血崩宜审血色之红紫。形色之虚实。如血紫有块。宜去其败血。若留之反作痛。不可以崩论。如鲜红之血大来。乃
是心因惊伤不能生血。肝因怒伤。不能藏血。脾因劳伤。不能统血。当以崩治之。宜于生化汤中加荆芥穗五分。连服几
剂则行中有补而血安矣。若形脱气促。或有汗晕厥。牙关紧闭。昏乱将绝。先用韭菜数十茎。细切放酒壶内。以滚醋一
碗泡入。将大口塞住。以小口对鼻孔熏之。速煎生化夺命汤灌救。如气欲绝。药不能入。即将鹅毛管插口内。用酒杯盛
三四分灌之。如灌下腹渐温暖。连服数剂可活。再用绵衣烘热。替换揉腹。方无他患。如产后半月崩来。又宜滋荣益气
汤以升举之。世医治崩。每以棕灰止之。此治末之法。即有偶效。祸不旋踵慎之。
川芎(二钱) 当归(四钱) 干姜(炙黑五分) 甘草(炙三分) 桃仁(去皮尖研十一粒) 肉桂(三分服二
剂去此味)
上药加黑枣一枚。用水一盏半煎七分。稍热服。
汗多加人参二钱。生黄 二钱。两手脉伏。或右手脉绝。加麦冬一钱。五味子十粒。如灌药得苏。其块痛未除。当
减去参 。只服生化汤。除块定痛。若块痛已除。仍加参 。口渴加麦冬。腹泻加茯苓。有痰加竹沥一匙。姜汁半匙。
若胃中久不纳食。闻药气即呕。先用人参一二钱煎汤。调饭锅焦末服之。以通胃气。此等危症。一日内须服二三剂。方
保无虞。
治疗血崩应当审察血色是红还是紫,以及形体表现的虚或实。如果血色紫暗且有血块,适宜祛除败血(瘀血)。如果保留这些败血反而会引起疼痛,这就不能单纯按血崩来论治。如果是鲜红色的血液大量涌出,这是心因受惊受损而不能生血,肝因受怒受损而不能藏血,脾因劳累受损而不能统摄血液。此时应当作为血崩来治疗。适宜在生化汤中加入荆芥穗五分,连续服用几剂,就能在行血中兼有补益作用,从而使血液安宁。
如果出现形体脱失、气息急促,或者出汗、晕厥、牙关紧闭、神志昏乱濒临死亡的情况,先用韭菜数十根,切碎放入酒壶内,用一碗滚开的醋浸泡进去,将大口塞住,用小口对着鼻孔熏蒸。迅速煎煮生化夺命汤进行灌服抢救。如果气息即将断绝,药物无法入口,就用鹅毛管插入口中,用酒杯盛三四分药液灌入。如果灌下药后腹部逐渐温暖,连续服用几剂可以救活。再用棉衣烘热,替换着揉搓腹部,这样就不会有其他祸患。如果是产后半个月出现血崩,又适宜用滋荣益气汤来升提举陷。世间的医生治疗血崩,常常用棕榈灰来止血,这是治末的方法,即使偶尔有效,灾祸也会立刻降临,务必谨慎。
【方剂组成】川芎(二钱)、当归(四钱)、干姜(炙黑五分)、甘草(炙三分)、桃仁(去皮尖研磨十一粒)、肉桂(三分,服用两剂后去掉此味)。
以上药物加黑枣一枚,用水一盏半煎至七分,稍热时服用。
如果汗多,加入人参二钱、生黄芪二钱。两手脉搏伏匿,或者右手脉搏消失,加入麦冬一钱、五味子十粒。如果灌药后患者苏醒,但血块疼痛未除,应当减去人参,只服用生化汤,以消除血块、定痛。如果血块疼痛已经消除,仍要加入人参。口渴加麦冬,腹泻加茯苓,有痰加竹沥一匙、姜汁半匙。如果胃中长期不能纳食,闻到药气就呕吐,先用人参一二钱煎汤,调和饭锅焦末服用,以疏通胃气。这类危重病症,一天内必须服用二三剂,才能确保没有危险。
In the treatment of metrorrhagia (uterine bleeding), one must examine whether the blood color is red or purple, and assess the deficiency or excess manifested in the physical condition. If the blood is dark purple with clots, it is appropriate to eliminate the stale blood (blood stasis). Retaining such stale blood will instead cause pain; therefore, this should not be treated merely as metrorrhagia. If fresh red blood flows profusely, it indicates that the Heart has been injured by fright and cannot generate blood, the Liver has been injured by anger and cannot store blood, and the Spleen has been injured by overexertion and cannot control blood. In such cases, it should be treated as metrorrhagia. It is advisable to add Schizonepeta Spike (Jingjie Sui) measuring 5 fen to Shenghua Tang (Life-Birth Decoction). Taking several doses consecutively will achieve tonification within blood-invigorating action, thereby calming the blood.
If there is collapse of form, rapid breathing, sweating, syncope, lockjaw, delirium, and a state nearing death, first take dozens of leek stalks, finely chop them, place them in a wine pot, pour in one bowl of boiling vinegar, seal the large opening tightly, and use the small opening to fumigate the nostrils. Quickly decoct Shenghua Duoming Tang (Life-Birth Life-Saving Decoction) for gavage rescue. If vital energy is about to cease and medicine cannot enter the mouth, insert a goose feather tube into the mouth, hold three to four fen of medicine in a wine cup, and administer it. If the abdomen gradually becomes warm after administration, continuous intake for several doses can save life. Subsequently, heat cotton garments and replace them to rub the abdomen, ensuring no further complications arise. If metrorrhagia occurs half a month postpartum, Zirong Yiqi Tang (Nourish Glory and Boost Qi Decoction) should be used to lift and raise sinking Qi. Physicians of the world often treat metrorrhagia by using Palm Ash (Zonghui) to stop bleeding; this is a method treating the branch rather than the root. Even if there is occasional efficacy, disaster will follow immediately; caution is advised.
[Formula Composition] Chuanxiong Rhizome (Chuanxiong, 2 qian), Angelica Sinensis Root (Danggui, 4 qian), Dried Ginger (Ganjiang, roasted until black, 5 fen), Licorice Root (Gancao, roasted, 3 fen), Peach Kernel (Taoren, peeled and core removed, ground, 11 grains), Cinnamon Bark (Rougui, 3 fen; remove this ingredient after two doses).
Add one black date to the above herbs, decoct in 1.5 cups of water until reduced to 0.7 cups, and take when slightly warm.
If sweating is excessive, add Ginseng Radix et Rhizoma (Renshen, 2 qian) and Astragali Radix (Sheng Huang, 2 qian). If pulses in both hands are deep-hidden, or the pulse in the right hand is absent, add Ophiopogonis Radix (Maidong, 1 qian) and Schisandrae Fructus (Wuweizi, 10 grains). If the patient revives after gavage but pain from clots persists, reduce the dosage of Renshen and administer only Shenghua Tang to resolve clots and relieve pain. If clot pain has subsided, resume adding Renshen. Add Maidong for thirst, Poria (Fuling) for diarrhea, Arisaematis Cum Bile (Zhuli, 1 spoon) and Zingiberis Recens Juice (Jiangzhi, half spoon) for phlegm. If the stomach fails to retain food for a long time and vomiting occurs upon smelling the medicine, first decoct 1-2 qian of Renshen in water, mix with rice crust powder, and administer to unblock Stomach Qi. For such critical conditions, two to three doses must be taken within one day to ensure safety.