此症勿拘古方,妄用苏木、蓬、棱,以轻人命。其一应散血方、破血药,俱禁用。虽山楂性缓,亦能害命,不
可擅用,惟生化汤系血块圣药也。
生化汤 原方
当归(八钱) 川芎(三钱) 桃仁(十四粒,去皮尖,研) 黑姜(五分) 炙草(五分)
用黄酒、童便各半,煎服。
歌括∶治血块用生化汤,当归川芎五分姜。
十粒桃仁五分草,引用黄酒童便良。
又益母丸、鹿角灰,就用生化汤送下一钱,外用烘热衣服,暖和块痛处,虽大暑亦要暖和块痛处。有气不运而晕迷
厥,切不可妄说恶血抢心,只服生化汤为妙。俗有生地、牛膝行血;山棱、蓬术败血;山楂、沙糖消块;蕲艾、椒酒定
痛,反致昏晕等症,切不可妄用。二、三、四日内,觉痛减可揉,乃虚痛也,宜加参生化汤。
如七日内,或因寒凉食物,结块痛甚者,加入肉桂八分(一作三分)于生化汤内。如血块未消,不可加参、 ,用
之则痛不止。总之,慎勿用峻利药,勿多饮姜椒艾酒,频服生化汤,行气助血,外用热衣以暖腹。如用红花以行之,苏
木、牛膝以攻之,则误。其胎气胀,用乌药、香附以顺之;枳壳、浓朴以舒之,甚有青皮、枳实、苏子以下气定喘;芩、
连、栀子、黄柏以退热除烦。至于血结更甚,反用承气汤下之而愈结;汗多小便短涩,反用五苓散通之而愈秘,非徒无
益,而又害之也。
凡儿生下,或停血不下,半月外尚痛,或外加肿毒,高寸许,或身热,减饮食,倦甚,必用生化汤加三棱、蓬
术、肉桂等,攻补兼治,其块自消。如虚甚,食少泄泻,只服此帖定痛,且健脾胃,进食止泻,然后服消块汤。
加味生化汤 治血块日久不消,半月后方可用之。
川芎(一钱) 当归(三钱) 肉姜(四分) 桃仁(十五粒) 三棱(醋炒,六分) 元胡(六分) 肉桂(六
分) 炙草(四分)
歌括∶加味生化归姜芎,桃仁元胡荆三棱。
肉桂炙草同煎服,产后半月此方灵。
对于这种病症,不要拘泥于古方,胡乱使用苏木、蓬术、三棱等药物,从而轻视人命。所有具有散血、破血功效的方剂和药物,都应当禁用。虽然山楂药性缓和,但也可能危害生命,不可擅自使用,只有生化汤是治疗血块的特效药。
生化汤 原方
当归(八钱) 川芎(三钱) 桃仁(十四粒,去皮尖,研磨) 黑姜(五分) 炙甘草(五分)
用黄酒和童便各一半,煎煮后服用。
歌诀:治疗血块使用生化汤,当归、川芎、黑姜各五分。
桃仁十粒、甘草五分,引用黄酒和童便效果良好。
另外配合益母丸、鹿角灰,用生化汤送服一钱,外用烘热的衣物,温暖疼痛的血块部位,即使在盛夏酷暑也要保持患处温暖。如果有气机运行不畅导致晕厥昏迷,千万不要妄说是恶血攻心,只服用生化汤最为巧妙。世俗有用地黄、牛膝行血;三棱、蓬术败血;山楂、砂糖消块;蕲艾、椒酒定痛的方法,反而会导致昏晕等症状,千万不可胡乱使用。产后二、三、四天内,如果感觉疼痛减轻且可以揉按,这是虚痛,应当在生化汤中加入人参。
如果在七天内,因为食用寒凉食物,导致结块疼痛剧烈,应当在生化汤中加入肉桂八分(另一种说法是三分)。如果血块没有消除,不可以加入人参、黄芪,否则会导致疼痛不止。总之,务必慎用峻猛利下的药物,不要多饮姜、椒、艾酒,频繁服用生化汤,以行气助血,外用热衣温暖腹部。如果使用红花来行血,苏木、牛膝来攻逐,那就是错误的。如果是胎气胀满,使用乌药、香附来顺气;枳壳、厚朴来舒理气机,甚至使用青皮、枳实、苏子来降气平喘;黄芩、黄连、栀子、黄柏来退热除烦。至于血结更加严重,反而使用承气汤泻下,结果会使结块更甚;出汗多且小便短少涩滞,反而使用五苓散通利小便,结果会使便秘更重,这不仅没有益处,反而有害。
凡是婴儿出生后,如果有瘀血不下,半个月后仍然疼痛,或者外加肿毒,高约一寸,或者身体发热,饮食减少,极度疲倦,必须使用生化汤加入三棱、蓬术、肉桂等药物,攻补兼治,血块自然消除。如果身体非常虚弱,食少泄泻,只服用这一帖药即可止痛,并且能健脾胃,促进进食并止泻,然后再服用消块汤。
加味生化汤 治疗血块日久不消,半个月后方可使用此方。
川芎(一钱) 当归(三钱) 肉姜(四分) 桃仁(十五粒) 三棱(醋炒,六分) 元胡(六分) 肉桂(六分) 炙甘草(四分)
For this condition, do not adhere rigidly to ancient prescriptions and recklessly employ *Sanmu* (Sappan Wood), *Pengling* (Curcuma and Burreed Rhizomes) to disregard human life. All formulas and herbs with blood-dispersing or blood-breaking properties are strictly contraindicated. Although *Shanzha* (Hawthorn Fruit) has a mild nature, it can also endanger life and should not be used arbitrarily; only *Shenghua Tang* (Transform the Stasis Decoction) is the sacred remedy for blood masses.
