由脬内素有冷气,因产发动,冷气入脬故也。用赤石脂二两为末,空心服。
又方,治小便数及遗尿,用益智仁二十八枚为末,米饮送下二钱。
又桑螵散
桑(三十个) 人参 黄 鹿茸 牡蛎 赤石脂(各三钱)
为末,空心服二钱,米饮送下。
歌括∶冷气入脬致便数,桑螵蛸散参 多。
鹿茸牡蛎赤石脂,研末服之泉可缩。
产后泄泻,非杂症有食泄、湿泄、水谷注下之论,大率气虚食积与湿也。气虚宜补、食积宜消、湿则宜燥,然恶露
未净,遽难骤燥,当先服生化汤二、三帖,化旧生新,加茯苓以利水道,俟血生,然后补气以消食,燥湿以分利水道,
使无滞涩虚虚之失。若产旬日外,方论杂症,尤当论虚实而治也。如痛下清水,腹鸣,米饮不化者,以寒泄治;如粪水
黄赤,肛门作痛,以热泄治之;有因饮食过多,伤脾成泄,气臭如败卵,以食积治之;又有脾气久虚少食,食下即鸣,
急尽下所食之物,方觉快者,以虚寒泄治之。治法寒则温之,热则清之,脾伤食积,分利健脾,兼消补虚,善为调治,
无失也。产后虚泻,眠昏人不识,弱甚形脱危症,必用人参二钱,白术、茯苓各二钱,附子一钱,方能回生。若脉浮弦,
按之不鼓,即为中寒,此盖阴先亡而阳欲去,速宜大补气血,加附子、黑姜以回元阳,万勿忽视。
加减生化汤 治产后块未消患泻症。
川芎(二钱) 茯苓(二钱) 当归(四钱) 黑姜(五分) 炙草(五分) 桃仁(十粒) 莲子(八枚)
水煎,温服。
健脾利水生化汤 治产后块已除,患泻症。
川芎(一钱) 茯苓(一钱半) 归身(二钱) 黑姜(四分) 陈皮(五分) 炙草(五分) 人参(三钱) 肉
果(一个,制) 白术(一钱,土炒) 泽泻(八分)
寒泻,加干姜八分;寒痛,加砂仁、炮姜各八分;热泻,加炒黄连八分;泻水腹痛,米饮不化,加砂仁八分,麦芽、
山楂各一钱;泻有酸嗳臭气,加神曲、砂仁各八分。脾气久虚,泻出所食物方快,以虚寒论∶泻水者,加苍术一钱以燥
湿;脾气弱,元气虚,必须大补,佐消食清热却寒药。弱甚形色脱,必须第一方,参、术、苓、附,必用之药也。诸泻
俱加升麻酒炒,莲子十粒。
歌括∶产后泻泄非杂症,气虚食积湿邪生。
湿则宜燥食消导,寒则温之热宜清。
产后泻泄块未散,生化汤中再加减。
川芎当归茯苓配,黑姜桃仁炙草莲。
产后块除患泻症,健脾利水生化汤。
归芎茯苓陈皮草,参术肉果泽泻姜。
由于膀胱内素有冷气,因分娩时发动,导致冷气侵入膀胱所致。使用赤石脂二两研成粉末,空腹服用。
另一个方子,治疗小便频数及遗尿,用益智仁二十八枚研成粉末,用米汤送服二钱。
还有桑螵蛸散:
桑螵蛸(三十个) 人参 黄芪 鹿茸 牡蛎 赤石脂(各三钱)
研成粉末,空腹服用二钱,用米汤送下。
歌诀:冷气侵入膀胱导致小便频数,桑螵蛸散中人参用量较多。
鹿茸、牡蛎、赤石脂,研末服用可使小便减少。
产后泄泻,不同于杂病中有食积泄、湿泄、水谷注下的论述,大体上是气虚、食积与湿邪所致。气虚应当补益,食积应当消导,湿邪应当燥化。然而恶露未净时,难以立即使用燥湿药,应当先服用生化汤二至三帖,以化瘀生新,加入茯苓以利水道,待血液生成后,然后再补气以消食,燥湿以利水道,避免造成滞涩和虚上加虚的失误。如果产后十天以外,才按杂病论治,尤其应当辨别虚实而治疗。如腹痛排出清水,肠鸣,米饮不消化者,按寒泄治疗;如粪便黄赤,肛门疼痛,按热泄治疗;有因饮食过多,损伤脾胃而成泄泻,气味臭如败卵者,按食积治疗;又有脾气久虚、少食,食物入口即肠鸣,急于排尽所食之物后才觉舒畅者,按虚寒泄治疗。治疗方法:寒证则温之,热证则清之,脾伤食积,分利健脾,兼以消补虚损,妥善调治,就不会有误。产后虚泻,出现昏睡昏迷、不认识人,身体极度虚弱、形体脱失的危重病症,必须用人参二钱,白术、茯苓各二钱,附子一钱,才能起死回生。如果脉象浮弦,重按无力,即为中寒,这是阴液先亡而阳气欲脱,速宜大补气血,加入附子、炮姜以挽回元阳,千万不要忽视。
