大全云∶夫产后恶露不绝者,由产后伤于经血,虚损不足,或分解之时,恶血不尽,在于
腹中,而脏腑挟于宿冷,致气血不调,故令恶露淋沥不绝也。
薛氏曰∶前证若肝气热而不能主血,用六味地黄丸;若肝气虚而不能藏血,用逍遥散;
若脾气虚而不能摄血,用六君子汤;若胃气下陷,而不能统血,用补中益气汤;若脾经郁热
而血不归源(以下诸方失载,当考立斋良方),用加味归脾汤;若肝经怒火而血妄行,用加味
四物汤;若气血俱虚,用十全大补汤;若肝经风邪而血沸腾,用一味防风丸。
芎归加芍药汤 治产后血崩眩晕,不知人事。
川芎 当归 芍药(各等分)(产后忌芍药,而此方用之,亦血崩者无忌耳)
上 咀,每服四钱,水煎热服。一方加黄芩、白术。
加味四物汤 治产后血崩如豆汁,紫黑过多者。(有谓如豆汁者湿,紫黑者热,
又曰寒过多者虚,此方不寒不热不燥,故可通用)
川芎 当归 芍药 生地 蒲黄 阿胶
蓟根 白芷
上水煎服。
一方 疗产后七八日,恶露不止。
败酱草(败酱治多年凝血,产后诸病腹痛,则此亦去故生新药也) 当归(各六分) 芍药 续断(
各八分) 川芎 竹茹(各四分) 生地黄(炒干,十二分)
上细锉,以水二升煮取八合,空心顿服。
以上补虚之剂。
加味四物汤 治产后月余,经血淋沥不止,此陷下者举之也。
当归 川芎 白芍 熟地 白芷 升麻(各一钱) 血余灰(另入)
上锉,水煎服。(族弟妇产后半月,离蓐过劳,下血倾盆,急以求救,余用此药一服立止,其效如神。)
千金方 治产后恶血不尽,或经月或半岁者。
升麻三两,清酒五升煮取二升半,分温再服。
以上升提之剂。
乌金散 治产后血迷血晕,败血不止,淋沥不断,脐腹绞痛,头目昏眩,多汗无力,及崩
中下血不止。(诸症皆从败血不止来,此方之妙,不在止而在行,行则归经而止矣。治崩者,要得此旨)
麒麟竭 男子乱发灰 松墨( 醋淬) 百草霜 当归 肉桂 赤芍 玄胡索 鲤鱼鳞(烧存性,
各等分)
上为末,每服二钱,空心温酒调下。
一方 治产后恶血不绝,崩血不可禁,腹中绞痛,气息急。
乱发(烧,一两) 阿胶(二两) 代赭石 干姜(各三两) 干地黄(四两)(妙在地黄
为君) 马蹄壳(烧,一个) 牛角腮(五两,酥炙)
上为细末,炼蜜丸如梧桐子大,每服三四十丸,空心米饮下,日二服。
豆淋酒 治产后犹有余血水气者。(余血瘀血也,故用行法)
黑豆五升熬令烟尽,投瓷器内,以酒一斗,淬之饮,盖豆淋酒治污血,又能发表也。
蒲醋饮子 治新产压血,逐败滋新,此药治血神效,又非黑神散之可比也。月内每日一
二服尤良,及疗一切恶露与血积。
真蒲黄不拘多少,熬米醋令稠,和药成膏,每服一弹子大,食前醋汤化开服。(二味有
且战且守之能)
一方用蒲黄二两,水煎顿服。
一方 治产后泄血不止,无禁度,及治腹痛胸膈闷。
姜黄为末,酒服方寸匕,日三四服。
胡氏曰∶姜黄治恶露不止。
以上行污血之剂。
牡蛎散 治产后恶露淋沥不断,心闷短气,四肢乏弱,头目昏重,五心烦热,面黄体瘦。
牡蛎粉( ) 川芎 熟地 茯苓 龙骨(各二钱) 当归(炒) 续断 艾叶 人参 五味子
地榆(各一钱) 甘草(五分)
上锉,分二帖,加生姜三片,枣一枚,水煎,食前服。此收涩之剂,虚脱者宜用。
《大全》说:产后恶露不绝,是因为产后损伤了经血,导致身体虚损不足;或者在分娩过程中,恶血没有排尽,残留于腹中,加上脏腑本身带有宿疾之冷,致使气血不调,从而导致恶露淋漓不断。
薛氏(薛己)说:上述病症,如果是肝气热而不能统摄血液,使用六味地黄丸;如果是肝气虚而不能藏血,使用逍遥散;如果是脾气虚而不能摄血,使用六君子汤;如果是胃气下陷而不能统血,使用补中益气汤;如果是脾经郁热而血不归源(以下各方原书未载,应当考证立斋良方),使用加味归脾汤;如果是肝经怒火导致血液妄行,使用加味四物汤;如果是气血俱虚,使用十全大补汤;如果是肝经风邪导致血液沸腾,使用一味防风丸。
芎归加芍药汤:治疗产后血崩眩晕,人事不知。
药材:川芎、当归、芍药(各等分)。(注:产后通常忌用芍药,但此方中使用,是因为血崩患者对此无忌。)
制法与用法:将药材切碎,每次服用四钱,加水煎煮后热服。另一版本加入黄芩、白术。
加味四物汤:治疗产后血崩如豆汁状,或紫黑色过多的情况。(有人说如豆汁状属湿,紫黑色属热,又说寒过多则虚。此方不寒不热不燥,因此可以通用。)
药材:川芎、当归、芍药、生地、蒲黄、阿胶、蓟根、白芷。
制法与用法:加水煎煮服用。
另一方:治疗产后七八天,恶露不止。
药材:败酱草(败酱能治疗多年的凝血及产后各种腹痛疾病,因此这也是去旧生新的药物)、当归(各六分)、芍药、续断(各八分)、川芎、竹茹(各四分)、生地黄(炒干,十二分)。
制法与用法:将药材细切,用水二升煮取八合,空腹一次性服用。
以上为补虚的药剂。
