《金匮》云∶亡津液,胃燥故也。
沈尧封曰∶当用当归、肉苁蓉、生首乌、麻仁、杏仁。不应,用麻仁丸四五十丸。
沈尧封曰∶阴虚于下,则阳易上升,致头痛者,童便最妙。褚侍中云∶童便降火甚速,降血甚神,故为
疗厥逆头疼之圣药。若血虚受风,宜一奇散,即芎归汤也。
薛立斋案载∶一产妇头痛,日用补中益气,已三年。稍劳则恶寒内热,拟作阳虚治,加附子一钱于前
汤中,数剂不发。
沈尧封曰∶有血瘀、血虚、停食、感寒、肝气之异。手按痛减者血虚也。按之痛增者,非停食即瘀血∶
停食则右关脉独实,且有嗳 气;瘀血则所下恶露必少。得热即减者,感寒也。至若厥阴肝脉,抵小腹,
挟胃,又为藏血之脏,血去肝虚,其气易动,一关气恼,陡然脘腹大痛。治法∶血虚宜归 建中;消食
惟楂肉炭最妙,兼和血也;消瘀宜夺命散;感寒者,轻则炮姜、艾叶,重则桂、附、茱萸;肝气作痛,养血
药中加川楝、橘核苦以泄之,重则乌梅,辛散、酸收、苦泄并用。
徐蔼辉曰∶一妇产后腹痛,令其夫以手按之,小腹痛尤甚,下恶露而痛仍不减,知其非瘀,乃燥屎
也。予药一剂,大便润下而愈。姜用川治验∶炮姜五分,丹皮二钱,归身三钱,川芎一钱五分,山楂
二钱炒,枳壳一钱五分炒,麻仁二钱杵烂,桃仁泥二钱,生地二钱,炙甘草四分,加研烂松子仁五粒。
萧赓六曰∶下血过多,肝经血少腹痛,其脉弦者,以熟地、萸肉为君,加白芍、木瓜、蒺藜,一剂可止。
有难产久坐,风入胞门,致腹痛欲绝,其脉浮而弦,续断一两,防风五钱,服之立愈。
《金匮要略》说:津液耗伤,导致胃中干燥的缘故。
沈尧封说:应当使用当归、肉苁蓉、生何首乌、火麻仁、杏仁。如果无效,服用麻仁丸四五十丸。
沈尧封说:下焦阴虚,阳气容易上升,从而导致头痛的,用童便(儿童尿液)最为妙。褚侍中说:童便降火速度极快,止血效果神奇,所以是治疗厥逆头痛的神药。如果是血虚受风,适宜用一奇散,也就是芎归汤。
薛立斋医案记载:一位产妇头痛,每天服用补中益气汤,已经三年了。稍微劳累就出现怕冷和内部发热,打算按照阳虚来治疗,在前面的方剂中加入一钱附子,服用几剂后不再发作。
沈尧封说:腹痛有血瘀、血虚、食积停滞、受寒、肝气郁结等不同情况。用手按压疼痛减轻的是血虚。按压后疼痛加重的是,不是食积就是瘀血:如果是食积,则右关脉单独实大,并且伴有嗳气;如果是瘀血,则排出的恶露必然很少。遇到热痛感减轻的是受寒。至于厥阴肝经,抵达小腹,夹行于胃旁,又是藏血的脏器,失血后肝脏虚弱,肝气容易妄动,一旦生气恼怒,突然脘腹部剧烈疼痛。治疗方法:血虚适宜用当归建中汤;消食积惟有用山楂炭最妙,兼能调和血液;消除瘀血适宜用夺命散;受寒的,轻症用炮姜、艾叶,重症用桂枝、附子、吴茱萸;肝气引起的疼痛,在养血药中加入川楝子、橘核,利用苦味来泄降肝气,重症加乌梅,辛散、酸收、苦泄并用。
徐蔼辉说:一位产妇产后腹痛,让她丈夫用手按压,小腹部疼痛尤其严重,排出恶露后疼痛仍然不减少,知道这不是瘀血,而是燥屎(干结的大便)。给予药物一剂,大便润利而下,病就好了。姜用川的治疗案例:炮姜五分,丹皮二钱,当归身三钱,川芎一钱五分,炒山楂二钱,炒枳壳一钱五分,捣烂的火麻仁二钱,桃仁泥二钱,生地二钱,炙甘草四分,加入研烂的松子仁五粒。
萧赓六说:下血过多,导致肝经血少而腹痛,脉象弦的,以熟地黄、山茱萸为君药,加入白芍、木瓜、蒺藜,一剂就可以止住。有因难产久坐,风气侵入胞门,导致腹痛欲绝,脉象浮而弦的,用续断一两,防风五钱,服用后立即痊愈。
The *Jin Gui Yao Lue* (Essential Prescriptions of the Golden Cabinet) states: It is due to the loss of body fluids and dryness in the Stomach.
