〔薛〕论见发热条。
四物汤加获神、远志,治产后虚烦,十全大补汤尤效。
〔大〕余血奔心,盖是分解了不便,与童子小便,并 心下,及卧太速,兼食不相
宜之物所致,但能根据方疗之,无不痊可。
疗产后余血不尽,奔冲心,烦闷腹痛。
川芎 生干地黄 枳壳 芍药(各等分为末)
上酒服方寸匕,日二服。
《集验》疗产后血气烦方。(《千金》同。)
生地黄汁 清酒(各一升)
上相和煎一沸,分为两服。
《广济》疗血气烦闷方 生藕汁饮二升效。竹沥亦得。
疗产后七日内宿血不散,时时冲心迷闷。
荷叶(一两七钱半) 延胡索(二两) 地黄汁(二合)
上水二升,煮二味,取八合,下延胡索,分三服,空心。忌肉食一日。
疗产后余血攻心,或下血不止,心闷面青,冷气欲绝。
羊血一盏,顿服。若不定,更服立效。
《经效》疗产后气虚,冷搏于血,血气结滞,上冲心腹胀满。
当归 桂心 川芎 吴茱萸 橘皮 生姜(各一两) 芍药(二两)
上 咀,以水三升,煮取一升,去渣空心服。
治产后余血奔心。
用陈白梅捶碎,渴,煎汤饮。
金黄散 治产后恶血冲心,时发烦躁。
玄胡索 蒲黄(各半两) 桂心(二钱半)
上为细末,乌梅煎汤,冷调下二钱。
没药丸 治产后心胸烦躁,恶血不快。
没药(研) 蛮姜 延胡索 干漆(炒) 当归 桂心 牛膝 牡丹皮 干姜(各等分)
上为细末,醋煮面糊丸,如梧桐子大。煎曲汤下十丸至十五丸。
《补遗》治产后余血冲心,烦闷腹痛。
用蒲黄(不以多少,)隔纸炒,每一钱,东流水煎汤调下。又失笑散亦佳。
治产后短气欲绝,心中烦闷,竹叶汤。
竹叶(切细) 麦门冬 小麦(各一升) 甘草(一两) 生姜(二两) 大枣(十二枚)
上切,以水一斗,煮竹叶、小麦至八升,去渣纳余药,煮取三升,去渣温服。虚悸加
人参二两,少气力加糯米五合。
甘竹茹汤 治产后内虚,烦热短气方。
甘竹茹(一升) 人参 茯苓 甘草(各一两) 黄芩(三两)
上 咀,以水六升,煮取二升,去渣分三服,日三。
人参当归汤 治产后去血过多,血虚则阴虚,阴虚生内热,令人心烦短气,自汗头痛。
熟地黄 人参(去芦) 当归身(去芦) 肉桂(去粗皮) 麦门冬(去心,各二钱)
白芍药(炒,二钱半) 血热甚者,加生地黄二钱。
水二盅,粳米一合,竹叶十片,煎至一盅,食远服。
薤白汤 治产后胸中烦热逆气方。
薤白 半夏 甘草 人参(各一两) 栝蒌根(二两) 麦门冬(半升)
上 咀,以水一斗三升,煮取四升,去渣分五服,日三夜二。热甚加知母一两。
云岐治产后虚烦不得眠。芍药栀豉汤。
芍药 当归 栀子(各五钱) 香豉(半合)
上如栀子豉汤修服。产后伤寒,便同下后变证。(此方虽云岐法,不若仲景酸枣汤稳当。)
仲景二物黄芩汤 妇人在草褥,自发露得风,四肢苦烦热头痛者,与小柴胡汤,头
不痛但烦者,此汤主之。(小柴胡汤见伤寒少阳病。)
黄芩(一两) 苦参(二两) 干地黄(四两)
上三味,以水八升,煮取二升,温服一升,多吐下虫。
妇人产中虚,烦乱呕逆,安中益气,竹皮大丸主之。
生竹茹 石膏(各二分) 桂枝 白薇(各一分) 甘草(七分)
上五味末之,枣肉和丸,弹子大。每以饮服一丸,日三夜二服。有热者倍白薇,烦
喘者加柏实一分。
〔陈〕寻常治诸虚烦热者。以竹叶石膏汤、温胆汤,殊不知产后与寻常不同,如石
膏等药,不宜轻用,用之必死。
经验方 治产后烦躁。
禹余粮一枚,状如酸馅者,入地埋一半,四面筑紧,用炭一秤,发顶火一斤 ,去火,
三分耗二为度,用湿沙土罨一宿,方取出,打去外面一层,只用里内,细研水淘,澄五七
度,将纸衬干,再研数千遍,用甘草煎汤调二钱匕,一服立效。
〔薛〕关于虚烦的论述,请参见“发热”条目。
四物汤加茯神、远志,用于治疗产后虚烦,十全大补汤效果更佳。
〔大〕余血奔心,是因为恶露分解排泄不畅,加上饮用童子小便,以及进食后立刻躺下,兼吃不相宜的食物所导致。只要根据方剂治疗,没有不能痊愈的。
治疗产后余血不尽,上冲于心,导致烦闷腹痛。
川芎、生干地黄、枳壳、芍药(各等分为末)。
以上药物用酒送服一方寸匕,每日两次。
