产后中风,数十日不解。头微痛,恶寒,时时有热,心下闷,干呕,汗出虽多,阳旦证耳。可
与阳旦汤。(即桂枝汤方。见太阳病。)
产后中风,发热面赤,喘而头痛,竹叶汤主之。
竹叶(一把) 葛根(三两) 防风 桔梗 桂枝 人参 甘草(各一两) 附子(一枚,炮)
上 咀,每服五钱,枣一枚,姜五片,水一盏半,煎一盏,去渣服。温覆使汗出。若头项强,用
大附子半钱,煎药,扬去沫。呕者,加半夏一钱。
〔丹〕产后发热恶寒,皆属血气虚。左手脉不足,补血;右手脉不足,补气。恶寒发热,又腹痛,
当去恶血。恶寒发热,乳汁不通及膨者,无子当消。用麦芽二两,炒,研细,清汤作四服调下;有子
当下,用木通、通草、猪蹄汁,调煎服。
产后才见身热,不可发表,并一切苦寒药。必用干姜治之,大发其热。轻则用茯苓淡渗其热。
〔《大》〕凡产后发热,头痛身疼,不可便作感冒治之。此等多是血虚,或败血作梗,宜以平和
之剂与服,必效。如玉露散,或四物加北柴胡等分,煎服。若便以小柴胡汤及竹叶石膏之类,竟不
救者多矣。
玉露散 治产后乳脉不行,身体壮热疼痛,头目昏痛,大便涩滞,悉治之。凉膈压热下乳。
人参 茯苓 甘草(各半两) 苦梗(炒) 川芎 白芷(各一两) 当归(一分) 芍药(三分)
上 咀,每服五钱,水一盏,煎至七分,温服。如烦热甚,大便秘者,加大黄二钱半。
产后感受风邪,经过数十日病情仍未缓解。出现轻微头痛、怕冷、时常发热、胃脘部闷胀、干呕、出汗虽多,但这只是阳旦证(即桂枝汤证)而已。可以使用阳旦汤。(即桂枝汤方,见太阳病篇。)
产后感受风邪,出现发热、面色红赤、气喘且头痛,用竹叶汤主治。
竹叶(一把) 葛根(三两) 防风 桔梗 桂枝 人参 甘草(各一两) 附子(一枚,炮制过)
以上药材切碎,每次服用五钱,加枣一枚、姜五片、水一盏半,煎煮至一盏水量,去渣后服用。服药后覆盖衣被使其出汗。如果头项强直疼痛,使用大附子半钱,在煎药时扬去浮沫。如果有呕吐症状,加半夏一钱。
〔丹溪〕产后发热恶寒,都属于血气虚弱。左手脉象不足,应补血;右手脉象不足,应补气。如果既有恶寒发热,又伴有腹痛,应当祛除瘀血。如果恶寒发热,同时乳汁不通且乳房肿胀,若无需哺乳则应回乳消胀。可用麦芽二两,炒熟后研成细粉,用清汤分四次调服;若需哺乳催乳,则用木通、通草、猪蹄汁,调和煎服。
产后刚出现身体发热,不可使用发汗解表药,以及一切苦寒药物。必须用干姜来治疗,以发散其热。轻症用茯苓淡渗利湿以退热。
〔《大全》〕凡是产后发热,头痛身疼,不可立即当作感冒来治疗。这种情况大多是由于血虚,或败血(瘀血)阻滞所致,适宜服用平和的药剂,必定有效。如玉露散,或者四物汤加上北柴胡等量,煎服。如果直接使用小柴胡汤及竹叶石膏汤之类的药物,不能治愈的情况很多了。
玉露散:治疗产后乳脉不通,身体壮热疼痛,头目昏痛,大便涩滞,都能治疗。具有凉膈、清热、下乳的功效。
人参 茯苓 甘草(各半两) 苦梗(炒) 川芎 白芷(各一两) 当归(一分) 芍药(三分)
以上药材切碎,每次服用五钱,加水一盏,煎至七分水量,温服。如果烦热严重,大便秘结者,加大黄二钱半。
After childbirth, wind-stroke (Zhongfeng) persists for dozens of days without resolution. There is slight headache, aversion to cold, occasional fever, oppression in the epigastrium, dry retching, and profuse sweating; this is merely Yangdan Syndrome (Yangdan Zheng). Yangdan Decoction (Yangdan Tang) may be administered. (This is Guizhi Tang [Cinnamon Twig Decoction], see Taiyang Disease.)
