钦 初产汗出眩晕。胸痞。腹痛。宜通恶露。(新产恶露瘀滞)
炒山楂 延胡 郁金 赤芍 炒牛膝 香附 童便(冲) 益母草汤代水。
又 腹痛少缓。但胸痞痰多。治从上焦。
炒山楂 郁金 丹参 橘红 炒川贝 甜花粉
程 冲脉为病。男子内结七疝。女子带下瘕聚。故奇脉之结实者。古人必用苦辛。和芳香。以通
脉络。其虚者。必辛甘温补。佐以流行脉络。务在气血调和。病必全愈。今产后体虚。兼瘀而痛。
法当益体攻病。日期已多。缓治为宜。(体虚兼瘀)
生地 生姜 丹皮 琥珀末(调入)
此苦辛偶方。加丹皮以通外。琥珀以通内。所以取效。
又 回生丹 取米醋煮大黄一味。约入病所。不碍无病之所。故亦效。二法皆入络药。
又 小生地 归须 红花 郁李仁 柏子仁 茯神
又照前方去红花郁李仁。加泽兰。
某(二五) 恶露淋漓。痛由腰起。攻及少腹。此督带空虚。奇经气阻奚疑。奇经为病。通因一法。为古圣
贤之定例。
当归 楂肉炭 炒丹皮 泽兰 川断 制首乌
唐 产后骤脱。参附急救。是挽阳固气方法。但损在阴分。其头痛汗出烦渴。乃阳气上冒。凡
开泄则伤阳。辛热则伤阴。俱非新产郁冒之治道。尝读仲景书。明本草意。为是拟方于后。亦
非杜撰也。(郁冒)
生左牡蛎(一钱) 生地(二钱) 上阿胶(二钱) 炒黑楂肉(三钱) 茺蔚子(一钱半)
吴 新产阴气下泄。阳气上冒。日晡至戌亥。阳明胃衰。厥阴肝横。肝血无藏。气冲扰膈。致心下
格拒。气干膻中。神乱昏谵。若恶露冲心则死矣。焉有天明再醒之理。回生丹酸苦直达下
焦血分。用过不应。谅非瘀痹。想初由汗淋发热。凡外感风邪。邪滞汗解。此热昏乱。即仲景之
新产郁冒也。倘失治。必四肢牵掣。如惊似风痫则危。议从亡阳汗出谵语例。用救逆法。
生龙骨(三钱) 生牡蛎(三钱) 桂枝(五分) 淮小麦(百粒) 炙甘草(三分) 南枣(二钱)
又 气从涌泉小腹中。直冲胸臆。而心下痛。巅晕神迷。此肝肾内怯。无以收纳自固。每假寐必
魂魄飞越。惊恐畏惧。非止一端。救逆法镇阳颇应。但少补虚宁神。益之固之耳。
人参(二钱) 龙齿(三钱捣) 枣仁(三钱) 茯神(三钱) 炒黑杞子(二钱) 黑壳建莲肉(五
钱)
紫石英一两。捣碎。用水三盏。煎减半。用以煎药。
又 两法皆效。下元虚损无疑。八脉无气把握。带下淋漓不止。梦魂跌仆。正经旨下虚则梦坠
也。议镇固奇脉方。
人参(二钱) 龙齿(三钱) 枣仁(三钱) 茯神(三钱) 桑螵蛸(炙二钱) 炒黑远志(五分)
用紫石英煎汤。煎药。
又 昨午忧悲嗔怒。大便后。陡然头晕。继以呕逆。胸痞止。心洞嘈杂。仍不能食。子夜寒战鼓
栗。寅刻津津微热。神昏妄见。巅痛乳胀。腹鸣。短气呵欠。似乎叹息之声。此乃下元根蒂未
坚。偶触心机。诸阳神飞旋动舞。仲景论先厥后热。知饥不能食。干呕。列于厥阴篇中。盖危病
初效。未沾水谷精华。则胃土大虚。中无砥柱。俾厥阴风木之威。横冲震荡。一如释典混沌劫。
于地水火风卒来莫御矣。当此医药。全以护阳固阴。但血舍耗涸。刚猛及滋腻。总在难施之
例。无暇理病。存体为要。
人参(五钱) 熟附子(一钱) 川桂枝木(一钱) 炮姜炭(一钱) 炙黑甘草(五分)
茯苓(三钱)
沈 此产后阴虚疟疾。鼻煤。喉燥舌干。脘痞不饥。大便窒塞不通。乃阳明津枯。不上供肺。下少
滋肠。风阳游行。面肿耳聋。仲景谓阴气先绝。阳气独发。后人以饮食消息。取义甘寒。则知辛
温逐瘀之谬。
人参 炒麦冬 枣仁 乌梅肉 蜜水炒黄知母
又 酸味泄肝。胃气乃降。大便通后。汗大出。心中刺痛。皆营液内耗。阳气冲突。仲景三病之郁
冒见端矣。虽痰吐咯。无苦燥耗气之理。
人参 阿胶 生地 麦冬 生白芍 炙草
张 产后郁冒。汗出潮热。腹痛。
炒生地 炒山楂 丹参 茯神 浮小麦 黑 豆皮
吴 产后十二朝。先寒战。后发热。少腹 痛。腹膨满。下部腰肢不能转侧伸缩。小溲涩少而痛。
此败血流入经络。延及变为疡症。议用交加散。(败血入经络为疡)
小生地 生姜 车前 牛膝 五灵脂 炒楂肉 调入琥珀末一钱
又 十六朝。诸症稍减。每黄昏戌亥时。冲气自下而上。至胸中即胀闷。肢冷汗出。右腹板实。此
厥阴肝脏。因惊气逆。今恶露未清。重镇酸敛。均为暂忌。拟和血调血为稳。
归须 炒桃仁 延胡 炒楂肉 官桂 香附 川楝 小茴
又 人参 当归 白芍 炙草 茯神 香附 桂心 广皮
程 脉濡。恶露紫黑。痛处紧按稍缓。此属络虚。治在冲任。以辛甘理阳。(营络虚寒恶露未清)
炒归身 炒白芍 肉桂 茯苓 小茴 杜仲
又 脉濡空大。营络虚冷。
人参 炒归身 炒白芍 茯神 炙草 桂心
又 当归羊肉汤加茯苓茴香。
许 产后阴虚。肝风动灼。喉干呛咳。晚则头晕。(阴虚风阳动)
阿胶 细生地 天冬 茯神 小麦 川斛
程 坐蓐过劳肝风阳气动。面浮气短。腹膨。恶露未清。不可腻滞。须防痉厥。
小生地 丹参 泽兰 茯神 黑 豆皮 琥珀末
又 血分既亏。风阳动泄。汗出心悸。此辛气走泄须忌。所虑痉厥。如已见端。议静药和阳意。
阿胶 鸡子黄 细生地 生牡蛎 丹参 茯神
某 产后下焦阴亏。奇脉不固。阳浮乃升。风动则飧泄嘈杂。液损必消渴骨热。治在肝肾。静药
固摄。
熟地 湖莲 炙草 五味 芡实 山药
旱莲 女贞
某 新产后。阴分大虚。汗出胸痞潮热。阳浮卫不固。虽痰多咳频。忌用苦辛表散。恐久延蓐劳
耳。(阴虚阳浮汗泄)
炒生地 炒麦冬 生扁豆 炙草 金石斛 丹参 茯神 甘蔗浆
某 产后身痛。少腹满。(血虚寒滞)
楂肉 川芎(醋炒) 延胡(醋炒) 泽兰 丹皮 艾叶 小茴 香附(醋炒) 茯苓 益母膏丸。
又 当归 桂心 茴香 香附 紫石英 茯苓 羊肉胶丸。
孙 产难。伤力惊恐。面微浮。腹膨。小便不爽。(气血滞兼湿)
炒黑楂肉 大黑豆皮 大腹皮绒 生香附 茯苓 泽泻
白花益母草煎汤代水。
金 腹胀气滞。久泻。产后五日。(气滞胀泻)
于术 浓朴 茯苓 泽泻 南山楂 延胡
凌 一岁四气之交。夏季发泄为甚。凡夏至一阴初复。未及充盈。恰当产期。为阴气未充先泄。
暑热乘隙内侵。正如内经最虚之处。便是容邪之处矣。产科未明此旨。徒晓产后逐瘀成药。
苦辛破血。津液愈劫。所伏暑热。无由可驱。六气客邪。内迫脏腑。渐渐昏蒙内闭。攻热害正。养
正邪留。药难立方调治。幼读仲景。揣摩圣诲。惟育阴可以除热。况乎暑必伤气。人参非益气
之圣药乎。大队阴药。佐以人参。诚为阴分益气之法。服之热疖垒垒而起。恶露缓缓而下。扶
