Treatment of Postpartum Diseases, Chapter Twenty-One
Question: A new mother commonly suffers from three conditions: first, spasm (also written as "zhì"), second, dizziness and confusion, third, severe constipation. What do these mean?
Master said: After childbirth, blood deficiency leads to excessive sweating, making her prone to wind invasion, hence spasm. Blood loss combined with sweating causes coldness, leading to dizziness and confusion. Loss of body fluids causes dryness in the stomach, resulting in constipation. In postpartum dizziness, the pulse is weak, unable to eat, stool is hard, only head sweats. Why? Because blood deficiency leads to collapse, which causes dizziness. When dizziness resolves, profuse sweating occurs. Due to blood deficiency and collapse, yang rises alone, hence head sweating. Why do new mothers often sweat? Because yin blood is depleted, yang becomes dominant, thus sweating occurs, restoring balance between yin and yang. Hard stool and vomiting with inability to eat should be treated with Xiao Chaihu Tang. (Formula found in vomiting section). Once recovery allows eating, if fever returns around seventh or eighth day, this indicates stomach accumulation, treat with Da Chengqi Tang. (Formula found in spasm section). For postpartum abdominal pain, treat with Danggui Shengjiang Yangtang; also treats cold hernia and deficiency in vital energy.
For postpartum abdominal pain with restlessness and fullness preventing lying down, treat with Zhi Shi Shaoyao San.
Zhi Shi Shaoyao San Formula: Zhi Shi (charred black, not too much) and Shaoyao in equal amounts. Grind into powder, take one square measure three times daily. Also treats abscesses; take with millet gruel.
Master said: For postpartum abdominal pain, the standard treatment is Zhi Shi Shaoyao San. If ineffective, this indicates dry blood adhering below the navel. Treat with Xia Yu Xue Tang; also treats menstrual blockage.
Xia Yu Xue Tang Formula: Dahuang three liang; Taoren twenty pieces; Chongchong twenty pieces (roasted, legs removed). Grind into powder, mix with honey to form four pills. Use one cup of wine to decoct one pill, take eight he in one go. Fresh blood will be expelled like pig liver.
Seven or eight days after childbirth, without solar symptoms, firm lower abdominal pain, indicating retained lochia, no bowel movement, restlessness, fever, pulse slightly strong. If fever increases further, especially during late afternoon, and if eating causes delirium, but improves at night—this indicates food stagnation. Treat with Da Chengqi Tang. Heat resides internally, accumulated in the bladder. Formula found in spasm disease section.
After childbirth, wind symptoms persist for tens of days without relief, slight headache, chills, intermittent fever, chest tightness, dry vomiting, sweating. Even after prolonged duration, Yang Dan syndrome remains—can be treated with Yang Dan Tang.
After childbirth, wind invasion, fever, flushed face, shortness of breath, headache—treat with Zhu Ye Tang.
Zhu Ye Tang Formula: One bundle of bamboo leaves; Ge Gen three liang; Fang Feng, Jiegeng, Gui Zhi, Ren Shen, Gan Cao each one liang; Fu Zi one piece (roasted); Da Zao fifteen pieces; Sheng Jiang five liang. Mix the ten ingredients with one dou of water, decoct until two sheng and half, divide into three doses, warm and take, cover to induce sweating. If neck stiffness, use one large Fu Zi, split into bean-sized pieces, decoct while removing foam. If vomiting, add Banxia half sheng (washed).
If a woman’s milk is deficient, with mental agitation, restlessness, and vomiting—treat with Zhu Pi Da Wan to stabilize the center and boost qi.
Zhu Pi Da Wan Formula: Raw bamboo fleece two fen; Shigao two fen; Gui Zhi one fen; Gan Cao seven fen; Bai Wei one fen. Grind into powder, mix with jujube paste into ball-sized pills, take one pill with drink, three times daily, once at night. If fever present, double Bai Wei; if irritability and shortness of breath, add Bo Shi one fen.
For postpartum diarrhea with extreme deficiency, treat with Bai Tou Weng Jia Gancao Ejiao Tang.
Bai Tou Weng Jia Gancao Ejiao Tang Formula: Bai Tou Weng, Gan Cao, Ejiao each two liang; Qin Pi, Huang Lian, Bo Pi each three liang. Mix the six ingredients with seven sheng of water, decoct until two sheng and half, add ejiao, let dissolve completely, divide into three warm doses.
Supplementary Formulas:
*Qianjin* Three-Ingredient Yellow Wormwood Decoction: Treats women who develop wind exposure during confinement, with severe heat and restlessness in limbs, headache—treat with Xiao Chaihu Tang; if no headache but only restlessness, use this formula. Huang Qin one liang; Ku Shen two liang; Gan Di Huang four liang. Mix with eight sheng of water, decoct until two sheng, warm and take one sheng; may cause expulsion of worms.
*Qianjin* Internal Supplement Danggui Jianzhong Tang: Treats postpartum deficiency and weakness, persistent abdominal stabbing pain, shallow breathing, or severe cramping in lower abdomen radiating to back, inability to eat or drink. After childbirth, take four to five doses daily for best results, promoting strength. Danggui four liang; Gui Zhi three liang; Shaoyao six liang; Sheng Jiang three liang; Gan Cao two liang; Da Zao twelve pieces. Mix with one dou of water, decoct until three sheng, divide into three warm doses, consume within one day. If extremely deficient, add Yi Tang six liang, dissolve after decoction over fire until dissolved. If excessive blood loss, uterine bleeding, internal hemorrhage—add Di Huang six liang, Ejiao two liang, total eight ingredients. Add Ejiao after decoction. If no Danggui, substitute with Chuanxiong; if no Sheng Jiang, use Gan Jiang.
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