川芎(二钱) 当归(六钱) 姜炭(四分) 木香(临服磨二分) 陈皮(二分)
产后无块痛。受气伤食。服下方。
白术(二钱) 当归(三钱) 川芎(一钱) 姜炭 炙草(各四分) 人参(二钱) 陈皮(三分)
如伤肉食。加山楂。砂仁。伤饭食。加神曲。伤面食加麦芽。伤寒冷物。胁下作痛加肉桂。
愈消则愈增满闷。必攻补并行。方可化滞进食。但时医所见。只知消
耗。而疑人参为补。而不敢用。误人多矣。故屡治误服散气消导药。致使少食思食之人。反
绝食。日久者。皆用长生活命丹而活者甚多。
产后忿怒气逆。及产后停食二症。善治者。重产而轻怒。治以补气血为主。佐以顺气调气。
则怒郁散而元不损。非徒恃用消导。则停滞行而胃思谷。此治产后忿怒伤食之良法也。若专
一理气消食。非惟气胀不散。停食不消。则正气尤减。食甚至绝谷不救。
产后寒热往来。每日应期而发。其症类疟。切不可用疟疾方药治之。夫气血虚。而寒热更作
。元气弱而外邪或侵。虽寒来股栗。汤火不能温。热如燔炙。水冰不能寒。或昼轻夜重。或
日晡寒热。虽所见症与疟同。其治法必当滋荣益气。以退寒热。有汗急当止汗。只头有汗。
不及于足。此乃孤阳绝阴之症。须当加当归地黄之剂。如阳明恶寒。头痛。无汗。宜于生化
汤加羌活。防风。莲须。葱白。以散之。慎不可作疟治。而用柴胡清肺饮等方。至常山、草
果等药。更害人不可用。
产后寒热有汗。每午后应期而发。类疟。
川芎(二钱) 当归(六钱) 姜炭(四分) 木香(临服时磨入二分) 陈皮(二分)
产后没有瘀血块疼痛。若是因受气、伤食所致,服用下方。
白术(二钱) 当归(三钱) 川芎(一钱) 姜炭 炙甘草(各四分) 人参(二钱) 陈皮(三分)
如果是损伤了肉食,加山楂、砂仁;损伤了饭食,加神曲;损伤了面食,加麦芽;损伤了寒冷食物,胁下作痛,加肉桂。
症状越是消退,胀满闷塞感反而越增加,必须攻邪与补益并行,才能化解积滞、促进进食。但是当时的医生所见,只知道消耗正气,却怀疑人参是补药而不敢使用,误人太多了。所以我屡次治疗那些误服了散气消导药的病人,致使原本少吃但想吃饭的人,反而绝食不吃。病程较长的,都用长生活命丹救治,活下来的很多。
产后因忿怒导致气逆,以及产后停食这两类病症,善于治疗的医生,重视产后体质虚弱而轻视愤怒情绪,治疗以补气血为主,辅以顺气调气的方法。这样怒气郁结消散而元气不损。如果仅仅依赖使用消导药,虽然停滞的气机得以运行,胃也思食,但这并非良法。若专门理气消食,不仅气胀不能消散,停食不能消除,反而使正气更加减少,甚至发展到绝食的地步就无法挽救了。
产后出现寒热往来,每天按时发作,症状类似疟疾,切不可用治疗疟疾的方药来治。这是因为气血虚弱,所以寒热交替发作;元气虚弱,外邪容易侵袭。虽然寒冷来时大腿发抖,汤火也不能温暖;发热如火烧炙烤,冰水也不能使其寒冷。或者白天轻晚上重,或者傍晚时分寒热交作。虽然所见症状与疟疾相同,但治疗方法必定应当滋养营血、益气,以退去寒热。有汗的话应当立即止汗。如果只有头部出汗,不及于足部,这是孤阳绝阴的病症,必须加入当归、地黄等药剂。如果是阳明经恶寒、头痛、无汗,适宜在生化汤中加入羌活、防风、莲须、葱白,以发散邪气。千万不可当作疟疾治疗,而使用柴胡清肺饮等方剂,至于常山、草果等药物,更是害人,不可使用。
产后寒热伴有汗出,每午后按时发作,症状类似疟疾。
Chuanxiong (2 qian) Danggui (6 qian) Jiangtan (4 fen) Muxiang (2 fen, ground and added just before taking) Chenpi (2 fen)
Postpartum without blood stasis pain. If caused by emotional constraint and food stagnation, take the following prescription.
Baizhu (2 qian) Danggui (3 qian) Chuanxiong (1 qian) Jiangtan Zhi Gancao (each 4 fen) Renshen (2 qian) Chenpi (3 fen)
If injured by meat, add Shanzha and Sharen; if injured by rice, add Shenqu; if injured by wheat products, add Maiya; if injured by cold foods with pain in the hypochondrium, add Rougui.
As symptoms subside, the sensation of fullness and distension may increase. It is necessary to combine purging and tonifying simultaneously to resolve stagnation and promote appetite. However, contemporary physicians only know how to deplete and suspect that Renshen is a tonic, thus daring not to use it, causing much harm. I have frequently treated patients who mistakenly took Qi-scattering and digestion-promoting medicines, causing those who ate little but desired food to stop eating entirely. For chronic cases, many were saved using Changsheng Huoming Dan.
For postpartum anger leading to rebellious Qi and postpartum food stagnation, skilled practitioners prioritize the postpartum condition over anger. Treatment focuses on tonifying Qi and Blood, assisted by regulating Qi. This disperses anger and depression without damaging Yuan Qi. Merely relying on digestion-promoting herbs allows stagnation to move and the stomach to desire grain, but this is not the best method for treating postpartum anger-induced food stagnation. Specializing solely in regulating Qi and digesting food will not only fail to dissipate Qi distension or eliminate food stagnation but will further reduce healthy Qi, potentially leading to anorexia that is incurable.
Postpartum alternating chills and fever occurring daily at regular intervals resemble malaria (Nue). One must absolutely not use prescriptions for malaria. Because Qi and Blood are deficient, chills and fever alternate; because Yuan Qi is weak, external pathogens may invade. Although chills cause shivering in the thighs, unable to be warmed by hot water or fire, and fever feels like roasting, unable to be cooled by ice or water; or symptoms are lighter during the day and heavier at night, or occur in the late afternoon. Although the symptoms appear identical to malaria, the treatment must nourish Ying (Nutrient) Qi and tonify Qi to resolve chills and fever. If sweating occurs, stop sweating immediately. If sweating is limited to the head and does not extend to the feet, this is a syndrome of isolated Yang and exhausted Yin. One must add Danggui and Dihuang preparations. If there is aversion to cold, headache, and no sweating indicative of the Yangming channel, Qianghuo, Fangfeng, Lianxu, and Congbai should be added to Shenghua Tang to disperse the pathogen. Do not treat as malaria using formulas such as Chaihu Qingfei Yin. Drugs such as Changshan and Caoguo are harmful and must not be used.
Postpartum alternating chills and fever with sweating, occurring daily at regular intervals in the afternoon, resembling malaria.