产后蓐劳者,由生产日浅,血气虚弱,饮食未平,将养失所,而风冷客之,使人虚乏,劳倦,乍卧乍起,容颜憔悴,
饮食不消,口干头昏,百节疼痛,有时盗汗,寒热如疟,背膊烦闷,四肢不举,沉重着床,此为蓐劳之候。薛立斋曰∶
前证当扶养正气为主,用六君子汤加当归。若脾肺气虚,而咳嗽口干,用补中益气汤加麦冬、五味子,头晕加蔓荆子。
若肝经血虚,而肢体作痛,用四物汤加参、术。肝肾虚弱,自汗、盗汗,寒热往来者,用六味丸加五味子。因脾血虚弱,
肚腹作痛,月经不调,用八珍汤倍白术。因脾虚血燥,皮肤瘙痒,用加味逍遥散。大抵此证,多因脾胃虚弱,饮食减少,
以致诸经疲惫,当补脾胃。饮食既进,精气化生,诸脏有所倚赖,其病自愈矣。
白茯苓散
治蓐劳,因生产日浅,久坐多语,勤动用力,以致四肢疼痛,寒热如疟。
白茯苓(一两) 当归 川芎 桂心 白芍 黄 人参(各半两) 熟地黄(一两)
上 咀,以水二盏,入猪肾一双,去筋皮切碎,姜三片,枣三枚,煎一盏,滤出清汁,入药半两,煎七分,去渣温
服。
黄 煮散
治产后肌肤黄瘦,面无颜色,或 寒壮热,四肢酸痛,心烦头痛。
鳖甲(醋炙) 黄 桂心 当归 桑寄生 白茯苓 白芍 人参 熟地 麦冬 甘草(炙。各半两)
牛膝(七钱)
上为细末,每服用猪石子一对,即睾丸去脂膜切破,先以水一盏,入姜三片,枣三枚,煎至七分,去石子姜枣,却
下药五钱,更煎至四分,去渣,空心临卧二服。渣并煎。
胡氏牡丹散
治产后虚羸,发热自汗,欲变蓐劳,或血气所搏,经候不调。
白芍药 当归 五加皮 地骨皮 人参(各半两) 没药 桂心(各二钱) 牡丹皮(三钱)
上为细末,每服五钱,水酒各半盏,如不饮酒,只用水一盏,开元钱一枚,麻油蘸之,同煎七分去滓,通口服,煎
不得搅,吃不得吹。
紫河车丸佳,猪腰子粥亦妙。
产后蓐劳(指产后因气血虚弱、调养不当而导致的慢性虚损性疾病),是由于分娩时间不久,血气虚弱,饮食未恢复平稳,调养失当,导致风冷之邪侵袭人体,使人出现身体虚弱乏力、劳累倦怠、时而躺卧时而起身、面容憔悴、饮食不消化、口干头晕、全身关节疼痛、有时盗汗、寒热往来像疟疾一样、背部和两胁烦闷、四肢无力抬举、身体沉重卧床不起等症状,这就是蓐劳的征候。薛立斋说:上述证候应当以扶持正气为主,使用六君子汤(由人参、白术、茯苓、甘草、陈皮、半夏组成)加入当归。如果是脾肺之气虚弱,伴有咳嗽、口干,使用补中益气汤(由黄芪、人参、白术、甘草、当归、升麻、柴胡、陈皮组成)加入麦冬、五味子,头晕则加入蔓荆子。如果是肝经血虚,导致肢体疼痛,使用四物汤(由熟地黄、当归、白芍、川芎组成)加入人参、白术。肝肾虚弱,出现自汗、盗汗、寒热往来的,使用六味丸(即六味地黄丸,由熟地黄、山茱萸、山药、泽泻、牡丹皮、茯苓组成)加入五味子。因为脾血虚弱,导致肚腹疼痛、月经不调的,使用八珍汤(由四君子汤合四物汤组成)加倍白术。因为脾虚导致血燥,皮肤瘙痒的,使用加味逍遥散(即丹栀逍遥散)。大抵这个证候,多是因为脾胃虚弱,饮食减少,以致各条经脉疲惫,应当补益脾胃。饮食既然能够进食,精气得以化生,各个脏腑有所依赖,疾病自然痊愈了。
白茯苓散
治疗蓐劳,由于分娩时间不久,久坐多言,勤劳用力,导致四肢疼痛,寒热往来像疟疾一样。
白茯苓(一两) 当归 川芎 桂心 白芍 黄芪 人参(各半两) 熟地黄(一两)
以上药材切碎,用水二盏,加入猪肾一双,去除筋膜和表皮切碎,生姜三片,大枣三枚,煎煮至一盏,滤出清汁,加入药末半两,再煎煮至七分,去渣温服。
黄芪煮散
治疗产后肌肤黄瘦,面色无华,或者恶寒壮热,四肢酸痛,心烦头痛。
鳖甲(醋炙) 黄芪 桂心 当归 桑寄生 白茯苓 白芍 人参 熟地 麦冬 甘草(炙。各半两)
牛膝(七钱)
以上研为细末,每次服用时取猪睾丸一对,即睾丸去掉脂膜切破,先用水一盏,加入生姜三片,大枣三枚,煎煮至七分,去掉猪睾丸、姜、枣,然后下药末五钱,再煎煮至四分,去渣,空腹和临睡前分两次服用。药渣一并煎煮服用。
胡氏牡丹散
治疗产后身体虚弱消瘦,发热自汗,想要转变为蓐劳,或者是血气相搏结,月经周期不调。
白芍药 当归 五加皮 地骨皮 人参(各半两) 没药 桂心(各二钱) 牡丹皮(三钱)
以上研为细末,每次服用五钱,水和酒各半盏,如果不饮酒,只用清水一盏,取开元钱一枚,用麻油蘸湿,一同煎煮至七分,去滓,通口服下,煎煮时不得搅动,喝的时候不得吹凉。
Postpartum Rutao (chronic deficiency syndrome after childbirth) is caused by the short time since delivery, weakness of blood and Qi, unstable diet, improper nursing, and invasion of wind-cold pathogens. It manifests as physical weakness and fatigue, exhaustion, alternating between lying down and getting up, haggard appearance, indigestion, dry mouth, dizziness, pain in all joints, occasional night sweats, chills and fever resembling malaria, irritability in the back and shoulders, inability to lift the limbs, heaviness in bed. These are the signs of Rutao. Xue Lizhai stated: For the aforementioned symptoms, the primary treatment should be to support the righteous Qi, using Liujunzi Tang (Six Gentlemen Decoction) with added Danggui (Angelicae Sinensis Radix). If there is Qi deficiency of the Spleen and Lung accompanied by cough and dry mouth, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with added Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Fructus); add Jingjie (or Manjingzi - *Note: Text says Manjingzi*) for dizziness. If there is Blood deficiency of the Liver Meridian causing limb pain, use Siwu Tang (Four Substances Decoction) with added Renshen (Ginseng Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma). If there is weakness of the Liver and Kidney manifesting as spontaneous sweating, night sweats, and alternating chills and fever, use Liuwei Wan (Six-Ingredient Pill with Rehmannia) with added Wuweizi. Due to Spleen Blood deficiency causing