何新之令嫒适汤氏,孟冬分娩,次日便泄一次,即发热痉厥,谵语昏狂。举家惶惶。乃翁邀孟英察之,脉弦滑,
恶露仍行。曰∶此胎前伏暑,乘新产血虚痰滞而发也。与大剂∶犀(角) 羚(羊角) 元参 竹叶 知母 花粉
栀(子) 楝(实) 银花,投之。遍身得赤疹而痉止神清。乃翁随以清肃调之而愈。
姚氏妇,产后昏谵汗厥,肌肤浮肿。医投补虚、破血、祛祟(痰)、安神之药,皆不能治。举家惶怖,转延
孟英诊耶。询之,恶露仍行。曰∶此证病家必以为奇病,其实易愈也。昔金尚陶先生曾治一人,与此相似,载于
沈尧夫《女科辑要》中,方用∶石菖蒲 胆星 旋复花 茯苓 橘红 半夏曲,名“蠲饮六神汤”。凡产后恶
露行而昏谵者,多属痰饮,不可误投攻补,此汤最着神效。如方服之,良愈。
张郑封妻,娩后即发热,服生化汤两帖,热益炽而发赤疹。顾听泉诊之,即予清解药,三剂不应,欲进犀角地
黄汤,而恐病家狃于产后以生疑也,乃拉孟英质之。诊其脉,弦滑而数,面赤热燥,胸闷善悲,肢肿而疼,两肘白
泡如扁豆大者数十颗,舌上亦有一颗,痛碍水饮,大便不解已旬日矣。曰∶此不但胎前伏暑,且有蕴毒,而误服生
化汤以助其虚,幸初手即用清解,尚不至于昏陷。犀角地黄(汤),极是治法,但犹恐不能胜任。乃与听泉商加∶西
洋参、滑石、知母、银花、花粉、人中白、蒌仁、竺黄、贝母、桑叶、栀子为剂。其所亲曰∶高明断为热证,何以
病者虽渴而喜热饮耶?孟英曰∶此方中所以多用痰药也。凡胸中有热痰阻碍气机者,每如是,不可以其向不吐痰而
疑吾言之妄也。若因此而指为寒证,则祸不旋踵矣。进四
帖,始得大解,频吐稠痰,而各恙皆减,饮食渐加。孟英曰∶病势虽稳,余热尚炽,苟不亟为清涤而遽投补益,犹
有蓐损之虞。其母家果疑药过寒凉,必欲招专科调治。幸将前方示彼,尚不妄施温补,然隔靴搔痒,纪律全无。旬
日后,余火复燃。郑封坚恳孟英设法,仍用甘寒疗之。周身肌蜕如蛇皮,爪甲更新,其病之再生也可知。继予
滋补真阴而起。
翁嘉顺室,娩后发热,竹林寺僧治之不应。温、龚二医皆主生化汤加减,病益剧。请孟英诊之,脉软滑微数。
曰∶素体阴亏,热自内生,新产血去,是以发热。惟谵妄昏瞀,最是吓医之证。渴喜热饮,宛似虚寒之据。宜其猜
风寒而投表散,疑血瘀以攻通。遂尔帖帖泡姜,人人桃、桂,阴愈受劫,病乃日加。幸而痰饮内盛,津液未至涸竭,
与∶蠲饮六神汤去橘(皮)、半(夏),加西洋参、生地、花粉、竹茹、知母、生白芍为剂,数日而瘳。逾旬复
发热。或疑凉药之弊,或谓产蓐成痨。众楚咻之,病渐进矣。其
小姑适吴氏者,向役于冥曹,俗谓之“活无常”。偶来探病,忽仆地而僵,口中喃喃。或问∶“汝嫂病何如”?答
曰∶须服王先生药。人皆异之。次日,仍乞诊于孟英。曰∶脉浮数而弦,是风温也。与前病异,便泻无溺,肺热
所迫,大渴无苔,胃汁受烁。亟与∶天生建中汤频灌。药主大剂甘凉,果得津回舌润,渐以痊可。
高禄卿室,吴濂仲之妹也。孟夏分娩发热,初疑蒸乳,数日不退。产科治之,知挟温邪,进以清解,而大便溏泻,
遂改温燥,其泻不减。另招张某视之,因谓专科误用蒌仁所致。与∶参、 、姜、术、鹿角、肉果等药,泄泻愈甚。
连服之,热壮神昏,汗出不止,势濒于危。酝香孝廉徐夫人,病者之从母也。心慈似佛。有子十人皆已出。闻其殆,
