凡产后疟疾,多由亏血挟寒热而作。大法宜柴胡四物汤调之。热多者草果饮子,寒多者生熟饮子。薛立斋曰∶产后
疟疾,因脾胃虚弱,饮食停滞,或因外邪所感。或郁怒伤脾,或暑邪所伏。审系饮食,用六君加桔梗、苍术、藿香;如
外邪多而饮食少,用藿香正气散;饮食劳役,用补中益气汤;气血虚弱,用十全大补汤;虚寒用六君加姜、桂;元气脱
陷、急加附子。大凡久疟多属元气虚寒。盖气虚则寒,血虚则热。胃虚则恶寒,阴火下流,则寒热交作;或吐泻不食,
腹痛,烦渴,发热,谵语;或手足逆冷。虽见百证,当峻温补,其病自退。若误用清脾截疟之类,多致不起,中气伤而
变证多矣。
草果饮子
治产后疟疾,寒热相半,或多热者宜此。
半夏 赤茯苓 甘草(炙) 草果 川芎 陈皮 白芷(各二钱) 青皮 良姜 紫苏(各二钱半) 干姜(四钱)
上为粗末,分作四服,每用水一大碗、姜三片、枣三枚、煎七分,临发日连进二服即愈。
生熟饮子
治产后疟疾多寒者。
肉豆蔻 草果仁 浓朴(生,去粗皮) 半夏(制) 陈皮 甘草 大枣 生姜
上八味各等分,细 一半,用湿纸裹煨,令香熟,去纸,与一半生者和匀,每服五钱,水一大碗,煎七分,
食前一服,食后一服。
按疟初起当用上两法,不愈当用薛氏法。
凡是产后患疟疾,多是因为阴血亏虚夹杂寒热邪气而发作。治疗的大法适宜用柴胡四物汤来调理。如果热象偏重,使用草果饮子;如果寒象偏重,使用生熟饮子。薛立斋说:产后疟疾,是因为脾胃虚弱,饮食停滞,或者是由于外感邪气所致。或者因郁怒损伤脾脏,或者暑邪潜伏体内。如果确认是饮食积滞引起,使用六君子汤加桔梗、苍术、藿香;如果是外感邪气重而饮食积滞轻,使用藿香正气散;如果是饮食不节加上过度劳累,使用补中益气汤;如果是气血虚弱,使用十全大补汤;如果是虚寒证,使用六君子汤加干姜、肉桂;如果是元气脱陷,紧急时加入附子。大凡久患疟疾多属于元气虚寒。因为气虚则生寒,血虚则生热。胃气虚弱则厌恶寒冷,阴火下流,则寒热交替发作;或者出现呕吐腹泻、不能进食、腹痛、烦躁口渴、发热、说胡话;或者手足逆冷。虽然见到各种症状,应当采用峻猛的温补疗法,病自然会消退。如果误用清脾截疟之类的药物,大多导致病情恶化无法治愈,这是因为中气受损而导致变证增多。
草果饮子
治疗产后疟疾,寒热各半,或者热象较多的情况适宜用此方。
半夏、赤茯苓、甘草(炙)、草果、川芎、陈皮、白芷(各二钱)、青皮、良姜、紫苏(各二钱半)、干姜(四钱)。
以上药材捣成粗末,分为四次服用。每次用水一大碗,生姜三片,大枣三枚,煎煮至七分满,在疟疾发作当天连续服用两次即可痊愈。
生熟饮子
治疗产后疟疾寒象较多的情况。
肉豆蔻、草果仁、浓朴(生,去掉粗皮)、半夏(制)、陈皮、甘草、大枣、生姜。
以上八味药各取等量,将一半细切,用湿纸包裹后煨烤,直到香气熟透,去掉纸张,与另一半生药混合均匀。每次服用五钱,用水一大碗,煎煮至七分满,饭前服一次,饭后服一次。
In cases of malaria occurring postpartum, it is mostly caused by a deficiency of blood complicated by cold and heat pathogens. The general principle of treatment is to regulate with Chaihu Siwu Tang (Bupleurum and Four Substances Decoction). If heat predominates, Caoguo Yinzi (Tsaoko Fruit Drink) should be used; if cold predominates, Shengshu Yinzi (Raw and Cooked Drink) should be used. Xue Lizhai stated: Postpartum malaria is due to the weakness of the Spleen and Stomach, stagnation of food, or invasion of external pathogens. It may also result from anger damaging the Spleen or latent summer-heat pathogens. If confirmed to be due to food stagnation, Liujunzi Tang (Six Gentlemen Decoction) with Jiegeng (Platycodon Root), Cangzhu (Atractylodis Rhizoma), and Huoxiang (Patchouli Herb) is used. If external pathogens are heavy and food stagnation is light, Huoxiang Zhengqi San (Patchouli Powder for Rectifying the Qi) is used. If caused by improper diet and overwork, Buzhong Yiqi Tang (Decoction for Supplementing the Middle and Augmenting the Qi) is used. For Qi and Blood deficiency, Shiquan Dabu Tang (Comprehensive Great Tonifying Decoction) is used. For deficiency-cold, Liujunzi Tang with Jiang (Ginger) and Gui (Cinnamon Twig) is used. In cases of Yuanqi (Original Qi) collapse and sinking, Fuzi (Aconite Lateral Root) is urgently added. Generally, chronic malaria belongs to deficiency-cold of Yuanqi. Qi deficiency leads to cold, while Blood deficiency leads to heat. Stomach deficiency leads to aversion to cold; downward flow of Yin fire causes alternating chills and fever; symptoms may include vomiting, diarrhea, anorexia, abdominal pain, irritability, thirst, fever, delirium, or cold extremities. Although various symptoms may appear, vigorous warming and tonification should be employed, and the disease will recede spontaneously. If mistakenly treated with drugs that clear the Spleen and arrest malaria, the condition often becomes incurable, as damage to the Middle Qi leads to numerous complications.
Caoguo Yinzi (Tsaoko Fruit Drink)
Indicated for postpartum malaria with equal amounts of cold and heat, or when heat predominates.
Banxia (Pinellia Tuber), Chi Fuling (Red Poria), Gancao (Licorice Root, honey-fried), Caoguo (Tsaoko Fruit), Chuanxiong (Szechwan Lovage Rhizome), Chenpi (Citrus Reticulata Peel), Baizhi (Angelica Dahurica Root) (each 2 qian); Qingpi (Green Citrus Peel), Liangjiang (Galangal Rhizome), Zisu (Perilla Leaf) (each 2.5 qian); Ganjiang (Dried Ginger) (4 qian).
Grind into coarse powder, divide into four doses. For each dose, use one large bowl of water, three slices of fresh ginger, and three jujubes. Decoct until reduced to 70%. On the day of onset, take two doses consecutively to achieve cure.
Shengshu Yinzi (Raw and Cooked Drink)
Indicated for postpartum malaria where cold predominates.
Roudoukou (Nutmeg), Caoguoren (Tsaoko Fruit Seed), Houpo (Magnolia Bark, raw, coarse skin removed), Banxia (Pinellia Tuber, processed), Chenpi (Citrus Returulata Peel), Gancao (Licorice Root), Dazao (Jujube), Shengjiang (Fresh Ginger).
Take equal parts of these eight herbs. Finely cut half of the mixture, wrap in wet paper, and roast until fragrant and cooked. Remove the paper and mix evenly with the other half which remains raw. Take 5 qian per dose with one large bowl of water, decoct until reduced to 70%. Take one dose before meals and one dose after meals.
Note: For early-stage malaria, the above two methods should be used first. If ineffective, Xue's method should be adopted.