牛膝(酒浸) 甘草(炙) 薤白(各一分) 当归 桂心 白术 黄 (各半两) 独活(半两) 生
姜(半两)
上锉散。每服半两,水五盏,煎至二盏,去滓,食前分二次热服。
评曰∶趁痛散不特治产后气弱血滞,兼能治太阳经感风头疼,腰背痛,自汗发热。若其
感寒伤食,忧恐惊怒,皆致身疼,发热头痛,况有蓐劳诸证尤甚,趁痛散皆不能疗,不若五
积散入醋煎用却不妨。
五积散 方见伤寒太阴经。
第十二论曰∶产后大便秘涩者何?答曰∶产卧水血俱下,肠胃虚竭,津液不足,是以大
便秘涩不通也。若过五六日,腹中闷胀者,此有燥粪在脏腑,以其干涩未能出耳,宜服麻
仁丸以津润之。若误以为有热而投以寒药,则阳消阴长,变动百出,性命危矣。
麻仁(研) 枳壳(麸炒) 人参 大黄(各等分)
上为末,蜜丸,如梧子大。空心温酒下二十丸;未通又加丸数。
评曰∶产后不得利,利者百无一生。去血过多,脏燥,大便秘涩,涩则固当滑之,大黄
似难轻用,唯葱涎调腊茶为丸,复以葱茶下之必通。
治产后虚羸,大便秘涩。
阿胶 枳壳(麸炒去瓤,等分)
上为末,蜜丸,如梧子大,别研滑石为衣。温水下二十丸;半日来未通又服。
第十三论曰∶产后血崩者何?答曰∶产卧伤耗经脉,未得平复,而劳役损动,致血暴崩
,淋沥不止;或因咸酸不节,伤蠹荣卫,气衰血弱,亦变崩中。若小腹满痛,肝经已坏,为
难治,急服固经丸以止之。
牛膝(用酒浸泡)、甘草(炙烤)、薤白(各一分),当归、桂心、白术、黄芩(各半两),独活(半两),生姜(半两)。
将上述药材切碎成散剂。每次服用半两,加水五盏,煎煮至剩余两盏药液,滤去药渣,在饭前分两次温热服用。
评论说:趁痛散不仅治疗产后气虚血滞,还能治疗太阳经受风邪引起的头痛、腰背痛、自汗和发热。如果是感受寒邪或饮食积滞,以及忧恐惊怒等原因导致的身疼、发热、头痛,况且还有产后劳损等各种病症更为严重,趁痛散都不能治疗,不如使用五积散加入醋煎服却不妨碍疗效。
第十二问说:产后大便秘结不通是什么原因?回答说:分娩时水和血液一起下行,导致肠胃虚弱枯竭,津液不足,所以大便干涩不通。如果过了五六天,腹部感到闷胀,这是体内有燥屎积聚,因为大便干涩无法排出,适宜服用麻仁丸来滋润肠道。如果误以为是有热邪而投用寒凉药物,就会导致阳气消减、阴气增长,引发各种病变,危及生命。
将上述药材制成粉末,用蜂蜜炼制成丸,大小如梧桐子。空腹时用温酒送服二十丸;如果仍未通便,可增加丸数。
评论说:产后不宜轻易使用泻下法,一旦误用泻下,百无一生。产后失血过多,脏腑干燥,大便秘结,既然干涩就应当用滑利之法,大黄似乎难以轻易使用,唯有用葱汁调和腊月茶制成丸药,再用葱茶送服,必然能通便。
治疗产后身体虚弱羸瘦,大便秘结涩滞。
阿胶、枳壳(麸皮炒制并去除瓤,等分)。
将上述药材制成粉末,用蜂蜜炼制成丸,大小如梧桐子,另外研磨滑石粉作为包衣。温水送服二十丸;半天后若仍未通便,再服用。
第十三问说:产后血崩是什么原因?回答说:分娩卧床耗伤经脉,尚未恢复平静,又因劳累损伤触动,导致血液突然大量崩漏,淋漓不止;或者因为咸味酸味食物摄入不节制,损伤荣卫之气,气衰血弱,也会变成崩中症。如果小腹胀满疼痛,说明肝经已经受损,属于难治之症,应立即服用固经丸以止血。
Radix Achyranthis Bidentatae (steeped in wine), Radix Glycyrrhizae Preparata (roasted with honey), Bulbus Allii Macrostemonis (each 1 fen), Radix Angelicae Sinensis, Cortex Cinnamomi, Rhizoma Atractylodis Macrocephalae, Radix Scutellariae (each 0.5 liang), Radix Angelicae Pubescentis (0.5 liang), Rhizoma Zingiberis Recens (0.5 liang).
