凡产母产时用力过甚,劳倦伤脾,脾气耗竭不能注于四肢,故足冷逆而厥气上行。经曰∶阳气衰于下则为
寒厥。厥气上行,满于经络,则神气浮越,去身而飘散矣。苟非大补,焉能回阳而复神,必用加参生化汤倍人参,
连进二帖,使气血旺而神复厥止。如渴,另用生脉散代茶,助津以滋脏燥。虽有四肢厥冷、泄漏,或类伤寒阴症,
亦不可四逆汤辈,必加参生化佐以黑姜,或加熟附一片,以回阳止逆则可,已足以行参 之力矣。
加参生化汤
人参(二钱) 川芎(二钱) 当归(四钱) 姜炭 炙草(各四分) 桃仁(十粒)
加元枣二枚水煎。如厥回,暂去人参,待血块痛除再加。此治新产发厥。
滋荣益气复神汤(产后发厥,无块痛者服此。)
川芎 焦术 炙 麦冬(各一钱) 人参 当归(各三钱) 熟地(二钱) 炙草(四分) 陈皮(四分)
五味(十粒)
水煎服。口渴,以生脉散代茶。汗多,加麻黄根、枣仁各一钱。块痛不止,加肉桂五分。便闭,加苁蓉,麻
仁各二钱。痰,加竹沥,姜汁、橘红各四分,酒一杯,手足口气渐冷,加附子五分,倍用人参。
按∶厥逆属阳虚者居多,若无块痛、腹胀等症,纯用参附。加肉桂可也,有桂则瘀亦去矣。不可迟疑。
大抵产后晕厥,皆由气血两竭,神将去而几息,仅有一线生意耳。若非大补,不能回将绝之元阳。但晕在临盆,
尤甚于厥,宜频服生化汤,先补血分之亏,可期块化血旺,神清晕止。如无汗脱、神倦、气促等症,切勿遽加参 。
或厥在分娩之后,气血两竭,宜用加参生化以复其神。总之,治晕问有块痛,参术未可骤进;问无块痛,参、 、
地、术,必须并用。
In cases where the mother exerts excessive effort during childbirth, fatigue damages the Spleen, causing Spleen Qi (Spleen energy) to exhaust and fail to nourish the four limbs. Consequently, the feet become cold and reverse into Jue syndrome (cold extremities with reversal of cold qi), while the Jue qi ascends. The Classics state: "When Yang Qi is deficient at the lower part, it results in Cold Jue." When Jue qi ascends and fills the meridians and collaterals, the Shen spirit becomes floating and scattered, departing from the body. Unless substantial tonification is applied, how can Yang Qi be restored and the Shen revived? One must use Jiashen Shenghua Decoction (Ginseng-Added Blood-Generating Decoction) with doubled Ginseng dosage, administered consecutively for two doses, to make Qi and Blood abundant, thereby restoring the Shen and stopping Jue. If there is thirst, use Shaoyang San (Pulse-Nourishing Powder) as tea substitute to assist Jin fluids and moisten organ dryness. Although symptoms such as cold extremities, sweating, or presentations resembling Yin syndromes of Shanghan (Cold Damage) may occur, one must not use Si Ni Tang (Frigid Extremities Decoction). Instead, Jiashen Shenghua Decoction should be combined with Heijiang (Charred Ginger) or one piece of Shu Fuzi (Prepared Aconite Root) to restore Yang and stop rebellion; this is sufficient to enhance the efficacy of Ginseng.
Jiashen Shenghua Decoction (Ginseng-Added Blood-Generating Decoction)
Renshen (Ginseng Radix et Rhizoma) (2 qian)
Chuanxiong (Ligusticum Chuanxiong Rhizome) (2 qian)
Danggui (Angelica Sinensis Radix) (4 qian)
Jiangtan (Charred Ginger)
Zhi Cao (Honey-fried Licorice Root) (each 4 fen)
Taoren (Prunus Persica Seed) (10 grains)
Decoct with 2 Yuan Zao (Jujube Fruit). If Jue resolves, temporarily remove Renshen; re-add it after blood stasis and pain are eliminated. This treats postpartum Jue following recent delivery.
Zirong Yiqi Fushen Decoction (Nourishing Blood, Replenishing Qi, and Restoring Spirit Decoction) (For postpartum Jue without blood stasis pain.)
Chuanxiong (Ligusticum Chuanxiong Rhizome)
Jiao Zhu (Charred Atractylodes Macrocephala Rhizome)
Zhi Maidong (Honey-fried Ophiopogon Tuber) (each 1 qian)
Renshen (Ginseng Radix et Rhizoma)
Danggui (Angelica Sinensis Radix) (each 3 qian)
Shu Di (Rehmannia Glutinosa Root Preparata) (2 qian)
Zhi Cao (Honey-fried Licorice Root) (4 fen)
Chenpi (Citrus Reticulata Pericarpium) (4 fen)
Wuwei (Schisandra Chinensis Fruit) (10 grains)
Decoct in water and take orally. For thirst, use Shaoyang San as tea. For profuse sweating, add Mahuang Gen (Ephedra Root) and Zao Ren (Ziziphus Jujuba Seed) each 1 qian. For persistent stasis pain, add Rougui (Cinnamon Bark) 5 fen. For constipation, add Congrong (Cistanche Deserticola) and Maren (Cannabis Seed) each 2 qian. For phlegm, add Zhuli (Bamboo Sap), Jiangzhi (Ginger Juice), and Juhong (Aged Tangerine Peel) each 4 fen, plus 1 cup of wine. If hands, feet, and breath become gradually cold, add Fuzi (Aconitum Lateralis Radix Preparata) 5 fen and double the dose of Renshen.
Note: Most cases of Jue involve Yang deficiency. If there are no symptoms like stasis pain or abdominal distension, using solely Renshen and Fuzi, possibly with Rougui, is acceptable; Rougui also dispels stasis. Do not hesitate.
Generally, postpartum fainting and Jue result from exhaustion of both Qi and Blood, with the Shen on the verge of departure and only a thread of life remaining. Without substantial tonification, the nearly extinct Yuan Yang cannot be restored. However, fainting occurring during labor is more severe than Jue; frequent administration of Shenghua Decoction is appropriate to first replenish Blood deficiency, expecting stasis resolution, Blood abundance, clear Shen, and cessation of fainting. If there are no symptoms of sweat collapse, mental fatigue, or shortness of breath, do not hastily add Renshen. If Jue occurs after delivery due to Qi and Blood exhaustion, Jiashen Shenghua Decoction should be used to restore the Shen. In summary, when treating fainting, inquire about stasis pain: if present, Renshen and Zhu should not be introduced abruptly; if absent, Renshen, Shu Di, and Zhu must be used together.