答曰。产后败血乘虚。停积于五脏。不行经络。流入于四肢。留滞日深。却还不得。腐坏如
水。故令四肢面目浮肿。医人不识。便作水气治。凡治水气。多用导水药。极虚。夫产后既
虚。是谓重虚。往往因致夭枉。但服调经散。自然血行肿消。
调经散(此方百发百中)
没药(研) 琥珀(研各一分) 官桂 赤芍 当归(各一两) 细辛 麝香(研各半分) 甘草(
炙二钱严氏方中多此一味药)
上为细末。每服五分七。生姜汁温酒各少许调服。
正脾散。治大病之后。脾气虚弱。中满腹胀。四肢虚浮。状若水气。此药治之。及产后四肢
浮肿。
莪术 香附 茴香(炒) 甘草(炙) 陈皮(各等分)
上为细末。每服二钱。煎灯心木瓜汤调下。
答曰。心主身之血脉。因产伤耗血脉。心气则虚。败血停积。上干于心。心不受触。遂致心
中烦躁。卧起不安。乍见鬼神。言语颠倒。医人不识。呼为风邪。如此治之。必不得愈。但服调
经散。加生龙齿一捻。得睡即安。
调经散(方见八十六问)
上件药如前。每服加龙齿一捻。
柏子仁散。治产后谎言乱语。繇内虚少血。邪气攻心。
柏子仁 远志 人参 桑寄生 防风 琥珀(细研) 当归 熟地 甘草(各半两)
上为 咀。每服以水二盏。入白羊心一个。切碎先煎七分。去心滓。须下药五钱。更煎四分
。去滓温服。不拘时。
琥珀散。治产后血邪攻心。迷闷。言语错乱。
琥珀(研) 铁粉(各一两) 人参 茯苓 干生地 阿胶(各七分半炒令黄色) 朱砂(研半两)
远志(七钱半去心) 甘草 麝香(研各二钱半)
上为细末。入研了药同和极细。每服一钱。金银汤调下。无时。
回答说：产后败血（产后未能排出的瘀血）乘虚而入，停滞积聚在五脏，不能正常运行于经络，流入四肢，停留日久，无法回流消散，腐败化水，因此导致四肢和面目浮肿。医生如果不了解这一病机，便将其当作水气病（水肿）来治疗。凡是治疗水气病，多使用导水药（利水消肿的药物），这会使患者极度虚弱。既然产后身体已经虚弱，再这样治疗就称为“重虚”（双重虚弱），往往因此导致死亡。只要服用调经散，自然血液运行通畅，肿胀消退。
调经散（此方疗效确切，百发百中）
没药（研碎） 琥珀（研碎，各一分） 官桂 赤芍 当归（各一两） 细辛 麝香（研碎，各半分） 甘草（炙制二钱，严氏方中多这一味药）
以上药物研为细末。每次服用五分七厘，用生姜汁和温酒各少许调和服用。
正脾散，治疗大病之后，脾气虚弱，出现中焦胀满、腹部胀大、四肢虚浮，症状类似水气病。此药用于治疗此类情况，以及产后四肢浮肿。
莪术 香附 茴香（炒制） 甘草（炙制） 陈皮（各等分）
以上药物研为细末。每次服用二钱，煎灯心草和木瓜汤送服。
回答说：心主宰身体的血脉。因为分娩损伤耗竭了血脉，心气因而虚弱。败血停滞积聚，上扰于心，心脏无法承受这种干扰，于是导致心中烦躁，坐卧不安，偶尔看见鬼神，言语错乱颠倒。医生如果不了解这一病机，称之为风邪。如果按照风邪治疗，必定无法痊愈。只要服用调经散，加入生龙齿一捻的量，能够入睡即能安宁。
调经散（方剂见第八十六问）
上述药物按前法制备。每次服用时加入龙齿一捻的量。
柏子仁散，治疗产后胡言乱语，由于体内虚弱、血液不足，邪气攻心所致。
柏子仁 远志 人参 桑寄生 防风 琥珀（细研） 当归 熟地黄 甘草（各半两）
以上药物切碎。每次取五钱药，用水两盏，加入一个白羊心，切碎后先煎至七分水量，去除心渣滓，再加入药末煎煮四分水量，去渣温服，不限时间。
琥珀散，治疗产后血邪攻心，导致神志迷闷，言语错乱。
琥珀（研碎） 铁粉（各一两） 人参 茯苓 干地黄 阿胶（各七分半，炒至黄色） 朱砂（研碎半两） 远志（七钱半，去心） 甘草 麝香（研碎，各二钱半）
以上药物研为细末，将已研碎的药物混合均匀至极细。每次服用一钱，用金银汤送服，不限时间。
Answer: Postpartum retained blood (stasis of blood remaining after childbirth) takes advantage of the deficiency, stagnates and accumulates in the five zang organs, fails to circulate through the meridians, flows into the four limbs, and remains stagnant for a long time without returning. It decomposes and transforms into fluid, causing edema of the four limbs and face. If physicians do not recognize this pathology and treat it as Shuiqi disease (edema/water swelling), they will often use Daoshui medicines (diuretics to drain water). This causes extreme deficiency. Since the postpartum state is already deficient, this constitutes Chongxu (double deficiency), which often leads to premature death. Simply administering Tiaojing San (Regulating Menses Powder) will naturally promote blood circulation and resolve the swelling.