正却邪。并行不悖。今谷食已安。谅无反复。难成易亏之阴。须安养可望图功。倘加情志感触。
轻则奇损带淋。重则髓枯蓐损。莫道赠言之不详也。(阴虚夹暑)
雄乌骨鸡(一只) 人参(二两秋石拌) 鲜生地(三两) 柏子仁(一两半) 天冬(一两半)
麦冬(二两) 阿胶(二两) 建莲肉(三两) 茯神(二两) 熬膏。
项 初病舌赤神烦。产后阴亏。暑热易深入。此亟清营热。所谓瘦人虑虚其阴。(暑伤营阴)
竹叶 细生地 银花 麦冬 玄参 连翘
张 产后十三朝。舌黄边赤。口渴脘中紧闷。不食不饥。不大便。此阴分已虚。热入营中。状如疟
症。大忌表散清克。议滋清营热。救其津液为要。
细生地 天冬 生鳖甲 丹皮 丹参 茯神
又 产后血络空虚。暑邪客气深入。疟乃间日而发。呕恶胸满。口渴。皆暑热烁胃津液也。此虚
人夹杂时气。只宜和解。不可发汗腻补。
青蒿梗 淡黄芩 丹皮 郁金 花粉 川贝 杏仁 橘红
又 脉缓热止。病减之象。但舌色未净。大便未通。产后大虚。不敢推荡。勿进荤腻。恐滞蒸化热。
蔬粥养胃。以滋清润燥。便通再议补虚。
生首乌 麻仁 麦冬 蜜水炒知母 苏子 花粉
某 浊阴上逆。恶心不食。冷汗烦燥。最防暴脱。不可但执恶露滞满。而专泻气攻血也。(阳虚欲脱)
人参 干姜 附子 泽泻 冲入童便
某 脉无神。神倦欲昏。汗出。乃阳气走泄。泻利系阴气不守。产后见症。是属重虚。深恐节间暴
脱。而寒热胸痞腹痛。岂遑论及标末。
人参 制附子 人尿 猪胆汁
某(二五) 产后骤加惊恐。阳上瞀冒为厥。左肢麻木。耳窍失聪。皆阳挟内风。混入清窍。以上实下虚。
镇阳填阴。味浓质静之药。(产后阴虚阳浮发厥)
熟地 龟甲心 天冬 萸肉 五味 磁石 茯神 黑壳建莲
某 产后去血过多。阴虚阳实。头中眩晕。汗出肉 。惊畏身热等症。最易昏厥。苦辛气味宜忌。
生地 小麦 炙黑甘草 麦冬 阿胶 茯神 生左牡蛎
顾(三一) 产后真阴不复。阳越风动。四肢麻木。先厥后热。
熟地 阿胶 炒杞子 生白芍 茯苓 菊花炭
徐 少腹冲及心下。脘中痛而胀满。若云肝气犯胃。必有呕逆。前法益阴和阳不应。显是产
后下虚。厥气上攻。议用柔阳之药。(冲任虚气上逆脘痛胀)
炒归身 苁蓉 炒枸杞 柏子仁 小茴 茯神
又 冲逆震动而痛。是产后冲任空乏。按定痛减。尤为虚象。缘胃弱减谷。未便汤剂之多。防胃
倒耳。
当归 苁蓉 紫石英 茯苓 河车 鹿角霜
又 冲脉逆。则诸脉皆动。天朗晴和少安。由阴分虚及阳分可征。前法包举大气。温养佐通。是
为络方。日来春升。略有衄血。然无清寒可投。加咸味佐其入阴。从产后下焦先伤耳。原方减
鹿霜归身。亦恐升阳也。加枸杞桂圆。以痛在左。故养肝是议。
虞(三二) 背寒心热。天明汗出乃凉。产后两三月若此。此属下焦真阴已亏。渐扰阳位。二气交乘。
并非客症。头晕耳鸣心悸。寒热后必泻。内风震动。当与静药。(阴虚风阳动,六月二十日)
人参 炙草 白芍 麦冬 炒生地 炒乌梅
又 前法酸甘。益阴和阳。诸病皆减。然此恙。是产后下焦百脉空乏。谓之蓐损。填隙固髓为正
治。缘谷食未加。沉腻恐妨胃口。加餐可用丸药。(七月初三)
人参 炙草 阿胶 生地 麦冬
又 照前方加桂枝木茯苓南枣(八月初七)
又 产后都属下焦先损。百脉空隙。时序夏秋。天暖发泄加病。此扶阳益阴得效。今诸症向愈。
寝食已安。独经水未至。其冲任奇脉不振。须脏阴充旺。脉中得以游溢耳。(九月初一)
熟地(水制) 人参 阿胶 萸肉 远志炭 山药 茯神 建莲 乌骨鸡膏丸。
吴 坐蓐过劳。惊恐交迫。真阴既伤。经年不复。目暗昏花。烦动热升。皆肾阴不得自充。何以涵
养肝木。厥仆眩晕。阳挟肝风直上无制。则当静药填阴。佐酸以收摄。
熟地 阿胶 五味 萸肉 北沙参 茯神 黑 豆皮 秋石(二分调入)
陈(二八) 寒热时作。经岁不痊。且产后病起。阳维为病明矣。(阳维病寒热) 归桂枝汤。
郭(二四) 产后下元阴分先伤。而奇经八脉。皆丽于下。肝肾怯不固。八脉咸失职司。经旨谓阳维脉
痛。苦寒热。阴维脉病。苦心痛。下损及胃。食物日减。然产伤先伤真阴。忌用桂附之刚。温煦阴
中之阳。能入奇经者宜之。(下损及胃奇脉虚)
人参 鹿茸 紫石英 当归 补骨脂 茯苓
陈(四一) 产后四月。腰痛牵引少腹。冷汗不食。(营络虚寒腰腹痛)
当归 羊肉 小茴 桂枝木 茯苓 紫石英
沈 产后动怒。气血皆逆。痛呕不卧。俯不能仰。面冷肢冷。口鼻气寒。痛必自下冲上。此属疝瘕
厥痛。(气血寒滞结瘕)
淡吴萸 韭白 两头尖 川楝子 桂枝木 茯苓
吴(二六) 产后百日内。右胁下少腹痛坚膨。络空无血。气乘于中。有结聚 瘕之累。延及变成胀满。
经水不转。成大病矣。
当归 桂心 生桃仁 牛膝 山楂 炒黑小茴
陆 产后邪深入阴。气血胶结。遂有瘕疝之形。身体伛偻。乃奇脉纲维不用。充形通络可效。仿
仲景当归羊肉汤意。
归身 苁蓉 杞子 小茴 茯苓 紫石英 羊肉胶丸
某 产后胞损溺淋。筋脉牵掣。治当摄下。(胞损)
桑螵蛸 生沙苑 萸肉炭 炒黄柏 茯神
冯(四二) 产后两月。汗出身痛。(营卫兼虚) 归 建中汤。
余 产后不复。心悸欲呕。遇寒腹痛。先议进和营卫。继当补摄。归桂枝汤加茯苓。
吴(三八) 胃痛三月不止。茹素面黄。产后吞酸少食。中焦阳惫。岂宜再加攻泄。与辛补血络方。
(阳虚胃痛血络瘀滞)
桃仁 归须 公丁香皮 川桂枝 半夏 茯苓
钦氏,初次生产后出现汗出、眩晕。伴有胸中痞闷、腹痛。应当疏通恶露。(新产后恶露瘀滞)
炒山楂 延胡索 郁金 赤芍 炒牛膝 香附 童便(冲服) 益母草汤代水煎药。
又诊:腹痛稍微缓解,但胸中痞闷、痰多。治疗应从上焦入手。
炒山楂 郁金 丹参 橘红 炒川贝母 天花粉
程氏,冲脉为病,男子表现为内结七疝,女子表现为带下及瘕聚积聚。所以奇经脉络结实者,古人必定用苦辛味药物,配合芳香之品,以疏通脉络。其虚损者,必用辛甘温补之法,佐以流通脉络的药物,务必使气血调和,疾病才能痊愈。如今产后身体虚弱,兼有瘀血而痛,治法应当补益体质同时攻逐病邪。病程已有多日,宜采用缓治的方法。(体质虚弱兼有瘀血)
生地黄 生姜 牡丹皮 琥珀末(调入药汁中)
这是苦辛偶用的方剂,加入牡丹皮以通外络,琥珀以通内络,所以能取得疗效。
又诊:回生丹,取米醋煮大黄一味药,约莫直达病所,不干扰无病之处,所以也有效。这两种方法都是入络的药。
小生地黄 当归须 红花 郁李仁 柏子仁 茯神
