产后颠狂,及狂言谵语,乍见鬼神,其间有败血上冲者,有血虚神不守舍者。大抵败血
上冲,则胸腹胀痛,恶露不行,宜用泽兰汤,并失笑丸。若血虚神不守舍,则心慌自汗,胸
腹无苦,宜用安神定志丸,倍人参,加归、芎主之,归脾汤亦得。此症多由心脾气血不足,
神思不宁所致。非补养元气不可,倘视为实证而攻之,祸不旋踵。
泽兰 生地(酒洗) 当归 赤芍(各一钱五分) 甘草(炙,五分) 生姜(一钱) 大枣(四枚) 桂
心(三分
水煎服。
失笑丸(见胞衣不下。
安神定志丸(见不得卧。
归脾汤(见虚证。
产后心神惊悸,或目睛不转,语言健忘,皆由心血空虚所致。夫人之所主者心,心之所
主者血,心血一虚,神气不守,惊悸所由来也。法当补养气血为主。
产后汗出不止,皆由阳气顿虚,腠理不密,而津液妄泄也。急用十全大补汤止之。如不
应,用参附、 附、术附等汤。若病势危急,则以参、 、术三汤合饮之。如或汗多亡阳,
遂变为痉,其症口噤切牙,角弓反张,尤为气血大虚之恶候。更当速服前药,庶可救疗。或
问∶无汗为刚痉,有汗为柔痉,古人治以小续命汤者,何也?答曰∶此外感发痉也,病属外
感则当祛邪为急。若产后汗多发痉,此内伤元气,气血大亏,筋无所养,虚极生风,借非十
全大补加附子,安能敛汗液,而救此垂危之症乎?且伤寒汗下过多,溃疡脓血大泄
亦多发痉,并宜补养气血为主,则产后之治法更无疑矣。甚矣!察证宜明,而投剂贵审也
产后出现癫狂,以及胡言乱语、恍惚间看见鬼神等症状,其中有的属于败血上冲所致,有的属于血虚导致神志不能守舍。大抵败血上冲的,会出现胸腹胀痛、恶露排出不畅的症状,适宜使用泽兰汤,配合失笑丸服用。如果是血虚导致神志不能守舍,则会出现心慌、自汗,但胸腹部没有痛苦感,适宜使用安神定志丸,并加倍人参用量,加入当归、川芎来主治,归脾汤也可以使用。这种病症多由心脾气血不足,神思不宁所引起。必须通过补养元气来治疗,如果将其视为实证而用攻伐之法,灾祸将立刻降临。
泽兰 生地(用酒清洗) 当归 赤芍(各一钱五分) 甘草(炙烤,五分) 生姜(一钱) 大枣(四枚) 桂心(三分)
用水煎服。
失笑丸(参见“胞衣不下”章节)。
安神定志丸(参见“不得卧”章节)。
归脾汤(参见“虚证”章节)。
产后心神惊悸,或者眼球转动不灵、言语健忘,都是由心血空虚所导致的。人的主宰是心,心所主管的是血,心血一旦虚弱,神气就不能安守,惊悸症状由此产生。治疗方法应当以补养气血为主。
产后汗出不止,都是由于阳气突然虚弱,腠理(皮肤毛孔)不紧密,导致津液妄自泄出。急需使用十全大补汤来止汗。如果无效,使用参附汤、术附汤等方剂。如果病情危急,则将参汤、附汤、术汤三种方剂合在一起饮用。如果出现汗多导致亡阳,进而转变为痉病,其症状表现为牙关紧闭、磨牙、角弓反张,这更是气血极度虚弱的危重征象。更应当迅速服用前面的药物,或许可以挽救治疗。有人问:无汗称为刚痉,有汗称为柔痉,古人用小续命汤治疗,这是为什么呢?回答说:这是外感引起的痉病,病属外感则当以祛邪为急务。如果是产后因汗多而发痉,这是内伤元气,气血大亏,筋脉失去滋养,虚极而生风,如果不是用十全大补汤加附子,怎么能收敛汗液,从而挽救这垂危的病症呢?况且伤寒因发汗和泻下过多,或者溃疡脓血大量流失,也多发痉病,都适宜以补养气血为主,那么产后痉病的治疗方法就更没有疑问了。观察病症务必明确,用药贵在审慎啊!
