产后喘极危,多死也。
郭氏治产后喉中气急喘促者,因所下过多,荣血暴竭,卫气无主,独聚肺中,故令喘也。此名孤阳绝阴,
为难治。(陈无择云∶宜大料芎归汤。一方用独参汤,尤妙。)若恶露不快,散血停凝,上熏于肺,亦令喘急,
但服夺命丹,血去喘自定。(夺命丹方见胞衣不下。)
〔世〕血竭散 治产后败血冲心,胸满上喘,命在须臾,宜服。
真血竭(如无,紫矿代) 没药
上等分,研细频筛再研,取尽为度,每服二钱,用童便合好酒半大盏,煎一沸,温调下。方产下一服,上
床良久再服,其恶血自循经下行,更不冲上,免生百病。
〔云〕参苏饮 治产后血入于肺,面黑发喘欲死者。
人参(一两,为末) 苏木(二两)
上以水两碗,煮取苏木一碗以下,去渣,调参末随时加减服,神效。
〔无〕若因忧怒,性理郁发而喘者,用小调经散,以桑白皮、杏仁煎汤调服。(小调经散方见水肿。)
旋复花汤 治产后伤风,寒咳喘嗽,痰涎壅盛,坐卧不宁。
旋复花 赤芍药 荆芥穗 半夏曲 五味子 麻黄 茯苓 杏仁 甘草 前胡(各等分)
上 咀,每服四钱,水盏半,姜五片,枣一枚,煎七分,去渣,食前温服。
浦江昊辉妻,孕时足肿,七月初旬产,后二月洗浴,即气喘,但坐不得卧者五个月,恶风,得暖稍宽,两关脉
动,尺寸皆虚,百药不效。用牡丹、桃仁、桂枝、茯苓、干姜、枳实、浓朴、桑白皮、紫苏、五味、栝蒌皮仁,
煎汤服之即宽,二三服得卧,其痰如失,盖作污血感寒治之也。若伤咸冷冻饮料食而喘者,宜见 丸。
姜黄 三棱 荜澄茄 陈皮 良姜 人参 蓬术(等分)
上为细末,用萝卜浸煮烂研细,将汁煮面糊丸,桐子大,萝卜子汤下。
产后出现极度喘息,病情极为危重,死亡率很高。
郭氏认为,治疗产后喉咙中气息急促、喘息紧迫的症状,是因为分娩时失血过多,导致营血突然枯竭,卫气失去主宰,独自聚集在肺中,从而引发喘息。这种情况被称为“孤阳绝阴”,属于难治之症。(陈无择说:适宜用大剂量的芎归汤。另一方案使用独参汤,效果尤其奇妙。)如果恶露排出不畅,瘀血停滞凝结,向上熏蒸于肺,也会导致喘息急促,此时只需服用夺命丹,待瘀血去除,喘息自然平息。(夺命丹的方剂见“胞衣不下”章节。)
〔世〕血竭散:治疗产后败血冲犯心脏,导致胸部胀满、上逆喘息,生命垂危之际,适宜服用。
真血竭(如果没有,可用紫矿代替) 没药
以上药材等分,研磨成细粉并频繁过筛再次研磨,直到全部取尽为止。每次服用二钱,用童子尿和好酒半大盏,煮沸一次,温服调下。刚生产完服一次,在床上躺很久后再服一次,这样败血自然会顺着经络下行,不再向上冲逆,从而避免产生各种疾病。
〔云〕参苏饮:治疗产后血液进入肺部,面色发黑、喘息欲死的症状。
人参(一两,研成粉末) 苏木(二两)
以上用水两碗,煮至苏木剩下一碗以下,滤去药渣,调入人参粉末,根据情况随时加减服用,效果神奇。
〔无〕如果是因忧愁愤怒,性情理气郁结爆发而导致的喘息,可使用小调经散,以桑白皮、杏仁煎汤送服。(小调经散的方剂见“水肿”章节。)
旋复花汤:治疗产后伤风,寒邪咳嗽喘息,痰涎壅盛,坐卧不安。
旋复花 赤芍药 荆芥穗 半夏曲 五味子 麻黄 茯苓 杏仁 甘草 前胡(各等分)
以上药材切碎,每次服用四钱,加水一盏半,生姜五片,大枣一枚,煎至七分熟,滤去药渣,饭前温服。
浦江人昊辉的妻子,怀孕期间脚部肿胀,七月上旬分娩,产后两个月洗浴后,立即出现气喘,只能坐着不能躺卧长达五个月,怕风,得到温暖稍感舒缓,两手关脉跳动,寸尺脉皆虚,服用百种药物均无效。使用牡丹、桃仁、桂枝、茯苓、干姜、枳实、浓朴、桑白皮、紫苏、五味子、栝蒌皮和栝蒌仁,煎汤服用后立即感到舒缓,二三服后即可躺卧,痰液消失,这被当作污血感受寒邪来治疗。如果是因食用咸味冷冻饮料食物而导致的喘息,适宜参考某丸剂(原文此处可能有缺字或指代前文未列出的丸剂,但根据上下文逻辑,此处应指代特定丸剂,原文写“宜见 丸”,结合下文列出的是姜黄等组成的丸剂,故推断为下文所述丸剂)。
姜黄 三棱 荜澄茄 陈皮 良姜 人参 蓬术(等分)
以上研成细末,用萝卜浸泡煮烂后研磨成细泥,将汁液煮面糊制成丸剂,大小如梧桐子,用萝卜子汤送服。
Postpartum extreme dyspnea is extremely critical and often fatal.
