀，不越产后治例，与阴亏劳损有歧。
当归（小茴香炒） 川楝子 延胡 香附 肉桂心（研，冲） 白芍（吴萸炒） 紫石英 砂仁 茺蔚子 玫瑰花
渊按∶从疟而起，脾气先伤，大便常溏，即其征据，徒治下焦血分无益。
又 产后蓐劳，已经八月。内热瘕痛，病在冲任。
当归（酒炒） 白芍（桂枝三分炒） 桃仁泥 丹参 党参 炒丹皮 豆衣 广皮 玫瑰花
张 寒气客于下焦，瘀凝停于小腹中央，乃膀胱之部也。寒气瘀凝，阻塞胞门，膀胱阳气失化，以致
癃闭。产后八日而小溲不通，脉细肢寒，腹中觉冷，恐其气逆上攻发厥。法以温通下焦，化瘀利水。
全当归（八钱） 川芎（四钱） 山楂炭（五钱） 炮姜（五分） 桃仁（三钱） 车前子（五钱）
益母草汤、陈酒各一碗煎药。另研桂心五分，血珀五分，甘遂三分，为末，药汁调下。
渊按∶从生化汤加通瘀祛寒药，可法。
又 小溲癃闭已通，恶露瘀凝未下，少腹板痛。再以温通。
肉桂 延胡索 红花 桃仁 丹参 归尾 山楂炭 牛膝 炮姜炭 冬葵子 两头尖 车前子
张 产后营虚发热，已经数月。多汗心跳，营阴大亏也。
大熟地 党参 黄 茯神 归身 酸枣仁 冬术 陈皮
玉竹 白芍 砂仁
某 产后营虚，内热日久，近感风邪，发热更甚，胸闷心跳。气滞血亏，显然可见。
香豆豉（炒） 黄 防风 全当归 白芍 白术 枣仁 茯神 玉竹 桑叶
渊按∶虚多邪少，从补营方中加轻散药一二味，即可祛邪。重加发散，邪转不服，反多变证。
赵 病后小产，产后感邪咳嗽，寒热似疟。服解散疏和药五六剂，邪退未尽，夜犹微热。然头晕心跳，
寐则惊惕，虚象见矣。拟养营化邪法。
四物汤合二贤，加苏子、苏梗、苏叶、川贝、杏仁、枳壳、茯苓、款冬花。
用三苏、二贤、四物，意在泄血分之风，和血中之气。加化痰止咳药，佐使之耳。
又 补肺阿胶合金水六君，去半夏，加川贝、款冬花。
某 左脉细数，营阴亏也；右脉细软，脾气虚也。
产后不能安息，反加劳碌，气血伤而不复，致身常内热，心荡若嘈，久延虑成劳损。人参养营汤加减。
党参 大熟地 冬术 白术 丹参 香附 远志（甘草汤制） 砂仁 归身（酒炒） 陈皮 茯神 枣仁
孙 前年小产，恶露数日即止，因而腹中作痛结块，心神妄乱，言语如癫。此谓血风病也。胞络下
连血海，上系心包，血凝动火，火炽生风，故见诸症。诊脉弦搏，肝阳有上亢之象，防加
吐血。为治之法，当以化瘀为先，清火化痰为佐。
川贝 赤苓 丹参 蒲黄炭 五灵脂 川连 香附 延胡 焦山栀 茺蔚子
另∶回生丹一粒，开水化服。
渊按∶血风病有数种，此因产后瘀凝而得，病在冲任血海，上及心包，不脱产后着笔。
毛 产后腹痛，一载有余。营虚木郁，脾胃受戕。时作恶心，时吐酸水。用《千金》当归建中汤法。
当归 炮姜炭 炙甘草 肉桂 川椒 白芍（吴萸炒） 橘饼 南枣
又 前投建中法，腹痛已止。复因经行之后，劳碌受寒，腹中又痛，加以晡热，饮食减少，舌苔干白。
此属血虚肝郁，脾虚木横。用归脾法加减。
黄 党参 冬术 茯苓 砂仁 炮姜 木香 陈皮 归身 白芍（吴萸炒） 橘饼
胡 小产半月，感邪发热，又遭惊恐，冲任受伤，少腹胀痛，白带淋浊，眼花口苦，腰膝拘挛。证
逾半月，饮食不纳，虑其昏厥。姑仿南阳以浊攻浊法，兼达邪化瘀，备商。
淡豆豉 白前 泽兰叶 延胡索 焦山栀 当归 丹参 焦楂肉 竹茹 交加散 两头尖
另∶旧裤裆一方，烧灰存性，药汁调下。
渊按∶此名烧裤散，仲圣治阴阳易病。
章 先痉厥半日而后产，产后厥仍不醒，痉仍不止，恶露稀少，汤水不能纳，纳则仍复吐出，面赤身温，
脉洪而荒。肝风炽张，营虚气耗，虚阳外越，冷汗遂出，恐其厥而不返，奈何奈何！姑拟一方，希冀万一。
肉桂（五分） 当归（三钱）
煎汤冲童便一杯，化下回生丹一丸。
渊按∶脉荒者，乱也。究属杜撰。虚风挟痰上逆，化痰降火，冲入童便最妙。
又 前方勉灌三分之一，恶露稍多，面赤稍退，脉大稍软，
而厥仍不醒，舌色灰黄，时沃涎沫，两日饮食不进。营虚气滞，
胃虚浊泛。必得温通化浊，以冀阳回厥醒为妙。
肉桂 炮姜 半夏 全当归 丹参 山楂肉 陈皮 茯苓 紫石英 童便（冲入）
又 厥醒进粥半盏，诸无所苦，惟周身疼痛，不能转侧。舌苔白，口不渴。拟温养气血，兼和胃气。
肉桂 炮姜 黄 半夏 当归 丹参 茯苓 陈皮 桑枝
丁 产后瘀凝未尽，新血不生，身热日久，少腹疼痛，小
溲淋浊，带下血筋。此肝经郁热，兼夹瘀凝为患，殊非小恙。姑拟泄肝、化瘀、和营为法。
鲜地渣（姜汁拌，炒焦） 金铃子 延胡索 丹参 焦山栀 生姜
渣（鲜地汁拌，炒焦） 龙胆草 当归 赤苓 甘草梢 青葱管 新绛屑
范 产未盈月操作，猝遇大雨淋身，水寒之气自毛窍而入于骨节，内舍于肾，外达太阳、阳明，是以始