夤夜命四郎季眉,请援于孟英。按脉,洪数七至,口渴苔黄,洞泻如火,小溲不行。因谓季眉曰∶病犹可治,第药
太惊人,未必敢服。季眉坚欲求方,且云∶在此监服。乃疏白头翁汤加石膏、犀角、银花、知母、花粉、竹叶、栀
(子)、楝(实)、桑叶予之。
次日复诊,脉证较减,仍用前方。而病家群哗,以为产后最忌寒凉,况洞泻数日乎?仍招张某商之,张谓∶幸
我屡投温补在前,否则昨药下咽,顷刻亡阳,复定 、术之方,业已煎矣,所亲张芷舟孝廉闻之,飞告于蕴香处。
汾伯昆季,即驰至病家,幸药未入口,夺盏倾之,索孟英方,煎而督灌,且嘱群季轮流守视,免致再投别药。孟
英感其情谊,快舒(抒)所长,大剂凉解,服至七帖,泻全止,热尽退。乃去白头翁汤,加∶生地、元参、(竹)
茹、贝(母),服半月始解黑色燥屎,而眠食渐安。第腑脏之邪,虽已清涤,而从前温补,将热邪壅滞于膜络之间,
复发数痈于胸之乳间。孟英令其恪守前法,复入蒲公英、
丝瓜络、橘叶、菊叶等药,服至百剂,始告痊愈。而天癸亦至。
孟英曰∶世俗泥于产后宜温之谬说,况兼泄泻,即使温补而死,病家不怨,医者无憾也。或具只眼,其谁信之。
此证苟非汾伯昆仲笃信于平时,而力排众论于危难之间,余虽见到(道)不疑,亦焉能有济耶?余尝曰∶病不易识,
尤不易患;医不易荐,尤不易任;药不易用,尤不易服。诚宇宙间第一难事也。而世人浅视之,可不悲哉!
陈书伯太史令弟妇,娩后三日,发热汗多,苔黄眩悸。
孟英切脉,弦细虚数。乃营阴素亏,酷热外烁,风阳浮动,痉厥之萌也。与∶元参 白薇 青蒿 生地 小 麦 豆
衣石斛 鳖甲 竹叶,两剂,热退知饥,悸汗不止。去(青)蒿、(白)薇,加龙(骨)、(牡)蛎、莲心、龟板、
(紫)石英而安。
继又因暑风外袭,壮热如焚、渴饮不饥,睹物尽赤。改授白虎(汤)加西洋参、竹叶、莲杆,一啜而瘳。仍与镇
摄滋潜善其后而愈。
赵子循室,娩后,服生化汤两帖,更因惊吓,三朝发热,连投四物、六合等汤,病日以甚。半月后,始延孟
英诊之。脉象∶左弦极,右洪滑数。苔黄大渴,谵语嗽痰,
恶露仍行,唇齿干燥。是因阴虚之体,血去过多,木火上浮,酷暑外烁,津液大耗,兼有伏痰之候也。亟与营卫两
清,冀免他变。而母家极畏石膏、坚不与服。越三日,势益剧,计无所施。子循之叔笛楼,与其表兄许芷卿,径以白
虎加减投之,证有转机。翌日,再迓孟英会同笛楼,暨其舅氏许吉斋山长协商妥治,咸是王(孟英)之议,且以
西瓜汁助其药力,热始日趋下行,二便如火。又数日,渐安粥食,神气亦清,起坐梳头,夜能静寐。然热蕴太久,
下焦患痈,脓虽即溃,阴液漏伤。脉复空数浮大,便泄善嗔,口干多梦,皆木少水涵,烁津侮胃之见证也。孟英与
笛楼商,以白头翁汤加龙骨、“三甲”、甘草、木瓜育阴潜阳。余粮(赤)石脂丸中,加(乌)梅、(黄)连以熄
风镇胃,果得疮口脓干,餐加泻止,脉柔热净,苔退神怡。正须善后,甫授滋填,不期酷兼旬,甘霖忽降,窗开彻夜,
复感风邪,身热微寒,鼻流清涕,而阴液久夺,外患未痂,培养碍投,又难发汗,肝风内应, 噤旋形,九仞之功,遂
成画饼。门外汉未免以成败论,然此案自堪传也。
陆浓甫室,陈芷浔主事之女也。产后经旬,偶发脘痛。专科用温补药因而寒热气逆,自汗不寐,登圊
