干、浑身烦躁、睡梦多惊、体虚无力、经水不来,名曰血闭。肠痛面赤,因此难治。变作骨蒸,治须仔细。若
服此丹不应,卢医不起。
第十六∶产后喉中似蝉声如何?答曰,败血冲遏于心,转入肺,气与血并,结成块入喉中,作声似蝉鸣,
人以为怪产。得此病者,十不救一。
第十七∶产后面黄舌干、鼻中流血、遍身色点生斑如何?答曰∶产后败血入五脏六腑皆满,流入肌肤,败
血出入,流走四肢,热结流注,传送不得,故有此疾。可畏可慎!产后有此,十无一活。但此疾百中无一二,
如遇此丹,可保无虞。
第十八∶产后眼涩,腰痛似角弓如何?答曰∶产后百日之后,方得脱体。今在月中,七日以来食麦、爽口
之物,以致烦躁,不得安宁。因循不肯服药调理,兼百日之内过伤房事,或久病,或坐卧当风,取其一时快乐,
殊不知产后血气亏损,倘一犯之,则不能免此患也。
第十九∶产后小便涩、大便不通如何?答曰∶血入肠中谁得知,小便淋沥大便迟;乍寒乍热常多汗,如醉
如痴似鬼迷;花发目前如碎锦,病缠身内总成虚;只消一粒回生药,
产妇从今免困危。
产后诸疾补遗∶
一产妇,略闻音响,其汗如水而昏愦。诸药到口即呕。余以为脾气虚败。用参附末为细丸,时含三五粒,
随液咽下,乃渐加之,至五钱许,却服参附汤而痊。
一产后生肠不收,皆由气虚血弱,所以悬下。但养气和血,其物自收。用补中益气汤去柴胡、陈皮,加川
芎升提之;用热手心常熨腰肚,气暖,其物自收。
一产妇,阴脱肿痛,脉滑数,欲作脓也。用十全大补汤而脓成,又数剂而溃。但小便频数,患处重坠,此
元气虚而下陷也。用补中益气汤而寻愈。
一产妇,生门不闭,发热恶寒,用十全大补加五味,数剂而热退,用补中益气加五味,数剂生门闭。
一产妇,血崩因怒,其血如涌,仆地,口噤目邪,手足搐搦,此肝经血耗生风。余用六味丸一料,诸症悉
退。但食少、晡热,佐以四君子、柴胡、牡丹皮而愈。
一产妇泄泻,四肢、面目浮肿,喘促恶寒。余谓脾肺虚寒,用六君子加姜、桂而泄泻愈;又补中益气而脾
胃健。
一产妇,泄痢腹痛日久,形体骨立、内热晡热、自汗盗汗、口舌糜烂、吐痰,脉洪大,重按全无,此命门
火衰、脾土虚寒而不能摄痰归元。用八味丸补火以生土;用补中益气汤兼补肺金而痊。
一产妇,牙关紧急、腰胀、背反张、四肢抽搐、两目连札,此血去过多、元气亏损、阴火炽盛。用十全大
补汤加炮姜一剂而苏,数剂而安。
一产妇,筋挛臂软、肌肉抽掣,皆属气血虚。用十全大补汤而痊。(以上诸方,俱见补益。)
干(此处疑为“身”或指身体某处干燥,结合上下文及古籍常见讹误,通常指身体燥热或津液亏损导致的干燥感,但原文仅一字“干”,暂译为“干燥”)、浑身烦躁、睡梦中多受惊吓、身体虚弱无力、月经不来潮,这叫做血闭。肠道疼痛且面色发红,因此难以治疗。病情演变出现骨蒸(一种自觉骨内发热、如潮汐般定时发作的热病),治疗必须仔细谨慎。如果服用此丹丸没有效果,即使是扁鹊再世也无法救治。
第十六问:产后喉咙里发出像蝉鸣一样的声音是怎么回事?答曰:这是败血(产后残留的瘀血)冲逆阻滞于心,进而转入肺脏,气与血相互搏结,结成块状进入喉中,发出类似蝉鸣的声音,人们以为这是怪异的产症。得了这种病的产妇,十个人中救不活一个。
第十七问:产后面色发黄、舌苔干燥、鼻孔流血、全身皮肤出现斑点形成斑疹是怎么回事?答曰:产后败血流入五脏六腑使其充满,进而流入肌肤,败血在体内出入流走于四肢,热邪凝结流注,导致气血传导受阻,所以产生这种疾病。令人畏惧且需谨慎对待!产后出现这种情况,十个人中没有一个人能活下来。但这种病在百例中只有一两例,如果遇到此丹丸,可以保证平安无事。
第十八问:产后眼睛干涩,腰痛得像角弓反张一样是怎么回事?答曰:产后一百天之后,身体才能完全恢复。现在还在坐月子期间,七天以来食用小麦、爽口之物,导致烦躁不安,不得安宁。因循守旧不肯服药调理,加上在百日之内过度进行房事,或者久病体虚,或者坐卧时对着风口,贪图一时的快乐,却不知道产后气血亏损,一旦触犯这些禁忌,就不能避免这种祸患。
第十九问:产后小便涩痛、大便不通畅是怎么回事?答曰:血液进入肠中谁能知道,小便淋漓不尽,大便迟缓;时而发冷时而发热,经常多汗,神志恍惚如醉如痴似被鬼迷住;眼前花发如同碎锦,病痛缠身体内总成虚损;只需服下一粒回生药,产妇从此免除困厄危险。
产后各种疾病的补充案例:
有一位产妇,稍微听到一点声响,就大汗淋漓如水并昏沉迷糊。所有药物入口即呕吐。我认为这是脾气虚败所致。用人参、附子研末制成细丸,每次含服三五粒,随着唾液慢慢咽下,然后逐渐增加剂量,直到服用约五钱(约15-25克,视具体度量衡而定,此处指总量或累计量,语境偏向累积或大剂量使用,但“至五钱许”通常指单次或短期总量,结合“渐加之”,理解为逐渐加量至五钱左右),随后服用参附汤而痊愈。
一位产妇子宫脱垂(生肠不收),都是由于气虚血弱,所以脏器悬垂向下。只要调养气和血,脏器自然会收回。使用补中益气汤去掉柴胡、陈皮,加入川芎以升提阳气;用温暖的手掌经常熨烫腰腹部,使气息温暖,脏器自然收回。
一位产妇,阴道脱出肿痛,脉象滑数,想要化脓。使用十全大补汤促使脓成,又服用几剂后溃破排脓。但小便频繁,患处有重坠感,这是元气虚衰而下陷所致。使用补中益气汤不久后痊愈。
一位产妇,宫颈口(生门)不闭合,发热恶寒,使用十全大补汤加五味子,服用几剂后热退,再用补中益气汤加五味子,服用几剂后宫颈口闭合。
一位产妇,因愤怒导致血崩,血流如涌,倒地不起,牙关紧闭,眼球上翻,手足抽搐,这是肝经血耗伤而生风所致。我使用六味丸一料,各种症状全部消退。但食欲少、下午发热,辅以四君子汤、柴胡、牡丹皮而痊愈。
一位产妇腹泻,四肢、面目浮肿,气喘急促,怕冷。我认为这是脾肺虚寒,使用六君子汤加生姜、肉桂而腹泻痊愈;后又用补中益气汤使脾胃健运。
一位产妇,泄痢腹痛日久,形体消瘦如骨立,内有虚热、午后发热、自汗盗汗、口舌糜烂、吐痰,脉象洪大,重按却全无,这是命门火衰、脾土虚寒而不能摄纳痰液归元。使用八味丸(金匮肾气丸)补火以生土;使用补中益气汤兼补肺金而痊愈。
