产后七日内外,患赤白痢疾,后重频并,为最难治。欲调气行血,而推荡痢邪,则虑产
后之
元气正虚;欲滋荣益气,而大补虚弱,又恐助痢邪之初盛,其行不损元,补不助邪,惟生化
汤减干姜,而代木香、茯苓,则善消恶露,兼行痢积,并行而不悖也。再服加味香连丸,以
俟二三日后,现病势加减,可保无虑。若产七日外,有患褐色后重频并虚痢,即当加补无疑
。若产妇禀浓,产期以及二十余日,可用生化汤,加芩、连、浓朴、芍药,行积之剂,加味
香连丸以治之。
加减生化汤 治产后七日内外患痢。
川芎(二钱) 当归(二钱) 炙甘草(五分) 桃仁(十二粒) 茯苓(一钱) 陈皮(四分)
木香(二分,磨)
白痢腹痛,加砂仁六分。
清血丸 治红痢神方,产七日内不可用寒性药也。
香连丸 香连为主,加莲肉粉各一半,治噤口痢,赤白痢下绞痛,加行积药。
产三四日后,血块散,痢积少,加减用照后开方治法。(方详八卷。)
一、产后久泻,元气下陷,大便不禁,肛门如脱,宜服六君子汤,加木香四分,制肉果
一个,干姜五分。
二、产后泻痢黄色,乃脾气久虚,宜服补中益气汤,加木香四分,肉果一个(制)。
三、产后伤面食泻痢,宜服加参生化汤,加神曲、麦芽。
四、产后伤肉食泻痢,宜服加参生化汤,加山楂、砂仁。
五、产后胃口虚弱,患痢泻,完谷不化,当温助胃气,宜服六君子丸,加木香、制肉果
一个。
六、产后肝脾二气俱虚,泻痢,四肢浮肿,宜服六君子汤加陈皮。
七、产后泻无后重,但日久不止,宜服六君子汤,加肉果、木香。
八、产后赤白痢,脐下气痛,用当归、浓朴、黄连、肉果、甘草。
九、产后痢久,白痢不止,属血虚。宜服四君子汤,加荆芥、人参。
十、产后痢,羸困,心腹绞痛,宜服薤白、石榴皮、当归、黄连、地榆。痢腹痛不止,
用温汤蘸熨,暖腹则缓。
Within seven days before or after childbirth, if the patient suffers from dysentery with red and white discharge, accompanied by frequent tenesmus (a feeling of incomplete defecation), it is considered the most difficult to treat. If one attempts to regulate qi and move blood to push out the dysenteric pathogen, there is a concern that postpartum primordial qi (the body's vital energy) is currently deficient; if one attempts to nourish blood and tonify qi to greatly supplement weakness, there is a fear of aiding the initial flourishing of the dysenteric pathogen. The method that neither damages the primordial qi nor aids the pathogen is to use Shenghua Tang (Life-Birth Decoction) minus Dried Ginger (Ganjiang), substituting with Aromatic Pepper (Muxiang) and Poria (Fuling). This approach effectively eliminates lochia (postpartum uterine discharge) while simultaneously moving dysenteric accumulation, allowing both actions to proceed without conflict. Subsequently, administer Jiawei Xianglian Wan (Modified Fragrant Link Pill). After two or three days, adjust the prescription according to the progression of the disease, ensuring safety and peace of mind. If, after seven days postpartum, the patient presents with brown stool, frequent tenesmus, and deficiency-type dysentery, addition of tonifying herbs is undoubtedly required. If the parturient has a robust constitution, within the period of confinement and up to twenty-plus days postpartum, Shenghua Tang can be used with added Scutellaria Root (Huangqin), Coptis Rhizome (Huanglian), Magnolia Bark (Houpo), and White Peony Root (Shaoyao) as agents to move accumulation, combined with Jiawei Xianglian Wan for treatment.
Jiawei Shenghua Tang: Treats dysentery occurring within seven days before or after childbirth.
Chuanxiong Rhizome (Chuanxiong, 2 qian)
Angelica Sinensis Root (Danggui, 2 qian)
Prepared Licorice Root (Zhi Gancao, 5 fen)
Peach Kernel (Taoren, 12 grains)
Poria (Fuling, 1 qian)
Tangerine Peel (Chenpi, 4 fen)
Aromatic Pepper (Muxiang, 2 fen, ground into juice)
For white dysentery with abdominal pain, add Amomum Fruit (Sharen, 6 fen).
Qingxue Wan: A miraculous formula for treating red dysentery. Cold-natured herbs must not be used within seven days postpartum.
Xianglian Wan: Uses Aromatic Pepper and Coptis as main ingredients, mixed with Lotus Seed Flesh Powder in equal halves, to treat Jin Kou Li (dysentery with inability to eat). For red and white dysentery with colicky pain, add herbs that move accumulation.
After three or four days postpartum, when blood clots have dispersed and dysenteric accumulation has decreased, adjust the prescription according to the methods listed below. (Detailed formulas are found in Volume 8.)
1. For prolonged diarrhea postpartum due to sinking of primordial qi, with involuntary defecation and a sensation of anal prolapse, Liu Junzi Tang (Six Gentlemen Decoction) is suitable, with added Aromatic Pepper (4 fen), processed Myrobalan (Rouguo, 1 piece), and Dried Ginger (5 fen).
2. For yellow-colored diarrhea and dysentery postpartum, caused by long-term deficiency of Spleen Qi, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) is suitable, with added Aromatic Pepper (4 fen) and one processed Myrobalan (Rouguo).
3. For diarrhea and dysentery postpartum caused by improper consumption of wheat products, Jia Shen Shenghua Tang (Shenghua Tang with Added Ginseng) is suitable, with added Medicated Leaven (Shenqu) and Malt (Maiya).
4. For diarrhea and dysentery postpartum caused by improper consumption of meat, Jia Shen Shenghua Tang is suitable, with added Hawthorn Fruit (Shanzha) and Amomum Fruit (Sharen).
5. For weak appetite postpartum with dysentery/diarrhea and undigested food in stool, which requires warming and assisting Stomach Qi, Liu Junzi Wan (Six Gentlemen Pill) is suitable, with added Aromatic Pepper and one processed Myrobalan (Rouguo).
6. For joint deficiency of Liver and Spleen Qi postpartum, presenting with diarrhea/dysentery and edema of the four limbs, Liu Junzi Tang with added Tangerine Peel (Chenpi) is suitable.
7. For postpartum diarrhea/dysentery without tenesmus but persisting for a long time, Liu Junzi Tang with added Myrobalan (Rouguo) and Aromatic Pepper (Muxiang) is suitable.
8. For red and white dysentery postpartum with Qi-stagnation pain below the umbilicus, use Angelica Sinensis Root (Danggui), Magnolia Bark (Houpo), Coptis Rhizome (Huanglian), Myrobalan (Rouguo), and Licorice Root (Gancao).
9. For prolonged postpartum dysentery where white dysentery does not cease, indicating Blood deficiency, Si Junzi Tang (Four Gentlemen Decoction) with added Schizonepeta Spike (Jingjie) and Ginseng (Renshen) is suitable.
10. For postpartum dysentery with emaciation and fatigue, and colicky pain in the heart and abdomen, use Allium Macrostemon Bulb (Xiebai), Pomegranate Rind (Shiliupi), Angelica Sinensis Root (Danggui), Coptis Rhizome (Huanglian), and Sanguisorba Root (Diyu). If dysentery-related abdominal pain persists, apply warm compresses soaked in warm water to the abdomen; warmth will alleviate the pain.