凡产母产时用力过甚,劳倦伤脾,脾气耗竭不能注于四肢,故足冷逆而厥气上行。经曰∶阳气衰于下则为
寒厥。厥气上行,满于经络,则神气浮越,去身而飘散矣。苟非大补,焉能回阳而复神,必用加参生化汤倍人参,
连进二帖,使气血旺而神复厥止。如渴,另用生脉散代茶,助津以滋脏燥。虽有四肢厥冷、泄漏,或类伤寒阴症,
亦不可四逆汤辈,必加参生化佐以黑姜,或加熟附一片,以回阳止逆则可,已足以行参 之力矣。
加参生化汤
人参(二钱) 川芎(二钱) 当归(四钱) 姜炭 炙草(各四分) 桃仁(十粒)
加元枣二枚水煎。如厥回,暂去人参,待血块痛除再加。此治新产发厥。
滋荣益气复神汤(产后发厥,无块痛者服此。)
川芎 焦术 炙 麦冬(各一钱) 人参 当归(各三钱) 熟地(二钱) 炙草(四分) 陈皮(四分)
五味(十粒)
水煎服。口渴,以生脉散代茶。汗多,加麻黄根、枣仁各一钱。块痛不止,加肉桂五分。便闭,加苁蓉,麻
仁各二钱。痰,加竹沥,姜汁、橘红各四分,酒一杯,手足口气渐冷,加附子五分,倍用人参。
按∶厥逆属阳虚者居多,若无块痛、腹胀等症,纯用参附。加肉桂可也,有桂则瘀亦去矣。不可迟疑。
大抵产后晕厥,皆由气血两竭,神将去而几息,仅有一线生意耳。若非大补,不能回将绝之元阳。但晕在临盆,
尤甚于厥,宜频服生化汤,先补血分之亏,可期块化血旺,神清晕止。如无汗脱、神倦、气促等症,切勿遽加参 。
或厥在分娩之后,气血两竭,宜用加参生化以复其神。总之,治晕问有块痛,参术未可骤进;问无块痛,参、 、
地、术,必须并用。
凡是产妇在分娩时用力过度,导致劳倦损伤脾脏,脾气耗竭无法输送到四肢,所以出现脚部发冷、逆冷甚至厥逆,且厥气向上逆行。医经说:阳气在下部衰微就会发生寒厥。厥气向上逆行,充满经络,就会导致神气浮越,脱离身体而飘散。如果不是大补元气,怎么能挽回阳气并恢复神志?必须使用加参生化汤并加倍人参用量,连续服用两帖,使气血旺盛从而神志恢复、厥逆停止。如果口渴,另外用生脉散代替茶水饮用,以补充津液滋润脏腑干燥。虽然出现四肢厥冷、汗出淋漓等症状,或者类似伤寒阴证的表现,也不能使用四逆汤这类方剂,必须用加参生化汤配合黑姜(炮姜),或者加一片熟附子,来挽回阳气、制止逆气,这就足以发挥人参的功效了。
加参生化汤
人参(二钱) 川芎(二钱) 当归(四钱) 姜炭 炙甘草(各四分) 桃仁(十粒)
加入元枣(大枣)两枚,用水煎煮。如果厥逆症状缓解,暂时去掉人参,等到血块疼痛消除后再重新加入。这是治疗新产妇产后发厥的方法。
滋荣益气复神汤(产后发厥,没有血块疼痛症状者服用此方。)
川芎 焦白术 炙麦冬(各一钱) 人参 当归(各三钱) 熟地黄(二钱) 炙甘草(四分) 陈皮(四分)
五味子(十粒)
用水煎服。如果口渴,用生脉散代替茶水。如果出汗多,加麻黄根、酸枣仁各一钱。如果血块疼痛不止,加肉桂五分。如果大便闭塞,加肉苁蓉、火麻仁各二钱。如果有痰,加竹沥、姜汁、橘红各四分,酒一杯。如果手足和口气逐渐变冷,加附子五分,加倍使用人参。
按语:厥逆属于阳虚的情况居多,如果没有血块疼痛、腹胀等症状,纯用人参、附子,加上肉桂也是可以的,有肉桂则瘀血也能去除。不可迟疑不决。
大抵产后晕厥,都是由气血两虚枯竭,神气即将离去而气息微弱,仅存一线生机罢了。如果不是大补元气,不能挽回将绝的元阳。但是晕厥发生在临盆之时,比厥逆更严重,适宜频繁服用生化汤,先补血分的亏损,期望血块化解、血液旺盛,神志清醒、晕厥停止。如果没有汗脱、神疲倦怠、气促等症状,切勿急于加入人参。或者厥逆发生在分娩之后,气血两虚枯竭,宜用加参生化汤来恢复神志。总之,治疗晕厥要询问是否有血块疼痛,如果有,人参、白术不可突然进补;询问如果没有血块疼痛,人参、熟地、熟地、白术必须同时使用。
In cases where the mother exerts excessive effort during childbirth, fatigue damages the Spleen, causing Spleen Qi (Spleen energy) to exhaust and fail to nourish the four limbs. Consequently, the feet become cold and reverse into Jue syndrome (cold extremities with reversal of cold qi), while the Jue qi ascends. The Classics state: "When Yang Qi is deficient at the lower part, it results in Cold Jue." When Jue qi ascends and fills the meridians and collaterals, the Shen spirit becomes floating and scattered, departing from the body. Unless substantial tonification is applied, how can Yang Qi be restored and the Shen revived? One must use Jiashen Shenghua Decoction (Ginseng-Added Blood-Generating Decoction) with doubled Ginseng dosage, administered consecutively for two doses, to make Qi and Blood abundant, thereby restoring the Shen and stopping Jue. If there is thirst, use Shaoyang San (Pulse-Nourishing Powder) as tea substitute to assist Jin fluids and moisten organ dryness. Although symptoms such as cold extremities, sweating, or presentations resembling Yin syndromes of Shanghan (Cold Damage) may occur, one must not use Si Ni Tang (Frigid Extremities Decoction). Instead, Jiashen Shenghua Decoction should be combined with Heijiang (Charred Ginger) or one piece of Shu Fuzi (Prepared Aconite Root) to restore Yang and stop rebellion; this is sufficient to enhance the efficacy of Ginseng.
