妇人产有用力过多,劳倦伤脾,故逆冷而厥,气上胸满,脉去形脱,非大补不可,岂钱数川芎、当归能回阳复神乎!
必用加参生化汤,倍参,进二剂,则气血旺而神自生矣,厥自止矣。若服药而反渴,另有生脉散,独参代茶饮,救脏之
燥。如四肢逆冷,又泄痢类伤寒阴症,又难用四逆汤,必用倍参生化汤,加附子一片,可以回阳止逆,又可以行参、归
之力。立二方于下分先后。
加参生化汤 治产后发厥,块痛未止,不可加 、术。
川芎(二钱) 当归(四钱) 炙草(五分) 炮姜四分(一作黑姜) 桃仁(十粒,去皮尖,研) 人参(二钱)
枣,水煎。进二服。
滋荣益气复神汤 治产后发厥,问块痛已除可服此方。
人参(三钱) 黄 (一钱,蜜炙) 白术(一钱,土炒) 当归(三钱) 炙草(四分) 陈皮(四分) 五味
(十粒) 川芎(一钱) 熟地(一钱) 麦芽(一钱)
枣一枚,水煎服。
手足冷,加附子五分;汗多,加麻黄根一钱,熟枣仁一钱;妄言妄见,加益智、柏子仁、龙眼肉;大便实,加肉苁
蓉二钱。大抵产后晕厥二症相类。但晕在临盆,症急甚于厥,宜频服生化汤几帖,块化血旺,神清晕止;若多气促形脱
等症,必加参、 。厥在分娩之后,宜倍参生化汤,止厥以复神,并补气血也,非如上偏补气血而可愈也。要知晕有块
痛, 、术不可加;厥症若无块痛, 、术、地黄,并用无疑也。
歌括∶妇人生产用力多,劳倦伤脾肢冷厥。
气上胸满脱去形,加参生化神自和。
产后发厥块痛消,滋荣益气复神好。
麦芽五味陈熟地,参 术草归芎枣。
妇女在生产时因用力过多,导致劳倦损伤脾气,从而出现四肢逆冷而厥逆的症状。气机上逆至胸部感到胀满,脉象微弱似去、形体脱失,这种情况非用大补之法不可,难道仅靠几钱川芎、当归就能回阳复神吗?
必须使用加参生化汤,重用人参,服用两剂后,气血旺盛则神气自然恢复,厥逆自然停止。如果服药后反而口渴,另有生脉散和独参代茶饮,用于救治脏腑之燥热。如果是四肢逆冷,又伴有泄痢类似伤寒阴证的情况,又难以使用四逆汤,必须使用倍参生化汤,加入一片附子,既可以回阳止逆,又可以推动人参、当归的药力。以下列出两个方剂,并区分使用的先后顺序。
加参生化汤:治疗产后发厥,恶露块痛未止,此时不可加入白芍、白术。
药材:川芎(二钱)、当归(四钱)、炙甘草(五分)、炮姜四分(一作黑姜)、桃仁(十粒,去皮尖,研碎)、人参(二钱)。
用法:加红枣一枚,水煎服。服用两剂。
滋荣益气复神汤:治疗产后发厥,若恶露块痛已消除,可服用此方。
药材:人参(三钱)、黄芪(一钱,蜜炙)、白术(一钱,土炒)、当归(三钱)、炙甘草(四分)、陈皮(四分)、五味子(十粒)、川芎(一钱)、熟地黄(一钱)、麦芽(一钱)。
用法:加红枣一枚,水煎服。
若手足冰冷,加附子五分;若汗多,加麻黄根一钱、熟枣仁一钱;若胡言乱语、幻视妄见,加益智仁、柏子仁、龙眼肉;若大便干结,加肉苁蓉二钱。大致上产后晕厥与厥逆两种症状相似。但“晕”发生在临盆之时,病情比“厥”更急重,宜频繁服用生化汤几帖,待瘀血化去、血液旺盛,神志清醒则晕止;若有多气促、形体脱失等症状,必须加入人参、黄芪。“厥”发生在分娩之后,宜用倍参生化汤,以止厥复神,并补益气血,不像上面那种情况只偏重于补气血就能痊愈。要知道,“晕”症若有块痛,白芍、白术不可加入;“厥”症若无块痛,白芍、白术、地黄并用无疑。
歌诀:妇人生产用力多,劳倦伤脾肢冷厥。
气上胸满脱去形,加参生化神自和。
产后发厥块痛消,滋荣益气复神好。
麦芽五味陈熟地,参芪术草归芎枣。
In women, excessive effort during childbirth may lead to fatigue and spleen injury, resulting in cold extremities and Jue (reversal cold syndrome). Qi rebels upward causing chest fullness, the pulse appears faint as if departing, and the physical form seems depleted. This condition requires substantial tonification; how can merely a few qian of Chuanxiong Rhizome (Chuanxiong) and Angelicae Sinensis Radix (Danggui) restore Yang and revive the spirit?
