〔大〕夫肺主气,五脏六腑俱禀于气,产后则气血伤,脏腑皆损,而风冷搏于气,气
则逆上,而又脾虚聚冷,胃中伏寒,因食热物,冷热气相冲击,使气厥而不顺,则吃逆
也。脾者主中焦,为三焦之关,五脏之仓廪,贮积水谷,若阴阳气虚,使荣卫气厥逆,则
致生斯病也。经云∶吃噫者,胃寒所生,服药无效者,灸期门三壮必愈。期门穴乃胃之
大络。
〔薛〕前证属胃气虚寒之恶候,如用后方未应,急投参附汤,亦有复生者。
参附汤(见前自汗。)
丁香散 治产后心烦,咳噫不止。
丁香 白豆蔻仁(各半两) 伏龙肝(一两)
上为细末,煎桃仁、吴茱萸汤调下一钱,如人行五里再服。
石莲散(见呕吐。)
《产宝》疗产后吃逆,三日不止,欲死方。
桂心(半两) 姜汁(三合)
上同煎取二合,以大火炙手摩背,热时涂药汁尽,妙。
治产后吃逆方 用干柿一枚切碎,以水一盏,煎至六分,热呷之。
又方 古壁镜窠三四个,水一小盏,煎至半小盏,热服。
羌活散 (《灵苑》)治吃逆。
羌活 附子(炮) 香(炒,各半两) 木香 白姜(炮,各二钱半)
上五味为未,每服二钱,水一盏,盐一捻,煎十数沸,热服一服止。
《补遗》治产后吃逆。橘皮汤及大小橘皮汤皆效。
上诸方当审寒热虚实用之,如寒者宜丁香、姜、桂,热者宜干柿、竹茹,实者宜香
附、橘皮,虚者宜人参,甚则附子佐之。误施则有噬脐之悔,慎之。
【戴元礼】肺主司气机,五脏六腑的气血运行都依赖于气。产后气血受损,脏腑功能随之减弱,若风冷之邪与气相搏结,导致气机上逆;加之脾虚生内寒,胃中潜伏寒气,此时若进食热性食物,冷热之气在体内相互冲击,致使气机厥逆而不顺畅,从而产生呃逆(打嗝)。脾脏位于中焦,是三焦气机升降的枢纽,也是五脏营养物质的仓库,负责贮藏水谷精微。如果阴阳之气虚弱,导致营卫之气厥逆上行,就会引发这种病症。《内经》记载:“呃逆和嗳气,是由胃寒引起的。”若服药无效,可艾灸期门穴三壮,必定痊愈。期门穴是胃经的大络脉所在之处。
【薛己】上述证候属于胃气虚寒的危重表现。如果使用前面的方剂没有见效,应立即投用参附汤,也有起死回生的案例。
参附汤(参见前文自汗章节)。
丁香散:治疗产后心烦、咳嗽及呃逆不止。
药材:丁香、白豆蔻仁(各半两)、伏龙肝(一两)。
制法用法:将上述药物研为细末,每次取一钱,用煎好的桃仁、吴茱萸汤调服。如步行五里路程的时间后,再服用一次。
石莲散(参见呕吐章节)。
《产宝》记载治疗产后呃逆,持续三天不止,有生命危险的方法:
药材:桂心(半两)、姜汁(三合)。
制法用法:将两者同煎,取药液二合。用药时,先用大火烤热手掌,按摩背部,待手热时将药汁涂擦全身,直至涂完,效果奇妙。
治疗产后呃逆的另一方:
取干柿子一枚切碎,加水一盏,煎至六分,趁热小口饮用。
又一方:
取古旧墙壁上镜框内的苔垢三四个,加水一小盏,煎至半小盏,趁热服用。
羌活散(出自《灵苑》):治疗呃逆。
药材:羌活、炮附子、炒香附(各半两)、木香、炮白姜(各二钱半)。
制法用法:将以上五味药研为细末。每次服用二钱,加水一盏,加入一捻盐,煎煮十余沸,趁热服用,通常一次即可止住。
《补遗》记载治疗产后呃逆:橘皮汤以及大橘皮汤、小橘皮汤均有效。
以上各方应当根据病证的寒、热、虚、实具体情况选用。如属寒证,适宜使用丁香、生姜、肉桂;属热证,适宜使用干柿、竹茹;属实证,适宜使用香附、橘皮;属虚证,适宜使用人参,病情严重者则辅以附子。若误用则会有噬脐莫及的悔恨,务必谨慎。
[Dai Yuanli] The Lung governs Qi, and the Qi of all five Zang organs and six Fu organs is derived from it. After childbirth, Qi and Blood are damaged, and the functions of the Zang and Fu organs are impaired. If Wind-Cold combats with Qi, causing Qi to rebel upwards, combined with Spleen deficiency leading to accumulated Cold and latent Cold in the Stomach, consuming hot food causes Cold and Heat energies to clash. This results in Qi Jue (rebellious Qi) and obstruction, manifesting as hiccup (e'ni). The Spleen governs the Middle Jiao, serving as the gate for the Three Jiao and the granary of the five Zang organs, storing water and grain essences. If Yin and Yang Qi are deficient, causing Ying-Wei Qi to rebel, this disease arises. The Classics state: "Hiccup and belching are generated by Stomach Cold." If medication is ineffective, moxibustion on Qimen (LR14) for three moxa cones will surely cure it. Qimen is the major collateral point of the Stomach meridian.
