黄公 徐 小产后带下如注,脉弦细涩,脘中有形,攻触而痛,癸水不调。姑宜涩下平肝。(六月七号乙巳二十二日。)
生牡蛎(四钱) 草豆蔻(一钱) 仙半夏(钱半) 丹皮(钱半) 化龙骨(钱半) 制香附(
二钱) 广皮(钱半) 玫瑰花(五朵) 炒杜仲(二钱) 左金丸(八分) 木蝴蝶(四分)
清煎五帖。
介按∶刘宗浓曰∶带下多本于阴虚阳竭,营气不升,经脉凝涩,冲气下陷,精气积滞于下焦
而成。今此案系是肝经抑郁,耗及营液,以致带脉失固,冲气下陷。故小产之后,而带下如
注,冲任虚气挟肝阳上逆,则脘腹作痛,治宜平肝补肾为先。
华舍施 产后湿臌,溲黄,腹满,足肿,脉滞,舌黄,症势棘手。(民国十年七月十九日。)
杜赤小豆(钱半,杵) 大腹绒(钱半) 带皮苓(四钱) 光杏仁(三钱) 冬葵子(三钱)
(五分) 泽泻(三钱) 地骷髅(一两,煎汤代水) 晚蚕砂(一两,包) 淡附片(四分) 炒米仁(四钱)
四帖。
又 产后臌胀,舌仍黄,溲较长,脘未展,脉尚滞,症尚棘手。
淡附片(五分) 鸡内金(三钱炒) 杜赤豆(钱半,杵) 枣槟(钱半) 光杏仁(三钱) 桃
(十粒) 官桂(五分) 椒目(五分) 晚蚕砂(一两,包) 沉香曲(钱半) 冬葵子(三钱) 地
煎汤代水)
又 产后臌胀,脉尚滞,溲长,舌黄,症尚棘 手。(八月初五日。)
沉香曲(钱半) 晚蚕砂(一两) 蜣螂(三双) 大腹绒(钱半) 炒鸡内金(三钱) 冬葵子(三钱) 乌药
(钱半) 椒目(五分) 杜赤豆(钱半,杵) 淡附片(四分) 原粒砂仁(一钱,盐水炒) 地骷髅(一两,煎汤
代水)
介按∶产后而患臌胀,须防瘀血凝结,但用普通治湿臌之药,决难奏效。虽则在后二方
,用桃仁十粒,亦难济事。若能参用抵当汤,庶几近之,否则兼与黄连、丹参、大黄、五灵脂、
蒲黄等品,下其瘀血,或能中鹄。后闻斯人转就诊于潘星如君而全愈,谅必兼用消瘀之品矣
。此方渗湿扶阳,若治普通湿臌之症,亦是极好。惟产后血臌,尚欠斟酌。今特录之,以资
黄公徐氏,小产后带下如注,脉象弦细而涩,脘腹中有形之物,攻冲触压则痛,月经不调。暂宜采用固涩止带、平抑肝阳之法。(六月七日,乙巳年二十二日。)
生牡蛎(四钱) 草豆蔻(一钱) 仙半夏(一钱半) 丹皮(一钱半) 煅龙骨(一钱半) 制香附(二钱) 广陈皮(一钱半) 玫瑰花(五朵) 炒杜仲(二钱) 左金丸(八分) 木蝴蝶(四分)
清水煎服,共五帖。
介按:刘宗浓说:带下病多本于阴虚阳竭,营气不能上升,经脉凝滞涩阻,冲脉之气下陷,精气积滞于下焦而成。如今这个案例属于肝经抑郁,耗伤营阴津液,导致带脉失于固摄,冲脉之气下陷。所以小产之后,带下如注,冲任虚气挟带肝阳上逆,则脘腹部作痛,治疗应当以平肝补肾为先。
华舍施氏,产后湿臌,小便黄,腹部胀满,足部浮肿,脉象滞涩,舌苔黄,病情棘手。(民国十年七月十九日。)
赤小豆(一钱半,捣碎) 大腹皮(一钱半) 茯苓皮(四钱) 光杏仁(三钱) 冬葵子(三钱) 泽泻(三钱) 地骷髅(一两,煎汤代水) 晚蚕砂(一两,包煎) 淡附片(四分) 炒薏苡仁(四钱)
四帖。
又诊:产后臌胀,舌苔仍黄,小便较长,脘腹胀闷未展,脉象尚滞涩,病情依然棘手。
淡附片(五分) 鸡内金(三钱,炒) 赤小豆(一钱半,捣碎) 枣槟榔(一钱半) 光杏仁(三钱) 桃仁(十粒) 肉桂(五分) 椒目(五分) 晚蚕砂(一两,包煎) 沉香曲(一钱半) 冬葵子(三钱) 地骷髅(一两,煎汤代水)
又诊:产后臌胀,脉象尚滞涩,小便较长,舌苔黄,病情依然棘手。(八月初五日。)
沉香曲(一钱半) 晚蚕砂(一两) 蜣螂(三双) 大腹皮(一钱半) 炒鸡内金(三钱) 冬葵子(三钱) 乌药(一钱半) 椒目(五分) 赤小豆(一钱半,捣碎) 淡附片(四分) 原粒砂仁(一钱,盐水炒) 地骷髅(一两,煎汤代水)
介按:产后患臌胀,须防备瘀血凝结,但若只用普通治疗湿臌的药物,决难奏效。虽然在后两个方剂中用了十粒桃仁,也难以济事。如果能参用抵当汤,或许接近有效,否则兼用黄连、丹参、大黄、五灵脂、蒲黄等药物,攻下其瘀血,或许能命中目标。后来听说此人转而就诊于潘星如医生而痊愈,想必是兼用了消瘀的药物了。此方渗湿扶阳,若治疗普通的湿臌病症,也是极好的。只是对于产后血臌,尚欠斟酌。今特意记录在此,以供参考。