,不能解,而卧则稀水自流,口渴善呕,杳不纳谷,佥云不起矣。乃父速孟英诊之,脉弦数而滑。曰∶本
属阴亏,肝阳侮胃,误投温补涩滞之剂,气机全不下降,以致诸证蜂起。医者见而却走,是未明其故也。与∶沙
参竹茹 楝实 延胡 栀(子) (黄)连 橘(皮) 贝(母) 杏(仁) (石)斛 枇杷叶,为肃肺以和
肝胃法,覆杯即安。但少腹隐隐作痛。于前方去杏(仁)、贝(母)、竹茹,加∶知母、花粉、苁蓉、白芍、
橘核、海 ,乃解宿垢而瘳。
【背景信息】
书名:回春录 作者:王士维 朝代:清 章节:产后发痉 / 产后昏谵 / 产后发热 类别:综合
何新之的女儿嫁给了汤家,初冬分娩,第二天大便泄泻一次,随即出现发热、痉挛抽搐和意识丧失(痉厥),伴有胡言乱语、神志昏迷狂躁。全家惊慌失措。其父邀请孟英诊治,脉象弦滑,恶露仍然通畅。孟英说:“这是胎前潜伏的暑邪,趁着新产血虚、痰湿阻滞而发作。”给予大剂量方药:犀角、羚羊角、玄参、竹叶、知母、天花粉、栀子、川楝子、金银花,服用后遍身发出红色疹子,痉挛停止,神志清醒。其父随后用清肃调理的方法治疗,病愈。
姚姓妇女,产后出现神志昏迷、胡言乱语、出汗晕厥,肌肤浮肿。医生投用补虚、破血、祛祟(此处指祛痰)、安神的药物,都不能治愈。全家惊恐害怕,转而延请孟英诊治。询问得知,恶露仍然通畅。孟英说:“这个病症家属一定认为是怪病,其实很容易治愈。以前金尚陶先生曾治疗过一个人,与此相似,记载在沈尧夫的《女科辑要》中,方药使用:石菖蒲、胆南星、旋覆花、茯苓、橘红、半夏曲,名为‘蠲饮六神汤’。凡是产后恶露行而昏谵的,多属于痰饮所致,不可误用攻伐或补益的药物,此汤效果显著。按方服用,果然痊愈。”
张郑封的妻子,分娩后立即发热,服用生化汤两帖,热势更加炽盛并出现红色疹子。顾听泉诊治,立即给予清热解表药,三剂无效,想要进用犀角地黄汤,但担心家属拘泥于产后禁忌而产生疑虑,于是拉上孟英共同质询。诊察其脉象,弦滑而数,面色红赤、身体燥热,胸闷且容易悲伤,肢体肿胀疼痛,双肘有数十颗如扁豆大小的白色水泡,舌上也有一颗,疼痛妨碍饮水,大便不通已有十天了。孟英说:“这不仅是胎前伏暑,还有蕴毒,而且误服生化汤助长了虚火,幸好初诊时就用了解表清热法,尚不至于陷入昏迷危境。犀角地黄汤是非常正确的治法,但恐怕不能胜任。于是与顾听泉商量加入:西洋参、滑石、知母、金银花、天花粉、人中白、瓜蒌仁、竺黄、贝母、桑叶、栀子为剂。患者的亲属问:‘高明诊断为热证,为什么病人虽然口渴却喜欢喝热水呢?’孟英说:‘这个方中所以多用化痰药的原因。凡是胸中有热痰阻碍气机的,往往如此,不能因为患者平时不吐痰就怀疑我的话是妄言。如果因此将其指认为寒证,那么灾祸很快就会降临。’服用四帖后,终于排出大便,频繁吐出稠痰,各种症状都减轻,饮食逐渐增加。孟英说:‘病势虽然稳定,余热依然炽盛,如果不赶紧彻底清除余热而贸然进补,仍有产后劳损的忧虑。’其母家果然怀疑药性过于寒凉,一定要聘请专科医生调理。幸好将前方给他们看,才没有妄施温补,然而隔靴搔痒,毫无章法。十天后,余火复燃。郑封坚决恳求孟英想办法,仍用甘寒疗法治疗。周身皮肤蜕皮如蛇皮,指甲更新,可知病情反复。继予滋补真阴的方法而康复。
