妊娠下痢,名曰子痢。若初起腹痛,里急后重,元气尚实者攻之,宜香连化滞丸。痢久元虚,日夜无度者
补之,宜胃风汤。热下迫痛里急者解之,宜当归芍药汤。若痢下脓血,宜白术汤。或痢下黄水,此脾气下陷,
治宜升补中气。或色兼青黄,此木来克土,治宜平肝补脾。或黄而兼黑,此水来侮土,必当温补脾胃。若黄而
兼赤,治当补母益子,宜补
中益气汤(方见前子气条中)。凡子痢通治,宜芩连红曲汤。若久痢腹痛、小便涩,宜当归黄 汤。
香连化滞丸
川黄连 条芩 白芍(各一钱二分) 浓朴(姜汁炒) 枳壳(麸炒) 青皮 陈皮 当归身(各八分)
山楂肉(一钱) 生甘草 南木香(各五分)
水二钟,煎一钟,空心服。(一方有槟榔、无楂肉)
胃风汤
人参 茯苓 当归 川芎 白术(蜜炙) 白芍(各一钱) 肉桂(四分)
水煎服。
当归芍药汤
白芍 白术(蜜炙,各一钱) 当归 茯苓 泽泻 条芩(各一钱) 木香 槟榔 黄连 甘草(各七分)
水煎服。如白痢腹痛,去芩连加干姜七分。
白术汤
白术(蜜炙) 当归 黄芩(各三钱)
水煎,食前服。
芩连红曲汤
黄芩 黄连(姜汁炒) 白芍 甘草(炙) 橘红 红曲 枳壳(麸炒) 建连(去皮心,各一钱)
升麻(炙,二分)
水煎服。
当归黄 汤
当归(酒炒) 黄 (蜜炙,各一两) 糯米(一合)
水二钟,煎一钟,温服。
妊娠期间出现下痢,称为“子痢”。如果初起时腹痛、里急后重,且元气尚实者,应采用攻邪法,适宜使用香连化滞丸。如果痢疾日久导致元气虚弱,日夜无度者,应采用补益法,适宜使用胃风汤。如果热邪下迫导致腹痛、里急后重者,应采用解表清热法,适宜使用当归芍药汤。如果痢下脓血者,适宜使用白术汤。或者痢下黄水,这是脾气下陷所致,治疗应当升提补益中气。或者大便颜色兼见青黄,这是肝木克伐脾土所致,治疗应当平抑肝木、补益脾土。或者大便颜色黄而兼黑,这是肾水反侮脾土所致,必须温补脾胃。如果大便颜色黄而兼赤,治疗应当补母益子(即补肾健脾),适宜使用补中益气汤(方剂见前文“子气”条中)。凡子痢的通治方法,适宜使用芩连红曲汤。如果久痢腹痛、小便涩痛者,适宜使用当归黄芪汤。
香连化滞丸:川黄连、条芩、白芍(各一钱二分);浓朴(姜汁炒)、枳壳(麸炒)、青皮、陈皮、当归身(各八分);山楂肉(一钱);生甘草、南木香(各五分)。用水二钟,煎至一钟,空腹服用。(另一版本有槟榔,无山楂肉)
胃风汤:人参、茯苓、当归、川芎、白术(蜜炙)、白芍(各一钱);肉桂(四分)。水煎服。
当归芍药汤:白芍、白术(蜜炙,各一钱);当归、茯苓、泽泻、条芩(各一钱);木香、槟榔、黄连、甘草(各七分)。水煎服。如果是白痢且腹痛,去掉黄芩、黄连,加入干姜七分。
白术汤:白术(蜜炙)、当归、黄芩(各三钱)。水煎,饭前服用。
芩连红曲汤:黄芩、黄连(姜汁炒)、白芍、甘草(炙)、橘红、红曲、枳壳(麸炒)、建连(去皮心,各一钱);升麻(炙,二分)。水煎服。
Dysentery occurring during pregnancy is termed "Zi Li" (Fetal Dysentery). If it begins with abdominal pain, tenesmus (里急后重), and the vital energy (Yuan Qi) remains substantial, attack the pathogen; Xianglian Huazhi Wan (Fragrant Coptis Stagnation-Resolving Pill) is appropriate. If dysentery persists leading to deficiency of vital energy, with frequent stools day and night, tonify the deficiency; Weifeng Tang (Stomach Wind Decoction) is appropriate. If heat forces downward causing abdominal pain and tenesmus, resolve the condition; Danggui Shaoyao Tang (Angelica Sinensis and White Peony Root Decoction) is appropriate. If pus and blood are passed in the stool, Baizhu Tang (Atractylodes Macrocephala Decoction) is appropriate. Or if yellow water is passed, this indicates sinking of Spleen Qi; treatment should focus on raising and tonifying Middle Jiao Qi. Or if the color includes green and yellow, this indicates Wood overacting on Earth (Liver attacking Spleen); treatment should soothe the Liver and tonify the Spleen. Or if the color is yellow mixed with black, this indicates Water insulting Earth (Kidney affecting Spleen); warming and tonifying the Spleen and Stomach is necessary. Or if the color is yellow mixed with red, treatment should tonify the mother and benefit the child (Tonify Kidney and Spleen); Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) is appropriate (formula see previous section on Zi Qi). For general treatment of Zi Li, Qinlian Hongqu Tang (Scutellaria, Coptis, and Red Yeast Rice Decoction) is appropriate. If chronic dysentery involves abdominal pain and astringent urination, Danggui Huangqi Tang (Angelica Sinensis and Astragalus Decoction) is appropriate.
