产后呃逆,气从胃中出,上冲贲门,呃忒作声。有胃气虚寒者,有中气不足者;有冲任
之火
,直犯清道而上者;有饮水过多,水停而逆者;有大小便秘,下焦不通而气上逆者,皆虚极
胃气将绝也。大约产后呃逆,乃胃气虚寒症,多加味理中汤主之。
人参(一钱) 白术(一钱) 炙甘(一钱) 炮姜(一钱) 陈皮(一钱) 丁香(五分) 干柿
蒂(二钱)
竹肉引。
有热去丁香。
产后恶露不下,此症有二∶或因子宫素冷,停滞不行,必小腹胀满,刺痛无时;或因中
气本虚惫,血少气乏,血阻不能尽下,腹必乍痛乍止,痛亦不甚,加减八珍汤主之。
人参 茯苓 炙甘草 当归 川芎 元胡索(酒炒) 香附(醋制)
姜枣引。
痛无补法,如腹痛者,参宜斟酌。
产后恶露不止,因冲任损伤,气血虚惫,旧血未尽,新血不敛,相并而下。当大补气血
,使
旧血行而新血生,不可轻用固涩之剂,致败血凝聚,变为 瘕,成终身大患,十全大补汤主
之。
产后眼见黑花头眩,乃恶露不尽,败血流入肝经,肝开窍于目,故见黑花。诸风振掉,
皆属肝木,故作头眩,清魂散主之。
人参(一钱) 泽叶兰(一钱) 荆芥穗(二钱) 当归(二钱) 川芎(二钱) 炙甘(八分)
丹皮(一钱)
产后呃逆,是气从胃中发出,向上冲撞贲门,发出呃忒的声音。这有因胃气虚寒引起的,有中气不足的;有因冲任二脉之火,直接侵犯清窍通道而向上的;有因饮水过多,水液停聚导致气逆的;有因大小便不通,下焦阻滞导致气机上逆的,这些情况都是极度虚弱、胃气即将断绝的表现。大概产后呃逆,属于胃气虚寒证,多用加味理中汤主治。
人参(一钱) 白术(一钱) 炙甘草(一钱) 炮姜(一钱) 陈皮(一钱) 丁香(五分) 干柿蒂(二钱)
用竹茹做药引。
如果有热象,去掉丁香。
产后恶露不下,这个病症有两种情况:一是因为子宫素来寒冷,血液停滞不行,必然小腹胀满,刺痛没有定时;二是因为中气本来虚弱疲惫,血少气乏,血液阻滞不能排尽,腹部必定时痛时止,疼痛也不严重,用加减八珍汤主治。
人参 茯苓 炙甘草 当归 川芎 元胡索(酒炒) 香附(醋制)
用生姜、大枣做药引。
腹痛没有补益的方法,如果是腹痛的情况,人参的使用需要斟酌。
产后恶露不止,是因为冲任二脉受损,气血虚弱疲惫,旧血未尽,新血无法收敛,新旧血液一同下行。应当大补气血,使旧血排出而新血生成,不可轻易使用固涩的药物,导致败血凝聚,形成瘕积,成为终身的重大隐患,用十全大补汤主治。
产后眼前看见黑花、头晕目眩,是因为恶露不尽,败血流入肝经,肝开窍于目,所以看见黑花。各种风邪引起的震颤动摇,都归属于肝木,所以导致头晕目眩,用清魂散主治。
人参(一钱) 泽兰叶(一钱) 荆芥穗(二钱) 当归(二钱) 川芎(二钱) 炙甘草(八分) 丹皮(一钱)
Postpartum hiccups occur when Qi issues from the stomach, rushes upward to strike the cardia (cardiac orifice), producing a "hic" sound. These may be caused by deficiency-cold of Stomach Qi, insufficiency of Middle Qi; by Fire of the Chong and Ren vessels directly invading the clear pathways and ascending; by excessive drinking leading to water retention and rebellious Qi; or by constipation of both stool and urine causing lower Jiao obstruction and upward rebellion of Qi. All these conditions indicate extreme deficiency with Stomach Qi on the verge of exhaustion. Generally, postpartum hiccups belong to the syndrome of Stomach Qi deficiency-cold, primarily treated with Modified Lizhong Decoction (Cinnamon Twig and Ginger Decoction).
Ren Shen (Ginseng Radix) (1 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma) (1 qian), Zhi Gan Cao (Honey-fried Licorice Root) (1 qian), Pao Jiang (Roasted Zingiberis Rhizoma) (1 qian), Chen Pi (Citri Reticulatae Pericarpium) (1 qian), Ding Xiang (Caryophylli Flos) (5 fen), Gan Shi Di (Dried Persimmon Calyx) (2 qian).
Use Zhu Ru (Bambusae Caulis in Taenia) as an adjuvant.
If there is heat, remove Ding Xiang.
Failure of lochia to discharge postpartum presents in two patterns: First, due to inherent coldness of the uterus causing stagnation, resulting in distension and fullness of the lower abdomen with unceasing, stabbing pain; second, due to inherent deficiency and exhaustion of Middle Qi, with scant blood and weak Qi, where blood stasis prevents complete expulsion, resulting in intermittent abdominal pain that is not severe. This is primarily treated with Modified Bazhen Decoction (Eight-Treasure Decoction).
Ren Shen (Ginseng Radix), Fu Ling (Poria), Zhi Gan Cao (Honey-fried Licorice Root), Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Yuan Hu Suo (Corydalis Rhizoma, stir-fried with wine), Xiang Fu (Cyperi Rhizoma, processed with vinegar).
Use Sheng Jiang (Zingiberis Rhizoma Recens) and Da Zao (Jujubae Fructus) as adjuvants.
There is no tonification method for abdominal pain; if abdominal pain is present, the use of Ren Shen should be carefully considered.
Persistent lochia discharge postpartum results from injury to the Chong and Ren vessels, leading to deficiency and exhaustion of Qi and Blood. With old blood not yet exhausted and new blood unable to consolidate, they flow down together. One must greatly tonify Qi and Blood to promote the expulsion of old blood and generation of new blood. One must not lightly employ astringent agents, which would cause blood stasis to coagulate, forming masses (zhang/jia accumulations), becoming a lifelong major affliction. This is primarily treated with Shiquan Dabu Decoction (Complete Great Tonifying Decoction).
Seeing black spots before the eyes and dizziness postpartum occurs because lochia is not fully discharged; stagnant blood flows into the Liver channel. Since the Liver opens into the eyes, black spots are seen. All wind-induced tremors and shaking belong to Wood of the Liver, thus causing dizziness. This is primarily treated with Qinghun San (Soul-Clearing Powder).
Ren Shen (Ginseng Radix) (1 qian), Ze Lan Ye (Lycopus Japonicus Herba) (1 qian), Jing Jie Sui (Schizonepetae Spica) (2 qian), Dang Gui (Angelicae Sinensis Radix) (2 qian), Chuan Xiong (Ligustici Chuanxiong Rhizoma) (2 qian), Zhi Gan Cao (Honey-fried Licorice Root) (8 fen), Dan Pi (Moutan Cortex) (1 qian).