Sudden dizziness and blurred vision after childbirth, inability to sit up, or a feeling of fullness and discomfort in the chest, nausea and vomiting, or phlegm congestion and shortness of breath, and in severe cases, unconsciousness and loss of consciousness, are referred to as "postpartum vertigo". Jingui Yaolue refers to it as "depression and dizziness". Later generations call it "postpartum dizziness due to hemorrhage", "blood syncope", or "blood faint". It is one of the critical conditions after childbirth. If not treated promptly when deficient, it can easily lead to sudden collapse, so it should be taken seriously.

bubble_chart Pattern Analysis

1. Blood Deficiency︰Excessive lochia, frequent dizziness, pale complexion, palpitation with distress, nausea and vomiting, even unconsciousness; qi collapse following blood loss manifests as closed eyes and open mouth, limp hands and cold limbs, profuse cold sweating. The tongue is pale and without coating, the pulse is faint and thin or floating, large, and weak. Typically, there is blood deficiency and weak qi, compounded by excessive postpartum blood loss or overstrain, leading to the depletion of nutrient-blood and the upward surging of solitary yang, resulting in vertigo, or even qi collapse following blood loss, presenting a pattern of collapse. *The Secret Records of the Stone Chamber: Blood Syncope* states: "Postpartum blood dryness leading to syncope and unconsciousness is a critical moment of life and death. This is due to excessive blood loss, where the old blood has been expelled and new blood cannot be generated quickly, causing a disconnection between yin and yang, leading to this condition." Its characteristic is excessive postpartum blood loss without recovery, initially presenting as vertigo, gradually progressing to a pattern of collapse. In cases of qi collapse, the face is pale, with profuse cold sweating, and the pulse is faint and on the verge of disappearing. Treatment should focus on restoring yang to stop collapse, using formulas such as Ginseng Decoction Alone or Ginseng and Aconite Decoction. For blood collapse, with unconsciousness, pale complexion, and a floating, large, and weak pulse, the treatment should nourish blood and secure desertion, using Angelica Blood-Tonifying Decoction. For dual collapse of qi and blood, treatment should replenish both qi and blood, using formulas like the Life-Saving Sacred Elixir or Blackend Swallowwort Root Decoction. Lochia is invariably excessive, belonging to deficiency, and unconsciousness manifests as a pattern of collapse.
2. Blood Stasis︰Scanty or absent lochia, paroxysmal lower abdominal pain with tenderness, or even epigastric distress and fullness, coarse panting, or upward surging of phlegm and saliva; sudden unconsciousness and lockjaw, loss of consciousness, clenched fists, tightly closed jaw, dark purple complexion, purple tongue and lips, and choppy pulse. This is mostly caused by postpartum lochiostasis, internal congestion of static blood, upward attack on the chest and heart, and disturbance of the spirit. The key points of pattern identification are: postpartum scanty lochia, paroxysmal lower abdominal pain with tenderness, purple tongue, choppy pulse, or manifestations of obstruction pattern such as lockjaw and clenched fists. Treatment should harmonize the nutrient aspect and expel stasis, using Soul-Clearing Powder combined with Sudden Smile Powder. If accompanied by cold stagnation, presenting with cold limbs and lower abdomen, and loose stools, it is appropriate to warm the meridians and dissipate cold, using Black Miraculous Powder. If accompanied by heat accumulation, presenting with a red face, heart vexation, severe constipation, red tongue with yellow fur, and rapid pulse, it is appropriate to clear heat and transform stasis, using Qing Yun Decoction taken cold. If accompanied by wind, presenting with dizziness and headache, slight chills and fever, and floating moderate pulse, it is appropriate to invigorate blood and dispel wind, using modified Schizonepeta Powder. If biased toward qi depression, presenting with chest and hypochondriac fullness and oppression, frequent sighing, and wiry pulse, it is appropriate to open depression and dissipate binds, using Peripatetic Powder minus Peony Root, plus Curcuma Root and Cyperus. If accompanied by phlegm, presenting with upward surging of phlegm and saliva, and coarse panting, it is appropriate to dispel phlegm and activate stasis, using Two-Ingredient Mai Su Drink combined with Two Old Ingredients Decoction.

bubble_chart Documentation

1. Zhubing Yuanhou Lun．Postpartum Blood Syncope and Fainting: "The symptoms of syncope and fainting are characterized by heart vexation and a sensation of qi on the verge of exhaustion. This can be caused by excessive blood loss or very little blood loss, both of which can lead to syncope. If postpartum blood loss is excessive, leading to blood deficiency and qi accumulation, the resulting syncope and fainting will manifest as restlessness alone. If blood loss is minimal and there is qi counterflow, then the blood follows the rising qi to oppress the heart, also causing syncope and fainting. This results in restlessness along with a sensation of fullness and urgency in the heart. These two conditions are different."
2. Nyuke Jinglun．Postpartum Conditions: "Postpartum dizziness due to hemorrhage is a condition of excess, where stagnant blood enters the liver and lochia attacks upwards, causing static blood to be the problem. Medicines that activate the blood to dispel stasis should be used. ... Postpartum dizziness due to hemorrhage that is of a deficient nature is caused by the sudden loss of yin blood and the rise of deficient fire, all due to emptiness in the abdomen. Medicines that tonify blood, nourish yin, and reduce fire should be used, but enriching yin should not involve the use of dihuang and shaoyao, and reducing fire should not involve the use of bitter and cold herbs."