加减生化汤:治疗产后瘀块未消患泄泻症。
川芎(二钱) 茯苓(二钱) 当归(四钱) 黑姜(五分) 炙甘草(五分) 桃仁(十粒) 莲子(八枚)
水煎,温服。
健脾利水生化汤:治疗产后瘀块已除,患泄泻症。
川芎(一钱) 茯苓(一钱半) 当归身(二钱) 黑姜(四分) 陈皮(五分) 炙甘草(五分) 人参(三钱) 肉豆蔻(一个,制过) 白术(一钱,土炒) 泽泻(八分)
寒泄,加干姜八分;寒痛,加砂仁、炮姜各八分;热泄,加炒黄连八分;泄水腹痛,米饮不化,加砂仁八分,麦芽、山楂各一钱;泄泻有酸腐臭气,加神曲、砂仁各八分。脾气久虚,泻出所吃食物后才觉快,按虚寒论治:泄水者,加苍术一钱以燥湿;脾气弱,元气虚,必须大补,佐以消食、清热、驱寒药。身体极度虚弱、形色脱失,必须用第一方,人参、白术、茯苓、附子,是必用的药物。所有泄泻均加酒炒升麻,莲子十粒。
歌诀:产后泄泻非杂病,气虚食积湿邪生。
湿邪宜燥食宜消导,寒证温之热证清。
产后泄泻瘀块未散,生化汤中再加减。
川芎当归茯苓配,黑姜桃仁炙草莲。
产后瘀块消除患泄泻,健脾利水生化汤。
归芎茯苓陈皮草,参术肉果泽泻姜。
Due to cold qi previously existing within the bladder (Pangguang, urinary bladder), triggered by childbirth, causing cold qi to enter the bladder. Use Chishizhi (Red Halloysite) two liang ground into powder, taken on an empty stomach.
Another prescription for treating frequent urination and enuresis: use Yizhiren (Bitter Almond Seed of Alpinia Oxyphylla) twenty-eight seeds ground into powder, taken with rice water, two qian per dose.
Also, Sangpiaoxiao San (Mantis Egg-case Powder):
Sangpiaoxiao (Mantis Egg-case) thirty pieces, Renshen (Ginseng Root), Huangqi (Astragalus Root), Lurong (Deer Antler without Horn), Muli (Oyster Shell), Chishizhi (Red Halloysite) (each three qian).
Ground into powder, take two qian on an empty stomach, delivered with rice water.
Verse: Cold qi entering the bladder causes frequent urination; in Sangpiaoxiao San, the amount of Renshen is relatively large.
Lurong (Deer Antler), Muli (Oyster Shell), Chishizhi (Red Halloysite), ground into powder and taken can reduce urine flow.
