【方歌】产后痈疽最属险,七情之伤六淫感,瘀血稽留成痈疽,
势溃托里不宜缓。
【注】此证因产后气血经络俱虚,或因七情所伤,或因六淫所
感,与瘀血相稽而成,最属险候。法宜大补,扶助根本
,兼活瘀生新为要,其客病以末治之。初服生化汤,随
证加减,以消毒;有表邪服清魂散,有里热服回生丹。
势欲溃脓时,急宜托里,迟则恐毒内陷,药味宜和平纯
善,最忌汗下峻剂。其余肿溃治法,俱按痈疽肿疡、溃
疡门。
方剂:生化汤
组成:当归(八钱) 川芎(四钱)
姜炭 甘草(炙,四分)
桃仁(去皮、尖,研泥,十粒)
水一钟半,煎六分,加无灰酒一小杯和服。
【方歌】生化汤宜产后疽,通滞和荣又补虚,归芎姜炭炙甘草,
桃仁酒服善消瘀。
又方:清魂散
组成:荆芥(一钱) 川芎(五分)
人参 甘草(炙)
泽兰叶(各三分)
为末,黄酒调服。
【方歌】清魂产后风邪侵,荆芥川芎与人参,炙甘泽兰同作剂,
能疏表证效通神。
又方:回生丹
组成:黑豆(煮熟,取汁三碗,去豆,三升)
红花(炒黄色,入醇酒,大壶同煮三、五碗,去红花用
汁)
生大黄(研末,一斤)
苏木(锉,用河水五碗煎汁,去楂)
先将大黄末,以好米醋三、四碗搅匀,文武火熬成
膏,如此二遍;次下红花酒、苏木汤、黑豆汁,共熬成
膏,离火,再入后药:
当归 熟地
川芎 白茯苓
延胡索 乌药
香附 蒲黄
牛膝 桃仁(另研)
苍术(米泔水浸,炒,各二两)
白芍(酒炒) 甘草(炙)
羌活 山萸肉(酒浸)
三棱 陈皮
地榆 木香
五灵脂(各五钱) 人参
白术(土炒) 青皮
木瓜(各三钱) 良姜(四钱)
乳香 没药(各一钱)
共研细末,用大黄膏为丸,如弹子大。每服一丸,
黄酒炖化,通口服。
【方歌】回生产后存恶露,致发痈疽服可逐,除热活瘀荣卫和,
红花大黄豆苏木,八珍羌萸棱延胡,乌药青陈榆香附,
乳没蒲黄良膝瓜,木香灵脂桃苍穴。
[Prescription Verse] Carbuncles and sores occurring postpartum are extremely perilous; they arise from emotional injuries or invasions by the six pathogenic factors (wind, cold, summer-heat, dampness, dryness, fire). Stagnant blood accumulates to form carbuncles and sores. When the condition progresses to suppuration, the method of supporting the interior (Tuo Li) should not be delayed.
[Annotation] This syndrome occurs because Qi and Blood, as well as the meridians and collaterals, are deficient after childbirth. It may result from emotional injury, invasion by the six pathogenic factors, or the interaction with stagnant blood, making it a critical condition. The treatment principle should primarily involve substantial tonification to support the root, while simultaneously promoting blood circulation to remove stasis and generating new blood is essential. External pathogens should be treated as secondary concerns. Initially, administer Shenghua Tang (Postpartum Restoration Decoction), modified according to specific symptoms, to eliminate toxins. If exterior pathogenic factors are present, administer Qinghun San (Soul-Clearing Powder); if interior heat is present, administer Huisheng Dan (Life-Restoring Pill). When the abscess is about to rupture and suppurate, urgent application of interior-supporting methods is required; delay risks the internal sinking of toxins. Medicinal properties should be mild, pure, and gentle. Harsh diaphoretic (sweating-inducing) or purgative (downward-draining) agents are strictly contraindicated. Other treatments for swelling and ulceration follow the guidelines in the sections on "Carbuncle and Sore Ulceration" and "Carbuncle and Sore Rupture."
Formula: Shenghua Tang (Postpartum Restoration Decoction)
Composition: Danggui Radix Angelicae Sinensis (8 qian), Chuanxiong Rhizoma (4 qian), Jiangtan Carbonized Zingiberis Rhizoma, Gancao Radix Glycyrrhizae Preparata (roasted, 4 fen), Taoren Semen Persicae (skin and tip removed, pounded into paste, 10 grains).
