妇人胎中。有血衣以裹儿。血衣之下。又有水衣以衬垫之。将产则胎水先破。水衣先下。然后血衣破而儿
生。儿生之后。血衣乃下。世谓水衣垫胎。水衣既行。则其胎颠坠。是以儿出。此乃着迹之论。未得其所以然
也。夫胎产之事。乃关气化。岂犹什物之衬垫悬坠所可拟者。吾为指出其理曰。天地之大。总是以阳统阴。
人身之生。总是以气统血。气乃肾中水化之阳。故气着于物。还复为水。吾是以有气即是水之论。妇人怀
子垫胎之水衣。即气也。胎乃气载举之。气即是水。故水垫其胎。实则气载其血也。将产之时。水衣先行。气
下行。故水下行。水行实则气行也。气既下行。则其胎血自随之而下。血之从气。又岂有气行而血不行者
哉。故胎之未生。气载之。胎之将产。气运之。知此。则知护胎者。必调气。催生者必行气。而治一切血证皆宜
治气。均可于此悟出。
将产之时。腰腹大痛者。以气欲行。而血未行。血阻其气。而气必欲迫之使行。故令大痛。此必初胎初产之
妇。血道新开。碍气之行。故其痛或甚。或数产之妇。内有瘀血阻滞其气。故令大痛。若壮妇身无瘀血。则将
产时微痛而已。或微胀而已。盖其气行而血随之下。血道既是熟路。又无瘀血阻滞。何痛之有。其极痛而
胎不下者。催生之法。总宜行血。不使阻滞其气。则气下而胎随以下。佛手散主之。交骨不开者。加败龟板。
及妇人油发烧灰。义总取于活血。血活则气通。胎顺而自生矣。
既产之后。身痛腰痛。恶血不尽。阻滞其气。故作痛也。盖离经之血。必须下行不留。斯气无阻滞。自不作痛。
又能生长新血。若瘀血不去。则新血不生。且多痛楚。宜归芎失笑散。及生化汤治之。夫产后百脉空虚。亟
宜补血。而犹力主去瘀者。瘀血不去。则新血断无生理。吾于男女异同论。已详言之。虽产后大虚。仍以去
瘀为急。去瘀正为生新计也。吐衄家须去瘀血。观此益信。
产后血晕。由血随气上。迷乱心神。故眼前生花。甚者闷绝口噤。神昏气冷。有下血过多而晕者。属虚。但昏
闷烦乱而已。法当补血。宜炙甘草汤。及八珍汤。加枣仁龙骨朱砂丹皮。有下血少而晕者。乃恶露上抢于
心。心下满急。神昏口噤。绝不知人。法当破血。宜当归延胡索血竭没药荆芥穗京墨 红醋淬童便引。血
晕之证。吐衄家间亦有之。医者不可不知。
产后血崩。乃荣气空虚。不能摄血归经。大剂归脾汤主之。如兼汗出气喘者。乃是血脱气散之危证。参附
汤。加阿胶熟地茯苓甘草以救之。然又有怒气伤肝。肝气横决。血因不藏者。归脾汤。加炒栀子阿胶艾叶
柴胡。逍遥散。加阿胶牡蛎棕炭炒栀莲叶香附皆宜。
败血干肺。口鼻黑色。面如茄色。或发鼻衄。乃气逆血升之危候。或则喘急。或咳逆欲死。总缘肺虚。不能制
节其下。是以下行之血。得以上干。宜参苏饮主之。鼻衄。加杏仁。喘咳。加五味。吐衄家血干肺脏者。亦与此
同。败血干心。心气闭塞。舌强不语。神昏谵语。如见鬼状。宜归芎失笑散。加龙脑朱砂血竭没药治之。牛膝
散。加枣仁琥珀熟地人参。皆宜。
败血干脾。则呕逆腹胀。不能饮食。生化汤。加半夏茯苓枳壳浓朴。如发为水肿。是血从水化。而变为水。与
血变为脓无异。既从水化。则从水治之。五苓散。加蒲黄丹皮以利之。
总之。血以下行为顺。上行为逆。知产血上逆之为病。则愈知吐衄之血上逆为病也。但吐衄与产血。其病
原不同。故治法亦异。此外尚有数证。乃产后多有之证。亦与吐衄义可参观。因连类及之。条列如下。
产后喘促。最危之候。因荣血暴竭。卫气无根据。为血脱气散之证。宜参附汤饮之。四磨汤亦可。若因败血乘
肺。气喘目黑。鼻起烟煤者。是为肺气将绝之证。参苏饮治之。二证。一是肾气虚脱。而阳上越。一是肺气虚
竭。而血上乘。两方皆主人参。大生水津。水者。气之母也。方主补气。故用人参以滋水。滋水即是补气。而阳
上越者。佐附子以引之归根。血上干者。佐苏木以速之下降。诚产后救危之良方。男子血气脱绝之证。亦
不能外此义也。
产后汗出。身微似汗者吉。盖产后血虚。微汗则气来就血。阳来和阴。汗者气分之水也。产后血不足而气
有余。故微泄其气。以与血配。最吉之兆。若阴虚于内。阳浮于外。 汗出。是为自汗。与微汗有别。法宜补
阴而引阳。圣愈汤。加附子五味麦冬龙骨治之。若大汗亡阳。其汗如水之流。乃元气脱散。气即水也。气脱
故大汗。非大剂参附汤。不能回阳。又有但头汗出。剂颈而还者。乃血不得其和。气因郁而上蒸。故但头汗。
仲景谓之郁冒。用小柴胡汤解之。盗汗阴虚者。当归六黄汤治之。此与吐衄家汗出诸证有相通处。宜参观之。
产后发热。因阴血暴伤。阳无所附。四物汤加炮姜。从阴引阳。为正治之法。若头痛恶寒而发热者。属外感。
不当作寻常伤寒治之。惟宜用四物汤。加荆芥柴胡葱白。和血解表而愈。又有停食发热者。必见胀闷嗳
气呕哕等证。异功散。加山楂神曲麦芽浓朴生姜治之。若因瘀血壅滞而发热者。必见身腹等处刺痛之
证。生化汤治之。若去血过多。烦躁口渴。面赤身热者。当归补血汤治之。若阴虚阳无所附。孤阳外越。而发
