Postpartum Sweating, No Sleep All Night and Dizzy Spells? Doctor Wang Mengying’s Case of Yin Deficiency After Childbirth, Cured by Nourishing Body Fluids

What the patient was searching for: sweating after childbirth / postpartum night sweats / postpartum insomnia / dizziness / scanty lochia / thirsty but not hungry Medical terms: postpartum yin deficiency · exhaustion of body fluids · deficiency of yin and blood (yang is rooted in yin; yin is transformed from fluids)

Opening: during the lying-in month, a loving family made a terrible, well-meaning mistake

The month after childbirth — the “lying-in month” (zuo yue zi) — is the time in a woman’s life when she most needs quiet and rest. But in the spring of the geng-zi year (1840, during the Qing Daoguang reign), one household made a grave error out of pure love: a new mother, doted on by her whole family, was nearly sent through the gates of death.

💬 Note from Doctor Luo: After giving birth, this mother’s lochia (e lu) was scanty. What is lochia? It is the discharge the uterus needs to expel after delivery, and normally it flows for a while. The family saw that very little was coming out and thought: this won’t do, we have to help her! So they boiled up hawthorn (shan zha) and motherwort (yi mu cao) — both herbs that move blood — mixed the brew with wine, and had her drink it every day for several days. That is where the trouble began.

Who was the patient: Doctor Wang Mengying arrived and named the root cause in four characters

The family called in one of the most celebrated physicians of the Qing dynasty — Doctor Wang Mengying (王孟英, 1808–1868), a native of Haining, Zhejiang, and the great synthesizer of the warm-disease school, author of Wen Re Jing Wei (A Systematic Differentiation of Warm Diseases) and Wang’s Case Records. After examining her, he spoke four characters: “bing shu yin xu” (禀属阴虚) — “by constitution, she is yin deficient.”

What does that mean? It means this woman’s physique was yin deficient from birth — her endowment (bing fu) was so. In a yin-deficient person, the body’s yin substances — blood, fluids, and the moist, cooling materials that belong to yin — are simply insufficient to begin with.

💬 Note from Doctor Luo: Constitution is partly something your parents give you. Look at children: some are yin deficient from a young age — hot palms and soles, a tendency to sweat, easy to flare up with “heat.” Then look at their parents, and you will usually find yin deficiency there too. Of course, constitution can also be built up later in life: eating spicy food every day, staying up late and never sleeping — slowly you can turn yourself into a yin-deficient constitution. This mother was yin deficient by birth, and then she had a baby — childbirth carries blood away with the child. She was already short of yin, and now a large amount of blood was gone too, so her yin and blood were thinner than ever.

The root of the illness: when yin and blood are badly injured, someone “spurs” them with blood-moving medicine

Doctor Wang Mengying noted that although her lochia was scanty, she felt no distending pain — which told him this was not blood stasis blocking the flow. It was purely that her yin and blood were depleted, so her body’s ability to produce and discharge secretions was weak. What should be done in that situation? Nourish her slowly — and above all, do not give random medicine.

But the family did not know that. Hawthorn and motherwort are both blood-moving herbs; and the wine was worse — wine is greatly heating in nature, it injures yin, and it disperses qi. Put these together, drink them for days on end, and every kind of trouble arrives:

• She began to run a fever;
• Sweat poured out of her on its own — spontaneous sweating that would not stop;
• Her mouth was thirsty, but she had no appetite (kou ke bu ji — thirsty but not hungry);
• Xuan yun yu tuo (眩晕欲脱) — she was so dizzy she felt she might faint at any moment, as if her upright qi were about to slip away;
• She lay awake all night (che ye bu mian) — not a wink of sleep.

💬 Note from Doctor Luo: When the sweat pours out like that, what is being damaged? Body fluids (jin ye)! The fluids were in danger of being completely exhausted (yu jie zhi shi) — nearly sweated dry. After childbirth a woman needs to be carefully nourished; but this one was sweating, burning with fever, and sleepless — how could her body recover? Everything had gone haywire.

