产后劳伤气血,脏腑虚损,不能运化食物,及风冷相乘,以致阴阳升降不顺,清浊乱于
肠胃,冷热不调,邪正相搏,上吐下泻,名曰霍乱。若块痛未除,宜生化六和汤,若块痛已
止,宜藿香温胃散。
生化六和汤∶川芎二钱,当归四钱,黑姜、炙甘草、陈皮各四分,砂仁六分,茯苓一钱
,姜一片,水煎。
藿香温胃散,当归、白术各三钱,姜炭、藿香、陈皮各四分,浓朴八分,人参一钱,炙
甘草三分,姜一片,水煎。若手足逆冷。加附子三分。
胎前素弱,临产又劳,中气多不足,心腹多不舒,胃虽纳谷,脾不健运。如产毕即服生
化三四帖,痛止后随服加参生化汤助脾健胃,自无中满等症。其或中满膨胀者,大率因消食
而误进消导,因气郁而专于消耗,又因多食冷物而停滞恶露,又因血虚便秘,误下而愈胀。
殊不知产后血气两亏,痛减后宜大补气血以助中气,不宜过于消耗。消耗稍峻,胃气益损,
满闷益增,气不升降,滋热助积,郁积之久,遂成膨胀。治当审何物误用,如误用耗气药,
宜益气汤;误用消导药,宜健脾汤;误服攻下药,宜养生化滞汤。
益气汤∶人参、白术、当归各三钱,川芎、白芍各八分,茯苓一钱五分,陈皮、浓朴各
四分,苏根、炙甘草各五分,腹皮六分,木香二分(磨),萝卜子三分,木通五分。
健脾汤∶人参、白术、当归、茯苓、白芍、神曲各一钱,川芎七分,陈皮四分,炙甘草
、砂仁各五分,腹皮五分。伤食加麦芽五分;伤冷物、腹大痛,加吴萸一钱。
差生化滞汤,川芎二钱,当归四钱,人参一钱半(胀甚者减半),白芍、茯苓各一钱,
白术二钱(胀甚倍用),桃仁十粒,腹皮四分,苁蓉(酒洗)一钱五分。如块痛,即将本汤
送三
产后因劳累损伤气血,导致脏腑功能虚弱受损,无法运化食物;加之风冷之邪侵袭,致使阴阳之气升降失常,清浊之气在肠胃中混乱,冷热不调,邪气与正气相互搏结,出现上吐下泻的症状,这种病症称为霍乱。如果恶露块痛尚未消除,适宜使用生化六和汤;如果块痛已经停止,适宜使用藿香温胃散。
生化六和汤:川芎二钱,当归四钱,黑姜、炙甘草、陈皮各四分,砂仁六分,茯苓一钱,生姜一片,加水煎服。
藿香温胃散:当归、白术各三钱,姜炭、藿香、陈皮各四分,厚朴八分,人参一钱,炙甘草三分,生姜一片,加水煎服。如果出现手足逆冷的症状,加入附子三分。
怀孕前体质素来虚弱,分娩时又过度劳累,导致中气大多不足,心腹部多感不适。虽然胃能接受食物,但脾脏不能健运消化。如果在生产结束后立即服用三四帖生化汤,待疼痛停止后随即服用加参生化汤以辅助脾胃健运,自然就不会出现中满等症。那些出现中满膨胀症状的,大都是因为误用消食导滞的药物,或因气机郁结而专门使用消耗正气的药物,又或因多吃生冷食物导致恶露停滞,还或因血虚便秘而误用攻下药导致胀满加重。殊不知产后气血两亏,疼痛减轻后应当大补气血以助长中气,不应当过于消耗正气。如果消耗药力稍猛,胃气会更加受损,胀闷感更加增加,气机不能升降,滋生热邪并助长积滞,郁积日久,最终形成膨胀病。治疗时应当审查是何种药物误用所致:如误用了耗气药,适宜使用益气汤;误用了消导药,适宜使用健脾汤;误服了攻下药,适宜使用差生化滞汤。
益气汤:人参、白术、当归各三钱,川芎、白芍各八分,茯苓一钱五分,陈皮、厚朴各四分,苏梗(或紫苏根)、炙甘草各五分,腹皮六分,木香二分(磨汁冲服),萝卜子三分,木通五分。
健脾汤:人参、白术、当归、茯苓、白芍、神曲各一钱,川芎七分,陈皮四分,炙甘草、砂仁各五分,腹皮五分。若因伤食,加麦芽五分;若因伤冷物且腹部大痛,加吴茱萸一钱。
差生化滞汤:川芎二钱,当归四钱,人参一钱半(胀甚者减半用量),白芍、茯苓各一钱,白术二钱(胀甚加倍使用),桃仁十粒,腹皮四分,肉苁蓉(酒洗)一钱五分。如果有块痛,就用本汤送服……(原文此处中断)
Postpartum labor and fatigue damage Qi and Blood, causing deficiency and impairment of the Zang-Fu organs, leading to an inability to transform and transport food. Additionally, invasion by wind-cold pathogens disrupts the ascending and descending of Yin and Yang, causing chaos between clear and turbid Qi in the intestines and stomach. With disharmony of cold and heat, and struggle between pathogenic factors and healthy Qi, symptoms of vomiting from above and diarrhea from below occur; this condition is named Huoluan (Cholera-like syndrome). If the pain from blood stasis masses has not subsided, Shenghua Liuhe Tang (Life-Generating Six-Harmonies Decoction) is appropriate. If the mass pain has ceased, Huoxiang Wenwei San (Agastache Stomach-Warming Powder) is appropriate.
