丁香豆寇散 茹橘饮
26.产后呃逆胃虚寒, 丁香白寇伏龙肝, 桃仁吴萸汤冲服, 不应急将
参附添, 热渴面红小便赤, 竹茹干柿橘红煎.
【注】产后呃逆, 皆因气血两伤, 脾胃虚寒, 中焦之气厥而不顺所致
,宜服丁香豆蔻散, 即丁香, 白豆蔻, 伏龙肝, 为末也. 用桃仁, 吴
茱萸, 煎汤冲服. 如不效, 当以参附汤峻补之. 若发热面红, 小便赤
色,属热实者, 宜用竹茹, 干柿, 橘红, 煎服之, 名茹橘饮.
二味参苏饮
27.产后气喘为危候, 血脱气散参附煎, 败血上攻面紫黑, 二味参苏
夺命痊.
【注】产后气喘, 极危证也. 因下血过多, 荣血暴竭, 卫气无倚, 孤
阳上越, 宜骤补其气, 用参, 附煎汤, 不时饮之. 若因恶露不行, 败
血上攻于肺而喘者, 必面色紫黑, 宜夺命散下瘀, 瘀去喘自定. 虚者
参苏饮, 即人参一两为末, 苏木二两煎汤, 冲服也.
枳术汤 小调中汤
28.产后肿分气水血, 轻浮胀满气之形, 水肿喘嗽小便涩, 皮如熟李
血之情. 气肿枳术汤最效, 水肿茯苓导水灵, 血肿调中归芍术, 茯陈
煎冲小调经. 归芍珀麝辛桂没, 理气调荣瘀血行.
【注】产后浮肿, 由于败血乘虚流入经络, 血化为水, 故令浮肿. 然
有气肿, 水肿之别, 不可不辨也. 若轻虚浮肿, 心胸胀满者, 因素有
水饮所作, 名曰气分也, 宜用枳术汤, 即枳实, 白术, 煎汤服之; 若
喘嗽小便不利者, 则为水肿, 宜茯苓导水汤利之; 若皮如熟李, 或遍
身青肿者, 则为血分, 宜小调中汤治之. 其方即当归, 白芍药, 白术
,茯苓, 陈皮, 煎汤, 冲小调经散服之, 即当归, 赤芍, 琥珀, 麝香
,细辛, 肉桂心, 没药也.
茯苓导水汤 方见三卷
26. 产后呃逆,多因胃气虚弱且伴有寒邪。治疗宜用丁香、白豆蔻、伏龙肝(灶心土),研成细末,再用桃仁、吴茱萸煎煮汤剂冲服该药末。若服药后症状未缓解,应及时加入人参、附子以增强疗效。若患者出现发热、口渴、面色发红、小便色赤等症状,则属热证,宜用竹茹、干柿(干燥的柿子)、橘红煎汤服用,此方名为“茹橘饮”。
【注】产后呃逆,皆是因为气血两伤,导致脾胃虚寒,中焦之气厥逆而不顺畅所致。适宜服用丁香豆蔻散,即由丁香、白豆蔻、伏龙肝三味药研为末。使用时,用桃仁、吴茱萸煎汤冲服。如果无效,应当使用参附汤进行峻补。如果出现发热、面红、小便颜色深赤,属于热实证,适宜用竹茹、干柿、橘红煎服,名为茹橘饮。
27. 产后气喘属于危重证候。若是因失血过多导致气随血脱,宜用参附汤煎服;若是败血上攻于肺,导致面色紫黑,宜用二味参苏饮或夺命散治愈。
【注】产后气喘,是极危重的证候。这是因为下血过多,营血突然枯竭,卫气失去依附,孤阳上浮外越所致。应当迅速补气,用人参、附子煎汤,随时饮用。如果是由于恶露排出不畅,败血上攻于肺而导致气喘,必然面色紫黑,宜用夺命散攻下瘀血,瘀血去除后气喘自然平息。对于虚证,使用参苏饮,即人参一两研为末,苏木二两煎汤,冲服该药末。
28. 产后浮肿分为气肿、水肿和血肿三种。轻微浮肿且伴有胀满感,是气肿的表现;若伴有气喘咳嗽、小便涩滞不通,皮肤像熟李子一样光亮,则是血肿的表现。气肿用枳术汤效果最好;水肿用茯苓导水汤疗效显著;血肿用小调中汤治疗。小调中汤的组成是当归、白芍药、白术、茯苓、陈皮煎汤,冲服小调经散。小调经散的组成包括当归、赤芍、琥珀、麝香、细辛、肉桂心、没药,具有理气、调和营血、行瘀血的功效。
【注】产后浮肿,是由于败血乘虚流入经络,血液化为水液,从而导致浮肿。然而有气肿和水肿的区别,不可不加以辨别。如果是轻微虚浮浮肿,心胸胀满,这是由于素有水饮停留所致,称为“气分”,适宜用枳术汤,即枳实、白术煎汤服用;如果伴有气喘咳嗽、小便不利,则是水肿,适宜用茯苓导水汤利水消肿;如果皮肤像熟李子一样光亮,或者全身青肿,则是血分病,适宜用小调中汤治疗。该方的组成是当归、白芍药、白术、茯苓、陈皮煎汤,冲服小调经散。小调经散由当归、赤芍、琥珀、麝香、细辛、肉桂心、没药组成。
茯苓导水汤 方见第三卷
Dingxiang Doukou San (Clove and White Cardamom Powder) and Rujü Yin (Zhu Ru and Dried Persimmon Decoction)
26. Postpartum hiccups are often caused by deficiency of the Stomach Qi accompanied by Cold. The treatment should employ Dingxiang (Clove), Baikou (White Cardamom), and Fulonggan (Furnace Earth), ground into fine powder, which is then taken with a decoction of Taoren (Peach Kernel) and Wuzhuyu (Evodia Fruit). If symptoms do not resolve promptly, Renshen (Ginseng) and Fuzi (Aconite Root) should be added to enhance efficacy. If the patient presents with fever, thirst, facial redness, and dark urine, it indicates a Heat syndrome; in such cases, a decoction of Zhuru (Bamboo Shavings), Ganshi (Dried Persimmon), and Juhong (Tangerine Peel) should be administered. This formula is named "Rujü Yin".