Tiaojing San (This formula is highly effective, with a hundred percent success rate)
Moyao (Myrrhae Resina, 没药, ground)
Hupo (Succinum, 琥珀, ground, each 1 fen)
Guangui (Cinnamomi Cortex, 官桂)
Chishao (Paeoniae Radix Rubra, 赤芍)
Danggui (Angelicae Sinensis Radix, 当归, each 1 liang)
Xixin (Asari Radix et Rhizoma, 细辛)
Shexiang (Moschus, 麝香, ground, each 0.5 fen)
Gancao (Glycyrrhizae Radix et Rhizoma, 甘草, honey-fried, 2 qian; Yan Shi's formula includes this additional herb)
Grind all ingredients into a fine powder. Take 0.57 qian per dose, mixed with a small amount of fresh ginger juice and warm wine.
Zhengpi San treats spleen qi deficiency following severe illness, characterized by middle jiao fullness, abdominal distension, and flaccid edema of the four limbs resembling Shuiqi disease. This formula is indicated for such conditions, as well as postpartum edema of the four limbs.
Ezhu (Curcumae Rhizoma, 莪术)
Xiangfu (Cyperi Rhizoma, 香附)
Huixiang (Foeniculi Fructus, 茴香, stir-fried)
Gancao (Glycyrrhizae Radix et Rhizoma, 甘草, honey-fried)
Chenpi (Citri Reticulatae Pericarpium, 陈皮, equal parts)
Grind all ingredients into a fine powder. Take 2 qian per dose, washed down with decoction of Dengxincao (Junci Medulla, 灯心草) and Mugua (Chaenomelis Fructus, 木瓜).
Answer: The Heart governs the blood vessels of the body. Childbirth damages and depletes the blood vessels, leading to Heart qi deficiency. Retained blood stagnates and accumulates, disturbing the Heart from above. The Heart cannot tolerate this disturbance, resulting in inner restlessness, inability to lie or sit comfortably, occasional hallucinations of ghosts and spirits, and disordered speech. If physicians fail to recognize this and diagnose it as Fengxie (wind pathogen), treatment according to wind pathogen principles will certainly fail to cure. Simply administer Tiaojing San (Regulating Menses Powder) with the addition of one pinch of Sheng Longchi (Unfossilized Dragon Tooth, 生龙齿). Sleep will bring peace.
Tiaojing San (See Question 86 for the formula)
Prepare the aforementioned herbs as described previously. Add one pinch of Longchi per dose.
Baiziren San treats postpartum delirious speech caused by internal deficiency and blood shortage, where pathogenic factors attack the Heart.
Baiziren (Biota Semen, 柏子仁)
Yuanzhi (Polygalae Radix, 远志)
Renshen (Ginseng Radix, 人参)
Sangjisheng (Taxilli Herba, 桑寄生)
Fangfeng (Saposhnikoviae Radix, 防风)
Hupo (Succinum, 琥珀, finely ground)
Danggui (Angelicae Sinensis Radix, 当归)
Shudi (Rehmanniae Radix Preparata, 熟地黄)
Gancao (Glycyrrhizae Radix et Rhizoma, 甘草, each 0.5 liang)
Cut the herbs into small pieces. For each dose, take 5 qian of herbs, add two cups of water and one white sheep heart. Cut the heart into pieces and boil first until reduced to 0.7 cup volume. Remove the heart residue, then add the herbal mixture and boil until reduced to 0.4 cup volume. Strain and take warm, at any time.
Hupo San treats postpartum blood-pathogen attacking the Heart, causing mental confusion and disordered speech.
Hupo (Succinum, 琥珀, ground)
Tiefen (Ferrum, 铁粉, each 1 liang)
Renshen (Ginseng Radix, 人参)
Fuling (Poria, 茯苓)
Ganshengdi (Rehmanniae Radix Recens, 干地黄)
Ejiao (Colla Corii Asini, 阿胶, each 0.75 qian, stir-fried until yellow)
Zhusha (Cinnabaris, 朱砂, ground, 0.5 liang)
Yuanzhi (Polygalae Radix, 远志, 0.75 qian, heart removed)
Gancao (Glycyrrhizae Radix et Rhizoma, 甘草)
Shexiang (Moschus, 麝香, ground, each 0.25 qian)
Grind all ingredients into a fine powder, mixing thoroughly with the pre-ground substances. Take 1 qian per dose, washed down with Yinjin Tang (Silver Gold Decoction), at any time.