乳香 太阴玄精 五灵脂 硫黄 陈皮 桑上寄生 阿胶(炙) 卷柏(生,各等分)
上将前四味同研匀,石器内微火炒,勿令焦了,又研极细,复入余药为末,用生地黄汁
和丸,梧子大。温洒或当归酒下二十丸,食前服。
评曰∶所下过多伤损,虚竭少气,唇青肉冷,汗出神昏,此皆虚脱证,何以谓之生风?
风是外淫,必因感冒中伤经络,然后发动,脏腑岂能自生风也?虚之说,盖因《脉经》云∶
浮为风为虚。此乃两病合说,在人迎则为风,在气口则为虚。后学无识,便谓风虚是一病,
谬滥之甚,学人当知。
《保庆集》二十一论,人用既多,因评其说,仍将得效方附行。外有产科诸证,并序于后。
妇人因产理不顺,疲极筋力,忧劳心虑,致虚羸喘乏,寒热如疟,头痛自汗,肢体倦怠
,咳嗽痰逆,腹中绞刺,名曰蓐劳。
治蓐劳。
猪肾(一对,去脂膜,四破;无则以羊肾代之) 香豉 葱白 粳米 当归 芍药(各二两)
上为锉散,分两剂。每一剂用水三升,煮取一小碗,去滓,分三服,任意服。
乳香、太阴玄精(一种矿物药)、五灵脂、硫黄、陈皮、桑上寄生(寄生在桑树上的槲寄生)、阿胶(经炙烤处理)、卷柏(新鲜采集),以上各取等量。
先将前四味药材一同研磨均匀,在石器中用微火炒制,不要炒焦了,再研磨得极细,然后加入其余药物制成粉末,用生地黄汁调和做成丸剂,大小如梧桐子。服用时,用温热的酒或当归酒送服二十丸,饭前服用。
评论说:产后恶露排出过多导致损伤,气血极度虚弱,气息短少,嘴唇发青,肌肉冰冷,出汗且神志昏迷,这些都是虚脱的证候,怎么能说是产生内风呢?风邪属于外感六淫之一,必定是因为感受风寒湿邪,损伤经络之后才会发作,脏腑怎么能够自己产生风邪呢?所谓“虚”的说法,大概是源于《脉经》中说:“浮脉既主风也又主虚。”这是将两种病症合在一起说的,在人迎脉(颈动脉)出现浮象则为风病,在气口脉(桡动脉)出现浮象则为虚证。后辈学者没有见识,便认为风病和虚证是同一种病,这种谬误非常严重,学习的人应当知晓。
《保庆集》中有二十一论,人们使用此方已经很多,因此对其学说进行评论,仍然将有效的方剂附在后面。此外还有产科的各种证候,一并叙述在后面。
妇女因为分娩过程不顺利,筋疲力尽,忧虑劳累心神,导致身体虚弱消瘦,气喘乏力,寒热往来像疟疾一样,头痛,自汗,肢体倦怠,咳嗽痰逆,腹中绞痛刺痛,名叫“蓐劳”。
治疗蓐劳。
猪肾(一对,去掉脂膜,切成四块;如果没有则用羊肾代替)、香豉(淡豆豉)、葱白、粳米、当归、芍药(各二两)。
以上药物切碎成散剂,分为两剂。每一剂用水三升,煮取一小碗,去渣,分三次服用,随意时间服用。
妇女急于生产,用力努挣太过,导致阴道脱出,如同脱肛的样子,以及阴道挺出,紧迫肿痛,举重或房事劳累,都能引发此症,清水不断流出,小便淋漓不尽。
治疗产后劳损,阴道脱垂。
以上药物研成粉末。撒敷患处。
Frankincense (Resina Olibanum), Taiyin Xuanjing (Mineral drug, likely Gypsum Fibrosum or similar), Tailingzhi (Trogopterori Faeces), Realgar (Realgar), Chenpi (Citri Reticulatae Pericarpium), Sangshang Jisheng (Taxillus chinensis parasitizing on mulberry), Ejiao (Donkey-hide gelatin, roasted), Juanbai (Selaginella tamariscina), all in equal parts.
First, grind the aforementioned four ingredients together until uniform, stir-fry them slightly over a low fire in a stone mortar, ensuring they do not burn, then grind them extremely fine. Subsequently, add the remaining herbs and process into powder. Mix with juice of fresh Rehmanniae Radix (Shengdihuang) to form pills, sized like wu-tong seeds. Take twenty pills with warm wine or Danggui wine before meals.
Commentary: Excessive discharge postpartum causes damage, leading to extreme deficiency of Qi and blood, shortness of breath, cyanosis of the lips, cold flesh, sweating, and confusion of spirit. These are all signs of collapse (Xu Tuo). How can this be called "generating wind"? Wind is an external pathogenic factor (one of the Six Excesses); it must arise from contracting external pathogens that injure the meridians before manifesting. How can the Zang-Fu organs generate wind internally? The notion of "deficiency" likely stems from the *Mai Jing* (Pulse Classic), which states: "Floating pulse indicates both wind and deficiency." This refers to two conditions discussed together: floating at the Renying pulse (carotid) indicates wind, while floating at the Qikou pulse (radial) indicates deficiency. Later scholars lacking insight mistakenly believed wind and deficiency are the same disease, which is a grave error; students should be aware of this.
In the 21st discussion of *Baoqing Ji*, this prescription has been widely used. Therefore, its theory is commented upon, and effective formulas are appended. Additionally, various obstetric conditions are described subsequently.
Women may suffer from difficult labor, exhausting their sinews and strength, coupled with worry and mental fatigue, resulting in emaciation, panting, and weakness, alternating chills and fever resembling malaria, headache, spontaneous sweating, limb lassitude, cough with rebellious phlegm, and cramping/stabbing pain in the abdomen. This condition is named "Rulao" (Postpartum Consumption).
Treatment for Rulao:
One pair of pig kidneys (remove fatty membrane, cut into four pieces; if unavailable, use sheep kidneys as substitute), Xiangchi (Prepared Soybean, Dan Dou Chi), Congbai (Scallion white), Jingmi (Japonica Rice), Danggui (Angelica sinensis), Shaoyao (White Peony Root), each two liang.
Grind the above into coarse powder, divide into two doses. For each dose, add three sheng of water, decoct until one small bowl remains, strain, and divide into three doses. Take at any time.
If a woman exerts herself excessively during urgent delivery, the vagina may prolapse, resembling rectal prolapse, or protrude externally, accompanied by tightness, swelling, and pain. Heavy lifting or sexual fatigue can also trigger these symptoms, along with continuous clear discharge and dribbling urination.
Treatment for postpartum exhaustion and vaginal prolapse:
Sulfur (Liu Huang), Cuttlebone (Hai Piao Xiao / Sepiae Endoconcha), each half liang; Wuweizi (Schisandra chinensis), one fen.
Grind into powder. Apply topically to the affected area.