产后气血空虚,真元未复,有所作劳,则寒热,食少,头目、四肢胀痛,名曰蓐劳,最
难调治。大法,阳虚则恶寒,阴虚则发热,清气不升则头痛,血气不充则四肢痛,宜用大剂
八珍汤以补之。若脾虚食少,即用六君子加炮姜以温补之,诸症自退。凡产后调治之法,或
补养气血,或温补脾土,虽有他症,从末治之。此一定之法也。
八珍汤(见虚证。
六君子汤(见类中。
新产后,喉中气急喘促,因荣血暴竭,卫气无根据,名曰孤阳,最为难治。宜用六味汤加
人参,以益其阴。若脾肺两虚,阳气不足,宜用四君子汤,加黑姜、当归,以益其阳。若自
汗、厥冷,更加附子。若兼外感,即于四君方内,加荆芥、陈皮、炮姜、川芎、当归,以散
之。若瘀血入肺,口鼻起黑气,及鼻衄者,此肺胃将绝之候,急服二味参苏饮,间有得生者
六君子汤(见类中。
人参(一两) 苏木(杵细,三钱
水煎,顿服。若厥冷自汗,更加附子二、三钱。
足阳明胃脉,起于鼻,交 中,还出挟口,交人中,左之右,右之左。盖鼻准属脾
土,鼻孔属肺金,而胃实统之。产后口鼻起黑气,及鼻衄,皆由气血空虚,荣血散乱,乃胃
败肺绝之危症也。急用二味参苏饮加附子,间有得生者。
二味参苏饮(见前。
产后气血虚弱,真元尚未恢复,若有所劳累,则出现寒热往来、食欲减退、头目及四肢胀痛等症状,称为蓐劳,最难调治。基本治疗原则是:阳虚则恶寒,阴虚则发热,清气不升则头痛,血气不充则四肢痛,宜用大剂量的八珍汤(由四君子汤和四物汤组成,补气养血)来补益。如果脾虚导致食欲少,即用六君子汤(人参、白术、茯苓、甘草、陈皮、半夏)加炮姜以温补脾胃,各种症状自然消退。凡是产后调治的方法,或是补养气血,或是温补脾土,即使有其他病症,也按照次要症状处理。这是固定的法则。
新近分娩后,喉中气急喘促,因为营血突然枯竭,卫气无所依附,称为孤阳,最为难治。宜用六味地黄汤(熟地黄、山茱萸、山药、泽泻、牡丹皮、茯苓)加人参,以滋养阴液。如果脾肺两虚,阳气不足,宜用四君子汤(人参、白术、茯苓、甘草),加黑姜、当归,以补益阳气。如果有自汗、四肢厥冷,再加附子。如果兼有外感,就在四君子汤方内,加荆芥、陈皮、炮姜、川芎、当归,以疏散外邪。如果瘀血进入肺部,口鼻出现黑气,以及鼻出血的,这是肺胃之气即将断绝的征象,急服二味参苏饮,偶尔有存活者。
人参(一两) 苏木(捣碎成细末,三钱)
用水煎煮,一次性服用。如果有四肢厥冷、自汗,再加附子二、三钱。
足阳明胃经,起于鼻翼两侧,交会于鼻根中,再出来挟持口角,交于人中部,左侧的脉气向右行,右侧的脉气向左行。大概鼻准属于脾土,鼻孔属于肺金,而胃经实际上统摄它们。产后口鼻出现黑气,以及鼻出血,都是由于气血空虚,营血散乱,乃是胃败肺绝的危重病症。急用二味参苏饮加附子,偶尔有存活者。
Postpartum, Qi and Blood are deficient, and the True Yuan (Original Vital Energy) has not yet recovered. If exertion occurs, symptoms such as alternating chills and fever, poor appetite, distending pain in the head, eyes, and limbs will appear. This is called *Rulao* (Puerperal Exhaustion), which is the most difficult to treat. The general principle is: Yang deficiency leads to aversion to cold; Yin deficiency leads to fever; failure of Clear Qi to ascend leads to headache; lack of Qi and Blood filling the channels leads to limb pain. It is appropriate to use a large dose of Bazhen Tang (Eight Treasure Decoction) to tonify them. If Spleen deficiency causes poor appetite, Liu Junzi Tang (Six Gentlemen Decoction) with Pao Jiang (Prepared Ginger) should be used to warm and tonify, and all symptoms will naturally recede. Regarding postpartum treatment methods, whether tonifying Qi and Blood or warming and tonifying the Spleen Earth, even if other symptoms exist, they should be treated as secondary manifestations. This is a fixed rule.
Shortly after childbirth, if there is rapid breathing and panting from the throat, it is because Ying Blood (Nutritive Blood) has suddenly exhausted, and Wei Qi (Defensive Qi) has no foundation. This is called Guyang (Lone Yang), which is extremely difficult to treat. Liunian Tang (Six Flavor Decoction, likely referring to Liuwei Dihuang Tang) with Renshen (Ginseng) should be used to benefit Yin. If both Spleen and Lung are deficient and Yang Qi is insufficient, Sijunzi Tang (Four Gentlemen Decoction) with Hei Jiang (Blackened Ginger) and Danggui (Angelica Sinensis) should be used to benefit Yang. If spontaneous sweating and cold extremities occur, Fuzi (Aconite) should be added. If accompanied by external contraction, Jingjie (Schizonepeta), Chenpi (Tangerine Peel), Pao Jiang, Chuanxiong (Sichuan Lovage Rhizome), and Danggui should be added to the Sijunzi Tang formula to disperse the pathogen. If blood stasis enters the Lung, causing black qi around the mouth and nose, along with epistaxis (nosebleed), this is a sign that the Lung and Stomach Qi are about to cease. Erwei Rensu Yin (Two-Ingredient Ginseng and Sappanwood Decoction) should be taken urgently; occasionally, survival is possible.
Renshen (Ginseng Root) (1 liang)
Sumu (Sappanwood Heartwood) (crushed into fine powder, 3 qian)
Decoct in water and take in one dose. If cold extremities and spontaneous sweating occur, add 2–3 qian of Fuzi.
The Foot-Yangming Stomach Meridian originates at the side of the nose, intersects at the root of the nose, emerges again to flank the mouth, and intersects at the philtrum. The left meridian crosses to the right, and the right crosses to the left. Generally, the tip of the nose belongs to Spleen Earth, the nostrils belong to Lung Metal, but the Stomach Meridian actually governs them. Postpartum black qi appearing around the mouth and nose, along with epistaxis, are due to the emptiness of Qi and Blood and the scattering of Ying Blood. These are critical signs of Stomach failure and Lung exhaustion. Erwei Rensu Yin with Fuzi should be used urgently; occasionally, survival is possible.