某氏(二十五岁),恶露淋漓不尽,疼痛从腰部发起,攻窜至少腹。这是督脉、带脉空虚,奇经之气阻滞,毫无疑问。奇经为病,通因通用的方法,是古代圣贤的定例。
当归 山楂肉炭 炒牡丹皮 泽兰 川断 制何首乌
唐氏,产后突然失血过多,用人参、附子急救,这是挽回阳气、固护气机的方法。但是损伤在阴分,出现的头痛、汗出、烦躁口渴,乃是阳气上冒所致。凡是开泄腠理则伤阳,辛热药物则伤阴,都不是新产郁冒的正确治法。曾读仲景之书,明晓本草之意,为此拟定后方,也不是凭空杜撰。(郁冒证)
生左牡蛎(一钱) 生地黄(二钱) 上阿胶(二钱) 炒黑山楂肉(三钱) 茺蔚子(一钱半)
吴氏,新产后阴气下泄,阳气上冒。傍晚至夜间,阳明胃气衰弱,厥阴肝气横逆。肝血无法藏守,气冲扰膈,导致心下格拒,气干犯膻中,神志混乱昏谵。如果恶露冲心就会死亡,哪有天亮再醒来的道理?回生丹酸苦直达下焦血分,用过无效,想必不是瘀血痹阻。想当初由汗淋发热引起,凡是外感风邪,邪气随汗解,这种热昏乱,就是仲景所说的新产郁冒。如果失治,必然四肢抽搐,像惊风似癫痫那样危险。议论按照亡阳汗出谵语的例子,用救逆法。
生龙骨(三钱) 生牡蛎(三钱) 桂枝(五分) 淮小麦(百粒) 炙甘草(三分) 南枣(二钱)
又诊:气从涌泉穴和小腹中,直冲胸臆,而心下疼痛,头顶晕眩神志昏迷。这是肝肾内里怯弱,无法收纳自固。每次假寐时魂魄飞越,惊恐畏惧,不止一端。救逆法镇潜阳气颇为应验,但缺少补虚宁神的药物,需要增加固摄之力。
人参(二钱) 龙齿(三钱捣碎) 酸枣仁(三钱) 茯神(三钱) 炒黑枸杞子(二钱) 黑壳建莲肉(五钱)
紫石英一两,捣碎,用水三盏,煎至减半,用来煎药。
又诊:两种方法都有效,下元虚损无疑,八脉没有气机把握,带下淋漓不止,梦中魂跌仆坠落,正经旨意说下虚则梦坠。议论镇固奇脉的方子。
人参(二钱) 龙齿(三钱) 酸枣仁(三钱) 茯神(三钱) 桑螵蛸(炙二钱) 炒黑远志(五分)
用紫石英煎汤煎药。
又诊:昨天中午忧悲嗔怒,大便后,陡然头晕,继以呕逆,胸痞停止,心中空洞嘈杂,仍然不能进食。半夜寒战鼓栗,寅刻微微发热,神昏妄见,头顶痛乳房胀,肠鸣,短气呵欠,似乎叹息之声。这是下元根蒂不坚固,偶然触动心机,诸阳之神飞旋舞动。仲景论述先厥后热,知饥不能食,干呕,列于厥阴篇中。大概是危病初愈,未沾水谷精华,则胃土大虚,中无砥柱,使得厥阴风木之威,横冲震荡,一如佛教经典混沌劫难,地水火风卒然来袭无法抵御。当此之时用药,全以护阳固阴为主。但血舍耗涸,刚猛及滋腻药物,总在难施之列。无暇顾及治病,保存体质为要。
人参(五钱) 熟附子(一钱) 川桂枝木(一钱) 炮姜炭(一钱) 炙黑甘草(五分) 茯苓(三钱)
沈氏,这是产后阴虚疟疾,鼻头色黑,喉燥舌干,脘痞不饥,大便窒塞不通,乃阳明津液枯涸,不上供肺,下少滋肠,风阳游行,面肿耳聋。仲景说阴气先绝,阳气独发,后人以饮食调养,取义甘寒,则知道辛温逐瘀的错误。
人参 炒麦冬 酸枣仁 乌梅肉 蜜水炒黄知母
又诊:酸味泄肝,胃气乃降,大便通后,大汗出,心中刺痛,都是营液内耗,阳气冲突。仲景三病中的郁冒显现端倪了。虽然痰吐咯出,没有苦燥耗气的道理。
人参 阿胶 生地黄 麦冬 生白芍 炙甘草
张氏,产后郁冒,汗出潮热,腹痛。
炒生地黄 炒山楂 丹参 茯神 浮小麦 黑豆皮
吴氏,产后十二天,先寒战,后发热,少腹痛,腹部膨满,下部腰肢不能转侧伸缩,小便涩少而痛。这是败血流入经络,蔓延变为疡症。议论用交加散。(败血入经络变为疡症)
小生地黄 生姜 车前子 牛膝 五灵脂 炒山楂肉 调入琥珀末一钱
又诊:十六天,各种症状稍减,每到黄昏戌亥时,冲气自下而上,到胸中即胀闷,肢冷汗出,右腹板实。这是厥阴肝脏,因惊气逆乱,如今恶露未清,重镇酸敛均为暂时禁忌。拟和血调血为稳妥。
当归须 炒桃仁 延胡索 炒山楂肉 官桂 香附 川楝子 小茴香
程氏,脉濡,恶露紫黑,痛处紧按稍缓,这属于络脉虚损,治疗在冲任二脉,用辛甘理阳之法。(营络虚寒恶露未清)
炒当归身 炒白芍 肉桂 茯苓 小茴香 杜仲
又诊:脉濡空大,营络虚冷。
人参 炒当归身 炒白芍 茯神 炙甘草
又诊:当归羊肉汤加茯苓、茴香。
许氏,产后阴虚,肝风动灼,喉干呛咳,晚间头晕。(阴虚风阳动)
阿胶 细生地黄 天冬 茯神 小麦 川石斛
程氏,坐蓐过劳导致肝风阳气动,面浮气短,腹部膨满,恶露未清,不可用腻滞药物,须防痉厥。
小生地黄 丹参 泽兰 茯神 黑豆皮 琥珀末
又诊:血分既亏,风阳动泄,汗出心悸,这种辛气走泄的药物须忌。所担心的痉厥,如果已有端倪,议论用静药和阳之意。
阿胶 鸡子黄 细生地黄 生牡蛎 丹参 茯神
某氏,产后下焦阴亏,奇脉不固,阳浮乃升,风动则飧泄嘈杂,液损必消渴骨热,治疗在肝肾,用静药固摄。
熟地黄 湖莲子 炙甘草 五味子 芡实 山药
旱莲草 女贞子
某氏,新产后,阴分大虚,汗出胸痞潮热,阳浮卫不固,虽然痰多咳频,忌用苦辛表散,恐怕久延成蓐劳。(阴虚阳浮汗泄)
炒生地黄 炒麦冬 生扁豆 炙甘草 金石斛 丹参 茯神 甘蔗浆
某氏,产后身痛,少腹满。(血虚寒滞)
山楂肉 川芎(醋炒) 延胡索(醋炒) 泽兰 丹皮 艾叶 小茴香 香附(醋炒) 茯苓 益母膏丸。
孙氏,产难,伤力惊恐,面微浮,腹部膨满,小便不爽。(气血滞兼湿)
炒黑山楂肉 大黑豆皮 大腹皮绒 生香附 茯苓 泽泻
白花益母草煎汤代水。
金氏,腹胀气滞,久泻,产后五日。(气滞胀泻)
于术 浓朴 茯苓 泽泻 南山楂 延胡索
凌氏,一岁四气之交,夏季发泄为甚。凡夏至一阴初复,未及充盈,恰当产期,为阴气未充先泄。暑热乘隙内侵,正如内经所说最虚之处,便是容邪之处。产科不明此旨,徒晓产后逐瘀成药,苦辛破血,津液愈劫,所伏暑热,无由可驱。六气客邪,内迫脏腑,渐渐昏蒙内闭,攻热害正,养正邪留,药难立方调治。幼读仲景,揣摩圣诲,惟育阴可以除热,况乎暑必伤气,人参非益气之圣药乎。大队阴药,佐以人参,诚为阴分益气之法。服之热疖垒垒而起,恶露缓缓而下,扶正却邪,并行不悖。今谷食已安,谅无反复,难成易亏之阴,须安养可望图功。倘加情志感触,轻则奇损带淋,重则髓枯蓐损,莫道赠言之不详也。(阴虚夹暑)
雄乌骨鸡(一只) 人参(二两秋石拌) 鲜生地黄(三两) 柏子仁(一两半) 天冬(一两半) 麦冬(二两) 阿胶(二两) 建莲肉(三两) 茯神(二两) 熬膏。