翁嘉顺的妻子,分娩后发热,竹林寺僧人治疗无效。温、龚两位医生都主张用生化汤加减,病情加重。请孟英诊治,脉象软滑微数。孟英说:“素体阴虚亏损,热气自内生,新产失血,所以发热。只有胡言乱语、神志昏蒙,是最吓唬医生的症状。口渴喜欢喝热水,完全像是虚寒的证据。难怪他们猜测是风寒而投用发散药,怀疑血瘀而攻通。于是每帖都用炮姜,人人用桃仁、桂枝,阴液更受劫夺,病情日益加重。幸好痰饮内盛,津液尚未枯竭,给予:蠲饮六神汤去掉橘皮、半夏,加入西洋参、生地、天花粉、竹茹、知母、生白芍为剂,数日而愈。过了十天又发热。有人怀疑是凉药的弊端,有人说产后成了痨病。众人议论纷纷,病情逐渐进展。他的小姑嫁到吴家,曾在冥曹服役,俗称‘活无常’。偶然来探病,突然倒地僵直,口中喃喃自语。有人问:‘你嫂子病得怎么样?’回答说:‘必须服用王先生的药。’大家都觉得很奇怪。第二天,仍然请求孟英诊治。孟英说:‘脉浮数而弦,这是风温病。与前病不同,便泻无尿,是肺热逼迫所致,大渴无苔,胃汁被灼伤。赶紧给予:天生建中汤频频灌服。药主大剂甘凉,果然得到津液回复、舌面滋润,逐渐康复。
高禄卿的妻子,是吴濂仲的妹妹。初夏分娩发热,起初怀疑是蒸乳(生理性发热),数日不退。产科治疗,知道挟带温邪,进用清热解表药,导致大便溏泻,于是改为温燥药,腹泻不减。另招张某诊治,因谓专科误用瓜蒌仁所致。给予:人参、[缺失字]、姜、术、鹿角、肉果等药,泄泻更加严重。连续服用,热势壮盛、神志昏迷,汗出不止,形势濒临危险。酝香孝廉徐夫人,是病人的从母(姨母)。心地慈悲似佛。有十个儿子都已成年。听说病情危急,深夜命四郎季眉,向孟英求救。切脉,洪数七至,口渴苔黄,洞泻如火,小便不通。对季眉说:“病还可以治,只是药太惊人,未必敢服用。”季眉坚决要求开方,并且说:“在这里监督服用。”于是开出白头翁汤加石膏、犀角、金银花、知母、天花粉、竹叶、栀子、川楝子、桑叶给她们。
第二天复诊,脉证有所减轻,仍用前方。而家属群起喧哗,认为产后最忌寒凉,何况已经洞泻数日呢?仍然招张某商量,张说:“幸好我之前多次投用温补药,否则昨天的药下咽,顷刻亡阳,我又定好了附子、白术的方子,已经煎好了。”所亲张芷舟孝廉听到后,飞速告诉蕴香处。汾伯兄弟,立刻赶到病人家,幸好药未入口,夺过碗倒掉,索要孟英的方子,煎好督促灌服,并且嘱咐众兄弟轮流守视,避免再投别药。孟英感激他们的情谊,痛快施展所长,大剂凉解药,服用至七帖,腹泻全止,热势尽退。于是去掉白头翁汤,加入:生地、玄参、竹茹、贝母,服用半月才排出黑色燥屎,睡眠和饮食逐渐安稳。只是脏腑的邪气,虽然已清除,但从前的温补,将热邪壅滞于膜络之间,又在胸部乳房间复发数个痈肿。孟英令其恪守前法,再加入蒲公英、丝瓜络、橘叶、菊叶等药,服用至百剂,才告痊愈。月经也来了。
孟英说:“世俗拘泥于产后宜温的谬论,况且兼有泄泻,即使因温补而死,家属不怨恨,医生也没有遗憾。或者有一双慧眼,谁会相信呢?此证如果不是汾伯兄弟平时笃信,而在危难之间力排众论,我虽然见解明确不疑,又怎么能有成效呢?我曾经说:病不容易识别,尤其不容易患病;医生不容易推荐,尤其不容易任用;药不容易使用,尤其不容易服用。确实是宇宙间第一难事啊。而世人轻视它,难道不可悲吗!
