大全云∶夫五脏六腑俱禀气于胃,而肺为主气之总司,若产后致伤气血,则脏腑气损,
而风冷搏之,肺因气逆而上则呃逆矣。又脾虚气冷,胃中伏寒,因食热物、冷热相击,气厥而
不顺,则呃逆也(言聚冷内因也,然又有痰热
虚呃之不同,并宜详辨)。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∶呃噫者,胃寒所生。服药无效者,灸期门(期门在乳下)三
壮必愈。期门穴乃胃之大络。
薛氏曰∶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。
丁香散 治产后心烦,咳噫不止。
丁香 白豆蔻(各半两) 伏龙肝(一两)
上为细末,每服一钱,煎桃仁吴茱萸汤调下,如人行五里再服。(此治咳逆也,而何又有
心烦焉,阅此方咳逆是虚寒气滞,心烦是败血瘀留,不然何以用桃仁同吴萸为汤也,当识之)
姜桂散 治产后咳逆,三日不止欲死。
肉桂(五钱) 姜汁(三合)
上锉,同煎,服三合,以大火炙手,摩令背热,时时涂药汁尽,妙。(此治寒自背入而咳逆
也,摩背法极妙,其曰时时涂药汁尽,则既服之外,又以药涂手摩之也)
羌活散 治呃逆。
羌活 附子(炮) 茴香(炒,各半两) 木香 白姜(炮,各二钱半)
上为末,每服二钱,水一盏,盐一捻,煎十数沸,热服,一服止。(治下元虚;中气弱,而又
为外感寒邪者设也,妙在用盐)
一方 治产后呃逆。
干柿一个切碎,以水一盏煎六分,热呷。(吃逆症俱用柿蒂,而此用干柿,意自有别)
一方 治产后呃逆三五日不止。
陈壁窠三五个,水煎呷,瘥。(即蜂子窠,壁窠土蜂窠也)
补遗 治产后呃逆,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,误施则噬脐之悔,慎之。
《大全》记载:五脏六腑都依赖胃气滋养,而肺是主司全身之气的总枢纽。如果产后导致气血损伤,脏腑之气受损,风冷邪气侵袭搏结,肺气因气机上逆而向上冲,就会发生呃逆。另外,脾虚气冷,胃中有潜伏的寒邪,因为吃了热性食物,冷热相互激荡,气机厥逆而不顺畅,也会导致呃逆(这里说的是内聚寒冷导致的病因,然而又有痰热、虚证呃逆的不同,应当仔细辨别)。脾位于中焦,是三焦的关隘,也是五脏的仓库,储存水谷精微。如果阴阳之气虚弱,导致营卫之气厥逆,就会产生这种病。医经说:呃逆和嗳气,是由胃寒引起的。服药无效时,灸期门穴(位于乳头下方)三壮必定痊愈。期门穴是胃的大络脉所在。
薛己说:上述症状属于胃气虚寒的危重证候,如果使用后面的方剂没有见效,应立即投用参附汤,也有起死回生的案例。
丁香散:治疗产后心烦,咳嗽伴呃逆不止。
丁香、白豆蔻(各半两)、伏龙肝(一两)。
以上药物研成细末,每次服用一钱,用桃仁、吴茱萸煎汤调服,如人行走五里的时间后再服一次。(这是治疗咳逆的,为什么又有心烦呢?阅读此方可知,咳逆是虚寒气滞所致,心烦是败血瘀留所致,否则为何要用桃仁同吴茱萸煎汤呢?应当明白这一点。)
姜桂散:治疗产后咳逆,三天不止,痛苦欲死。
肉桂(五钱)、姜汁(三合)。
以上药物切碎,共同煎煮,服用三合,同时用大火烤热双手,按摩背部使其发热,时常涂抹药汁直至用完,效果奇妙。(这是治疗寒气从背部侵入导致的咳逆,按摩背部的方法极为巧妙,所谓“时时涂药汁尽”,是指除了内服之外,还用药汁涂手进行按摩。)
羌活散:治疗呃逆。
羌活、炮附子、炒小茴香(各半两)、木香、炮白姜(各二钱半)。
以上药物研成粉末,每次服用二钱,用水一盏,盐一捻,煎煮十余沸,热服,一服即可止住。(这是针对下元虚损、中气虚弱,又外感寒邪的情况设立的,妙在用盐。)
另一方:治疗产后呃逆。
干柿一个切碎,用水一盏煎至六分,趁热慢慢饮用。(治疗呃逆症通常都用柿蒂,但此处用干柿,用意自然不同。)
另一方:治疗产后呃逆持续三五天不止。
陈年墙壁上的蜂巢三五个,用水煎煮后慢慢饮用,病愈。(即蜂子窠,壁窠指土蜂在墙上做的窠。)
以上各方应当审察寒热虚实的具体情况使用。如属寒证,适宜用丁香、生姜、肉桂;属热证,适宜用干柿、竹茹;属实证,适宜用香附、陈皮;属虚证,适宜用人参,严重时辅以附子。误用则会有噬脐莫及的悔恨,务必谨慎。
The *Daquan* records: The five zang organs and six fu organs all derive their qi from the Stomach, while the Lung is the chief manager of the body's qi. If postpartum injury damages the blood and qi, causing deficiency in the zang and fu organs' qi, and wind-cold pathogens attack and contend with it, the Lung's qi rebels and ascends, resulting in hiccup (Hiccup). Furthermore, Spleen deficiency with cold qi and latent cold in the Stomach, caused by consuming hot foods that clash with the internal cold, leading to qi rebellion and obstruction, also causes hiccup. (This refers to the internal accumulation of cold as the cause; however, there are differences such as phlegm-heat and deficient hiccups, which must be carefully distinguished.) The Spleen governs the Middle Jiao, serves as the gate for the Three Jiao, and acts as the granary of the five zang organs, storing water and grain essences. If yin and yang qi are deficient, causing the Ying and Wei qi to rebel, this disease arises. The Classics state: Hiccup and belching are generated by Stomach cold. When medication is ineffective, moxibustion on Qimen (LR14) [located below the nipple] three moxa cones will surely cure it. Qimen is the great collateral of the Stomach.
