治妊娠胎动下血, 故因伤动, 子死腹中, 下血疼痛, 口
噤欲死, 服此探之, 不损则痛止, 已损则立下. 及横生倒生, 交骨不
开,产后血晕昏乱, 崩中金疮, 去血过多等证.
当归二两或三两 川芎一两, 右锉粗末合均, 每服五钱, 水一盏, 酒
半盏, 煎八分, 热服. 未效再服. 加败龟板一具, 梳发一团, 名开骨
散.
【注】命名不曰归芎, 而曰佛手者, 谓此方治妇人胎前, 产后诸疾,
如佛手之神妙也. 当归, 川芎为血分之主药, 性温而味甘辛, 以温能
和血, 甘能补血, 辛能散血也. 古人俱必以当归君川芎, 或一倍或再
倍者, 盖以川芎辛窜, 捷于升散, 过则伤气, 故蔻宗奭曰: 不可单服
,久服, 亦此义也. 然施之于气郁血凝, 无不奏效, 故用以佐当归而
收血病之功, 使瘀去新生, 血各有所归也. 血既有所归, 则血安其部
,而诸血病愈矣. 至妊娠胎动, 胎伤下血, 非血壅胎伤, 即血乱妄下
,服此以探之, 血乱胎未动者, 血顺则痛止, 血壅胎未损者, 血行痛
止,则胎因之而安也; 已动已损者, 血得顺行, 则胎亦因之而顺下也
.横生倒生, 或用力太早, 或误服催生之药, 致气逆血乱, 亦用此以
调之. 产后崩中金疮, 亡血昏冒, 亦用此以补之. 子死腹中, 腹痛欲
死,亦用此以逐之. 以上诸病, 皆血病而气不虚者也. 若夫气虚难产
,产后血脱, 唇面黄白, 少气烦乱, 动则昏冒, 若误与此, 反致立败
,则必倍加人参, 速固无形之气, 以救有形之血也. 至于交骨难开,
加龟板, 梳发, 下输阴道; 寒加姜, 桂, 热加黄耆, 汗加桂枝, 搐加
荆穗, 又当以意消息, 加减可也.
治疗妊娠期间胎动不安、阴道出血,或因外伤导致胎动下血、胎儿死于腹中、阴道出血伴腹痛、牙关紧闭濒临死亡等症状。服用此方以试探病情:若胎儿未受损则疼痛停止;若胎儿已受损则迅速排出。同时也用于治疗横位分娩、倒位分娩、骨盆交骨不开、产后血晕神志昏乱、崩漏及金疮失血过多等证候。
当归二两或三两,川芎一两,将上述药材切碎成粗末并混合均匀。每次服用五钱,加水一盏、酒半盏,煎煮至八分满,热服。若无效可再次服用。若加入败龟板一块、头发一团,则名为开骨散。
【注解】该方不命名为“归芎”,而称为“佛手”,是比喻此方治疗妇人产前、产后各种疾病的效果如佛手般神妙。当归和川芎是调理血分的要药,性温,味甘辛。其中,温性能调和血液,甘性能补益血液,辛性能消散瘀血。古人使用此方时,必定以当归为君药(主药),川芎为臣药(辅药),川芎的用量通常是当归的一倍或两倍。这是因为川芎气味辛香走窜,升散作用迅速,但过量使用会耗伤正气,所以寇宗奭说:“不可单独服用,也不宜长期服用”,也是基于同样的道理。然而,对于气机郁滞、血液凝涩的病证,此方无不奏效,因此用它辅助当归,以收治疗血病之功,使瘀血去除、新血生成,让血液各归其经。血液既然能归经安行,就能安守其部位,从而各种血病得以痊愈。至于妊娠胎动、胎伤下血,如果不是因为血壅阻滞损伤了胎儿,就是因血乱妄行所致。服用此方以试探:若是血乱而胎未动者,血液顺行则疼痛停止;若是血壅而胎未损者,血液流通则疼痛停止,胎儿因此得以安宁;若是胎儿已动已损者,血液顺行后,胎儿也会随之顺利排出。横生倒位,或是用力过早,或是误服催生药物,导致气逆血乱,也使用此方来调理。产后崩漏、金疮亡血导致的昏冒,也使用此方来补益。胎儿死于腹中,腹痛剧烈欲死,也使用此方来驱逐死胎。以上这些病症,都是血病而气并未虚弱的情况。如果是气虚导致的难产,或产后血脱,出现面色唇口黄白、少气烦乱、动则昏冒等症状,如果误用此方,反而会导致病情立即恶化,此时必须加倍加入人参,快速固护无形之气,以挽救有形之血。至于骨盆交骨难以张开,加入龟板和头发,引药下行输注于阴道;寒证加生姜、肉桂,热证加黄芪,汗出多加桂枝,抽搐加荆芥穗,又应当根据具体情况斟酌加减。
Treats conditions during pregnancy such as fetal restlessness and vaginal bleeding, or bleeding with abdominal pain due to trauma causing the fetus to die in the uterus. It also addresses symptoms like trismus (lockjaw) approaching death. After taking this formula, if the fetus is not damaged, the pain will cease; if the fetus is already damaged, it will be expelled rapidly. It is also used for transverse presentation, breech presentation, failure of the pelvic symphysis pubis to open, postpartum blood syncope with confusion, metrorrhagia (bing zhong), excessive blood loss from traumatic wounds, and other syndromes.
