产后汗多,即变痉者,项强而身反,气息如绝,宜速服加减生化汤。
加减生化汤 专治有汗变痉者。
川芎 麻黄根(各一钱) 当归(四钱) 桂枝(五分) 人参(一钱) 炙草(五分) 羌活(五分) 天麻(八
分) 附子(一片) 羚羊角(八分)
如无汗类痉者中风,用川芎三钱,当归一两酒洗,枣仁、防风俱无份量。
眉批∶一本引用生姜一片,枣一枚。
歌括∶产后汗多即变痉,项强身反似角弓。
气息如绝难接续,加减生化速煎送。
加减生化止痉好,归芎附子炙甘草。
天麻人参麻黄根,桂枝羌活羚羊角。
凡分娩时汗出,由劳伤脾、惊伤心、恐伤肝也。产妇多兼三者而汗出,不可即用敛汗之剂,神定而汗自止。若血块
作痛, 术未可遽加,宜服生化汤二、三帖,以消块痛,随继服加参生化汤,以止虚汗。若分娩后倦甚, 然汗出,
形色又脱,乃亡阳脱汗也;汗本亡阳,阳亡则阴随之,故又当从权,速灌加参生化汤,倍参以救危,毋拘块痛。妇人产
多汗,当健脾以敛水液之精,益荣卫以嘘血归源,灌溉四肢,不使妄行。杂症虽有自汗盗汗之分,然当归六黄汤不可治
产后之盗汗也,并宜服加参生化汤及加味补中益气二方;若服参 而汗多不止,及头出汗而不至腰足,必难疗矣;如汗
出而手拭不及者,不治。产后汗出气喘等症,虚之极也,不受补者,不治。
麻黄根汤 治产后虚汗不止。
人参(二钱) 当归(二钱) 黄 (一钱半,炙) 白术(一钱,炒) 桂枝(五分) 麻黄根(一钱) 粉草
(五分,炒) 牡蛎(研,少许) 浮麦(一大撮)
虚脱汗多,手足冷,加黑姜四分,熟附子一片;渴加麦冬一钱,五味十粒。肥白人产后多汗,加竹沥一盏,姜汁一
小匙,以清痰火。恶风寒,加防风、桂枝各五分;血块不落,加熟地三钱,晚服八味地黄九。
山茱萸 山药 丹皮 云苓(各八钱) 泽泻(五钱) 熟地(八钱) 五味子(五钱) 炙黄 (一两)
炼蜜为丸。阳加于阴则汗,因而遇风,变为螈 者有之,尤难治。故汗多,宜谨避风寒。汗多小便不通,乃亡津液
故也,勿用利水药。
歌括∶分娩之时汗淋漓,惊恐劳伤心肝脾。
不可骤用敛汗剂,参加生化救危急。
麻黄根汤当归参, 术桂枝麻黄根。
牡蛎粉草浮小麦,汗多服此效如神。
产后汗出过多,进而转变为痉病(以项背强直、四肢抽搐为主要表现的病证),出现颈部僵硬、身体向后反折如弓状,气息微弱仿佛断绝,应当迅速服用加减生化汤。
川芎、麻黄根(各一钱),当归(四钱),桂枝(五分),人参(一钱),炙甘草(五分),羌活(五分),天麻(八分),附子(一片),羚羊角(八分)。
如果是无汗但类似痉病的中风症状,使用川芎三钱,当归一两(用酒清洗),酸枣仁、防风均不规定具体份量。
歌诀:产后汗多即刻变为痉病,颈项强硬身体反折似角弓反张。气息微弱难以接续,迅速煎服加减生化汤送下。加减生化汤止痉效果良好,包含当归、川芎、附子、炙甘草。还有天麻、人参、麻黄根,以及桂枝、羌活、羚羊角。
凡是分娩时出汗,是由于劳累损伤脾脏、受惊损伤心脏、恐惧损伤肝脏所致。产妇往往同时兼有这三种情况而导致出汗,不能立即使用收敛止汗的药物,待心神安定后汗自然停止。如果有血块引起疼痛,此时不可急于加入白术,适宜服用二到三帖生化汤,以消除血块引起的疼痛,随后继服加参生化汤,以止住虚性汗出。如果分娩后极度疲倦,大汗淋漓,面色苍白无神,这是亡阳脱汗;汗出本源于阳气亡失,阳气亡失则阴液随之流失,因此应当权变处理,迅速灌服加参生化汤,加倍人参用量以挽救危局,不要拘泥于血块疼痛的问题。妇人生产后汗出过多,应当健脾以收敛水液之精华,补益营卫之气以使血液回归本源,灌溉四肢,防止血液妄行。杂症中虽然有自汗和盗汗的区别,但是当归六黄汤不适合治疗产后的盗汗,都适宜服用加参生化汤及加味补中益气汤两方;如果服用人参后汗出仍然不止,以及只有头部出汗而不到腰足部位,必定难以治愈;如果汗出量大到用手擦拭都来不及,属于不治之症。产后汗出并伴有气喘等症状,是虚损到了极点,无法承受补益治疗的,属于不治之症。
人参(二钱),当归(二钱),黄芪(一钱半,蜜炙),白术(一钱,炒制),桂枝(五分),麻黄根(一钱),粉甘草(五分,炒制),牡蛎(研碎,少许),浮小麦(一大撮)。
虚脱且汗多、手足冰冷者,加黑姜四分,熟附子一片;口渴者加麦冬一钱,五味子十粒。肥胖白色体质的产妇多汗,加竹沥一盏,姜汁一小匙,以清除痰火。恶风寒者,加防风、桂枝各五分;血块未排出者,加熟地黄三钱,晚上服用八味地黄丸。
山茱萸、山药、牡丹皮、云茯苓(各八钱),泽泻(五钱),熟地黄(八钱),五味子(五钱),炙黄芪(一两)。炼蜜为丸。