病腰疼，继而上攻头痛，遍体机关不利也。脉沉而寒热，寐少而恐惧，纳少而恶心，邪
气留连于胃肾。据云头痛甚则汗出，太阳之表虚矣。用许学士法。
香豆豉 牛蒡子 豆卷 杜仲 磁石 本 白芷 川芎 金狗脊 赤苓 半夏 甘菊花
渊按∶太阳表虚，风药未免太过，况得之产后乎！
又 前投益肾通经，和胃泄湿，头项腰脊之痛原有松机。今产后两月有余，经水适来，而心跳恐惧，
是营气虚而不摄也。拟和营止痛，仍佐理胃泄湿。
党参 桂枝 秦艽 枣仁 杜仲 豆卷 半夏 赤苓 苡仁 金狗脊 归身 陈皮 桑枝（酒炒）
又 产后营虚，雨湿寒气袭入，经络机关不利。前投宣通养
血两法，俱无少效。虽头痛略松，而右半之腿臂转增痛热。犹幸
脾胃稍旺。今恶风、发热、口干，是寒湿渐化为热矣。拟疏泄湿热以通经络，再议。
羚羊角 丹参 防风 秦艽 苡仁 陈皮 羌活 丝瓜络 防己 当归 白芷 木通 桑枝 忍冬藤
王 产未百日，骨蒸发热，淹延匝月，热势渐加，迄今五十日矣。诊左寸关轻取虚小，中按之数，重按数
而且坚，知其热在阴中，心肝之火独亢；右寸关虚软而数，则知脾肺气虚；两尺皆虚，肾阴亏也。阴虚阳盛，
热气熏于胸中，蒸动水谷之湿上泛，故舌苔反见浊浓耳。耳鸣而聋者，肾虚肝阳上逆也。据述服参、 则热
势愈甚，投胶、地则胃气益惫。节近清明，地中阳气大泄，阴虚阳亢莫制，恐其交夏加剧。刻下用药，以
脾胃为要。土旺四季各十八日，清明节后土气司权，趁此培土，冀其脾胃渐醒，饮食渐加，
佐以清金平木，必须热退为妙。
北沙参 地骨皮 丹皮 归身 怀山药 白扁豆 茯苓 白芍 生熟谷芽 白蔷薇露
仁渊曰∶产后病最难治，最多变证，难以殚述。朱丹溪云∶产后以大补为主，虽有别证，从未治之。此
言虽是，亦未可泥。有少壮之妇素体不虚，或兼外感六淫，内阻瘀滞，当见证治证。
若执产后须补之论，不但本病不退，势必转增他变。盖新产百脉虽虚，感邪则实，急去其邪，即所以养其
正也。倘遇可攻可下之证，即白虎、承气不为过。胎前亦然。惟下笔切宜仔细，未可率意轻忽。心中须念此
产后虚体，若一击而中，便与轻松调理。果是纯虚，自当大补，补之有方，不可集几味养血套剂便为了事。
再者，胎前温药宜慎，产后凉药宜慎。谚云∶胎前一把火，产后一块冰。虽未尽然，却也不差。
盖胎前多实，实者多热，产后多虚，虚者多寒，理固然也。
丁某，因患疟疾导致小产，瘀血凝结未尽，冲任二脉受损，少腹形成结块（瘕），向上攻冲引起疼痛，大便经常稀溏，体内发热不止，至今已达半年。口不渴，无咳嗽，病位在下焦。治疗宜通补冲任、调和营血、化瘀散结，不离产后治疗的常规，这与阴液亏损的劳损证有所区别。
处方：当归（用小茴香炒）、川楝子、延胡索、香附、肉桂心（研末，冲服）、白芍（用吴茱萸炒）、紫石英、砂仁、茺蔚子、玫瑰花。
渊按：病情从疟疾而起，脾气首先受伤，大便经常稀溏，就是其征象依据，单纯治疗下焦血分没有益处。
又案：产后蓐劳（产后虚损性疾病），已经持续八月。体内发热且有瘕痛，病在冲任二脉。
处方：当归（用酒炒）、白芍（用桂枝三分同炒）、桃仁泥、丹参、党参、炒牡丹皮、豆衣、广陈皮、玫瑰花。
张某：寒气客居在下焦，瘀血凝结停在小腹中央，这是膀胱所属的部位。寒气和瘀血凝结，阻塞胞门，膀胱阳气失去气化功能，导致小便不通（癃闭）。产后八天小便不通，脉象细弱，四肢发冷，腹部感觉寒冷，担心气逆上冲引发昏厥（发厥）。治法以温通下焦，化瘀利水为主。
处方：全当归（八钱）、川芎（四钱）、山楂炭（五钱）、炮姜（五分）、桃仁（三钱）、车前子（五钱）。
煎药方法：用益母草汤和陈酒各一碗来煎煮药物。另外将桂心五分、血珀五分、甘遂三分研为细末，用药汁调服。
渊按：这是在生化汤基础上加入通瘀祛寒的药物，值得效法。
又案：小便癃闭已经通畅，但恶露瘀凝仍未下行，少腹僵硬疼痛。再用温通之法。
处方：肉桂、延胡索、红花、桃仁、丹参、归尾、山楂炭、牛膝、炮姜炭、冬葵子、两头尖、车前子。
张某：产后营血虚弱发热，已经数月。多汗且心跳，说明营阴大亏。
处方：大熟地黄、党参、黄芪、茯神、当归身、酸枣仁、冬术（白术的一种）、陈皮。
另加：玉竹、白芍、砂仁。
某患者：产后营血虚弱，内热日久，近日感受风邪，发热更加严重，胸闷且心跳。气滞血亏，症状明显可见。
处方：香豆豉（炒）、黄芪、防风、全当归、白芍、白术、枣仁、茯神、玉竹、桑叶。
渊按：虚证多而邪气少，在补营血的方剂中加入一两味轻宣疏散的药物，即可祛除邪气。如果重用发散药，邪气反而不能耐受，容易产生多种变证。
赵某：病后小产，产后感受邪气咳嗽，寒热往来像疟疾一样。服用解散疏和的药物五六剂后，邪气退去但未除尽，夜间仍有微热。然而出现头晕、心跳，睡眠时惊惕不安，虚象已显现。拟定养营化邪的法度。