One must use Jiashen Shenghua Decoction (Ginseng-Added Blood-Generating Decoction), doubling the dosage of Ginseng Root (Renshen). After taking two doses, when Qi and blood become robust, the spirit will naturally regenerate, and the Jue syndrome will cease. If thirst occurs after taking the medicine, there is another option: Shengmai San (Generate the Pulse Powder) or Dushen Tea (Single Ginseng Tea) to rescue the dryness of the internal organs. If there are cold extremities accompanied by diarrhea and dysentery resembling the Yin syndrome of Cold Damage (Shanghan), Sini Tang (Frigid Extremities Decoction) should be used with caution. Instead, one must use Jiashen Shenghua Decoction with doubled Ginseng, adding one slice of Aconiti Lateralis Radix Praeparata (Fuzi). This can restore Yang, stop reversal cold, and facilitate the action of Ginseng and Angelica. Two prescriptions are listed below with their sequence of application specified.
Jiashen Shenghua Decoction (Ginseng-Added Blood-Generating Decoction): Treats postpartum Jue syndrome where lochia clots and pain persist. Bai Shao (White Peony Root) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) should not be added.
Ingredients: Chuanxiong Rhizome (Chuanxiong) 2 qian, Angelicae Sinensis Radix (Danggui) 4 qian, Honey-fried Glycyrrhizae Radix et Rhizoma (Zhigancao) 5 fen, Roasted Zingiberis Rhizoma (Paojiang, alternatively Heijiang/Black Ginger) 4 fen, Prunus Persica Semen (Taoren) 10 grains, peeled and crushed, Ginseng Root (Renshen) 2 qian.
Preparation: Add one red date, decoct in water. Take two doses.
Zirong Yiqi Fushen Decoction (Nourish Glory, Tonify Qi, and Revive Spirit Decoction): Treats postpartum Jue syndrome where lochia clots and pain have been eliminated.
Ingredients: Ginseng Root (Renshen) 3 qian, Astragali Radix (Huangqi) 1 qian, honey-fried; Atractylodis Macrocephalae Rhizoma (Baizhu) 1 qian, earth-fried; Angelicae Sinensis Radix (Danggui) 3 qian; Honey-fried Glycyrrhizae Radix et Rhizoma (Zhigancao) 4 fen; Citri Reticulatae Pericarpium (Chenpi) 4 fen; Schisandrae Fructus (Wuweizi) 10 grains; Chuanxiong Rhizome (Chuanxiong) 1 qian; Rehmanniae Radix Praeparata (Shudi) 1 qian; Hordeum Vulgare Fructus Germinatus (Maiya) 1 qian.
Preparation: Add one red date, decoct in water, and take orally.
Modifications: If hands and feet are cold, add Aconiti Lateralis Radix Praeparata (Fuzi) 5 fen; if sweating is profuse, add Ephedrae Herba Radix (Mahuanggen) 1 qian and Ziziphi Spinosae Semen Preparatum (Shu Zaoren) 1 qian; if there is delirious speech and visual hallucinations, add Alpiniae Oxyphyllae Fructus (Yizhiren), Biota Orientalis Seed (Baiziren), and Longan Aril (Longyanrou); if stool is hard, add Cistanche Deserticola Herb (Roucongrou) 2 qian. Generally, postpartum Yun (fainting/dizziness) and Jue (reversal cold) syndromes are similar. However, Yun occurs during labor, is more acute than Jue, and should be treated with frequent doses of Shenghua Decoction until clots dissolve, blood becomes abundant, and the spirit clears, stopping the dizziness. If there are symptoms of shortness of breath and physical depletion, Ginseng and Astragalus must be added. Jue occurs after delivery; it should be treated with Jiashen Shenghua Decoction with doubled Ginseng to stop Jue, revive the spirit, and tonify Qi and blood. It cannot be cured merely by tonifying Qi and blood as in the case of Yun. One must know that if Yun involves clot pain, Bai Shao and Bai Zhu should not be added; if Jue has no clot pain, using Bai Shao, Bai Zhu, and Shudi together is undoubtedly correct.
Verse:
Women exert much effort in childbirth,
Fatigue injures the spleen, limbs grow cold and Jue arises.
Qi rises, chest feels full, form seems depleted,
Add Ginseng to Shenghua Decoction, spirit harmonizes itself.
Postpartum Jue ceases when clots and pain vanish,
Nourishing glory, tonifying Qi, and reviving spirit is good.
Hordeum, Schisandra, Tangerine Peel, and Prepared Rehmannia,
Ginseng, Astragalus, Atractylodes, Licorice, Angelica, Chuanxiong, and Dates.