当归之味甘胜于辛,性温虽能助热,而濡润多液,又实能滋阴退热,原不可但以助热论。故《神农本
草经》谓可治温疟,且谓煮汁饮之尤良,诚以煮汁则其液浓浓,濡润之功益胜也。其性虽流通活血,而用之得
当亦能止血。友人王××曾小便溺血,用黄酒煮当归一两饮之而愈。后其症反复,再服原方不效,问治于
仆,俾用鸦胆子去皮五十粒,白糖水送服而愈。继其症又反复,用鸦胆子又不效,仍用酒煎当归法治愈。
又傅青主治老妇血崩,用黄 、当归各一两,桑叶十四片,煎汤送服三七细末三钱,甚效。又单用醋
炒当归一两煎服,治血崩亦恒有效。是当归可用以活血,亦可用以止血,故其药原名“文无”,为其能使气
血各有所归,而又名当归也。产后血脉淆乱,且兼有瘀血,故可谓产后良药。至川芎其香窜之性,虽甚于
当归,然善升清阳之气。凡清阳下陷作寒热者,用川芎治之甚效,而产后又恒有此证。
同邑赵姓之妇,因临盆用力过甚,产后得寒热症,其家人为购生化汤二剂服之病顿愈。盖其临盆努力
之时,致上焦清阳下陷,故产后遂发寒热,至服生化汤而愈者,全赖川芎升举清阳之力也。旬余寒热又作,其
叔父××知医,往省视之,谓系产后瘀血为恙又兼受寒,于活血化瘀药中,重加干姜。数剂后,寒热益甚,
连连饮水,不能解渴。当时仲夏,身热如炙,又复严裹浓被,略以展动即觉冷气侵肤。后仆诊视,左脉沉
细欲无,右脉沉紧皆有数象,知其上焦清阳之气下陷,又为热药所伤也。从前服生化汤,
借川芎升举之力而暂愈,然川芎能升举清阳,实不能补助清阳之气
使之充盛,是以愈而又反复也。为疏方黄 、玄参各六钱,知母八钱(时已弥月,故可重用凉药),柴胡、
桔梗各钱半,升麻一钱,一剂而寒热已,又少为加减,服数剂全愈。由是观之,川芎亦产后之要药也。吴鞠
通、王士雄之言皆不可奉为定论。惟发热汗多者,不宜用耳。至包氏所定生化汤,大致亦顺适。惟限于四点
钟内服完三剂,未免服药过多。每次冲入绍酒一两,其性过热,又能醉人,必多有不能任受者。仆于妇人产
后用生化汤原方,加生怀山药数钱,其大便难者,加阿胶数钱,俾日服一剂,连服三日停止,亦必不至
有产后病也。
The flavor of Angelicae Sinensis Radix (Danggui, 当归) is sweeter than pungent. Although its warm nature can assist heat, its abundant fluid and moistening properties actually enable it to nourish yin and reduce fever; thus, it should not be regarded merely as a substance that assists heat. Therefore, the *Shennong Bencao Jing* (Divine Farmer's Materia Medica) states that it can treat warm malaria (Wen Nue, 温疟), and adds that drinking its decoction is particularly effective. This is indeed because boiling it yields a concentrated liquid, thereby enhancing its moistening efficacy. Although its nature promotes circulation and invigorates blood, when used appropriately, it can also stop bleeding. My friend Mr. Wang suffered from hematuria (blood in urine). He was cured by drinking one liang of Danggui boiled in yellow wine. Later, his symptoms recurred, and taking the original prescription again proved ineffective. He consulted me for treatment, and I instructed him to take fifty seeds of Brayera Semen (Yadanszi, 鸦胆子) with the skin removed, delivered with sugar water, which cured him. Subsequently, the symptoms recurred again, and Yadanszi became ineffective. The condition was finally cured by returning to the method of decocting Danggui with wine.