加味四物汤:治疗产后一个多月,经血淋漓不止,这是采用“陷下者举之”(提升下陷之气)的方法。
药材:当归、川芎、白芍、熟地、白芷、升麻(各一钱)、血余灰(另入)。
制法与用法:切碎,加水煎煮服用。(族弟妇产后半月,因离床过早劳累,下血如倾盆,急忙求救,我使用此药一服即止,效果神奇。)
千金方:治疗产后恶血不尽,或持续一个月甚至半年的情况。
药材:升麻三两,清酒五升,煮取二升半,分两次温服。
以上为升提的药剂。
乌金散:治疗产后血迷血晕,败血不止,淋漓不断,脐腹绞痛,头目昏眩,多汗无力,以及崩中下血不止。(这些症状都源于败血不止,此方的妙处不在于止血而在于行血,行血则血归经脉而自止。治疗崩漏者,要领悟这一宗旨。)
药材:麒麟竭、男子乱发灰、松墨(醋淬)、百草霜、当归、肉桂、赤芍、玄胡索、鲤鱼鳞(烧存性,各等分)。
制法与用法:研为末,每次服用二钱,空腹用温酒调服。
另一方:治疗产后恶血不绝,崩血不可控制,腹中绞痛,气息急促。
药材:乱发(烧,一两)、阿胶(二两)、代赭石、干姜(各三两)、干地黄(四两)(妙在地黄作为君药)、马蹄壳(烧,一个)、牛角腮(五两,酥炙)。
制法与用法:研为细末,炼蜜制成梧桐子大小的丸剂,每次服用三四十丸,空腹用米饮送服,每日两次。
豆淋酒:治疗产后仍有残余血水气的情况。(余血即瘀血,所以使用行血的方法。)
制法与用法:黑豆五升熬至烟尽,投入瓷器内,用一斗酒淬之饮用。盖豆淋酒能治污血,又能发表。
蒲醋饮子:治疗新产压血,逐除败血滋养新血,此药治疗血证神效,又非黑神散可比。一个月内每日一二服尤其好,以及治疗一切恶露与血积。
制法与用法:真蒲黄不拘多少,熬米醋令稠,和药成膏,每次服用弹子大小,食前用醋汤化开服下。(这两味药有且战且守的能力。)
另一方:蒲黄二两,水煎顿服。
另一方:治疗产后泄血不止,无节制,以及治疗腹痛胸膈闷。
制法与用法:姜黄研为末,酒服方寸匕,每日三四次。
胡氏说:姜黄治疗恶露不止。
以上为行污血的药剂。
牡蛎散:治疗产后恶露淋沥不断,心闷短气,四肢乏力,头目昏重,五心烦热,面黄体瘦。
药材:牡蛎粉(煅)、川芎、熟地、茯苓、龙骨(各二钱)、当归(炒)、续断、艾叶、人参、五味子、地榆(各一钱)、甘草(五分)。
制法与用法:切碎,分两帖,加生姜三片,枣一枚,水煎,食前服用。此为收涩的药剂,适用于虚脱者。
Daquan states: Postpartum lochia that does not cease is caused by damage to the menstrual blood after childbirth, resulting in deficiency and insufficiency. Alternatively, during delivery, if the lochia (postpartum discharge) is not completely expelled and remains in the abdomen, combined with pre-existing coldness in the Zang-Fu organs, it leads to disharmony of Qi and Blood, causing the lochia to drip continuously.
Xue (Xue Ji) states: Regarding the above conditions, if Liver Qi Heat fails to control the Blood, use Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill); if Liver Qi Deficiency fails to store the Blood, use Xiaoyao San (Free and Easy Wanderer Powder); if Spleen Qi Deficiency fails to contain the Blood, use Liujunzi Tang (Six-Gentleman Decoction); if Stomach Qi sinks and fails to command the Blood, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction); if Spleen Meridian Depressed Heat causes Blood to fail to return to its source (the following formulas are missing from the text and