陈书伯太史的弟媳,分娩后三天,发热汗多,苔黄眩晕心悸。孟英切脉,弦细虚数。这是营阴素亏,酷热外烁,风阳浮动,是痉挛抽搐的先兆。给予:玄参、白薇、青蒿、生地、小麦、豆衣、石斛、鳖甲、竹叶,两剂,热退知饥,心悸出汗不止。去掉青蒿、白薇,加入龙骨、牡蛎、莲心、龟板、紫石英而安定。
接着又因暑风外袭,壮热如焚、口渴饮水不知饥饿,看东西全是红色。改授白虎汤加西洋参、竹叶、莲杆,一喝即愈。仍用镇摄滋潜的方法善后而痊愈。
赵子循的妻子,分娩后,服用生化汤两帖,又因惊吓,第三天发热,连续投用四物汤、六合汤等,病情日益加重。半个月后,才延请孟英诊治。脉象:左弦极,右洪滑数。苔黄大渴,胡言乱语咳嗽痰多,恶露仍然通畅,嘴唇牙齿干燥。这是因为阴虚体质,失血过多,肝木火上浮,酷暑外烁,津液大耗,兼有伏痰的征候。急需营卫两清,希望避免其他变故。而母家极度畏惧石膏,坚决不给服用。过了三天,形势更加严重,计无所施。子循的叔叔笛楼,与其表兄许芷卿,直接用白虎汤加减投用,证情有转机。第二天,再次邀请孟英会同笛楼,以及舅舅许吉斋山长协商妥善治疗,都是王孟英的意见,并且用西瓜汁辅助药力,热势才开始趋向下行,大小便如火般灼热。又几天,逐渐能喝粥,神气也清醒,起坐梳头,夜间能安静睡眠。然而热蕴积太久,下焦患痈,脓虽即刻溃破,阴液漏伤。脉复空数浮大,便泄易怒,口干多梦,都是肝木少水涵润,灼伤津液侮犯脾胃的见证。孟英与笛楼商量,用白头翁汤加龙骨、“三甲”、甘草、木瓜育阴潜阳。余粮赤石脂丸中加入乌梅、黄连以熄风镇胃,果然疮口脓干,饮食增加腹泻停止,脉柔热净,苔退神怡。正须善后,刚授予滋填药,不料酷热持续旬日,甘霖忽降,窗户整夜敞开,又感风邪,身热微寒,鼻流清涕,而阴液久夺,外患未结痂,培养碍投,又难发汗,肝风内应,牙关紧闭四肢抽搐,九仞之功,遂成画饼。门外汉未免以成败论英雄,然而此案自然值得流传。
陆浓甫的妻子,是陈芷浔主事的女儿。产后经旬,偶尔发生胃痛。专科用温补药因而寒热气逆,自汗不寐,上厕所,不能解大便,而躺下则稀水自流,口渴善呕,完全不纳谷食,都说救不活了。父亲急忙请孟英诊治,脉弦数而滑。孟英说:“本属阴亏,肝阳侮胃,误投温补涩滞之剂,气机全不下降,以致诸证蜂起。医者见而却走,是不明白其中的缘故。给予:沙参、竹茹、川楝子、延胡索、栀子、黄连、橘皮、贝母、杏仁、石斛、枇杷叶,这是肃肺以和肝胃的方法,喝完药碗即安。但少腹隐隐作痛。于前方去掉杏仁、贝母、竹茹,加入:知母、天花粉、肉苁蓉、白芍、橘核、海螵蛸,乃解宿垢而痊愈。”
Background Information
Book: Huichun Lu (Records of Recovery)
Author: Wang Shiwei
Dynasty: Qing
Chapter: Postpartum Spasm / Postpartum Delirium / Postpartum Fever
Category: Comprehensive
The daughter of He Xinzhi married into the Tang family. In early winter, she gave birth. The next day, she had one episode of diarrhea, followed immediately by fever, spasm and syncope (Jing Jue), delirium, coma, and mania. The whole family was in a panic. Her father invited Meng Ying to examine her. The pulse was wiry and slippery, and lochia (postpartum vaginal discharge) was still flowing. Meng Ying said: "This is latent summer-heat from before pregnancy, triggered by postpartum blood deficiency and phlegm stagnation." He prescribed a large dose of: Rhinoceros Horn (Xi Jiao), Antelope Horn (Ling Yang Jiao), Scrophulariae Radix (Xuan Shen), Bambusa Leaves (Zhu Ye), Anemarrhenae Rhizoma (Zhi Mu), Trichosanthis Radix (Hua Fen), Gardeniae Fructus (Zhi Zi), Toosendan Fructus (Chuan Lian Zi), Lonicerae Japonicae Flos (Jin Yin Hua). After administration, red rashes appeared all over the body, spasms stopped, and consciousness cleared. Her father then used clearing and purifying methods to regulate, and she recovered.
A woman surnamed Yao suffered from postpartum delirium, sweating, and syncope, with edema of the skin and muscles. Physicians administered tonifying deficiency, breaking blood stasis, dispelling evil spirits (referring to dispelling phlegm), and calming the spirit medicines, but none were effective. The family was terrified and sought out Meng Ying for diagnosis. Upon inquiry, it was found that lochia was still flowing. Meng Ying said: "The family must consider this a strange disease, but it is actually easy to cure. Previously, Mr. Jin Shangtao treated a person similar to this case, recorded in Shen Yaofu's *Nuke Jiyao* (Essentials of Gynecology). The formula used was: Acori Tatarinowii Rhizoma (Shi Chang Pu), Arecae Semen Preparatum (Dan Xing), Inulae Flos (Xuan Fu Hua), Poria (Fu Ling), Citri Reticulatae Pericarpium (Ju Hong), Pinelliae Fermentatum (Ban Xia Qu), named 'Juan Yin Liu Shen Tang' (Six Divine Spirits Decoction to Remove Fluid Retention). In cases of postpartum delirium with flowing lochia, it mostly belongs to fluid retention (Tan Yin); one must not mistakenly use purgatives or tonics. This decoction is most effective. Taking it as prescribed resulted in good recovery."