Usage: Decoct with 1.5 zhong of water until reduced to 0.6 zhong. Mix with a small cup of unadulterated wine and take orally.
[Prescription Verse] Shenghua Tang is suitable for postpartum carbuncles and sores; it unblocks stagnation, harmonizes Ying and Wei (nutritive and defensive qi), and tonifies deficiency. Composed of Danggui, Chuanxiong, Jiangtan, and roasted Gancao, taken with Taoren and wine, it effectively eliminates blood stasis.
Another Formula: Qinghun San (Soul-Clearing Powder)
Composition: Jingjie Herba Schizonepetae (1 qian), Chuanxiong Rhizoma (5 fen), Renshen Radix Ginseng, Gancao Radix Glycyrrhizae Preparata (roasted), Zelan Ye Herba Lycopi (each 3 fen).
Usage: Grind into fine powder, mix with yellow wine, and take orally.
[Prescription Verse] Qinghun San addresses wind-pathogen invasion postpartum; composed of Jingjie, Chuanxiong, and Renshen, combined with roasted Gancao and Zelan Ye, it can disperse exterior syndromes with miraculous efficacy.
Another Formula: Huisheng Dan (Life-Restoring Pill)
Composition: Heidou Fructus Sojae Preparatus (boiled thoroughly, extract 3 bowls of juice, remove bean dregs, total volume 3 sheng), Honghua Flos Carthami (stir-fried until yellow, steeped in pure wine, boiled together in a large pot until reduced to 3-5 bowls, remove flowers and use only the juice), Dasheng Radix et Rhizoma Rhei (powdered, 1 jin), Sumu Lignum Calami.
Preparation: First, mix Dahuang powder with 3-4 bowls of good rice vinegar, stir evenly, and simmer over alternating mild and strong heat until it forms a paste; repeat this process twice. Then, add Honghua wine, Sumu decoction, and Heidou juice, and continue simmering until a paste is formed. Remove from heat, then add the following herbs:
Danggui Radix Angelicae Sinensis, Shudi Radix Rehmanniae Preparata, Chuanxiong Rhizoma, Baifuling Poria, Yanshusu Rhizoma Cyperi Rotundi, Wuyao Radix Linderae, Xiangfu Rhizoma Cyperi, Puhuang Pollinis Typhae, Niuxeni Radix Achyranthis Bidentata, Taoren Semen Persicae (separately pounded), Cangzhu Rhizoma Atractylodis Macrocephalae (soaked in rice wash water, stir-fried, each 2 liang), Baishao Radix Paeoniae Alba (wine-fried), Gancao Radix Glycyrrhizae Preparata (roasted), Qianghuo Rhizoma et Radix Notopterygii, Shanyurou Fructus Corni Officinalis (wine-soaked), Sanleng Rhizoma Sparganii, Chenpi Pericarpium Citri Reticulatae, Diyu Herba Sanguisorbae, Muxiang Radix Aucklandiae, Wulingzi Faeces Trogopterori (each 5 qian), Renshen Radix Ginseng, Baizhu Rhizoma Atractylodis Macrocephalae (earth-fried), Qingpi Pericarpium Citri Reticulatae Viride, Mugua Fructus Chaenomelis (each 3 qian), Liangjiang Rhizoma Alpiniae Officinarum (4 qian), Ruxiang Resina Olibani, Moyao Resina Myrrhae (each 1 qian).
Grind all ingredients into fine powder. Use the Dahuang paste as a binder to form pills the size of quail eggs. Take one pill per dose, melt in yellow wine by warming, and swallow orally.
[Prescription Verse] Huisheng Dan is used when lochia remains postpartum, leading to carbuncles and sores; it expels pathogens, clears heat, activates blood, resolves stasis, and harmonizes Ying and Wei. Ingredients include Honghua, Dahuang, Heidou, Sumu, plus the base of Bazhen Tang (Eight-Tonics Decoction) augmented with Qianghuo, Shanyurou, Sanleng, Yanshusu, Wuyao, Qingpi, Chenpi, Diyu, Xiangfu, Ruxiang, Moyao, Puhuang, Liangjiang, Niuxi, Mugua, Muxiang, Wulingzi, Taoren, and Cangzhu.