血之为病,冒闷烦躁,迷忘惊狂,痰呕汗多,骨热肢冷,此外证然尔。何以知其蓄在下
焦?曰∶脐下结急,外热内痛,尺脉洪而数也。桃仁、灵脂、生地黄、北大黄、甘草利而逐
之。
此候因产断赶血未尽所致。世俗收生,多就踏板赶血,不思生产之时,已坐草近地久矣。
产毕脏腑虚空,又且近地赶血,冷湿乘之,风邪入之,使败淤凝为血块,是谓血母。冲筑硬
痛,非乳香、没药、延胡索、五灵脂辈所能疗也。治法不换金正气散加辣桂、川芎、白芷、
蓬莪术、干姜同煎,乘热入法醋,连进两服。冷湿风邪一散,其块自消,散淤皆从大小便而
出。凡新产,须就床上赶血,下帐避风。
身体疼痛,非湿则痰固也。人有挟刀锯之,惊而又馁在其中,为风寒水湿所伤,致使心
窍凝滞,于是经络壅闭,血流不行,肠肉骨节为之刺痛。治法当归、川芎、芍药、白芷、灵
脂、大黄、甘草利之,黑物小片而下,其痛有瘳。
此血之为病也。以其饮酒嗜欲,伏热受暑得之。惟热毒、暑毒、酒毒为能伤血,淤血未
去,新血不营身体,所以隐痛拘急。其里热足冷者,血之证也。用柴胡、黄芩、青皮、枳壳、
灵脂、桃仁、木通、甘草作剂,多入大黄以利之,俟其流利已尽,小腹略无结急,即以当归、
川芎一倍,橘皮、半夏、枳壳、北梗、木通、甘草平之,调其气血,于是有瘳。血属于心,
木通以通其心窍,心窍既通,经络之流行可知矣。
血分病证,表现为头目昏闷、烦躁不安、神志昏迷遗忘、惊悸发狂,伴有痰多呕吐、汗出过多、骨中发热而四肢厥冷,这些是外在的证候表现。如何判断瘀血蓄积在下焦呢?回答说:脐下部位结聚拘急,体表发热而体内疼痛,尺部脉象洪大且数。治疗可用桃仁、五灵脂、生地黄、北大黄、甘草来通利并驱逐瘀血。
这种病候是因为产后恶露排不尽所致。世俗接生婆,多在产妇坐在产床上时用力按压腹部以催赶瘀血排出,却不思考分娩之时,产妇早已在草席上久坐很久了。生产完毕后脏腑空虚,又靠近地面按压催血,冷湿之气趁机侵袭,风邪随之进入,导致败血凝结成血块,这被称为“血母”(产后瘀血块)。此时冲任二脉受攻筑,坚硬疼痛,不是乳香、没药、延胡索、五灵脂这类药物所能治疗的。治疗方法是用不换金正气散加入辣桂(肉桂)、川芎、白芷、蓬莪术、干姜共同煎煮,趁热兑入法醋,连续服用两剂。待冷湿风邪散去,血块自然消除,散瘀的血都会从大小便排出。凡是刚生产完,必须在床上进行排瘀处理,并在床帐内避风。
身体疼痛,若非湿气阻滞,便是痰浊固结。有人因遭受刀锯创伤,惊恐之后正气虚弱留于体内,被风寒水湿所伤,致使心窍凝滞,于是经络壅塞闭阻,血液流动不行,肠肉骨节因此产生刺痛。治疗方法用当归、川芎、芍药、白芷、五灵脂、大黄、甘草来通利,排出黑色小片状瘀血后,疼痛就会缓解。
这是血分病证。因为饮酒纵欲,潜伏的热毒和暑气所致。只有热毒、暑毒、酒毒能够损伤血液,瘀血未去,新血无法滋养身体,所以出现隐隐作痛和拘急感。其内部发热而足部发冷的,是血的病证。用药用柴胡、黄芩、青皮、枳壳、五灵脂、桃仁、木通、甘草组成方剂,多加大黄以通利之,等到气血流利顺畅,小腹略微没有结聚拘急感后,就改用加倍剂量的当归、川芎,加上橘皮、半夏、枳壳、北梗(桔梗)、木通、甘草来平调,调和气血,于是疾病痊愈。血归属于心,木通能通利心窍,心窍既然通畅,经络的运行情况也就可知了。
Diseases of the blood manifest as dizziness and oppression, irritability, confusion and forgetfulness, palpitations and mania, accompanied by profuse phlegm and vomiting, excessive sweating, bone-heat with cold limbs; these are the external manifestations. How can one know that the blood is retained in the Lower Jiao (Lower Burner)? It is said: there is a knotted and tense sensation below the umbilicus, external heat with internal pain, and the pulse at the Chi position (Cun Kou) is surging and rapid. Treatment employs Tao Ren (Peach Seed), Wu Ling Zhi (Trogopterus Dung), Sheng Di Huang (Rehmannia Root), Bei Da Huang (Rhubarb Rhizome), and Gan Cao (Licorice Root) to promote purgation and expel the stasis.