should be verified against Lijiang's Good Prescriptions), use Jiaweigui Pi Tang (Modified Guipi Decoction); if Liver Meridian Fierce Fire causes Blood to move recklessly, use Jiawei Siwu Tang (Modified Four Substances Decoction); if both Qi and Blood are deficient, use Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction); if Liver Meridian Wind Pathogen causes Blood to boil, use Yiwei Fangfeng Wan (Single-Ingredient Saposhnikovia Pill).
Xionggui Ji Shaoyao Tang (Chuanxiong and Angelica with Added Peony Decoction): Treats postpartum hemorrhage with dizziness and loss of consciousness.
Ingredients: Chuanxiong Rhizoma (Rhizoma Chuanxiong), Dang Gui Radix Angelicae Sinensis (Radix Angelicae Sinensis), Shaoyao Radix Paeoniae Alba (Radix Paeoniae Alba) (equal parts). (Note: Peony is usually contraindicated postpartum, but this formula uses it because there is no contraindication for patients with hemorrhage.)
Preparation and Administration: Coarsely crush the ingredients. Take 4 qian per dose, decoct in water, and take warm. Another version adds Huangqin Cortex Scutellariae (Cortex Scutellariae) and Baizhuus Atractylodis Macrocephalae Rhizoma (Rhizoma Atractylodis Macrocephalae).
Jiawei Siwu Tang (Modified Four Substances Decoction): Treats postpartum hemorrhage resembling bean curd juice or excessive dark purple/black discharge. (Some say bean-curd-like discharge indicates Dampness, dark purple/black indicates Heat, and excessive cold indicates Deficiency. This formula is neither cold nor hot nor dry, so it can be used generally.)
Ingredients: Chuanxiong Rhizoma (Rhizoma Chuanxiong), Dang Gui Radix Angelicae Sinensis (Radix Angelicae Sinensis), Shaoyao Radix Paeoniae Alba (Radix Paeoniae Alba), Shengdi Huang Radix Rehmanniae Preparata (Radix Rehmanniae Preparata), Puhuang Pollinis Typhae (Pollinis Typhae), Ejiao Colla Asini (Colla Corii Asini), Jigen Radix Cirsii Japonici (Radix Cirsii Japonici), Baizhi Radix Angelicae Dahuricae (Radix Angelicae Dahuricae).
