Treatment of Postpartum Disorders in Women, Pulse and Syndrome Patterns, Chapter Twenty-One
Treatment of Postpartum Disorders in Women, Pulse and Syndrome Patterns, Chapter Twenty-One
Question: A new mother may suffer from three conditions: one is spasm (also written as "zhì"), second is vertigo and confusion, third is difficult defecation. What do you mean?
The Master said: After childbirth, blood deficiency leads to excessive sweating, making her prone to wind invasion, hence spasms occur. Blood loss combined with sweating causes cold dominance, leading to vertigo and confusion. Loss of body fluids results in dry stomach, causing constipation. In a postpartum woman suffering from vertigo, her pulse is faint and weak, she cannot eat, her stool is hard, and only her head sweats. This happens because blood deficiency leads to collapse, which then causes dizziness. When dizziness resolves, profuse sweating must occur. Because blood deficiency causes downward collapse, the isolated yang rises upward, resulting in head sweating. Thus, new mothers tend to sweat because their yin is depleted and yang is dominant, so sweating is necessary to restore balance. Hard stools and vomiting preventing eating indicate Xiao Chai Hu Tang should be used. (Formula found in the vomiting section). Once symptoms resolve and she can eat, if fever returns around day seven or eight, this indicates stomach accumulation, requiring Da Cheng Qi Tang. (Formula found in the spasm section). For postpartum abdominal pain, Dang Gui Sheng Jiang Yang Tang should be used; also treats cold hernia and deficiency due to exhaustion.
For postpartum abdominal pain with restlessness and fullness preventing lying down, Zhi Shi Shao Yao San should be used.
Zhi Shi Shao Yao San Formula: Zhi Shi (charred until black, not too much), white peony root, equal parts. Crush into powder, take one square inch measure three times daily. Also treats abscesses; take with barley porridge.
The Master said: For postpartum abdominal pain, the method is to use Zhi Shi Shao Yao San. If ineffective, this indicates dry blood adhering below the navel. Then Xie Yu Xue Tang should be used; also treats irregular menstruation.
Xie Yu Xue Tang Formula: Da Huang three liang; peach kernel twenty pieces; Eupolyphaga twenty pieces (roasted, remove legs). Powder the three ingredients, mix with honey to make four pills. Boil one pill in one sheng of wine, take eight he in one dose. Fresh blood will pass out like pig liver.
Seven or eight days after childbirth, if there are no signs of Tai Yang syndrome, hardness and pain in the lower abdomen, this indicates retained lochia, constipation, irritability, fever, and a slightly firm pulse. If fever increases significantly, especially during late afternoon, and if eating triggers delirium but resolves by night, Da Cheng Qi Tang should be used. This indicates heat inside, stagnation in the bladder. Formula found in the spasm section.
After childbirth, wind symptoms persist for tens of days without relief, slight headache, aversion to cold, occasional fever, chest tightness, dry vomiting, sweating—though long-standing, the Yang Dan syndrome remains, so Yang Dan Tang may be used.
After childbirth, wind stroke with fever, flushed face, shortness of breath, and headache—Bamboo Leaf Tang should be used.
Bamboo Leaf Tang Formula: One bundle of bamboo leaves; Ge Gen three liang; Fang Feng, Jie Geng, 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, boil down to two sheng and a half, divide into three doses, warm and take, cover warmly to induce sweating. If neck stiffness occurs, use one large Fu Zi, split into bean-sized pieces, add to decoction and skim off foam. If vomiting occurs, add Ban Xia half sheng (washed).
If a woman’s milk ducts are deficient, causing restlessness, agitation, and vomiting, An Zhong Yi Qi, Bamboo Skin Great Pill should be used.
Bamboo Skin Great Pill Formula: Raw bamboo scrapings two fen; gypsum two fen; Gui Zhi one fen; licorice seven fen; Bai Wei one fen. Powder the five ingredients, mix with jujube paste into pill size of a plum, take one pill with drink, three times daily, once at night. If fever exists, double the Bai Wei; if restless and short of breath, add Bo Shi one fen.
After childbirth, severe diarrhea leading to extreme deficiency—Bai Tou Weng Add Gan Cao E Jiao Tang should be used.
Bai Tou Weng Add Gan Cao E Jiao Tang Formula: Bai Tou Weng, Gan Cao, E Jiao, each two liang; Qin Pi, Huang Lian, Bo Pi, each three liang. Mix the six ingredients with seven sheng water, boil down to two sheng and a half, add E Jiao and let it dissolve completely, divide into three doses, warm and take.
Supplementary Formulas:
*Qian Jin* Three-Ingredient Huang Qin Tang: Treats women who develop wind exposure after childbirth while in confinement, experiencing severe heat and restlessness in limbs, headache—use Xiao Chai Hu Tang. If no headache but only restlessness, this formula applies. Huang Qin one liang; Ku Shen two liang; Sheng Di Huang four liang. Mix with eight sheng water, boil down to two sheng, take one sheng warm, often induces vomiting of worms.
*Qian Jin* Internal Supplement Dang Gui Jian Zhong Tang: Treats postpartum weakness, abdominal stabbing pain that won’t stop, shallow breathing, or severe lower abdominal tension radiating to the back, inability to eat or drink. One month after childbirth, take four to five doses daily for best results, promoting strength. Dang Gui four liang; Gui Zhi three liang; Bai Shao six liang; Sheng Jiang three liang; Gan Cao two liang; Da Zao twelve pieces. Mix with one dou water, boil down to three sheng, divide into three doses, consume within one day. If extremely weak, add Yitang six liang, stir in after decoction, warm over fire until dissolved. If excessive blood loss or internal bleeding from rupture doesn’t stop, add Sheng Di Huang six liang, E Jiao two liang, total eight ingredients. Add E Jiao after decoction. If Dang Gui is unavailable, substitute with Chuan Xiong. If Sheng Jiang is unavailable, substitute with Gan Jiang.
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