典藏书目

Within seven days before and after childbirth, if fever, headache, and aversion to cold occur, do not exclusively diagnose it as Taiyang disease (disease of the Taiyang channel caused by pathogenic invasion); if fever, headache, and hypochondriac pain occur, do not exclusively diagnose it as Shaoyang disease (disease of the Shaoyang channel caused by pathogenic invasion). Both conditions arise from deficiency of both Qi and Blood, and disharmony of Yin and Yang, presenting symptoms similar to external contraction. Practitioners must be cautious and never lightly disregard the postpartum state, nor rigidly apply formulas from biased approaches such as using Mahuang Tang (Ephedra Decoction) to treat Taiyang-like conditions, or Chaihu Tang (Bupleurum Decoction) to treat Shaoyang-like conditions. This is because after blood loss in parturients, heavy sweating would lead to the disaster of "making deficiency more deficient," the consequences of which are beyond description.

In the past, Zhang Zhongjing stated: "Those who have lost blood should not be induced to sweat." Zhu Danxi stated: "Postpartum women should not be treated with exterior-releasing methods." These two masters did not mean that parturients truly lack concurrent cold pathogens, nor did they imply that Mahuang (Ephedrae Herba) and Chaihu (Bupleuri Radix) are inappropriate for specific syndromes; rather, they genuinely feared that later practitioners would neglect the postpartum condition due to biased approaches and casually use exterior-releasing methods based on fixed prescriptions. Although it is known that true wind-cold invasion can occur postpartum, the Xiong (Chuanxiong Rhizome) and Jiang (Zingiberis Rhizoma Preparatum) in Shenghua Tang (Decoction for Generating New Blood) can also disperse them. Furthermore, the *Neijing* states: "In the northwest, where the qi is dispersing and cold, one should use dispersing and cooling methods; in the southeast, where the qi is gathering and warm, one should use gathering and warming methods." This is what is meant by "treating the same disease differently." It refers to the fact that people in the southeast are physically delicate, while those in the northwest are robust, hence treatment methods differ. Although postpartum fatigue and deficiency require treatment that cannot simply be divided by north-south geography, one must prioritize the postpartum state and use tonification as the main approach, adding slight amounts of dispersing agents. Even if other symptoms exist, they should be treated as secondary issues; this principle must be clearly understood.

**Jiawei Shenghua Tang (Modified Decoction for Generating New Blood)**: Treats fever and headache within three days postpartum.
Ingredients: Chuanxiong Rhizome (1.5 qian), Danggui (Angelicae Sinensis Radix) (3 qian), Zhi Gancao (Prepared Licorice Root) (0.4 qian), Pao Jiang (Prepared Ginger) (0.4 qian), Taoren (Persicae Semen) (10 grains), Qianghuo (Notopterygii Rhizoma et Radix) (0.4 qian), Fangfeng (Saposhnikoviae Radix) (0.4 qian).
Take two doses.

If headache and body heat persist, add Baizhi (Angelicae Dahuricae Radix) 0.8 qian and Xixin (Asari Radix et Rhizoma) 0.4 qian. If the headache is severe as if breaking, add Lianxu (Nelumbinis Stamen) 1 qian and Congtou (Allii Cepae Bulbus) 5 pieces. For deficiency, add Renshen (Ginseng Radix et Rhizoma) 2 qian.