Postpartum mania, along with delirious speech and hallucinations of seeing ghosts or spirits, may be caused by either the upward rushing of retained blood (stasis) or by blood deficiency leading to the spirit failing to reside in its proper place. Generally, if retained blood rushes upward, there will be distension and pain in the chest and abdomen, and lochia will not discharge; Ze Lan Tang (Dillettant Decoction) combined with Shi Xiao Wan (Pain-Relieving Pill) should be used. If it is blood deficiency causing the spirit to fail to reside, there will be palpitations and spontaneous sweating, but no distress in the chest and abdomen; An Shen Ding Zhi Wan (Calming the Spirit and Stabilizing Will Pill) should be used, with the dosage of Ren Shen (Ginseng Root) doubled, plus Dang Gui (Angelica Sinensis Root) and Chuan Xiong (Ligusticum Wallichii Rhizome). Gui Pi Tang (Restore the Spleen Decoction) is also acceptable. This condition is mostly caused by insufficiency of Qi and Blood in the Heart and Spleen, resulting in a restless mind. It must be treated by tonifying Yuan Qi (Original Qi); if mistaken for an Excess pattern and treated with purgatives, disaster will follow immediately.
Ze Lan (Lycopus Lucidus Herb), Sheng Di (Rehmannia Glutinosa Root Prepared with Wine), Dang Gui (Angelica Sinensis Root), Chi Shao (Red Peony Root) [each 1.5 qian], Gan Cao (Licorice Root, honey-fried) [0.5 qian], Sheng Jiang (Fresh Ginger Rhizome) [1 qian], Da Zao (Jujube Fruit) [4 pieces], Gui Xin (Cinnamon Twig Center) [0.3 qian].
Decoct in water and take orally.
Shi Xiao Wan (See "Retained Placenta").
An Shen Ding Zhi Wan (See "Insomnia").
Gui Pi Tang (See "Deficiency Patterns").
Postpartum palpitations and fright, or immobility of the eyeballs and forgetfulness in speech, are all caused by emptiness of Heart Blood. The human body is governed by the Heart, and the Heart governs Blood; once Heart Blood is deficient, the Spirit fails to abide, giving rise to palpitations and fright. The treatment method should primarily focus on tonifying Qi and Blood.
Unceasing sweating after childbirth is due to a sudden deficiency of Yang Qi, loose pores (Cou Li), and the reckless leakage of Body Fluids. Ji Yong Shi Quan Da Bu Tang (Complete Great Tonifying Decoction) should be used urgently to stop the sweating. If ineffective, use Shen Fu Tang (Ginseng and Aconite Decoction) or Zhu Fu Tang (Atractylodes and Aconite Decoction). If the condition is critical, combine these three decoctions (Shen, Fu, Zhu) and administer them together. If excessive sweating leads to collapse of Yang, transforming into Jing Bing (Spasm Disorder), characterized by locked jaw, grinding teeth, and opisthotonos, this is a particularly ominous sign of extreme Qi and Blood deficiency. One must quickly administer the aforementioned medicines to have a chance of rescue. Someone asked: "No sweat indicates Gang Jing (Rigid Spasm), while sweat indicates Rou Jing (Flaccid Spasm); why did ancients treat this with Xiao Xu Ming Tang (Minor Continuation of Life Decoction)?" The answer is: "This refers to spasm caused by external pathogens. When the disease belongs to external contraction, dispelling the pathogen is urgent. However, postpartum spasm caused by excessive sweating stems from internal injury to Yuan Qi, severe depletion of Qi and Blood, and malnourishment of sinews, generating wind from extreme deficiency. Without using Shi Quan Da Bu Tang added with Fu Zi (Aconite Lateral Root Prepared), how can one consolidate fluids and save this critical condition? Moreover, Tai Yang disease caused by excessive sweating and purging, or large loss of pus and blood from ulcers, also frequently leads to spasm; all should be treated primarily by tonifying Qi and Blood. Thus, the treatment principle for postpartum spasm leaves no doubt. Indeed, observing patterns must be clear, and prescribing medications must be prudent!"