项氏,初病舌赤神烦,产后阴亏,暑热易深入,此亟清营热,所谓瘦人虑虚其阴。(暑伤营阴)
竹叶 细生地黄 银花 麦冬 玄参 连翘
张氏,产后十三天,舌黄边赤,口渴脘中紧闷,不食不饥,不大便,这是阴分已虚,热入营中,状如疟症,大忌表散清克。议论滋清营热,救其津液为要。
细生地黄 天冬 生鳖甲 丹皮 丹参 茯神
又诊:产后血络空虚,暑邪客气深入,疟乃间日而发,呕恶胸满,口渴,都是暑热烁胃津液也。此虚人夹杂时气,只宜和解,不可发汗腻补。
青蒿梗 淡黄芩 丹皮 郁金 花粉 川贝 杏仁 橘红
又诊:脉缓热止,病减之象。但舌色未净,大便未通,产后大虚,不敢推荡,勿进荤腻,恐滞蒸化热。蔬粥养胃,以滋清润燥,便通再议补虚。
生首乌 麻仁 麦冬 蜜水炒知母 苏子 花粉
某氏,浊阴上逆,恶心不食,冷汗烦躁,最防暴脱,不可但执恶露滞满,而专泻气攻血也。(阳虚欲脱)
人参 干姜 附子 泽泻 冲入童便
某氏,脉无神,神倦欲昏,汗出,乃阳气走泄,泻利系阴气不守,产后见症,是属重虚,深恐节间暴脱,而寒热胸痞腹痛,岂遑论及标末。
人参 制附子 人尿 猪胆汁
某氏(二十五岁),产后骤加惊恐,阳上瞀冒为厥,左肢麻木,耳窍失聪,皆阳挟内风,混入清窍,以上实下虚,镇阳填阴,味浓质静之药。(产后阴虚阳浮发厥)
熟地黄 龟甲心 天冬 萸肉 五味子 磁石 茯神 黑壳建莲
某氏,产后去血过多,阴虚阳实,头中眩晕,汗出肉...(此处原文可能有缺字,推测为肌肉跳动或类似症状),惊畏身热等症,最易昏厥,苦辛气味宜忌。
生地黄 小麦 炙黑甘草 麦冬 阿胶 茯神 生左牡蛎
顾氏(三十一岁),产后真阴不复,阳越风动,四肢麻木,先厥后热。
熟地黄 阿胶 炒枸杞子 生白芍 茯苓 菊花炭
徐氏,少腹冲及心下,脘中痛而胀满,若云肝气犯胃,必有呕逆,前法益阴和阳不应,显是产后下虚,厥气上攻,议用柔阳之药。(冲任虚气上逆脘痛胀)
炒当归身 肉苁蓉 炒枸杞子 柏子仁 小茴香 茯神
又诊:冲逆震动而痛,是产后冲任空乏,按定痛减,尤为虚象。缘胃弱减谷,未便汤剂之多,防胃倒耳。
当归 肉苁蓉 紫石英 茯苓 河车 鹿角霜
又诊:冲脉逆,则诸脉皆动,天朗晴和少安,由阴分虚及阳分可征。前法包举大气,温养佐通,是为络方。日来春升,略有衄血,然无清寒可投,加咸味佐其入阴,从产后下焦先伤耳。原方减鹿霜归身,亦恐升阳也。加枸杞桂圆,以痛在左,故养肝是议。
虞氏(三十二岁),背寒心热,天明汗出乃凉,产后两三月若此,此属下焦真阴已亏,渐扰阳位,二气交乘,并非客症。头晕耳鸣心悸,寒热后必泻,内风震动,当与静药。(阴虚风阳动,六月二十日)
人参 炙甘草 白芍 麦冬 炒生地黄 炒乌梅
又诊:前法酸甘,益阴和阳,诸病皆减。然此恙,是产后下焦百脉空乏,谓之蓐损,填隙固髓为正治。缘谷食未加,沉腻恐妨胃口,加餐可用丸药。(七月初三)
人参 炙甘草 阿胶 生地黄 麦冬
又诊:产后都属下焦先损,百脉空隙,时序夏秋,天暖发泄加病,此扶阳益阴得效。今诸症向愈,寝食已安,独经水未至,其冲任奇脉不振,须脏阴充旺,脉中得以游溢耳。(九月初一)
熟地黄(水制) 人参 阿胶 萸肉 远志炭 山药 茯神 建莲 乌骨鸡膏丸。
吴氏,坐蓐过劳,惊恐交迫,真阴既伤,经年不复,目暗昏花,烦动热升,皆肾阴不得自充,何以涵养肝木,厥仆眩晕,阳挟肝风直上无制,则当静药填阴,佐酸以收摄。
熟地黄 阿胶 五味子 萸肉 北沙参 茯神 黑豆皮 秋石(二分调入)
陈氏(二十八岁),寒热时作,经岁不痊,且产后病起,阳维为病明矣。(阳维病寒热) 归桂枝汤。
郭氏(二十四岁),产后下元阴分先伤,而奇经八脉,皆丽于下,肝肾怯不固,八脉咸失职司,经旨谓阳维脉痛,苦寒热,阴维脉病,苦心痛,下损及胃,食物日减,然产伤先伤真阴,忌用桂附之刚,温煦阴中之阳,能入奇经者宜之。(下损及胃奇脉虚)
人参 鹿茸 紫石英 当归 补骨脂 茯苓
陈氏(四十一岁),产后四月,腰痛牵引少腹,冷汗不食。(营络虚寒腰腹痛)
当归 羊肉 小茴香 桂枝木 茯苓 紫石英
沈氏,产后动怒,气血皆逆,痛呕不卧,俯不能仰,面冷肢冷,口鼻气寒,痛必自下冲上,此属疝瘕厥痛。(气血寒滞结瘕)
淡吴茱萸 韭白 两头尖 川楝子 桂枝木 茯苓
吴氏(二十六岁),产后百日内,右胁下少腹痛坚膨,络空无血,气乘于中,有结聚瘕之累,延及变成胀满,经水不转,成大病矣。
当归 桂心 生桃仁 牛膝 山楂 炒黑小茴香
陆氏,产后邪深入阴,气血胶结,遂有瘕疝之形,身体伛偻,乃奇脉纲维不用,充形通络可效,仿仲景当归羊肉汤意。
当归身 肉苁蓉 枸杞子 小茴香 茯苓 紫石英 羊肉胶丸
某氏,产后胞损溺淋,筋脉牵掣,治当摄下。(胞损)
桑螵蛸 生沙苑蒺藜 萸肉炭 炒黄柏 茯神
冯氏(四十二岁),产后两月,汗出身痛。(营卫兼虚) 归建中汤。
余氏,产后不复,心悸欲呕,遇寒腹痛,先议进和营卫,继当补摄,归桂枝汤加茯苓。
吴氏(三十八岁),胃痛三月不止,茹素面黄,产后吞酸少食,中焦阳惫,岂宜再加攻泄,与辛补血络方。(阳虚胃痛血络瘀滞)
桃仁 当归须 公丁香皮 川桂枝 半夏 茯苓
Qin, after first childbirth, experienced sweating, dizziness. Accompanied by chest fullness and abdominal pain. Should promote the discharge of lochia. (Stagnation of lochia after recent childbirth)
Fried Hawthorn Fruit (Shanzha), Corydalis Rhizome (Yanhusuo), Curcuma Aromatica Rhizome (Yujin), Red Peony Root (Chishao), Fried Achyranthes Root (Niuxi), Cyperus Rhizome (Xiangfu), Child's Urine (Tongbian, taken with medicine), Motherwort Decoction (Yimucao Tang) as water for decoction.
