川芎(一钱) 当归(三钱) 炙姜(五分) 肉桂 吴茱萸 砂仁(各八分) 如伤食作痛。可照
上伤食症条加减。下腹痛亦仿此。
凡产后腹痛。先问血块有无。若无块痛。因遇风冷。乘虚入腹作痛。宜服加味生化汤。若有
血块痛。只服生化汤调元胡索末(一钱) 块痛消止。产后遇风寒。乘虚入腹作痛。
川芎(二钱) 当归(四钱) 炙甘草 炙姜(各四分) 桂枝(七分痛止减去) 防风(七分) 吴
茱萸(六分) 白豆蔻(五分) 如服之块未消。再煎一服。送失笑散(一钱)
产后虚中感寒饮冷。寒气下攻。则小腹作痛。又有血块作痛者。亦有产后血虚。脐下痛者。
并宜加减生化汤治之。
川芎(二钱) 当归(三钱) 干姜 甘草(各四分) 桃仁(十粒) 有血块痛。本汤送元胡索散
(一钱) 亦治寒气痛。无血块痛。但小腹痛。又可按而少止者。属血虚。上方加熟地(三钱)
延胡索 肉桂(各一钱) 为末。
人参 黄 (各二钱) 生姜(一钱) 淡豉(一钱) 韭白(一钱) 当归(三钱) 用猪肾(二个)
先将肾煮熟。取汁二碗。煎药八分盏。温服。
由产后百节开张。血脉流散。气弱则经络间血多阻滞。累日不散。故筋骨急引。诸节不利。
至腰背不能转侧。手足不能动履。或身热。头痛。若误作伤寒发表使汗出。则筋脉动惕。手
足厥冷。变症百出矣。
川芎(一钱)、当归(三钱)、炙姜(五分)、肉桂、吴茱萸、砂仁(各八分)。如果因饮食积滞导致疼痛,可以按照上述伤食症状的条文进行加减。下腹部疼痛也参照此法处理。
凡是产后腹痛,首先要询问是否有血块。如果没有血块而疼痛,是因为受风寒侵袭,寒气乘虚进入腹部所致,适宜服用加味生化汤(在生化汤基础上加减的方剂)。如果有血块引起的疼痛,只服用生化汤(促进子宫收缩、排出瘀血的经典方剂),并调服元胡索末(一钱),待血块疼痛消除即止。产后若遭遇风寒,寒气乘虚入腹引起疼痛:
川芎(二钱)、当归(四钱)、炙甘草、炙姜(各四分)、桂枝(七分,疼痛停止后减去)、防风(七分)、吴茱萸(六分)、白豆蔻(五分)。如果服用后血块仍未消散,再煎服一剂,送服失笑散(一钱)(一种活血祛瘀止痛的方剂)。
产后身体虚弱中寒,饮用冷饮,寒气向下攻冲,会导致小腹疼痛。也有因血块引起疼痛的,还有因产后血虚导致脐下疼痛的,这些都适宜用加减生化汤治疗。
川芎(二钱)、当归(三钱)、干姜、甘草(各四分)、桃仁(十粒)。若有血块疼痛,本汤送服元胡索散(一钱)。也能治疗寒气疼痛。若无血块疼痛,仅小腹痛,且按压后疼痛稍减的,属于血虚。上方加入熟地(三钱)、延胡索、肉桂(各一钱),研为细末。
人参、黄芪(各二钱)、生姜(一钱)、淡豉(一钱)、韭白(一钱)、当归(三钱)。使用猪肾(二个),先将肾煮熟,取汁两碗,煎药至剩余八分盏,温服。
由于产后全身关节开张,血脉流散,气弱则经络间血液多阻滞,日久不散,所以筋骨拘急牵引,各个关节活动不利,甚至腰背不能转侧,手足不能行动。或者出现身热、头痛。如果误当作伤寒发表使汗出,则会导致筋脉跳动抽搐,手足厥冷,变症百出。
Chuanxiong Rhizoma (1 qian), Danggui Radix (3 qian), Zhi Jiang (Fried Ginger, 0.5 qian), Rougui (Cinnamon Bark), Wuzhuyu (Evodia Fruit), Sharen (Amomum Fruit) (each 0.8 qian). If pain is caused by food stagnation, adjustments can be made according to the section on food stagnation symptoms above. Pain in the lower abdomen should also be treated following this method.
For postpartum abdominal pain, first inquire whether there are blood clots. If there are no clots and pain occurs, it is due to wind-cold invading the abdomen while the body is deficient; Jia Wei Sheng Hua Tang (Modified Decoction for Generating New Blood) is suitable. If pain is caused by blood clots, only Sheng Hua Tang (Decoction for Generating New Blood) should be taken, along with Yuanhusuo Powder (Corydalis Rhizoma Powder, 1 qian); stop when the clot-related pain subsides. When postpartum exposure to wind-cold causes cold qi to invade the abdomen while the body is deficient:
Chuanxiong Rhizoma (2 qian), Danggui Radix (4 qian), Zhi Gancao (Honey-fried Licorice Root), Zhi Jiang (Fried Ginger) (each 0.4 qian), Guizhi (Cinnamon Twig, 0.7 qian, remove after pain stops), Fangfeng (Saposhnikovia Root, 0.7 qian), Wuzhuyu (Evodia Fruit, 0.6 qian), Baidoukou (White Cardamom, 0.5 qian). If the clots do not dissipate after taking this, decoct another dose and administer Shixiao San (Powder that Makes One Smile, 1 qian) with it.
Postpartum deficiency with cold invasion and consumption of cold drinks causes cold qi to attack downward, resulting in lower abdominal pain. There are also cases of pain caused by blood clots, and cases of pain below the umbilicus caused by postpartum blood deficiency. All these are suitable for treatment with Jia Wei Sheng Hua Tang (Modified Decoction for Generating New Blood).
Chuanxiong Rhizoma (2 qian), Danggui Radix (3 qian), Ganjiang (Dried Ginger), Gancao (Licorice Root) (each 0.4 qian), Taoren (Peach Seed, 10 grains). For pain caused by blood clots, take this decoction with Yuanhusuo San (Corydalis Powder, 1 qian). It also treats pain caused by cold qi. For pain without blood clots, located only in the lower abdomen, which is relieved slightly by pressure, this belongs to blood deficiency. Add Shudi (Prepared Rehmannia Root, 3 qian), Yanhusu (Corydalis Rhizoma), and Rougui (Cinnamon Bark) (each 1 qian) to the above formula, and grind into powder.
For postpartum consumptive disease characterized by joint pain in fingers, headache, and incessant sweating:
Renshen (Ginseng Root), Huangqi (Astragalus Root) (each 2 qian), Shengjiang (Fresh Ginger, 1 qian), Danshi (Light Fermented Soybean, 1 qian), Jiubai (Leek White, 1 qian), Danggui Radix (3 qian). Use Zhushen (Pig Kidney, 2 pieces); first boil the kidneys until cooked, take two bowls of the juice, decoct the herbs until reduced to 0.8 bowl, and take warm.
Because all joints open up after childbirth and blood vessels scatter, weak qi leads to blood stasis in the meridians that persists for days. Thus, sinews and bones become tight and pulling, and all joints move poorly, extending to inability to turn the waist and back or move hands and feet. Or there may be fever and headache. If mistakenly treated as Taiyang syndrome (Exterior Syndrome) with diaphoretic methods causing sweating, it will lead to twitching of sinews and vessels, cold extremities, and myriad complications.