热者。急进参附汤救之。金鉴此条。于产后发热虚实之证略备。与男子亡血发热者。治法相同。但亡血是
血上行。产后是血下行。一逆一顺。其间略有不同耳。
产后杂证犹多。所举数条。皆与吐血之证有互相发明者。其余不及备载。另有产科诸书可查。
又补论曰。产后气下泄。故多脱证。吐血气上逆。故少脱证。吐血之脱证皆宜降。产后之脱证则宜升。此绝不同。
妇女在妊娠期间，胞宫内有“血衣”包裹着胎儿。在血衣之下，又有“水衣”作为衬垫。临产时，胎水首先破裂，“水衣”先排出，随后“血衣”破裂，胎儿出生。胎儿出生后，“血衣”才随之排出。世人认为“水衣”是垫在胎下的，因为“水衣”先行排出，导致胎头下坠，从而促使胎儿娩出。这是一种拘泥于表象的论断，并未探求其根本原理。
其实，胎产之事，关乎气化功能，岂能像普通器物那样用衬垫和悬坠来比拟呢？我指出其中的道理：天地之间，总是以阳统摄阴；人体的生命活动，总是以气统摄血。气是由肾中水液转化而来的阳气，所以气附着于物体上，又会还原为水。因此我有“气即是水”的理论。妇人怀孕时垫胎的“水衣”，其实就是气。胎儿是由气承载举托的，既然气就是水，所以说水在垫胎，实际上是气在承载血液。临产之时，“水衣”先行，是因为气向下运行，所以水也向下运行；水的下行实际上反映了气的下行。气既然向下运行，那么胎血自然随之而下。血跟随气而行，难道有气行而血不行的道理吗？所以，胎儿未生时，由气承载；胎儿将产时，由气推动。明白了这一点，就知道护胎必须调气，催生必须行气，而治疗一切血证也都应当治气，这些道理都可以由此悟出。
临产时腰腹部剧烈疼痛，是因为气欲下行而血未下行，血阻滞了气，气必然想要逼迫血使其下行，从而导致剧烈疼痛。这多见于初产妇，因为血道初次开启，阻碍了气的运行，所以疼痛可能很严重。或者是多次生产的妇女，体内有瘀血阻滞了气，也会导致剧烈疼痛。如果是身体强壮、体内无瘀血的妇女，临产时只是轻微疼痛，或者只是轻微胀感罢了。这是因为气下行而血随之而下，血道既然是熟路，又没有瘀血阻滞，有什么疼痛可言呢？如果疼痛极度剧烈且胎儿不下，催生的方法总宜活血，不让血阻滞气，这样气下行而胎儿随之而下。主方用佛手散。如果交骨（耻骨联合）不开，加败龟板及妇人头发烧成的灰。其义总在于活血，血活则气通，胎儿顺利便能产出。
产后身体疼痛、腰痛，是因为恶露不尽，阻滞了气机，所以产生疼痛。凡是离经之血，必须下行而不留滞，这样气就没有阻滞，自然不作痛，又能生长新血。如果瘀血不去，新血就无法生成，而且会多受痛苦。宜用归芎失笑散及生化汤治疗。产后百脉空虚，急需补血，但我仍极力主张先去瘀，因为瘀血不去，新血就绝对没有生成的生机。我在《男女异同论》中已详细论述过。虽然产后大虚，仍以去瘀为急务，去瘀正是为了生新。吐血、衄血患者也需要去瘀血，看了这点更加相信。
产后血晕，是由于血随气上逆，迷乱心神，所以眼前出现金花。严重的会出现闷绝、口噤、神志昏迷、四肢厥冷。有的是因下血过多导致的晕厥，属于虚证，只是昏闷烦乱而已。治法应当补血，宜用炙甘草汤及八珍汤，加酸枣仁、龙骨、朱砂、牡丹皮。有的是因下血少而晕厥，这是恶露上冲于心，心下满闷急迫，神志昏迷、口噤、完全不知人事。治法应当破血，宜用当归、延胡索、血竭、没药、荆芥穗、京墨，用红醋淬后，以童便为引。血晕这一病症，吐血、衄血患者间也有发生，医者不可不知道。
产后血崩，是因为营气空虚，不能摄血归经。宜用大剂量的归脾汤主治。如果兼有汗出、气喘，这是血脱气散的危重证候，用参附汤，加阿胶、熟地黄、茯苓、甘草来救治。然而又有因怒气伤肝，肝气横逆决裂，导致血不能藏纳的情况，可用归脾汤加炒栀子、阿胶、艾叶、柴胡；或者逍遥散加阿胶、牡蛎、棕榈炭、炒栀子、莲叶、香附，都适宜。
败血干犯肺脏，表现为口鼻发黑，面色如茄子色，或者发生鼻衄，这是气逆血升的危重征象。或者出现喘急，或者咳嗽气逆欲死，总原因是肺虚，不能制约下部，所以下行的血得以向上干犯。宜用参苏饮主治。鼻衄者，加杏仁；喘咳者，加五味子。吐血、衄血患者若血干犯肺脏，也与这种情况相同。败血干犯心脏，导致心气闭塞，舌强不语，神志昏迷、胡言乱语，如同见鬼一般。宜用归芎失笑散加龙脑、朱砂、血竭、没药治疗；或者牛膝散加酸枣仁、琥珀、熟地黄、人参，都适宜。
败血干犯脾脏，则出现呕吐、腹胀、不能饮食。用生化汤加半夏、茯苓、枳壳、厚朴。如果发展为水肿，这是血转化为水，变成了水邪，与血化为脓无异。既然从水化，就按水病治疗，用五苓散加蒲黄、牡丹皮以利水。
总之，血以下行为顺，上行为逆。知道了产后血上逆致病，就更知道吐血、衄血的血上逆也是致病原因。但吐血、衄血与产后出血，其病因不同，所以治疗方法也不同。此外还有几种病症，是产后常见的，其义理也可与吐血、衄血互相参照，因此连带列出如下。