Mr. Huang's wife, Xu, suffered from leukorrhea flowing like a torrent after a minor abortion. Her pulse was wiry, fine, and choppy. There was a palpable mass in the epigastrium that caused pain upon pressure or thrusting, and her menstrual periods were irregular. It is tentatively advisable to employ methods to astringe the discharge and calm the Liver Yang. (June 7th, Yisi Year, 22nd day.)
Sheng Muli (Raw Oyster Shell, 4 qian) Caodoukou (Grass Cardamom Seed, 1 qian) Xian Banxia (Prepared Pinellia Tuber, 1.5 qian) Danpi (Moutan Cortex, 1.5 qian) Hua Longgu (Calcined Dragon Bone, 1.5 qian) Zhi Xiangfu (Processed Cyperus Rhizome, 2 qian) Guangpi (Broad-leaved Tangerine Peel, 1.5 qian) Meiguihua (Rose Flower, 5 pieces) Chao Duzhong (Stir-fried Eucommia Bark, 2 qian) Zuojin Wan (Left Metal Pill, 0.8 fen) Mutuhdie (Butterfly Tree Leaf, 0.4 fen)
Decoct in clear water for five doses.
Commentary by Jie: Liu Zongnong stated that leukorrhea mostly originates from Yin deficiency and Yang exhaustion, where Ying Qi fails to ascend, meridians become coagulated and stagnant, Chong Mai (Penetrating Vessel) Qi sinks downward, and essence accumulates stagnantly in the Lower Jiao (Lower Burner). In this case, it is due to depression of the Liver Meridian, consuming Ying fluids, leading to the Dai Mai (Girdle Vessel) losing its firmness and Chong Qi sinking. Thus, after the minor abortion, leukorrhea flows like a torrent. The deficient Qi of Chong and Ren vessels carries Liver Yang upward in rebellion, causing pain in the epigastrium and abdomen. Treatment should prioritize calming the Liver and tonifying the Kidney.
