〔薛〕若脬中有热,宜用加味逍遥散。若脾肺气虚,宜用补中益气汤加益智。若肝
肾阴虚,宜用六味丸。一妊妇遗尿内热,肝脉洪数,按之微弱,或两太阳作痛,胁肋作
胀。余以为肝火血虚,用加味逍遥散、六味地黄丸寻愈。后又寒热,或发热,或恚怒,前
证仍作。用八珍散、逍遥散兼服,以清肝火、养肝血而痊。
白薇散 疗妊娠胎满,不知小便出时。(见前三卷遗尿。)
桑螵蛸散 治妊娠小便不禁。
桑螵蛸(二十枚,炙黄)
上为细末,每服二钱,空心米饮调下。
又方 益智仁为末,米饮下,亦效。
〔大〕妊妇劳伤经络,有热在内,热乘于血,血得热则流溢渗入脬,故令尿血也。
〔薛〕前证因怒动火者,宜小柴胡汤加山栀。因劳动火者,宜用补中益气汤。若因
浓味积热,宜用清胃散(杂病齿。)加犀角、连翘、甘草。若因肝经血热,宜用加味逍遥散。若
因脾气下陷,宜用补中益气汤。若因脾虚血热,宜用加味逍遥散。一妊妇因怒尿血,内
热作渴,寒热往来,胸乳间作胀,饮食少思,肝脉弦弱,此肝经血虚而热也。用加味逍遥
散、六味地黄丸兼服渐愈。又用八珍汤加柴胡、丹皮、山栀而痊。
《千金》疗妊娠卒下血及子淋方。
葵子(一升,研)
上以水五升,煮取二升,分温三服。
又方 生艾叶(一斤,研。冬用干者亦得)
上以酒五升,煮取二升,分三服。
又方 生地黄(一升,切)
上以酒四升,煮取二升,分温三服。亦疗落身后血。
续断汤 治妊娠下血及尿血。
当归 生地黄(各一两) 续断(半两) 赤芍药(二钱半)
上为末,空心葱白煎汤调下二钱。
疗妊娠尿血方。
阿胶 熟地黄(各等分)
上为细末,空心粥饮调下二钱。
补遗姜蜜汤 治妊娠小便尿血。
生姜(七片) 蜜(半盏) 白茅根(一握)
上入水,浓煎服。
五苓散去桂加阿胶。(炒)同为粗末,每服四钱,用车前子、白茅根浓煎温服。
又方 白茅根浓煎汤,吞酒蒸黄连丸。
[Xue] If there is heat in the bladder (Pangguang), Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) should be used. If there is deficiency of Qi in the Spleen and Lung, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Yi Zhi Ren (Alpinia Oxyphylla Fruit) should be used. If there is Yin deficiency of the Liver and Kidney, Liuwei Wan (Six-Ingredient Pill with Rehmannia) should be used. A pregnant woman presented with enuresis and internal heat; her Liver pulse was surging and rapid, but weak upon deep pressure, accompanied by pain in both temporal regions and distension in the hypochondrium. I diagnosed this as Liver Fire with Blood deficiency, and treated her with Jiawei Xiaoyao San and Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia), leading to recovery. Later, she experienced alternating chills and fever, or isolated fever, and the previous symptoms recurred due to anger. She was then treated with a combination of Bazhen San (Eight-Treasure Powder) and Xiaoyao San (Free and Easy Wanderer Powder) to clear Liver Fire and nourish Liver Blood, resulting in a cure.
Baiwei San (Cynanchum Atratum Powder): Treats pregnancy with fetal fullness and involuntary urination. (See Enuresis in the first three volumes.)
Sangpiaoxiao San (Mantis Egg-case Powder): Treats urinary incontinence during pregnancy.
Sangpiaoxiao (Mantis Egg-case) (20 pieces, stir-fried until yellow).
Grind into a fine powder. Take 2 qian per dose, mixed with rice decoction on an empty stomach.