[Xue Ji] The aforementioned syndrome belongs to the ominous presentation of Deficiency-Cold of Stomach Qi. If the posterior formula yields no response, urgently administer Shenfu Decoction (Ginseng and Aconite Decoction), and there are cases of recovery from near death.
Shenfu Decoction (see Self-Sweating section above).
Dingxiang San (Clove Powder): Treats postpartum restlessness, coughing, and incessant hiccuping/belching.
Ingredients: Dingxiang (Clove Baihua), Baidoukou Ren (Cardamomi Fructus Rotundus), Fulonggan (Terra Fusca).
Preparation and Administration: Grind the above into a fine powder. Take one qian, mixed with decoction of Tao Ren (Persicae Semen) and Wuzhuyu (Evodiae Fructus). Re-administer after walking for the distance covered in five li.
Shilian San (Lotus Seed Powder) (see Vomiting section).
"Chanbao" records a prescription for postpartum hiccup persisting for three days, approaching death:
Ingredients: Guixin (Cinnamomi Ramulus Cortex), Jiangzhi (Zingiberis Rhizoma Expressum).
Preparation and Administration: Decoct together to obtain two he. While applying, heat the hands over a strong fire and massage the back. Apply the medicinal juice while hot until exhausted; this is miraculous.
Another prescription for postpartum hiccup:
Take one dried persimmon, chop finely, add one zhan of water, decoct to six fen, and drink while hot in small sips.
Another prescription:
Take three or four pieces of moss from ancient wall mirror frames, add a small zhan of water, decoct to half a small zhan, and take while hot.
Qianghuo San (Qianghuo Powder) (from "Lingyuan"): Treats hiccup.
Ingredients: Qianghuo (Notopterygii Rhizoma et Radix), Paofuzi (Prepared Aconiti Lateralis Radix), Xiangfu (Cyperi Rhizoma, stir-fried), Muxiang (Aucklandiae Radix), Baijiang (Zingiberis Rhizoma Recens, roasted).
Preparation and Administration: Grind the five ingredients into powder. Take two qian per dose, with one zhan of water and a pinch of salt. Decoct for more than ten boils, take hot. One dose usually stops the hiccup.
"Buyi" records treatments for postpartum hiccup: Jupi Tang (Tangerine Peel Decoction), as well as Dajupi Tang (Large Tangerine Peel Decoction) and Xiaojupi Tang (Small Tangerine Peel Decoction) are all effective.
The above prescriptions should be selected according to the cold, heat, deficiency, and excess patterns. For Cold patterns, Dingxiang (Clove), Shengjiang (Fresh Ginger), and Rougui (Cinnamon Bark) are suitable. For Heat patterns, Ganshi (Dried Persimmon) and Zhuru (Bambusae Caulis in Taenia) are suitable. For Excess patterns, Xiangfu (Cyperi Rhizoma) and Jupi (Citri Reticulatae Pericarpium) are suitable. For Deficiency patterns, Renshen (Ginseng Radix et Rhizoma) is suitable, and in severe cases, Fuzi (Aconiti Lateralis Radix Praeparata) is added as an assistant. Misapplication leads to regret too late to remedy; proceed with caution.