明雄黄 鬼臼(去毛) 丹砂(细研,水飞,各五钱) 延胡索(七钱) 麝香(一钱) 川芎(七钱)
半夏(姜汁炒,一两
上为末,蜜丸,桐子大。每服三十丸,空心,温酒送下。
逍遥散(见类中。
归脾汤(见虚损。
六君子汤(见类中。
安神定志丸(见不得卧。
娠妊热病不解,以致胎损腹中,不能出者。须验其产母,面赤舌青者,其子已损;若面
青舌赤,母亦难全。古方通用黑神散下之,然药性燥烈,不宜于热病,应用平胃散加朴硝五
隆冬寒月,及体气虚寒者,须此。
桂心 当归 芍药 甘草(炙) 干姜(炒) 生地黄(各一两) 黑豆(炒去皮,二两) 附子(
炮,去皮脐,五钱
上为细末,每服二钱,空心,用牛膝三钱,煎水调下。
平胃散(见类中)
又方朴硝三钱,童子小便一钟,和热酒调下,立出。
娠妊中,小便不通,乃小肠有热,古方用四物汤加黄芩、泽泻主之。然孕妇胞胎坠下
多致压胞,胞系撩乱,则小便点滴不通,名曰转胞,其祸最速,法当升举其胎,俾胎不下
坠,则小便通矣。丹溪用补中益气,随服而探吐之,往往有验,予用茯苓升麻汤,亦多获效
皆升举之意也。然则仲景治转胞,用桂附八味汤,何也。予曰∶此下焦虚寒,胎气阴冷,
无阳则阴不化,寒水断流,得桂、附、温暖命门,则阳气宣通,寒冰解冻,而小便行矣。况方
内复有茯苓、泽泻为之疏决乎!然亦有阳亢阴消,孤阳无阴,不能化气者,必须补其真阴,
古方用滋肾丸,予尝用六味加车前、牛膝收功。斯二者,一阴一阳,一水一火,如冰炭
相反,最宜深究。大抵右尺偏旺,左尺偏弱,脉细数而无力者,真水虚也;左尺偏旺,右尺
偏弱,脉虚大而无力者,真火虚也。火虚者,腹中阴冷,喜热、畏寒,小便滴沥而清白;水
虚者,腹中烦热,喜冷、畏热,小便滴出如黄柏。脉症自是不同,安危在于反掌,辨之不可
不早辨也。复有分娩之时,稳婆不谨,伤损尿胞,以致小便滴沥淋漓,不知约束,因思在外
肌肉,尚可补完,腹中之肉,独不可补乎?遂用大剂八珍汤,加紫河车三钱,而以猪胞中汤
煎药饮之,如此数服即愈。但须早治,不可轻忽。
八味汤(见类中。
明雄黄、鬼臼(去除绒毛)、丹砂(细研,水飞法处理,各五钱)、延胡索(七钱)、麝香(一钱)、川芎(七钱)、半夏(用姜汁炒制,一两)。
以上药物研为细末,用蜂蜜制成丸剂,大小如梧桐子。每次服用三十丸,空腹时,用温酒送服。
逍遥散(参见类中风章节)。
归脾汤(参见虚损章节)。
六君子汤(参见类中风章节)。
安神定志丸(参见失眠章节)。
妊娠期间患热病未能痊愈,导致胎儿在腹中受损死亡,无法排出。必须查验产妇,若面部红润而舌色青紫,说明胎儿已死;若面部青紫而舌色红润,则母亲也难以保全。古方通用黑神散来攻下排出,然而该药性味燥烈,不适用于热病,应当使用平胃散加入朴硝五钱。隆冬寒月,以及体质虚弱寒冷者,必须使用此方。
桂心、当归、芍药、甘草(炙烤)、干姜(炒制)、生地黄(各一两)、黑豆(炒后去皮,二两)、附子(炮制,去外皮和脐部,五钱)。
以上药物研为细末,每次服用二钱,空腹时,用牛膝三钱煎水调服药末。
平胃散(参见类中风章节)。
又一方:朴硝三钱,童子小便一杯,与热酒调和后送服,胎儿可立即排出。
妊娠期出现小便不通,这是由于小肠有热,古方使用四物汤加入黄芩、泽泻为主治方。然而孕妇因胞胎下坠,多导致压迫膀胱,膀胱系膜紊乱,致使小便点滴不通,名为转胞(妊娠小便不通),其危害最为迅速,治疗方法应当升举胎位,使胎不下坠,则小便自然通畅。朱丹溪采用补中益气汤,并在服药后探吐,往往有效;我使用茯苓升麻汤,也多获效验,这都是升举胎气的意思。那么张仲景治疗转胞,使用桂附八味汤,是什么原因呢?我说:这是下焦虚寒,胎气阴冷,无阳气则阴液不能气化,寒水断流,得到肉桂、附子温暖命门之火,则阳气宣通,寒冰解冻,而小便得以通行。况且方中还有茯苓、泽泻起到疏泄决渎的作用!然而也有阳亢阴消,孤阳无阴,不能化气的情况,必须滋补真阴,古方使用滋肾丸,我曾使用六味地黄丸加入车前子、牛膝收功。这两种情况,一阴一阳,一水一火,如同冰炭相反,最宜深入探究。大致而言,右尺脉偏旺,左尺脉偏弱,脉象细数而无力者,是真水(肾阴)虚;左尺脉偏旺,右尺脉偏弱,脉象虚大而无力者,是真火(肾阳)虚。火虚者,腹中阴冷,喜热畏寒,小便滴沥且清白;水虚者,腹中烦热,喜冷畏热,小便滴出颜色如黄柏般深黄。脉象与症状自然不同,安危只在顷刻之间,辨证不可不尽早进行。又有分娩之时,接生婆不慎,损伤尿胞,致使小便滴沥淋漓,不知约束,我想既然体表的肌肉尚可修补,腹中的脏器独不可补吗?于是使用大剂量的八珍汤,加入紫河车三钱,并用猪膀胱煮的水煎药让患者饮用,如此服用数次即愈。但必须早期治疗,不可轻视疏忽。
八味汤(参见类中风章节)。
Ming Xionghuang (Realgar), Guiji (Aristolochia debilis, with hairs removed), Dansha (Cinnabar, finely ground and levigated by water, each 5 qian), Yanhusuo (Corydalis Rhizome, 7 qian), Shexiang (Moschus, 1 qian), Chuanxiong (Ligusticum Rhizome, 7 qian), Banxia (Pinellia Tuber, stir-fried with ginger juice, 1 liang).
