产后阴血暴竭，阳气无所根据，独侵于肺，故喘也。此为孤阳绝阴。最为难治。
凡产后血脱，劳伤之甚，气短似喘，无所倚恃，而呼吸息止违常矣。世有妄论痰火，用
散气
化痰之方，误人致夭多矣。夫肺受脾禀，运气生脉，通水道，顺呼吸，清肃上下，调和荣卫
，而为平人之常气也。值产血亡气脱，呼吸短促，言语不相接续，似喘危症，不待诊问自明
，不待智者而后知也。
加减生化汤 治分娩儿下，即患气短症。有血块，不加 、术。
川芎（二钱） 当归（四钱） 炙草（五分） 干姜（四分） 桃仁（十粒） 人参（二钱）
枣引，水煎，连服二三帖，然后可服续气养荣汤。
续气回阳汤 治产后气短促，问无血块痛，宜服此方。
川芎（二钱） 当归（四钱） 炙草（四分） 人参（三钱） 黄 （一钱） 白术（二钱） 陈皮
（四分） 熟地（二钱）
如足冷，加熟附五分。汗多，加麻黄根一钱，浮小麦一撮。渴，加麦冬一钱，五味子十
粒。
大便不通，加肉苁蓉一钱，麻仁一撮。伤饭面，加神曲一钱，麦芽五分。伤肉，加山楂五粒
，砂仁五分。又服滋荣益气复神汤。（方详八卷中。）
凡产后妄言妄见，由气血虚而神魂无倚也。夫心藏神主血，而言乃心之声也，心有血而
神存
，则言不妄发。又肝藏血而藏魂，而目乃肝之窍也，目得血而司视，则瞳 视正。若夫产后
血气暴竭，致心神失守，言语无伦，肝魂无倚，则瞳 妄见。况心为一身之主，目为百脉之
宗，虚症见于心目，则十二官各失其职矣。是以视听言动，皆由虚妄，治法当论产期，块痛
有无缓急。若娩儿之后，块痛未除，先服生化汤三帖，以化块定痛。服药痛止，即继服加参
生化汤；或补中益气汤，加安神定志汤丸调治之也。若产日久，形气血气俱不足，即当大补
为主，生养气血，安神定志，服至药力充足，其病全愈。病家毋救速效，医家毋论邪祟，若
喷以法水，惊以法尺，多致不救。屡治此病，服药十数帖方效。一妇妄言妄见，服补剂十五
帖方见效。丹溪云∶虚病犹似邪祟也。又云∶欲泄其邪，先补其虚，先调其气，次论诸疾。
此古人治虚弱人，有挟外因内之确论，但人不能体认其议用药，反言攻补难同于方，愚人必
攻邪尽，方可用补，病家不信难补，此医家治产后虚症，及年老人虚喘，弱人妄言，三症所
当用心也。
宁神生化汤 治产后血块痛未止，患妄言症，未可加 、术。
川芎（一钱） 当归（三钱） 炮姜（四分） 炙草（四分） 桃仁（十二粒） 茯神（一钱） 人
参（二钱） 益智仁（一钱，炒） 柏子仁（一钱） 陈皮（三分）
枣引，水煎服。
滋荣益气复神汤 治产后块痛止，可服此方。
川芎（一钱） 当归（二钱） 熟地（二钱） 炙甘（四分） 黄 （一钱） 白术（一钱） 人参
（二
钱） 茯神（一钱） 枣仁（二钱） 柏子仁（一钱） 益智（一钱，炒） 陈皮（三分） 麦冬（一钱
）五味子（十粒） 莲子（八个） 龙眼肉（八个）
枣引。
大抵产后患崩，曰血脱。短气似喘，曰气脱。妄言妄见，曰神脱。三症虽有阴血气阳之
分，
其精散神去之促，无异前晕症，治若少缓，亦危症也。若非浓药急方频服，失之夭者多矣。
误论气实痰火皆非也。若新产有块痛，并用加参生化汤，行中有补，斯免滞血，血虚之失也
。其块痛止，宜升举大补方，少佐以黄连，堕火以治崩脱，宁血归经也。用倍参补中益气汤
，少佐以附子，助参以治气脱，摄气归元也。宜滋荣益气复神汤，少佐痰剂以清心火，治神
脱，宁君主之官也。余因人妄论气脱、妄言等症，误用气实痰方药，屡夭人年，重复录告，
凡遇气胎痰重之症，必当补救，切不可用消散，误人以受夭殃。
产后阴血突然枯竭，阳气失去依附，独自侵犯肺脏，所以出现喘息。这属于孤阳绝阴的证候，是最难治疗的。
凡是产后血脱，劳损伤身严重，气短类似喘息，气息无所依托，导致呼吸节律失常。世间有人妄加议论认为是痰火所致，使用理气化痰的方剂，误人致死的情况很多。肺受脾的滋养，运行气机生成脉气，通调水道，顺应呼吸，清肃上下，调和营卫，这是健康人的正常生理状态。正值生产时血液流失、气随血脱，呼吸短促，言语不能接续，呈现类似喘息的危重症状，不需要诊断询问就能明白，不需要智者才能知晓。
加减生化汤：治疗分娩后即刻出现气短症状。如果有血块，不加白芍、白术。
川芎（二钱） 当归（四钱） 炙甘草（五分） 干姜（四分） 桃仁（十粒） 人参（二钱）