Re-examination: Abdominal pain slightly relieved, but chest fullness and profuse phlegm persist. Treatment should focus on the Upper Jiao.
Fried Hawthorn Fruit (Shanzha), Curcuma Aromatica Rhizome (Yujin), Salvia Miltiorrhiza Root (Danshen), Tangerine Peel (Juhong), Fried Fritillaria Bulb (Chuanbeimu), Trichosanthes Root (Tianhuafen).
Cheng, diseases of the Chong vessel: in men, internal knotting of seven types of hernia; in women, leukorrhea and masses (zhao ju). Therefore, for solid conditions of the extraordinary vessels, ancients used bitter and acrid flavors combined with aromatic substances to unblock the collaterals. For deficiency conditions, acrid-sweet warming tonification is necessary, assisted by agents that circulate through the collaterals, ensuring harmonious Qi and Blood for complete recovery. Now, postpartum constitution is weak, accompanied by blood stasis causing pain. The method should be to tonify the body while attacking the pathogen. As many days have passed, slow treatment is appropriate. (Weak constitution with blood stasis)
Raw Rehmannia Root (Shengdi), Fresh Ginger (Shengjiang), Moutan Bark (Danpi), Powdered Amber (Hupo, mixed into the decoction).
This is a formula combining bitter and acrid flavors. Adding Moutan Bark to unblock the exterior collaterals, and Amber to unblock the interior, thus achieving efficacy.
Re-examination: Huisheng Dan (Return-to-Life Pill): Boiling a single herb, Rhubarb (Dahuang), in rice vinegar, allows it to reach the disease site precisely without affecting healthy areas, hence its efficacy. Both methods involve herbs entering the collaterals.
Small Raw Rehmannia Root (Xiao Shengdi), Dang Gui Tendrils (Guixu), Safflower (Honghua), Apricot Kernel (Yuliren), Seed of Ziziphus (Baiziren), Poria (Fushen).
Re-examination: Following the previous formula, remove Safflower (Honghua) and Apricot Kernel (Yuliren), add Lyonia Berry (Zelan).
Ms. (25 years old), lochia dripping continuously, pain originating from the waist and radiating to the lower abdomen. This indicates emptiness of the Du and Dai vessels, and obstruction of Qi in the extraordinary vessels, beyond doubt. For diseases of the extraordinary vessels, the method of "treating obstruction with unblocking" is a fixed principle of ancient sages.
Angelica Sinensis Root (Danggui), Charred Hawthorn Flesh (Zharon Tan), Fried Moutan Bark (Danpi), Lyonia Berry (Zelan), Dipsacus Root (Chuanduan), Prepared Polygonum Multiflorum (Zhi Shouwu).
Tang, sudden severe blood loss after childbirth requires urgent rescue with Ginseng (Renshen) and Aconite (Fuzi); this is a method to salvage Yang and consolidate Qi. However, the damage is in the Yin aspect. Headache, sweating, irritability, and thirst are due to Yang Qi rushing upward. Any opening or dispersing action damages Yang, while acrid-hot drugs damage Yin; neither is the correct treatment for postpartum Yu Mao (depression and vertigo). Having studied Zhang Zhongjing's works and understood the materia medica, I propose the following formula, which is not fabricated. (Yu Mao syndrome)
Raw Left Oyster Shell (Sheng Zuomuli, 1 qian), Raw Rehmannia Root (Shengdi, 2 qian), High-quality Donkey-hide Gelatin (Ejiao, 2 qian), Charred Fried Hawthorn Flesh (Hei Cha Sharon, 3 qian), Leonurus Seed (Chongweizi, 1.5 qian).
Wu, after recent childbirth, Yin Qi descends and leaks, while Yang Qi rushes upward. From dusk to night (Xu-Hai hours), the Stomach Qi of the Yangming channel declines, and the Liver Qi of the Jueyin channel becomes horizontal. Liver Blood cannot be stored, Qi rushes and disturbs the diaphragm, causing rejection in the epigastrium, Qi invading the Danzhong (Conception Vessel origin), leading to chaotic spirit, confusion, and delirium. If lochia rushes to the Heart, death ensues; there is no logic for waking up again at dawn. Huisheng Dan, sour and bitter, reaches directly to the Lower Jiao Blood aspect. Having been used without effect, it is likely not blood stasis obstruction. Initially caused by sweating and fever, where external Wind pathogen resolves with sweat, this heat-induced confusion corresponds to Zhang Zhongjing's description of postpartum Yu Mao. If untreated, limbs will twitch, resembling convulsions or wind-epilepsy, which is critical. Discussing according to the example of Yang collapse with sweating and delirium, use the Rescue Counteraction Method (Jiuniu Fa).
Raw Dragon Bone (Sheng Longgu, 3 qian), Raw Oyster Shell (Sheng Muli, 3 qian), Cinnamon Twig (Guizhi, 0.5 fen), Triticum Aestivum (Huaimaixian, 100 grains), Honey-fried Licorice Root (Zhigancao, 3 fen), Southern Date (Nanzao, 2 qian).
Re-examination: Qi rushes from the Yongquan point and lower abdomen straight to the chest and epigastrium, causing pain below the heart, top-of-head dizziness, and spiritual confusion. This is due to weakness in the Liver and Kidney internally, unable to receive and consolidate. During light sleep, the soul flies away, causing fear and terror, among other symptoms. The Rescue Counteraction Method effectively calms Yang, but lacks tonifying deficiency and calming the spirit. It needs supplementation and consolidation.
Ginseng (Renshen, 2 qian), Dragon Teeth (Longchi, 3 qian, crushed), Sour Jujube Seed (Zaoren, 3 qian), Poria (Fushen, 3 qian), Charred Black Goji Berry (Heiqi, 2 qian), Black-shell Jian Lotus Seed Meat (Heike Jianlianrou, 5 qian).
Purple Quartz (Zishi, 1 liang), crushed, decocted in three cups of water until reduced by half, used to decoct the other herbs.
Re-examination: Both methods were effective; Lower Yuan deficiency is undeniable. The Eight Extraordinary Vessels lack Qi control, resulting in continuous leukorrhea, dreams of falling, consistent with the classic saying that lower deficiency leads to dreams of falling. Proposing a formula to calm and secure the extraordinary vessels.
Ginseng (Renshen, 2 qian), Dragon Teeth (Longchi, 3 qian), Sour Jujube Seed (Zaoren, 3 qian), Poria (Fushen, 3 qian), Mantis Egg Case (Sangpiaoxiao, honey-fried 2 qian), Charred Black Polygala Root (Heiyuanzhi, 0.5 fen).
Decoct Purple Quartz (Zishi) in water to decoct the medicine.
Re-examination: Yesterday noon, grief and anger occurred. After defecation, sudden dizziness followed by vomiting and reversal. Chest fullness stopped, but the heart felt empty and嘈杂 (clashing/uncomfortable), still unable to eat. At midnight, chills and shivering; at Yin hour, slight fever, confusion, hallucinations, head pain, breast distension, borborygmus, shortness of breath, yawning, sounding like sighing. This is because the root of the Lower Yuan is not firm. Accidental emotional disturbance causes the spirits of all Yang to fly and dance. Zhang Zhongjing discusses "first cold extremities then fever," knowing hunger but unable to eat, dry retching, listed in the Jueyin chapter. Likely, after a critical illness shows initial improvement, without nourishment from food and drink essence, the Earth of the Stomach is greatly deficient, lacking a pillar in the center, allowing the tyranny of Jueyin Wind-Wood to rush horizontally and shake violently, like the Buddhist concept of the Kalpa chaos, where Earth, Water, Fire, and Wind suddenly attack and cannot be resisted. Medication at this time must entirely protect Yang and consolidate Yin. However, since the Blood residence is depleted and dried, harsh/pungent and cloying/nourishing drugs are difficult to apply. There is no time to treat the disease; preserving the constitution is paramount.
