产后中风,由产时伤动血气,劳损脏腑,未曾平复,早起劳动,致气虚而风邪乘
之,冷气客于皮肤经络,疼痹羸乏,不任少气。凡筋脉挟寒,则挛急 僻,挟温则纵缓
虚弱。若入诸脏,恍惚惊悸,随其所伤脏腑经络而生病焉。然《大全》曰∶妇人以荣血
为主,因产血下太多,气无所主,唇青肉冷汗出,目眩神昏,命在须臾,此虚极生风
也。若以风药治之则误矣。不问何候,大与温补,十全大补汤加附子,令人推正其身,
一人夹正其面,挖开口灌之,如不得下,令侧其面出之仍灌,热者,又冷又灌,数次即
能下,少倾苏,此立斋法也。
产后血虚,角弓反张,病名曰痉。痉者,劲也。阴气暴虚,阴虚内热,热极生
风,故外现如风假症,实阴血不足,无以养筋所致。厥阴大虚之候,宜益阴补血,血长
而虚风自灭也。
产后中风口噤,是血气虚而风入颔,颊口之筋也。于三阳之筋结于颔,产前劳损脏
腑,伤于筋脉,风乘之,则三阳之筋脉偏虚,得风冷则急,故冷口噤。更有心气虚
极,不能为语而口噤者,惟有峻补之中,兼以通调心气之药。
产后角弓反张者,因气血耗损,腠理不密,汗出过多,神无所主,筋骨失养,而有
此虚象也。乃气血虚极,宜大剂参、桂、 、术、归、地、温养之,不应,再加附子
倍人参,名参附汤,犹未应,乃药力未到,宜多用之。
产后中风,是因为分娩时损伤了气血,劳损了脏腑,身体尚未恢复平静,就早起劳作,导致气虚而风邪趁机侵袭。寒气客居在皮肤经络中,引起疼痛、痹阻、消瘦乏力,无法承受轻微的气短。凡是筋脉夹带寒邪,就会拘挛抽搐、身体歪斜;夹带温邪(热邪),就会松弛缓弱、身体虚弱。如果病邪侵入各个脏腑,就会出现神志恍惚、惊悸不安等症状,根据所伤害的脏腑经络不同而产生相应的疾病。然而《大全》中说:妇女以荣血为主,因为生产时失血过多,气失去了依附的主宰,出现嘴唇发青、肌肉发冷、出汗、头晕眼花、神志昏迷,生命危在旦夕,这是极度虚弱而生内风。如果用治风药来治疗就错了。不论有什么证候,都应当给予大剂量的温补,用十全大补汤加入附子,让人将患者身体扶正,一人固定其面部,撬开嘴巴灌药,如果药液下不去,让患者侧身使药液流出后再灌,如果是热的药,又冷着灌下去,反复几次就能喝下去,过一会儿患者苏醒,这是薛立斋的方法。
产后血虚,出现角弓反张的症状,病名叫做痉病。“痉”的意思是强劲僵硬。阴气突然严重亏损,阴虚导致内热,热极生风,所以外表看起来像外感风邪的假象,实际上是阴血不足,无法滋养筋脉所致。这是厥阴经极度虚弱的征候,应当滋阴补血,血液充盈后虚风自然平息。
产后中风口噤(牙关紧闭),是气血虚弱而风邪侵入下颌、面颊和口部的筋脉。三阳经的筋脉结聚于下颌,产前劳损脏腑,伤及筋脉,风邪乘虚而入,导致三阳经的筋脉偏于虚弱,遇到风冷就会拘急,所以导致牙关紧闭。还有的是心气极度虚弱,不能言语而导致口噤的,只有在峻补之中,兼用通调心气的药物。
产后角弓反张,是因为气血耗损,腠理不紧密,出汗过多,神志失去主宰,筋骨失去滋养,而出现这种虚弱的表象。这是气血极度虚弱,应当用大剂量的参、桂、[缺字]、术、归、地等药材温养,如果不见效,再加附子并加倍人参,名为参附汤,如果仍然没有反应,那是药力未到,应该多用此药。
Postpartum wind-stroke arises from the injury to Qi and Blood during childbirth, damaging the Zang-Fu organs. If the body has not yet recovered and one rises early to engage in labor, Qi deficiency allows Wind pathogen to take advantage of this weakness. Cold Qi lodges in the skin and meridians, causing pain, bi-syndrome (obstruction), emaciation, and fatigue, making the patient unable to tolerate even slight shortness of breath. When tendons and vessels are affected by Cold, they become spasmodic and deviated; when affected by Warmth (Heat), they become lax and weak. If the pathogen enters the Zang-Fu organs, it causes mental confusion, palpitations, and fright, producing diseases corresponding to the specific damaged Zang-Fu or meridians. However, *Da Quan* states: Women rely primarily on Ying Blood. Due to excessive blood loss during childbirth, Qi loses its master anchor, leading to cyanosis of the lips, cold flesh, sweating, dizziness, and coma, with life hanging in the balance. This is internal wind generated by extreme deficiency. Treating this with Wind-dispelling herbs would be a mistake. Regardless of the specific symptoms, major warming and tonification should be administered immediately. Use Shiquan Dabu Tang (Complete and Great Tonifying Decoction) with added Fuzi (Aconite Lateral Root). Have someone straighten the patient's body, another person stabilizes the face, opens the mouth, and administers the decoction. If the liquid does not go down, turn the patient to the side to let it drain out, then administer again. If the decoction is hot, administering it cold may facilitate swallowing; after several times, it can be taken, and shortly after, the patient will regain consciousness. This is the method of Xue Lizhai.
Postpartum blood deficiency leading to opisthotonos (rigid arching of the back like a bow) is named Jing syndrome (Spasm). "Jing" means stiffness or rigidity. Sudden severe deficiency of Yin leads to internal heat due to Yin deficiency; extreme heat generates internal wind. Thus, external manifestations resemble wind-pathogen symptoms, but the root cause is actually insufficient Yin and Blood failing to nourish the tendons. This is a sign of extreme deficiency of the Jueyin channel. The treatment should focus on nourishing Yin and tonifying Blood; once Blood is replenished, the deficient wind will naturally extinguish itself.
Postpartum wind-stroke presenting with trismus (lockjaw) occurs because Qi and Blood are deficient, allowing Wind to invade the tendons of the mandible, cheeks, and mouth. The tendons of the Three Yang channels converge at the mandible. Prior to childbirth, damage to the Zang-Fu organs injures the tendons and vessels. When Wind takes advantage of this, the tendons and vessels of the Three Yang channels become relatively weak. Upon exposure to Wind-Cold, they contract severely, resulting in lockjaw. In other cases, extreme deficiency of Heart Qi prevents speech and causes lockjaw. In such instances, within the context of vigorous tonification, herbs that also regulate and unblock Heart Qi should be included.
Postpartum opisthotonos results from the depletion of Qi and Blood, loose interstices (couli), excessive sweating, loss of Shen (Spirit) mastery, and malnourishment of the bones and sinews, presenting as a deficiency pattern. This indicates extreme deficiency of Qi and Blood. Large doses of Ginseng, Cinnamon Twig, [missing character], Atractylodes, Angelica Sinensis, and Rehmannia should be used for warming and nourishing. If there is no response, add Fuzi (Aconite Lateral Root) and double the amount of Ginseng, creating Shenfu Tang (Ginseng and Aconite Decoction). If there is still no response, it is because the medicinal force has not yet reached the target; continue to administer larger doses.