用大枣为引，水煎服，连续服用二三帖后，再服用续气养荣汤。
续气回阳汤：治疗产后气短急促，询问没有血块疼痛，适宜服用此方。
川芎（二钱） 当归（四钱） 炙甘草（四分） 人参（三钱） 黄芪（一钱） 白术（二钱） 陈皮（四分） 熟地黄（二钱）
如果脚冷，加熟附子五分。汗多，加麻黄根一钱，浮小麦一撮。口渴，加麦冬一钱，五味子十粒。
大便不通，加肉苁蓉一钱，火麻仁一撮。饮食积滞于米面，加神曲一钱，麦芽五分。饮食积滞于肉类，加山楂五粒，砂仁五分。又服用滋荣益气复神汤。（该方详见第八卷中。）
凡是产后胡言乱语、幻视幻听，是由于气血虚弱，神魂没有依托所致。心藏神主司血液，言语是心的声音，心有血液而神志存在，则言语不会胡乱发出。肝藏血而藏魂，眼睛是肝的窍穴，眼睛得到血液滋养而能视物，则瞳孔视力正常。如果产后气血突然枯竭，导致心神失守，言语无条理，肝魂无依托，则瞳孔出现妄见。况且心是一身的主宰，目是百脉的宗汇，虚证表现在心和目上，则十二脏腑都失去了各自的职能。因此视听言行，都由虚妄引起，治疗方法应当根据产期长短、有无血块疼痛来论定缓急。如果在娩出胎儿之后，血块疼痛未消除，先服用生化汤三帖，以化瘀定痛。服药后疼痛停止，接着服用加参生化汤；或者补中益气汤，配合安神定志汤丸进行调理。如果生产时间已久，形体气血都不足，就应当以大补为主，生养气血，安神定志，服用到药力充足，疾病痊愈。病人不要追求速效，医生不要谈论邪祟，如果用符水喷洒，用法尺惊吓，大多导致无法救治。多次治疗此类疾病，服药十几帖才见效。有一位妇女胡言乱语、幻视幻听，服用补益剂十五帖才见效。朱丹溪说：“虚病好像邪祟一样。”又说：“想要祛除邪气，先要补其虚损，先调理气机，其次再讨论其他疾病。”这是古人治疗虚弱之人兼夹外因的确切论述，只是人们不能体认其中的议用药道理，反而说攻邪与补虚难以同用一方，愚昧的人一定要将邪气攻尽，然后才可用补法，病人不相信难以进补，这是医生在治疗产后虚症、老年人虚喘、体弱者妄言这三种病症时应当用心思考的。
宁神生化汤：治疗产后血块疼痛未止，出现胡言乱语症状，不可加白芍、白术。
川芎（一钱） 当归（三钱） 炮姜（四分） 炙甘草（四分） 桃仁（十二粒） 茯神（一钱） 人参（二钱） 益智仁（一钱，炒） 柏子仁（一钱） 陈皮（三分）
用大枣为引，水煎服。
滋荣益气复神汤：治疗产后血块疼痛停止，可服用此方。
川芎（一钱） 当归（二钱） 熟地黄（二钱） 炙甘草（四分） 黄芪（一钱） 白术（一钱） 人参（二钱） 茯神（一钱） 酸枣仁（二钱） 柏子仁（一钱） 益智仁（一钱，炒） 陈皮（三分） 麦冬（一钱） 五味子（十粒） 莲子（八个） 龙眼肉（八个）
用大枣为引。
大抵产后患崩漏，称为血脱。气短似喘，称为气脱。胡言乱语、幻视幻听，称为神脱。这三种症状虽然分为阴血、气阳的不同，但其精气散失、神志离去的危急程度，与前文的晕厥症状无异，治疗如果稍有迟缓，也是危重病症。如果不是浓药急方频繁服用，错失时机致死者很多。错误地议论为气实痰火都是不对的。如果是新近生产有血块疼痛，并用加参生化汤，在行血中有补益作用，这样可以避免瘀血滞留导致的血虚失治。血块疼痛停止后，宜用升举大补方，少佐黄连，降火以治疗崩脱，使血归经。用加倍人参的补中益气汤，少佐附子，辅助人参以治疗气脱，摄纳气机归于元气。宜用滋荣益气复神汤，少佐化痰剂以清心火，治疗神脱，安宁君主之官。我因为看到有人妄论气脱、妄言等症，误用气实痰火的方药，屡次使人夭折，再次记录告诫，凡遇到气胎痰重的症状，必须当补救，切不可使用消散之法，误人遭受夭折之祸。
Postpartum, Yin blood is suddenly exhausted, and Yang Qi has no basis for attachment. It invades the Lung independently, thus causing panting. This is a condition of "Lone Yang and Absent Yin," which is the most difficult to treat.