After childbirth, wind-stroke presents with fever, red face, wheezing, and headache. Zhuye Tang (Bamboo Leaf Decoction) is the principal formula.
Zhuye (Bamboo Leaf, one handful), Gegen (Kudzu Root, three liang), Fangfeng (Saposhnikovia Root), Jiegeng (Platycodon Root), Guizhi (Cinnamon Twig), Renshen (Ginseng Root), Gancao (Licorice Root, one liang each), Fuzi (Prepared Aconite Root, one piece, processed).
The above herbs are cut into small pieces. Each dose consists of five qian, with one jujube, five slices of ginger, and one and a half sheng of water. Decoct until one sheng remains, strain, and take warm. Cover with blankets to induce sweating. If there is stiffness in the head and neck, use half a qian of large Fuzi (Aconite Root), decoct the medicine, and skim off the foam. If vomiting occurs, add Banxia (Pinellia Tuber) one qian.
[Danxi] Fever and aversion to cold after childbirth all belong to deficiency of blood and qi. If the pulse at the left position is insufficient, tonify blood; if the pulse at the right position is insufficient, tonify qi. If there is aversion to cold, fever, and abdominal pain, it is necessary to eliminate blood stasis. If there is aversion to cold, fever, along with blocked lactation and breast distension, if nursing is not intended, milk production should be suppressed. Use two liang of Maiya (Barley Sprout), stir-fried and ground into fine powder, taken in four doses mixed with clear broth; if nursing is intended, use Mutong (Akebia Stem), Tongcao (Tetrapanax Pith), and pig trotter juice, mixed and decocted for oral administration.
When fever first appears after childbirth, exterior-releasing methods must not be used, nor any bitter-cold medicines. Ganjiang (Dried Ginger Rhizome) must be used to treat it, vigorously dispersing the heat. For mild cases, Fuling (Poria Sclerotium) is used to drain dampness and reduce heat.
[Daquan] In all cases of postpartum fever, headache, and body ache, do not immediately treat it as a common cold. These cases are mostly due to blood deficiency or obstruction by retained blood (stasis). It is appropriate to administer mild and harmonizing formulas, which will certainly be effective. Such as Yulu San (Jade Dew Powder), or Siwu Tang (Four Substances Decoction) added with Beichaihu (Northern Bupleurum Root) in equal proportions, decocted and taken. If Xiaochaihu Tang (Minor Bupleurum Decoction) or formulas like Zhuyegao Tang (Bamboo Leaf and Gypsum Decoction) are used directly, many cases fail to be cured.
Yulu San (Jade Dew Powder): Treats postpartum blocked lactation, severe body heat and pain, dizziness and headache, and constipation. It cools the diaphragm, clears heat, and promotes lactation.
Renshen (Ginseng Root), Fuling (Poria Sclerotium), Gancao (Licorice Root, half liang each), Kugeng (Fried Platycodon Root), Chuanxiong (Ligusticum Rhizome), Baizhi (Angelica Dahurica Root, one liang each), Danggui (Angelica Sinensis Root, one fen), Shaoyao (Peony Root, three fen).
The above herbs are cut into small pieces. Each dose consists of five qian, with one sheng of water. Decoct until seven-tenths remain, and take warm. If vexation and heat are severe and stool is constipated, add Dahuang (Rhubarb Root) two and a half qian.