一位产妇,牙关紧急、腰部胀满、背部反张、四肢抽搐、两眼连眨,这是失血过多、元气亏损、阴火炽盛所致。使用十全大补汤加炮姜,一剂后苏醒,几剂后安稳。
Dryness (likely referring to body dryness or fluid deficiency), restlessness throughout the body, frequent startles in dreams, physical weakness and lack of strength, and amenorrhea are collectively named "Blood Obstruction" (Xue Bi). Intestinal pain accompanied by a red face makes it difficult to treat. If the condition evolves into "Bone-steaming Fever" (Gu Zheng, a type of tidal fever with a sensation of heat deep within the bones), treatment requires meticulous care. If this pill fails to produce an effect, even Bian Que (Lu Yi, a legendary physician) could not save the patient.
Question 16: Why does a postpartum woman's throat emit a sound like a cicada? Answer: This is caused by "Decayed Blood" (Bai Xue, residual blood stasis after childbirth) rushing upward and obstructing the Heart, then transferring to the Lungs. Qi and Blood combine to form masses that enter the throat, producing a sound resembling a cicada's chirp. People consider this a strange obstetric disorder. For those who contract this disease, fewer than one in ten can be saved.
Question 17: Why does a postpartum woman present with a sallow complexion, dry tongue, epistaxis (nosebleed), and macules/petechiae appearing all over the body? Answer: Postpartum decayed blood fills the Five Zang and Six Fu organs, flows into the skin and muscles, and circulates through the limbs. Heat condenses and flows, blocking transmission, thus causing this illness. It is fearful and demands caution! If a postpartum woman presents with this, none out of ten will survive. However, such cases are rare, occurring only once or twice in a hundred. If treated with this pill, safety can be ensured.
Question 18: Why do eyes feel gritty and the lower back ache as if in opisthotonos (arched back) after childbirth? Answer: The body typically recovers fully after one hundred days postpartum. Currently, the woman is still in the confinement period. Having consumed wheat and palatable foods for seven days has led to restlessness and unrest. Due to negligence in refusing medicinal regulation, combined with excessive sexual activity within the hundred-day period, prolonged illness, or sitting/lying in drafts for momentary pleasure, she ignores the fact that postpartum Qi and Blood are depleted. Violating these taboos inevitably leads to this affliction.
