产后疟疾,宜分别施治,有寒热相兼,有热多寒少,草果饮子,或青皮饮,寒多,养胃汤,
或四兽饮之类。
草果饮
草果(一钱) 川芎(一钱) 紫苏(一钱) 白芷(一钱) 良姜(七分) 甘草(八分) 陈皮(八
分) 青皮(一钱)
水煎。
四兽饮
人参(一钱) 白术(一钱,炒) 陈皮(一钱二分) 茯苓(一钱二分) 甘草(五分) 草果(八
分) 乌梅(三个) 半夏(六分)
加姜枣,水煎服。
胜金丹
常山(四两,酒蒸) 尖槟榔(一两)
共为末,醋糊丸,未发时,先吞三十丸,至五更再吞十五丸,温酒送下,丸如菀豆大。发时
切不可服。
养胃汤(见胎前)
产后血气大亏,纵有寒,不可大发汗,芎归汤加人参、苏叶、葛根微汗之。故郑氏只用带须
葱煎汤服。如热不止,黄龙汤加芎、归。大热不得已,加知母、黄连。可攻可温者,临时斟
酌,不可妄投峻剂,耗损真元也,慎之。
产后泄泻,小便不利而泻,此阴阳不分之故,宜胃苓汤,腹痛是食积,宜加消食药。恶露不
行,宜行血。若外感风寒而内伤饮食者,宜养胃汤。恶露已净,不必活血,如未净,加归尾
、桃仁之类。如久泻不止,养胃汤,加肉桂、肉果。如挟寒腹痛肠鸣,小水清白不浊,口不
渴,加肉果炒白芍。如热泻,肠垢口渴,时痛时泻,火也,宜姜炒黄连、木通。或泻或不泻
,或多或少者,痰也。肯堂云∶产后泻痢,不可混治,以补脾为主,如白术茯苓神曲甘草陈
皮之类,兼以消食理气之剂。
君苓汤
白术(二钱,炒) 茯苓(二钱) 猪苓(一钱) 泽泻(一钱)
水煎服。
胃苓汤(即君苓汤加平胃散)
Malaria occurring after childbirth should be treated differently according to specific conditions. Some cases present with alternating chills and fever, while others have more heat than chills; Caoguo Yinzi (Grass Cardamom Decoction) or Qingpi Yin (Green Peel Decoction) may be used. If chills are predominant, Yangwei Tang (Stomach-Nourishing Decoction) or formulas similar to Sishou Yin (Four Beasts Decoction) should be employed.
Caoguo Yin (Grass Cardamom Decoction)
Caoguo (Tsaoko Fructus, 1 qian) Chuanxiong (Rhizoma Ligustici Chuanxiong, 1 qian) Zisu (Perillae Folium, 1 qian) Baizhi (Radix Angelicae Dahuricae, 1 qian) Liangjiang (Rhizoma Alpiniae Officinarum, 7 fen) Gancao (Radix Glycyrrhizae Uralensis, 8 fen) Chenpi (Pericarpium Citri Reticulatae, 8 fen) Qingpi (Pericarpium Citri Reticulatae Viride, 1 qian)
Decoct in water and take.
Sishou Yin (Four Beasts Decoction)
Renshen (Radix Ginseng, 1 qian) Baizhu (Rhizoma Atractylodis Macrocephalae, 1 qian, stir-fried) Chenpi (Pericarpium Citri Reticulatae, 1.2 qian) Fuling (Poria, 1.2 qian) Gancao (Radix Glycyrrhizae Uralensis, 5 fen) Caoguo (Tsaoko Fructus, 8 fen) Wumei (Fructus Mume, 3 pieces) Banxia (Rhizoma Pinelliae Ternatae, 6 fen)
Add fresh ginger and Chinese jujube, decoct in water, and take.
Shengjin Dan (Victory Gold Pill)
Changshan (Radix Dichroae, 4 liang, steamed with wine) Jianbinglang (Arecae Semen, 1 liang)
Grind together into powder, make pills using vinegar paste. Before the onset of malaria, swallow thirty pills first, and at wugeng time (early morning), swallow another fifteen pills, taken down with warm wine. The pills should be as large as rabbit seeds. Do not take during an attack.
Yangwei Tang (Stomach-Nourishing Decoction) (See section on Prenatal Conditions)
After childbirth, blood and qi are severely depleted. Even if there is external cold, strong diaphoresis (sweating therapy) must not be used. Instead, Xiongui Tang (Cyathula and Angelica Decoction) can be added with Renshen (Radix Ginseng), Ziye (Perillae Folium), and Gegen (Puerariae Radix) to induce mild sweating. Therefore, Zheng Shi only uses scallions with roots decocted in water for consumption. If fever persists, Huanglong Tang (Yellow Dragon Decoction) can be added with Chuanxiong (Rhizoma Ligustici Chuanxiong) and Danggui (Angelicae Sinensis Radix). If high fever is unavoidable, Zhimu (Anemarrhenae Rhizoma) and Huanglian (Coptidis Rhizoma) can be added. One may choose between purgative or warming methods based on the situation, deciding temporarily; do not recklessly administer harsh agents that deplete the body's true yuan (vital energy). Exercise caution.
Diarrhea after childbirth, accompanied by difficult urination and diarrhea, is due to the failure of yin and yang to separate properly. Weiling Tang (Gastrointestinal Regulating Decoction) is suitable. Abdominal pain indicates food stagnation, so digestive-resolving herbs should be added. If lochia (postpartum discharge) is not flowing smoothly, blood-invigorating herbs are appropriate. If caused by external wind-cold and internal dietary injury, Yangwei Tang (Stomach-Nourishing Decoction) is suitable. If lochia has cleared completely, blood-invigorating herbs are unnecessary; if not fully cleared, add Dangguiwei (Angelicae Sinensis Radix Cauda) and Taoren (Persicae Semen). If chronic diarrhea persists, use Yangwei Tang (Stomach-Nourishing Decoction) with Rougui (Cinnamomi Cortex) and Rouguo (Myristicae Semen). If accompanied by cold-induced abdominal pain and borborygmus, with clear and non-turbid urine and no thirst, add stir-fried Rouguo (Myristicae Semen) and Baishao (Paeoniae Radix Alba). For hot diarrhea with sticky stool, thirst, intermittent pain and diarrhea, which indicates fire syndrome, use Jiangchao Huanglian (Coptidis Rhizoma stir-fried with ginger) and Mutong (Akebiae Caulis). Intermittent diarrhea with varying amounts suggests phlegm-dampness. Kentang stated: Diarrhea and dysentery after childbirth should not be treated indiscriminately; the primary approach should be strengthening the spleen, using herbs such as Baizhu (Rhizoma Atractylodis Macrocephalae), Fuling (Poria), Shenqu (Massa Medicata Fermentata), Gancao (Radix Glycyrrhizae Uralensis), and Chenpi (Pericarpium Citri Reticulatae), combined with agents that resolve food stagnation and regulate qi.
Junling Tang (Lord Poria Decoction)
Baizhu (Rhizoma Atractylodis Macrocephalae, 2 qian, stir-fried) Fuling (Poria, 2 qian) Zhuling (Polyporus, 1 qian) Zexie (Alismatis Rhizoma, 1 qian)
Decoct in water and take.
Weiling Tang (Gastrointestinal Regulating Decoction) (This is Junling Tang plus Pingwei San [Powder to Maintain Stability])