Xue Ji stated: The aforementioned symptoms belong to the ominous condition of Stomach qi deficiency and cold. If the following formula does not yield results, urgently administer Shenfu Decoction (Ginseng and Aconite Decoction), and there have been cases of recovery from near death.
Dingxiang San (Clove Powder): Treats postpartum mental restlessness and continuous coughing with hiccup.
Dingxiang (Clove), Baidoukou (Cardamomi Fructus Rotundus) (each 0.5 liang), Fulonggan (Dragon's Liver) (1 liang).
Grind the above into a fine powder. Take 1 qian each time, mixed with decoction of Tao Ren (Persicae Semen) and Wuzhuyu (Evodiae Fructus). Repeat the dose after the time it takes for a person to walk five li. (This treats cough-hiccup; why is there mental restlessness? Reading this formula reveals that cough-hiccup is due to deficiency-cold and qi stagnation, while mental restlessness is due to retained敗血 [damaged blood] stasis. Otherwise, why use Tao Ren with Wuzhuyu as a decoction? One must understand this.)
Jianggui San (Ginger and Cinnamon Powder): Treats postpartum cough-hiccup lasting three days without relief, causing extreme distress.
Rougui (Cinnamomi Cortex), Jiangzhi (Zingiberis Juice) (3 he).
Chop the above ingredients and decoct them together. Take 3 he. Simultaneously, heat hands over a strong fire and massage the back until it feels warm. Frequently apply the medicinal juice until exhausted. This is miraculous. (This treats hiccup caused by cold entering from the back. The method of massaging the back is excellent. "Frequently apply the medicinal juice until exhausted" means that besides oral administration, the juice is applied to the hands for massage.)
Qianghuo San (Notopterygii Radix Powder): Treats hiccup.
Qianghuo (Notopterygii Rhizoma et Radix), Pao Fuzi (Prepared Aconiti Lateralis Radix), Chao Huixiang (Stir-fried Foeniculi Fructus) (each 0.5 liang), Muxiang (Aucklandiae Radix), Pao Baijiang (Prepared Zingiberis Rhizoma) (each 2.5 qian).
Grind the above into powder. Take 2 qian each time with one cup of water and a pinch of salt. Boil for more than ten boils. Drink hot. One dose stops the hiccup. (This is prescribed for deficiency of the Lower Yuan, weak Middle Qi, and external contraction of cold pathogens. The brilliance lies in the use of salt.)
Another prescription: Treats postpartum hiccup.
One dried persimmon, chopped finely. Decoct with one cup of water until reduced to 0.6 cups. Sip hot. (Persimmi Calyx is commonly used for hiccup, but here dried persimmon is used, implying a different intention.)
Another prescription: Treats postpartum hiccup persisting for three to five days.
Three or five Chenbi Ke (Old wall wasp nests). Decoct with water and sip. The illness will heal. (These are wasp nests, specifically earth wasp nests on walls.)
Supplement: For treating postpartum hiccup, Jupi Tang (Tangerine Peel Decoction) and Da/Small Jupi Tang are both effective.
The above formulas should be used according to an assessment of cold, heat, excess, and deficiency. For cold patterns, Dingxiang, Shengjiang, and Rougui are suitable; for heat patterns, Ganshi and Zhuru are suitable; for excess patterns, Xiangfu and Chenpi are suitable; for deficiency patterns, Renshen is suitable, supplemented by Fuzi in severe cases. Misapplication leads to regret too late to remedy; proceed with caution.