Furthermore, Fu Qingzhu treated an elderly woman suffering from metrorrhagia (Xue Beng, 血崩) using Huangqi (Astragali Radix) and Danggui, each one liang, along with fourteen leaves of Morus Alba Folium (Sangye, 桑叶), decocted in water to deliver three qian of finely powdered Notoginseng Radix et Rhizoma (Sanqi, 三七). This was highly effective. Additionally, using one liang of Danggui stir-fried with vinegar alone and decocted for oral administration often effectively treats metrorrhagia. Thus, Danggui can be used to invigorate blood or to stop bleeding. Its original name was "Wenwu" (文无), signifying that it enables qi and blood to return to their proper places; hence, it is also named Danggui. Postpartum, the blood vessels are chaotic and accompanied by blood stasis (Yu Xue, 瘀血); therefore, it is considered an excellent medicine for the postpartum period. As for Ligusticum Chuanxiong Rhizoma (Chuanxiong, 川芎), although its aromatic and penetrating nature is stronger than that of Danggui, it excels at ascending clear yang qi (Qingyang Zhi Qi, 清阳之气). For conditions where clear yang sinks and causes alternating chills and fever, Chuanxiong is very effective, and such syndromes are common after childbirth.
A woman surnamed Zhao from my hometown experienced excessive exertion during labor and subsequently developed alternating chills and fever. Her family purchased two doses of Shenghua Tang (Decoction for Generating New Blood) for her, and her illness resolved immediately. This was likely because her exertion during delivery caused the clear yang qi of the upper jiao to sink, leading to postpartum chills and fever. The cure achieved by Shenghua Tang relied entirely on the power of Chuanxiong to lift and raise clear yang. More than ten days later, the chills and fever returned. Her uncle, who knew medicine, visited and diagnosed the condition as postpartum blood stasis complicated by cold invasion. He added large amounts of Zingiberis Rhizoma Recens (Ganjiang, 干姜) to blood-invigorating and stasis-resolving herbs. After several doses, the chills and fever worsened significantly. She drank water continuously but could not quench her thirst. It was midsummer, and her body felt hot as if roasted, yet she wrapped herself tightly in thick quilts; any slight movement made her feel cold air invading her skin. When I examined her, her left pulse was deep, fine, and nearly imperceptible, while her right pulse was deep, tight, and rapid. I determined that her clear yang qi of the upper jiao had sunk and was further injured by hot medicines. Previously, Shenghua Tang provided temporary relief through Chuanxiong’s lifting power; however, while Chuanxiong can ascend clear yang, it cannot truly tonify and enrich clear yang qi, which explains why the condition recurred. I prescribed Huangqi (Astragali Radix) and Scrophulariae Radix (Xuanshen, 玄参), each six qian, Anemarrhenae Rhizoma (Zhimu, 知母) eight qian (since it had been a month since delivery, heavy use of cooling herbs was permissible), Bupleuri Radix (Chaihu, 柴胡) and Platycodonis Radix (Jiegeng, 桔梗), each one and a half qian, and Cimicifugae Rhizoma (Shengma, 升麻) one qian. After one dose, the chills and fever ceased. With minor adjustments, she took several more doses and recovered completely. From this, we see that Chuanxiong is also an essential medicine for the postpartum period. The statements of Wu Jutong and Wang Shixiong cannot be accepted as absolute conclusions. Only patients with fever and profuse sweating should avoid its use. Regarding Bao’s formulation of Shenghua Tang, it is generally appropriate. However, limiting the consumption of three doses within four hours involves excessive medication frequency. Adding one liang of Shaoxing wine to each dose makes the nature too hot and may cause intoxication, meaning many patients would not tolerate it. In my practice, when using the original Shenghua Tang formula for postpartum women, I add several qian of Dioscoreae Hypoglauca Rhizoma (Sheng Huai Shanyao, 生怀山药). For those with difficulty defecating, I add several qian of Colla Corii Asini (Ejiao, 阿胶). Administering one dose daily for three consecutive days, then stopping, ensures that postpartum diseases will likely not occur.