Postpartum blood dizziness

Dizzy head and flowery vision occurring after childbirth. Postpartum blood dizziness is often so severe that the patient cannot get up and is sometimes accompanied by fullness and oppression in the chest, nausea and vomiting, welling of phlegm and rapid breathing, heart vexation, and, in severe cases, clenched jaw, clouded spirit, and loss of consciousness.

Biomedical correspondence: postpartum syncope, postpartum shock, postpartum amniotic embolism, postpartum vasomotor collapse.

Distinction is made between vacuity and repletion patterns.

Vacuity patterns result from postpartum flooding and spotting causing yīn vacuity and sudden collapse. The blood is usually thin. Dizziness comes on suddenly with heart palpitation, heart vexation, oppression and discomfort, and, in severe cases, clouding loss of consciousness. General signs include somber-white complexion, closed eyes and open mouth, limp hands and cold limbs, dripping cold sweat, pale tongue without fur, and a faint pulse on the verge of expiration or a large floating pulse. In vacuity patterns, there may also be signs of upflow of phlegm-fire causing sudden dizzy head and flowery vision, nausea and vomiting, fullness and oppression in the chest and heart, and, in severe cases, loss of consciousness.

Medicinal therapy: Boost qì and stem desertion using Pure Ginseng Decoction (独参汤 dú shēn tāng) or Qì-Supplementing Dizziness-Resolving Decoction (补气解晕汤 bǔ qì jiě yūn tāng). For clouded spirit, cold limbs, and sweating, apply emergency yáng-returning counterflow-stemming treatment using Ginseng and Aconite Decoction (参附汤 shēn fù tāng). Treat vacuity with phlegm-fire by supplementing qì and nourishing the blood and by transforming phlegm and quieting the spirit. Use Engendering Transformation Decoction (生化汤 shēng huà tāng) plus ginseng (Ginseng Radix, 人参 rén shēn), red tangerine peel (Citri Reticulatae Exocarpium Rubrum, 橘红 jú hóng), bamboo sap (Bambusae Succus, 竹沥 zhú lì), and ginger juice (Zingiberis Rhizomatis Succus, 姜汁 jiāng zhī) taken in small frequent doses.

Acumoxatherapy: Base treatment mainly on GV, CV, ST, and SP. Select GV-26 (Human Center, 人中 rén zhōng), GV-20 (Hundred Convergences, 百会 bǎi huì), PC-6 (Inner Pass, 内关 nèi guān), SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), and ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ); needle with supplementation. In addition, moxa CV-6 (Sea of Qì, 气海 qì hǎi), GV-20 (Hundred Convergences, 百会 bǎi huì), and ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ).

Point selection according to signs: For incessant postpartum bleeding, add moxa at SP-1 (Hidden White, 隐白 yǐn bái). For heart palpitation, vexation, and oppression, add HT-7 (Spirit Gate, 神门 shén mén) and BL-15 (Heart Transport, 心俞 xīn shù). For dripping cold sweat, add HT-6 (Yīn Cleft, 阴郄 yīn xī) and LI-4 (Union Valley, 合谷 hé gǔ). For cold limbs and reversal dizziness (fainting), add CV-4 (Pass Head, 关元 guān yuán) and Hall of Impression (印堂 yìn táng), and perform moxibustion on ginger at CV-8 (Spirit Gate Tower, 神阙 shén què). If there are signs of qì and blood vacuity with upflow of phlegm-fire, needle with drainage at LU-5 (Cubit Marsh, 尺泽 chǐ zé), PC-6 (Inner Pass, 内关 nèi guān), ST-40 (Bountiful Bulge, 丰隆 fēng lóng), ST-44 (Inner Court, 内庭 nèi tíng), and HT-7 (Spirit Gate, 神门 shén mén).

Repletion patterns are attributable to stasis obstruction and qì block; they arise when postpartum depletion of original qì and vacuity of the uterine vessels, sometimes exacerbated by contraction of cold, cause congealing and stagnation that prevents normal elimination of the lochia and upsets the movement of qì. Signs include retention or scant flow of lochia, with periodic lesser abdominal pain that refuses pressure. In severe cases, there is acute fullness below the heart. General signs include rough breathing and hasty panting, clouded spirit and loss of consciousness, clenched jaw and clenched hand, dark purple complexion and purple tongue, and a rough pulse.

Medicinal therapy: Move the blood and dispel stasis using Life-Clutching Powder (夺命散 duó mìng sǎn). Either add to this formula Chinese angelica (Angelicae Sinensis Radix, 当归 dāng guī), chuanxiong (Chuanxiong Rhizoma, 川芎 chuān xiōng), or combine it with Engendering Transformation Decoction (生化汤 shēng huà tāng) plus ginseng (Ginseng Radix, 人参 rén shēn), cyathula (Cyathulae Radix, 川牛膝 chuān niú xī), leonurus (Leonuri Herba, 益母草 yì mǔ cǎo), and flying squirrel’s droppings (Trogopteri Faeces, 五灵脂 wǔ líng zhī). If there is oppression in the chest, add fresh ginger (Zingiberis Rhizoma Recens, 生姜 shēng jiāng), and bile arisaema (Arisaema cum Bile, 胆星 dǎn xīng) to downbear counterflow and transform phlegm.

Acumoxatherapy: Base treatment mainly on GV, LR, PC, and SP. Select GV-26 (Human Center, 人中 rén zhōng), KI-1 (Gushing Spring, 湧泉 yǒng quán), LR-1 (Large Pile, 大敦 dà dūn), SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), LR-3 (Supreme Surge, 太冲 tài chōng), PC-6 (Inner Pass, 内关 nèi guān), and ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ); needle with drainage. Prick GV-20 (Hundred Convergences, 百会 bǎi huì) and Ten Diffusing Points (十宣 shí xuān) to bleed. For oppression in the chest, add CV-12 (Center Stomach Duct, 中脘 zhōng wǎn) and CV-17 (Chest Center, 膻中 shān zhōng). For contraction of cold, add GB-20 (Wind Pool, 风池 fēng chí), TB-5 (Outer Pass, 外关 wài guān). and LU-7 (Broken Sequence, 列缺 liè quē).