产后瘀血上攻,忽两乳伸长,细小如肠,直过小腹,痛不可忍,名曰乳悬,乃
危证也。速用川芎、当归各一斤,水煎浓汤,不时温服。再用二斤,逐旋烧烟,安在病患面前桌子下。令
病患屈身低头,将口鼻及病乳常吸烟气。如未甚缩,再用一料,则瘀血消而乳头自复矣。若更不复旧,用
蓖麻子捣烂,贴顶上片时,收即洗去。
产门不闭,如无肿痛,或肿既消而不闭者,此气血虚不能收摄,以十全大补汤服数帖,再用补中益气
汤,加五味子治之。或以补中益气汤,加制半夏、茯苓以健脾,使元气复而诸疾自愈。或以硫黄汤外洗。
又敛宫方治子宫不敛甚效。
产后阴户脱下,乃元气不足。及阴挺突出肿痛,清水淋漓者,用八珍汤加炙黄 、防风、升麻各五分
即收。或用补中益气加醋炒白芍一钱,五味子十粒。或易酒炒白芍一钱,肉桂五分,补而举之亦可,兼以硫
黄散外治之。又有熨阴洗阴法,录后备用。
产门肿痛,因脏中风冷者,当归汤洗之。
产后阴挺阴菌,诸虫痛痒,盖因妇人七情郁火,伤损肝脾,湿热下注,故有阴中舒出如蛇,俗呼阴挺。
有翻突如饼,俗呼阴菌。亦有如鸡冠,如鼠乳。亦有生诸虫,肿痛湿痒,溃烂出水,胀闷脱坠者。其
内证口干,内热体热,饮食无味,晡热发热,胸膈不利,小腹痞胀,赤白带下,小水淋沥。其治法,如气
虚,十全大补加五味子、倍参、桂补而敛之。初产肿胀痛而热者,宜加味逍遥散,或逍遥散加荆芥、
牡丹皮。如产久,则于杂证同治法,用四物汤加柴胡、山栀、丹皮、胆草。湿痒者,归脾汤加山栀、柴胡、
丹皮。淋沥者,龙胆泻肝汤加白术、丹皮。溃腐者,加味逍遥散。肿闷脱坠者,补中益气加山栀、丹皮。
以上诸证,均可佐以外治之法,如硫黄汤、熨阴洗阴诸方,选而用之。
产后子肠不收,宜用收肠方收之,神应丹收肠甚捷。
产后阴户中生小疮,形如痱子,名曰慝疮。或痛痒如虫行状,脓汁淋沥,用疗蚀方、椒汤、肉汁、金
银散、杀虫硫黄散等方选用。
硫黄汤 治产后玉门开而不闭,及阴户突出。
硫黄(三钱) 吴茱萸 菟丝子(各二钱) 蛇床子(一钱五分)
上研匀,水一腕,煎汤频洗自收。
敛宫方 治子宫不敛。
荆芥 藿香 椿根白皮
煎汤熏洗,神效。
硫黄散 治产后阳气虚寒,玉门不闭。
硫黄 乌贼骨(各五钱) 五味子(一钱)
上为末,掺患处,日三易。
熨阴洗阴法 治阴肿、阴痛、阴脱。用蛇床子不拘多少,炒极热,以绢袋盛或布裹,熨患处。
又法 用蛇床子五两,乌梅十四个,煎水,日洗五六次。
当归汤 治产后脏中风冷,阴肿痛。
当归 独活 白芷 地榆 矾石 败酱
煎水,适寒暖洗阴,自愈。《千金》不用败酱。
龙胆泻肝汤 治肝经湿热,腋胁满通,小便赤涩。
柴胡梢 泽泻(各一钱五分) 车前 木通 当归梢 草龙胆(各八分) 生地(二钱) 生姜(三片)
水煎,食远热服,更以美膳压之。此本导赤散加柴胡、胆草之属,入肝以泻湿热也。
收肠方 治子肠不收。
枳壳 诃子 五倍子 白矾
煎汤熏洗。若不收,再炙顶心百会穴数壮,即上。
又收肠方 凡遇生肠不收,以铁锈水润肠上,用堪舆家真磁石一钱,研末,酒服,肠即收矣。
千金疗蚀方 治慝疮。
川芎 当归 芍药 地榆 甘草(各等分)
用水五升,煮至二升,去渣,热熏温洗,日三夜一,即愈。
椒汤治法 治阴中小碎疮如痱子,痒不可当。
胡椒(二十一粒)
煎汤,洗之自愈。
肉汁治法 治阴户内疮。用猪肉十斤,水煮,取肉汁一半,浸疮。冷再炖热,浸之。
不过三两次即愈。
金银散 杀阴户内疮虫。
蒲黄(一升) 水银(一两)
二味研匀细末,用以搽疮即愈。此方不可轻用。
杀虫硫黄散 治疳虫蚀下部五脏。
硫黄研为细末,取东南桃树枝五七枝,轻打头使散,以绵缠粘末,令少浓。又截一竹筒,先内下部
中,仍以所捻药桃枝,烧着熏之。
十全大补汤(见上卷胎不长养门。) 补中益气汤 八珍汤(俱见上卷诸痛门。) 加味逍
遥散(见上卷胎逆上逼门,附逍遥散下。) 逍遥散(见上卷胎逆上逼门。) 四物汤
(见上卷安胎门。) 归脾汤(见上卷胎漏小产门。) 神应丹(见中卷催生门。)
产后瘀血上冲,突然双侧乳房伸长,细小如肠管,直垂至小腹,疼痛难以忍受,称为乳悬,属于危重证候。应立即使用川芎、当归各一斤,加水煎煮成浓汤,不时温服。再用两斤药渣,慢慢烧烟,放在病人面前的桌子下面。让病人弯腰低头,使口鼻及患侧乳房经常吸入烟气。如果乳房没有明显回缩,再服用一剂药,则瘀血消散,乳头自然恢复原状。如果仍不能恢复,用蓖麻子捣烂,贴在头顶片刻,待乳房收回后立即洗去。
