川芎 茯神 柏子仁(各一钱) 当归(三钱) 姜炭 炙草(各四分) 桃仁(十二粒) 人参(
二钱) 益智(炒八分) 陈皮(三分) 枣(二枚)
产后块痛已止。患妄言妄见。
黄 白术 人参 麦冬 川芎 枣仁 茯神 柏子仁 益智(炒) 当归 熟地(各二钱)
炙草 陈皮(三分) 莲子(八粒) 五味子(七粒) 元眼肉(八个) 枣(二个)
大凡产后患崩血脱。短气似喘气脱。妄言妄见神脱。三症虽有血阴气阳之分。其精散神去无
异。比前晕症。治可少缓。然亦危症也。若非浓药妥方频服。失之者多矣。若医者误论气实
痰火。皆误人也。如新产有血块痛三症。并用加参生化汤。此行中有补斯免滞血虚晕之失也
。其块痛既止。宜用升举大补药。少佐黄连清火。以治崩脱。摄气归源也。宜用滋荣益气复
神汤。少佐痰药。以清心火。宁君主之官也。每见人妄论气脱妄言之症。误用气实痰火方药
。屡夭人命。故重复录告。倘执论痰气而致病愈重者。或能试以补剂。救之犹可活也。毋害
(〔吴按〕治病先分虚实。尤以脉为凭。经云。血脱有生血之机。尤须补气。而气脱亦应加
入补血药。所谓阴阳互相为根。不可偏重也。)
凡产形体劳倦。脾胃俱伤。是以新产之后。禁膏粱远浓味。食粥茹蔬。乃切务也。不善调治
之家。唯虑产妇之虚。以多食为有益。以浓味为补本。产妇不思而强与。致餍食则有伤。胃
虽纳受。脾难转输。食停痞塞。酸嗳恶食。治宜保元为主。温补气血。健脾助胃。审伤何物
。佐以消导。使脾气腹而转输。散积则滞物行而胃始思食。夫饮食 脾虚之滋味。在产后未
尝不藉此为补助。但劳倦伤食。不胜甘饫。薄味渐进。运化易速。乃事产者不知此意。业已
受伤。须知服生化汤。佐神曲。麦芽。以消面食。山楂。砂仁。以消肉食。吴茱萸。肉桂。
以消冷物。如此则补消并济。无有不安。屡见治产者不重产虚人弱。唯知速消伤物。反损其
气。益增满闷。一帖不效。又加峻药。一医无功。又更一医。先后方类。轻症加重。致使少
食之人反虚。而绝不思食者。十常八九。病家自归数命。医家以为尽技。惜哉。
产后块痛未消。服下方以消食。
川芎、茯神、柏子仁(各一钱)、当归(三钱)、姜炭、炙甘草(各四分)、桃仁(十二粒)、人参(二钱)、益智仁(炒八分)、陈皮(三分)、大枣(二枚)。
产后血块疼痛已经停止,但患者出现胡言乱语、幻视等精神异常症状。
黄芪、白术、人参、麦冬、川芎、酸枣仁、茯神、柏子仁、益智仁(炒)、当归、熟地黄(各二钱)、炙甘草、陈皮(三分)、莲子(八粒)、五味子(七粒)、龙眼肉(八个)、大枣(二个)。
大凡产后患崩漏下血导致气血脱失,短气似喘导致气脱,胡言乱语、幻视导致神脱。这三种病症虽然分别涉及血阴和气阳的亏损,但其精气涣散、神明离去的病机并无不同。与前文的眩晕症相比,治疗可以稍微延缓,但这仍然是危重病症。如果不是用浓稠的药液和稳妥的方剂频繁服用,失误者很多。如果医生错误地论述为气实痰火,都是误人子弟。如新产后有血块疼痛三种症状,应并用加参生化汤(Shenghua Tang with Ginseng),这样行血中有补益,从而避免瘀血停滞导致虚性眩晕的过失。其血块疼痛既然已经停止,适宜使用升举大补的药物,少佐黄连以清火,来治疗崩漏脱血,摄纳气机回归本源。适宜使用滋荣养气复神汤(Zirong Yangqi Fushen Tang),少佐化痰药物,以清心火,安宁君主之官(心脏)。经常看到有人胡乱论述气脱妄言之症,错误地使用气实痰火的方药,屡次夭折人命。所以重复记录告知。倘若固执于痰气致病而使得病情加重,如果能试用补剂,救治还可以存活。不要害了病人。(〔吴氏按〕治病首先要分辨虚实,尤其以脉象为依据。经典说:血脱有生血之机,尤其必须补气;而气脱也应加入补血药,所谓阴阳互相为根本,不可偏重。)