Ginseng (Renshen, 5 qian), Prepared Aconite Root (Shu Fuzi, 1 qian), Cinnamon Twig Wood (Chuan Guizhimu, 1 qian), Charred Roasted Ginger (Pao Jiangtan, 1 qian), Honey-fried Black Licorice Root (Zhei Gancao, 0.5 fen), Poria (Fuling, 3 qian).
Shen, this is postpartum Yin-deficiency malaria. Blackening of the nose, dry throat and tongue, epigastric fullness and lack of appetite, fecal impaction. This is depletion of Yangming fluids, failing to nourish the Lungs above and Intestines below. Wind-Yang wanders, causing facial swelling and deafness. Zhang Zhongjing states: "When Yin Qi is exhausted first, Yang Qi acts alone." Later practitioners use dietary management with sweet-cold principles, realizing the error of acrid-warm blood-dispelling methods.
Ginseng (Renshen), Fried Ophiopogon Tuber (Mai Dong), Sour Jujube Seed (Zaoren), Dark Plum Flesh (Wumei Rou), Honey-fried Anemarrhena Rhizome (Zhi Zhimu).
Re-examination: Sour flavor drains the Liver, allowing Stomach Qi to descend. After bowel movement, profuse sweating and stabbing heart pain occur, indicating consumption of Ying fluids and conflict of Yang Qi. The signs of Yu Mao in Zhang Zhongjing's three diseases are emerging. Although phlegm is expectorated, there is no rationale for using bitter-dry drugs that consume Qi.
Ginseng (Renshen), Donkey-hide Gelatin (Ejiao), Raw Rehmannia Root (Shengdi), Ophiopogon Tuber (Maidong), Raw White Peony Root (Baishao), Honey-fried Licorice Root (Zhicao).
Zhang, postpartum Yu Mao, sweating, tidal fever, abdominal pain.
Fried Raw Rehmannia Root (Chao Shengdi), Fried Hawthorn Fruit (Chao Shanzha), Salvia Miltiorrhiza Root (Danshen), Poria (Fushen), Floating Wheat (Fuxiaomai), Black Bean Skin (Heidoupi).
Wu, twelve days postpartum, initially chills, then fever, lower abdominal pain, abdominal distension, inability to turn or extend/flex lower back and limbs, scanty painful urination. This is败血 (decayed blood) flowing into the collaterals, spreading to become an abscess/ulcer condition. Propose using Jiaojia San. (Decayed blood entering collaterals becomes ulcer)
Small Raw Rehmannia Root (Xiao Shengdi), Fresh Ginger (Shengjiang), Plantago Seed (Cheqian), Achyranthes Root (Niuxi), Trogopterus Dung (Wulingzhi), Fried Hawthorn Flesh (Chao Sharon), mixed with 1 qian Powdered Amber (Hupo).
Re-examination: Sixteen days later, symptoms slightly reduced. Every evening during Xu-Hai hours, Chong Qi rises from below to the chest, causing distension and stuffiness, cold limbs, and sweating. Right abdomen is hard and solid. This is Jueyin Liver channel, due to逆 Qi from fright. Since lochia is not yet clear, heavy sedatives and astringents are temporarily contraindicated. Harmonizing and regulating Blood is proposed as stable.
Dang Gui Tendrils (Guixu), Fried Peach Kernel (Chao Taoren), Corydalis Rhizome (Yanhusuo), Fried Hawthorn Flesh (Chao Sharon), Official Cinnamon (Guangui), Cyperus Rhizome (Xiangfu), Toosendan Fruit (Chuanli), Small Fennel (Xiaohui).
Re-examination: Ginseng (Renshen), Angelica Sinensis Root (Danggui), White Peony Root (Baishao), Honey-fried Licorice Root (Zhicao), Poria (Fushen), Cyperus Rhizome (Xiangfu), Cinnamon Heart (Guixin), Broad-leaved Citrus Peel (Guangpi).
Cheng, pulse is soft (Ru), lochia is purple-black, pain slightly relieved by tight pressure. This belongs to collateral deficiency. Treatment focuses on Chong and Ren vessels, using acrid-sweet to regulate Yang. (Deficient and cold Ying collaterals with unresolved lochia)
Fried Dang Gui Body (Chao Guishen), Fried White Peony Root (Chao Baishao), Cinnamon Bark (Rougui), Poria (Fuling), Small Fennel (Xiaohui), Eucommia Bark (Duzhong).
Re-examination: Pulse is soft and hollow/large, Ying collaterals are deficient and cold.
Ginseng (Renshen), Fried Dang Gui Body (Chao Guishen), Fried White Peony Root (Chao Baishao), Poria (Fushen), Honey-fried Licorice Root (Zhicao), Cinnamon Heart (Guixin).
Re-examination: Dang Gui Lamb Soup added with Poria (Fuling) and Fennel (Huixiang).
Xu, postpartum Yin deficiency, Liver Wind stirring and burning, dry throat, coughing, evening dizziness. (Yin deficiency with stirring Wind-Yang)
Donkey-hide Gelatin (Ejiao), Fine Raw Rehmannia Root (Xi Shengdi), Asparagus Tuber (Tiantong), Poria (Fushen), Wheat (Xiaomai), Dendrobium Stem (Chuanhu).
Cheng, overexertion during confinement stirs Liver Wind and Yang Qi. Facial edema, shortness of breath, abdominal distension, unresolved lochia. Cannot use cloying/stagnant drugs; must prevent convulsions.
Small Raw Rehmannia Root (Xiao Shengdi), Salvia Miltiorrhiza Root (Danshen), Lyonia Berry (Zelan), Poria (Fushen), Black Bean Skin (Heidoupi), Powdered Amber (Hupo).
Re-examination: Blood aspect is already deficient, Wind-Yang stirring and leaking, sweating, palpitations. Acrid drugs that disperse Qi must be avoided. Concerning convulsions, if signs appear, propose using quiet herbs to harmonize Yang.
Donkey-hide Gelatin (Ejiao), Chicken Egg Yolk (Jizihuang), Fine Raw Rehmannia Root (Xi Shengdi), Raw Oyster Shell (Sheng Muli), Salvia Miltiorrhiza Root (Danshen), Poria (Fushen).
Ms., postpartum Lower Jiao Yin deficiency, extraordinary vessels insecure, Yang floats upward, Wind stirring causes undigested food diarrhea and stomach discomfort, fluid damage causes thirst and bone heat. Treatment focuses on Liver and Kidney, using quiet herbs to secure.
Prepared Rehmannia Root (Shudi), Lake Lotus Seed (Hulian), Honey-fried Licorice Root (Zhicao), Schisandra Berry (Wuweizi), Euryale Seed (Qianshi), Chinese Yam (Shanyao).
Eclipta Herb (Hanlian), Ligustrum Lucidum Fruit (Nvzhen).
Ms., new postpartum, Yin aspect greatly deficient, sweating, chest fullness, tidal fever, Yang floating and Wei Qi insecure. Although profuse phlegm and frequent cough, avoid bitter-acrid exterior-dispersing, fearing prolonged consumptive disease. (Yin deficiency with Yang floating and sweating)
Fried Raw Rehmannia Root (Chao Shengdi), Fried Ophiopogon Tuber (Chao Maidong), Raw Coix Seed (Sheng Bian Dou), Honey-fried Licorice Root (Zhicao), Dendrobium (Jinshihu), Salvia Miltiorrhiza Root (Danshen), Poria (Fushen), Sugarcane Juice (Ganzhe Jiang).
Ms., postpartum body pain, lower abdominal fullness. (Blood deficiency with Cold stagnation)
Hawthorn Flesh (Sharon), Ligusticum Rhizome (Chuanxiong, vinegar-fried), Corydalis Rhizome (Yanhusuo, vinegar-fried), Lyonia Berry (Zelan), Moutan Bark (Danpi), Mugwort Leaf (Aiye), Small Fennel (Xiaohui), Cyperus Rhizome (Xiangfu, vinegar-fried), Poria (Fuling), Motherwort Pill Paste (Yimu Gao Wan).
Re-examination: Angelica Sinensis Root (Danggui), Cinnamon Heart (Guixin), Fennel (Huixiang), Cyperus Rhizome (Xiangfu), Purple Quartz (Zishi), Poria (Fuling), Lamb Gelatin Pill (Yangrou Jiao Wan).
