头者诸阳之会也。产后五脏皆虚,胃气亏弱,谷气尚乏,则令虚热,阳气不守,上凑于头,阳实阴虚则令头痛也。
亦有产后败血作痛者。薛立斋曰∶前证若中气虚,用补中益气汤加蔓荆子;若血虚,用四扬加参术;气血俱虚,用八珍
汤;若因风寒所伤,用补中益气汤加川芎。
产宝黑龙丹
治产后头痛不可忍,一切血痛,危急欲死及胎衣不下,但灌药得下者遂安,真产门之宝剂也。
五灵脂 当归 川芎 熟地 高良姜(各五钱)
上咀碎,晒极干,以固济小罐盛之,灯盏封口严密,以文武火, 一柱香,放凉处,退火毒取出,药如黑糟,研细
入花蕊石( 过,另研,二钱)、琥珀(另研,一钱)、乳香(另研,钱半)、百草霜(五钱)。
共前 过药研匀,醋糊为丸,弹子大,每服一丸,用姜汁,好酒、童便半盏,将药一丸于炭火中烧,淬入酒便内,
调化顿服,立效。
黑龙丹序
仲氏嫂金华君在秦,产七日而不食,始言头痛甚,欲取大石压,食顷渐定,心痛则以十指抓壁欲死,目痛即欲以手
自剜之,如是者旬日。国医三四人,郡官中善亦数人,相顾无以为计,不知病根所起,医者术穷,病者益困。余度疾势
危急,非神丹不能愈,须进黑龙丹。仲氏犹豫,谓数日不食,恐不胜,黄昏进半粒,疾少间,中夜再进,药下寐如平时,
平旦一行三升许如蝗虫子,疾减半,巳刻又行如前,则顿愈矣。遣荆钗辈视之,奄殆无气,午后体方凉,气方属,微言
索饮,自此遂平复。大抵产后以去污血为先,血滞不快,作祸如是,老妪中医不识疾病之根,岂得无夭枉者?不遇良医,
终抱遗恨。今以黑龙丹,广济施人。俾世之人,感是疾者,得尽起天年,非祈于报,所翼救疾苦、存性命耳。崇宁元年
五月五日郭 序。
川芎散
治产后头痛。
真天台乌药 大川芎(等分)
上为细末,每服三钱,烧红称锤,淬酒调服。
加减四物汤
治产后头痛、血虚、痰癖、寒厥皆治。
苍术(一钱半) 羌活 川芎 防风 香附(炒) 白芷(各一钱) 石膏(二钱半) 细辛(一钱二分) 当归
(八分) 甘草(五分)
用水二盏,姜三片,煎服。血虚倍当归加芍药;有汗加黄 及桂;痰癖加半夏、茯苓;热痰倍加石膏加知母;寒厥
加天麻、附子。
头部是诸阳经汇聚的地方。产后五脏都处于虚弱状态,胃气亏损衰弱,水谷精气尚且匮乏,从而产生虚热,阳气不能固守,向上冲逆至头部,导致阳盛阴虚,进而引发头痛。
也有因产后败血(瘀血)作痛的情况。薛立斋说:上述证候如果属于中气虚弱,使用补中益气汤加蔓荆子;如果是血虚,用四物汤加人参、白术;如果是气血俱虚,使用八珍汤;如果是因风寒侵袭所致,使用补中益气汤加川芎。
产宝黑龙丹
治疗产后剧烈头痛无法忍受,以及一切血瘀疼痛,危急欲死及胎衣不下,只要灌入药物能咽下的,随即平安,真是产科的宝贵药剂。
五灵脂 当归 川芎 熟地黄 高良姜(各五钱)
以上药材切碎,晒至极干,用固济法密封的小罐盛装,用灯盏封口严密,以文火和武火交替煎煮一炷香的时间,放在凉处,退去火毒后取出,药渣如黑糟状,研细。
加入花蕊石(煅过,另研,二钱)、琥珀(另研,一钱)、乳香(另研,一钱半)、百草霜(五钱)。
与前药混合研匀,用醋糊制作成丸,大小如弹子,每次服用一丸,用姜汁、好酒、童便各半盏,将药丸在炭火中烧红,淬入酒和童便中,调化后顿服,立即见效。
黑龙丹序
仲氏的嫂子金华君在秦地,生产七天后不进食,才开始诉说头痛非常严重,甚至想用大石头压头,过了一会儿稍微安定,心痛时则用十指抓墙壁,痛苦欲死,眼睛痛时就想用手挖眼,像这样的情况持续了十天。国医三四人,郡官中擅长医术的也有几人,面面相觑没有办法,不知道病根所在,医生技艺穷尽,病人更加困苦。我推测病情危急,非神丹不能治愈,必须进服黑龙丹。仲氏犹豫,说几天没吃东西,恐怕身体承受不住,黄昏时进服半粒,疾病稍减,半夜再进服,服药后像平时一样入睡,清晨排便约三升左右,像蝗虫卵一样的东西,疾病减半,巳时又排便如前,于是顿时痊愈。派遣婢女们照顾她,奄奄一息气息微弱,午后身体才变凉,气息才接续,低声索要饮水,从此便恢复平静。大抵产后以去除污血为先,血液停滞不畅,造成祸患如此,老妪中医不识疾病根源,难道没有夭折枉死者吗?不遇到良医,最终抱憾终身。现在公布黑龙丹,广泛救济世人。使世间的人,感患此疾者,得以尽享天年,并非祈求回报,所希望的是救助疾苦、保全性命罢了。崇宁元年五月五日郭序。
川芎散
治疗产后头痛。
真天台乌药 大川芎(等分)
以上研为细末,每次服用三钱,烧红的秤锤,淬酒调服。
加减四物汤
治疗产后头痛、血虚、痰癖、寒厥都有效。
苍术(一钱半) 羌活 川芎 防风 香附(炒) 白芷(各一钱) 石膏(二钱半) 细辛(一钱二分) 当归(八分) 甘草(五分)
用水二盏,生姜三片,煎服。血虚加倍当归并加芍药;有汗加黄芪及桂枝;痰癖加半夏、茯苓;热痰加倍石膏并加知母;寒厥加天麻、附子。