产门不闭合,如果没有肿痛,或者肿胀消退后仍不闭合的,这是气血虚弱不能固摄所致,服用十全大补汤数帖,再用补中益气汤,加入五味子治疗。或者用补中益气汤,加入制半夏、茯苓以健脾,使元气恢复而诸病自愈。或者用硫黄汤外洗。另外,敛宫方治疗子宫不收缩非常有效。
产后阴户脱出,是元气不足所致。以及阴挺突出并伴有肿痛、清水淋漓的,用八珍汤加入炙黄芪、防风、升麻各五分即可收回。或者用补中益气汤加入醋炒白芍一钱、五味子十粒。或者改用酒炒白芍一钱、肉桂五分,起到补益和提升的作用也可以,同时配合硫黄散外治。又有熨阴法和洗阴法,记录在此以备后用。
产后阴挺、阴菌,各种虫蚀引起的疼痛瘙痒,大概是因为妇人七情郁结化火,损伤肝脾,湿热下注,所以有从阴中伸出如蛇状者,俗称阴挺。有翻突如饼状者,俗称阴菌。也有像鸡冠、像鼠乳形状的。也有生出各种虫子,导致肿痛湿痒、溃烂流水、胀闷坠脱的情况。其内部症状表现为口干、内热、体表发热、饮食无味、午后潮热、胸膈不适、小腹胀满、赤白带下、小便淋沥不尽。其治疗方法,如果是气虚,用十全大补汤加入五味子、加倍人参和肉桂进行补益收敛。初产时肿胀疼痛且发热的,宜用加味逍遥散,或逍遥散加入荆芥、牡丹皮。如果生产时间较长,则按杂证同法治疗,用四物汤加入柴胡、山栀、丹皮、龙胆草。湿痒的,用归脾汤加入山栀、柴胡、丹皮。淋沥不尽的,用龙胆泻肝汤加入白术、丹皮。溃烂腐坏的,用加味逍遥散。肿胀闷痛坠脱的,用补中益气汤加入山栀、丹皮。以上各种证候,都可以辅助以外治方法,如硫黄汤、熨阴洗阴等方剂,选择使用。
产后阴户中生小疮,形状像痱子,称为慝疮。或者疼痛瘙痒如虫爬状,脓汁淋沥,选用疗蚀方、椒汤、肉汁、金银散、杀虫硫黄散等方剂治疗。
硫黄汤 治疗产后玉门开而不闭,以及阴户突出。
硫黄(三钱) 吴茱萸 菟丝子(各二钱) 蛇床子(一钱五分)
以上研匀,用水一碗,煎汤频繁清洗,自然收回。
敛宫方 治疗子宫不收缩。
荆芥 藿香 椿根白皮
煎汤熏洗,效果神奇。
硫黄散 治疗产后阳气虚寒,玉门不闭。
硫黄 乌贼骨(各五钱) 五味子(一钱)
以上研为末,撒在患处,每天更换三次。
熨阴洗阴法 治疗阴肿、阴痛、阴脱。用蛇床子不拘多少,炒至极热,用绢袋盛装或用布包裹,熨烫患处。
又一种方法:用蛇床子五两,乌梅十四个,煎水,每天清洗五六次。
当归汤 治疗产后脏腑受风冷,阴部肿痛。
当归 独活 白芷 地榆 矾石 败酱
煎水,温度适宜时清洗阴部,自愈。《千金方》不用败酱。
龙胆泻肝汤 治疗肝经湿热,腋下胁肋胀满通畅感异常,小便赤涩。
柴胡梢 泽泻(各一钱五分) 车前子 木通 当归梢 草龙胆(各八分) 生地(二钱) 生姜(三片)
水煎,饭后热服,并用美味食物压住药性。此方本由导赤散加入柴胡、龙胆草等组成,入肝经以泻湿热。
收肠方 治疗子肠不收。
枳壳 诃子 五倍子 白矾
煎汤熏洗。如果不收回,再灸头顶百会穴几壮,即会上提。
又一种收肠方:凡是遇到子肠不收,用铁锈水润湿肠体,用堪舆家使用的真磁石一钱,研末,酒送服,肠即收回。
千金疗蚀方 治疗慝疮。
川芎 当归 芍药 地榆 甘草(各等分)
用水五升,煮至二升,去渣,热熏温洗,每天三次夜间一次,即可痊愈。
椒汤治法 治疗阴中小碎疮如痱子,痒得无法忍受。
胡椒(二十一粒)
煎汤,清洗即自愈。
肉汁治法 治疗阴户内疮。用猪肉十斤,水煮,取一半肉汁,浸泡疮处。冷了再炖热,继续浸泡。
不过两三次即可痊愈。
金银散 杀灭阴户内疮虫。
蒲黄(一升) 水银(一两)
两味研成细末,用来涂抹疮处即愈。此方不可轻易使用。
杀虫硫黄散 治疗疳虫侵蚀下部五脏。
硫黄研为细末,取东南方向的桃树枝五七枝,轻打头部使其散开,用棉絮缠绕粘附药末,使其稍浓。再截一段竹筒,先放入下部中,仍将所捻药的桃枝点燃熏之。
十全大补汤(见上卷胎不长养门。) 补中益气汤 八珍汤(俱见上卷诸痛门。) 加味逍遥散(见上卷胎逆上逼门,附逍遥散下。) 逍遥散(见上卷胎逆上逼门。) 四物汤(见上卷安胎门。) 归脾汤(见上卷胎漏小产门。) 神应丹(见中卷催生门。)