For postpartum conditions resembling Shanghan (Cold Damage) involving the Three Yin channels, presenting with tidal fever, sweating, and constipation, do not exclusively diagnose it as Yangming disease (disease of the Yangming channel); for dry mouth, throat, and thirst, do not exclusively diagnose it as Shaoyin disease (disease of the Shaoyin channel); for abdominal fullness, dry fluids, and solid stool, do not exclusively diagnose it as Taiyin disease (disease of the Taiyin channel); for sweating, delirium, and constipation, do not exclusively diagnose it as having dry fecal matter in the abdomen requiring purgation. These symptoms often result from labor and fatigue damaging the Spleen, leading to delayed transformation and transportation, exhaustion of Qi and Blood, and dryness of the Intestines and Bowels. This is a deficiency syndrome manifesting as excess, and it requires tonification. Practitioners should not rely on biased approaches to轻视 the postpartum state and rashly advocate using Chengqi Tang (Major Order the Qi Decoction) to treat these Three Yin-like conditions. Occasionally, young and strong individuals suffering from such conditions may survive accidental purgation without harm, but if weak postpartum women are mistakenly purged, the disaster of "making deficiency more deficient" is incalculable. There are frequent cases where mistaken purgation leads to dysphagia (Yi Ge), and misleading treatments cause further stagnation. It is also said that many cases of constipation due to blood deficiency are mistakenly purged, leading to incessant diarrhea.

**Yangzheng Tongyou Tang (Decoction for Nourishing Righteousness and Unblocking the Obstruction)**: Treats postpartum severe constipation resembling Three Yin Shanghan.
Ingredients: Chuanxiong Rhizome (1.5 qian), Danggui (Angelicae Sinensis Radix) (6 qian), Zhi Gancao (Prepared Licorice Root) (0.5 qian), Taoren (Persicae Semen) (15 grains), Roushouyu (Cynomorii Folium) (1 qian, washed in wine, remove scale), Chenpi (Citri Reticulatae Pericarpium) (0.4 qian), Hren (Canavaliae Semen / Hemp Seed) (1 qian).

If there is excessive sweating and solid stool, add Huangqi (Astragali Radix) 1 qian and Mahuanggen (Ephedrae Radix et Rhizoma) 1 qian. If there is dry mouth and thirst, add Maidong (Ophiopogonis Radix) 1 qian. If there is abdominal fullness, dry fluids, and solid stool, add Maidong (Ophiopogonis Radix) 1 qian, Renshen (Ginseng Radix et Rhizoma) 1 qian, and Roushouyu (Cynomorii Folium) 1 qian. If there is excessive sweating, delirium, and solid stool, this indicates exhaustion of Qi and Blood, decline of Shen (Spirit), and loss of control by the Heart Master; it is appropriate to nourish Ying (Nutritive Qi) and calm the Spirit. Add Fushen (Poria Cum Pinus) 1 qian, Zaoren (Ziziphi Spinosae Semen) 1 qian, Yuanzhi (Polygalae Radix) 1 qian, Baiziren (Biota Semen) 1 qian, Baizhu (Atractylodis Macrocephalae Rhizoma) 2 qian, Renshen (Ginseng Radix et Rhizoma) 1 qian, and Huangqi (Astragali Radix) 1 qian. For the above conditions with dry and hard stool, large doses of Chuanxiong Rhizome and Danggui (Angelicae Sinensis Radix) to tonify Blood are suitable; Renshen (Ginseng Radix et Rhizoma) dosage can be smaller. However, unless Chuanxiong and Danggui are used in quantities approaching a jin (approx. 500g), efficacy is difficult to achieve.

Generally, when parturients suffer from cold damage amidst deficiency, with possible food stagnation from cold, although external symptoms like headache, fever, hypochondriac pain, or lower back pain appear, resembling external contraction requiring sweating, one must still prioritize the prohibition of sweating due to postpartum blood loss. It is best to adjust and treat within Shenghua Tang (Decoction for Generating New Blood) with appropriate modifications. Similarly, for constipation, one must prioritize the postpartum state and the prohibition of purgation due to blood loss. It is most prudent to nourish righteousness, assist Blood, and unblock stagnation.

Another prescription: **Runchang Zhou (Intestine-Moistening Porridge)**. For prolonged postpartum constipation, use 1 sheng of Sesame seeds ground into powder, mixed with 2 he of rice, cooked into porridge and eaten to relieve constipation.