The wife of Zhang Zhengfeng developed fever immediately after delivery. After taking two doses of Shenghua Tang, the heat intensified and red rashes appeared. Gu Tingquan diagnosed her and immediately gave clearing and resolving medicines. After three doses, there was no response. He wanted to administer Xi Jiao Di Huang Tang, but feared the family would be suspicious due to postpartum taboos against cold medicines. So he brought Meng Ying to consult. The pulse was wiry, slippery, and rapid. The face was red and hot/dry, chest fullness with frequent sadness, limb swelling and pain, dozens of white blisters the size of broad beans on both elbows, and one on the tongue, causing pain when drinking water. Bowel movement had been absent for ten days. Meng Ying said: "This is not only latent summer-heat from before pregnancy, but also accumulated toxicity, exacerbated by the mistaken use of Shenghua Tang which aided deficiency fire. Fortunately, clearing and resolving methods were used initially, so she did not fall into coma/collapse. Xi Jiao Di Huang Tang is an extremely correct method, but I fear it may not be sufficient." He then consulted with Gu Tingquan to add: Panax quinquefolius Folium (Xi Yang Shen), Talcum (Hua Shi), Anemarrhenae Rhizoma (Zhi Mu), Lonicerae Japonicae Flos (Jin Yin Hua), Trichosanthis Radix (Hua Fen), Natrii Sulfas (Ren Zhong Bai), Benincasae Semen (Lou Ren), Fritillariae Thunbergii Bulbus (Zhu Huang), Fritillariae Cirrhosae Bulbus (Bei Mu), Mori Folium (Sang Ye), Gardeniae Fructus (Zhi Zi) to the formula. The patient's relative asked: "If it is diagnosed as a heat syndrome by experts, why does the patient prefer hot drinks despite thirst?" Meng Ying replied: "This is why many phlegm-resolving herbs are used in this formula. Whenever there is hot-phlegm obstructing Qi mechanism in the chest, it often presents this way. One cannot doubt my words just because the patient usually does not expectorate phlegm. If this is mistaken for a cold syndrome, disaster will follow quickly." After four doses, a large bowel movement occurred, frequent expectoration of thick phlegm, and all symptoms decreased; diet gradually increased. Meng Ying said: "Although the disease trend is stable, residual heat is still intense. If we do not urgently clear it and rashly administer tonics, there is still the danger of postpartum consumptive disease." The maternal family indeed suspected the medicine was too cold and insisted on consulting a specialist. Fortunately, they showed them the previous formula, avoiding reckless warming and tonification, but it was like scratching an itch through boots—ineffective and lacking discipline. Ten days later, residual fire flared up again. Zheng Feng earnestly requested Meng Ying to find a solution, continuing with sweet-cold therapy. The whole body shed skin like snake scales, and nails renewed, indicating disease recurrence. Subsequently, nourishing true Yin led to recovery.
The wife of Weng Jiashun developed fever after delivery. Treatment by a monk from Zhulin Temple failed. Doctors Wen and Gong both advocated modifying Shenghua Tang, worsening the condition. Meng Ying was invited. The pulse was soft, slippery, and slightly rapid. Meng Ying said: "Constitutionally Yin deficient, heat arises internally. New postpartum blood loss causes fever. Only the delirium and confusion are terrifying to doctors. Thirst preferring hot drinks looks exactly like deficiency-cold evidence. No wonder they guessed wind-cold and used dispersants, suspected blood stasis and used purgatives. Thus, every dose contained prepared ginger, everyone used Peach Kernel and Cinnamon Twig. Yin was further depleted, and the disease worsened daily. Fortunately, internal fluid retention existed, and fluids were not exhausted. Prescribed: Juan Yin Liu Shen Tang removing Citri Reticulatae Pericarpium and Pinelliae Rhizoma, adding Panax quinquefolius Folium, Rehmanniae Radix Recens (Sheng Di), Trichosanthis Radix, Bamboo Shavings (Zhu Ru), Anemarrhenae Rhizoma, and Raw White Peony Root (Sheng Bai Shao). Recovered in a few days. Ten days later, fever returned. Some suspected the harm of cold medicines, others claimed it became a postpartum consumption. Amidst public clamor, the disease progressed. Her sister-in-law, married to the Wu family, who served in the underworld (known as 'Living Impermanence'), came to visit, suddenly fell stiff, muttering. Asked: 'How is your sister-in-law?' Answered: 'Must take Mr. Wang's medicine.' Everyone was surprised. The next day, still requested Meng Ying's diagnosis. Meng Ying said: "Pulse floating, rapid, and wiry indicates Wind-Warmth. Different from the previous illness. Diarrhea without urination is forced by Lung Heat. Great thirst with no coating indicates Stomach fluids scorched. Urgently prescribe Tian Sheng Jian Zhong Tang frequently. The main principle is large-dose sweet-cool. Indeed, fluids returned, tongue moistened, and gradually recovered.
