人参 石菖蒲 川芎 生干地黄(各一两) 细辛(一钱) 防风 朱砂(各半两,别研)
上为末。每服一钱,薄荷汤调下,不以时服。
第十论曰∶产后腹痛又泻痢者何?答曰∶产后肠胃虚怯,寒邪易侵,若未盈月,饮冷当
风,乘虚袭留于肓膜,散于腹胁,故腹痛作阵,或如锥刀所刺,流入大肠,水谷不化,洞泻
肠鸣,或下赤白, 胁 胀,或走痛不定,急服调中汤立愈;若医者以为积滞取之
,则祸不旋踵。谨之谨之!。
高良姜 当归 桂心 芍药 附子(炮) 川芎(各一两) 甘草(炙,半两)
上为锉散。每服三钱匕,水三盏,煎至一盏,去滓热服。
评曰∶产后下痢,非止一证,当随所因而调之,既云饮冷当风,何所不至。寒热风湿,
本属外因;喜怒忧思,还从自性;况劳逸饥饱,皆能致病。若其洞泄,可服调中;赤白滞下
,非此能愈,各随门类,别有正方。今录桃胶散、白头翁汤以备用,余从滞下门选用之。
治产后利下赤白,里急后重, 刺疼痛等证。
桃胶(瓦上焙干) 沉香 蒲黄(纸鬲炒,各等分)
上为末。每服二钱,陈米饮调下,食前服。
治产后下利虚极。
白头翁 甘草(炙) 阿胶(各二两) 黄连 柏皮(去粗皮) 秦皮(去粗皮,各三两)
上为锉散。每服四钱,水一盏半,煎七分,去滓,空心服。
第十一论曰∶产后遍身疼痛者何?答曰∶产后百节开张,血脉流走,遇气弱,则经络分
肉之间,血多流滞,累月不散,则骨节不利,筋脉急引,故腰背不得转侧,手脚不能动摇
,身热头痛也。若医以为伤寒治之,则汗出而筋脉动摇,手足厥冷,变生他病,但服趁痛散以默除之。
人参、石菖蒲、川芎、生干地黄(各一两)、细辛(一钱)、防风、朱砂(各半两,单独研磨)。
以上药物研为细末。每次服用一钱,用薄荷汤调服,不限时间服用。
第十篇论述说:产后腹痛又伴有腹泻痢疾是怎么回事?回答说:产后肠胃虚弱怯弱,寒邪容易侵袭,如果未满一个月,饮用冷水或当风受寒,寒气乘虚侵入并停留在肓膜(心下膈上的部位),散布于腹胁部,所以阵发性腹痛,或者像锥子刀子刺割一样,流入大肠,导致水谷不消化,呈水样直泻且肠鸣,或者排出赤白黏液,胁肋胀满,或者疼痛游走不定,此时应紧急服用调中汤(调和脾胃的方剂)即可立即痊愈;如果医生误认为是积滞而采用攻下法治疗,那么灾祸立刻就会降临。务必谨慎!务必谨慎!
高良姜、当归、桂心、芍药、附子(炮制)、川芎(各一两)、甘草(炙,半两)。
以上药物锉成散剂。每次取三钱匕,用水三盏,煎煮至一盏,滤去药渣,趁热服用。
评论说:产后下痢,不止一种证型,应当根据病因进行调理,既然提到饮冷当风,什么病邪都可能产生。寒、热、风、湿,原本属于外因;喜、怒、忧、思,还源于内在情志;况且劳累、安逸、饥饿、饱食,都能导致疾病。如果是水样直泻,可以服用调中汤;如果是赤白黏液便(痢疾),此方不能治愈,各自按照门类,另有正方的记载。现在记录桃胶散、白头翁汤以备选用,其余的从痢疾门中选用。
治疗产后下痢排出赤白黏液,伴有里急后重(想拉拉不出,拉完还想拉)、腹部刺痛等症状。
桃胶(在瓦上焙干)、沉香、蒲黄(用纸隔开炒,各等分)。
以上药物研为细末。每次服用二钱,用陈年米汤调服,饭前服用。
治疗产后下痢导致极度虚弱。
白头翁、甘草(炙)、阿胶(各二两)、黄连、黄柏(去除粗皮)、秦皮(去除粗皮,各三两)。
以上药物锉成散剂。每次服用四钱,用水一盏半,煎煮至七分,滤去药渣,空腹服用。
第十一篇论述说:产后全身疼痛是怎么回事?回答说:产后全身关节开张,血脉运行流动,如果遇到气虚,那么在经络和分肉之间,血液多会流滞,累积数月不散,就会导致骨节活动不利,筋脉拘急牵引,所以腰背不能转侧,手脚不能动摇,身体发热头痛。如果医生误以为是伤寒而用发汗法治疗,就会导致出汗而筋脉动摇,手足冰冷,变生其他疾病,只应服用趁痛散以默默消除病痛。
Ren Shen (Ginseng Radix), Shichangpu (Acori Tatarinowii Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), Sheng Gan Di Huang (Rehmanniae Radix Recens), each 1 liang; Xixin (Asari Radix et Rhizoma) 1 qian; Fangfeng (Saposhnikoviae Radix), Zhusha (Cinnabaris), each 0.5 liang, separately ground.