凡是生产时形体劳倦,脾胃都受到损伤。所以在刚生产之后,禁止食用肥甘厚味,远离浓腻食物,吃粥吃蔬菜,才是迫切重要的事务。不善于调理护理的家庭,只担心产妇虚弱,认为多吃有益,认为浓味是补本。产妇不想吃却强行给吃,导致饱食过度则有伤害。胃虽然能受纳,脾难以转输运化,食物停聚痞塞,嗳气泛酸,厌恶食物。治疗应以保元汤为主,温补气血,健脾助胃。审察伤了什么东西,辅助以消导药物,使脾气腹(此处疑为“脾气复”或“脾气运”,指脾气恢复运化功能)而转输,消散积滞则停滞之物运行而胃才开始想进食。饮食对于脾虚的人来说,在产后未尝不是借此作为补助。但是劳倦伤食,不能承受甘甜饱腻,清淡味道逐渐进服,运化容易快速。这是从事产科的人不知道这个意思。已经受伤,须知服用生化汤,辅助神曲、麦芽,以消化面食;山楂、砂仁,以消化肉食;吴茱萸、肉桂,以消化冷物。这样则补益与消导并济,没有不安稳的。屡见治疗产后病的人不重视产后人体虚弱的本质,只知道迅速消除伤食之物,反而损伤正气,增加满闷。一帖药不效,又加上峻烈药物。一个医生无功效,又换另一个医生,先后方剂类似,轻症加重,致使原本少食之人反而更虚,而完全不想吃东西的,十常八九。病家自己归咎于命运,医家以为已经尽了技术,可惜啊。
产后血块疼痛未消除,服用下方以消食。
Chuanxiong (Rhizoma Chuanxiong), Fushen (Poria with Hostwood), Baiziren (Semen Platycladi) (each 1 qian), Danggui (Radix Angelicae Sinensis) (3 qian), Jiangtan (Carbonized Rhizoma Zingiberis), Zhigancao (Prepared Radix Glycyrrhizae) (each 4 fen), Taoren (Semen Persicae) (12 grains), Renshen (Radix Ginseng) (2 qian), Yizhi (Fructus Alpiniae Oxyphyllae, stir-fried) (8 fen), Chenpi (Pericarpium Citri Reticulatae) (3 fen), Zao (Fructus Jujubae) (2 pieces).
After childbirth, the pain from blood stasis masses has ceased, but the patient presents with delirious speech and visual hallucinations.
Huangqi (Radix Astragali), Baizhu (Rhizoma Atractylodis Macrocephalae), Renshen (Radix Ginseng), Maidong (Radix Ophiopogonis), Chuanxiong (Rhizoma Chuanxiong), Zaoren (Semen Ziziphi Spinosae), Fushen (Poria with Hostwood), Baiziren (Semen Platycladi), Yizhi (Fructus Alpiniae Oxyphyllae, stir-fried), Danggui (Radix Angelicae Sinensis), Shudi (Prepared Radix Rehmanniae) (each 2 qian), Zhigancao (Prepared Radix Glycyrrhizae), Chenpi (Pericarpium Citri Reticulatae) (3 fen), Lianzi (Semen Nelumbinis) (8 grains), Wuweizi (Fructus Schisandrae) (7 grains), Yuanyanrou (Arillus Longan) (8 pieces), Zao (Fructus Jujubae) (2 pieces).
