叔和曰∶产后寸口洪疾不调者,死;沉微附骨不绝者,生。又曰∶沉小滑者生;实大紧
弦急者死。
朱丹溪曰∶胎前脉宜洪数,既产而脉仍洪数者,死。又曰∶胎前脉细小,产后脉洪大多
死。
《济生产经》曰∶胎前之病,其脉贵实;产后之病,其脉贵虚。胎前则顺气安胎;产后
则扶虚消瘀。此其要也。
《脉要》曰∶欲产之脉,必见离经,或沉细而滑,夜半觉痛,来朝日中必娩。新产脉缓
滑为
吉,若实大弦急,近乎无胃,凶危之候。或寸口疾滑不调,恶症立见。惟宜沉细,附骨不绝
,虽剧无恙。
加参生化汤 治产后危急诸症。此方虽有血块可服。
当归(四钱) 川芎(二钱) 干姜(四分) 桃仁(十粒,去皮尖,研) 炙甘草(五分) 人
参(二三钱)
随症缓急。如危症,参加五六钱。分娩儿下,血崩晕去形脱,宜服此方。
原方加减法,娩儿下汗多倦甚,加参三四钱;娩儿下无力送胞,倦怠,宜服此方;胎前
患泻
、产后倦怠,宜服此方,加参三四钱;汗多,加麻黄根一钱,黄 一钱,防风五分;足厥冷
,加人参四五钱,附子四分;气短促,加人参四钱;渴,加麦冬一钱,五味子十粒;大便实
,加肉苁蓉一钱;烦渴,加竹肉一丸;寒渴,加杏仁十粒,桔梗五分;痰,加天花粉八分,
竹沥半盅,姜汁少许。
凡产后血块痛,生化汤为主。血块痛散(散,痛止也),加参生化汤为主。
Shuhe stated: If the Cun-kou (radial artery pulse position) pulse is surging, rapid, and irregular after childbirth, it indicates death; if the pulse is deep, minute, and faint but remains unbroken when pressed to the bone, it indicates survival. He further stated: A deep, small, and slippery pulse indicates life; a full, large, tight, wiry, and urgent pulse indicates death.
Zhu Danxi stated: During pregnancy, the pulse should be surging and rapid; if the pulse remains surging and rapid after delivery, it indicates death. He also stated: If the pulse is fine and small during pregnancy but becomes surging and large after delivery, death is likely.
The *Ji Chan Sheng Jing* (Classic of Delivering Life in Obstetrics) states: For diseases during pregnancy, the pulse should ideally be substantial; for diseases after childbirth, the pulse should ideally be deficient. During pregnancy, one should regulate Qi to calm the fetus; after childbirth, one should support deficiency and eliminate blood stasis. This is the key principle.
The *Mai Yao* (Essentials of Pulse Diagnosis) states: The pulse before delivery must show the "Li Jing" pulse (an abnormal pulse distinct from the usual pattern), or appear deep, fine, and slippery. If pain begins at midnight, delivery will surely occur by noon the next day. After fresh delivery, a slow and slippery pulse is auspicious; however, a full, large, wiry, and urgent pulse suggests nearly exhausted Stomach Qi, which is an ominous and critical sign. If the Cun-kou pulse is rapid, slippery, and irregular, severe pathological conditions such as retained lochia will immediately manifest. Only a deep and fine pulse that remains unbroken when pressed to the bone is safe, even if the condition is severe.
**Jia Shen Sheng Hua Tang (Ginseng-Added Decoction for Generating New Blood)**: Treats various critical conditions after childbirth. This formula can be used even if there are blood clots.
Angelicae Sinensis Radix (Danggui, 4 qian), Chuanxiong Rhizome (Chuanxiong, 2 qian), Dried Ginger (Ganjiang, 4 fen), Peach Kernel (Taoren, 10 grains, skin and tip removed, crushed), Prepared Licorice Root (Zhigancao, 5 fen), Ginseng Root (Renshen, 2-3 qian).
Adjust dosage according to the urgency of symptoms. In critical cases, increase Ginseng to 5-6 qian. It is suitable for use after fetal expulsion when there is hemorrhage, syncope, or collapse of form.
Original modification methods: If there is excessive sweating and extreme fatigue after delivery, add 3-4 qian of Ginseng; if there is weakness in expelling the placenta and fatigue after delivery, this formula is suitable; if diarrhea occurred during pregnancy and fatigue persists after delivery, this formula is suitable with the addition of 3-4 qian of Ginseng; for excessive sweating, add 1 qian of Equisetum Arvense Caulis (Mahuanggen), 1 qian of Astragali Membranacei Radix (Huangqi), and 5 fen of Saposhnikoviae Radix (Fangfeng); for cold extremities, add 4-5 qian of Ginseng Root (Renshen) and 4 fen of Aconiti Lateralis Radix Praeparata (Fuzi); for shortness of breath, add 4 qian of Ginseng Root (Renshen); for thirst, add 1 qian of Ophiopogonis Radix (Maidong) and 10 seeds of Schisandrae Chinensis Fructus (Wuweizi); for constipation, add 1 qian of Cistanche Deserticola Herba (Roucongrong); for irritability and thirst, add one pill of Bamboo Shavings (Zhuru); for cold-type thirst, add 10 Almond Seeds (Xingren) and 5 fen of Platycodonis Radix (Jiegeng); for phlegm, add 8 fen of Platycodonis Radix (Tianhuafen), half cup of Bamboo Juice (Zhuli), and a little Ginger Juice (Jiangzhi).
For postpartum pain caused by blood clots, Shenghua Tang is the primary formula. If the blood clots dissipate but pain persists, Jia Shen Sheng Hua Tang is the primary formula.