产妇多喜多怒,时发癫狂,言语无伦,甚有罔顾身体,此皆五志所发为热,火实制金,
不能
平下,则肝实而多怒也。又发热于中,则属阳明,经谓阳明之厥则癫,又谓服膏粱芳香等则
热气剽悍,发为癫狂 。大率因痰结于胸中,宜开痰镇心神为主。又神不守舍,狂言妄作,
久不愈,如心经蓄热,当清心除热为先。如痰迷心窍,当去痰宁心,宜大吐下则愈。产后身
热感风,遍身
麻痹,手足牵搐,口 痰盛,言语无伦,乃痰结胸膈心经蓄热之症,当以归脾砂香等汤。
归脾汤
橘红 胆星 茯神 杏仁 人参 当归 甘草 半夏 枳实 川芎 柏子仁 五味子
白术 圆眼
砂香散
人参 木香 砂仁 黄 山药 柏子仁 茯神 远志 枣仁
上为细末,蜜调服。
发热 头痛 腹胀 咳嗽 呃逆 恶露不下 恶露不止 眼见黑花头眩 胁痛 不语
言语含糊 瘕
产后发热,非有余之热,乃亡血过多,阴虚则生内热也,其症心胸烦满,吸吸短气,头
痛闷乱,晡时转甚。人参芎归汤主之。
当归(一钱五分) 川芎(一钱五分) 白芍(一钱五分,酒炒) 熟地(一钱五分) 麦冬(
一钱)
干姜(一钱)
水两杯,先以粳米一撮,淡竹叶十片,煎至一杯,去米叶入药,加枣三个,煎七分服。
必加
干姜者,因姜能入肺和肺气,入肝引血药生血,然不独用,必与补阳药同此造化之妙,惟天
下之神者可以语此。
产妇常常情绪波动,表现为多喜或易怒,时而发作癫狂,言语混乱无序,甚至有不顾及自身身体的行为。这些症状都是由于五志(喜、怒、忧、思、恐)化火生热所致。若火气过盛克制肺金(肺属金),导致肺气不能肃降下行,则肝气(肝属木)偏实而引发多怒。
此外,若体内发热,多归属于阳明经病变。医经记载:“阳明经气逆乱则发为癫狂”,又说“食用膏粱厚味及芳香辛辣食物会导致热气剽悍急疾,从而引发癫狂”。这种情况大多是因为痰浊结聚于胸中,治疗应以化痰开窍、镇心安神为主。
如果心神不守舍,出现狂言妄语且久治不愈,这属于心经蓄积热邪,应当以清心除热为首要任务。若是痰浊迷蔽心窍,则应去除痰浊以宁心安神,采用催吐或泻下的方法即可痊愈。
产后身体发热并感受风邪,导致全身麻痹,手足抽搐牵引,口中痰涎壅盛,言语混乱,这是痰结胸膈兼有心经蓄热的证候,应当使用归脾汤合砂香散等方剂治疗。
【归脾汤】
橘红、胆南星、茯神、杏仁、人参、当归、甘草、半夏、枳实、川芎、柏子仁、五味子、白术、龙眼肉。
【砂香散】
人参、木香、砂仁、黄芪、山药、柏子仁、茯神、远志、酸枣仁。
以上药物研为细末,用蜂蜜调服。
【增补产后十二症】
包括:发热、头痛、腹胀、咳嗽、呃逆、恶露不下、恶露不止、眼前见黑花、头晕、胁痛、不语、言语含糊、瘕积。
产后发热,并非有余之实热,而是因为失血过多,阴虚而生内热。其症状表现为心胸烦闷胀满,呼吸短促,头痛头昏扰乱,傍晚时分症状加重。用人参芎归汤主治。
【人参芎归汤】
当归(一钱五分)、川芎(一钱五分)、白芍(一钱五分,酒炒)、熟地黄(一钱五分)、麦冬(一钱)、干姜(一钱)。
取水两杯,先用粳米一撮、淡竹叶十片,煎煮至一杯,去掉米粒和竹叶,加入药物,再放入三个红枣,煎至七分,服用。
必须加入干姜的原因,是因为生姜能入肺经调和肺气,入肝经引导血药生成血液。然而干姜不单用,必须与补阳药同用,才能发挥这种造化的奇妙作用,只有天下精通医道的神明之人才能与此谈论此理。
Postpartum women often exhibit emotional volatility, manifesting as excessive joy or irritability, and may occasionally suffer from mania (mania), characterized by incoherent speech and even behaviors disregarding their own physical well-being. These conditions arise from the transformation of the Five Emotions (joy, anger, worry, thought, fear) into heat. When Fire excess suppresses Metal (the Lung element), preventing its descending function, Liver Qi becomes excessive, leading to irritability.
