产后妄言妄见。由气血大虚。精夺神昏。妄有所见而妄言也。轻则梦中呢喃。重则不睡亦语
。又有痰乘虚客于中焦。以致五官失其职。视听言动。俱有虚妄。毋认邪鬼。误用符水。以
致不救。朱丹溪云。虚症有似邪祟是也。屡治此症。服药多。方能见效。
(〔吴按〕痰火逆传心胞。为虚中实症。急治不任攻伐。缓调恐成痼疾。况值产后。尤以
扶正驱邪。消息而医之。)
产后三日内。血块未除。患妄言妄见症。服下方三四帖后加减。
川芎(二钱) 当归(四钱) 茯苓(一钱) 甘草(四分) 干姜(四分) 桃仁(十粒) 枣仁(一钱) 枣(二枚) 水煎。
食远服。
产后三日内外。血块不痛。妄言妄见。此虚极之症。服下方但见平稳。虽未见大效。候药力
充足。诸症方除。盖除痛须二十帖外。方见全效。
川芎(一钱五分) 当归(三钱) 茯苓 人参 柏子仁 枣仁(各一钱) 甘草(五分) 龙眼肉
(八个) 陈皮(去白三分) 竹茹(四分) 如汗。加黄 。麻黄根(各一钱) 泻加白术。(一
钱五分) 大便不通。切忌大下发汗。
生黄 (一两) 当归 白芷(共五钱) 七孔猪蹄(一对) 将猪蹄煮汤。吹去浮油。煎药一大
碗服。服后被覆面睡一觉。即有乳。或未效。再一服。无不通矣。若新产无乳。不用猪蹄。
只以药料用水和酒各半煎服。体壮者加好红花三四分。以消恶露。
(〔吴按〕黄 当归补血汤也。再加王不留行。通草叶。馒头。卧时煎服。乳即涌出。屡经
试验。)
产后育子乳少。无钱雇乳母。勉强乳子。以至母子俱疲。日食减少。急断儿乳。连服下方。
产后出现胡言乱语、幻视幻听的症状。这是由于气血严重亏虚,精气耗损导致神志昏沉,从而产生虚幻的所见并随之妄言。轻者表现为梦中喃喃自语,重者即使不睡觉也胡言乱语。又有因痰邪乘虚侵袭中焦,致使五官功能失常,看、听、说、动等表现均出现虚妄不实的情况。切勿误认为是邪鬼作祟而错误使用符水治疗,以免导致无法救治。朱丹溪说:“虚证有类似邪祟附体的表现。”我多次治疗此类病症,发现服药较多时才能见效。
(吴氏按:痰火逆传心包,属于本虚标实之证。若急治则身体难以承受攻伐,缓调又恐形成顽固疾病。况且正值产后,更应以扶助正气、驱除邪气为主,斟酌病情缓慢医治。)
产后三日内,恶露血块尚未清除,出现胡言乱语、幻视幻听症状,服用下方三四剂后根据情况加减。
川芎(二钱) 当归(四钱) 茯苓(一钱) 甘草(四分) 干姜(四分) 桃仁(十粒) 酸枣仁(一钱) 大枣(两枚) 用水煎煮。饭后不久服用。
产后三日内外,恶露血块不痛,出现胡言乱语、幻视幻听,这是极度虚弱的病症。服用下方只要见到病情平稳,虽然未见显著疗效,但待药力充足后,各种症状才会消除。大概需要二十多剂之后,才能看到完全的效果。
川芎(一钱五分) 当归(三钱) 茯苓 人参 柏子仁 酸枣仁(各一钱) 甘草(五分) 龙眼肉(八个) 陈皮(去白三分) 竹茹(四分) 如果有汗出,加黄芪、麻黄根(各一钱);如果腹泻,加白术(一钱五分)。大便不通时,切忌使用大发汗的药物。
产后乳汁不通,或者乳汁稀少。
生黄芪(一两) 当归 白芷(共五钱) 七孔猪蹄(一对) 将猪蹄煮汤,撇去浮油,用此汤煎药一大碗服用。服药后用被子覆盖面部睡一觉,就会有乳汁,或者效果不明显,再服一次,就没有不通的了。如果是新产妇产后无乳,不用猪蹄,只用药材用水和酒各半煎服。体质强壮者加好红花三四分,以消散恶露。
(吴氏按:这是黄芪当归补血汤。再加王不留行、通草叶、馒头,睡前煎服,乳汁就会涌出,屡经试验有效。)
产后哺育婴儿乳汁少,没钱雇佣乳母,勉强哺乳,以至于母子都疲惫不堪,饮食减少,应紧急断绝婴儿吃母乳,连续服用下方。
Postpartum delirium and hallucinations. These symptoms arise from severe deficiency of Qi and Blood, where the essence is depleted and the Spirit becomes confused, leading to false perceptions and delirious speech. In mild cases, there is muttering in dreams; in severe cases, the patient speaks even when awake and not sleeping. Additionally, phlegm may invade the Middle Jiao (Middle Burner) due to deficiency, causing dysfunction of the five sense organs, resulting in false visual, auditory, verbal, and motor behaviors. One must not mistake this for possession by evil spirits or ghosts and erroneously use talismanic waters, which could lead to untreatable conditions. Zhu Danxi stated: "Deficiency syndromes can resemble manifestations of spirit possession." Having treated this syndrome repeatedly, I have found that it often requires a larger dosage of medicine before efficacy is seen.
(Wu's Commentary: Phlegm-fire reversely transmitting to the Pericardium constitutes a syndrome of deficiency with excess characteristics. Urgent treatment with aggressive methods may overwhelm the body, while slow regulation risks becoming a chronic disease. Moreover, given the postpartum state, the priority should be supporting the Righteous Qi (Zheng Qi) and expelling pathogenic factors, treating with careful deliberation.)
