妇人有一时血崩,两目黑暗,昏晕在地,不省人事者人莫不谓火盛动血也。然此火非实火,乃虚火耳。世人一
见血崩,往往用止涩之品,虽亦能取效于一时,但不用补阴之药,则虚火易于冲击,恐随止随发,以致经年累月不
能全愈者有之。是止崩之药,不可独用,必须于补阴之中行止崩之法。
方用固本止崩汤。
大熟地(一两,九蒸) 白术(一两,土炒焦) 黄 (三钱,生用) 当归(五钱,酒洗) 黑姜(二钱) 人
参(三钱)
水煎服。一剂崩止,十剂不再发。倘畏药味之重而减半,则力薄而不能止。方妙在全不去止血而惟补血,又不
止补血而更补气,非惟补气而更补火。盖血崩而至于黑暗昏晕,则血已尽去,仅存一线之气,以为护持,若不急补
其气以生血,而先补其血而遗气,则有形之血,恐不能遽生,而无形之气,必且至尽散,此所以不先补血而先补气
也。然单补气则血又不易生,单补血而不补火则血又必凝滞,而不能随气而速生。况黑姜引血归经,是补中又有
收敛之妙,所以同补气补血之药并用之耳。
眉批∶若血崩数日,血下数斗,六脉俱无,鼻中微微有息,不可遽服此方,恐气将脱不能受峻补也。有力者
用辽人参去芦三钱煎成,冲贯众炭末一钱服之,待气息微旺然后服此方,仍加贯众炭末一钱,无不见效;无力者用无灰
黄酒冲贯众炭末三钱服之,待其气接神清始可服此方。人参以党参代之,临服亦加贯众炭末一钱冲入。
歌括∶妇人血崩一时临,不省人事甚昏沉。
只因虚火盛动血,止崩切勿忘滋阴。
固本止崩宜补阴,熟地白芍当归参。
黄 黑姜同煎服,不用止涩功亦深。
妇女出现突然的大量阴道出血,双眼昏暗,昏倒在地,不省人事的情况,人们无不认为是火盛导致动血。然而这种火并非实火,而是虚火。世人一见血崩,往往使用具有收敛固涩作用的药物,虽然也能暂时见效,但如果不同时使用滋阴的药物,那么虚火就容易再次冲击脉络,恐怕刚止住血又会复发,从而导致经年累月无法完全治愈的情况存在。因此,治疗血崩的药物,不能单独使用,必须在滋补阴血的药物中施行止血的方法。
方剂名为固本止崩汤。
大熟地黄(一两,经过九次蒸制) 白术(一两,用土炒至焦黄) 黄芪(三钱,生用) 当归(五钱,用酒清洗) 黑姜(二钱) 人参(三钱)
用水煎服。服用一剂后血崩停止,服用十剂后不再复发。如果因为畏惧药味厚重而减半用量,则药力薄弱而不能止血。此方的妙处在于全不去直接止血,而是专注于补血,不仅如此,还在补血的基础上进一步补气,不仅补气,更进一步补益命门之火。因为血崩发展到双眼昏暗、昏晕的程度,说明血液已经大量流失,仅存一线元气,用来维持生命,如果不急于补气以生血,反而先补血而遗留气机不管,那么有形的血液恐怕不能迅速生成,而无形的元气必定会耗散殆尽,这就是为什么不先补血而先补气的原因。然而,如果单纯补气,血液又不容易生成;单纯补血而不补火,血液又会凝滞,不能随着气的推动而迅速生成。况且黑姜能引导血液回归经脉,这是在补益之中又有收敛的妙用,所以与补气补血的药物一同使用。
眉批:如果血崩持续数日,出血量多达数斗,六脉皆摸不到,只有鼻中微微有呼吸气息,不可以立即服用此方,恐怕气将脱失而不能承受峻猛的补益。家境富裕者,可用辽人参(去芦头)三钱,煎煮好后,冲入贯众炭末一钱服用,待气息稍微旺盛后再服用此方,仍然加入贯众炭末一钱,没有不见效的;家境贫寒者,可用无灰黄酒冲服贯众炭末三钱,待其气息恢复、神志清醒后才可服用此方,用人参的地方可以用党参代替,临服药时也要加入贯众炭末一钱冲入。
歌诀:妇人突发血崩,不省人事非常昏沉。
只因虚火旺盛扰动血液,止血切勿忘记滋阴。
固本止崩应当补阴,熟地白芍当归人参。
黄芪黑姜同煎服用,不用收敛固涩之品功效亦深。
When a woman experiences sudden profuse uterine bleeding, dimness in both eyes, fainting to the ground, and loss of consciousness, people invariably attribute it to excessive fire disturbing the blood. However, this is not excess fire (Shi Huo), but deficiency fire (Xu Huo). Upon seeing uterine bleeding, people often employ astringent herbs; although they may achieve temporary effect, if yin-nourishing herbs are not used concurrently, the deficiency fire is prone to flare up again. It is feared that the bleeding will stop and then recur immediately, leading to cases where complete recovery takes years or even decades. Therefore, hemostatic drugs should not be used alone; the method of stopping bleeding must be implemented within a regimen of nourishing yin.