Generally, postpartum patients suffering from metrorrhagia leading to Qi and Blood collapse, shortness of breath resembling asthma leading to Qi collapse, or delirious speech and hallucinations leading to Spirit collapse, although these three conditions differ in involving Yin/Blood or Yang/Qi depletion, their pathogenesis of scattered essence and departing spirit is identical. Compared to previous vertigo symptoms, treatment may be slightly delayed, yet this remains a critical condition. If thick decoctions and appropriate formulas are not administered frequently, many will fail. If physicians erroneously diagnose it as Excess Qi and Phlegm-Fire, they mislead people. For example, if there are three symptoms of blood stasis mass pain immediately after childbirth, Jia Shen Shenghua Tang (Shenghua Decoction with Ginseng) should be used together. This method includes tonification within blood-moving actions, thereby avoiding the error of deficiency-induced vertigo due to stagnant blood. Once the pain from blood stasis masses ceases, it is suitable to use lifting and major tonifying medicines, with a small addition of Huanglian (Rhizoma Coptidis) to clear fire, to treat metrorrhagia and collapse, and to guide Qi back to its source. It is suitable to use Zirong Yangqi Fushen Tang (Nourishing Glory, Tonifying Qi, and Restoring Spirit Decoction), with a small addition of phlegm-resolving medicines, to clear Heart Fire and calm the Monarch Organ (Heart). One often sees people rashly discussing symptoms of Qi collapse and delirious speech, mistakenly using formulas for Excess Qi and Phlegm-Fire, repeatedly causing premature death. Therefore, I repeat this record for warning. If one stubbornly adheres to the theory of Phlegm-Qi causing disease and the condition worsens, attempting tonifying agents might still save the life. Do not harm the patient. ([Wu's Note]: In treating diseases, one must first differentiate Deficiency and Excess, relying especially on the pulse. The Classics state: When Blood collapses, there is a mechanism for generating new Blood; thus, tonifying Qi is essential. Conversely, when Qi collapses, Blood-tonifying medicines should also be added. This is because Yin and Yang are mutually rooted; one cannot favor one over the other.)
Whenever childbirth causes physical fatigue, both the Spleen and Stomach are injured. Therefore, immediately after childbirth, one must prohibit the consumption of rich, greasy, and strong-flavored foods, avoid heavy flavors, and eat porridge and vegetables; this is an urgent necessity. Families unskilled in care, only worrying about the mother's weakness, consider eating more beneficial and rich flavors as foundational tonification. They force-feed the mother when she has no appetite, leading to injury from overeating. Although the Stomach can receive food, the Spleen struggles to transport and transform. Food stagnates causing fullness and obstruction, acid belching, and aversion to food. Treatment should primarily focus on Baoyuan Tang (Preserve the Origin Decoction) to warm and tonify Qi and Blood, strengthen the Spleen, and assist the Stomach. Determine what was ingested, and assist with digestive aids, so that Spleen Qi recovers its transport function, accumulated stagnation disperses, retained matter moves, and the Stomach begins to desire food. Diet serves as assistance for Spleen Deficiency, which is indeed helpful postpartum. However, due to fatigue and food injury, the body cannot tolerate sweet and cloying richness. Gradual intake of light flavors allows for easier and faster digestion and transformation. Obstetricians who do not understand this meaning cause further injury. It is known that after taking Shenghua Tang, one should add Shenqu (Massa Medicata Fermentata) and Maiya (Frumentum Germinatum Hordei) to digest wheat products; Shanzha (Fructus Crataegi) and Sharen (Fructus Amomi Rotundus) to digest meat; Wuzhuyu (Fructus Evodiae) and Rougui (Cortex Cinnamomi) to digest cold items. Thus, tonification and digestion are balanced, ensuring stability. I have often seen practitioners neglect the inherent weakness of postpartum women, focusing only on rapidly eliminating food stagnation, which反而 damages Qi and increases fullness. If one dose is ineffective, stronger drugs are added. If one physician fails, another is consulted. The prescriptions are similar; mild conditions become severe, causing those who already eat little to become even weaker, while those who completely lose appetite constitute eight or nine out of ten cases. The family blames fate, and the physician claims to have exhausted their skills. What a pity.
If postpartum blood stasis pain has not subsided, take the following formula to digest food.