《集验》治疗产后血气烦闷的方子。(《千金方》相同。)
生地黄汁、清酒(各一升)。
以上两味相和煎煮至沸腾一次,分两次服用。
《广济》治疗血气烦闷的方子:饮用生藕汁二升有效。竹沥也可以。
治疗产后七日内宿血不散,时时上冲心胸导致迷闷。
荷叶(一两七钱半)、延胡索(二两)、地黄汁(二合)。
以上用水二升,煎煮前两种药,取八合药液,加入延胡索,分三次空腹服用。忌食肉食一天。
治疗产后余血攻心,或者下血不止,心中烦闷面色青紫,冷气欲绝。
羊血一盏,一次性顿服。如果症状未定,再服用立即见效。
《经效》治疗产后气虚,冷邪搏结于血,导致血气结滞,上冲引起心腹胀满。
当归、桂心、川芎、吴茱萸、橘皮、生姜(各一两)、芍药(二两)。
以上药物切碎,用水三升,煎取一升,去渣,空腹服用。
治疗产后余血奔心。
用陈年白梅捶碎,口渴时煎汤饮用。
金黄散:治疗产后恶血冲心,时常发作烦躁。
玄胡索、蒲黄(各半两)、桂心(二钱半)。
以上研为细末,用乌梅煎汤,冷却后调服二钱。
没药丸:治疗产后心胸烦躁,恶血运行不畅。
没药(研)、蛮姜、延胡索、干漆(炒)、当归、桂心、牛膝、牡丹皮、干姜(各等分)。
以上研为细末,用醋煮面糊制成梧桐子大小的丸药。煎曲汤送服十丸至十五丸。
《补遗》治疗产后余血冲心,烦闷腹痛。
用蒲黄(不限多少),隔纸炒,每次一钱,用东流水煎汤调服。另外失笑散也很好。
治疗产后短气欲绝,心中烦闷,竹叶汤。
竹叶(切细)、麦门冬、小麦(各一升)、甘草(一两)、生姜(二两)、大枣(十二枚)。
以上切碎,用水一斗,先煎竹叶、小麦至八升,去渣加入其余药物,煎取三升,去渣温服。若见虚悸加人参二两,若少气力加糯米五合。
甘竹茹汤:治疗产后内虚,烦热短气的方子。
甘竹茹(一升)、人参、茯苓、甘草(各一两)、黄芩(三两)。
以上切碎,用水六升,煎取二升,去渣分三次服用,每日三次。
人参当归汤:治疗产后失血过多,血虚则阴虚,阴虚生内热,导致人心烦短气,自汗头痛。
熟地黄、人参(去芦)、当归身(去芦)、肉桂(去粗皮)、麦门冬(去心,各二钱)、白芍药(炒,二钱半)。血热甚者,加生地黄二钱。
用水二盅,粳米一合,竹叶十片,煎至一盅,饭后服用。
薤白汤:治疗产后胸中烦热逆气的方子。
薤白、半夏、甘草、人参(各一两)、栝蒌根(二两)、麦门冬(半升)。
以上切碎,用水一斗三升,煎取四升,去渣分五次服用,白天三次,夜间两次。热甚加知母一两。
云岐治疗产后虚烦不得眠。使用芍药栀豉汤。
芍药、当归、栀子(各五钱)、香豉(半合)。
以上按照栀子豉汤的方法煎服。产后伤寒,其变证同于下法后的变证。(此方虽出自云岐之法,但不如仲景的酸枣汤稳妥。)
仲景二物黄芩汤:妇女在产褥期,因自发露受风,四肢苦于烦热头痛者,给予小柴胡汤;头不痛但烦闷者,此汤主治之。(小柴胡汤见伤寒少阳病篇。)
黄芩(一两)、苦参(二两)、干地黄(四两)。
以上三味,用水八升,煎取二升,温服一升,多会吐出或泻出虫体。
妇女生产中虚弱,烦乱呕逆,安中益气,用竹皮大丸主治。
生竹茹、石膏(各二分)、桂枝、白薇(各一分)、甘草(七分)。
以上五味研为末,用枣肉和丸,如弹子大小。每次用饮服一丸,白天三次,夜间两次。有热者加倍白薇,烦喘者加柏实一分。
〔陈〕通常治疗各种虚烦热者,多用竹叶石膏汤、温胆汤,殊不知产后与寻常不同,如石膏等药,不宜轻用,用了必死。
经验方:治疗产后烦躁。
禹余粮一枚,形状像酸馅子的,埋入地下的一半处,四面筑紧,用炭一秤,发顶火一斤,烧去火力,以消耗掉三分之二为度,用湿沙土覆盖一夜,才取出,打去外面一层,只用内部,细研后用水淘洗,澄清五七次,将纸衬干,再研数千遍,用甘草煎汤调服二钱匕,一服立效。
[Xue] The discussion on deficiency vexation can be found under the entry "Febrile Disease" (Fever).