The above are powdered. Take 1 qian per dose, mixed with Bohe Tang (Mint Decoction), taken at any time.
The tenth treatise states: What is the cause of postpartum abdominal pain accompanied by diarrhea and dysentery? The answer is: Postpartum, the intestines and stomach are weak and deficient, making them susceptible to invasion by cold pathogens. If within one month after delivery, one drinks cold water or exposes oneself to wind, the pathogenic cold may invade due to deficiency and remain in the huangmo (the area between the heart and diaphragm), spreading to the abdomen and hypochondrium. This causes paroxysmal abdominal pain, feeling as if pierced by awls or knives. If it flows into the large intestine, food and fluids fail to digest, resulting in watery diarrhea with borborygmus, or passage of red and white mucus, distension in the hypochondrium, or wandering pain. In such cases, immediately administer Tiaozhong Tang (Regulate the Middle Decoction) for immediate relief; if a physician mistakenly treats it as accumulation and uses purgatives, disaster will follow swiftly. Be extremely cautious! Be extremely cautious!
Gaoliangjiang (Alpiniae Officinarum Rhizoma), Danggui (Angelicae Sinensis Radix), Guixin (Cinnamomi Ramulus), Shaoyao (Paeoniae Radix), Fuzi (Aconiti Lateralis Radix Praeparata), Chuanxiong (Ligustici Chuanxiong Rhizoma), each 1 liang; Gancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle) 0.5 liang.
The above are cut into pieces and made into a powder. Take three qianbi (approx. 3-4 grams) per dose, with three zhan (approx. 600ml) of water, decocted to one zhan (approx. 200ml). Strain and take hot.
Commentary: Postpartum dysentery presents in various syndromes; treatment must be adjusted according to the specific etiology. Given the mention of drinking cold water and exposure to wind, what pathogen could not arise? Cold, heat, wind, and dampness belong to external causes; joy, anger, worry, and thought stem from internal nature; moreover, overwork, rest, hunger, and satiety can all induce disease. For watery diarrhea, Tiaozhong Tang may be used; for red and white dysentery, this formula is ineffective. Refer to respective categories for specific formulas. Here, Taojiao San (Peach Gum Powder) and Baitouweng Tang (Baitouweng Decoction) are recorded for备用 (reference use); others should be selected from the dysentery category.
Treats postpartum dysentery with passage of red and white mucus, tenesmus (feeling of incomplete evacuation), and stabbing abdominal pain.
Taojiao (Tragacanthae Gum, dried on tile), Chenxiang (Aquilariae Lignum Resinatum), Puhuang (Pollinis Typhae, stir-fried between paper), equal parts.
The above are powdered. Take 2 qian per dose, mixed with Chenmi Yin (aged rice water), taken before meals.
Treats postpartum dysentery leading to extreme deficiency.
Baitouweng (Pulsatillae Radix), Gancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle), Ejiao (Colla Corii Asini), each 2 liang; Huanglian (Coptidis Rhizoma), Bai pi (Phellodendri Cortex), Qinpi (Fraxini Cortex), each 3 liang (bark removed).
The above are cut into pieces and made into a powder. Take 4 qian per dose, with 1.5 zhan (approx. 300ml) of water, decocted to 0.7 zhan (approx. 140ml). Strain and take on an empty stomach.
The eleventh treatise states: What is the cause of generalized body pain after childbirth? The answer is: After childbirth, the joints open, and blood vessels flow freely. If qi is weak, blood tends to stagnate in the meridians and between muscles. If this stagnation persists for months, joint mobility becomes impaired, tendons and vessels become tight and pulling, causing inability to turn the waist and back, immobility of hands and feet, fever, and headache. If a physician mistakenly treats this as Taiyang syndrome (Exogenous Cold Damage) and induces sweating, it will lead to sweating with trembling tendons, cold extremities, and the generation of other diseases. One should only use Chentong San (Chentong Powder) to silently resolve the condition.