凡产用力过多,劳倦伤脾,孤脏不能注于四旁。(心、肝、肺、肾。)故足逆冷而厥气上行也。经曰∶阳气衰于下,
则为寒厥。厥气上升,满脉去形。逆气上行,满于经络,则神气浮越,去身而散矣。此非急以峻补大剂与之,不能举气
以归元,回阳而复神。宜重用参、 ,使气血旺而神复,厥症自止。人参生化汤。如无块痛,滋荣益气汤。(补三十七、
补三十八)
养胎余血,溷以浆水为恶露。气血旺者,随产而下。气血衰弱,或挟寒冷,或挟风邪,遂留滞不行,上攻则为血晕,
蓄瘀则为儿枕,日久不出,腹痛心痛,遍身发热,五心烦热,骨蒸潮热,时作时止,浑如疟状,块在两胁,动作雷鸣,
嘈杂眩晕,食少羸瘦,又与虚弱病相似,慎勿误治,致成血臌等症,宜生化汤合失笑散,补而消之。(和二十四、攻七。)
起枕散亦好。(攻九。)若恶露流注四肢腰背等处,久必肿起作痛,速用葱熨以散之,内服加参生化汤。如不速治,将所
注者,化而为脓,宜用神仙回脓散(攻十一)。然气血不旺,不可轻用,憎寒恶热,气虚也,十全大补汤。(补三十九。)
日晡潮热,血虚也,四物汤加参、术、丹皮。(补七。)呕逆,胃气虚也,六君子汤加炒干姜(补一)。食少体倦,脾虚也,
补中益气汤。(补六。)四肢逆冷,小便频数,肾气虚也,补中益气汤加益智仁。熨法,用葱一把,捣烂为饼,贴患处,
衬浓布两三层,以熨斗文火熨之。
凡是分娩时用力过多,导致劳倦损伤脾气,孤立无援的脾脏无法将精气输布到四肢(心、肝、肺、肾)。因此足部逆冷并出现厥证,厥气向上逆行。医经说:阳气在下部衰微,就会发生寒厥。厥气上升,充斥脉道而脱离形体。逆气上行,充满经络,就会导致神气浮越,离开身体而散失。这种情况如果不紧急使用峻补的大剂量药物来治疗,就不能提升下陷之气以回归本源,回阳救逆并恢复神志。应当重用参、[药名缺失],使气血旺盛而神志恢复,厥证自然停止。宜用人参生化汤。如果没有血块疼痛,可用滋荣益气汤。(见补三十七、补三十八)
产后余留的血液,混杂着浆水样的分泌物称为恶露。气血旺盛者,恶露会随分娩排出。若气血衰弱,或夹杂寒冷,或夹杂风邪,就会停滞不行。向上攻冲则导致血晕,蓄积瘀血则形成儿枕(产后腹痛包块)。日久不出,会出现腹痛、心痛,全身发热,五心烦热,骨蒸潮热,时作时止,症状如同疟疾一般,胁下有肿块,腹部肠鸣如雷,嘈杂眩晕,食少体瘦,又与虚弱病相似,务必谨慎不要误治,以免发展成血臌等病症。宜用生化汤合失笑散,采用补益兼消瘀的方法治疗。(见和二十四、攻七。)起枕散也很好。(见攻九。)如果恶露流注于四肢、腰背等处,时间久了必然肿胀疼痛,应迅速用葱熨法以消散之,内服加参生化汤。如果不迅速治疗,所流注的恶露会化而为脓,宜用神仙回脓散(见攻十一)。然而气血不旺者,不可轻易使用此方。憎寒恶热,属于气虚,宜用十全大补汤。(见补三十九。)日晡潮热(下午3-5点发热),属于血虚,宜用四物汤加人参、白术、丹皮。(见补七。)呕逆,属于胃气虚,宜用六君子汤加炒干姜(见补一)。食少体倦,属于脾虚,宜用补中益气汤。(见补六。)四肢逆冷,小便频数,属于肾气虚,宜用补中益气汤加益智仁。熨法:用一把葱,捣烂做成饼,贴在患处,衬垫两层三层厚布,用熨斗文火熨烫。
Whenever excessive effort during childbirth leads to fatigue and injury to the Spleen Qi, the isolated Zang organ (Spleen) fails to distribute essence to the four extremities (Heart, Liver, Lung, Kidney). Consequently, the feet become cold and reversed, with Jue Qi (pathogenic cold/counterflow qi) ascending. The Classics state: "When Yang Qi is deficient at the lower part, it results in Cold Jue." As Jue Qi ascends, it fills the vessels and separates from the form. When counterflow Qi ascends and fills the meridians, the Shen Spirit becomes floating and disperse, leaving the body. In such cases, unless urgent treatment with a potent, large-dose tonic is administered to raise the Qi and return it to its origin, restore Yang, and recover the Shen, the condition cannot be resolved. It is advisable to heavily use Ren Shen (Ginseng Root) and [missing herb name], so that when Qi and Blood are abundant and the Shen recovers, the Jue syndrome will naturally cease. Ren Shen Sheng Hua Tang (Ginseng Birth-Expelling Decoction) is indicated. If there is no mass or pain, Zi Rong Yi Qi Tang (Nourish Blood and Benefit Qi Decoction) should be used. (See Supplement 37, Supplement 38)
