〔郭〕问产后口干痞闷者何?答∶产后荣卫大虚,血气未定,食面太早,胃不能消
化,面毒结聚于胃脘,上熏胸中,是以口干燥渴,心下痞闷,医者不识,认为胸膈壅滞,
以药下之,万不得一,但服见 丸则愈。
陈无择评曰∶产后口干痞闷,未必只因食面,或产母内积忧烦,外伤燥热,饮食甘
肥,使口干痞闷。当随其所因,调之可也。心烦宜四物汤去地黄加人参、乌梅煎。若外伤
燥热,看属何经,当随经为治,难以备举。饮食所伤,见 丸却能作效。
〔薛〕前证若宿食停滞,用六君、枳实、神曲。若因肉食所致,更加山楂。若因鱼
之类,再加陈皮。其物既消而仍痞,或反作痛作呕,此脾胃受伤,用六君子汤。或咽酸
嗳腐,加炮姜。作泻,更加升麻。如不应,佐以四神丸,或间用补中益气汤。一妇人食
角黍烦渴,痞闷腹痛,大便欲去不去,服消
导之药不应,饮食日减,肌体日瘦,半年矣。余谓此食积为患,用大酒曲炒为末,温酒调
服二钱。俄而腹鸣,良久仍下粽而愈。一妇人食鱼 ,腹痛患痢,诸药不应,用陈皮、
白术等分为末,以陈皮汤送下,数剂而愈。
见 丸
姜黄(炒) 三棱(醋炒) 毕澄茄 陈皮(去白) 良姜 人参 蓬莪术(酒炒,各等分)
上为细末,用萝卜捣烂,绞取汁,煮面糊丸如梧子大。每服三十丸,萝卜汤下,白
汤亦可。
[Guo] Question: What is the cause of dry mouth and epigastric fullness/stuffiness after childbirth? Answer: After childbirth, Ying (Nutritive) and Wei (Defensive) Qi are severely deficient, and Blood and Qi have not yet stabilized. If noodles are consumed too early, the Stomach cannot digest them. The "toxicity" of noodles accumulates in the epigastrium and steams upward to the chest. Consequently, there is dry mouth with thirst and epigastric fullness/stuffiness. If physicians do not recognize this pattern and mistakenly treat it as stagnation in the chest and diaphragm using purgatives, success will be rare in ten attempts. Simply administering Jian Wan (See Pill) will lead to recovery.
Chen Wuyue commented: Dry mouth and epigastric fullness after childbirth are not necessarily solely due to eating noodles. It may also result from the mother's internal accumulation of worry and vexation, external contraction of dry-heat pathogens, or consumption of sweet, greasy, and rich foods, leading to dry mouth and fullness. Treatment should be based on the specific etiology. For heart vexation, Si Wu Tang (Four Substances Decoction) without Rehmanniae Radix (Di Huang), added with Ginseng Radix et Rhizoma (Ren Shen) and Mume Fructus (Wu Mei), is appropriate. For external dry-heat, one must determine which meridian is affected and treat accordingly; it is difficult to list all possibilities. For injuries caused by diet, Jian Wan can be effective.
[Xue] If the aforementioned symptoms are due to retained food stagnation, Liu Jun Zi Tang (Six Gentlemen Decoction) combined with Zhi Shi (Immature Bitter Orange) and Shen Qu (Medicated Leaven) should be used. If caused by meat consumption, add Hawthorn Fruit (Shan Zha). If caused by fish, add Tangerine Peel (Chen Pi). If the food has been digested but fullness persists, or if pain and vomiting occur instead, this indicates injury to the Spleen and Stomach; use Liu Jun Zi Tang. If accompanied by acid regurgitation and belching of rotten smells, add Roasted Ginger (Pao Jiang). If diarrhea occurs, add Cimicifugae Rhizoma (Sheng Ma). If there is no response, assist with Si Shen Wan (Four Spirits Pill), or alternatively use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). A woman who ate zongzi (sticky rice dumplings) experienced vexation, thirst, epigastric fullness, abdominal pain, and a sensation of incomplete defecation. After taking digestive herbs without effect, her diet decreased daily, and she emaciated over half a year. I diagnosed this as food stagnation. I used Da Jiu Qu (Large Yeast) stir-fried into powder, taken with warm wine, two qian per dose. Soon, borborygmus occurred, and after some time, undigested zongzi was passed, leading to recovery. Another woman developed abdominal pain and dysentery after eating fish. Various medicines failed. Using Chen Pi and Bai Zhu in equal parts ground into powder, administered with Chen Pi decoction, cured her after several doses.
Jian Wan (See Pill)
Curcumae Longae Rhizoma (Jiang Huang, stir-fried) Sanleng Rhizoma (Sanzhe, vinegar-fried) Galangal Fruit (Bichengqie) Citri Reticulatae Pericarpium (Chen Pi, white pith removed) Galangal Rhizoma (Liang Jiang) Ginseng Radix et Rhizoma (Ren Shen) Curcumae Aromatica Rhizoma (Peng'ezhu, wine-fried), each in equal proportions.
Grind the above into fine powder. Use fresh radish mashed and juiced, mixed with flour paste to make pills the size of mulberry seeds. Take thirty pills per dose, washed down with radish decoction; plain water is also acceptable.