阳气加于阴气则产生汗液,如果因此遇到风邪,可能变为抽搐痉挛的症状,尤其难以治疗。所以汗多时,应当谨慎避免风寒。汗多导致小便不通,是因为津液亡失的缘故,不要使用利水药物。
歌诀:分娩之时汗流浃背,惊恐劳累损伤心肝脾。不可骤然使用收敛止汗剂,加参生化汤可救危急。麻黄根汤含当归、人参、白术、桂枝、麻黄根。加上牡蛎、粉草、浮小麦,汗多服用此方效如神明。
After childbirth, excessive sweating may transform into Jing disease (a syndrome characterized by stiffness of the neck and back, and convulsions of the limbs), presenting with a stiff neck, opisthotonos (backward arching of the body like a bow), and breath so faint it seems as if life has ceased. In such cases, Ji Jian Sheng Hua Tang (Modified Decoction for Generating New Blood) should be administered rapidly.
Ji Jian Sheng Hua Tang is specifically indicated for Jing disease triggered by sweating.
Chuanxiong Rhizome (Chuanxiong), Ephedrae Radix et Rhizoma Root Node (Mahuanggen) (each 1 qian), Angelicae Sinensis Radix (Danggui) (4 qian), Cinnamomi Ramulus (Guizhi) (5 fen), Ginseng Radix (Renshen) (1 qian), Glycyrrhizae Radix et Rhizoma Preparata (Zhigancao) (5 fen), Notopterygii Rhizoma et Radix (Qianghuo) (5 fen), Gastrodiae Rhizoma (Tianma) (8 fen), Aconiti Lateralis Radix Praeparata (Fuzi) (1 slice), Saigae Tataricae Cornu (Lingyangjiao) (8 fen).
In cases of wind-stroke resembling Jing disease but without sweating, use Chuanxiong Rhizome (3 qian), Angelicae Sinensis Radix (1 liang, washed with wine), Semen Ziziphi Spinosae (Zaoren), and Saposhnikoviae Radix (Fangfeng), with no specific dosages prescribed.
Marginal note: Another version cites one slice of Zingiberis Rhizoma Recens (Shengjiang) and one Jujubae Fructus (Zao).
Verse: Excessive sweating after childbirth immediately transforms into Jing disease; the neck becomes stiff and the body arches backward like a bow. Breath is faint and difficult to sustain; quickly decoct Ji Jian Sheng Hua Tang and administer it. Ji Jian Sheng Hua Tang effectively stops spasms, containing Danggui, Chuanxiong, Fuzi, and Zhigancao. It also includes Tianma, Renshen, Mahuanggen, Guizhi, Qianghuo, and Lingyangjiao.
