妇人产后气喘,最是大危之症,苟不急治,立刻死亡,人只知是气血之虚也,谁知是气血两脱乎!夫既气血两脱,
人将立死,何又能作喘?然此血将脱,而气犹未脱也。血将脱而气欲挽之,而反上喘,如人救溺,援之而力不胜,又不
肯自安于不救,乃召号同志以求助,故呼声而喘作,其症虽危,而可救处正在能作喘也。盖肺主气,喘则肺气似盛而实
衰,当是之时,血将脱而万难骤生,望肺气之相救甚急;而肺因血失,只存几微之气,自顾尚且不暇,又何能提挈乎血,
气不与血俱脱者几希矣,是救血必须补气也。
方用救脱活母汤。
人参(二两) 当归(一两,酒洗) 熟地(一两,九蒸) 枸杞子(五钱) 山萸(五钱,蒸,去核) 麦冬
(一两,去心) 阿胶(二钱,蛤粉炒) 肉桂(一钱,去粗,研) 黑芥穗(二钱)
水煎服。一剂而喘轻,二剂而喘减,三剂而喘定,四剂而全愈矣。此方用人参以接续元阳,然徒补其气而不补其血,
则阳燥而狂,虽回生于一时,亦旋得旋失之道;即补血而不补其肝肾之精,则本原不固,阳气又安得而续乎!所以又用
熟地、山萸、枸杞之类,以大补其肝肾之精,而后大益其肺气,则肺气健旺,升提有力矣。特虑新产之后,用补阴之药,
腻滞不行,又加肉桂以补命门之火,使火气有根,助人参以生气,且能运化地黄之类,以化精生血。若过于助阳,万一
血随阳动瘀而上行,亦非保全之策,更加荆芥以引血归经,则肺气安而喘速定,治几其神乎。
眉批∶方妙不可加减。
歌括∶产后气喘病膏肓,气血双脱无主张。
救脱尚须补气血,抓紧时机施妙方。
救脱活母人参当,麦冬枸杞熟地黄。
山萸阿胶桂芥穗,肺安喘定病复康。
妇女在产后出现气喘,这是非常危险的病症。如果不立即治疗,患者会立刻死亡。人们只知道这是因为气血虚弱,但哪里知道这是气血同时脱失呢!既然气血都脱失了,人应该立刻死亡,为什么还能产生气喘呢?然而,这是因为血即将脱失,而气还没有完全脱失。血即将脱失时,气想要挽回它,反而向上导致气喘,就像有人落水溺水,施救者用力拉拽却力量不够,施救者又不甘心看着病人不救,于是呼号召集同伴来寻求帮助,所以发出呼喊声而导致气喘发作。这个症状虽然危险,但能救治的关键点恰恰在于还能产生气喘。因为肺主司气,气喘时肺气看似旺盛实际上却是衰弱的。在这个时候,血即将脱失且很难迅速生成,非常指望肺气来救助;而肺因为血液的丧失,只存留微弱的元气,自顾不暇,又怎么能提携血液呢?气不随血一起脱失的情况是很少见的,因此救治血脱必须补气。
方剂使用救脱活母汤。
人参(二两) 当归(一两,用酒清洗) 熟地黄(一两,九次蒸制) 枸杞子(五钱) 山茱萸(五钱,蒸制,去核) 麦冬(一两,去心) 阿胶(二钱,用蛤粉炒) 肉桂(一钱,去掉粗皮,研碎) 黑芥穗(二钱)
用水煎服。服用一剂后气喘减轻,两剂后气喘减少,三剂后气喘停止,四剂后完全痊愈。这个方子用人参来接续元阳,但如果只补气而不补血,那么阳气就会燥热而狂躁,虽然能暂时起死回生,也是很快得到很快失去的道理;即使补血而不补肝肾的精气,那么根本源头就不稳固,阳气又怎么能延续呢!所以又使用熟地黄、山茱萸、枸杞子等药物,来大补肝肾的精气,然后大益肺气,这样肺气健壮旺盛,升提有力了。特别担心新产之后,使用补阴的药物会导致腻滞而不运行,所以又加入肉桂来补命门之火,使火气有根,帮助人参来生气,并且能运化熟地黄等药物,以化精生血。如果过于助长阳气,万一血液随着阳气变动瘀阻而上行,也不是保全生命的策略,再加上荆芥来引导血液回归经脉,那么肺气安宁而气喘迅速安定,治疗几乎达到神妙的境界了。
眉批:此方妙处不可随意加减。
歌诀:产后气喘病入膏肓,气血双脱无主张。
救脱尚须补气血,抓紧时机施妙方。
救脱活母用人参和当归,麦冬枸杞熟地黄。
山茱萸阿胶肉桂黑芥穗,肺气安宁气喘停止疾病康复。
Dyspnea (asthma-like breathing) occurring after childbirth is a critical and dangerous condition. If not treated urgently, death will ensue immediately. People generally attribute this to the deficiency of Qi and Blood, but few realize it is actually a simultaneous collapse (prolapse/loss) of both Qi and Blood. Since both Qi and Blood are collapsing, one should die instantly; why is there still dyspnea? This occurs because while Blood is on the verge of collapsing, Qi has not yet fully collapsed. As Blood is about to be lost, Qi attempts to retain it, resulting in upward rebellion manifesting as dyspnea. It is akin to rescuing someone drowning: the rescuer pulls with insufficient strength and, unwilling to accept failure, calls out to companions for help. Thus, the shouting leads to the onset of dyspnea. Although the condition appears critical, the very fact that dyspnea exists indicates a possibility for rescue. The Lung governs Qi; during dyspnea, Lung Qi appears vigorous but is actually deficient. At this moment, Blood is on the verge of loss and difficult to regenerate rapidly, creating an urgent need for Lung Qi to provide assistance. However, due to the loss of Blood, the Lung retains only a trace amount of Yuan Qi (Primordial Qi), leaving no time even to care for itself, let alone support the Blood. It is rare for Qi not to collapse along with Blood; therefore, to treat Blood collapse, one must tonify Qi.