Postpartum residual blood, mixed with serous fluid, is termed E Lu (Lochia). When Qi and Blood are robust, E Lu is discharged with delivery. However, if Qi and Blood are weak, or if accompanied by Cold pathogens or Wind pathogens, the E Lu may stagnate and fail to flow. Ascending attack causes Xue Yun (Blood Fainting); accumulation of stasis forms Er Zhen (Child Pillow/Mass postpartum). If not expelled over time, it leads to abdominal pain, heart pain, generalized fever, heat sensation in the palms, soles, and chest (Five Hearts Heat), bone-steaming tidal fever, which comes and goes resembling Malaria (Nue Ji), masses in the hypochondrium, borborygmus (rumbling in the abdomen), epigastric discomfort, dizziness, poor appetite, emaciation, and resembles deficiency syndromes. One must be cautious not to misdiagnose or mistreat this, lest it develop into Xue Gu (Blood Distension) and other conditions. It is appropriate to combine Sheng Hua Tang (Birth-Expelling Decoction) with Shi Xiao San (Excellent Payment Powder), employing a method of tonifying while resolving stasis. (See Harmonize 24, Attack 7) Qi Zhen San (Pillow-Raising Powder) is also good. (See Attack 9) If E Lu flows into the limbs, back, and waist, swelling and pain will eventually occur; one should quickly apply Cong Yan (Scallion Moxibustion/Ironing) to dissipate it, and internally administer Jia Shen Sheng Hua Tang (Sheng Hua Tang with Ginseng). If not treated promptly, the accumulated material will transform into pus, for which Shen Xian Hui Nong San (Divine Return Pus Powder) is indicated. (See Attack 11) However, due to insufficient Qi and Blood, this formula should not be used lightly. Aversion to cold and fear of heat indicate Qi Deficiency; Shi Quan Da Bu Tang (Great Tonification of Ten Thousand Tonic Decoction) is suitable. (See Supplement 39) Tidal fever in the late afternoon (Ri Bu Chao Re) indicates Blood Deficiency; Si Wu Tang (Four Substance Decoction) with Ren Shen (Ginseng Root), Bai Zhu (Atractylodes Macrocephala Rhizome), and Mu Dan Pi (Moutan Cortex) is indicated. (See Supplement 7) Vomiting and reversal of Qi indicate Stomach Qi Deficiency; Liu Jun Zi Tang (Six Gentlemen Decoction) with fried Gan Jiang (Dried Ginger) is suitable. (See Supplement 1) Poor appetite and physical fatigue indicate Spleen Deficiency; Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is appropriate. (See Supplement 6) Cold extremities and frequent urination indicate Kidney Qi Deficiency; Bu Zhong Yi Qi Tang with Yi Zhi Ren (Alpinia Oxyphylla Fruit) is indicated. Ironing Method: Take one bunch of scallions, pound them into a paste/biscuit, apply to the affected area, cover with two or three layers of thick cloth, and iron with a warm iron using mild heat.