After childbirth, if stagnant blood attacks upward, the two breasts suddenly elongate, becoming thin and small like intestines, extending straight down to the lower abdomen, with unbearable pain. This is called "Breast Suspension" (Ruxuan), a critical condition. Immediately use Chuanxiong Rhizoma (Chuanxiong) and Angelicae Sinensis Radix (Danggui), each one jin (approx. 500g), decocted in water into a thick soup, taken warm occasionally. Then take another two jin of the dregs, burn them slowly to produce smoke, and place them under the table in front of the patient. Instruct the patient to bend forward and lower their head, frequently inhaling the smoke through the mouth and nose as well as exposing the affected breast to the smoke. If the breasts do not shrink significantly, administer another dose; once the stagnant blood dissipates, the nipples will naturally return to normal. If they still do not recover, crush Semen Cannabis (Huomaren/Bidamazi - note: text says Bidamazi/Castor Bean) and apply it to the top of the head for a moment; wash it off immediately once the breasts retract.
If the vaginal opening does not close, without swelling or pain, or if swelling subsides but it remains open, this is due to deficiency of Qi and Blood failing to consolidate. Administer Shiquan Dabu Decoction (Ten Superior Tonifying Decoction) for several doses, followed by Buzhong Yiqi Decoction (Tonify the Middle and Augment the Qi Decoction) with added Wuweizi (Schisandra Fruit). Alternatively, use Buzhong Yiqi Decoction with processed Banxia (Pinellia Tuber) and Fuling (Poria) to strengthen the Spleen, allowing Yuan Qi (Original Qi) to recover and diseases to heal spontaneously. Or wash externally with Liuhuang Tang (Sulfur Decoction). Additionally, Lian Gong Fang (Uterus Consolidating Formula) is very effective for treating uterine laxity.