In cases of postpartum blood loss with severe physical exhaustion, shortness of breath resembling panting occurs because the Qi has nothing to rely upon, leading to abnormal respiratory rhythms. In the world, there are those who rashly attribute this to Phlegm-Fire and use formulas that disperse Qi and resolve Phlegm, mistakenly harming people to the point of death. The Lung receives nourishment from the Spleen, regulates Qi mechanism to generate pulse Qi, unblocks water passages, facilitates respiration, clears and descends the upper and lower Jiao, and harmonizes Ying (Nutritive) and Wei (Defensive) Qi; this constitutes the normal physiological state of a healthy person. At the time of childbirth, when blood is lost and Qi escapes with it, breathing becomes short and rapid, speech cannot continue, presenting a critical symptom resembling panting. This does not require diagnosis or inquiry to understand, nor does it require a wise person to recognize it.
Jiajian Shenghua Decoction: Treats shortness of breath occurring immediately after delivery. If blood clots are present, do not add Baishao (White Peony Root) and Baizhu (Atractylodes Macrocephala Rhizome).
Chuanxiong (2 qian) Danggui (4 qian) Zhi Cao (5 fen) Ganjiang (4 fen) Taoren (10 grains) Renshen (2 qian)
Use Jujube as an guide, decoct in water, take continuously for 2-3 doses, then one may take Xuqi Yangrong Decoction.
Xuqi Huiyang Decoction: Treats postpartum shortness of breath and rapidity, where there is no pain from blood clots upon inquiry; this formula is suitable.
Chuanxiong (2 qian) Danggui (4 qian) Zhi Cao (4 fen) Renshen (3 qian) Huangqi (1 qian) Baizhu (2 qian) Chenpi (4 fen) Shudi (2 qian)
If feet are cold, add Shu Fuzi (5 fen). If sweating is excessive, add Mahuanggen (1 qian) and Xiaomai (a pinch). If thirsty, add Maidong (1 qian) and Wuweizi (10 grains).
If stool is obstructed, add Rongzong (1 qian) and Huomaren (a pinch). If food stagnation is due to rice/flour, add Shenqu (1 qian) and Maiya (5 fen). If food stagnation is due to meat, add Shanzha (5 grains) and Sharen (5 fen). Also take Zirong Yiqi Fushen Decoction. (See Volume 8 for details.)