产后喘促，是最危险的征候。因为营血突然枯竭，卫气无所依附，属于血脱气散的证候。宜饮用参附汤。四磨汤也可以使用。如果是因败血乘袭肺脏，气喘、目黑、鼻起烟煤状物，这是肺气将绝的证候，用参苏饮治疗。这两种情况，一种是肾气虚脱而阳气上越，一种是肺气虚竭而血上乘。两个方子都以人参为主，大补生水津。水是气的母亲，方子主旨补气，所以用人参来滋水，滋水即是补气。对于阳气上越的，佐以附子引导其归根；对于血上干的，佐以苏木加速其下降。这确实是产后急救危证的良方。男子血气脱绝的证候，也不能脱离这个义理。
产后出汗，身上微微似有汗出的为吉兆。因为产后血虚，微汗则气来就血，阳来调和阴。汗是气分中的水液。产后血不足而气有余，所以微微泄出其气，以与血相配，这是最吉祥的征兆。如果是阴虚于内，阳浮于外，出汗，这叫自汗，与微汗不同。治法宜补阴而引阳，用圣愈汤加附子、五味子、麦冬、龙骨治疗。如果是大汗亡阳，汗如水直流，这是元气脱散，气即水，气脱故大汗，非大剂量参附汤不能回阳。又有仅头部出汗，到颈部而止的，这是血不得调和，气因郁结而上蒸，所以仅头部出汗，张仲景称之为郁冒，用小柴胡汤解表。盗汗属阴虚的，用当归六黄汤治疗。这与吐血、衄血患者的汗出诸证有相通之处，宜互相参照。
产后发热，因阴血突然受伤，阳无所依附，用四物汤加炮姜，从阴引阳，是正治之法。如果有头痛、恶寒而发热的，属于外感，不应当当作寻常伤寒治疗，只宜用四物汤加荆芥、柴胡、葱白，和血解表而痊愈。又有因停食发热的，必定见到胀闷、嗳气、呕哕等症状，用异功散加山楂、神曲、麦芽、厚朴、生姜治疗。如果是因瘀血壅滞而发热，必定见到身体、腹部等处刺痛的症状，用生化汤治疗。如果去血过多，烦躁口渴，面赤身热，用当归补血汤治疗。如果是阴虚阳无所依附，孤阳外越而发热，急进参附汤救治。《医宗金鉴》此条，对产后发热虚实各证略备，与男子亡血发热的治法相同。只是亡血是血上行，产后是血下行，一逆一顺，其间略有不同罢了。
During pregnancy, the uterus contains a "blood coat" (a membrane-like structure formed by blood) wrapping the fetus. Beneath this blood coat lies a "water coat" (amniotic fluid/membrane) acting as a cushion. At the time of delivery, the amniotic sac first ruptures, and the water coat is expelled first. Subsequently, the blood coat breaks, and the infant is born. After the infant is delivered, the blood coat is then expelled. The common belief holds that the water coat cushions the fetus; because the water coat is expelled first, it causes the fetal head to descend, thereby facilitating birth. This is a superficial argument that fails to grasp the underlying mechanism.
In fact, matters of gestation and childbirth are related to Qi transformation (Qi Hua), and cannot be compared to ordinary objects relying on physical cushioning or suspension. I elucidate the principle thus: In the vast universe, Yang always governs Yin. In human life, Qi always governs Blood. Qi is the Yang aspect transformed from Kidney Water. Therefore, when Qi attaches to matter, it reverts to water. Hence, my theory states that "Qi is Water." The "water coat" that cushions