Question 19: Why are urination difficult and painful, and defecation obstructed after childbirth? Answer: Who knows when blood enters the intestines? Urination is dribbling and delayed; defecation is sluggish. Alternating chills and fever occur frequently with profuse sweating; the mind is confused like intoxication or ghost possession. Visual disturbances appear like fragmented brocade; the illness entangles the body, resulting in total deficiency. Only one pill of the "Reviving Medicine" is needed, and the parturient will be freed from danger henceforth.
Supplementary Cases of Postpartum Diseases:
Case 1: A parturient, upon hearing any slight noise, would sweat profusely like water and become faint and confused. All medicines taken orally were vomited immediately. I diagnosed this as Spleen Qi deficiency and collapse. I prepared fine pills from Ginseng Radix et Rhizoma (Renshen) and Aconiti Lateralis Radix Praeparata (Fuzi). She held three to five pills in her mouth at a time, swallowing them gradually with saliva, and the dosage was slowly increased until reaching approximately five qian (approx. 15-25g cumulative or per course depending on context, here implying a significant dose). Subsequently, she took Shenfu Decoction (Ginseng and Aconite Decoction) and recovered.
Case 2: A postpartum woman suffered from uterine prolapse (intestine descending and not retracting), caused by Qi deficiency and Blood weakness, leading to suspension and descent. Nourishing Qi and Blood allows the organ to retract naturally. I used Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), removing Chai Hu (Bupleuri Radix) and Chen Pi (Citri Reticulatae Pericarpium), and added Chuan Xiong (Ligustici Chuanxiong Rhizoma) to lift the Qi. Additionally, she warmed her waist and abdomen with her hands regularly; as warmth generated, the organ retracted.
Case 3: A parturient presented with vaginal prolapse, swelling, and pain. Her pulse was slippery and rapid, indicating impending suppuration (pus formation). I used Shiquan Dabu Tang (Ten Substance Great Tonifying Decoction) to promote pus formation, followed by several doses to induce rupture and drainage. However, she experienced frequent urination and a heavy, dragging sensation at the lesion site, indicating Yuan Qi (Original Qi) deficiency with sinking. She recovered quickly after taking Buzhong Yiqi Tang.
Case 4: A parturient had a cervix that did not close, accompanied by fever and aversion to cold. I used Shiquan Dabu Tang plus Wu Wei Zi (Schisandrae Chinensis Fructus). After several doses, the fever subsided. Then, using Buzhong Yiqi Tang plus Wu Wei Zi for several doses, the cervix closed.
Case 5: A parturient suffered from metrorrhagia due to anger, with blood gushing forth, causing her to collapse. She exhibited trismus (locked jaw), deviated eyes, and convulsions of the hands and feet. This was Liver Channel Blood depletion generating Wind. I prescribed one package of Liuwei Wan (Six Ingredient Pill with Rehmannia), and all symptoms receded. However, she had poor appetite and afternoon fever. I supplemented with Sijunzi Tang (Four Gentlemen Decoction), Chai Hu (Bupleuri Radix), and Mudan Pi (Moutan Cortex), and she recovered.
Case 6: A parturient suffered from diarrhea, edema of the four limbs and face, panting, and aversion to cold. I diagnosed Spleen and Lung Deficiency-Cold and used Liujunzi Tang (Six Gentlemen Decoction) with Sheng Jiang (Zingiberis Rhizoma Recens) and Rou Gui (Cinnamomi Cortex). The diarrhea ceased; subsequently, Buzhong Yiqi Tang strengthened the Spleen and Stomach.
Case 7: A parturient had chronic dysentery with abdominal pain, emaciation (body reduced to bones), internal heat, afternoon fever, spontaneous sweating, night sweats, oral and lingual ulceration, and expectoration. Her pulse was flooding but empty upon deep pressure. This indicated Decline of Mingmen Fire (Gate of Life Fire) and Spleen Earth Deficiency-Cold, failing to transform phlegm and return it to its source. I used Bajiao Wan (Eight Flavor Pill, i.e., Jin Gui Shenqi Wan) to tonify Fire to generate Earth; combined with Buzhong Yiqi Tang to tonify Lung Metal, and she recovered.
Case 8: A parturient presented with trismus, abdominal distension, opisthotonos, limb convulsions, and blinking eyes. This was due to excessive blood loss, Yuan Qi depletion, and flourishing Yin Fire. One dose of Shiquan Dabu Tang with Pao Jiang (Zingiberis Rhizoma Preparatum) revived her consciousness, and several doses brought stability.
Case 9: A parturient suffered from tendon spasms, arm flaccidity, and muscle twitching, all attributable to Qi and Blood deficiency. She recovered after taking Shiquan Dabu Tang. (All the above formulas are found in the Tonifying Section.)