处方：四物汤合二贤散，加苏子、苏梗、苏叶、川贝母、杏仁、枳壳、茯苓、款冬花。
使用三苏（苏子、苏梗、苏叶）、二贤、四物，意在疏泄血分中的风邪，调和血中的气机。加入化痰止咳药，作为佐使药而已。
某患者：左脉细数，是营阴亏损；右脉细软，是脾气虚弱。
产后不能安心静养，反而增加劳累，气血损伤而不能恢复，导致身体经常内热，心中荡漾如嘈杂感，久延下去担心成为劳损。用人参养营汤加减。
处方：党参、大熟地黄、冬术、白术、丹参、香附、远志（甘草汤制）、砂仁、当归身（酒炒）、陈皮、茯神、枣仁。
孙某：前年小产，恶露几天就停止，因而腹中作痛并结块，心神狂乱，言语像癫狂一样。这叫做血风病。胞络下连血海，上系心包，血凝而动火，火炽盛而生风，所以出现各种症状。诊脉弦搏，肝阳有上亢的迹象，防止加重吐血。治疗的方法，应当以化瘀为先，清火化痰为辅。
处方：川贝母、赤茯苓、丹参、蒲黄炭、五灵脂、川黄连、香附、延胡索、焦山栀、茺蔚子。
另：回生丹一粒，开水化服。
渊按：血风病有好几种，这是因产后瘀血凝结而得的，病在冲任血海，上行波及心包，没有脱离产后病的范畴。
毛某：产后腹痛，一年多有余。营血虚弱，肝气郁结，脾胃受到损害。时常恶心，时而吐酸水。用《千金》当归建中汤的法度。
处方：当归、炮姜炭、炙甘草、肉桂、川椒、白芍（吴茱萸炒）、橘饼、南枣。
又案：之前投用建中法，腹痛已经停止。又因月经之后，劳累受寒，腹中又痛，加上傍晚发热，饮食减少，舌苔干白。
这属于血虚肝郁，脾虚木横（肝木克脾土）。用归脾汤法加减。
处方：黄芪、党参、冬术、茯苓、砂仁、炮姜、木香、陈皮、当归身、白芍（吴茱萸炒）、橘饼。
胡某：小产半月，感受邪气发热，又遭受惊恐，冲任受伤，少腹胀痛，白带淋漓浑浊，眼花口苦，腰膝拘挛。病症超过半个月，饮食不进，担心昏厥。姑且仿照张仲景“以浊攻浊”的方法，兼以达邪化瘀，供商量参考。
处方：淡豆豉、白前、泽兰叶、延胡索、焦山栀、当归、丹参、焦山楂肉、竹茹、交加散、两头尖。
另：旧裤裆一方，烧灰存性，用药汁调服。
章某：先发生痉厥半天然后生产，产后厥逆仍不苏醒，痉挛仍不停止，恶露稀少，汤水不能咽下，咽下则立即吐出，面红身温，脉象洪大而散乱（荒）。肝风炽盛张扬，营血虚弱气耗，虚阳外越，冷汗于是流出，恐怕厥逆不能返回，这可怎么办！姑且拟定一方，希冀万一之效。
处方：肉桂（五分）、当归（三钱）。
煎汤冲入童便一杯，化服回生丹一丸。
渊按：脉荒，就是乱的意思。究其本质属于杜撰（指脉象描述不准确或理论牵强）。虚风挟痰上逆，化痰降火，冲入童便最为巧妙。
又案：前方勉强灌服三分之一，恶露稍多，面红稍退，脉大稍软，
但厥逆仍不苏醒，舌色灰黄，不时流涎沫，两天饮食不进。营虚气滞，
胃虚浊泛。必须得到温通化浊，希望阳气回复、厥逆苏醒才是妙策。
处方：肉桂、炮姜、半夏、全当归、丹参、山楂肉、陈皮、茯苓、紫石英、童便（冲入）。
又案：厥逆苏醒后进食半盏粥，其他无所痛苦，只是周身疼痛，不能转动侧身。舌苔白，口不渴。拟定温养气血，兼和胃气。
处方：肉桂、炮姜、黄芪、半夏、当归、丹参、茯苓、陈皮、桑枝。
丁某：产后瘀血凝结未尽，新血不生，身体发热日久，少腹疼痛，小便淋浊，带下中有血丝。这是肝经郁热，兼夹瘀血凝结为患，绝非小病。姑且拟定泄肝、化瘀、和营为法。
处方：鲜地渣（姜汁拌，炒焦）、金铃子（川楝子）、延胡索、丹参、焦山栀、生姜。
另一组：地渣（鲜地黄汁拌，炒焦）、龙胆草、当归、赤茯苓、甘草梢、青葱管、新绛屑。
范某：生产未满月即劳作，突然遇大雨淋身，水寒之气自毛孔进入骨节，内舍于肾，外达太阳、阳明经，所以起初腰痛，继而上攻头痛，全身关节不利。脉沉而有寒热，睡眠少且恐惧，进食少且恶心，邪气留连于胃肾。据说是头痛严重时出汗，这是太阳表虚。用许学士的法度。
处方：香豆豉、牛蒡子、豆卷、杜仲、磁石、藁本、白芷、川芎、金狗脊、赤茯苓、半夏、甘菊花。
又案：之前投用益肾通经，和胃泄湿，头项腰脊的疼痛原本有缓解之机。现在产后两个多月，月经适来，而心跳恐惧，
这是营气虚而不摄。拟定和营止痛，仍佐以理胃泄湿。
处方：党参、桂枝、秦艽、枣仁、杜仲、豆卷、半夏、赤茯苓、苡仁、金狗脊、当归身、陈皮、桑枝（酒炒）。
又案：产后营血虚弱，雨湿寒气袭入，经络关节不利。之前投用宣通养血两法，都没有一点效果。虽然头痛略松，但右半边的腿臂转增痛热。犹幸
脾胃稍旺。现在恶风、发热、口干，是寒湿逐渐化为热了。拟定疏泄湿热以通经络，再议。
处方：羚羊角、丹参、防风、秦艽、苡仁、陈皮、羌活、丝瓜络、防己、当归、白芷、木通、桑枝、忍冬藤。