the fetus during pregnancy is essentially Qi. The fetus is carried and supported by Qi. Since Qi is Water, although we say water cushions the fetus, in reality, Qi carries the Blood. At the time of delivery, the water coat goes first because Qi moves downward; thus, water moves downward. The movement of water actually reflects the movement of Qi. Once Qi moves downward, the uterine blood naturally follows. Blood follows Qi; how could there be a case where Qi moves but Blood does not? Therefore, before birth, the fetus is carried by Qi; at the time of birth, the fetus is propelled by Qi. Understanding this, one knows that protecting the fetus requires regulating Qi, inducing labor requires promoting Qi movement, and treating all blood disorders should also involve treating Qi. These insights can be derived from this principle.
Severe pain in the lower back and abdomen during labor occurs because Qi desires to move downward while Blood has not yet moved. Blood obstructs Qi, and Qi forcefully attempts to compel Blood to move, causing severe pain. This is common in first-time mothers whose birth canal is newly opened, creating resistance to Qi flow, leading to intense pain. It may also occur in multiparous women due to internal blood stasis obstructing Qi. However, in robust women without blood stasis, labor involves only mild pain or slight distension. This is because Qi descends and Blood follows; since the birth canal is familiar and free of stasis, why would there be pain? If pain is extreme and the fetus does not deliver, the method for inducing labor should primarily focus on invigorating Blood to prevent obstruction of Qi. When Qi descends, the fetus will follow. The principal formula is Foshou San (Buddha's Hand Powder). If the pubic symphysis (Jiaogu) fails to open, add Gui Ban Jiao (Tortoise Shell Gelatin) and ash from burnt human hair. The rationale is to invigorate Blood; when Blood flows freely, Qi unblocks, and the fetus delivers smoothly.