Within three days after childbirth, if blood stasis (lochia clots) has not been eliminated and delirium/hallucinations occur, take the following prescription for three to four doses, then modify based on changes.
Chuanxiong Rhizome (2 qian), Danggui Radix (4 qian), Poria (1 qian), Glycyrrhiza Root (4 fen), Dried Ginger (4 fen), Peach Kernel (10 grains), Ziziphus Seed (1 qian), Jujube (2 pieces). Decoct in water. Take shortly after meals.
Between three days before and after delivery, if lochia clots are painless but delirium/hallucinations occur, this is an extremely deficient syndrome. After taking the following prescription, if stability is achieved—even without dramatic improvement—wait for the medicinal power to accumulate sufficiently, then all symptoms will subside. Generally, more than twenty doses are required to see full effects.
Chuanxiong Rhizome (1.5 qian), Danggui Radix (3 qian), Poria, Ginseng Radix, Biota Seed, Ziziphus Seed (each 1 qian), Glycyrrhiza Root (5 fen), Longan Aril (8 pieces), Tangerine Peel (deprived of white pith, 3 fen), Bamboo Shavings (4 fen). If sweating occurs, add Astragali Radix and Ephedrae Herba roots (each 1 qian); if diarrhea occurs, add Atractylodis Macrocephalae Rhizoma (1.5 qian). If constipation is present, strictly avoid strong diaphoretic purgatives.
Postpartum lactation obstruction or scanty milk secretion.
Raw Astragali Radix (1 liang), Danggui Radix, Angelica Dahurica Root (total 5 qian), Seven-hole Pig Trotters (1 pair). Boil the pig trotters to make soup, skim off the floating oil, and decoct the herbs in this soup until one large bowl remains. Drink. Cover the face with a blanket and sleep for a while; milk will flow. If ineffective, take another dose; no case will remain unrelieved. For new mothers with no milk, do not use pig trotters; instead, decoct the herbs in half water and half wine. Those with robust constitution may add Safflower (3-4 fen) to resolve lochia.
(Wu's Commentary: This is Huangqi Danggui Buxue Tang (Astragalus and Angelica Tonifying Blood Decoction). Adding Vitex Fruit, Tetrapanacis Medulla, and Mantou (steamed bun), taken warm at bedtime, causes milk to gush forth; this has been verified repeatedly.)
Postpartum nursing with insufficient milk, inability to afford a wet nurse, forcing breastfeeding leads to exhaustion of both mother and infant, and reduced food intake. Immediately wean the infant and continuously administer the following prescription.