王某：生产未满百日，骨蒸发热，拖延一个月，热势渐加，至今五十天了。诊左寸关轻取虚小，中按之数，重按数而且坚，知道热在阴分，心肝之火独亢；右寸关虚软而数，则知脾肺气虚；两尺皆虚，肾阴亏也。阴虚阳盛，
热气熏于胸中，蒸动水谷之湿上泛，所以舌苔反见浊浓耳。耳鸣而聋者，肾虚肝阳上逆也。据述服人参、黄芪则热
势愈甚，投阿胶、熟地则胃气益惫。节近清明，地中阳气大泄，阴虚阳亢莫制，恐其交夏加剧。刻下用药，以
脾胃为要。土旺四季各十八日，清明节后土气司权，趁此培土，冀其脾胃渐醒，饮食渐加，
佐以清金平木，必须热退为妙。
处方：北沙参、地骨皮、丹皮、归身、怀山药、白扁豆、茯苓、白芍、生熟谷芽、白蔷薇露。
仁渊曰：产后病最难治，最多变证，难以详尽叙述。朱丹溪说：产后以大补为主，虽有别证，从未治之。此
言虽是，亦未可泥。有少壮之妇素体不虚，或兼外感六淫，内阻瘀滞，当见证治证。
若执产后须补之论，不但本病不退，势必转增他变。盖新产百脉虽虚，感邪则实，急去其邪，即所以养其
正也。倘遇可攻可下之证，即白虎、承气不为过。胎前亦然。惟下笔切宜仔细，未可率意轻忽。心中须念此
产后虚体，若一击而中，便与轻松调理。果是纯虚，自当大补，补之有方，不可集几味养血套剂便为了事。
再者，胎前温药宜慎，产后凉药宜慎。谚云：胎前一把火，产后一块冰。虽未尽然，却也不差。
盖胎前多实，实者多热，产后多虚，虚者多寒，理固然也。
Case of Patient Ding: Due to malaria leading to a miscarriage, blood stasis has not fully resolved. The Chong and Ren meridians are injured, resulting in a mass (Zhen) in the lower abdomen that attacks upward causing pain. Stool is often loose, internal heat persists without ceasing, and this has lasted for half a year. There is no thirst or cough; the disease is located in the Lower Jiao. Treatment should tonify and unblock the Chong and Ren meridians, harmonize Ying (Nutritive) blood, and resolve stasis, adhering to the general principles of postpartum treatment, which differs from Yin deficiency consumptive diseases.
Prescription: Dang Gui (Angelicae Sinensis Radix) stir-fried with Xiao Hui Xiang (Foeniculi Fructus); Chuan Lian Zi (Meliae Fructus); Yan Hu Suo (Corydalis Rhizoma); Xiang Fu (Cyperi Rhizoma); Rou Gui Xin (Cinnamomi Cortex Medulla) ground into powder, taken with decoction; Bai Shao (Paeoniae Radix Alba) stir-fried with Wu Zhu Yu (Evodiae Fructus); Zi Shi Ying (Fluorite); Sha Ren (Amomi Fructus Rotundus); Chong Wei Zi (Leonuri Fructus); Mei Gui Hua (Rosae Rugosae Flos).
Commentary by Yuan: The illness originated from malaria, damaging the Spleen Qi first; the frequent loose stools are evidence of this. Treating only the Blood aspect of the Lower Jiao would be ineffective.