Shen Yaofeng said: One should use Dang Gui (Angelicae Sinensis Radix), Rou Cong Rong (Cistanches Herba), Sheng Shou Wu (Polygoni Multiflori Radix Praeparata), Huo Ma Ren (Cannabis Fructus), and Xing Ren (Armeniacae Semen Amarum). If ineffective, administer Ma Ren Wan (Hemp Seed Pill) 40-50 pills.
Shen Yaofeng said: When Yin deficiency occurs in the lower jiao, Yang easily ascends, causing headache; in such cases, Tong Bian (Child's Urine) is most excellent. Chu Shizhong said: Tong Bian descends Fire very rapidly and stops bleeding miraculously, thus it is a sacred medicine for treating Jue Ni (reversal cold) and headache. If it is Blood deficiency with Wind invasion, Yi Qi San (Single Miracle Powder), which is Xiong Gui Tang (Ligusticum and Angelica Decoction), is suitable.
Xue Lizhai's medical case records: A postpartum woman suffered from headache, taking Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) daily for three years. Slight exertion led to aversion to cold and internal heat. It was proposed to treat it as Yang deficiency, adding one qian of Fu Zi (Aconiti Lateralis Radix Praeparata) to the previous decoction. After several doses, the symptoms did not recur.
Shen Yaofeng said: There are differences among Blood stasis, Blood deficiency, Food stagnation, Cold invasion, and Liver Qi [stagnation]. Pain that decreases upon manual pressure indicates Blood deficiency. Pain that increases upon pressure indicates either Food stagnation or Blood stasis: In Food stagnation, the Right Guan pulse alone is excess, accompanied by belching; in Blood stasis, the discharged lochia must be scanty. Pain that alleviates with heat indicates Cold invasion. As for the Jueyin Liver meridian, it reaches the lower abdomen, flanks the Stomach, and is the zang organ that stores Blood. After blood loss, the Liver becomes deficient, and its Qi moves easily. Once angered or annoyed, sudden severe pain in the epigastrium and abdomen occurs. Treatment methods: For Blood deficiency, Gui Jian Zhong Tang (Dang Gui Tonify the Middle Decoction) is suitable; for eliminating food stagnation, Zha Rou Tan (Charred Hawthorn Fruit) is best, as it also harmonizes Blood; for eliminating Blood stasis, Duo Ming San (Life-Restoring Powder) is suitable; for Cold invasion, mild cases use Pao Jiang (Prepared Ginger) and Ai Ye (Mugwort Leaf), while severe cases use Gui Zhi (Cinnamon Twig), Fu Zi (Prepared Aconite Root), and Zhu Yu (Evodia Fruit); for pain caused by Liver Qi, add Chuan Lian Zi (Szechwan Chinaberry Fruit) and Ju He (Tangerine Seed) to Blood-nourishing herbs, using bitterness to drain; in severe cases, add Mei (Mume Fruit), combining acrid dispersing, sour astringing, and bitter draining.
Xu Aihui said: A postpartum woman suffered from abdominal pain. Upon her husband pressing it, the lower abdominal pain was particularly severe. Even after discharging lochia, the pain did not decrease. Knowing it was not Blood stasis but Dry Stool (constipation), he prescribed one dose of medicine. The bowels became moist and moved, and she recovered. Case from Jiang Yongchuan: Pao Jiang (Prepared Ginger) 5 fen, Mu Dan Pi (Moutan Cortex) 2 qian, Dang Gui Shen (Angelica Sinensis Root Heart) 3 qian, Chuan Xiong (Ligusticum Rhizome) 1.5 qian, Chao Shan Zha (Stir-fried Hawthorn Fruit) 2 qian, Chao Zhi Qiao (Stir-fried Aurantium Fructus) 1.5 qian, Chu Lan Huo Ma Ren (Crushed Hemp Seed) 2 qian, Tao Ren Ni (Peach Kernel Paste) 2 qian, Sheng Di Huang (Rehmanniae Radix) 2 qian, Zhi Gan Cao (Prepared Licorice Root) 4 fen, plus five crushed Song Zi Ren (Pine Nut Kernels).
Xiao Gengliu said: Excessive bleeding leads to Blood deficiency in the Liver channel and abdominal pain. If the pulse is Wiry (Xian), use Shu Di Huang (Prepared Rehmannia Root) and Yu Rou (Cornus Fruit) as the sovereign drugs, adding Bai Shao (White Peony Root), Mu Gua (Chaenomeles Fruit), and Ji Li (Tribulus Fruit). One dose can stop the pain. In cases of difficult labor with prolonged sitting, Wind enters the Bao Men (Uterine Gate), causing abdominal pain nearly unbearable. If the pulse is Floating and Wiry, use Xu Duan (Dipsaci Radix) 1 liang and Fang Feng (Saposhnikoviae Radix) 5 qian. Administration leads to immediate recovery.