Siwu Tang (Four-Substance Decoction) with added Fushen (Poria with Hostwood) and Yuanzhi (Polygala Root) is used to treat postpartum deficiency vexation; Shiquan Dabu Tang (Ten-Increment Great Tonifying Decoction) is even more effective.
[Da] Blood rushing to the heart due to residual lochia occurs because the decomposition and discharge of lochia are obstructed, combined with drinking child's urine, lying down immediately after eating, and consuming incompatible foods. As long as treatment follows the formula, recovery is certain.
To treat residual lochia not fully expelled postpartum, rushing to the heart causing vexation and abdominal pain:
Chuanxiong Rhizome (Chuanxiong), Raw Prepared Rehmannia Root (Sheng Dihuang), Aurantium Fruit (Zhiqiao), Peony Root (Shaoyao) (equal parts, ground into powder).
Take one fangcun bi (approx. 5-10 grams) with wine, twice daily.
Jiyan Fang (Collected Proven Prescriptions) treats postpartum blood and qi vexation. (Same as Qianjin Fang.)
Raw Rehmannia Juice (Sheng Dizhi), Clear Wine (Qingjiu) (each 1 sheng).
Mix and boil once, divide into two doses.
Guangji Fang (Guangji Prescriptions) treats blood and qi vexation: Drinking 2 sheng of fresh lotus root juice is effective. Bamboo sap (Zhuli) is also acceptable.
To treat residual blood remaining for seven days postpartum that does not dissipate, occasionally rushing to the heart causing dizziness and stifling sensation:
Lotus Leaf (Heye) (1 liang 7 qian 5 fen), Corydalis Rhizome (Yanhusuo) (2 liang), Rehmannia Juice (Dihuang Zhi) (2 he).
Add water 2 sheng, decoct the first two ingredients to obtain 8 he, then add Corydalis Rhizome. Divide into three doses, taken on an empty stomach. Avoid meat for one day.