Another Case: Postpartum Ru Lao (consumptive disease after childbirth) has persisted for eight months. Internal heat and Zhen pain indicate the disease is in the Chong and Ren meridians.
Prescription: Dang Gui (Angelicae Sinensis Radix) stir-fried with wine; Bai Shao (Paeoniae Radix Alba) stir-fried with three fen of Gui Zhi (Cinnamomi Ramulus); Tao Ren (Persicae Semen) paste; Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma); Dang Shen (Codonopsis Radix); Chao Dan Pi (Moutan Cortex); Dou Yi (Soiae Semen Praeparatum); Guang Pi (Citri Reticulatae Pericarpium); Mei Gui Hua (Rosae Rugosae Flos).
Case of Patient Zhang: Cold pathogen lodges in the Lower Jiao, and blood stasis condenses in the center of the lower abdomen, which is the region of the Bladder. Cold and stasis obstruct the Bao Men (uterine gate), causing the Yang Qi of the Bladder to lose its transformative function, resulting in Long Bi (difficulty urinating). Eight days postpartum, urine flow is blocked; pulse is fine, limbs are cold, and the abdomen feels cold. There is fear of Qi rebelling upward causing Jue (syncope/cold extremities). The method is to warm and unblock the Lower Jiao, resolve stasis, and promote urination.
Prescription: Quan Dang Gui (Angelicae Sinensis Radix) 8 qian; Chuan Xiong (Ligustici Chuanxiong Rhizoma) 4 qian; Shan Zha Tan (Crataegi Fructus Carbonisatus) 5 qian; Pao Jiang (Zingiberis Rhizoma Preparatum) 0.5 fen; Tao Ren (Persicae Semen) 3 qian; Che Qian Zi (Plantaginis Semen) 5 qian.
Decoction Method: Decoct with one bowl of Yi Mu Cao Tang (Leonuri Herba Decoction) and one bowl of aged rice wine. Separately, grind Rou Gui Xin (Cinnamomi Cortex Medulla) 0.5 fen, Xue Po (Succinum) 0.5 fen, and Gan Sui (Kansui Radix) 0.3 fen into powder; take with the medicinal juice.
Commentary by Yuan: This adds herbs to unblock stasis and dispel cold to the Sheng Hua Tang, a method worth following.
Another Case: Urinary retention (Long Bi) has been relieved, but lochia stasis has not yet descended, and the lower abdomen is stiff and painful. Use warming and unblocking methods again.
Prescription: Rou Gui (Cinnamomi Cortex); Yan Hu Suo (Corydalis Rhizoma); Hong Hua (Carthami Flos); Tao Ren (Persicae Semen); Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma); Gui Wei (Angelicae Sinensis Radix Cauda); Shan Zha Tan (Crataegi Fructus Carbonisatus); Niu Xi (Achyranthis Bidentatae Radix); Pao Jiang Tan (Zingiberis Rhizoma Preparatum Carbonisatus); Dong Kui Zi (Abutilonis Semen); Liang Tou Jian (Asari Radix et Rhizoma); Che Qian Zi (Plantaginis Semen).
Case of Patient Zhang: Postpartum Ying deficiency fever has lasted for several months. Profuse sweating and palpitations indicate severe depletion of Ying Yin (Nutritive Yin).
Prescription: Da Shu Di (Rehmanniae Radix Preparata); Dang Shen (Codonopsis Radix); Huang Qi (Astragali Radix); Fu Shen (Poria Cum Radix); Gui Shen (Angelicae Sinensis Radix Radix); Suan Zao Ren (Ziziphi Spinosae Semen); Dong Zhu (Atractylodis Macrocephalae Rhizoma); Chen Pi (Citri Reticulatae Pericarpium).
Additions: Yu Zhu (Polygonati Odorati Rhizoma); Bai Shao (Paeoniae Radix Alba); Sha Ren (Amomi Fructus Rotundus).
Case of Patient Mou: Postpartum Ying deficiency with long-standing internal heat; recently contracted wind pathogen, causing worsened fever, chest tightness, and palpitations. Qi stagnation and blood deficiency are clearly visible.
Prescription: Xiang Dou Chi (Soiae Semen Preparatum) stir-fried; Huang Qi (Astragali Radix); Fang Feng (Saposhnikoviae Radix); Quan Dang Gui (Angelicae Sinensis Radix); Bai Shao (Paeoniae Radix Alba); Bai Zhu (Atractylodis Macrocephalae Rhizoma); Zao Ren (Ziziphi Spinosae Semen); Fu Shen (Poria Cum Radix); Yu Zhu (Polygonati Odorati Rhizoma); Sang Ye (Mori Folium).
Commentary by Yuan: Deficiency is predominant with minimal pathogenic factor. Adding one or two mild dispersing herbs to a Ying-tonifying formula can expel the pathogen. Heavy use of dispersing agents may cause the pathogen to resist, leading to various complications.
Case of Patient Zhao: After illness and miscarriage, contracted pathogen postpartum causing cough, alternating chills and fever resembling malaria. After taking five or six doses of resolving and harmonizing formulas, the pathogen receded but did not fully clear; slight fever persists at night. However, dizziness, palpitations, and startle during sleep indicate deficiency signs. The proposed method is to nourish Ying and transform pathogen.
