Post-Partum Conditions and Classical Formulas

October 29, 2019

As Chinese medicine practitioners we support fertility and pregnancy with a lot of time, dedication and attention. After the baby has been born, the focus shifts to the infant and the mother tends to be overlooked.

Chapter 21 of the Jin Gui Yao Lue (Essential prescriptions of the Golden Cabinet – 金 匱要略) is dedicated to common post-partum conditions. In contains a range of formulas that address imbalances arising from the post-partum situation. They are great formulas to support a mother and render assistance if giving her back balance and wellbeing.

In relation to treatment, Zhang Zhongjing (张仲景) emphasises the characteristics of post-partum blood collapse, damaging liquids and both deficiency of Qi and blood, but otherwise recommends flexible treatment approaches. “Do not restrict [treatment] to the postpartum [aspect of disease]

; and do not forget the postpartum [aspect of disease]”[i]. Here are the formulas in table format:

Condition                          PatternSignsFormula
Depression and veiling with hard stoolsHarmonise ShaoyangSlightly weak pulse, Inability to eat, hard stool and sweating from the head.Xiao Chai Hu Tang (Line 21.2)
Post-partum abdominal painBlood deficiency with cold in the centreTense pain in the abdomen.Dang Gui Sheng Jiang Yang Rou Tang (Line 21.4)
Qi & blood depressionStagnation Abdominal pain with vexation, fullness, and inability to lie down.Zhi Shi Shao Yao San Line (Line 21.5)
Blood stasisStasisAbdominal pain that refuses pressure.  Xia Yu Xue Tang (Line 21.6)
Incomplete elimination of lochiaYangming heatLate afternoon tidal heat, vexation and agitation, inability to eat, delirium and constipation.Da Cheng Qi Tang (Line 21.7)
Post-partum insufficency of yin-blood with deficiency heat causing internal harassmentDeficiency of blood and yin with internal heat stirringVexation and vomiting.Zhu Pi Da Wan (Line 21.10)
Post-partum diarrhoeaDeficiency of yin with heatVexation and vomiting.  Bai Tou Weng Jia Gan Cao E Jiao Tang (Line 21.11)
Post-partum wind-strikeInstable exterior with wind attackWind-strike that lasted for several days, with aversion to cold, fever, sweating and dry retching.Yang Dan Tang[ii] (Line 21.8)
Wind strike with yang deficiencyHarmonise interior and exteriorFever, full red complexion, panting and headache.Zhu Ye Tang (Line 21.9)

[i] Jin Gui Yao Lue, Essential prescriptions of the Golden Cabinet, Nigel Wiseman and Sabine Wilms, p512. 

[ii] Commentators have interpreted Yang Dan Tang as Gui Zhi Tang, Gui Zhi Tang with the addition of Huang Qin, Gui Zhi Tang with the addition of Fu Zi, Gui Zhi Tang with an increased Gui Zhi and Fu Zi, or a Yang upbearing ormula with principally Chai Hu. The formula is most likely identical or a derivative of Gui Zhi Tang. Jin Gui Yao Lue, Essential prescriptions of the Golden Cabinet, Nigel Wiseman and Sabine Wilms, p523. 

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