Sweating during delivery results from labor injuring the Spleen, fright injuring the Heart, and fear injuring the Liver. Parturient women often suffer from all three conditions simultaneously, leading to sweating. One must not immediately use astringent herbs to stop sweating; once the Spirit settles, the sweating will cease naturally. If pain caused by blood stasis clots exists, Baizhu should not be added hastily at this stage. It is appropriate to take two or three doses of Sheng Hua Tang to eliminate the clots and relieve pain, followed by Ji Shen Sheng Hua Tang (Ginseng-Added Decoction for Generating New Blood) to stop deficiency-type sweating. If the woman is extremely fatigued after delivery, with profuse sweating (Hanran), pale complexion, and signs of collapse, this is Wang Yang Tuo Han (Yang Collapse and Sweat Leakage). Since sweating originates from the loss of Yang Qi, and the loss of Yang leads to the subsequent loss of Yin fluids, one must apply flexible treatment: rapidly administer Ji Shen Sheng Hua Tang with doubled Renshen dosage to save the critical condition, disregarding the issue of clot-related pain. For women with excessive sweating after multiple births, one should strengthen the Spleen to consolidate the essence of fluids, benefit Ying and Wei (Nutritive and Defensive Qi) to guide blood back to its source, irrigate the four limbs, and prevent blood from moving recklessly. Although miscellaneous diseases distinguish between spontaneous sweating and night sweats, Danggui Liuhuang Tang (Angelica Six-Huang Decoction) is not suitable for treating night sweats postpartum. Instead, Ji Shen Sheng Hua Tang and Jia Wei Bu Zhong Yi Qi Tang (Modified Tonify the Middle and Augment the Qi Decoction) are appropriate. If sweating continues despite the administration of Renshen, or if sweating is confined only to the head and does not extend to the waist and feet, the prognosis is poor. If sweating is so profuse that wiping it away cannot keep up, it is incurable. Postpartum sweating accompanied by asthma indicates extreme deficiency; if the patient cannot tolerate tonification, it is incurable.
Mahuanggen Tang (Ephedra Root Node Decoction) treats persistent deficiency sweating after childbirth.
Ginseng Radix (Renshen) (2 qian), Angelicae Sinensis Radix (Danggui) (2 qian), Astragali Membranacei Radix (Huangqi) (1.5 qian, honey-fried), Atractylodis Macrocephalae Rhizoma (Baizhu) (1 qian, stir-fried), Cinnamomi Ramulus (Guizhi) (5 fen), Ephedrae Radix et Rhizoma Root Node (Mahuanggen) (1 qian), Glycyrrhizae Radix et Rhizoma Preparata (Fengcao) (5 fen, stir-fried), Ostreae Concha (Muli) (crushed, a small amount), Tritici Levis Fructus (Fumai) (a large pinch).
For deficiency collapse with excessive sweating and cold hands and feet, add Heijiang (Black Ginger) 4 fen and Shufu Zi (Prepared Aconite) 1 slice. For thirst, add Ophiopogonis Radix (Maidong) 1 qian and Schisandrae Fructus (Wuweizi) 10 grains. For obese, fair-skinned parturients with excessive sweating, add Zhuli (Bamboo Juice) 1 zhan and Jiangzhi (Ginger Juice) 1 small spoon to clear phlegm-fire. For aversion to wind and cold, add Fangfeng and Guizhi, each 5 fen. For retained blood clots, add Shudi (Prepared Rehmannia) 3 qian, and take Bawei Dihuang Wan (Eight-Ingredient Pill with Rehmannia) in the evening.
Cornus Officinalis Fructus (Shanzhuyu), Dioscoreae Oppositae Rhizoma (Shanyao), Paeoniae Rubra Radix (Danpi), Poria (Yunling), Alismatis Rhizoma (Zexie) (each 8 qian), Prepared Rehmannia Root (Shudi) (8 qian), Schisandrae Fructus (Wuweizi) (5 qian), Honey-fried Astragali Membranacei Radix (Huangqi) (1 liang). Processed into pills with refined honey.
When Yang Qi acts upon Yin fluids, sweat is produced. If exposed to wind in this state, convulsions (Chouyin) may occur, which are particularly difficult to treat. Therefore, when sweating is excessive, one must carefully avoid wind and cold. Excessive sweating leading to urinary retention is due to the depletion of Jin Ye (Body Fluids); diuretics should not be used.
Verse: During delivery, sweat pours down profusely; fright, labor, and injury damage the Heart, Liver, and Spleen. Do not abruptly use astringent sweating-stopping agents; Ji Shen Sheng Hua Tang can rescue critical situations. Mahuanggen Tang contains Danggui, Renshen, Baizhu, Guizhi, and Mahuanggen. Combined with Muli, Fengcao, and Xiaomai, this formula is effective as a divine remedy for excessive sweating.