Guo believed that for postpartum patients with urgent breathing and panting in the throat, this is caused by excessive blood loss during delivery, leading to a sudden depletion of Ying Blood (nutritive blood). Consequently, Wei Qi (defensive qi) loses its master and gathers exclusively in the lungs, causing panting. This condition is named "Lone Yang and Absolute Yin" and is difficult to treat. (Chen Wuzhe stated: It is suitable to use a large dose of Xiong Gui Tang [Angelica and Ligusticum Decoction]. Another prescription uses Du Shen Tang [Single Ginseng Decoction], which is particularly excellent.) If lochia discharge is not smooth, causing blood stasis to stagnate and coagulate, and steaming upward into the lungs, it will also cause urgent panting. In such cases, simply administering Duo Ming Dan [Life-Restoring Pill] will allow the panting to subside naturally once the blood stasis is removed. (The formula for Duo Ming Dan is found under the section "Retained Placenta".)
[Shi] Xue Jie San [Dragon's Blood Powder]: Treats postpartum敗血 (decayed blood) rushing to the heart, causing chest fullness and upward panting, where life hangs in the balance. It is suitable for administration.
Zhen Xue Jie [True Dragon's Blood] (if unavailable, substitute with Zi Kuang [Purple Mineral]); Mo Yao [Myrrh].
Grind the above herbs into fine powder, sifting frequently and regrinding until all material is collected. Take two qian per dose, mixed with half a large cup of good wine and urine from a healthy boy (Tong Bian), boiled once, and taken warm. Administer one dose immediately after childbirth, and another dose after lying in bed for a long time. This ensures the decaying blood flows downward along the meridians without rushing upward, preventing various diseases.
[Yun] Shen Su Yin [Ginseng and Perilla Decoction]: Treats postpartum blood entering the lungs, resulting in a dark complexion and severe panting approaching death.
Ren Shen [Ginseng Root] (1 liang, ground into powder); Su Mu [Sappan Wood] (2 liang).
Boil the Su Mu in two bowls of water until reduced to less than one bowl. Strain the dregs, mix in the Ren Shen powder, and adjust the dosage as needed. The effect is miraculous.
[Wu] If panting is caused by depression or anger leading to the stagnation and eruption of emotional qi, use Xiao Tiao Jing San [Minor Regulating Menses Powder], administered with a decoction of Sang Bai Pi [Mulberry Bark] and Xing Ren [Apricot Seed]. (The formula for Xiao Tiao Jing San is found under the section "Edema".)
Xuan Fu Hua Tang [Inula Flower Decoction]: Treats postpartum wind-cold invasion, cold-induced cough and panting, abundant phlegm-saliva, and restlessness in sitting or lying down.
Xuan Fu Hua [Inula Flower]; Chi Shao Yao [Red Peony Root]; Jing Jie Sui [Schizonepeta Spike]; Ban Xia Qu [Pinellia Fermented Paste]; Wu Wei Zi [Schisandra Berry]; Ma Huang [Ephedra Stem]; Fu Ling [Poria]; Xing Ren [Apricot Seed]; Gan Cao [Licorice Root]; Qian Hu [Peucedani Radix] (all in equal proportions).
Cut the herbs roughly. Take four qian per dose, add one and a half cups of water, five slices of fresh ginger, and one jujube. Decoct until three-tenths remain, strain, and take warm before meals.
The wife of Hao Hui from Pujiang suffered from swollen feet during pregnancy. She gave birth in early July. Two months postpartum, after bathing, she immediately developed panting, able only to sit and unable to lie down for five months. She was aversive to wind, feeling slightly relieved by warmth. Her Guan pulses on both hands were pulsating, while the Cun and Chi pulses were both deficient. Hundreds of medicines had failed. A decoction of Mu Dan Pi [Moutan Cortex], Tao Ren [Peach Kernel], Gui Zhi [Cinnamon Twig], Fu Ling [Poria], Gan Jiang [Dried Ginger], Zhi Shi [Immature Bitter Orange], Hou Po [Magnolia Bark], Sang Bai Pi [Mulberry Bark], Zi Su [Perilla Leaf], Wu Wei Zi [Schisandra Berry], Gua Lou Pi [Trichosanthes Peel], and Gua Lou Ren [Trichosanthes Seed] was prescribed. Relief came immediately upon ingestion; after two or three doses, she could lie down, and her phlegm disappeared. This case was treated as blood stasis complicated by cold invasion. If panting is caused by consuming salty, frozen drinks or food, refer to the Wan [Pill] mentioned below.
Jiang Huang [Curcuma Longa Rhizome]; San Leng [Burreed Tuber]; Bi Cheng Qie [Long Pepper Fruit]; Chen Pi [Citrus Reticulata Peel]; Liang Jiang [Galangal Rhizome]; Ren Shen [Ginseng Root]; Peng Zhu [Curcuma Phaeocaulis Rhizome] (equal proportions).
Grind into fine powder. Soak and boil radish until soft, grind into a fine paste, extract the juice, and use it to cook a flour paste to form pills the size of tung tree seeds. Take with a decoction of radish seeds.