Prescription: Si Wu Tang combined with Er Xian San, plus Su Zi (Perillae Fructus), Su Geng (Perillae Caulis), Su Ye (Perillae Folium), Chuan Bei Mu (Fritillariae Cirrhosae Bulbus), Xing Ren (Armeniacae Semen Amarum), Zhi Ke (Aurantii Fructus Immaturus), Fu Ling (Poria), Kuan Dong Hua (Farfarae Flos).
The use of "Three Sus" (Su Zi, Su Geng, Su Ye), Er Xian, and Si Wu aims to vent wind from the Blood level and harmonize Qi within the blood. Added phlegm-resolving and cough-stopping herbs serve as assistants.
Another Prescription: Bu Fei E Jiao combined with Jin Shui Liu Jun Tang, removing Ban Xia, adding Chuan Bei Mu (Fritillariae Cirrhosae Bulbus) and Kuan Dong Hua (Farfarae Flos).
Case of Patient Mou: Left pulse is fine and rapid, indicating Ying Yin deficiency; right pulse is fine and soft, indicating Spleen Qi deficiency.
Postpartum inability to rest, compounded by labor, damages Qi and Blood without recovery, leading to chronic internal heat and a sensation of heart agitation like hunger pangs. Prolonged, this may become a consumptive disease. Modify Ren Shen Yang Ying Tang.
Prescription: Dang Shen (Codonopsis Radix); Da Shu Di (Rehmanniae Radix Preparata); Dong Zhu (Atractylodis Macrocephalae Rhizoma); Bai Zhu (Atractylodis Macrocephalae Rhizoma); Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma); Xiang Fu (Cyperi Rhizoma); Yuan Zhi (Polygalae Radix) processed with Licorice decoction; Sha Ren (Amomi Fructus Rotundus); Gui Shen (Angelicae Sinensis Radix Radix) stir-fried with wine; Chen Pi (Citri Reticulatae Pericarpium); Fu Shen (Poria Cum Radix); Zao Ren (Ziziphi Spinosae Semen).
Case of Patient Sun: Miscarriage the previous year; lochia stopped after a few days, leading to abdominal pain and mass formation, mental confusion, and speech resembling mania. This is called Xue Feng Bing (Blood Wind Disease). The Bao Luo (uterine collaterals) connects downward to the Blood Sea and upward to the Pericardium. Blood coagulation agitates Fire; excessive Fire generates Wind, causing these symptoms. Pulse is wiry and bounding, suggesting Liver Yang hyperactivity, with risk of hemoptysis. Treatment priority is to resolve stasis, assisted by clearing Fire and transforming phlegm.
Prescription: Chuan Bei Mu (Fritillariae Cirrhosae Bulbus); Chi Ling (Poria cum Rosa); Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma); Pu Huang Tan (Typhae Pollen Carbonisatus); Wu Ling Zhi (Trogopterori Faeces); Chuan Lian (Coptidis Rhizoma); Xiang Fu (Cyperi Rhizoma); Yan Hu Suo (Corydalis Rhizoma); Jiao Shan Zhi (Gardeniae Fructus Carbonisatus); Chong Wei Zi (Leonuri Fructus).
Separately: Hui Sheng Dan (Revival Pill) one pill, dissolved in boiled water.
Commentary by Yuan: Xue Feng Bing has several types; this one results from postpartum stasis condensation. The disease is in the Chong, Ren, and Blood Sea, extending to the Pericardium, consistent with postpartum pathology.
Case of Patient Mao: Postpartum abdominal pain for over a year. Ying deficiency with Liver depression damages the Spleen and Stomach. Occasional nausea and acid regurgitation. Apply the method of Dang Gui Jian Zhong Tang from *Qian Jin Fang*.
Prescription: Dang Gui (Angelicae Sinensis Radix); Pao Jiang Tan (Zingiberis Rhizoma Preparatum Carbonisatus); Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma Preparata); Rou Gui (Cinnamomi Cortex); Chuan Jiao (Zanthoxyli Pericarpium); Bai Shao (Paeoniae Radix Alba) stir-fried with Wu Zhu Yu (Evodiae Fructus); Ju Bing (Citri Reticulatae Pericarpium); Nan Zao (Jujubae Fructus).
Another Case: Previous Jian Zhong method stopped the abdominal pain. However, after menstruation, labor and cold exposure caused recurrent abdominal pain, accompanied by afternoon fever, reduced appetite, and dry white tongue coating.
This belongs to Blood deficiency with Liver depression and Spleen deficiency with Liver overacting on Spleen. Modify Gui Pi Tang method.
Prescription: Huang Qi (Astragali Radix); Dang Shen (Codonopsis Radix); Dong Zhu (Atractylodis Macrocephalae Rhizoma); Fu Ling (Poria); Sha Ren (Amomi Fructus Rotundus); Pao Jiang (Zingiberis Rhizoma Preparatum); Mu Xiang (Aucklandiae Radix); Chen Pi (Citri Reticulatae Pericarpium); Gui Shen (Angelicae Sinensis Radix Radix); Bai Shao (Paeoniae Radix Alba) stir-fried with Wu Zhu Yu (Evodiae Fructus); Ju Bing (Citri Reticulatae Pericarpium).
Case of Patient Hu: Miscarriage half a month ago; contracted pathogen with fever, followed by fright. Chong and Ren meridians injured, lower abdomen distended and painful, leukorrhea dripping turbid, blurred vision, bitter taste, spasms of waist and knees. Illness exceeds half a month, food intake refused, fearing syncope. Tentatively imitate Zhang Zhongjing's "using turbid to attack turbid" method, combining pathogen expulsion and stasis resolution for discussion.