Jiashen Shenghua Decoction (Ginseng-Added Blood-Generating Decoction)
Renshen (Ginseng Radix et Rhizoma) (2 qian)
Chuanxiong (Ligusticum Chuanxiong Rhizome) (2 qian)
Danggui (Angelica Sinensis Radix) (4 qian)
Jiangtan (Charred Ginger)
Zhi Cao (Honey-fried Licorice Root) (each 4 fen)
Taoren (Prunus Persica Seed) (10 grains)
Decoct with 2 Yuan Zao (Jujube Fruit). If Jue resolves, temporarily remove Renshen; re-add it after blood stasis and pain are eliminated. This treats postpartum Jue following recent delivery.
Zirong Yiqi Fushen Decoction (Nourishing Blood, Replenishing Qi, and Restoring Spirit Decoction) (For postpartum Jue without blood stasis pain.)
Chuanxiong (Ligusticum Chuanxiong Rhizome)
Jiao Zhu (Charred Atractylodes Macrocephala Rhizome)
Zhi Maidong (Honey-fried Ophiopogon Tuber) (each 1 qian)
Renshen (Ginseng Radix et Rhizoma)
Danggui (Angelica Sinensis Radix) (each 3 qian)
Shu Di (Rehmannia Glutinosa Root Preparata) (2 qian)
Zhi Cao (Honey-fried Licorice Root) (4 fen)
Chenpi (Citrus Reticulata Pericarpium) (4 fen)
Wuwei (Schisandra Chinensis Fruit) (10 grains)
Decoct in water and take orally. For thirst, use Shaoyang San as tea. For profuse sweating, add Mahuang Gen (Ephedra Root) and Zao Ren (Ziziphus Jujuba Seed) each 1 qian. For persistent stasis pain, add Rougui (Cinnamon Bark) 5 fen. For constipation, add Congrong (Cistanche Deserticola) and Maren (Cannabis Seed) each 2 qian. For phlegm, add Zhuli (Bamboo Sap), Jiangzhi (Ginger Juice), and Juhong (Aged Tangerine Peel) each 4 fen, plus 1 cup of wine. If hands, feet, and breath become gradually cold, add Fuzi (Aconitum Lateralis Radix Preparata) 5 fen and double the dose of Renshen.
Note: Most cases of Jue involve Yang deficiency. If there are no symptoms like stasis pain or abdominal distension, using solely Renshen and Fuzi, possibly with Rougui, is acceptable; Rougui also dispels stasis. Do not hesitate.
Generally, postpartum fainting and Jue result from exhaustion of both Qi and Blood, with the Shen on the verge of departure and only a thread of life remaining. Without substantial tonification, the nearly extinct Yuan Yang cannot be restored. However, fainting occurring during labor is more severe than Jue; frequent administration of Shenghua Decoction is appropriate to first replenish Blood deficiency, expecting stasis resolution, Blood abundance, clear Shen, and cessation of fainting. If there are no symptoms of sweat collapse, mental fatigue, or shortness of breath, do not hastily add Renshen. If Jue occurs after delivery due to Qi and Blood exhaustion, Jiashen Shenghua Decoction should be used to restore the Shen. In summary, when treating fainting, inquire about stasis pain: if present, Renshen and Zhu should not be introduced abruptly; if absent, Renshen, Shu Di, and Zhu must be used together.