To treat residual lochia attacking the heart postpartum, or continuous bleeding, with chest stifling, cyanotic complexion, and feeling of cold approaching death:
Sheep blood (Yangxue) 1 zhan, taken in one dose. If symptoms persist, take again for immediate effect.
Jingxiao Fang (Effective Prescriptions) treats postpartum qi deficiency where cold pathogens clash with blood, causing blood and qi stagnation, rushing upward leading to chest and abdominal fullness:
Angelica Sinensis Radix (Danggui), Cinnamon Twig Heart (Guixin), Chuanxiong Rhizome (Chuanxiong), Evodia Fruit (Wuzhuyu), Tangerine Peel (Jupi), Fresh Ginger (Shengjiang) (each 1 liang), Peony Root (Shaoyao) (2 liang).
Coarsely crush the herbs, add water 3 sheng, decoct to obtain 1 sheng, remove dregs, and take on an empty stomach.
To treat residual lochia rushing to the heart postpartum:
Use aged white plums, crushed, decocted into soup when thirsty.
Jinhuang San (Golden Powder) treats postpartum evil blood rushing to the heart, with intermittent irritability.
Corydalis Rhizome (Yanhusuo), Pollen Typhae (Puhuang) (each ban liang), Cinnamon Twig Heart (Guixin) (2 qian 5 fen).
Grind into fine powder, mix with sour plum decoction, cool, and take 2 qian.
Moyao Wan (Myrrh Pill) treats postpartum chest and heart irritability and sluggish evil blood:
Myrrh (Mo Yao, ground), Galangal (Manjiang), Corydalis Rhizome (Yanhusuo), Processed Dry Bitumen (Ganqi, stir-fried), Angelica Sinensis Radix (Danggui), Cinnamon Twig Heart (Guixin), Achyranthes Root (Niuxi), Moutan Bark (Mudanpi), Dried Ginger (Ganjiang) (equal parts).
Grind into powder, make pills using vinegar-boiled wheat paste, size of paulownia seeds. Take 10-15 pills with fermented grain soup.
Buyi (Supplement) treats postpartum residual lochia rushing to the heart, causing vexation and abdominal pain:
Use Puhuang (amount unspecified), stir-fry between papers. Take 1 qian each time, mixed with east-flowing water decoction. Also, Shixiao San (Decoction for Stopping Pain) is excellent.
For postpartum shortness of breath approaching death and chest vexation, use Zhuye Tang (Bamboo Leaf Decoction):
Bamboo Leaves (Zhuye, finely cut), Ophiopogon Tuber (Mendong), Wheat (Xiaomai) (each 1 sheng), Licorice Root (Gancao) (1 liang), Fresh Ginger (Shengjiang) (2 liang), Jujube (Dazao) (12 pieces).
Cut all ingredients, add water 1 dou, decoct bamboo leaves and wheat until 8 sheng remain, remove dregs, add remaining herbs, decoct to obtain 3 sheng, remove dregs, and take warm. For deficiency palpitations, add Ginseng Radix et Rhizoma (Renshen) 2 liang; for weakness, add Glutinous Rice (Nuomi) 5 he.
Ganzhuru Tang (Sweet Bamboo Sheath Decoction) treats postpartum internal deficiency with vexation, heat, and shortness of breath:
Prepared Bamboo Sheath (Ganzhuru) (1 sheng), Ginseng Radix et Rhizoma (Renshen), Poria (Fuling), Licorice Root (Gancao) (each 1 liang), Scutellaria Root (Huangqin) (3 liang).
Coarsely crush, add water 6 sheng, decoct to obtain 2 sheng, remove dregs, divide into three doses, three times daily.