Prescription: Dan Dou Chi (Soiae Semen Preparatum); Bai Qian (Cynanchi Stauntonii Radix); Ze Lan Ye (Lycopersici Herba); Yan Hu Suo (Corydalis Rhizoma); Jiao Shan Zhi (Gardeniae Fructus Carbonisatus); Dang Gui (Angelicae Sinensis Radix); Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma); Jiao Zha Rou (Crataegi Fructus Carbonisatus); Zhu Ru (Bambusae Caulis in Taenia); Jiao Jia San; Liang Tou Jian (Asari Radix et Rhizoma).
Separately: One piece of old underwear, burned to ash retaining nature, taken with medicinal juice.
Commentary by Yuan: This is called Shao Ku San (Burnt Panties Powder), used by Zhang Zhongjing to treat Yin-Yang Yi disease.
Case of Patient Zhang: Experienced Jing Jue (spasm and syncope) for half a day before delivery; postpartum Jue persists without waking, Jing continues, lochia is scant, cannot retain fluids (vomits immediately), face red, body warm, pulse is surging and chaotic (Huang). Liver Wind is blazing, Ying deficiency and Qi exhaustion, floating Yang escapes outward, cold sweat ensues. Fear of irreversible Jue. Tentative prescription for hope.
Prescription: Rou Gui (Cinnamomi Cortex) 0.5 fen; Dang Gui (Angelicae Sinensis Radix) 3 qian.
Decoct and mix with one cup of Tong Bian (Infant Urine), dissolve one pill of Hui Sheng Dan (Revival Pill) and take.
Commentary by Yuan: "Huang" pulse means chaotic. Ultimately, this description is fabricated. Floating Wind carrying Phlegm rebels upward; resolving Phlegm and descending Fire, mixed with Infant Urine, is excellent.
Another Case: Forced administration of one-third of the previous prescription resulted in slightly increased lochia, slightly reduced facial redness, and slightly softer large pulse,
but Jue persists without waking, tongue is gray-yellow, salivation occurs intermittently, no food intake for two days. Ying deficiency and Qi stagnation,
Stomach deficiency with turbid reflux. Must achieve warming, unblocking, and resolving turbidity to hope for Yang return and Jue reversal.
Prescription: Rou Gui (Cinnamomi Cortex); Pao Jiang (Zingiberis Rhizoma Preparatum); Ban Xia (Pinelliae Rhizoma); Quan Dang Gui (Angelicae Sinensis Radix); Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma); Shan Zha Rou (Crataegi Fructus); Chen Pi (Citri Reticulatae Pericarpium); Fu Ling (Poria); Zi Shi Ying (Fluorite); Tong Bian (Infant Urine) added to decoction.
Another Case: Jue reversed, consumed half a bowl of porridge, no other discomfort, only whole-body pain unable to turn. Tongue coating white, no thirst. Prescribe warming and nourishing Qi and Blood, harmonizing Stomach Qi.
Prescription: Rou Gui (Cinnamomi Cortex); Pao Jiang (Zingiberis Rhizoma Preparatum); Huang Qi (Astragali Radix); Ban Xia (Pinelliae Rhizoma); Dang Gui (Angelicae Sinensis Radix); Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma); Fu Ling (Poria); Chen Pi (Citri Reticulatae Pericarpium); Sang Zhi (Mori Ramulus).
Case of Patient Ding: Postpartum stasis not fully resolved, new blood not generated, prolonged body heat, lower abdominal pain, urinary dribbling/turbidity, leukorrhea with blood strands. This is Liver channel depressed heat combined with stasis condensation, not a minor ailment. Tentatively prescribe venting Liver, resolving stasis, and harmonizing Ying.
Prescription Group 1: Xian Di Zha (Fresh Rehmannia Residue) mixed with Ginger Juice, stir-fried until scorched; Jin Ling Zi (Meliae Fructus); Yan Hu Suo (Corydalis Rhizoma); Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma); Jiao Shan Zhi (Gardeniae Fructus Carbonisatus); Sheng Jiang (Zingiberis Rhizoma Recens).
Prescription Group 2: Di Zha (Fresh Rehmannia Residue) mixed with Fresh Rehmannia Juice, stir-fried until scorched; Long Dan Cao (Gentianae Radix); Dang Gui (Angelicae Sinensis Radix); Chi Ling (Poria cum Rosa); Gan Cao Shao (Glycyrrhizae Radix et Rhizoma Tip); Qing Cong Guan (Allii Fistulosi Caulis); Xin Jiang Xie (Safflower Silk/Crocus remnant).
Case of Patient Fan: Worked less than a month postpartum; suddenly caught in heavy rain, water-cold entered bones/joints through pores, lodged internally in Kidney, externally reached Tai Yang and Yang Ming channels. Initially lower back pain, then attacked upward causing headache, general joint stiffness. Pulse deep with chills/fever, little sleep with fear, poor appetite with nausea, pathogen lingering in Stomach and Kidney. Reports severe headache causes sweating, indicating Tai Yang exterior deficiency. Apply Xu Xue Shi's method.
Prescription: Xiang Dou Chi (Soiae Semen Preparatum); Niu Bang Zi (Arctii Fructus); Dou Juan (Soiae Semen Germinatum); Du Zhong (Eucommiae Cortex); Ci Shi (Hematitum); Ben Cao (Ligustici Wallichii Rhizoma et Radix); Bai Zhi (Angelicae Dahuricae Radix); Chuan Xiong (Ligustici Chuanxiong Rhizoma); Jin Gou Ji (Athyrii Spinae-Ramosae Rhizoma); Chi Ling (Poria cum Rosa); Ban Xia (Pinelliae Rhizoma); Gan Ju Hua (Chrysanthemi Flos).