Crush the above herbs into a coarse powder. Take 0.5 liang per dose, add five cups of water, decoct until two cups remain, strain off the dregs, and take warm in two divided doses before meals.
Comment: *Chentong San* (Pain-Relieving Powder) not only treats postpartum Qi deficiency and blood stasis but also treats headache, lower back pain, spontaneous sweating, and fever caused by Wind pathogen affecting the Taiyang channel (Taiyang channel disease). If body pain, fever, and headache are caused by Cold pathogen invasion, food stagnation, or emotional disturbances such as worry, fear, shock, or anger, especially when complicated by severe postpartum consumptive diseases, *Chentong San* cannot treat them. In such cases, it is better to use *Wuji San* (Five Accumulations Powder) decocted with vinegar.
The formula for *Wuji San* (Five Accumulations Powder) is found in the Taiyin channel chapter of *Shanghan Lun* (Treatise on Cold Damage).
Question 12: What causes severe constipation after childbirth? Answer: During delivery, fluids and blood descend together, leading to emptiness and exhaustion of the intestines and stomach, and insufficiency of body fluids, resulting in dryness and difficulty in defecation. If five or six days pass and abdominal distension occurs, this indicates dry stool accumulated in the viscera; due to its dryness and stickiness, it cannot be expelled easily. It is appropriate to take *Maren Wan* (Hemp Seed Pill) to moisten and lubricate. If mistakenly treated as having Heat and administered cold-natured medicines, Yang will decline and Yin will grow, causing various pathological changes and endangering life.
Semen Cannabisae (crushed), Pericarpium Aurantii Fructus (stir-fried with bran), Radix Ginseng, Radix et Rhizoma Rhei (equal parts).
Grind the above herbs into powder, mix with honey to make pills the size of wet cherry seeds. Take twenty pills with warm wine on an empty stomach; if defecation has not occurred, increase the number of pills.
Comment: Purging should not be used lightly in the postpartum period; improper purging leads to death in almost all cases. Due to excessive blood loss, the viscera become dry, and constipation occurs. Since there is dryness and stickiness, lubricating methods should be employed. Dahuang (Rhubarb Root) seems difficult to use lightly. Instead, mixing scallion juice with tea from the twelfth lunar month to form pills, and taking them down with scallion-tea, will surely promote bowel movement.
To treat postpartum emaciation and severe constipation.
Corpus Corneum Asini Colla, Pericarpium Aurantii Fructus (stir-fried with bran, remove albedo, equal parts).
Grind the above herbs into powder, mix with honey to make pills the size of wet cherry seeds. Coat with powdered Talcum. Take twenty pills with warm water; if defecation has not occurred after half a day, take again.
Question 13: What causes postpartum metrorrhagia (profuse uterine bleeding)? Answer: Childbed rest consumes and damages the meridians, which have not yet recovered, and physical exertion further injures and disturbs them, causing sudden profuse bleeding that drips continuously. Alternatively, irregular consumption of salty and sour foods damages Ying and Wei (Nutritive and Defensive Qi), leading to Qi deficiency and Blood weakness, which can also transform into Metrorrhagia. If there is fullness and pain in the lower abdomen, indicating damage to the Liver channel, it is difficult to treat. Immediately administer *Gu Jing Wan* (Meridian-Stabilizing Pill) to stop the bleeding.