Renshen Danggui Tang (Ginseng and Angelica Decoction) treats excessive blood loss postpartum leading to blood deficiency and yin deficiency, generating internal heat, causing chest vexation, shortness of breath, spontaneous sweating, and headache:
Prepared Rehmannia Root (Shudihuang), Ginseng Radix et Rhizoma (Renshen, removed rhizome), Angelica Sinensis Radix Body (Danggui Shen, removed rhizome), Cinnamon Bark (Rougui, removed coarse bark), Ophiopogon Tuber (Mendong, removed heart) (each 2 qian), White Peony Root (Baishaoyao, stir-fried) (2 qian 5 fen). For severe blood heat, add Raw Rehmannia Root (Shengdihuang) 2 qian.
Add water 2 zhong, Glutinous Rice (Jingmi) 1 he, Bamboo Leaves (Zhuye) 10 leaves, decoct to 1 zhong, take well after meals.
Xiebai Tang (Allium Macrostemon Decoction) treats postpartum chest vexation, heat, and rebellious qi:
Allium Macrostemon Bulb (Xiebai), Pinellia Tuber (Banxia), Licorice Root (Gancao), Ginseng Radix et Rhizoma (Renshen) (each 1 liang), Trichosanthes Root (Gualougen) (2 liang), Ophiopogon Tuber (Mendong) (ban sheng).
Coarsely crush, add water 1 dou 3 sheng, decoct to obtain 4 sheng, remove dregs, divide into five doses, three times by day and twice by night. For severe heat, add Anemarrhena Rhizome (Zhimu) 1 liang.
Yunqi treated postpartum deficiency vexation with insomnia using Shaoyao Zhichi Tang (Peony and Fermented Soybean Decoction):
White Peony Root (Shaoyao), Angelica Sinensis Radix (Danggui), Gardenia Fruit (Zhizi) (each 5 qian), Fermented Soybean (Xiangchi) (ban he).
Prepare and take according to Zhizi Chi Tang method. Postpartum cold damage presents similarly to complications after purging. (Although this prescription originates from Yunqi, it is less stable than Zhongjing's Suanzaoren Tang.)
Zhongjing's Erwu Huangqin Tang (Two-Ingredient Scutellaria Decoction): When a woman in the puerperium exposes herself to wind, suffering from vexation and heat in the four limbs and headache, give Xiaochaihu Tang (Minor Bupleurum Decoction); if there is no headache but only vexation, this decoction governs. (See Xiaochailu Tang under Shaoyang Disease in Cold Damage Treatise.)
Scutellaria Root (Huangqin) (1 liang), Sophora Root (Kushen) (2 liang), Prepared Rehmannia Root (Gan Dihuang) (4 liang).
These three ingredients, add water 8 sheng, decoct to obtain 2 sheng, take 1 sheng warm; often results in vomiting or purging of parasites.
When women are deficient during childbirth, experiencing vexation, disarray, nausea, and vomiting, to calm the middle and benefit qi, use Zhupi Dawan (Bark Pill).
Raw Bamboo Sheath (Sheng Zhuru), Gypsum (Shigao) (each 2 fen), Cinnamon Twig (Guizhi), Anemarrhena Root (Baiwei) (each 1 fen), Licorice Root (Gancao) (7 fen).
Grind these five into powder, mix with jujube flesh to form pills the size of a bullet. Take one pill with water, three times by day and twice by night. Increase Baiwei if there is heat; add Platycladi Seed (Baishi) 1 fen if there is vexation and panting.
[Chen] Usually, various deficiency vexation and heat conditions are treated with Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) or Wendan Tang (Warm Gallbladder Decoction). However, one must not ignore that postpartum conditions differ from ordinary ones; drugs like Gypsum should not be used lightly, as doing so will cause death.
Empirical Prescription for treating postpartum irritability:
One piece of Yuyuliang (Halloysitum Rubrum), shaped like a sour filling, bury half of it in the ground, compacting the surroundings tightly. Burn one cheng of charcoal and one jin of hair ash. After extinguishing the fire, allow two-thirds to consume. Cover with wet sandy soil overnight, then retrieve. Remove the outer layer, use only the inner part, grind finely, wash with water, clarify five to seven times, dry on paper, and grind thousands of times more. Mix with Licorice decoction, take two qianbi, effective immediately.