*Shenghua Tang* (Transform the Stasis Decoction) Original Formula
*Danggui* (Radix Angelicae Sinensis) (8 qian) *Chuanxiong* (Rhizoma Chuanxiong) (3 qian) *Taoren* (Semen Persicae) (14 grains, skin and tips removed, ground) *Heijiang* (Charred Ginger) (5 fen) *Zhigancao* (Prepared Licorice Root) (5 fen).
Decoct and take with half yellow wine and half child's urine.
Verse: To treat blood masses, use *Shenghua Tang*; *Danggui*, *Chuanxiong*, and ginger each at 5 fen.
Ten grains of *Taoren* and 5 fen of licorice; using yellow wine and child's urine as guides is excellent.
Additionally, combine *Yimu Wan* (Motherwort Pill) and *Lujiaohui* (Deer Horn Ash), taking one qian delivered by *Shenghua Tang*. Externally, apply heated clothing to warm the painful mass area; even in midsummer heat, the painful area must be kept warm. If there is fainting or coma due to qi stagnation, do not rashly diagnose it as "evil blood rushing to the heart"; taking only *Shenghua Tang* is the best approach. Common practices include using *Dihuang* (Rehmannia Root) and *Niuxi* (Achyranthes Root) to move blood; *Sanleng* (Sparganium Rhizome) and *Pingshu* (Curcuma Rhizome) to break blood; *Shanzha* (Hawthorn Fruit) and brown sugar to dissolve masses; *Qiai* (Mugwort) and pepper wine to relieve pain. These methods may instead cause symptoms such as dizziness and fainting, and must never be used recklessly. Within two to four days after delivery, if pain decreases and the area can be massaged, it indicates deficiency pain; add *Renshen* (Ginseng Root) to *Shenghua Tang*.
If within seven days, severe pain from clumps occurs due to cold-cooling foods, add 8 fen of *Rougui* (Cinnamon Bark) [some say 3 fen] to *Shenghua Tang*. If the blood mass does not dissipate, do not add *Renshen* (Ginseng Root) or *Huangqi* (Astragalus Root); doing so will result in unceasing pain. In summary, be cautious about using harsh purgative drugs, avoid drinking excessive ginger, pepper, and mugwort wine, frequently take *Shenghua Tang* to move qi and assist blood, and externally use hot clothes to warm the abdomen. Using *Honghua* (Safflower) to move blood, or *Sanmu* (Sappan Wood) and *Niuxi* (Achyranthes Root) to attack, would be erroneous. For distension caused by fetal qi, use *Wuyao* (Lindera Root) and *Xiangfu* (Cyperus Rhizome) to smooth qi; *Zhiqiao* (Immature Bitter Orange) and *Houpo* (Magnolia Bark) to relax qi; even *Qingpi* (Green Tangerine Peel), *Zhishi* (Immature Bitter Orange), and *Suzi* (Perilla Seed) to descend qi and calm wheezing; *Huangqin* (Scutellaria Root), *Huanglian* (Coptis Rhizome), *Zhizi* (Gardenia Fruit), and *Huangbai* (Phellodendron Bark) to clear heat and remove irritability. As for more severe blood binding, using *Chengqi Tang* (Order the Qi Decoction) to purge will cause further binding; sweating excessively with scanty, difficult urination, using *Wuling San* (Five-Ingredient Powder with Poria) to promote urination will worsen constipation. This is not only ineffective but harmful.
After childbirth, if lochia remains stagnant, pain persists beyond half a month, or external swelling/toxins appear (about one cun high), accompanied by fever, reduced appetite, and extreme fatigue, *Shenghua Tang* must be used with added *Sanleng* (Sparganium Rhizome), *Pingshu* (Curcuma Rhizome), and *Rougui* (Cinnamon Bark) to simultaneously attack and tonify; the mass will naturally dissipate. If deficiency is severe, with poor appetite and diarrhea, take only this prescription to stop pain, strengthen the spleen and stomach, improve food intake, and stop diarrhea, before taking *Xiaokuai Tang* (Mass-Dissolving Decoction).
Modified *Shenghua Tang* (Modified Transform the Stasis Decoction) Treats long-standing blood masses that have not dissipated; usable only after half a month.
*Chuanxiong* (Rhizoma Chuanxiong) (1 qian) *Danggui* (Radix Angelicae Sinensis) (3 qian) *Roujiang* (Meat Ginger) (4 fen) *Taoren* (Semen Persicae) (15 grains) *Sanleng* (Sparganium Rhizome) (vinegar-fried, 6 fen) *Yuanhu* (Corydalis Rhizome) (6 fen) *Rougui* (Cinnamon Bark) (6 fen) *Zhigancao* (Prepared Licorice Root) (4 fen).
Verse: Modified *Shenghua Tang* contains *Danggui*, ginger, and *Chuanxiong*; *Taoren*, *Yuanhu*, and *Jingsanleng* (Wild Sparganium).
*Rougui* and *Zhigancao* decocted together; this formula is effective for postpartum conditions after half a month.