The diagnostic highlight: fluids nearly exhausted, yang left without a root — the “yang collapse” Zhang Zhongjing spoke of

Doctor Wang Mengying said this was what Zhang Zhongjing meant by “wang yang” (亡阳, collapse of yang). At this, everyone is puzzled: her fluids are nearly gone, she is clearly yin deficient — what does yang have to do with it? Here is one of the most exquisite ideas in all of Chinese medicine: yin and yang generate and root each other (yin yang hu gen hu sheng).

Doctor Wang’s own words: “Gai ren sheng tian zhen zhi qi wei zhi yang, yang gen yu yin, yin hua yu ye” (盖人生天真之气谓之阳，阳根于阴，阴化于液) — “The innate true qi of a person is called yang. Yang is rooted in yin, and yin is transformed from fluids.” Now that the fluids were nearly dried up, yang had lost its foundation — so it floated upward and leaked outward, which is why she was dizzy to the point of collapse and sweating without stop. And because yin and blood were not being generated, the heart-spirit (xin shen) received no nourishment — hence the sleepless nights.

What should be done? Merely tonifying qi and nourishing yin would be treating the branch and abandoning the root — qi and blood by themselves cannot generate fluids. The only way was to clear the source and stop the leak (cheng yuan jie liu): fix the root that produces yin, make the fluids full so that qi and blood recover (shi jin ye chong er qi xue fu) — then, as Doctor Wang put it, “there need be no further worry,” and the illness would truly be resolved.

💬 Note from Doctor Luo: Let me take a moment to clarify the difference between “jin” (津) and “ye” (液) — we usually lump them together and say “jin ye,” but they are actually different. Jin (fluid) is thin and free-flowing; it spreads through the whole body, moistens the skin and muscles, and can even transform into sweat — you see, sweat is jin that has changed form. Ye (humor) is thicker and slower-moving; it stays in the organs, joints and deeper places, providing deep-layer moisture. When blood is insufficient, the fluids also transform and replenish the blood. Both are the body’s liquid nourishment and part of its upright qi (zheng qi) — entirely different from the phlegm-dampness pathogenic factors we discussed in earlier cases.

The prescription: one dose of a textbook on “nourishing yin and saving fluids”

Doctor Wang Mengying’s prescription is itself a textbook on how to nourish yin. Let us look at it herb by herb:

• American ginseng (xi yang shen) and raw astragalus (sheng huang qi) — to tonify qi. Why tonify qi in a yin-nourishing formula? Because yin and yang generate each other — you borrow qi-tonifying to generate fluids. American ginseng had only recently been introduced to China at that time; it both tonifies qi and nourishes yin, and its nature is on the cool side — exactly right here;
• Dragon bone (long gu) and oyster shell (mu li) — to astringe and to calm the spirit. The patient’s yang was already drifting away (the dizzy spells and pouring sweat are proof), so it had to be drawn back in; and since she could not sleep at night, the same pair also settles the spirit — two birds with one stone;
• Wei rui (yuzhu, Solomon’s seal), mai dong (dwarf lilyturf) and shi hu (dendrobium) — the main force for nourishing yin and generating fluids;
• Lily bulb (bai he) — to calm the spirit. When a woman’s heart-spirit is frightened and uneasy, Chinese medicine often turns to lily bulb;
• Papaya (mu gua) and licorice (gan cao) — sour and sweet together generate yin (suan gan hua yin) — another time-honored method of nourishing yin;
• Raw coix seed (sheng yi yi ren) and raw white hyacinth bean (sheng bian dou) — to strengthen the spleen. When the spleen and stomach are robust, qi and blood can be generated, and only then does yin-nourishing have a root to stand on;
• Mulberry leaf (sang ye) — to clear deficient heat;
• Sugarcane juice (gan zhe zhi) — to nourish blood. Doctor Wang Mengying called sugarcane juice the “Tian Sheng Fu Mai Tang” (天生复脉汤) — heaven-made Restore the Pulse Decoction, a natural version of the classic Fu Mai Tang (Restore the Pulse Decoction, the licorice-based formula for the heart)!

