产后潮热有汗,大便不通,毋专论为阳明症;口燥咽干而渴,毋专论为少阴症;腹满嗌干,大便
实,毋专论为太阴症。又汗出,谵语,便秘,毋专谓为胃中有燥屎。且下数症多由劳倦伤脾,运化稽迟,
气血枯竭,肠腑燥涸,乃虚症类实,当补之症,治者毋执偏门轻产而妄议三承气汤,以治类三阴之症
也。若少旺产患,以类症妄下,侥幸万一,幸毋仿此。且虚弱产妇而复误下,则虚虚之祸大乎。屡见妄
下成臌,误导反结。又有血少数日不通,误而即下,致泻不止者,不可慎欤。
养正通幽汤 治产后大便秘,类三阴伤寒症。
川芎(二钱半) 川归(六钱) 甘草(五分,炙) 桃仁(五粒,去皮尖) 苁蓉(一钱)
陈皮(四分) 麻仁(二钱,炒)
汗多便实,加黄 一钱,麻黄根一钱,人参二钱;燥渴,加麦冬一钱,人参一钱;腹满,嗌干,便
实,加麦冬一钱,枳壳六分,人参二钱,苁蓉一钱。汗出,谵语,便实,乃气血并竭,神衰心主失守,
宜养荣安神,加茯神、枣仁、远志、柏子仁、苁蓉、人参、黄 各一钱,白术二钱,水煎。
滋荣益气扶正汤 治产后寒热自汗,每午应期发者。
川芎(一钱) 川归(三钱) 甘草(五分,炙) 人参(二钱) 淮生地(二钱,自蒸) 黄
(一钱) 陈皮(四分) 麦冬(一钱) 白术(一钱半) 麻黄根(一钱)
水煎。夜服六味地黄丸,每服七、十丸,清汤送下。
加减养胃汤 治产后寒热往来,头痛无汗,类疟症。
川芎(一钱) 川归(三钱) 藿香(四分) 甘草(四分) 茯苓(一钱)
苍术(一钱) 人参(一钱半) 半夏(八分) 陈皮(四分) 姜(二片)
水煎服。有痰加竹沥、姜汁少许,半夏曲;弱人兼服大造丸;若产后久虚,无汗不愈,兼煎
人参白术膏以助力。
Tidal fever with sweating and unsmooth bowel movements after childbirth should not be exclusively diagnosed as Yangming disease (disease of the Yangming channel); dry mouth and throat with thirst should not be exclusively diagnosed as Shaoyin disease (disease of the Shaoyin channel); abdominal fullness, dry throat, and solid stool should not be exclusively diagnosed as Taiyin disease (disease of the Taiyin channel). Furthermore, cases involving sweating, delirium (speaking incoherently), and constipation should not simply be attributed to dry feces in the stomach. Moreover, most of the aforementioned symptoms arise from fatigue damaging the Spleen Qi, leading to sluggish transportation and transformation, depletion of Qi and Blood, and desiccation of the intestinal Fu organs. This presents as a deficiency syndrome mimicking excess (Xu Zheng Lei Shi), which actually requires tonification. Physicians must not adhere to biased views or underestimate the postpartum constitution to recklessly prescribe San Chengqi Tang (Three Inevitable Purgative Decoctions) for treating these conditions resembling Three Yin diseases. Even if a robust postpartum patient is mistakenly purged due to similar symptoms and happens to survive once, one must never imitate this practice. For weak postpartum patients, misusing purgatives again will cause severe harm by further depleting the deficient state ("making the deficient even more deficient"). It has been frequently observed that reckless purging leads to abdominal distension (Gu Zhang), and misguided treatment results in pathological accumulation. There are also cases where blood deficiency causes constipation for several days; mistaking this for excess and using purgatives leads to incessant diarrhea. Should one not be cautious?
Yangzheng Tongyou Tang (Nourish Righteousness and Unblock the Obscure Decoction): Treats postpartum severe constipation with symptoms resembling Three Yin Shanghan (Cold Damage) diseases.