Sun, difficult labor, injury and fright, slight facial edema, abdominal distension, unsatisfactory urination. (Qi and Blood stagnation with Dampness)
Charred Fried Hawthorn Flesh (Heicha Sharon), Large Black Bean Skin (Da Heidoupi), Areca Peel (Dafupi Rong), Raw Cyperus Rhizome (Sheng Xiangfu), Poria (Fuling), Alisma Rhizome (Zexie).
White-flowered Motherwort Decoction (Baihua Yimucao Tang) as water for decoction.
Jin, abdominal distension with Qi stagnation, chronic diarrhea, five days postpartum. (Qi stagnation with distension and diarrhea)
Atractylodes Macrocephala Rhizome (Yuzhu), Magnolia Bark (Nongpu), Poria (Fuling), Alisma Rhizome (Zexie), Southern Hawthorn (Nanshan Zha), Corydalis Rhizome (Yanhusuo).
Ling, transition of four Qi in a year, summer excretion is severe. At Summer Solstice, Yin begins to recover but is not yet full, coinciding with the postpartum period, meaning Yin Qi is leaked before being filled. Summer-Heat invades through gaps, just as the Neijing says: "The most deficient place is where pathogens reside." Obstetrics does not understand this principle, only knowing postpartum blood-stasis dispelling pills, bitter-acrid breaking blood, further劫 (robbing) fluids, leaving trapped Summer-Heat unable to be expelled. Six Qi pathogenic factors invade organs, gradually causing confusion and internal closure. Attacking Heat harms Zheng Qi, tonifying Zheng leaves Pathogen, making prescription difficult. Reading Zhang Zhongjing in youth, pondering sage teachings, only nourishing Yin can eliminate Heat. Moreover, Summer-Heat must damage Qi; is not Ginseng the holy drug for tonifying Qi? A large group of Yin-nourishing drugs, assisted by Ginseng, is indeed the method of tonifying Qi in the Yin aspect. Taking it, heat boils rise continuously, lochia slowly flows down, supporting Zheng and expelling Pathogen proceed together without contradiction. Now food intake is stable, likely no recurrence. Difficult-to-form and easily-lost Yin must be nurtured to achieve results. If emotional disturbances occur, mild cases lead to extraordinary vessel damage and leukorrhea/dysuria, severe cases to marrow depletion and postpartum consumptive disease. Do not say my advice is not detailed. (Yin deficiency with Summer-Heat)
Male Black-bone Hen (Xiong Wuji, one), Ginseng (Renshen, 2 liang mixed with Autumn Stone/Qiushi), Fresh Raw Rehmannia Root (Xian Shengdi, 3 liang), Seed of Ziziphus (Baiziren, 1.5 liang), Asparagus Tuber (Tiantong, 1.5 liang), Ophiopogon Tuber (Maidong, 2 liang), Donkey-hide Gelatin (Ejiao, 2 liang), Jian Lotus Seed Meat (Jianlianrou, 3 liang), Poria (Fushen, 2 liang). Decoct into paste.
Xiang, initially red tongue and restless spirit, postpartum Yin deficiency, Summer-Heat easily penetrates deeply. Urgently clear Ying Heat, as said, thin people worry about Yin deficiency. (Summer-Heat damaging Ying Yin)
Bamboo Leaf (Zhuye), Fine Raw Rehmannia Root (Xi Shengdi), Honeysuckle Flower (Yinhua), Ophiopogon Tuber (Maidong), Scrophularia Root (Xuanshen), Forsythia Fruit (Lianqiao).
Zhang, thirteen days postpartum, yellow tongue with red edges, thirst, tight stuffiness in epigastrium, no eating or hunger, no bowel movement. Yin aspect is already deficient, Heat has entered Ying, resembling malaria. Strongly contraindicate exterior-dispersing and cold-purging. Propose nourishing and clearing Ying Heat, saving Jin Ye (fluids) is essential.
Fine Raw Rehmannia Root (Xi Shengdi), Asparagus Tuber (Tiantong), Raw Softshell Turtle Shell (Sheng Biejia), Moutan Bark (Danpi), Salvia Miltiorrhiza Root (Danshen), Poria (Fushen).
Re-examination: Postpartum blood collaterals are empty, Summer-Heat guest pathogen penetrates deeply, malaria occurs every other day, nausea/vomiting, chest fullness, thirst, all due to Summer-Heat scorching Stomach fluids. This is a deficient person complicated by seasonal Qi, only suitable for harmonization, not sweating or cloying tonification.
Artemisia Annua Stem (Qinghao Geng), Light Scutellaria Root (Dan Huangqin), Moutan Bark (Danpi), Curcuma Aromatica Rhizome (Yujin), Trichosanthes Root (Huafen), Fritillaria Bulb (Chuanbei), Apricot Kernel (Xingren), Tangerine Peel (Juhong).
Re-examination: Pulse slow, heat stopped, sign of disease reduction. But tongue color not clean, bowel movement not通畅 (unobstructed). Postpartum great deficiency, dare not use purgatives. Avoid meat/greasy foods, fearing stagnation steaming into Heat. Vegetable porridge nourishes Stomach, moistening and drying-resolving. Once bowels move, discuss tonifying deficiency.
Raw Polygonum Multiflorum (Sheng Shouwu), Hemp Seed (Maren), Ophiopogon Tuber (Maidong), Honey-fried Anemarrhena Rhizome (Zhi Zhimu), Perilla Fruit (Suzi), Trichosanthes Root (Huafen).
Ms., Turbid Yin reverses upward, nausea, no eating, cold sweat, irritability. Most fear sudden collapse. Cannot solely rely on lochia stagnation/fullness and exclusively purge Qi and attack Blood. (Yang deficiency impending collapse)
Ginseng (Renshen), Dried Ginger (Ganjiang), Aconite Root (Fuzi), Alisma Rhizome (Zexie), mixed with Child's Urine (Tongbian).
Ms., pulse lacks spirit, spiritual fatigue, desire to faint, sweating, indicating Yang Qi leakage. Diarrhea is due to Yin Qi not holding. Postpartum manifestation, belonging to double deficiency. Deeply fear sudden collapse between periods. How can we discuss branch and root regarding alternating fever, chest fullness, and abdominal pain?
Ginseng (Renshen), Processed Aconite Root (Zhi Fuzi), Human Urine (Ren Niao), Pig Bile (Zhu Danzhi).
Ms. (25 years old), postpartum sudden fright, Yang rises causing dizziness/collapse (Jue), left limb numbness, ear deafness. All due to Yang carrying internal Wind, mixing into clear orifices. Upper excess, lower deficiency. Calm Yang and fill Yin, using thick-flavored and static-substance drugs. (Postpartum Yin deficiency with Yang floating causing Jue)
Prepared Rehmannia Root (Shudi), Tortoise Plastron Heart (Guijiaxin), Asparagus Tuber (Tiantong), Cornus Fruit (Yurou), Schisandra Berry (Wuweizi), Magnetite (Cishi), Poria (Fushen), Black-shell Jian Lotus Seed (Heike Jianlian).
Ms., excessive blood loss postpartum, Yin deficiency with Yang excess, head dizziness, sweating, muscle twitching..., fear of body heat, etc. Most prone to fainting. Acrid-pungent flavors are contraindicated.
Raw Rehmannia Root (Shengdi), Wheat (Xiaomai), Honey-fried Black Licorice Root (Zhei Gancao), Ophiopogon Tuber (Maidong), Donkey-hide Gelatin (Ejiao), Poria (Fushen), Raw Left Oyster Shell (Sheng Zuomuli).
Gu (31 years old), postpartum True Yin does not recover, Yang escapes, Wind stirs, limb numbness, first cold extremities then fever.
Prepared Rehmannia Root (Shudi), Donkey-hide Gelatin (Ejiao), Fried Goji Berry (Chao Qizi), Raw White Peony Root (Sheng Baishao), Poria (Fuling), Charred Chrysanthemum Flower (Ju Hua Tan).
Xu, lower abdomen Qi rushes to epigastrium, epigastric pain and distension. If claiming Liver Qi invades Stomach, there must be vomiting/reversal. Previous methods of tonifying Yin and harmonizing Yang failed. Clearly postpartum lower deficiency, Jue Qi attacks upward. Propose using soft-Yang drugs. (Chong-Ren deficiency Qi reversing upward causing epigastric pain/distension)
Fried Dang Gui Body (Chao Guishen), Cistanche Stem (Rongrong), Fried Goji Berry (Chao Qizi), Seed of Ziziphus (Baiziren), Small Fennel (Xiaohui), Poria (Fushen).