Postpartum body pain and lower back pain result from incomplete expulsion of lochia (evil blood), which obstructs Qi mechanism, causing pain. Blood that has left its vessels must descend and not remain stagnant; otherwise, Qi will be obstructed, leading to pain. Furthermore, if stasis remains, new Blood cannot be generated, resulting in suffering. The appropriate treatments are Guixiong Shixiao San (Angelica and Ligusticum Shixiao Powder) and Shenghua Tang (Generation of New Blood Decoction). Although postpartum deficiency of all meridians necessitates tonifying Blood, I strongly emphasize removing stasis first. Without removing stasis, new Blood cannot possibly be generated. As detailed in my discussion on gender differences, despite severe postpartum deficiency, removing stasis is urgent because it is the prerequisite for generating new Blood. Patients with hematemesis or epistaxis also require removal of stasis, confirming this view.
Postpartum syncope (Blood Dizziness) is caused by Blood ascending with Qi, confusing the Spirit (Shen), leading to visual disturbances like seeing flowers. Severe cases present with coma, locked jaws, unconsciousness, and cold limbs. Syncope due to excessive bleeding belongs to Deficiency, characterized merely by drowsiness and restlessness. The treatment should tonify Blood, using Zhigancao Tang (Licorice Decoction) or Bazhen Tang (Eight Treasures Decoction) supplemented with Suanzaoren (Ziziphus Seed), Longgu (Dragon Bone), Zhusha (Cinnabar), and Mudanpi (Moutan Bark). Syncope with minimal bleeding indicates lochia rushing upward to the Heart, causing fullness and urgency below the heart, coma, locked jaws, and loss of consciousness. The treatment should break Blood stasis, using Danggui (Angelica Sinensis), Yanhusuo (Corydalis Rhizome), Xuejie (Dragon's Blood), Moyao (Myrrh), Jingjiesui (Schizonepeta Spike), and Jingmo (Beijing Ink), quenched in Hongcu (Red Vinegar), and guided by Tongbian (Child's Urine). Syncope can also occur in patients with hematemesis or epistaxis; physicians must be aware of this.
Postpartum metrorrhagia (profuse bleeding) results from emptiness of Ying Qi (Nutritive Qi), failing to control Blood within its vessels. A large dose of Guipi Tang (Restore the Spleen Decoction) is indicated. If accompanied by sweating and panting, it signifies a critical condition of Blood depletion and Qi scattering. Treat with Shenfu Tang (Ginseng and Aconite Decoction) plus Ejiao (Donkey-hide Gelatin), Shudi (Rehmannia Root), Fuling (Poria), and Gancao (Licorice). Alternatively, anger injuring the Liver may cause Liver Qi to surge recklessly, preventing Blood storage. In such cases, Guipi Tang plus Chao Zhizi (Fried Gardenia), Ejiao, Aiye (Mugwort Leaf), and Chaihu (Bupleurum Root) is suitable. Or Xiaoyao San (Free and Easy Wanderer Powder) plus Ejiao, Muli (Oyster Shell), Zongtan (Palmito Char), Chao Zhizi, Lianye (Lotus Leaf), and Xiangfu (Cyperus Rhizome) is also appropriate.
Stasis interfering with the Lung manifests as blackening of the mouth and nose, a face color resembling an eggplant, or epistaxis. This is a critical sign of rebellious Qi and ascending Blood. Symptoms may include急促 breathing or violent coughing. The root cause is Lung deficiency, failing to regulate the lower aspects, allowing descending Blood to ascend and interfere. Treat with Rensu Yin (Ginseng and Perilla Drink). Add Xingren (Apricot Seed) for epistaxis; add Wuweizi (Schisandra Berry) for coughing. Patients with hematemesis or epistaxis suffering from dryness affecting the Lung are treated similarly. Stasis interfering with the Heart causes Heart Qi blockage, stiff tongue, aphasia, coma, delirium, and hallucinations. Treat with Guixiong Shixiao San plus Nao Bing (Borneol), Zhusha, Xuejie, and Moyao. Niuxi San (Achyranthes Powder) plus Suanzaoren, Hupo (Amber), Shudi, and Renshen is also suitable.
Stasis interfering with the Spleen causes vomiting, abdominal distension, and anorexia. Treat with Shenghua Tang plus Banxia (Pinellia Tuber), Fuling, Zhike (Immature Bitter Orange), and Houpo (Magnolia Bark). If edema develops, it indicates Blood transforming into Water, similar to Blood turning into pus. Since it transforms via Water, treat it as a Water disorder using Wuling San (Five-Ingredient Powder with Poria) plus Huangpu (Polygonatum Rhizome - *Note: Text says Pu Huang, likely Lygodii Spora*) and Mudanpi to promote diuresis.