Postpartum rambling speech and visual hallucinations arise from deficiency of Qi and Blood, leaving the Hun (Ethereal Soul) and Shen (Spirit) without support. The Heart stores Shen and governs Blood; speech is the voice of the Heart. When the Heart has Blood and Shen resides, speech is not erratic. The Liver stores Blood and houses the Hun; the eyes are the opening of the Liver. When the eyes receive Blood, vision is regulated, and pupils see correctly. However, if postpartum Blood and Qi are suddenly exhausted, causing the Heart Shen to lose its hold, resulting in incoherent speech, and the Liver Hun lacking support, leading to visual hallucinations, consider that the Heart is the master of the whole body, and the eyes are the gathering point of all vessels. When deficiency manifests in the Heart and Eyes, the Twelve Officials each lose their functions. Therefore, seeing, hearing, speaking, and moving are all caused by deficiency and illusion. Treatment methods should be determined based on the postpartum period duration and the presence or absence of clot-related pain. If after delivering the infant, clot pain remains, first administer Shenghua Decoction for three doses to dissolve clots and relieve pain. Once pain ceases after medication, subsequently administer Jiashen Shenghua Decoction; or Buzhong Yiqi Decoction, combined with Anshen Zhizhi Pills/Powders for regulation. If childbirth occurred long ago and both form and Qi/Blood are insufficient, major tonification should be the primary approach to generate and nourish Qi and Blood, calm the Spirit, and stabilize the Will. Continue until medicinal strength is sufficient and the disease is fully cured. Patients should not seek rapid effects; physicians should not discuss evil spirits. Using talismanic water sprays or ritual rulers to frighten often leads to untreatable conditions. I have treated this disease repeatedly, finding efficacy only after more than ten doses. One woman with rambling speech and hallucinations showed improvement only after fifteen doses of tonics. Danxi stated: "Deficiency diseases resemble evil spirit possession." He also said: "To drain the pathogen, first tonify the deficiency; first regulate Qi, then address other ailments." This is a definitive theory from ancients regarding treating weak individuals with concurrent external pathogens. However, people fail to comprehend the rationale behind prescribing, instead claiming that attacking pathogens and tonifying deficiency cannot be combined in one formula. Foolish practitioners insist on completely eliminating pathogens before using tonics. Patients distrust tonics. These are points requiring careful consideration for physicians treating postpartum deficiency, elderly deficiency panting, and weak individuals' rambling speech.
Ningshen Shenghua Decoction: Treats postpartum persistent clot pain accompanied by rambling speech; do not add Baishao and Baizhu.
Chuanxiong (1 qian) Danggui (3 qian) Paojiang (4 fen) Zhi Cao (4 fen) Taoren (12 grains) Fushen (1 qian) Renshen (2 qian) Yizhiren (1 qian, stir-fried) Baiziren (1 qian) Chenpi (3 fen)
Use Jujube as a guide, decoct in water and take.
Zirong Yiqi Fushen Decoction: Treats postpartum condition after clot pain has ceased; this formula is suitable.
Chuanxiong (1 qian) Danggui (2 qian) Shudi (2 qian) Zhi Gancao (4 fen) Huangqi (1 qian) Baizhu (1 qian) Renshen (2 qian) Fushen (1 qian) Suanzaoren (2 qian) Baiziren (1 qian) Yizhi (1 qian, stir-fried) Chenpi (3 fen) Maidong (1 qian) Wuweizi (10 grains) Lianzi (8 seeds) Longyanrou (8 pieces)
Use Jujube as a guide.
Generally, postpartum metrorrhagia is called "Blood Collapse" (Xue Tuo). Shortness of breath resembling panting is called "Qi Collapse" (Qi Tuo). Rambling speech and hallucinations are called "Shen Collapse" (Shen Tuo). Although these three symptoms differ in terms of Yin Blood and Qi/Yang, the urgency of essence scattering and spirit departing is no different from previous syncope symptoms. If treatment is delayed even slightly, it is also a critical condition. If thick medicines and urgent prescriptions are not taken frequently, many will die due to missed opportunities. Erroneously attributing this to Excess Qi and Phlegm-Fire is incorrect. For recent childbirth with clot pain, use Jiashen Shenghua Decoction; this promotes blood circulation while providing tonification, thereby avoiding stagnation of blood and loss due to blood deficiency. Once clot pain stops, use Shengju Dabu Formula with a small addition of Huanglian to descend fire and treat metrorrhagia, calming blood and returning it to its vessels. Use Buzhong Yiqi Decoction with double the amount of Renshen, with a small addition of Fuzi to assist Renshen in treating Qi Collapse, capturing Qi and returning it to the Yuan (Original) Qi. Use Zirong Yiqi Fushen Decoction with a small addition of phlegm-resolving agents to clear Heart Fire, treating Shen Collapse and pacifying the Monarch organ. Due to others' erroneous discussions on Qi Collapse and rambling speech, and the frequent misuse of formulas for Excess Qi and Phlegm, causing many deaths, I repeat this record to warn: for any symptoms involving heavy Qi, fetal issues, or Phlegm, remediation must be applied; one must absolutely avoid using dispersing methods, lest one harm people and bring about premature death.