abdominal pain and irregular menstruation, use Bazhen Tang (Eight Treasures Decoction) with doubled Baizhu. Due to Spleen deficiency leading to Blood dryness causing skin itching, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). Generally, this syndrome is mostly due to Spleen and Stomach weakness and reduced food intake, leading to fatigue of all meridians; therefore, tonifying the Spleen and Stomach is indicated. Once food intake resumes and Essence-Qi is generated, the Zang-Fu organs find reliance, and the disease heals itself.
Bai Fuling San (White Poria Powder)
Treats Rutao caused by sitting for long periods and talking excessively shortly after delivery, or overexertion, leading to limb pain and chills/fever resembling malaria.
Bai Fuling (Poria, 1 liang), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligusticum Chuanxiong Rhizoma), Guixin (Cinnamomi Cortex), Baishao (Paeoniae Radix Alba), Huangqi (Astragali Membranacei Radix), Renshen (Ginseng Radix) (each 0.5 liang), Shudihuang (Rehmanniae Radix Praeparata, 1 liang).
Chop the herbs. Add two zhan of water, one pair of pig kidneys (cleaned, tendons and skin removed, chopped), three slices of ginger, and three jujubes. Decoct until one zhan remains, strain to obtain clear liquid. Add half a liang of herbal powder, decoct until 0.7 parts remain, remove dregs, and take warm.
Huangqi Zhusan (Astragalus Decoction Powder)
Treats postpartum sallow and emaciated skin, lack of luster in the face, or severe chills and high fever, soreness and pain in the limbs, restlessness, headache.
Biejia (Testudo Carapax et Plastrum, vinegar-fried), Huangqi (Astragali Membranacei Radix), Guixin (Cinnamomi Cortex), Danggui (Angelicae Sinensis Radix), Sangjisheng (Taxilli Herba), Bai Fuling (Poria), Baishao (Paeoniae Radix Alba), Renshen (Ginseng Radix), Shudi (Rehmanniae Radix Praeparata), Maidong (Ophiopogonis Radix), Gancao (Glycyrrhizae Radix et Rhizoma, honey-fried) (each 0.5 liang), Niuxi (Achyranthis Bidentatae Radix, 7 qian).
Grind into fine powder. For each dose, use one pair of pig testicles (remove fat membrane, cut open). First, decoct one zhan of water with three slices of ginger and three jujubes until 0.7 parts remain. Remove testicles, ginger, and jujubes. Add five qian of herbal powder, decoct until 0.4 parts remain. Strain. Take on an empty stomach and before sleep. Consume both the liquid and the dregs.
Hu's Mudan San (Hu's Moutan Powder)
Treats postpartum emaciation and weakness, fever with spontaneous sweating, impending transformation into Rutao, or menstrual irregularities due to stagnation of Qi and Blood.
Baishao (Paeoniae Radix Alba), Danggui (Angelicae Sinensis Radix), Wujapi (Acanthopanacis Cortex), Digupi (Lycii Cortex), Renshen (Ginseng Radix) (each 0.5 liang), Moyao (Myrrha), Guixin (Cinnamomi Cortex) (each 2 qian), Mudanpi (Moutan Cortex, 3 qian).
Grind into fine powder. Take five qian per dose with half a zhan of water and half a zhan of wine. If unable to drink alcohol, use one zhan of water only. Add one Kaiyuan Tongbao coin dipped in sesame oil. Decoct together until 0.7 parts remain. Strain and take orally. Do not stir during decoction; do not blow on it while drinking.
Ziheche Wan (Placenta Pill) is excellent, and Zhu Yaozi Zhou (Pig Kidney Porridge) is also wonderful.