〔丹〕云∶ 比痫为虚。盖因劳汗遇风,内挟太阳寒湿之邪。治亦与 同法,但当视其所劳,则知虚在
何藏。如房劳则肾虚汗出,腠理开,风入皮腠,得寒则闭,风不能出,与水俱行。其人当目下肿如卧蚕之状。
戴人云∶肾主水,其经至于目下故也,不禁房室则死,明其虚在肾也。所以关于太阳,何也?太阳主寒,其经
最在外,腠理得寒则闭,故太阳先受邪也,治宜八物白术散、仓公当归汤。(见前 门。)
〔河间〕芎枳丸。(方未考。)皂角化痰丸。(方见咳嗽条。)
此病多由风寒湿,乘虚而感,皆从太阳经治之。
〔《活》〕独活防风汤 治 太阳有汗。
桂枝(一两) 芍药(三两) 甘草(半两) 独活 防风(各一两)
上锉细,每服一两,水二钟,煎至一钟温服。
防风葛根汤 治 太阳无汗。
葛根(四两) 麻黄(三两) 芍药 防风(各二两) 桂枝(一两)
上锉细,每用一两,先煮麻黄去上沫,入后药,同煎数沸温服。
〔《千》〕竹沥汤 治产中风,口噤面青,手足急强。
用竹沥一升,分为五服,微温频服,大效。
此症因虚遇风,挟痰而作,宜服人参、竹沥之类。
〔《产》〕问曰∶产后汗出多而变 者何?答曰∶产后血虚,腠理不密,因遇风邪搏之,故变 也。宜速斡
口,灌小续命汤,稍缓即汗出如雨,手拭不及,不可救也。(小续命方见前 条。)
举卿古拜散 治新产血虚 者。
荆芥穗不以多少,瓦上微炒为末。大豆黄卷,热酒沃之,去黄卷取汁,调四五钱,和渣饮之,其效如神。
〔《千》〕大豆紫汤 治产后中风,形如角弓反张,口噤涎潮。
黑豆半升,炒令焦黑烟起,以无灰酒二升沃之,入瓷器中,每用一盏,入独活五钱同煎至六七分,去滓温服。
按续命以下三方,太阳、厥阴药也,邪实脉浮弦有力者固宜,但产后血气大虚之人,不宜轻发其表,但用
防风当归散治之为妙。
〔海〕防风当归散(方见前 条。)
丹溪说:此病比癫痫属虚证。大概是因为劳累出汗后感受风邪,体内兼夹太阳经的寒湿之邪。治疗原则与上述疾病相同,但应当根据患者所劳损的部位,来推断虚损在哪个脏腑。例如房事过度导致肾虚而汗出,腠理(皮肤毛孔)张开,风邪侵入皮腠之间,遇到寒气则闭塞,风邪无法排出,与体内的水饮共同运行。患者眼下会肿胀,形状像卧蚕一样。
戴人(张从正)说:肾主水,其经脉到达眼下,所以如果不节制房事就会死亡,这说明虚损在肾脏。那么为什么关系到太阳经呢?因为太阳经主管寒,其经脉位置最表浅,腠理受寒则闭塞,所以太阳经最先受到邪气侵袭。治疗适宜用八物白术散、仓公当归汤。(见前文某门。)
河间(刘完素)主张用芎枳丸。(方剂未考证。)皂角化痰丸。(方剂见咳嗽条目。)
这种病多由风寒湿邪,乘人体虚弱之时侵袭,都从太阳经进行治疗。
《活幼心书》记载:独活防风汤,治疗太阳经受邪且有汗出的情况。
桂枝(一两) 芍药(三两) 甘草(半两) 独活 防风(各一两)
以上药材切碎,每次服用一两,加水二钟,煎煮至一钟,温服。
防风葛根汤,治疗太阳经受邪且无汗出的情况。
葛根(四两) 麻黄(三两) 芍药 防风(各二两) 桂枝(一两)
以上药材切碎,每次使用一两,先煮麻黄去掉上面的浮沫,加入其他药物,同煎数沸,温服。
《千金方》记载:竹沥汤,治疗产后中风,口噤(牙关紧闭)面色青,手足拘急强直。
用竹沥一升,分为五次服用,微温频服,效果显著。
此症因体虚遇风,挟带痰浊而发作,适宜服用人参、竹沥之类的药物。
《产宝》问:产后出汗多而变成痉病的缘故是什么?答:产后血虚,腠理不致密,因遭遇风邪搏结,所以变成痉病。应当迅速撬开口腔,灌服小续命汤,如果稍加迟缓就会汗出如雨,手擦不及,就无法救治了。(小续命汤方见前文某条。)
举卿古拜散,治疗新产后血虚发生痉病的患者。
荆芥穗不限多少,在瓦上微炒后研为粉末。大豆黄卷,用热酒浇灌它,去掉豆渣取汁,调服四五钱,连同药渣一起喝下,效果神奇。
《千金方》记载:大豆紫汤,治疗产后中风,身体僵硬如角弓反张,口噤流涎。
黑豆半升,炒至焦黑冒烟,用无灰酒二升浇灌,放入瓷器中,每次用一盏,加入独活五钱同煎至六七分满,去渣温服。
按语:续命汤以下的三个方子,是治疗太阳经和厥阴经的药物,对于邪气实盛、脉象浮弦有力的患者固然适宜,但对于产后气血大虚的人,不宜轻易发汗解表,只用防风当归散治疗才是妙法。
海藏(张元素/李东垣等流派代表,此处指代相关医家观点):防风当归散(方剂见前文某条。)
Danxi stated: This condition is deficient in nature, more so than epilepsy. It arises from wind invasion following sweating due to exertion, internally accompanied by cold-dampness pathogenic factors of the Taiyang (Greater Yang) meridian. The treatment principle is similar to that of the aforementioned conditions; however, one must examine the site of exertion to determine which Zang organ is deficient. For instance, excessive sexual activity leads to Kidney deficiency and sweating, causing the Couli (skin pores) to open. Wind pathogens enter the skin and Couli; upon encountering cold, they become closed, preventing the wind from exiting, where it travels together with fluid retention. The patient will exhibit swelling under the eyes resembling a sleeping silkworm.