The above herbs are processed into a fine powder, mixed with honey to form pills the size of wutong seeds. Take 30 pills per dose, on an empty stomach, washed down with warm wine.
Xiaoyao San (Free and Easy Wanderer Powder) (See section on Stroke-like syndromes).
Guipi Tang (Restore the Spleen Decoction) (See section on Deficiency and Damage).
Liujunzi Tang (Six Gentlemen Decoction) (See section on Stroke-like syndromes).
Anshen Dingzhi Wan (Calming the Spirit and Stabilizing Will Pill) (See section on Insomnia).
When a pregnant woman suffers from unresolved febrile disease, leading to fetal death in utero and inability to expel it, one must examine the mother: if her face is red and tongue blue, the fetus is dead; if her face is blue and tongue red, the mother’s life is also at risk. Ancient formulas generally used Heishen San (Black Divine Powder) to purge and expel, but since this medicine is drying and acrid, it is unsuitable for febrile diseases. Instead, Pingwei San (Stomach-Pacifying Powder) should be used with adding Puxiao (Mirabilite, 5 qian). This is required during mid-winter or for those with deficient-cold constitutions.
Guixin (Cinnamon Bark), Danggui (Angelica Sinensis Root), Shaoyao (Peony Root), Gancao (Licorice Root, honey-fried), Ganjiang (Dried Ginger), Shengdihuang (Rehmannia Root, fresh, each 1 liang), Heidou (Black Soybean, fried and peeled, 2 liang), Fuzi (Aconite Lateralis Radix Praeparata, processed, peeled and navel removed, 5 qian).
Process the above into a fine powder. Take 2 qian per dose, on an empty stomach, mixed with water decocted from Niuxi (Achyranthes Root, 3 qian).
Pingwei San (Stomach-Pacifying Powder) (See section on Stroke-like syndromes).
Another prescription: Puxiao (Mirabilite, 3 qian), Tongzi Xiaonbian (Child’s Urine, one cup), mixed with warm wine and taken orally; expulsion occurs immediately.
During pregnancy, difficulty in urination is caused by heat in the Small Intestine. Ancient formulas used Siwu Tang (Four Substances Decoction) added with Huangqin (Scutellaria Root) and Zexie (Alisma Rhizome) as the main treatment. However, due to the descent of the gestational sac, pressure on the bladder often causes disorder of the bladder ligaments, resulting in scanty or obstructed urination, termed Zhuanbao (Displacement of the Bladder/Pregnancy-related urinary retention). The danger is rapid. The method should be to lift the fetus so that it does not descend, thereby restoring normal urination. Zhu Danxi used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), followed by inducing vomiting after ingestion, which was often effective. I used Fuling Shengma Tang (Poria and Cimicifuga Decoction), which also yielded many successes. Both approaches share the intent of lifting the qi. Then why did Zhang Zhongjing use Guifu Bawei Tang (Cinnamon and Aconite Eight-Ingredient Decoction) for Zhuanbao? I say: This is due to deficiency-cold in the Lower Jiao and cold yin affecting the fetal qi. Without yang, yin cannot transform; cold water ceases to flow. With Guizhi (Cinnamon Twig) and Fuzi warming the Mingmen (Gate of Vitality), yang qi circulates freely, ice thaws, and urination resumes. Moreover, the formula contains Fuling (Poria) and Zexie to drain dampness. However, there are cases of hyperactive yang and consuming yin, where solitary yang without yin cannot transform qi; these require tonifying true yin. Ancient formulas used Zishen Wan (Nourish Kidney Pill); I have used Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) added with Cheqianzi (Plantago Seed) and Niuxi (Achyranthes Root) to achieve recovery. These two conditions, one yin and one yang, one water and one fire, are like ice and charcoal—opposite yet requiring deep investigation. Generally, if the right Chi pulse is vigorous while the left Chi is weak, with a fine, rapid, and forceless pulse, it indicates deficiency of True Water (Kidney Yin); if the left Chi is vigorous while the right Chi is weak, with a void, large, and forceless pulse, it indicates deficiency of True Fire (Kidney Yang). In cases of fire deficiency, the abdomen feels coldly yin, preferring warmth and fearing cold, with scanty, clear urine; in cases of water deficiency, the abdomen feels vexatious heat, preferring coolness and fearing heat, with urine dripping out dark yellow like Phellodendron bark. Pulse and symptoms differ naturally; safety or peril hangs in the balance, so differentiation must be done early. Additionally, during delivery, if the midwife is careless and damages the bladder, causing dribbling and incontinence, I reasoned that if external muscles can be repaired, why not internal organs? Thus, I used a large dose of Bazhen Tang (Eight-Treasure Decoction), added with Ziheche (Placenta Hominis, 3 qian), and decocted the medicine in pig bladder soup for the patient to drink. After several doses, recovery occurred. Early treatment is essential; do not neglect it lightly.
Bawei Tang (Eight-Ingredient Decoction) (See section on Stroke-like syndromes).