Re-examination: Reversal vibration causing pain, indicates Chong-Ren emptiness postpartum. Pressing reduces pain, especially a sign of deficiency. Due to weak Stomach reducing food intake, cannot use large amounts of decoctions, fearing Stomach collapse.
Dang Gui, Cistanche Stem (Rongrong), Purple Quartz (Zishi), Poria (Fuling), Human Placenta (Heche), Deer Antler Frost (Lu Jiaoshuang).
Re-examination: When Chong vessel reverses, all vessels move. Clear sky and gentle weather bring slight relief, indicating Yin deficiency extending to Yang aspect. Previous method encompassed Great Qi, warming/nourishing assisting unblocking, this is a collateral formula. Recently spring rising, slight nasal bleeding, but no cold-clearing drugs available. Add salty flavor to assist entering Yin, addressing postpartum Lower Jiao initial injury. Original formula reduce Deer Antler Frost and Dang Gui, also fearing Yang rising. Add Goji and Longan, since pain is on the left, thus nourishing Liver is the proposal.
Yu (32 years old), back cold, heart hot, cool after sweating at dawn. Lasting two to three months postpartum. This is Lower Jiao True Yin already deficient, gradually disturbing Yang position, two Qi interacting, not an external pathogen. Dizziness, tinnitus, palpitations, diarrhea after alternating fever, internal Wind stirring. Should give quiet drugs. (Yin deficiency with stirring Wind-Yang, June 20)
Ginseng (Renshen), Honey-fried Licorice Root (Zhicao), White Peony Root (Baishao), Ophiopogon Tuber (Maidong), Fried Raw Rehmannia Root (Chao Shengdi), Fried Dark Plum (Chao Wumei).
Re-examination: Previous method sour-sweet, tonifying Yin and harmonizing Yang, all diseases reduced. However, this ailment is postpartum Lower Jiao hundred vessels empty, called Rusun (postpartum consumptive disease). Filling gaps and consolidating marrow is the correct treatment. Due to no increase in food intake, heavy/cloying may hinder appetite, pills can be used for meals. (July 3)
Ginseng (Renshen), Honey-fried Licorice Root (Zhicao), Donkey-hide Gelatin (Ejiao), Raw Rehmannia Root (Shengdi), Ophiopogon Tuber (Maidong).
Re-examination: Follow previous formula adding Cinnamon Twig Wood (Guizhimu), Poria (Fuling), Southern Date (Nanzao). (August 7)
Re-examination: Postpartum all belong to Lower Jiao initial damage, hundred vessels empty. Season is Summer-Autumn, warm weather increases excretion worsening disease. This supporting Yang and tonifying Yin achieved effect. Now symptoms improving, sleep and appetite stable, only menstruation not arrived. Its Chong-Ren extraordinary vessels do not rise, must have visceral Yin full and vigorous, allowing flow in vessels. (September 1)
Prepared Rehmannia Root (Shudi, water-processed), Ginseng (Renshen), Donkey-hide Gelatin (Ejiao), Cornus Fruit (Yurou), Charred Polygala Root (Yuanzhi Tan), Chinese Yam (Shanyao), Poria (Fushen), Jian Lotus Seed (Jianlian), Black-bone Hen Paste (Wuji Ji Gao Wan).
Wu, overexertion during confinement, fear and distress intersecting, True Yin injured, not recovering for years. Dim vision, blurry sight, irritability, heat rising, all due to Kidney Yin unable to self-fill, how to nourish Liver Wood? Collapse and dizziness, Yang carrying Liver Wind rushing up uncontrollably. Then must use quiet drugs to fill Yin, assist sour to collect.
Prepared Rehmannia Root (Shudi), Donkey-hide Gelatin (Ejiao), Schisandra Berry (Wuweizi), Cornus Fruit (Yurou), North Glehnia Root (Beishashen), Poria (Fushen), Black Bean Skin (Heidoupi), Autumn Stone (Qiushi, 2 fen mixed in).
Chen (28 years old), alternating fever and chills, not cured for a year, and postpartum disease onset, Yang Wei disease is clear. (Yang Wei disease alternating fever/chills) Guizhi Tang.
Guo (24 years old), postpartum Lower Yuan Yin aspect injured first, and Eight Extraordinary Vessels all attach to the lower. Liver and Kidney weak and insecure, eight vessels all fail in their duties. Classic states: Yang Wei vessel pain suffers alternating fever/chills, Yin Wei vessel disease suffers heart pain. Lower damage extends to Stomach, food intake decreases daily. However, birth injury first injures True Yin, contraindicate acrid-hot Cinnamon and Aconite. Warm Yang within Yin, those able to enter extraordinary vessels are suitable. (Lower damage extending to Stomach, extraordinary vessel deficiency)
Ginseng (Renshen), Deer Antler (Lurong), Purple Quartz (Zishi), Angelica Sinensis Root (Danggui), Psoralea Fruit (Buguzhi), Poria (Fuling).
Chen (41 years old), four months postpartum, lower back pain radiating to lower abdomen, cold sweat, no eating. (Deficient and cold Ying collaterals causing lower back/abdominal pain)
Angelica Sinensis Root (Danggui), Lamb Meat (Yangrou), Small Fennel (Xiaohui), Cinnamon Twig Wood (Guizhimu), Poria (Fuling), Purple Quartz (Zishi).
Shen, postpartum anger, Qi and Blood both reverse, pain, vomiting, unable to lie down, cannot bend forward or backward, cold face and limbs, cold breath from mouth/nose, pain necessarily rushes upward from below. This belongs to Hernia/Mass Jue pain. (Qi and Blood cold stagnation forming mass)
Light Evodia Fruit (Dan Wuyu), Leek White (Jiu Bai), Two-headed Sharp (Liangtoujian), Toosendan Fruit (Chuanlianzi), Cinnamon Twig Wood (Guizhimu), Poria (Fuling).
Wu (26 years old), within one hundred days postpartum, right hypochondriac and lower abdominal pain, hard and distended. Collaterals empty without Blood, Qi enters middle, having accumulation/mass burden, extending to become distension. Menstruation does not return, becoming major disease.
Angelica Sinensis Root (Danggui), Cinnamon Heart (Guixin), Raw Peach Kernel (Sheng Taoren), Achyranthes Root (Niuxi), Hawthorn (Shanzha), Charred Black Small Fennel (Chaohei Xiaohui).
Lu, postpartum pathogen deeply enters Yin, Qi and Blood knotted, thus forming mass/hernia shape, body stooped, extraordinary vessel framework useless. Filling form and unblocking collaterals can be effective. Imitating Zhang Zhongjing's Dang Gui Lamb Soup intent.
Dang Gui Body (Guishen), Cistanche Stem (Rongrong), Goji Berry (Qizi), Small Fennel (Xiaohui), Poria (Fuling), Purple Quartz (Zishi), Lamb Gelatin Pill (Yangrou Jiao Wan).
Ms., postpartum bladder damage, dysuria, tendon pulling. Treatment should secure lower. (Bladder damage)
Mantis Egg Case (Sangpiaoxiao), Raw Astragalus Complanatus (Sheng Shayuan), Charred Cornus Fruit (Yurou Tan), Fried Phellodendron Bark (Chao Huangbai), Poria (Fushen).
Feng (42 years old), two months postpartum, sweating, body pain. (Ying and Wei both deficient) Guijianzhong Tang.
Yu, postpartum not recovering, palpitations, desire to vomit, abdominal pain upon cold exposure. First discuss advancing Ying-Wei harmonization, subsequently tonifying and securing. Guizhi Tang added with Poria (Fuling).
Wu (38 years old), stomach pain lasting three months, vegetarian diet, sallow face, postpartum acid regurgitation, little food intake, Middle Jiao Yang exhausted. How can one add purging/draining? Give acrid drug tonifying Blood collaterals formula. (Yang deficiency stomach pain with Blood collateral stasis)
Peach Kernel (Taoren), Dang Gui Tendrils (Guixu), Clove Bark (Gong Dingxiapi), Cinnamon Twig (Chuan Guizhi), Pinellia Tuber (Banxia), Poria (Fuling).