产后小便不通及淋沥涩痛者,由气虚挟热,不可专用分利渗导之药,重损真气。膀胱虚热用六味丸,若阴
虚而阳无以化,用滋阴肾气丸。盖土生金,金生水,当滋化源也。
滑石散
疗产后淋闭。
滑石(一两二钱) 通草 车前子 葵子(各一两)
上为末,热水调服三钱。
张不愚方
疗产后小便不通。
陈皮(一两,去白为末)
上空心温酒调下二钱,一服便通。
又方
杏仁十四枚去皮尖炒为末,和饮顿服,立通。
又方
用食盐填脐中,可与脐平,却用葱白剥去粗皮十余茎作一缚,切作一指浓安盐上,大艾炷如葱饼子大小,
以火灸之,觉热气直入腹内,实时便通,神验不可俱述。
产妇生理不顺,致伤尿脬,遗尿无时。丹溪曰∶尝见收生者不谨,损破尿脬,因而淋漓遂成废疾者。有徐
氏妇得此,因思肌肉破伤在外者,既可补完,在内者,恐也可治,遂兹其脉虚甚,试与峻补。因以参 为君,
芎归为臣,陈皮、茯苓为佐,以猪羊胞煮汤煎服,极饥时饮之,一月而安。盖气血骤长,其胞自完,恐稍缓亦
难成功矣。
补脬饮
治产妇伤动脬破,终日不小便,但淋湿不干。
黄丝绢(一尺,自然黄丝织成者) 白芨末 白牡丹 根皮(各一钱) 黄蜡(五钱)
用水三碗,煎至绢烂如饧,服之勿作声,作声无效。
产后出现小便不通畅以及淋漓涩痛的症状,是由于气虚兼有内热所致。此时不可专门使用分利渗导(通过利尿作用使水湿从小便排出)的药物,以免进一步损伤人体的真气。若因膀胱虚热导致此症,可使用六味丸;若是阴虚导致阳气无法气化水液,则使用滋阴肾气丸。这是因为土能生金,金能生水,治疗应当滋生化之源(即通过补益脾胃肺肾以恢复津液代谢)。
滑石散
用于治疗产后淋证及小便闭塞。
滑石(一两二钱) 通草 车前子 葵子(各一两)
将上述药材研为细末,用热水调服三钱。
张不愚方
用于治疗产后小便不通。
陈皮(一两,去除白色内层后研为细末)
空腹时温酒调服二钱,服用一次即可通畅。
又一方
杏仁十四枚,去皮尖后炒制并研为细末,与饮品混合一次性顿服,小便立即通畅。
又一方
用食盐填满肚脐中,使其与肚脐平齐,然后用十余茎葱白剥去粗皮捆成一束,切成一指厚的片状放置在盐上,再用如葱饼大小的大艾炷进行艾灸。当感觉到热气直接传入腹内时,小便随即通畅,此法神效难以尽述。
产妇因生理过程不顺,导致尿脬(膀胱)受伤,出现随时遗尿的情况。朱丹溪说:我曾见到接生者不慎,损伤破裂了尿脬,因而导致淋漓不尽最终成为废疾的案例。有一位徐姓妇人得了此病,我想肌肉在外部的破损尚且可以修补愈合,内部的损伤恐怕也可以治疗。诊察发现她的脉象非常虚弱,于是尝试给予峻补(强力补益)。以人参为君药,川芎、当归为臣药,陈皮、茯苓为佐药,用猪羊胞(膀胱)煮汤来煎服这些药物,在极度饥饿时饮用,一个月后痊愈。这是因为气血迅速生长,其胞自然修复,如果稍加迟缓也难以成功。
补脬饮
治疗产妇损伤导致膀胱破裂,整天不能正常排尿,只是淋湿衣物不干。
黄丝绢(一尺,由天然黄丝织成者) 白芨末 白牡丹根皮(各一钱) 黄蜡(五钱)
用水三碗,煎至丝绢烂熟如糖浆状,服用时不要发出声音,发出声音则无效。
Postpartum urinary retention accompanied by dribbling and painful urination is caused by Qi deficiency with accompanying heat. It is inadvisable to exclusively use diuretic and draining herbs (herbs that promote urination to drain dampness), as this would severely damage the True Qi. For bladder deficiency-heat, Liuwei Wan (Six-Ingredient Pill) should be used; if Yin deficiency leads to an inability of Yang to transform fluids, Ziyin Shenqi Wan (Yin-Nourishing Kidney-Energy Pill) is indicated. This is because Earth generates Metal, and Metal generates Water; therefore, treatment should focus on nourishing the source of transformation (i.e., tonifying the Spleen, Lung, and Kidney to restore fluid metabolism).
Shihui San (Talc Powder)
Treats postpartum strangury and urinary obstruction.
Talcum (1 liang 2 qian) Tongcao (Licorice Root of Akebia Vine), Cheqianzi (Plantago Seed), Kuizi (Okra Seed) (each 1 liang)
Grind the above into powder, mix with hot water, and take 3 qian per dose.
Zhang Buyu's Formula
Treats postpartum urinary retention.
Chenpi (Dried Tangerine Peel) (1 liang, remove the white pith and grind into powder)
Take 2 qian mixed with warm wine on an empty stomach; patency is achieved after one dose.
Another Formula
Take 14 Xingren (Apricot Seeds), remove the skin and tips, stir-fry, and grind into powder. Mix with a beverage and consume in one dose; urination will immediately become patent.
Another Formula
Fill the umbilicus with edible salt until level with the navel. Then, take more than ten stalks of Congbai (Scallion White), peel off the coarse skin, bundle them together, cut them into slices about one finger-thick, and place them on the salt. Apply a large moxa cone (Ai Zhu) the size of a scallion pancake and moxibustion. When heat sensation is felt penetrating directly into the abdomen, urination will immediately become patent. This method is miraculous and cannot be fully described.
If a parturient experiences irregular physiological processes leading to injury of the Niao Pao (Urinary Bladder), she may suffer from involuntary urination at any time. Zhu Danxi stated: "I have observed cases where midwives were not careful, damaging or rupturing the urinary bladder, resulting in continuous dribbling and becoming a chronic disability." There was a woman surnamed Xu who suffered from this condition. She reasoned that since external muscle wounds can be repaired, internal injuries might also be treatable. Upon examination, her pulse was extremely deficient, so we attempted strong tonification (Jun Bu). We used Renshen (Ginseng) as the Sovereign herb, Chuanxiong (Szechwan Lovage Rhizome) and Danggui (Angelica Sinensis) as the Minister herbs, Chenpi (Dried Tangerine Peel) and Fuling (Poria) as the Assistant herbs, and decocted them in soup made from Zhu Yang Bao (Pig/Sheep Bladder). The patient drank this when extremely hungry and recovered within one month. This is because rapid regeneration of Qi and Blood allows the bladder to heal itself; delay would have hindered success.
Bupao Yin (Bladder-Repairing Decoction)
Treats postpartum injury causing rupture of the bladder, resulting in an inability to void urine for the entire day, with only constant wetness.
Huang Si Juan (Yellow Silk Fabric) (1 chi, woven from natural yellow silk) Baiji (Bletilla Rhizome) powder, Baidanpi Genpi (White Peony Root Bark) (each 1 qian) Huang La (Yellow Beeswax) (5 qian)
Decoct in three bowls of water until the silk fabric dissolves like syrup. Take orally without making any noise; making noise renders it ineffective.