The head is the convergence point of all Yang meridians (Yang meridians: meridians that run along the exterior of the body and are associated with Yang energy). After childbirth, the five Zang organs (Five Zang organs: Heart, Liver, Spleen, Lung, Kidney) are all deficient. The Stomach Qi (Stomach Qi: the functional activity of the Stomach) is weakened, and the Grain Qi (Grain Qi: energy derived from food digestion) is still insufficient, leading to deficiency heat (Deficiency heat: heat syndrome caused by Yin deficiency). Yang Qi fails to remain in its proper place and rushes upward to the head. Excess Yang and deficiency Yin result in headache.
There are also cases where pain is caused by postpartum retained blood (Retained blood: blood stasis remaining after childbirth). Xue Lizhai stated: If the above symptoms are due to Middle Qi deficiency (Middle Qi deficiency: weakness of Spleen and Stomach function), use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Jingjie (Eupatorium Leaf) added; if it is Blood deficiency (Blood deficiency: lack of nourishing blood), use Siwu Tang (Four Substance Decoction) with Renshen (Ginseng) and Baizhu (Atractylodes Rhizome) added; if both Qi and Blood are deficient, use Bazhen Tang (Eight Treasures Decoction); if caused by Wind-Cold invasion (Wind-Cold invasion: pathogenic factors of wind and cold), use Buzhong Yiqi Tang with Chuanxiong (Ligusticum Rhizome) added.
Chanbao Heilong Dan (Black Dragon Pill for Obstetrics)
Treats unbearable postpartum headache, all types of blood-stasis pain, critical conditions approaching death, and retained placenta. As long as the medicine can be administered and swallowed, peace is restored immediately. It is truly a precious remedy for obstetrics.
Wulingzhi (Trogopterus Dung), Danggui (Angelica Sinensis Root), Chuanxiong (Ligusticum Rhizome), Shudi (Prepared Rehmannia Root), Gaoliangjiang (Galangal Rhizome) (each 5 qian).
Crush the above herbs, dry them thoroughly in the sun, store them in a small jar sealed with Guji method (a traditional sealing technique), cover tightly with a lamp saucer, and decoct using alternating mild and strong fire for the duration of one incense stick. Let it cool in a shaded place to dissipate "fire toxicity" (Fire toxicity: toxic effects resulting from excessive heating or processing). Remove the medicine, which should resemble black dregs, and grind into fine powder.