Shenghua Liuhe Tang: Chuanxiong Rhizome (Chuanxiong) 2 qian, Angelicae Sinensis Radix (Danggui) 4 qian, Black Ginger (Heijiang), Honey-fried Licorice Root (Zhigancao), and Tangerine Peel (Chenpi) each 4 fen, Amomum Fruit (Sharen) 6 fen, Poria (Fuling) 1 qian, one slice of Fresh Ginger (Jiang), decocted in water.
Huoxiang Wenwei San: Angelicae Sinensis Radix (Danggui) and Atractylodis Macrocephalae Rhizoma (Baizhu) each 3 qian, Charred Ginger (Jiangtan), Agastache Herba (Huoxiang), and Tangerine Peel (Chenpi) each 4 fen, Magnolia Bark (Houpo) 8 fen, Ginseng Radix et Rhizoma (Renshen) 1 qian, Honey-fried Licorice Root (Zhigancao) 3 fen, one slice of Fresh Ginger (Jiang), decocted in water. If there is cold reversal of the hands and feet, add Aconiti Lateralis Radix Praeparata (Fuzi) 3 fen.
If the constitution was weak prior to pregnancy, and labor during delivery caused further exhaustion, Middle Qi is often insufficient, and the heart and abdomen are often uncomfortable. Although the Stomach accepts grain, the Spleen fails to transport and transform effectively. If one takes three or four doses of Shenghua Tang immediately after childbirth, and subsequently takes Jia Shen Shenghua Tang (Ginseng-Added Life-Generating Decoction) after the pain stops to assist the Spleen and Stomach in robust transportation, symptoms such as Middle Fullness will naturally be avoided. Those who suffer from Middle Fullness and Distension generally do so because they mistakenly took digestive-promoting drugs for food stagnation, used draining drugs exclusively for Qi depression, consumed excessive cold foods causing lochia retention, or mistakenly used purgatives for constipation due to Blood deficiency, thereby worsening distension. It is unknown that postpartum involves a dual deficiency of Blood and Qi; after pain subsides, one should greatly tonify Qi and Blood to support Middle Qi, rather than excessively deplete it. If depletion is too harsh, Stomach Qi is further damaged, fullness and oppression increase, Qi fails to ascend and descend, generating heat and assisting accumulation. Long-standing depression and accumulation eventually form Distension disease. Treatment should examine which drug was misused: if Qi-depleting drugs were misused, Yiqi Tang (Benefit-Qi Decoction) is appropriate; if digestive-promoting drugs were misused, Jianpi Tang (Strengthen-Spleen Decoction) is appropriate; if purgative drugs were mistakenly taken, Cha Shenghua Zhizhi Tang (Correcting Life-Generating Resolving-Stasis Decoction) is appropriate.
Yiqi Tang: Ginseng Radix et Rhizoma (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu), and Angelicae Sinensis Radix (Danggui) each 3 qian, Chuanxiong Rhizome (Chuanxiong) and Paeoniae Radix Alba (Baishao) each 8 fen, Poria (Fuling) 1.5 qian, Tangerine Peel (Chenpi) and Magnolia Bark (Houpo) each 4 fen, Perilla Stem (Sugen), and Honey-fried Licorice Root (Zhigancao) each 5 fen, Citrus Aurantium Fructus Immaturus (Fupi) 6 fen, Aucklandiae Radix (Muxiang) 2 fen (ground into powder), Raphani Semen (Luobozhi) 3 fen, Akebia Caulis (Mutong) 5 fen.
Jianpi Tang: Ginseng Radix et Rhizoma (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu), Angelicae Sinensis Radix (Danggui), Poria (Fuling), Paeoniae Radix Alba (Baishao), and Massao Fungus (Shenqu) each 1 qian, Chuanxiong Rhizome (Chuanxiong) 7 fen, Tangerine Peel (Chenpi) 4 fen, Honey-fried Licorice Root (Zhigancao) and Amomum Fruit (Sharen) each 5 fen, Citrus Aurantium Fructus Immaturus (Fupi) 5 fen. For food injury, add Hordeum Vulgare Fructus Germinatus (Maiya) 5 fen; for cold food injury with severe abdominal pain, add Evodiae Fructus (Wuyu) 1 qian.
Cha Shenghua Zhizhi Tang: Chuanxiong Rhizome (Chuanxiong) 2 qian, Angelicae Sinensis Radix (Danggui) 4 qian, Ginseng Radix et Rhizoma (Renshen) 1.5 qian (reduce by half if distension is severe), Paeoniae Radix Alba (Baishao) and Poria (Fuling) each 1 qian, Atractylodis Macrocephalae Rhizoma (Baizhu) 2 qian (double if distension is severe), Prunus Persica Semen (Taoren) 10 grains, Citrus Aurantium Fructus Immaturus (Fupi) 4 fen, Cistanche Deserticola (Congrong) washed in wine 1.5 qian. If there is mass pain, administer this decoction to deliver... (text ends here)