Dang Gui (Angelicae Sinensis Radix) 2 liang or 3 liang, Chuan Xiong (Ligustici Chuanxiong Rhizoma) 1 liang. The above herbs are coarsely chopped, mixed evenly. Take 5 qian per dose, add 1 zhan of water and 0.5 zhan of wine, decoct until 0.8 zhan remains, and take hot. If ineffective, take again. If added with one piece of turtle shell (Gui Ban) and a tuft of hair, it is named Ka Gu San (Bone-Opening Powder).
[Annotation] The formula is not named "Gui Xiong" but "Fo Shou" (Buddha's Hand), implying that its efficacy in treating various pre- and postpartum diseases in women is as miraculous as Buddha's hand. Dang Gui and Chuan Xiong are principal herbs for regulating the blood aspect. Their nature is warm, and their taste is sweet and acrid. Warmth can harmonize the blood, sweetness can tonify the blood, and acridity can disperse blood stasis. In ancient usage, Dang Gui was always used as the Jun herb (monarch drug) and Chuan Xiong as the Chen herb (minister drug), with Chuan Xiong often used at one or two times the dosage of Dang Gui. This is because Chuan Xiong is acrid and penetrating, with rapid ascending and dispersing properties; excessive use damages Qi. Therefore, Kou Zongshi stated: "It should not be taken alone or for a long time," which reflects this principle. However, for conditions of Qi stagnation and blood coagulation, this formula is invariably effective. Thus, it is used to assist Dang Gui to achieve therapeutic effects on blood disorders, promoting the elimination of stasis and generation of new blood, allowing blood to return to its vessels. Once the blood returns to its vessels and resides peacefully, all blood disorders are cured. Regarding fetal restlessness and bleeding due to fetal injury, whether caused by blood obstruction damaging the fetus or chaotic blood flow, taking this formula serves as a probe. If the blood is chaotic but the fetus is undisturbed, smooth blood flow stops the pain; if the blood is obstructed but the fetus is undamaged, circulation stops the pain, thereby stabilizing the fetus. If the fetus is already moving or damaged, smooth blood flow facilitates the expulsion of the fetus. For transverse or breech presentations caused by premature exertion or misuse of labor-inducing drugs leading to rebellious Qi and chaotic blood, this formula is also used to regulate. For postpartum metrorrhagia or traumatic blood loss causing fainting, this formula is used to tonify. For a dead fetus in the uterus causing severe abdominal pain, this formula is used to expel. All the above conditions involve blood disorders without Qi deficiency. However, in cases of difficult labor due to Qi deficiency, or postpartum blood collapse presenting with yellowish-white lips and face, shortness of breath, irritability, and fainting upon movement, misusing this formula may cause immediate deterioration. In such cases, Ren Shen (Ginseng Radix) must be doubled to rapidly secure formless Qi to save formed blood. As for the difficulty in opening the pelvic symphysis, adding turtle shell and hair guides the medicine downward to the vagina; for cold patterns, add Sheng Jiang (Zingiberis Rhizoma Recens) and Rou Gui (Cinnamomi Cortex); for heat patterns, add Huang Qi (Astragali Radix); for excessive sweating, add Gui Zhi (Cinnamomi Ramulus); for convulsions, add Jing Sui (Schizonepetae Spica). Dosage adjustments should be made according to clinical judgment.