Postpartum prolapse of the vaginal introitus is due to insufficiency of Yuan Qi. For Yin Ting (Yin Prolapse) protruding with swelling, pain, and dripping clear fluid, use Bazhen Tang (Eight Treasures Decoction) with added Zhi Huangqi (Prepared Astragalus Root), Fangfeng (Saposhnikovia Root), and Shengma (Cimicifuga Rhizome), each 5 fen, to achieve retraction. Or use Buzhong Yiqi Decoction with Cu Chao Baishao (Vinegar-fried White Peony Root) 1 qian and Wuweizi 10 grains. Alternatively, substitute with Jiu Chao Baishao (Wine-fried White Peony Root) 1 qian and Rougui (Cinnamon Bark) 5 fen; tonification and lifting can also work, combined with external treatment using Liuhuang San (Sulfur Powder). There are also methods for warming and washing the yin area, recorded here for future reference.
Swelling and pain of the vaginal opening due to wind-cold invading the zang organs should be washed with Danggui Tang (Angelica Decoction).
Postpartum Yin Ting (Yin Prolapse) and Yin Jun (Yin Fungus), along with itching and pain caused by various parasites, generally arise from emotional stagnation transforming into fire, damaging the Liver and Spleen, leading to damp-heat pouring downward. Thus, snake-like structures may protrude from the vagina, commonly called Yin Ting. Protrusions resembling cakes are commonly called Yin Jun. Others may resemble chicken combs or mouse teats. Some cases involve growing parasites, causing swelling, pain, dampness, itching, ulceration, weeping, distension, and a sensation of falling. Internal symptoms include dry mouth, internal heat, fever, loss of appetite, afternoon tidal fever, chest and diaphragm discomfort, lower abdominal fullness, red and white leukorrhea, and dribbling urination. The treatment method, if Qi deficient, uses Shiquan Dabu Decoction with added Wuweizi, doubled Renshen (Ginseng Root), and Rougui for tonification and consolidation. For initial postpartum swelling, pain, and heat, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) or Xiaoyao San with Jingjie (Schizonepeta Spike) and Mudanpi (Tree Peony Bark) is suitable. If the postpartum period has been long, treat according to miscellaneous disease protocols using Siwu Tang (Four Substances Decoction) with Chaihu (Bupleurum Root), Zhizi (Gardenia Fruit), Danpi, and Longdancao (Gentian Root). For dampness and itching, use Guipi Tang (Restore the Spleen Decoction) with Zhizi, Chaihu, and Danpi. For dribbling urination, use Longdan Xiegan Tang (Gentian Liver-Draining Decoction) with Baizhu (Atractylodes Macrocephala Rhizome) and Danpi. For ulceration and putrefaction, use Jiawei Xiaoyao San. For swelling, distension, and prolapse, use Buzhong Yiqi Decoction with Zhizi and Danpi. All the above conditions can be assisted with external treatments, such as Liuhuang Tang, Yin Warming Method, and Yin Washing Method; select and use appropriately.
For postpartum failure of the uterus/intestine to retract, use Shouchang Fang (Intestine-Retracting Formula); Shenying Dan (Miraculous Efficacy Pill) retracts the intestine very quickly.
Small sores appearing in the postpartum vaginal introitus, resembling prickly heat, are called Te Chuang (Hidden Sores). If painful and itchy like insects crawling, with dripping pus, select from Liaoshi Fang (Erosion-Treating Formula), Jiao Tang (Pepper Decoction), Rouzhi (Meat Juice), Jinyin San (Gold and Silver Powder), or Shachong Liuhuang San (Parasite-Killing Sulfur Powder).
Liuhuang Tang (Sulfur Decoction): Treats postpartum opening of the Yu Men (Jade Gate/Vaginal Opening) that does not close, and protrusion of the vaginal introitus.
Liuhuang (Sulfur) (3 qian), Wuzhuyu (Evodia Fruit), Tusizi (Dodder Seed) (each 2 qian), Shechuangzi (Cnidium Fruit) (1.5 qian).
Grind evenly, decoct in one bowl of water, and wash frequently until retracted.
Lian Gong Fang (Uterus Consolidating Formula): Treats uterine laxity.
Jingjie (Schizonepeta Spike), Huoxiang (Patchouli Herb), Chun Gen Bai Pi (Toona Root Bark).
Decoct for fumigation and washing; miraculous effect.
Liuhuang San (Sulfur Powder): Treats postpartum Yang Qi deficiency and cold, causing the Yu Men to remain open.
Liuhuang (Sulfur), Haiheke (Cuttlefish Bone) (each 5 qian), Wuweizi (Schisandra Fruit) (1 qian).
Grind into powder, apply to the affected area, change three times daily.