The formula used is Gu Ben Zhi Beng Tang (Solidify the Root Decoction to Stop Uterine Bleeding).
Prepared Rehmannia Root (Shu Di Huang) - 1 liang, steamed nine times; Atractylodes Macrocephala Rhizome (Bai Zhu) - 1 liang, stir-fried with soil until charred; Astragalus Membranaceus Root (Huang Qi) - 3 qian, raw; Angelica Sinensis Root (Dang Gui) - 5 qian, washed with wine; Charred Ginger (Hei Jiang) - 2 qian; Ginseng Root (Ren Shen) - 3 qian.
Decoct in water and take orally. One dose stops the bleeding; ten doses prevent recurrence. If one halves the dosage due to fear of the heavy medicinal taste, the potency will be too weak to stop the bleeding. The brilliance of this formula lies in its focus on not directly arresting bleeding but rather on nourishing blood; furthermore, it does not merely nourish blood but also tonifies qi; and not only tonifies qi but also tonifies fire (Ming Men Fire). When uterine bleeding progresses to dimness and fainting, it indicates that blood has been largely lost, leaving only a thread of primordial qi to sustain life. If one does not urgently tonify qi to generate blood, but instead prioritizes nourishing blood while neglecting qi, the substantial blood may fail to regenerate quickly, while the insubstantial qi will surely dissipate completely. This is why qi is tonified before blood. However, tonifying qi alone makes blood difficult to generate; nourishing blood alone without tonifying fire causes blood stagnation, preventing it from generating rapidly along with the qi. Moreover, Charred Ginger guides blood back to its vessels, offering the subtle benefit of astringency within tonification. Hence, it is used together with qi- and blood-tonifying herbs.
Marginal Note: If uterine bleeding persists for several days, with blood loss amounting to several dou, and all six pulses are imperceptible, yet there is a faint breath in the nose, do not administer this formula immediately, as the qi may be on the verge of collapse and unable to withstand strong tonification. Those with financial means should use 3 qian of Liaoning Ginseng (Ren Shen), de-gorged, decocted, and taken with 1 qian of Cyperus Rotundus Charcoal Powder (Guan Zhong Tan); once the breath strengthens slightly, administer this formula again, adding another 1 qian of Cyperus Rotundus Charcoal Powder. Cases treated this way invariably show efficacy. For those with limited means, use 3 qian of Cyperus Rotundus Charcoal Powder mixed with unadulterated yellow wine; once their qi recovers and consciousness clears, they may take this formula, substituting Codonopsis Pilosula Root (Dang Shen) for Ginseng, and adding 1 qian of Cyperus Rotundus Charcoal Powder just before administration.
Rhyme Formula:
Sudden uterine bleeding strikes a woman,
Loss of consciousness, deep coma ensues.
Due to vigorous deficiency fire disturbing the blood,
Never forget to nourish yin when stopping bleeding.
Gu Ben Zhi Beng Tang should nourish yin,
With Prepared Rehmannia, White Peony, Angelica, and Ginseng.
Astragalus and Charred Ginger decocted together,
Without astringents, the merit is profound.