Furthermore, internal fever often belongs to the Yangming channel disorder. The classics state: "Reversal of Yangming Qi leads to mania," and also note that consuming rich, fatty foods and aromatic spices generates fierce and rapid pathogenic heat, resulting in mania. Generally, this is due to phlegm accumulation in the chest; treatment should primarily focus on resolving phlegm and calming the Spirit (Shen).
If the Spirit fails to reside within its abode, causing wild speech and delirium that persists for a long time without cure, it indicates Heat accumulation in the Heart channel. In such cases, clearing Heart Heat should be the priority. If Phlegm confuses the Heart orifices, removing Phlegm to calm the Heart is required, and emetic or purgative methods can lead to recovery.
When postpartum fever is accompanied by wind invasion, causing general body numbness, twitching and convulsions of the limbs, profuse salivary phlegm, and incoherent speech, it is a syndrome of Phlegm binding in the chest and diaphragm combined with Heat accumulation in the Heart channel. Treatment should employ formulas such as Guipi Tang (Spleen-Restoring Decoction) combined with Shaxiang San.
[Guipi Tang]
Chenhpi (Tangerine Peel), Danxing (Arisaema cum Bile), Fushen (Poria with Hostwood), Xingren (Apricot Seed), Renshen (Ginseng), Danggui (Angelica Sinensis), Gancao (Licorice Root), Banxia (Pinellia Tuber), Zhishi (Immature Bitter Orange), Chuanxiong (Ligusticum Rhizome), Baiziren (Biota Seed), Wuweizi (Schisandra Fruit), Baizhu (Atractylodes Macrocephala Rhizome), Guiyuan (Longan Aril).
[Shaxiang San]
Renshen (Ginseng), Muxiang (Costus Root), Sharen (Amomum Fruit), Huangqi (Astragalus Root), Shanyao (Dioscorea Rhizome), Baiziren (Biota Seed), Fushen (Poria with Hostwood), Yuanzhi (Polygala Root), Suanzaoren (Ziziphus Seed).
Grind the above ingredients into fine powder and take with honey.
[Supplementary Twelve Postpartum Syndromes]
Including: Fever, headache, abdominal distension, cough, hiccups, lochia retention, lochia overflow, visual hallucinations (seeing black flowers), dizziness, hypochondriac pain, mutism, slurred speech, and mass accumulation (Jia).
Postpartum fever is not due to Excess Heat, but rather results from excessive blood loss leading to Yin deficiency and subsequent internal heat generation. Symptoms include vexation and fullness in the chest and heart, shortness of breath, headache with mental confusion, which worsen in the late afternoon. This is treated with Renshen Xiong Gui Tang (Ginseng, Ligusticum, and Angelica Decoction).
[Renshen Xiong Gui Tang]
Danggui (Angelica Sinensis Root) (1.5 qian), Chuanxiong (Ligusticum Rhizome) (1.5 qian), Baishao (White Peony Root, stir-fried with wine) (1.5 qian), Shudi (Prepared Rehmannia Root) (1.5 qian), Maidong (Ophiopogon Tuber) (1 qian), Ganjiang (Dried Ginger) (1 qian).
Take two cups of water. First, decoct a pinch of Jingmi (Rice Grain) and ten leaves of Danzhuye (Bamboo Leaf) until reduced to one cup. Remove the rice and leaves, add the medicinal herbs, and three dates. Decoct until 70% remains, then administer.
The reason for adding Ganjiang (Dried Ginger) is that ginger enters the Lung channel to harmonize Lung Qi and enters the Liver channel to guide blood-invigorating herbs to generate blood. However, it is not used alone; it must be combined with Yang-tonifying herbs to achieve this miraculous synergy. Only those with divine medical insight can fully appreciate this principle.