Yin Warming and Washing Method: Treats vulvar swelling, pain, and prolapse. Use Shechuangzi (Cnidium Fruit) in any amount, stir-fry until extremely hot, place in a silk bag or wrap in cloth, and apply as a hot compress to the affected area.
Another method: Use 5 liang of Shechuangzi and 14 Wumei (Mume Fruit), decoct in water, wash 5-6 times daily.
Danggui Tang (Angelica Decoction): Treats postpartum wind-cold invading the zang organs, causing vulvar swelling and pain.
Danggui (Angelica Root), Duhuo (Angelica Pubescens Root), Baizhi (Angelica Dahurica Root), Diyü (Sanguisorba Root), Fanshi (Alum), Baijiang (Patrinia Herb).
Decoct in water, wash the vulva at a comfortable temperature for spontaneous healing. *Qianjin* formula omits Baijiang.
Longdan Xiegan Tang (Gentian Liver-Draining Decoction): Treats damp-heat in the Liver channel, fullness in the axilla and hypochondrium, and scanty dark urination.
Chaihu Shao (Bupleurum Tip), Zexie (Alisma Rhizome) (each 1.5 qian), Cheqian (Plantago Seed), Mutong (Akebia Stem), Danggui Shao (Angelica Root Tip), Caolongdan (Gentian Root) (each 8 fen), Shengdi (Rehmannia Root) (2 qian), Shengjiang (Fresh Ginger) (3 slices).
Decoct in water, take warm well after meals, and follow with a good meal to settle the stomach. This formula originates from Daochi San (Guide Out Red Powder) plus Chaihu and Longdancao, entering the Liver channel to drain damp-heat.
Shouchang Fang (Intestine-Retracting Formula): Treats prolapse of the uterus/intestine.
Zhiqiao (Bitter Orange Fruit), Hezi (Chebula Fruit), Wubeizi (Chinese Gall), Baifan (Alum).
Decoct for fumigation and washing. If it does not retract, moxa the Baihui point (GV20) on the vertex of the head for several moxa cones, and it will rise.
Another Intestine-Retracting Formula: Whenever intestinal prolapse fails to retract, moisten the intestine with rust-water. Take 1 qian of genuine magnetite (from geomancers), grind into powder, take with wine, and the intestine will retract.
Qianjin Liaoshi Fang (Qianjin Erosion-Treating Formula): Treats Te Chuang (Hidden Sores).
Chuanxiong (Ligusticum Rhizome), Danggui (Angelica Root), Shaoyao (Peony Root), Diyu (Sanguisorba Root), Gancao (Licorice Root) (equal parts).
Use 5 sheng of water, boil down to 2 sheng, strain, fumigate while hot and wash while warm, three times daily and once at night until healed.
Jiao Tang Treatment: Treats small sores in the vagina resembling prickly heat, intolerably itchy.
Hujiao (Black Pepper) (21 grains).
Decoct in water, wash to heal spontaneously.
Rouzhi Treatment: Treats sores inside the vaginal introitus. Use 10 jin of pork, boil in water, take half the meat juice, and soak the sore. Reheat when cool and continue soaking.
Heals within two or three applications.
Jinyin San (Gold and Silver Powder): Kills parasites in sores within the vaginal introitus.
Puhuang (Lygodium Spore) (1 sheng), Shuiyin (Mercury) (1 liang).
Grind both into fine powder, apply to the sore to heal. This formula should not be used lightly.
Shachong Liuhuang San (Parasite-Killing Sulfur Powder): Treats gan parasites eroding the lower five zang organs.
Grind Liuhuang (Sulfur) into fine powder. Take 5-7 branches of peach wood from the southeast, gently beat the ends to fray, wrap cotton around to adhere the powder, making it slightly thick. Cut a bamboo tube, insert it into the lower part, and burn the prepared peach branch to fumigate.
Shiquan Dabu Decoction (See Vol. 1, Chapter on Failure of Fetal Nourishment). Buzhong Yiqi Decoction. Bazhen Tang (See Vol. 1, Chapter on Various Pains). Jiawei Xiaoyao San (See Vol. 1, Chapter on Fetal Rebellion Upward, attached to Xiaoyao San below). Xiaoyao San (See Vol. 1, Chapter on Fetal Rebellion Upward). Siwu Tang (See Vol. 1, Chapter on Calming the Fetus). Guipi Tang (See Vol. 1, Chapter on Fetal Leakage and Miscarriage). Shenying Dan (See Vol. 2, Chapter on Inducing Labor).