Another prescription: Yi Zhi Ren (Alpinia Oxyphylla Fruit) ground into powder, taken with rice decoction. Also effective.
[Da] In pregnant women, labor damages the collaterals, causing heat within. Heat attacks the Blood; when Blood is heated, it flows excessively and渗 (seeps) into the bladder, causing hematuria.
[Xue] For the above condition caused by anger stirring up Fire, Xiao Chaihu Tang (Minor Bupleurum Decoction) with Shan Zhi (Gardeniae Fructus) should be used. For that caused by labor stirring up Fire, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) should be used. For heat accumulation from rich flavors, Qingwei San (Clear the Stomach Powder) [see Miscellaneous Diseases - Teeth] with Xi Jiao (Rhinoceros Horn), Lian Qiao (Forsythiae Fructus), and Gan Cao (Licorice Root) should be used. For Liver Channel Blood Heat, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) should be used. For Spleen Qi sinking, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) should be used. For Spleen deficiency with Blood Heat, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) should be used. A pregnant woman presented with hematuria due to anger, internal heat, thirst, alternating chills and fever, distension in the chest and breasts, and poor appetite. Her Liver pulse was wiry and weak, indicating Liver Blood deficiency with Heat. She was treated with a combination of Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) and Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia), gradually recovering. Subsequently, she was cured using Bazhen Tang (Eight-Treasure Decoction) with Chai Hu (Bupleuri Radix), Dan Pi (Moutan Cortex), and Shan Zhi (Gardeniae Fructus).
Qianjin Fang (Prescriptions Worth a Thousand Gold) treats sudden bleeding and Zi Lin (Stranguria of Pregnancy):
Kui Zi (Abutilonis Semen), 1 sheng, ground.
Boil in 5 sheng of water to obtain 2 sheng of liquid. Divide into three warm doses.
Another prescription: Sheng Ai Ye (Fresh Artemisiae Argyi Folium), 1 jin, ground. (Dried leaves may be used in winter.)
Boil in 5 sheng of wine to obtain 2 sheng of liquid. Divide into three doses.
Another prescription: Sheng Di Huang (Rehmanniae Radix Recens), 1 sheng, sliced.
Boil in 4 sheng of wine to obtain 2 sheng of liquid. Divide into three warm doses. This also treats postpartum lochia retention with bleeding.
Xuduan Tang (Dipsaci Decoction): Treats lower bleeding and hematuria during pregnancy.
Dang Gui (Angelicae Sinensis Radix), Sheng Di Huang (Rehmanniae Radix Recens) (each 1 liang), Xuduan (Dipsaci Radix) (0.5 liang), Chi Shao Yao (Paeoniae Radix Rubra) (2.5 qian).
Grind into powder. Take 2 qian on an empty stomach, mixed with decoction of Cong Bai (Allii Fistulosi Bulbus).
Prescription for treating hematuria during pregnancy:
E Jiao (Colla Corii Asini), Shu Di Huang (Rehmanniae Radix Praeparata) (equal parts).
Grind into a fine powder. Take 2 qian on an empty stomach, mixed with porridge drink.
Supplementary Jiang Mi Tang (Ginger and Honey Decoction): Treats hematuria in urine during pregnancy.
Sheng Jiang (Zingiberis Rhizoma Recens) (7 slices), Mi (Mel), Bai Mao Gen (Imperatae Rhizoma) (one handful).
Add water, boil strongly, and take.
Wuling San (Five-Ingredient Powder with Poria) minus Gui Zhi (Cinnamomi Ramulus), plus E Jiao (Colla Corii Asini) (stir-fried). Grind together into coarse powder. Take 4 qian per dose, boiled with Che Qian Zi (Plantaginis Semen) and Bai Mao Gen (Imperatae Rhizoma), taken warm.
Another prescription: Boil Bai Mao Gen (Imperatae Rhizoma) strongly into a decoction, swallow Jiu Zheng Huang Lian Wan (Wine-steamed Coptidis Pills).