治产后伤风,感寒暑湿,咳嗽喘满,痰涎壅塞,坐卧不宁。
旋复花 赤芍药 半夏曲 前胡 荆芥穗 五味子 甘草(炙) 茯苓 麻黄(去节汤) 杏仁(各等分)
上为锉散。每服四大钱,水一盏半,姜五片,枣一枚,煎七分,去滓,食前服。
大调经散 方见第七论
五积散 方见伤寒太阴经,入醋煎
见 丸 方见第五论
第十七论曰∶产后中风者何?答曰∶产后五七日内,强力下床;或一月之内,伤于房室
;或怀忧发怒,扰荡冲和;或因着艾伤艾,伤动脏腑,得病之初,眼涩口噤,肌内
搐。渐至腰脊筋急强直者不可治,此乃人作,非偶尔中风所得也。
评曰,问产后中风,风是外邪,血虚则或有中之者,直答以人作,不可治,问答不相领
解,如何开示后人,立论之难有如此者。若是中风,当以脉辨,看在何脏,根据经调之,强力
下床,月内房室,忧怒着灸,非中风类,蓐劳、性气、火邪,治各有法,非产后病。不暇繁引,学人识之。
第十八论曰∶产后心痛者何?答曰∶心者血之主。人有伏宿寒,因产大虚,寒搏于血
,血凝不得消散,其气遂上冲,击于心之络脉,故心痛。但以大岩蜜汤治之,寒去则血脉温
而经络通,心痛自止,若误以为所伤治之,则虚极,寒益甚矣。心络寒甚,传心之正经,则
变为真心痛,朝发夕死,夕发朝死,药不可轻用如此。
治疗产后感受风邪,或受寒、暑、湿侵袭,出现咳嗽气喘、胸膈满闷,痰涎壅盛阻塞气道,导致坐卧不安。
旋复花、赤芍药、半夏曲、前胡、荆芥穗、五味子、甘草(炙)、茯苓、麻黄(去节,用汤煮过)、杏仁(以上各等分)。
将上述药物捣碎成粗散。每次服用四大钱,加水一盏半,生姜五片,大枣一枚,煎至七分水量,滤去药渣,在饭前服用。
大调经散 方剂见第七论
五积散 方剂见《伤寒论》太阴经篇,煎煮时加入醋
见 丸 方剂见第五论
第十七论说:什么是产后感冒中风?回答说:产后五到七天内,勉强下床活动;或者一个月内,因房事受损;或者怀着忧愁发怒,扰乱冲和之气;或者因为艾灸不当损伤身体,触动脏腑。患病初期,眼睛干涩,口噤不开,肌肉抽搐。逐渐发展到腰脊筋脉拘急强直,这就不可治愈了。这是人为造成的,不是偶然的中风所致。
评论说:问的是产后感冒中风,风属于外邪,血虚时或许会被风邪所中,但回答却直接说是人为造成、不可治愈,问答之间不能相互理解,这样如何开导后人呢?立论的困难竟有如此严重的。如果是中风,应当通过脉象来辨别,看在哪一脏受病,根据经络理论进行调理。勉强下床、月内行房、忧怒、艾灸,这些不属于中风类别,而是蓐劳、性气、火邪等病症,治疗各有方法,不属于普通的产后病。不再繁琐引用,学习者请知晓。
第十八论说:什么是产后心痛?回答说:心是血液的主宰。人体内有潜伏的宿寒,因为生产后极度虚弱,寒气与血相搏结,血液凝滞无法消散,气机于是向上冲逆,冲击心的络脉,所以发生心痛。只需使用大岩蜜汤治疗,寒气去除则血脉温暖而经络通畅,心痛自然停止。如果误以为是外伤而按伤科治疗,就会导致正气极度虚弱,寒气更加严重。心络寒气极重,传入心的正经,就会变成真心痛,早上发病晚上死亡,晚上发病早上死亡,用药不可如此轻率。
Treat postpartum wind-stroke, or invasion by cold, summer-heat, and dampness, presenting with cough, asthma, chest fullness, phlegm-saliva congestion obstructing the airway, causing restlessness in sitting and lying.
*Huaxin Flower* (Inulae Flos), *Chi Shaoyao* (Red Peony Root), *Banxia Qu* (Pinellia Fermented Paste), *Qianhu* (Peucedani Radix), *Jingjie Sui* (Schizonepetae Spica), *Wuweizi* (Schisandrae Fructus), *Gancao* (Licorice Root, honey-fried), *Fuling* (Poria), *Mahuang* (Ephedrae Herba, nodes removed, decocted in water), *Xingren* (Prunus Armeniacae Semen) (all in equal parts).
Crush the above herbs into coarse powder. Take four large qian per dose, add one and a half lamps of water, five slices of fresh ginger, and one jujube. Decoct until three-tenths of the liquid remains, filter out the dregs, and take before meals.
*Dajiao Jing San* (Great Menstruation Regulating Powder) - See Formula in Chapter 7.
*Wuji San* (Five Accumulations Powder) - See *Shanghan Lun* (Treatise on Cold Damage), Taiyin Channel chapter; decoct with vinegar.
*Jian Wan* (See Pill) - See Formula in Chapter 5.
Chapter 17 states: What is postpartum wind-stroke? The answer is: Within five to seven days after childbirth, forcing oneself to get out of bed; or within a month, injury from sexual intercourse; or harboring sorrow and anger, disturbing the harmonious flow of Chong and Ren vessels; or improper moxibustion causing injury, disturbing the zang-fu organs. At the onset of illness, there is dryness in the eyes, lockjaw, and muscle twitching. Gradually progressing to stiffness and rigidity of the lumbar spine and back tendons indicates an incurable condition. This is caused by human error, not accidental wind-stroke.
Commentary: The question asks about postpartum wind-stroke. Wind is an external pathogen; when blood is deficient, it may be invaded by wind. However, the answer directly states it is self-inflicted and incurable. The question and answer do not align logically. How can this guide future generations? The difficulty in establishing theories can be so severe. If it were true wind-stroke, differentiation should be based on pulse diagnosis to determine which zang organ is affected, and treatment should follow meridian theory. Forcing out of bed, sexual activity within a month, sorrow/anger, and moxibustion injuries are not categories of wind-stroke but rather conditions such as Ruolao (postpartum consumptive disease), Xingqi (emotional qi disorder), and Huoxie (fire evil). Each has its own treatment methods and does not belong to ordinary postpartum diseases. Without further tedious citation, let students understand this.
Chapter 18 states: What is postpartum heart pain? The answer is: The Heart is the master of blood. If there is latent chronic cold in the body, and due to the extreme deficiency after childbirth, cold condenses with blood, causing blood stasis that cannot dissipate. The qi then rushes upward, striking the collateral vessels of the Heart, resulting in heart pain. Treat only with *Dayanmi Tang* (Great Rock Honey Decoction). When the cold is eliminated, the blood vessels become warm and meridians unblocked, and heart pain stops naturally. If mistakenly treated for trauma, it will lead to extreme deficiency and worsen the cold. If cold in the Heart collaterals is severe and transmits to the main meridians of the Heart, it becomes Zhenxintong (True Heart Pain), leading to death if onset occurs in the morning and death by evening, or vice versa. Medication must not be used so lightly.