川芎(二钱) 当归(三钱) 诃子皮(八分) 干姜(炙黑五分) 茯苓(一钱五分) 肉果霜(五分) 莲子
(十粒) 桃仁(去皮尖研十四粒) 甘草(炙五分)
两服后不止。加人参一钱五分。口渴加麦冬一钱。五味子九粒。人参一钱。
川芎(二钱) 当归(三钱) 诃子皮(八分) 人参(一钱) 干姜(炙黑五分) 肉果霜(五分) 茯苓(一
钱五分) 山药(炒二钱) 甘草(炙五分) 莲子(九粒) 糯米(炒黄三钱)
块痛未除。去肉果。块痛已除。加生于术二钱。陈皮三分。
川芎(一钱五分) 当归(炒二钱) 干姜(炙黑四分) 人参(二钱) 于术(生二钱) 茯苓(一钱五分) 陈
皮(五分) 泽泻(八分) 肉果霜(五分) 甘草(炙五分) 莲子(九粒)
因寒作泻。倍用黑姜。腹痛泄水。饮食不化。加砂仁八分。炒山楂二钱。炒麦芽二钱。久泻不止。加升麻一钱。
七日内外。患赤白痢后重便脓。最为难治。夫痢以通利为主。然产后而欲推荡秽邪。虑元气之虚弱。欲滋补气血。
恐积滞之留连。余于此症。斟酌数四。只有服生化汤。去黑姜。加木香四分。方能并行不悖。服二三剂不应。接服香连
生化汤。应手可愈。惟产妇体气素浓。已及一月。可用推荡之法。若体气素弱。虽产月余。难议攻下。如槟榔枳实浓朴
大黄之属用之。产后鲜有不成败症者。可不谨欤。
川芎(二钱) 当归(三钱) 诃子皮(八分) 干姜(炮制至黑,五分) 茯苓(一钱五分) 肉豆蔻霜(五分) 莲子(十粒) 桃仁(去皮尖,研碎,十四粒) 甘草(炙,五分)
服用两剂后若腹泻不止。加入人参一钱五分。若口渴,加入麦冬一钱、五味子九粒、人参一钱。
川芎(二钱) 当归(三钱) 诃子皮(八分) 人参(一钱) 干姜(炮制至黑,五分) 肉豆蔻霜(五分) 茯苓(一钱五分) 山药(炒,二钱) 甘草(炙,五分) 莲子(九粒) 糯米(炒黄,三钱)
腹部有块状疼痛未消除。去掉肉豆蔻。块状疼痛已消除。加入生白术二钱、陈皮三分。
川芎(一钱五分) 当归(炒,二钱) 干姜(炮制至黑,四分) 人参(二钱) 白术(生,二钱) 茯苓(一钱五分) 陈皮(五分) 泽泻(八分) 肉豆蔻霜(五分) 甘草(炙,五分) 莲子(九粒)
因受寒导致腹泻。加倍使用黑干姜。腹痛且泻下清水,饮食不消化。加入砂仁八分、炒山楂二钱、炒麦芽二钱。久泻不止。加入升麻一钱。
产后七日内外,出现赤白痢疾、里急后重、便脓血的症状,最为难治。治疗痢疾通常以通利为主,但产后患者若想通过攻下法推荡秽浊邪气,又担心元气虚弱;若想滋补气血,又恐积滞留恋不去。我对此症斟酌多次,认为只有服用生化汤(Postpartum Involution Decoction),去掉黑干姜,加入木香四分,才能补泻并行而不冲突。服用二三剂无效后,接续服用香连生化汤(Xianglian Shenghua Tang),即可应手而愈。只有产妇体质原本强盛,且产后已满一个月,才可用攻下推荡之法。如果体质原本虚弱,即使产后一个多月,也难以议用攻下法。如槟榔、枳实、厚朴、大黄这类药物,在产后使用,很少有不成败症的。能不谨慎吗?
Chuanxiong (2 qian) Danggui (3 qian) Heqipi (8 fen) Ganjiang (charred, 5 fen) Fuling (1.5 qian) Rouguoshuang (5 fen) Lianzi (10 grains) Taoren (peeled and deseeded, crushed, 14 grains) Gancao (honey-fried, 5 fen)
If diarrhea persists after two doses, add Renshen (1.5 qian). If thirst is present, add Maidong (1 qian), Wuweizi (9 grains), and Renshen (1 qian).
Chuanxiong (2 qian) Danggui (3 qian) Heqipi (8 fen) Renshen (1 qian) Ganjiang (charred, 5 fen) Rouguoshuang (5 fen) Fuling (1.5 qian) Shanyao (stir-fried, 2 qian) Gancao (honey-fried, 5 fen) Lianzi (9 grains) Nuomi (stir-fried until yellow, 3 qian)
If abdominal mass-like pain remains, remove Rouguo. If the mass-like pain has resolved, add Baizhu (raw, 2 qian) and Chenpi (0.3 qian).
Chuanxiong (1.5 qian) Danggui (stir-fried, 2 qian) Ganjiang (charred, 4 fen) Renshen (2 qian) Baizhu (raw, 2 qian) Fuling (1.5 qian) Chenpi (0.5 qian) Zexie (0.8 qian) Rouguoshuang (5 fen) Gancao (honey-fried, 5 fen) Lianzi (9 grains)
For diarrhea caused by cold, double the dosage of charred Ganjiang. For abdominal pain with watery stool and undigested food in the stool, add Sharen (0.8 qian), Chao Shanzha (2 qian), and Chao Maiya (2 qian). For chronic persistent diarrhea, add Shengma (1 qian).
Within seven days postpartum, presenting with dysentery characterized by red and white discharge, tenesmus, and pus/blood in stool, is the most difficult to treat. Dysentery is generally treated with purgation/drainage. However, in postpartum patients, while one might wish to use purgatives to expel turbid pathogens, there is concern regarding the deficiency of Yuanqi (primordial qi); conversely, while tonifying Qi and Blood is desired, there is fear that stagnation will persist. After careful deliberation on this condition, I conclude that only by administering Shenghua Tang (Postpartum Involution Decoction), removing charred Ganjiang, and adding Muxiang (0.4 qian), can tonification and purgation proceed without conflict. If no improvement is seen after two to three doses, follow up with Xianglian Shenghua Tang (Xianglian Postpartum Involution Decoction), which should yield immediate results. Only if the parturient’s constitution is naturally robust and it has been a full month since delivery may purgative methods be considered. If the constitution is inherently weak, even if more than a month has passed since delivery, aggressive purgation is contraindicated. The use of substances such as Binglang (Areca Seed), Zhishi (Immature Bitter Orange), Houpo (Magnolia Bark), and Dahuang (Rhubarb Root) in the postpartum period rarely fails to result in treatment failure or adverse outcomes. Can one not be cautious?