产后虚中,感寒饮冷,其寒下攻,小腹作痛。又有血块作痛者,又有产后血虚,脐下痛
者,并宜加减生化汤调治。
加减生化汤
川芎(六分) 当归(二钱) 炮姜(五分) 炙甘(四分) 桃仁(十粒)
问有血块痛,本方加元胡散二钱,亦治寒气痛。如血块无,但小腹痛,按而稍止者,属
虚,加熟地二钱。
元胡散
肉桂(一钱) 元胡(一钱)
为末。
产后遍身疼痛,由产后百节开放,血脉流散,气弱则经络间血多凝滞,累日不散。故筋
脉急
引,骨节不利,甚至腰背不能转侧,手足不能动履,或身热头痛,若误作寒热治而散表出汗
,则筋脉力竭,手足厥冷,变病出焉。
趁痛散 治遍身痛。
当归(二钱) 甘草(三分) 白术 牛膝 独活 肉桂(各八分) 葱白(八根) 黄 (一
钱) 姜(二片)
产后虚劳,指节痛颈痛,汗不出,用∶
当归 人参 黄 生姜 淡豉 薤白 猪肾(二个)
先将猪肾水煮热,取汁二盏,煎药八分碗温服。
筋骨乃血所养,产后血虚,亦能作痛。又寒主拘急,或感寒气,皆能作痛,须凭脉症,
加减用药为当。
产后腰痛,由妇人位系胞腰为肾腑,产后劳伤,肾气损动胞络;或虚未即平复,而风寒
易乘,二者皆致腰痛也。
当归(二钱) 独活(八分) 杜心(八分) 川芎(八分) 杜仲(八分) 续断(八分) 防风
(八分) 桑寄生(八分) 姜(三片)
服两帖后,痛未止,属肾虚,服加味大造丸。
加味大造丸 治产后日久,肾虚腰痛。
当归 川芎 熟地 天冬 五味子 杜仲 续断 山药 牛膝 故纸(炒) 小茴(炒)
丹皮 胡桃 人参(各等分)
为丸服。
又败血流入腰肾,痛如锥刺,宜服复元通气散。
川芎(一钱) 当归(一钱) 小茴(一钱) 故纸(一钱) 桂心(一钱) 元胡索(一钱) 牛
膝(一钱) 丹皮(一钱) 木香(水磨,五分)
甚者,加乳香、没药(四五分)。
产后身体虚弱,若感受寒邪或饮食生冷,寒气向下攻冲,会导致小腹部疼痛。也有因血块阻滞引起疼痛的,还有因产后血虚导致脐下疼痛的,这些情况都适宜使用加减生化汤进行调理治疗。
加减生化汤
川芎(六分) 当归(二钱) 炮姜(五分) 炙甘草(四分) 桃仁(十粒)
问:如果有血块引起的疼痛,本方需加入元胡散二钱,这也适用于寒气引起的疼痛。如果无血块,仅小腹痛,按压后疼痛稍缓解的,属于虚证,需加入熟地黄二钱。
产后全身疼痛,是因为产后全身关节腠理开放,血脉流散,气虚则经络间血液多凝滞,数日不散。因此筋脉拘急牵引,骨节活动不利,甚至腰背不能转身侧卧,手足不能行走活动,或者伴有身热头痛。如果误当作外感寒热证治疗而使用发散表邪出汗的方法,就会导致筋脉力量枯竭,手足厥冷,从而产生变证疾病。
趁痛散 治疗全身疼痛。
当归(二钱) 甘草(三分) 白术 牛膝 独活 肉桂(各八分) 葱白(八根) 黄芪(一钱) 生姜(二片)
产后虚劳,出现指节痛、颈痛,汗不出,使用以下方剂:
当归 人参 黄芪 生姜 淡豆豉 薤白 猪肾(二个)
先将猪肾用水煮热,取药汁两盏,再煎煮药物至八分碗,温服。
筋骨是由血液滋养的,产后血虚,也能引起疼痛。另外寒邪主收引拘急,或是感受寒气,都能引起疼痛,必须依据脉象和症状,加减用药才恰当。
产后腰痛,是因为妇人腰部系胞宫,归属于肾脏腑脏,产后劳累损伤,肾气受损触动胞络;或者是产后体虚未能立即平复,风寒之邪容易乘虚而入,这两种情况都会导致腰痛。
当归(二钱) 独活(八分) 杜心(此处疑为杜仲之误或特定用法,暂译作杜心/杜仲类,依原文保留“杜心”但注:通常指杜仲或相关补肝肾药,此处按字面翻译并保留原名)(八分) 川芎(八分) 杜仲(八分) 续断(八分) 防风(八分) 桑寄生(八分) 生姜(三片)
服用两帖后,疼痛未止,属于肾虚,服用加味大造丸。
加味大造丸 治疗产后日久,肾虚腰痛。
当归 川芎 熟地黄 天冬 五味子 杜仲 续断 山药 牛膝 故纸(即补骨脂,炒) 小茴香(炒)
牡丹皮 胡桃 人参(各等分)
制成丸剂服用。
又有败血流入腰肾部位,疼痛如锥刺般剧烈,适宜服用复元通气散。
川芎(一钱) 当归(一钱) 小茴香(一钱) 故纸(即补骨脂,一钱) 桂心(一钱) 延胡索(一钱) 牛膝(一钱) 牡丹皮(一钱) 木香(水磨,五分)
病情严重的,加入乳香、没药(四五分)。
Postpartum deficiency combined with cold invasion or consumption of cold drinks causes cold pathogenic factors to attack downward, resulting in lower abdominal pain. There are also cases where pain is caused by blood stasis (blood masses), and others where pain below the umbilicus results from postpartum blood deficiency. All these conditions are suitable for treatment with Modified Shenghua Decoction (Jiajian Shenghua Tang).