Preparation and Administration: Decoct in water and take.
Another Prescription: Treats postpartum lochia that does not stop after seven or eight days.
Ingredients: Baijiangcao Herba Patriniae (Herba Patriniae) (Patrinia treats old coagulated blood and various postpartum abdominal pains; thus, this is also a herb for removing the old and generating the new), Dang Gui Radix Angelicae Sinensis (Radix Angelicae Sinensis) (each 6 fen), Shaoyao Radix Paeoniae Alba (Radix Paeoniae Alba), Xuduan Radix Dipsaci (Radix Dipsaci) (each 8 fen), Chuanxiong Rhizoma (Rhizoma Chuanxiong), Zhuru Endocarpus Bambusae in Taenia (Endocarpus Bambusae in Taenia) (each 4 fen), Sheng Di Huang Radix Rehmanniae Recens (Radix Rehmanniae Recens) (stir-fried until dry, 12 fen).
Preparation and Administration: Finely chop the ingredients. Boil in two sheng of water until reduced to eight ge. Take on an empty stomach in one dose.
The above are tonifying formulas for Deficiency.
Jiawei Siwu Tang (Modified Four Substances Decoction): Treats postpartum menstruation dripping continuously for over a month. This applies the principle of "lifting what has sunk."
Ingredients: Dang Gui Radix Angelicae Sinensis (Radix Angelicae Sinensis), Chuanxiong Rhizoma (Rhizoma Chuanxiong), Baishao Radix Paeoniae Alba (Radix Paeoniae Alba), Shudi Huang Radix Rehmanniae Preparata (Radix Rehmanniae Preparata), Baizhi Radix Angelicae Dahuricae (Radix Angelicae Dahuricae), Shengma Rhizoma Cimicifugae (Rhizoma Cimicifugae) (each 1 qian), Xuyuhui Cinis Capilli Humani (Cinis Capilli Humani) (added separately).
Preparation and Administration: Chop, decoct in water, and take. (My cousin's wife had severe bleeding like a pouring basin half a month postpartum due to overexertion too soon after confinement. I used this prescription, and the bleeding stopped immediately after one dose; the effect was miraculous.)
Qianjin Fang (Prescription from the Thousand Gold Formulas): Treats postpartum retention of evil blood lasting one month or even half a year.
Ingredients: Shengma Rhizoma Cimicifugae (Rhizoma Cimicifugae) 3 liang, Qingjiu Clear Wine 5 sheng. Boil until reduced to two and a half sheng. Divide into two doses and take warm.
The above are lifting formulas.
Wujin San (Black Gold Powder): Treats postpartum blood confusion and fainting, continuous flow of retained blood, dripping without cessation, colicky pain in the umbilical and abdominal regions, dizziness of the head and eyes, excessive sweating, weakness, and metrorrhagia with continuous bleeding. (These symptoms all stem from continuous retained blood. The efficacy of this formula lies not in stopping the blood but in moving it; when moved, the blood returns to its vessels and stops naturally. Those treating metrorrhagia must grasp this principle.)
Ingredients: Qilinjie Dragon's Blood (Sanguis Dracaena), Nanzi Luangfa Hui Cinis Capilli Humani Virilis (Cinis Capilli Humani Virilis), Songmo Pine Charcoal (Quenched in Vinegar), Baicaoshang Carbonis Herbae (Carbonis Herbae), Dang Gui Radix Angelicae Sinensis (Radix Angelicae Sinensis), Rouguai Cortex Cinnamomi (Cortex Cinnamomi), Chishao Radix Paeoniae Rubra (Radix Paeoniae Rubra), Yanhusuo Rhizoma Corydalis (Rhizoma Corydalis), Liyu Lin Scales Cyprini Carassii (Squama Cyprini Carassii) (burned to retain nature, equal parts).
Preparation and Administration: Grind into powder. Take 2 qian per dose, mix with warm wine, and take on an empty stomach.