Add Huarui Shi (Pyrite, calcined and ground separately, 2 qian), Hupo (Amber, ground separately, 1 qian), Ruxiang (Frankincense, ground separately, 1.5 qian), Baicaoshuang (Soot from burning straw, 5 qian).
Grind uniformly with the previously processed powder. Form pills using vinegar paste, sized like bullet seeds. Take one pill per dose. Use Ginger Juice (Jiangzhi), good wine, and Child's Urine (Tongbian) half a cup each. Roast one pill on charcoal until red-hot, quench it in the wine and urine mixture, dissolve, and take in one go. Effect is immediate.
Preface to Heilong Dan
The sister-in-law of Zhong, Lady Jinhua, was in Qin. Seven days after childbirth, she refused food and began complaining of severe headache, wishing to have a large stone pressed upon her head. After a short while, she stabilized slightly. When experiencing heart pain, she would scratch the walls with her ten fingers, suffering agonizingly. When her eyes hurt, she wished to gouge them out with her hands. Such conditions persisted for ten days. Three or four imperial physicians and several local officials skilled in medicine looked at each other helplessly, unable to determine the root cause. The doctors' skills were exhausted, and the patient became increasingly distressed. I assessed the critical nature of the illness, believing that only a miraculous elixir could cure it, necessitating the administration of Heilong Dan. Zhong hesitated, fearing that since she had not eaten for several days, her body might not withstand it. At dusk, half a pill was administered, and the disease subsided slightly. At midnight, another dose was given. After taking the medicine, she slept as usual. At dawn, she passed stool approximately three sheng, resembling locust eggs. The disease reduced by half. At the Si hour (9-11 AM), she passed stool again as before, and then recovered instantly. Maid servants were sent to attend to her; she was nearly lifeless and breathless. Her body cooled and her breath resumed only in the afternoon. She whispered requesting drink, and from then on, she gradually recovered. Generally, postpartum treatment prioritizes the expulsion of foul blood. If blood stagnation is not resolved swiftly, disasters such as these occur. Old women and unskilled TCM practitioners who do not understand the root of diseases inevitably lead to premature deaths. Without encountering a good physician, one ends up with lifelong regrets. Now, I publish Heilong Dan to widely benefit people. May those in the world afflicted by this disease be able to live out their natural lifespan. This is not done for reward, but solely to alleviate suffering and preserve life. Prefaced by Guo on the fifth day of the fifth month, first year of Chongning.
Chuanxiong San (Ligusticum Powder)
Treats postpartum headache.
Zhen Tiantai Wuyao (True Tiantai Litsea Root), Da Chuanxiong (Large Ligusticum Rhizome) (equal parts).
Grind into fine powder. Take 3 qian per dose. Quench a red-hot weighing hammer in wine, mix with the powder, and take orally.
Jiajian Siwu Tang (Modified Four Substance Decoction)
Treats postpartum headache, Blood deficiency, Phlegm-Lump (Phlegm-lump: accumulation of phlegm causing masses or discomfort), and Cold-Jue (Cold-Jue: cold extremities due to Yang deficiency or obstruction).
Cangzhu (Atractodis Rhizoma, 1.5 qian), Qianghuo (Notopterygium Rhizome), Chuanxiong (Ligusticum Rhizome), Fangfeng (Saposhnikovia Root), Xiangfu (Cyperi Rhizome, stir-fried), Baizhu (Angelicae Dahuricae Radix) (each 1 qian), Shigao (Gypsum Fibrosum, 2.5 qian), Xixin (Asari Radix et Rhizoma, 1.2 qian), Danggui (Angelicae Sinensis Radix, 0.8 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 0.5 qian).
Decoct with two zhan of water and three slices of ginger. For Blood deficiency, double the Danggui and add Shaoyao (Paeoniae Radix); for sweating, add Huangqi (Astragali Radix) and Guizhi (Cinnamomi Ramulus); for Phlegm-lump, add Banxia (Pinelliae Rhizoma) and Fuling (Poria); for Heat-Phlegm, double the Shigao and add Zhimu (Anemarrhenae Rhizoma); for Cold-Jue, add Tianma (Gastrodiae Rhizoma) and Fuzi (Aconiti Lateralis Radix Praeparata).