Dairen (Zhang Congzheng) stated: The Kidney governs water, and its meridian reaches the area under the eyes. Therefore, failure to restrain sexual desire leads to death, indicating that the deficiency lies in the Kidney. Why is it related to the Taiyang meridian? Because the Taiyang meridian governs cold, and its pathway is the most superficial. When the Couli are exposed to cold, they close, so the Taiyang meridian is the first to be invaded by pathogens. Treatment should utilize Bawu Baizhu San (Eight-Ingredient Atractylodes Macrocephala Powder) or Cangong Danggui Tang (Cangong Angelica Sinensis Decoction). (See previous section.)
Hejian (Liu Wansu) advocated Xiongji Wan (Sichuan Lovage and Magnolia Bark Pill). (Formula not verified.) Zaorao Huatan Wan (Gleditsia Phlegm-Resolving Pill). (Formula see Cough section.)
This disease is mostly caused by wind-cold-dampness pathogens invading when the body is weak, and all treatments should address the Taiyang meridian.
*Huoyou Xinshu* records: Duhuo Fangfeng Tang (Angelica Pubescens and Saposhnikovia Decoction), treating Taiyang invasion with sweating.
Guizhi (Cinnamon Twig) (1 liang) Shaoyao (Peony Root) (3 liang) Gancao (Licorice Root) (0.5 liang) Duhuo (Angelica Pubescens) Fangfeng (Saposhnikovia Root) (each 1 liang).
Crush these finely. Take 1 liang per dose, add 2 zhong of water, decoct until 1 zhong remains, and take warm.
Fangfeng Gegen Tang (Saposhnikovia and Kudzu Root Decoction), treating Taiyang invasion without sweating.
Gegen (Kudzu Root) (4 liang) Mahuang (Ephedra Herb) (3 liang) Shaoyao (Peony Root) Fangfeng (Saposhnikovia Root) (each 2 liang) Guizhi (Cinnamon Twig) (1 liang).
Crush these finely. Use 1 liang per dose. First decoct Mahuang (Ephedra Herb) and remove the foam on the surface, then add the remaining herbs, boil for a few more boils, and take warm.
*Qianjin Fang* records: Zhuli Tang (Bamboo Juice Decoction), treating postpartum wind-stroke with trismus (lockjaw), cyanotic face, and stiffness/spasticity of the limbs.
Use 1 sheng of Bamboo Juice (Zhuli), divide into five doses, take frequently while slightly warm, yielding great efficacy.
This syndrome occurs due to wind invasion in a deficient state, complicated by phlegm turbidity. It is suitable to administer Ren Shen (Ginseng Root) and Bamboo Juice (Zhuli).
*Chanbao* asks: What is the reason for postpartum excessive sweating transforming into Jing illness (spasm)? Answer: Postpartum blood deficiency causes the Couli (skin pores) to be loose. Encountering wind pathogens causes them to bind, thus transforming into Jing illness (spasm). One must quickly pry open the mouth and administer Xiao Xuming Tang (Minor Continuation Life Decoction). If delayed even slightly, sweating will occur like rain, making wiping impossible, rendering it incurable. (Xiao Xuming Tang formula see previous section.)
Juxing Gabai San (Juxing Ancient Worship Powder), treating new postpartum patients with blood deficiency and Jing illness (spasm).
Jingjie Sui (Schizonepeta Spike) as needed, lightly stir-fried on a tile and ground into powder. Dayao Huangjuan (Yellow Soybean Sprout), irrigated with hot wine, remove the sprouts and collect the juice. Mix with 4-5 qian of powder, drink including the dregs, with miraculous effect.
*Qianjin Fang* records: Dayao Zi Tang (Black Soybean Purple Decoction), treating postpartum wind-stroke with opisthotonos (body arched backward like a bow), trismus (lockjaw), and profuse salivation.
Half a sheng of Heidou (Black Soybean), stir-fried until charred black and smoking. Irrigate with 2 sheng of unadulterated wine, place in a porcelain vessel. Each time use 1 zhan, add 5 qian of Duhuo (Angelica Pubescens), decoct until 6-7 parts remain, strain, and take warm.
Note: The three formulas below Xuming Tang are medications for the Taiyang (Greater Yang) and Jueyin (Terminal Yin) meridians. They are indeed suitable for cases with excess pathogens and floating, wiry, forceful pulses. However, for those with severe postpartum Qi and Blood deficiency, one should not lightly induce sweating to release the exterior. Using Fangfeng Danggui San (Saposhnikovia and Angelica Sinensis Powder) is the superior method.
Haicang (representing Zhang Yuansu/Li Dongguan lineage): Fangfeng Danggui San (Saposhnikovia and Angelica Sinensis Powder). (Formula see previous section.)