Chuanxiong Rhizome (Chuanxiong) (2.5 qian)
Angelicae Sinensis Radix (Danggui) (6 qian)
Glycyrrhizae Radix et Rhizoma (Gancao) (0.5 qian, honey-fried)
Persicae Semen (Taoren) (5 grains, skin and tip removed)
Cistanches Herba (Rongshou) (1 qian)
Citri Reticulatae Pericarpium (Chenpi) (0.4 qian)
Cannabis Fructus (Haren) (2 qian, stir-fried)
If sweating is profuse and stool is solid, add Astragali Radix (Huangqi) (1 qian), Ephedrae Radix et Rhizoma Root (Mahuanggen) (1 qian), and Ginseng Radix (Renshen) (2 qian). If there is dryness and thirst, add Ophiopogonis Radix (Maidong) (1 qian) and Ginseng Radix (Renshen) (1 qian). If there is abdominal fullness, dry throat, and solid stool, add Ophiopogonis Radix (Maidong) (1 qian), Aurantii Fructus (Zhike) (0.6 fen), Ginseng Radix (Renshen) (2 qian), and Cistanches Herba (Rongshou) (1 qian). If there is sweating, delirium, and solid stool, this indicates simultaneous depletion of Qi and Blood, with decline of Shen (Spirit) and loss of control by the Heart Master. It is appropriate to nourish Ying (Nutritive) Qi and calm the Spirit; add Poria (Fushen), Ziziphi Spinosae Semen (Zaoren), Polygalae Radix (Yuanzhi), Biota Seed (Baiziren), Cistanches Herba (Rongshou), Ginseng Radix (Renshen), and Astragali Radix (Huangqi) (each 1 qian), and Atractylodis Macrocephalae Rhizoma (Baizhu) (2 qian). Decoct in water.
Zirong Yiqi Fuzheng Tang (Nourish Glory, Replenish Qi, and Support Righteousness Decoction): Treats postpartum alternating chills and fever with spontaneous sweating, occurring periodically at noon.
Chuanxiong Rhizome (Chuanxiong) (1 qian)
Angelicae Sinensis Radix (Danggui) (3 qian)
Glycyrrhizae Radix et Rhizoma (Gancao) (0.5 qian, honey-fried)
Ginseng Radix (Renshen) (2 qian)
Rehmanniae Radix Praeparata (Shudihuang/Huaishengdi) (2 qian, self-steamed)
Astragali Radix (Huangqi) (1 qian)
Citri Reticulatae Pericarpium (Chenpi) (0.4 qian)
Ophiopogonis Radix (Maidong) (1 qian)
Atractylodis Macrocephalae Rhizoma (Baizhu) (1.5 qian)
Ephedrae Radix et Rhizoma Root (Mahuanggen) (1 qian)
Decoct in water. Take Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) at night, 7–10 pills per dose, taken down with clear water.
Jiajian Yangwei Tang (Modified Stomach-Nourishing Decoction): Treats postpartum alternating chills and fever, headache without sweating, with symptoms resembling Malaria (Nue Bing).
Chuanxiong Rhizome (Chuanxiong) (1 qian)
Angelicae Sinensis Radix (Danggui) (3 qian)
Agastaches Herba (Huoxiang) (0.4 qian)
Glycyrrhizae Radix et Rhizoma (Gancao) (0.4 qian)
Poria (Fuling) (1 qian)
Atractylodis Rhizoma (Cangzhu) (1 qian)
Ginseng Radix (Renshen) (1.5 qian)
Pinelliae Rhizoma (Banxia) (0.8 fen)
Citri Reticulatae Pericarpium (Chenpi) (0.4 qian)
Zingiberis Rhizoma Recens (Jiang) (2 slices)
Decoct in water and take orally. If there is phlegm, add a small amount of Bamboo Sap (Zhuli), Ginger Juice (Jiangzhi), and Pinelliae Fermentatum (Banxiaku). For weak individuals, concurrently take Dachao Wan (Great Creation Pill). If postpartum deficiency persists for a long time with no sweating and non-resolution, concurrently decoct Renshen Baizhu Gao (Ginseng and Atractylodes Paste) to assist the medicinal power.