产后气急喘促者,因产所下过多,荣血暴竭,卫气无主,不能百达营运,独聚肺
中,故令喘也,此名孤阳绝阴,为难治,惟大进参附,或可得生。
产后发喘气促,此第一危症也。若作痰火实症治之必死,当以人参生化汤加减。人
疑参能助喘不用,致不救者多矣。况同穹归黑姜,万无有失,要知人生于气,气壮则根
本固。而藏源者敛纳于下,营运者强健于中,何有为喘为胀之虞!只有虚弱而致死。
未有强壮而成病也。有用人参加陈皮监制,则盗泄元气,反致耗散,只可消导药中兼。
产后四肢浮肿,由败血乘虚停积,而循经流入四肢,留淫日深,腐坏如水,故令面
黄,四肢浮肿。医人不识,便作水气治之。多用导水。凡治水药极能虚人,产后既虚。
药又虚之,是谓重虚,多致夭枉,服小调经
散,血行肿消即愈。
产后浮肿,若寒水侮土,宜养脾肺,若气虚浮肿,宜益脾胃。若水气浮肿。宜补中
汤,若兼喘咳而脉沉细无力,此命问火衰。脾土虚寒也,八味丸主之,腹满者。虚气而
非血也,补中汤送八味丸,一以升补清阳,一以敛纳浊气,升降既得,而胀满自消矣。
产后身痛者,是血虚而不能荣也。手足走痛者,是气血不能养荣四末,而浊气流于
四肢则肿,阴火游行四旁则痛也,不出荣养,如黑姜主之。
In the postpartum period, if there is shortness of breath and rapid panting, it is due to excessive blood loss during childbirth. This causes a sudden depletion of Ying Blood (Nutritive Blood), leaving Wei Qi (Defensive Qi) without a master to anchor it. Consequently, Wei Qi cannot circulate normally throughout the body but gathers exclusively in the Lungs, causing panting. This condition is named "Solitary Yang and Absent Yin" and is difficult to treat; only by administering large doses of Renshen (Ginseng Root) and Fuzi (Aconite Lateralis Preparata) can life potentially be saved.
Postpartum panting with rapid breathing is the most critical emergency. If treated as a Phlegm-Fire Excess syndrome, death is inevitable. One should use Ren Shen Sheng Hua Tang (Ginseng and Blood-Generating Decoction) with modifications. Some doubt that Renshen (Ginseng Root) might exacerbate panting and thus avoid its use, leading to many unrescued cases. Moreover, the combination of Xiongqiong (Angelica Sinensis Radix and Ligusticum Chuanxiong Rhizoma) and Heijiang (Prepared Ginger Rhizome) is infallible. It must be understood that human life depends on Qi; when Qi is strong, the root is solid. The source of storage is consolidated below, and the power of operation is strengthened in the middle. How could there be worry about panting or distension? Only weakness leads to death; strength does not cause disease. If Renshen (Ginseng Root) is used with Chenpi (Citrus Reticulata Pericarpium) to restrain it, it may leak Yuan Qi (Original Qi) and cause dispersion instead; this combination is only suitable for inclusion in digestion-promoting formulas.
Postpartum edema of the four limbs results from stagnant blood taking advantage of deficiency to accumulate, flowing along the meridians into the limbs. As it remains deep within for days, it corrupts and spreads like water, causing yellowish complexion and edema of the limbs. Physicians who do not recognize this pathology often treat it as Water-Qi (Edema). They frequently use diuretic drugs to guide out water. However, all drugs treating Water-Qi severely weaken the person. Since the postpartum state is already deficient, using such drugs causes further deficiency, termed "Double Deficiency," often leading to premature death. Taking Xiao Tiao Jing San (Minor Regulating Menses Powder) allows blood circulation to resume and swelling to subside, resulting in recovery.
For postpartum edema: if Cold-Water insults Earth (Kidney Cold overwhelming Spleen), nourishing the Spleen and Lungs is appropriate; if caused by Qi deficiency, tonifying the Spleen and Stomach is indicated; if caused by Water-Qi, Bu Zhong Tang (Tonify the Middle Decoction) is suitable. If accompanied by panting, coughing, and a deep, thin, and forceless pulse, this indicates failure of Mingmen Fire (Gate of Life Fire) and deficiency-cold of Spleen Earth, treated primarily with Ba Wei Wan (Eight-Ingredient Pill). Abdominal fullness here is due to deficient Qi rather than blood stasis; one may administer Bu Zhong Tang to deliver Ba Wei Wan. One formula raises and tonifies Clear Yang, while the other gathers and accepts turbid Qi. Once ascending and descending functions are restored, distension and fullness will naturally disappear.
Postpartum body pain is due to Blood deficiency failing to nourish the tissues. Wandering pain in the hands and feet indicates that Qi and Blood fail to nourish the extremities. Turbid Qi flowing into the limbs causes swelling, while Yin Fire wandering around the sides causes pain. These issues fundamentally stem from a lack of nourishment; Prepared Ginger Rhizome (Heijiang) is used as the primary treatment.