Gao Luqing's wife, younger sister of Wu Lianzhong, developed fever in early summer after delivery. Initially suspected of physiological milk fever, lasting several days. Obstetric treatment identified warm pathogen involvement, using clearing/resolving meds, leading to loose stools. Then changed to warm/dry meds, diarrhea persisted. Another doctor, Zhang, blamed the obstetrician for using Benincasae Semen. Prescribed: Ginseng, [missing character], Ginger, Atractylodes Macrocephala Rhizoma (Bai Zhu), Cervus Cornu (Lu Jiao), Myristica Seed (Rou Guo), etc. Diarrhea worsened. Continuous intake led to high fever, coma, incessant sweating, critical condition. Lady Xu, concubine of Xulan Xiaolian and maternal aunt of the patient, kind-hearted as Buddha, with ten grown sons, heard of the crisis, sent Si Lang Qimei late at night to beg Meng Ying for help. Pulse: surging, rapid, seven beats per breath. Thirsty, yellow coating, profuse watery diarrhea like fire, no urination. Said to Qimei: "The disease is treatable, but the prescription is shocking; they may not dare to take it." Qimei insisted on the prescription and promised supervision. Prescribed: Baitouweng Tang plus Gypsum (Shi Gao), Rhinoceros Horn, Lonicerae Japonicae Flos, Anemarrhenae Rhizoma, Trichosanthis Radix, Bambusa Leaves, Gardeniae Fructus, Toosendan Fructus, Mori Folium.
Next day re-examination: pulse and symptoms reduced, continued with previous formula. Family uproar: postpartum strictly forbids cold medicines, especially with days of diarrhea! Still summoned Dr. Zhang. Zhang said: "Fortunately I previously used warming/tonifying drugs; otherwise, yesterday's cold medicine would have caused instant Yang collapse. I already prepared a formula with Aconite and Atractylodes." Relative Zhang Zhizhou Xiaolian heard this, rushed to inform Yunxiang. Brothers Fenbo arrived immediately at the patient's home. Fortunately, the medicine hadn't been taken. They snatched the bowl, poured it out, demanded Meng Ying's prescription, brewed it, supervised ingestion, and ordered brothers to take turns guarding to prevent other medicines. Grateful for their trust, Meng Ying freely applied his expertise. Large-dose cooling/resolving medicines. After seven doses, diarrhea stopped completely, heat subsided. Removed Baitouweng Tang, added: Rehmanniae Radix Recens, Scrophulariae Radix, Bamboo Shavings, Fritillariae Cirrhosae Bulbus. After half a month, black dry stool passed, sleep and diet stabilized. However, although internal pathogens were cleared, previous warming/tonifying had trapped heat in the membrane network, causing multiple abscesses between breasts. Meng Ying instructed strict adherence to previous method, adding Dandelion, Luffa Fruit Rind (Si Gua Luo), Tangerine Peel (Ju Ye), Chrysanthemum Leaf (Ju Ye). After hundred doses, fully recovered. Menstruation resumed.
Meng Ying said: "Secular people stick to the fallacy that postpartum requires warming. Especially with diarrhea, even if death results from warming/tonifying, families don't blame, doctors have no regrets. Or those with insight, who believes them? If not for the firm belief of Brothers Fenbo in normal times and their forceful rejection of mass opinion in crisis, although I saw clearly without doubt, how could I have succeeded? I once said: Diseases are hard to identify, harder to suffer; Doctors are hard to recommend, harder to employ; Medicines are hard to use, harder to take. Truly the greatest difficulty in the universe. Yet people look down on it, is it not sad!"
The wife of Chen Shubo's eldest brother, three days postpartum, fever, excessive sweating, yellow coating, dizziness, palpitations. Meng Ying palpated pulse: wiry, fine, deficient, rapid. Constitutionally deficient Ying-Yin, scorched by extreme heat, floating Wind-Yang, precursor to spasm/syncope. Prescribed: Scrophulariae Radix, Anemidis Radix (Bai Wei), Artemisiae Annuae Herba (Qing Hao), Rehmanniae Radix Recens, Triticum Sativum (Xiao Mai), Vigna Angularis Cotyledo (Dou Yi), Dendrobii Caulis (Shi Hu), Testudinis Carapax et Plastrum (Bie Jia), Bambusa Leaves. Two doses: heat subsided, appetite returned, but palpitations and sweating persisted. Removed Qing Hao, Bai Wei, added: Ostreae Concha (Long Gu), Margarita (Mu Li), Nelumbinis Plumula (Lian Xin), Testudinis Carapax et Plastrum (Gui Ban), Fulguris Os (Zhi Shi Ying) to stabilize.