Commentary by Yuan: Tai Yang exterior deficiency, wind-dispersing herbs are likely too harsh, especially postpartum!
Another Case: Previous treatment tonified Kidney, unblocked meridians, harmonized Stomach, and drained dampness; pain in head, neck, waist, and spine showed relief. Now over two months postpartum, menstruation arrived, with palpitations and fear,
indicating Ying Qi deficiency failing to secure. Prescribe harmonizing Ying and stopping pain, assisting with regulating Stomach and draining dampness.
Prescription: Dang Shen (Codonopsis Radix); Gui Zhi (Cinnamomi Ramulus); Qin Jiao (Gentianae Macrophyllae Radix); Zao Ren (Ziziphi Spinosae Semen); Du Zhong (Eucommiae Cortex); Dou Juan (Soiae Semen Germinatum); Ban Xia (Pinelliae Rhizoma); Chi Ling (Poria cum Rosa); Yi Yi Ren (Coicis Semen); Jin Gou Ji (Athyrii Spinae-Ramosae Rhizoma); Gui Shen (Angelicae Sinensis Radix Radix); Chen Pi (Citri Reticulatae Pericarpium); Sang Zhi (Mori Ramulus) stir-fried with wine.
Another Case: Postpartum Ying deficiency, rain-damp cold invaded, meridians and joints stiff. Previous ventilation and blood-nourishing methods had no effect. Although headache slightly eased, right leg and arm pain/heat increased. Fortunately, Spleen/Stomach slightly strong. Now aversion to wind, fever, dry mouth indicate cold-damp transforming into heat. Prescribe dispersing/drainage of damp-heat to unblock meridians, to be discussed further.
Prescription: Ling Yang Jiao (Capricornis Cornu); Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma); Fang Feng (Saposhnikoviae Radix); Qin Jiao (Gentianae Macrophyllae Radix); Yi Yi Ren (Coicis Semen); Chen Pi (Citri Reticulatae Pericarpium); Qiang Huo (Notopterygii Rhizoma et Radix); Si Gua Luo (Luffae Fructus Retinervia); Fang Ji (Stephaniae Tetrandrae Radix); Dang Gui (Angelicae Sinensis Radix); Bai Zhi (Angelicae Dahuricae Radix); Mu Tong (Akebiae Caulis); Sang Zhi (Mori Ramulus); Ren Dong Teng (Lonicerae Japonicae Caulis).
Case of Patient Wang: Less than 100 days postpartum, bone-steaming fever persisted for a month, worsening, now 50 days. Left Cun/Guan light touch deficient/small, medium touch rapid, heavy touch rapid and firm; heat is in Yin, Heart/Liver fire hyperactive. Right Cun/Guan deficient/soft and rapid; Spleen/Lung Qi deficient. Both Chi deficient; Kidney Yin depleted. Yin deficiency with Yang excess,
heat steams in Chest, steaming grain-dampness upward refluxes, hence thick turbid tongue coating. Tinnitus/deafness is Kidney deficiency with Liver Yang rebellion. Reports taking Ren Shen/Huang Qi worsens heat; taking E Jiao/Shu Di weakens Stomach Qi. Approaching Qingming, Earth Qi releases, Yin deficiency/Yang hyperactivity unchecked, fear worsening in Summer. Current medication prioritizes Spleen/Stomach. Earth prospers 18 days in each season; after Qingming, Earth Qi governs. Cultivate Earth now, hoping Spleen/Stomach revive and appetite increases,
assisted by clearing Metal and pacifying Wood, must reduce heat to be effective.
Prescription: Bei Sha Shen (Glehniae Radix); Di Gu Pi (Lycii Cortex); Dan Pi (Moutan Cortex); Gui Shen (Angelicae Sinensis Radix Radix); Huai Shan Yao (Dioscoreae Hypoglaucae Rhizoma); Bai Bian Dou (Phaseoli Multiflori Semen); Fu Ling (Poria); Bai Shao (Paeoniae Radix Alba); Sheng Shu Gu Ya (Hordei Fructus Germinatus Raw/Roasted); Bai Qiang Wei Lu (Rosae Centifoliae Aqua).
Ren Yuan said: Postpartum diseases are hardest to treat, with most variations, difficult to exhaustively describe. Zhu Danxi said: Postpartum primarily uses great tonification; even with other syndromes, never treat them otherwise.
While true, it should not be rigidly applied. Young women with constitutionally robust bodies, or those with external Six Excess pathogens or internal stasis obstruction, should be treated according to their specific syndromes.
If one insists on postpartum must-be-tonified theory, not only will the primary disease persist, but other changes will inevitably arise. Newly delivered mothers have deficient hundred vessels, but if contracted pathogen, it becomes excess. Urgently removing the pathogen is how one nourishes Zheng (Righteous Qi). If encountering conditions suitable for purgation, using Bai Hu Tang or Cheng Qi Tang is not excessive. Prenatal care is similar. Writing prescriptions requires care, not negligence. Keep in mind the postpartum deficient body; if one strike hits the mark, easy regulation follows. If purely deficient, indeed great tonification is needed, with proper method, not just collecting a few blood-nourishing standard formulas to finish the job.
Furthermore, prenatal warming herbs should be cautious; postpartum cooling herbs should be cautious. Proverb says: Prenatal is a handful of fire, postpartum is a block of ice. Though not entirely accurate, it is not wrong.
Generally, prenatal is mostly excess, excess tends to be heat; postpartum is mostly deficiency, deficiency tends to be cold. This is logical.