Modified Shenghua Decoction (Jiajian Shenghua Tang)
Chuanxiong Rhizome (Liu Fen) Angelica Sinensis Root (Er Qian) Prepared Ginger (Wu Fen) Honey-fried Licorice Root (Si Fen) Peach Kernel (Shi Li)
Question: If pain is caused by blood stasis, add Eruthrea Powder (Yuanhu San) two Qian; this also treats pain due to cold pathogenic factors. If there is no blood stasis but only lower abdominal pain that alleviates slightly upon pressure, it belongs to deficiency; add Prepared Rehmannia Root (Shudi) two Qian.
Eruthrea Powder (Yuanhu San)
Cinnamon Twig (Rougui) Corydalis Rhizome (Yuanhu)
Grind into powder.
Postpartum generalized body pain occurs because after childbirth, all joints and pores are open, and blood vessels disperse. Qi deficiency leads to stagnation of blood in the meridians, which does not dissipate over several days. Consequently, tendons and vessels become tense and pulling, joints are stiff and difficult to move, and even the waist and back cannot turn or bend, nor can the hands and feet walk or move. It may be accompanied by fever and headache. If mistakenly treated as an exterior cold-heat syndrome and treated with diaphoresis (sweating methods), tendon and vessel strength will be exhausted, leading to cold extremities and various complications.
Chentong San treats generalized body pain.
Angelica Sinensis Root (Er Qian) Licorice Root (San Fen) Atractylodes Macrocephala Rhizome Achyranthes Bidentata Root Eucommia Bark Cinnamon Twig (Each Ba Fen) Scallion White (Ba Gen) Astragalus Membranaceus Root (Yi Qian) Ginger (Pian)
For postpartum consumptive disease presenting with finger joint pain, neck pain, and absence of sweating, use the following prescription:
Angelica Sinensis Root Ginseng Radix Astragalus Membranaceus Root Fresh Ginger Fermented Soybean Scallion Bulb Pig Kidney (Two pieces)
First, boil pig kidneys in water until hot, take two cups of the broth, then decoct the herbs until reduced to eight-tenths of a bowl. Take warm.
Tendons and bones are nourished by blood; postpartum blood deficiency can also cause pain. Furthermore, cold pathogenic factors cause contraction and stiffness, and contracting cold can also cause pain. Treatment must rely on pulse and symptom differentiation to adjust the prescription appropriately.
Postpartum lumbar pain occurs because the woman's waist is connected to the uterus and belongs to the Kidney organ system. Postpartum labor injury damages the Kidney Qi and disturbs the uterine collaterals; or if the body remains deficient and has not yet recovered, wind-cold pathogens easily invade. Both situations lead to lumbar pain.
Angelica Sinensis Root (Er Qian) Eucommia Bark (Ba Fen) "Duxin" (Ba Fen - likely a variant or error for Du Zhong/Eucommia) Chuanxiong Rhizome (Ba Fen) Eucommia Bark (Ba Fen) Dipsacus Asper Root (Ba Fen) Saposhnikovia Root (Ba Fen) Taxillus Chinensis Stem (Ba Fen) Ginger (San Pian)
After taking two doses, if pain persists, it indicates Kidney deficiency; take Additive Da Zao Wan.
Additive Da Zao Wan treats prolonged postpartum Kidney deficiency lumbar pain.
Angelica Sinensis Root Chuanxiong Rhizome Prepared Rehmannia Root Asparagus Cochinchinensis Stem Schisandra Berry Eucommia Bark Dipsacus Asper Root Chinese Yam Achyranthes Bidentata Root Psoralea Corylifolia Seed (Stir-fried) Fennel Fruit (Stir-fried) Moutan Cortex Walnut Kernel Ginseng Radix (Equal parts)
Form into pills and take.
Additionally, if failed blood (stasis) flows into the lumbar region and kidneys, causing pain like needle pricks, Fu Yuan Tong Qi San is indicated.
Chuanxiong Rhizome (Yi Qian) Angelica Sinensis Root (Yi Qian) Fennel Fruit (Yi Qian) Psoralea Corylifolia Seed (Yi Qian) Cassia Bark (Gui Xin) Corydalis Rhizome (Yi Qian) Achyranthes Bidentata Root (Yi Qian) Moutan Cortex (Yi Qian) Aucklandia Root (Water-ground, Wu Fen)
In severe cases, add Frankincense (Ruxiang) and Myrrh (Moyao) (Si-Wu Fen).