The formula used is Jiu Tuo Huo Mu Tang (Rescue Collapse and Save Mother Decoction).
Ren Shen (Ginseng Radix et Rhizoma, 2 liang) Dang Gui (Angelicae Sinensis Radix, 1 liang, washed with wine) Shu Di Huang (Prepared Rehmanniae Radix, 1 liang, steamed nine times) Gou Qi Zi (Lycii Fructus, 5 qian) Shan Zhu Yu (Corni Fructus, 5 qian, steamed, pitted) Mai Dong (Ophiopogonis Radix, 1 liang, heart removed) E Jiao (Colla Corii Asini, 2 qian, stir-fried with clam powder) Rou Gui (Cinnamomi Cortex, 1 qian, coarse bark removed, crushed) Hei Jing Sui (Blackened Schizonepetae Spica, 2 qian)
Decoct in water and take orally. After one dose, dyspnea lightens; after two doses, it decreases; after three doses, it stabilizes; after four doses, full recovery is achieved. This formula uses Ren Shen to reconnect Yuan Yang (Primordial Yang). However, if one merely tonifies Qi without tonifying Blood, Yang becomes dry and erratic, leading to mania. Although life may be temporarily restored, it is a transient gain easily lost. Even if Blood is tonified without nourishing the Essence of the Liver and Kidneys, the root remains unstable, and how can Yang be sustained? Therefore, Shu Di Huang, Shan Zhu Yu, and Gou Qi Zi are added to greatly tonify the Essence of the Liver and Kidneys. Subsequently, Lung Qi is significantly benefited, making Lung Qi robust and capable of effective ascending and lifting. Special concern arises that after recent childbirth, Yin-tonifying herbs may cause stagnation and impede circulation. Thus, Rou Gui is added to tonify the Fire of the Gate of Vitality (Ming Men), providing a root for the Fire, assisting Ren Shen in generating Qi, and facilitating the transformation of Shu Di Huang and similar herbs to transform Essence into Blood. If Yang is assisted too excessively, there is a risk that Blood might move with Yang, causing stasis and upward rebellion, which would not preserve life. Therefore, Jing Jie (Schizonepetae Herba) is added to guide Blood back to its vessels. With Lung Qi pacified, dyspnea resolves quickly, rendering the treatment nearly miraculous.
Marginal note: The efficacy of this formula lies in its precision; it should not be arbitrarily modified.
Song verse: Postpartum dyspnea enters the deep layers (Gao Huang), with dual collapse of Qi and Blood lacking direction.
To rescue collapse, one must tonify Qi and Blood, seizing the moment to apply the exquisite prescription.
Jiu Tuo Huo Mu relies on Ren Shen and Dang Gui, combined with Mai Dong, Gou Qi Zi, and Shu Di Huang.
Shan Zhu Yu, E Jiao, Rou Gui, and Hei Jing Sui ensure Lung peace, cessation of dyspnea, and restoration of health.