Ms. Shi from Huashe suffered from damp distension after childbirth, with yellow urine, abdominal fullness, swollen feet, a sluggish pulse, and a yellow tongue coating. The condition was difficult to treat. (July 19th, Republic of China Year 10.)
Chi Xiaodou (Red Adzuki Bean, 1.5 qian, crushed) Dafurong (Areca Peel, 1.5 qian) Daipi Ling (Poria with Coconut Husk, 4 qian) Guang Xingren (Apricot Kernel, 3 qian) Dongkuizi (Malva Seeds, 3 qian) Zexie (Alisma Rhizome, 3 qian) Diskulou (Dried Trichosanthes Root, 1 liang, decocted as water substitute) Wancansha (Silkworm Excrement, 1 liang, wrapped) Dan Fupian (Lightly Processed Aconite Slice, 0.4 fen) Chao Yiren (Stir-fried Coix Seed, 4 qian)
Four doses.
Second visit: Postpartum distension, tongue coating remains yellow, urination continues to be prolonged, epigastric fullness has not resolved, pulse is still sluggish, and the condition remains difficult.
Dan Fupian (Lightly Processed Aconite Slice, 0.5 fen) Ji Neijin (Chicken Gizzard Lining, 3 qian, stir-fried) Chi Xiaodou (Red Adzuki Bean, 1.5 qian, crushed) Zao Binglang (Betel Nut with Jujube, 1.5 qian) Guang Xingren (Apricot Kernel, 3 qian) Tao Ren (Peach Kernel, 10 grains) Guanzi Gui (Cinnamon Twig, 0.5 fen) Jiaomu (Zanthoxylum Seed, 0.5 fen) Wancansha (Silkworm Excrement, 1 liang, wrapped) Chenxiang Qu (Agarwood Fermented Medicine, 1.5 qian) Dongkuizi (Malva Seeds, 3 qian) Diskulou (Dried Trichosanthes Root, 1 liang, decocted as water substitute)
Third visit: Postpartum distension, pulse is still sluggish, urination is prolonged, tongue coating is yellow, and the condition remains difficult. (August 5th.)
Chenxiang Qu (Agarwood Fermented Medicine, 1.5 qian) Wancansha (Silkworm Excrement, 1 liang) Danglang (Dung Beetle, 3 pairs) Dafurong (Areca Peel, 1.5 qian) Chao Ji Neijin (Stir-fried Chicken Gizzard Lining, 3 qian) Dongkuizi (Malva Seeds, 3 qian) Wuyao (Lindera Root, 1.5 qian) Jiaomu (Zanthoxylum Seed, 0.5 fen) Chi Xiaodou (Red Adzuki Bean, 1.5 qian, crushed) Dan Fupian (Lightly Processed Aconite Slice, 0.4 fen) Yuanli Sharen (Whole Amomum Fruit, 1 qian, stir-fried with salt water) Diskulou (Dried Trichosanthes Root, 1 liang, decocted as water substitute)
Commentary by Jie: When distension occurs postpartum, one must guard against blood stasis coagulation. Using ordinary drugs for treating damp distension will certainly fail. Although ten peach kernels were used in the latter two prescriptions, they are insufficient. If Didang Tang (Ephedra Decoction for Breaking Stasis) were incorporated, it might be effective; otherwise, combining herbs such as Huanglian (Coptis Rhizome), Danshen (Salvia Root), Dahuang (Rhubarb Root), Wulingzhi (Trogopterus Dung), and Puhuang (Typha Pollen) to purge blood stasis might hit the target. Later, I heard that this patient recovered completely under the care of Dr. Pan Xingru, likely because blood-resolving agents were also used. This prescription drains dampness and supports Yang; if applied to ordinary damp distension, it is excellent. However, regarding postpartum blood distension, it requires further deliberation. I record this here for reference.