In summary, Blood moving downward is favorable (Shun); moving upward is unfavorable (Ni). Understanding that postpartum Blood rebellion causes disease clarifies that upward-rebellious Blood in hematemesis/epistaxis is also pathological. However, the etiology differs between postpartum conditions and hemorrhagic diseases, so treatments differ. Several other postpartum syndromes share principles with hematemesis and are listed below for reference.
Postpartum panting is a critical sign. It results from sudden exhaustion of Ying Blood, leaving Wei Qi (Defensive Qi) without support, indicating Blood depletion and Qi scattering. Treat with Shenfu Tang. Simo Tang (Four-Mortar Decoction) may also be used. If panting, black vision, and soot-like nasal discharge occur due to stasis attacking the Lung, it indicates impending Lung Qi exhaustion. Treat with Rensu Yin. These two conditions represent either Kidney Qi deficiency with Yang floating upward, or Lung Qi exhaustion with Blood ascending. Both formulas prioritize Renshen (Ginseng) to generate abundant fluids. Water is the mother of Qi; tonifying Qi via Ginseng generates Water. For floating Yang, add Fuzi (Aconite Root) to guide it back to its root. For ascending Blood, add Sumu (Sappan Wood) to accelerate its descent. These are excellent emergency formulas for postpartum crises, applicable to men suffering from Qi and Blood collapse as well.
Postpartum sweating: Mild perspiration is auspicious. Postpartum Blood deficiency allows Qi to join Blood, and Yang to harmonize Yin. Sweat is water within the Qi aspect. With insufficient Blood and excess Qi, mild sweating releases excess Qi to match Blood, which is a good sign. Internal Yin deficiency with external Yang floating causes spontaneous sweating (Zihan), distinct from mild sweating. Treat by tonifying Yin and guiding Yang using Shengyu Tang (Generate Survival Decoction) plus Fuzi, Wuweizi, Maidong (Ophiopogon Tuber), and Longgu. Profuse sweating resembling flowing water indicates Yang collapse and Yuan Qi scattering. Since Qi is Water, Qi collapse causes profuse sweating; only a large dose of Shenfu Tang can restore Yang. Sweating limited to the head, stopping at the neck, indicates Blood disharmony and Qi steaming upward due to depression. Zhang Zhongjing calls this Yu Mao (Depression and Fullness); treat with Xiao Chaihu Tang (Minor Bupleurum Decoction). Night sweats due to Yin deficiency are treated with Danggui Liuhuang Tang (Angelica Six-Huang Decoction). These relate to sweating patterns in hematemesis/epistaxis and should be cross-referenced.
Postpartum fever: Caused by sudden injury to Yin Blood, leaving Yang without attachment. Treat with Siwu Tang (Four Substance Decoction) plus Paojiang (Roasted Ginger) to draw Yang from Yin, which is the correct approach. Fever with headache and aversion to cold indicates external contraction; do not treat as typical Shaoyang syndrome. Use Siwu Tang plus Jingjie (Schizonepeta), Chaihu, and Congbai (Scallion White) to harmonize Blood and release the exterior. Fever due to food stagnation presents with distension, belching, and retching. Treat with Yigong San (Extra Merit Powder) plus Shanzha (Hawthorn Fruit), Shenqu (Medicated Leaven), Maiya (Barley Sprout), Houpo, and Shengjiang (Fresh Ginger). Fever due to Blood stasis obstruction presents with stabbing pain in the body or abdomen. Treat with Shenghua Tang. Excessive blood loss causing irritability, thirst, red face, and fever is treated with Danggui Buxue Tang (Angelica Tonify Blood Decoction). Fever due to Yin deficiency with unattached Yang (Lone Yang floating outward) requires immediate Shenfu Tang. The *Yizong Jinjian* covers both excess and deficiency types of postpartum fever, similar to treating fever after blood loss in men. The difference lies in direction: blood loss involves upward movement (rebellious), while postpartum involves downward movement (favorable).
There are many other postpartum miscellaneous syndromes. The few listed here illustrate connections with hematemesis. Others are omitted but available in obstetric texts.
Supplementary discussion: Postpartum Qi tends to descend, leading to many collapse syndromes. Hematemesis involves Qi rebelling upward, so collapse syndromes are rare. Collapse in hematemesis requires descending methods; collapse in postpartum conditions requires ascending methods. These are fundamentally different.