💬 Note from Doctor Luo: See how rich Doctor Wang’s yin-nourishing technique is: qi-tonifying, astringing, yin-nourishing, spleen-strengthening, heat-clearing, blood-nourishing — all assembled together. And it does not stop there — he was a man who set great store by food therapy: he called watermelon the “Tian Sheng Bai Hu Tang” (heaven-made White Tiger Decoction), sugarcane juice the “Tian Sheng Fu Mai Tang” (heaven-made Restore the Pulse Decoction), and he created the famous blood-nourishing formula Yu Ling Gao (玉灵膏, a paste of longan pulp and American ginseng). After the herbal decoction was prepared, the sugarcane juice was mixed in and drunk together with it. That is Doctor Wang Mengying’s wisdom about nourishing life.

A cautionary turn: when yin is depleted and blood is scanty, the body cannot take “fierce medicine”

In this formula there is not a single blood-moving or blood-breaking herb — and that is precisely where Doctor Wang’s brilliance lies. A person with depleted yin and scanty blood is like a canal with no water in it:

💬 Note from Doctor Luo: Let me use an analogy: when a canal still has water in it, you can clear out the debris and it washes away with one push. But when the canal has run dry, if you take a knife and scrape at the bottom, a few scrapes and you have ruined the canal. To move and break blood when yin is deficient is exactly that — scraping a dry canal. I have seen a real case: a woman asked a physician to regulate her after childbirth; the physician decided she “had blood stasis” and started with fierce blood-breaking agents like leech (shui zhi) and gadfly (meng chong) — and the result was that her vision went black, everything she looked at was dark, she needed seconds to register anything, and she wasted away until she was skin and bones. It took her years to recover, and she lived exhausted. When yin and blood have been badly injured, attacking them with blood-breaking medicine wounds the upright qi, and the body truly cannot bounce back.

The result and aftercare: settled in one dose, cured within days

How did the formula work? One dose brought calm (yi ji ji an) — after a single bowl she steadied: the sweat stopped, the dizziness left, and she could sleep. Within days she was cured (shu ri er yu). Afterward Doctor Wang Mengying “zi tian yin fen” (滋填阴分) — slowly replenished her yin essence, supporting her until she was strong, and her body recovered completely.

💬 Note from Doctor Luo: From “sweat pouring out, dizzy to the point of collapse” to “settled in one dose, cured within days” — that is the power of getting the pattern right and the direction right. The root of the illness was yin deficiency with injured fluids. If you only think of stopping the sweat, calming the spirit, and bringing down the fever, you are treating the branches; once you nourish the fluids back and give yang its root again, those symptoms dissolve by themselves.

What to take away: three things to remember for postpartum care

There is a great deal to learn from this case:

First — when yin and blood have been badly injured, do not use medicine recklessly. After childbirth, blood is lost and yin is depleted. At such a time, any “big move” — moving blood, breaking blood, fierce attack — is more than the body can bear. You must first distinguish whether the patient needs blood-nourishing or yin-nourishing.

Second — nourishing yin is a craft, not a single herb. Tonifying qi to generate fluids, astringing and calming the spirit, strengthening the spleen to create the source, clearing deficient heat, nourishing blood… Doctor Wang Mengying brought yin back from every angle. And this approach was already present in the great Ming-dynasty physician Miao Xiyong (缪希雍), who came earlier — when Miao nourished yin he often spoke of spleen yin, pairing raw white hyacinth bean with raw coix seed to strengthen the spleen while nourishing yin. The pathways of Chinese medicine run in one continuous lineage.

Third — do not cook tonics in wine after childbirth. Many regions have the custom of stewing tonic foods in wine for the new mother. Wine is hot in nature — it injures yin and disperses qi, and it is not good for a postpartum woman; and during breastfeeding, the alcohol passes to the baby, which is also harmful to the child’s health.

💬 Note from Doctor Luo: Finally, a practical tip for everyday use: when you nourish yin, do not leave dampness behind. Most yin-nourishing herbs are rich and cloying, and they can easily obstruct the stomach — so pair them with a little coix seed or white hyacinth bean to strengthen the spleen and transform dampness. And if nourishing yin gives you loose stools, adding white hyacinth bean will both stop the diarrhea and strengthen the spleen. This is the approach of masters like Wang Mengying and Miao Xiyong, and you can use it in your own daily care.

Compiled from Doctor Luo Dalun’s commentary on the case records of Doctor Wang Mengying; the case is from Wang’s Case Records (《王氏医案》).