Subsequently, attacked by Summer-Wind external pathogen, blazing heat like burning, thirst/drinking without hunger, seeing everything as red. Changed to Bai Hu Tang plus Panax quinquefolius Folium, Bambusa Leaves, Nelumbinis Nodus (Lian Gan). One sip cured. Continued with calming/nourishing/submerging methods for recovery.
Zhao Zixun's wife, postpartum, took two doses of Shenghua Tang, then due to fright, fever on the third day. Continuously given Si Wu Tang, Liu He Tang, etc., worsening daily. Half a month later, Meng Ying was consulted. Pulse: Left extremely wiry, Right surging, slippery, rapid. Yellow coating, great thirst, delirium, cough with phlegm, lochia still flowing, lips/teeth dry. Due to Yin-deficient constitution, excessive blood loss, Liver Fire floating up, extreme summer heat scorching externally, massive fluid depletion, plus latent phlegm signs. Urgently needed clearing both Ying and Wei to avoid complications. Maternal family feared Gypsum strongly, refused to give it. Three days later, condition worsened, helpless. Zhao Zixun's uncle Dilou and cousin Xu Zhiqing directly administered modified Bai Hu Tang, showing improvement. Next day, invited Meng Ying together with Dilou and maternal uncle Xu Jizhai Shan Zhang to negotiate treatment. All agreed with Wang Meng Ying's proposal, assisted by Watermelon Juice to aid medicinal power. Heat began to descend, urination/defecation felt like fire. Several days later, gradually tolerated porridge, spirit cleared, sat/combed hair, slept quietly at night. However, long-stagnant heat caused lower jiao abscess. Pus drained, but Yin fluid leaked. Pulse became empty, rapid, floating, large. Diarrhea, irritability, dry mouth, vivid dreams—all signs of Liver lacking Water nourishment, scorching fluids, insulting Stomach. Meng Ying consulted Dilou: Baitouweng Tang plus Ostreae Concha, "San Jia" (Tortoise Shell, Turtle Shell, Ox Horn), Licorice, Quince (Mu Gua) to nourish Yin and submerge Yang. Yuliang Chishizhi Wan (Red Halloysite Pill) plus Chinese Plum (Wu Mei), Coptis Rhizome (Huang Lian) to extinguish wind and calm stomach. Indeed, pus dried, diet increased, diarrhea stopped, pulse soft, heat gone, coating receded, spirit refreshed. Just as aftercare with filling/nourishing was started, unexpectedly, extreme heat lasted ten days, sudden rain fell, windows open all night, caught Wind pathogen again. Fever, slight chills, runny nose. But Yin fluid long deprived, external wound unhealed, nourishment hindered, sweating difficult. Internal Liver Wind responded, trismus and convulsions. Nine feet of effort, thus became a pie in the sky (failed). Laymen judge by success/failure, but this case is worthy of transmission.
Lu Nongfu's wife, daughter of Director Chen Zhixun. Ten days postpartum, occasional epigastric pain. Specialist used warming/tonifying meds, leading to alternating cold/heat, Qi rebellion, spontaneous sweating, insomnia. Went to toilet, unable to defecate, lying down caused loose water flow. Thirsty, prone to vomiting, no appetite. All said hopeless. Father hurriedly summoned Meng Ying. Pulse: wiry, rapid, slippery. Meng Ying said: "Originally Yin deficient, Liver Yang insulting Stomach. Mistakenly administered warming/tonifying/astringent/stagnating agents. Qi mechanism completely failed to descend, causing various symptoms to swarm. Doctors fleeing upon seeing this didn't understand the cause. Prescribed: Glehniae Radix (Sha Shen), Bamboo Shavings, Toosendan Fructus, Corydalis Rhizoma (Yan Hu Suo), Gardeniae Fructus, Coptis Rhizome, Citri Reticulatae Pericarpium, Fritillariae Cirrhosae Bulbus, Apricot Seed (Xing Ren), Dendrobii Caulis, Loquat Leaf (Pi Pa Ye). This is肃肺 (Purging Lung) to harmonize Liver-Stomach method. Settled immediately after one cup. But lower abdomen faintly painful. Removed Apricot Seed, Fritillariae Cirrhosae Bulbus, Bamboo Shavings from previous formula, added: Anemarrhenae Rhizoma, Trichosanthis Radix, Cynomorii Fructus (Rong Rong), White Peony Root, Tangerine Seed (Ju He), Sepiae Endoconcha (Hai Piao Xiao). Resolved old fecal matter and recovered."