This condition arises from incomplete expulsion of lochia after childbirth. Lay midwives often press the abdomen while the patient is still on the birthing stool, failing to realize that during labor, the patient has already been sitting on the straw mat for a long time. After delivery, the Zang-Fu organs are empty; pressing near the ground to expel blood allows cold-dampness to invade and wind pathogens to enter, causing degenerated blood to coagulate into clumps, termed "Xue Mu" (Blood Mother). The Chong and Ren vessels are assaulted, resulting in hardness and pain, which cannot be treated with herbs such as Ru Xiang (Frankincense), Mo Yao (Myrrh), Yan Hu Suo (Corydalis Rhizome), or Wu Ling Zhi. The treatment method involves using Bu Huan Jin Zheng Qi San (Golden Exchange Upright Qi Powder) added with La Gui (Cinnamon Twig), Chuan Xiong (Sichuan Lovage Rhizome), Bai Zhi (Angelica Dahurica Root), Peng E Zhu (Curcuma Zedoaria Rhizome), and Gan Jiang (Dried Ginger), decocted together. Take warm, add Fa Cu (Medicinal Vinegar), and administer two doses consecutively. Once the cold-dampness and wind pathogens dissipate, the clumps will naturally resolve, and the dispersed stasis will exit through urination and defecation. For all new postpartum cases, blood expulsion must occur on the bed, and wind avoidance is required within the bed curtains.
Body pain, if not due to dampness, is caused by phlegm consolidation. Individuals who have suffered knife or saw trauma, followed by fright and subsequent deficiency remaining inside, may be injured by wind-cold and water-dampness. This causes obstruction of the Heart Orifices, leading to congestion and blockage of the meridians, cessation of blood flow, and stabbing pain in the intestines, flesh, bones, and joints. Treatment uses Dang Gui (Chinese Angelica Root), Chuan Xiong, Shao Yao (Peony Root), Bai Zhi, Wu Ling Zhi, Da Huang (Rhubarb Root), and Gan Cao to promote unblocking. When small black fragments are passed, the pain alleviates.
This is a disease of the blood, caused by indulgence in alcohol and sexual desire, leading to latent heat and summer-heat accumulation. Only heat-toxin, summer-heat toxin, and alcohol-toxin can damage the blood. Since the stasis remains and new blood fails to nourish the body, dull pain and tension occur. Internal heat with cold feet is a sign of blood pathology. The prescription consists of Chai Hu (Bupleurum Root), Huang Qin (Scutellaria Root), Qing Pi (Aged Tangerine Peel), Zhi Ke (Aurantii Fructus Immaturus), Wu Ling Zhi, Tao Ren, Mu Tong (Akebia Stem), and Gan Cao. Add more Da Huang to promote purgation. Wait until the qi and blood flow smoothly and the lower abdomen feels slightly free of tension, then switch to a formula with double the dose of Dang Gui and Chuan Xiong, plus Ju Pi (Tangerine Peel), Ban Xia (Pinellia Tuber), Zhi Ke, Bei Jing (Platycodon Root), Mu Tong, and Gan Cao to regulate and calm. By harmonizing the qi and blood, recovery ensues. Blood belongs to the Heart; Mu Tong opens the Heart Orifices. Once the Heart Orifices are open, the circulation of the meridians becomes evident.