[Annotation] Postpartum hiccups result from injury to both Qi and Blood, leading to deficiency-cold of the Spleen and Stomach, causing the Qi of the Middle Jiao to rebel and flow unsmoothly. It is appropriate to take Dingxiang Doukou San, composed of Dingxiang (Clove), Baikou (White Cardamom), and Fulonggan (Furnace Earth), ground into powder. Use a decoction of Taoren (Peach Kernel) and Wuzhuyu (Evodia Fruit) to wash down the powder. If ineffective, Shenfu Tang (Ginseng and Aconite Decoction) should be used for vigorous tonification. If fever, facial redness, and dark urine occur, indicating an Excess-Heat pattern, Zhu Ru (Bamboo Shavings), Ganshi (Dried Persimmon), and Juhong (Tangerine Peel) should be decocted and taken, named "Rujü Yin".
Erwei Renshen Su Mu Yin (Two-Ingredient Ginseng and Dalbergia Decoction)
27. Postpartum panting/dyspnea is a critical condition. If caused by excessive blood loss leading to Qi scattering due to Blood depletion, Shenfu Tang (Ginseng and Aconite Decoction) should be decocted and taken. If turbid blood attacks upward, causing purple-black complexion, Erwei Renshen Su Mu Yin or Duoming San (Life-Restoring Powder) can cure it.
[Annotation] Postpartum panting/dyspnea is an extremely critical syndrome. It occurs because excessive bleeding causes sudden exhaustion of Ying Blood (Nutritive Blood), leaving Wei Qi (Defensive Qi) without support, resulting in solitary Yang floating upward and outward. One should rapidly tonify Qi by decocting Renshen (Ginseng) and Fuzi (Aconite Root) and drinking it frequently. If the panting/dyspnea is due to lochia retention, where turbid blood attacks the Lung, necessarily presenting with a purple-black complexion, Duoming San (Life-Restoring Powder) should be used to purge stasis. Once the stasis is removed, the panting/dyspnea will naturally settle. For deficiency patterns, use Renshen Su Mu Yin (Ginseng and Dalbergia Decoction), which consists of one liang of Renshen (Ginseng) ground into powder, taken with a decoction of two liang of Sumu (Dalbergia Wood).
Zhizhu Tang (Immature Bitter Orange and Atractylodes Decoction) and Xiao Tiaozhong Tang (Minor Regulating the Middle Decoction)
28. Postpartum edema is divided into Qi edema, Water edema, and Blood edema. Mild swelling with distension and fullness represents Qi edema. Edema accompanied by panting/coughing and scanty/difficult urination, with skin resembling that of a ripe plum, represents Blood edema. Qi edema is best treated with Zhizhu Tang (Immature Bitter Orange and Atractylodes Decoction); Water edema responds well to Fuling Daoshui Tang (Poria Draining Water Decoction); Blood edema is treated with Xiao Tiaozhong Tang (Minor Regulating the Middle Decoction). The latter is prepared by decocting Danggui (Angelica Sinensis), Baishao (White Peony Root), Baizhu (Atractylodes Macrocephala), Fuling (Poria), and Chenpi (Tangerine Peel), and taking it with Xiaotiaojing San (Minor Regulating Menses Powder). Xiaotiaojing San consists of Danggui (Angelica Sinensis), Chishao (Red Peony Root), Hupo (Amber), Shexiang (Musk), Xixin (Asarum), Rouguixin (Cinnamon Bark Heart), and Moyao (Myrrh). These herbs regulate Qi, harmonize Ying Blood, and promote the circulation of Blood stasis.
[Annotation] Postpartum edema occurs when turbid blood flows into the meridians due to deficiency, transforming into water fluid, thus causing edema. However, there is a distinction between Qi edema and Water edema, which must not be confused. If there is mild, flaccid edema with chest and epigastric distension/fullness, this is due to pre-existing retained fluid, termed "Qi Fen" (Qi Division/Pattern), and Zhizhu Tang (Immature Bitter Orange and Atractylodes Decoction), consisting of Zhishi (Immature Bitter Orange) and Baizhu (Atractylodes Macrocephala) decocted, is appropriate. If accompanied by panting/coughing and difficult urination, it is Water edema, and Fuling Daoshui Tang (Poria Draining Water Decoction) should be used to promote diuresis. If the skin resembles that of a ripe plum or the whole body is swollen and bruised, it is Blood edema, and Xiao Tiaozhong Tang (Minor Regulating the Middle Decoction) is indicated. This formula is made by decocting Danggui (Angelica Sinensis), Baishao (White Peony Root), Baizhu (Atractylodes Macrocephala), Fuling (Poria), and Chenpi (Tangerine Peel), and taking it with Xiaotiaojing San (Minor Regulating Menses Powder), which contains Danggui (Angelica Sinensis), Chishao (Red Peony Root), Hupo (Amber), Shexiang (Musk), Xixin (Asarum), Rouguixin (Cinnamon Bark Heart), and Moyao (Myrrh).
Fuling Daoshui Tang (Poria Draining Water Decoction) - See Volume III for the formula.