Xianglian Huazhi Wan: Chuan Huanglian (Coptidis Rhizoma), Tiao Qin (Scutellariae Radix), Baishao (Paeoniae Radix Alba) (each 1.2 qian); Nongpo (Magnoliae Officinalis Cortex stir-fried with ginger juice), Ziqiao (Aurantii Fructus stir-fried with bran), Qingpi (Citri Reticulatae Pericarpium Viride), Chenpi (Citri Reticulatae Pericarpium), Dangguishen (Angelicae Sinensis Radix) (each 0.8 qian); Shanzharen (Crataegi Fructus) (1 qian); Sheng Gancao (Glycyrrhizae Radix et Rhizoma), Nanmuxiang (Costi Rhizoma) (each 0.5 qian). Add two zhong of water, decoct to one zhong, take on an empty stomach. (Another prescription contains Binglang Arecae Semen but lacks Shanzharen Crataegi Fructus).
Weifeng Tang: Ren Shen (Ginseng Radix et Rhizoma), Fuling (Poria), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma honey-roasted), Baishao (Paeoniae Radix Alba) (each 1 qian); Rougui (Cinnamomi Cortex) (0.4 qian). Decoct in water and take.
Danggui Shaoyao Tang: Baishao (Paeoniae Radix Alba), Baizhu (Atractylodis Macrocephalae Rhizoma honey-roasted) (each 1 qian); Danggui (Angelicae Sinensis Radix), Fuling (Poria), Zexie (Alismatis Rhizoma), Tiao Qin (Scutellariae Radix) (each 1 qian); Muxiang (Aucklandiae Radix), Binglang (Arecae Semen), Huanglian (Coptidis Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma) (each 0.7 qian). Decoct in water and take. If white dysentery with abdominal pain, remove Qin Scutellariae Radix and Lian Coptidis Rhizoma, add Jianggan Drying Ginger Rhizome 0.7 qian.
Baizhu Tang: Baizhu (Atractylodis Macrocephalae Rhizoma honey-roasted), Danggui (Angelicae Sinensis Radix), Huangqin (Scutellariae Radix) (each 3 qian). Decoct in water, take before meals.
Qinlian Hongqu Tang: Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma stir-fried with ginger juice), Baishao (Paeoniae Radix Alba), Gancao (Glycyrrhizae Radix et Rhizoma roasted), Juhong (Citri Reticulatae Pericarpium), Hongqu (Monascus Ruber), Ziqiao (Aurantii Fructus stir-fried with bran), Jianlian (Coptidis Rhizoma peeled and dehearted) (each 1 qian); Shengma (Bupleuri Radix roasted) (0.2 qian). Decoct in water and take.
Danggui Huangqi Tang: Danggui (Angelicae Sinensis Radix wine-stir-fried), Huangqi (Astragali Radix honey-roasted) (each 1 liang); Nuomi (Oryza Sativa Glutinosa) (1 he). Add two zhong of water, decoct to one zhong, take warm.