Postpartum diarrhea differs from miscellaneous diseases' discussions on food stagnation diarrhea, dampness diarrhea, and watery stool discharge. It is generally caused by Qi deficiency, food stagnation, and dampness. Qi deficiency should be tonified, food stagnation should be resolved, and dampness should be dried. However, when lochia (postpartum vaginal discharge) is not yet cleared, it is difficult to immediately use drying herbs. One should first administer Shenghua Tang (Life-Restoring Decoction) for two or three doses to transform old blood and generate new, adding Fuling (Poria) to benefit the water passages. Wait until blood is generated, then tonify Qi to resolve food stagnation, dry dampness to separate and drain the water passages, avoiding stagnation and the error of further weakening the deficient state. If more than ten days postpartum, treat as miscellaneous diseases, specifically distinguishing between excess and deficiency. For example, if there is painful passage of clear water, abdominal borborygmi, and undigested rice/water, treat as cold diarrhea; if stools are yellow-red with anal pain, treat as heat diarrhea; if caused by excessive eating damaging the Spleen/Stomach resulting in diarrhea with a foul odor like rotting eggs, treat as food stagnation; if there is long-standing Spleen Qi deficiency with little intake, borborygmi immediately after eating, and relief only after urgently evacuating all ingested food, treat as deficiency-cold diarrhea. Treatment methods: warm for cold patterns, clear for heat patterns, separate and drain while strengthening the Spleen for Spleen injury and food stagnation, combining resolution and tonification for deficiency. Proper regulation ensures no errors. For postpartum deficiency diarrhea presenting with lethargy, coma, inability to recognize people, extreme weakness, and emaciation—a critical condition—Renshen (Ginseng Root) two qian, Baizhu (Atractylodes Macrocephala Rhizome) and Fuling (Poria) each two qian, and Fuzi (Prepared Aconite Lateral Root) one qian are necessary to restore life. If the pulse is floating and wiry, but weak upon deep pressure, it indicates middle Jiao cold. This suggests Yin has been depleted and Yang is about to depart; quickly tonify Qi and Blood extensively, adding Fuzi (Prepared Aconite Lateral Root) and Heijiang (Charred Ginger) to recover Yuan Yang. Do not neglect this.
Jiajian Shenghua Tang (Modified Life-Restoring Decoction): Treats diarrhea occurring when postpartum masses (blood stasis) have not yet dissipated.
Chuanxiong (Ligusticum Rhizome) two qian, Fuling (Poria) two qian, Danggui (Angelica Sinensis Root) four qian, Heijiang (Charred Ginger) five fen, Zhigancao (Honey-fried Licorice Root) five fen, Taoren (Peach Kernel) ten grains, Lianzi (Lotus Seed) eight pieces.
Decoct in water, take warm.
Jianpi Li Shui Shenghua Tang (Spleen-Strengthening and Water-Draining Life-Restoring Decoction): Treats diarrhea occurring when postpartum masses have been removed.
Chuanxiong (Ligusticum Rhizome) one qian, Fuling (Poria) one qian half, Guishen (Angelica Sinensis Root Body) two qian, Heijiang (Charred Ginger) four fen, Chenpi (Tangerine Peel) five fen, Zhigancao (Honey-fried Licorice Root) five fen, Renshen (Ginseng Root) three qian, Rougu (Myristica Seed, prepared) one piece, Baizhu (Atractylodes Macrocephala Rhizome, earth-fried) one qian, Zexie (Alisma Rhizome) eight fen.
For cold diarrhea, add Ganjiang (Dried Ginger) eight fen; for cold pain, add Sharen (Amomum Fruit) and Paojiang (Prepared Ginger) each eight fen; for heat diarrhea, add Chao Huanglian (Fried Coptis Rhizome) eight fen; for watery diarrhea with abdominal pain and undigested food, add Sharen (Amomum Fruit) eight fen, Maiya (Barley Sprout) and Shanzha (Hawthorn Fruit) each one qian; for diarrhea with sour, foul belching, add Shenqu (Medicated Leaven) and Sharen (Amomum Fruit) each eight fen. For long-standing Spleen Qi deficiency where relief comes only after evacuating ingested food, treat as deficiency-cold: for watery diarrhea, add Cangzhu (Atractylodes Lancea Rhizome) one qian to dry dampness; for weak Spleen Qi and deficient Yuan Qi, extensive tonification is required, assisted by herbs that resolve food stagnation, clear heat, and dispel cold. For extreme weakness and emaciation, the first formula (Renshen, Baizhu, Fuling, Fuzi) is essential. All types of diarrhea should include Jiushengma (Wine-processed Cimicifuga Rhizome) and ten Lianzi (Lotus Seeds).
Verse: Postpartum diarrhea is not a miscellaneous disease; Qi deficiency, food stagnation, and dampness arise.
Dampness should be dried, food stagnation resolved; cold should be warmed, heat should be cleared.
Postpartum diarrhea with unresolved masses: modify Shenghua Tang.
Chuanxiong, Danggui, Fuling combined; Heijiang, Taoren, Zhigancao, Lianzi.
When postpartum masses are gone and diarrhea occurs: Jianpi Li Shui Shenghua Tang.
Guishen, Chuanxiong, Fuling, Chenpi, Caog; Renshen, Baizhu, Rougu, Zexie, Jiang.