Another Prescription: Treats postpartum continuous flow of evil blood, uncontrollable hemorrhage, colicky abdominal pain, and rapid breathing.
Ingredients: Luangfa Hui Cinis Capilli Humani (Cinis Capilli Humani) (burned, 1 liang), Ejiao Colla Asini (Colla Corii Asini) (2 liang), Daizheshi Haematitum (Haematitum), Ganjiang Rhizoma Zingiberis Recens (Rhizoma Zingiberis Recens) (each 3 liang), Gan Dihuang Radix Rehmanniae Preparata (Radix Rehmanniae Preparata) (4 liang) (The brilliance lies in using Dihuang as the Sovereign herb), Matike Shell Equi (Burned, 1 piece), Niujiaosai Cornu Bubali (Cornu Bubali) (5 liang, roasted with butter).
Preparation and Administration: Grind into fine powder. Make pills the size of paulownia seeds using refined honey. Take 30-40 pills per dose, with rice drink on an empty stomach, twice daily.
Doulín Jiǔ (Black Bean Dripping Wine): Treats residual blood and fluid qi after childbirth. (Residual blood is stasis, hence the method of moving blood is used.)
Preparation and Administration: Stir-fry 5 sheng of Black Beans until smoke ceases. Pour into a porcelain vessel and quench with one dou of Wine. Drink. It is said that Black Bean Dripping Wine treats foul blood and can also release the exterior.
Pucú Yǐnzǐ (Polygonum and Vinegar Decoction): Treats blood compression after new birth, expelling retained blood and nourishing new blood. This medicine is miraculously effective for blood disorders and cannot be compared to Heishen San. Taking it once or twice daily within the first month is especially good, and it treats all lochia and blood accumulations.
Preparation and Administration: Use genuine Puhuang Pollinis Typhae (Pollinis Typhae) in any amount. Simmer with Rice Vinegar until thick, mix with medicine to form a paste. Take a size of a bullet before meals, dissolved in vinegar-water. (These two ingredients have the ability to attack and defend simultaneously.)
Another prescription: 2 liang of Puhuang Pollinis Typhae (Pollinis Typhae), decoct in water and take in one dose.
Another Prescription: Treats postpartum uncontrolled bleeding and abdominal pain with chest oppression.
Preparation and Administration: Jianghuang Curcumae Longae Rhizoma (Rhizoma Curcumae Longae) ground into powder. Take one fangcun bi with wine, three to four times daily.
Hu states: Jianghuang Curcumae Longae Rhizoma (Rhizoma Curcumae Longae) treats continuous lochia.
The above are formulas for moving foul blood.
Muli San (Oyster Shell Powder): Treats postpartum continuous dripping of lochia, chest stuffiness, shortness of breath, weakness of the four limbs, heaviness of the head and eyes, five-palm heat, sallow complexion, and emaciation.
Ingredients: Muli Musculus Ostreae (Concha Ostreae) (calcined), Chuanxiong Rhizoma (Rhizoma Chuanxiong), Shudi Huang Radix Rehmanniae Preparata (Radix Rehmanniae Preparata), Fuling Poria (Poria), Longgu Os Draconis (Os Draconis) (each 2 qian), Dang Gui Radix Angelicae Sinensis (Radix Angelicae Sinensis) (stir-fried), Xuduan Radix Dipsaci (Radix Dipsaci), Aiye Folium Artemisiae Argyi (Folium Artemisiae Argyi), Renshen Ginseng Radix et Rhizoma (Radix Ginseng), Wuweizi Fructus Schisandrae Chinensis (Fructus Schisandrae Chinensis), Diyü Radix Sanguisorbae (Radix Sanguisorbae) (each 1 qian), Gancao Radix Glycyrrhizae Uralensis (Radix Glycyrrhizae) (0.5 qian).
Preparation and Administration: Chop. Divide into two doses. Add three slices of Shengjiang Rhizoma Zingiberis Recens (Rhizoma Zingiberis Recens) and one Jujube Fructus Jujubae (Fructus Jujubae). Decoct in water and take before meals. This is an astringent formula suitable for collapse due to Deficiency.