产后气喘,由营血暴竭,气无所主,触发于肺,故至喘急也。此孤阳绝阴,难以治疗,十死
一生之证也。若败血停滞,上逆于肺作喘者,夺命丹主之。郑氏谓产后发喘,最为危险。经
曰∶诸喘皆凶。然此亦当视其有痰无痰,痰之多少,以断其吉凶。若痰壅盛而喘,痰声必大
作,此痰犯肺金,肺不宁也。法当豁痰,其喘自定,其喘犹可救,旋复花汤主之。恶露未尽
者,加生姜自然汁,及行血消食药。已净而小腹不痛者,加片芩服之。若不咳而喘者,此谓
肺火所迫,乃真喘也。证多不治,不必下药。
产后发呃,此症不宜见之,新产须辨症施治。如恶露未净者,多是血迷上冲所致,当服行血
之药。已净而呃者,多因受寒也,法当顺气调脾,如紫苏饮之类。
产后呕恶,胃气不化也,恶露未行者,二陈、四物加减活血药。若已行者,不必活血,若胸
满而呕逆者,食也,宜消导之。如饮食入胃而即呕者,火也。纳谷少顷呕出者。胃寒也,宜
白蔻、丁香之类治之。
产后吞酸者少见,或因病久脾胃虚弱,致有此患耳。如恶露净后,二陈汤或四物汤,加姜汁
炒黄连、吴茱萸之类。
产后噤口不语,乃败血裹迷心窍所致,不须恐怖,但服八珍散,一月自安。亦有痰迷心窍者
二陈、四物,加竹沥姜汁甚妙。如产后着风不语,小续命汤主之,加姜汁,其法最稳而取效
亦速。
产后气喘,是由于营血突然枯竭,气失去主宰,触动肺脏,从而导致呼吸急促。这是孤阳脱离绝阴的危重证候,难以治疗,属于十死一生的病症。如果是败血停滞,向上逆犯于肺而引发气喘的,以夺命丹为主治方剂。郑氏认为产后发喘最为危险。医经说:各种气喘都属于凶险之证。然而这也应当根据患者有痰还是无痰、痰量的多少,来判断病情的吉凶。如果痰液壅盛导致气喘,痰鸣声必然很大,这是痰邪侵犯肺金,导致肺气不宁。治疗方法应当豁除痰浊,气喘自然平息,这种病情尚可救治,以旋复花汤为主治方剂。恶露未排尽者,加入生姜自然汁,以及具有行血消食作用的药物。恶露已排净且小腹部不疼痛者,加入黄芩服用。如果不咳嗽而气喘的,这称为被肺火所逼迫,才是真正的喘证。此类证候大多难以治愈,不必使用药物攻下。
产后呃逆(打嗝),此症不宜出现,新产妇人必须辨证施治。如恶露未排净者,多是瘀血迷乱上冲所致,应当服用行血化瘀的药物。恶露已排净却出现呃逆者,多因感受寒邪引起,治疗方法应当顺气调脾,如紫苏饮之类的方剂。
产后呕吐恶心,是胃气不能正常运化的表现。若恶露尚未排出,可用二陈汤和四物汤加减,配合活血药物。若恶露已经排出,则不必再用活血药。如果胸膈满闷且呕吐逆气的,是因为饮食积滞,适宜用消食导滞的方法治疗。如食物进入胃中随即呕吐的,是胃中有火。进食片刻后呕吐出来的,是胃寒,适宜用白豆蔻、丁香等药物治疗。
产后吞酸的情况较少见,或者是由于患病日久脾胃虚弱,导致出现这种情况。如在恶露排净后,可用二陈汤或四物汤,加入姜汁炒制的黄连、吴茱萸等药物。
产后牙关紧闭、不能言语(噤口不语),是由败血包裹迷蔽心窍所致,不必恐惧,只需服用八珍散,一个月左右自然安宁。也有因痰迷心窍导致的,用二陈汤、四物汤,加入竹沥和姜汁效果很好。如产后受风邪导致不能言语的,以续命汤(小续命汤)为主治方剂,加入姜汁,这种方法最稳妥且见效迅速。
Postpartum panting (asthma) results from the sudden depletion of Ying blood (nutritive blood), causing Qi to lose its mastery and triggering the Lung, thus leading to rapid breathing. This is a critical condition where solitary Yang is severed from Yin, making it difficult to treat; it is a syndrome with ten deaths for every one survival. If stagnant evil blood rises upward to invade the Lung causing panting, Duoming Dan (Life-Rescuing Pill) is the primary formula. Zheng stated that postpartum panting is extremely dangerous. The Classics say: "All panting is ominous." However, one must also assess whether there is phlegm or not, and the quantity of phlegm, to judge the prognosis. If phlegm obstruction causes severe panting with loud phlegm rales, this indicates phlegm invading Lung Metal, disturbing Lung tranquility. The method should be to resolve phlegm, after which the panting will subside naturally; this condition is still salvageable, and Xuanfuhua Tang (Inula Flower Decoction) is the primary formula. For those with incomplete lochia discharge, add fresh ginger juice and herbs promoting blood circulation and digestion. For those whose lochia has cleared and who have no lower abdominal pain, add Huangqin (Scutellariae Radix). If there is panting without coughing, this is termed being forced by Lung fire, representing true panting. Such conditions are mostly incurable, and purgative drugs should not be used.
Postpartum hiccups are a symptom that should not appear; new mothers require treatment based on syndrome differentiation. If lochia is not yet clear, it is mostly caused by blood confusion rushing upward, requiring herbs that promote blood circulation. If hiccups occur after lochia has cleared, it is often due to cold invasion; the method should be to smooth Qi and regulate the Spleen, such as using Zisu Yin (Perilla Infusion).
Postpartum nausea and vomiting result from the Stomach's failure to transform and transport. If lochia has not yet moved, Erchen Tang (Two-Aged Decoction) and Siwu Tang (Four Substances Decoction) can be modified with blood-invigorating herbs. If lochia has already moved, blood-invigorating herbs are unnecessary. If chest fullness accompanies vomiting and reflux, it is due to food stagnation, and digestive methods are appropriate. If food vomited immediately after entering the Stomach, it is due to heat. If food vomited shortly after ingestion, it is due to Stomach cold, treated with Baikouren (Amomi Fructus Rotundus) and Dingxiang (Caryophylli Flos).
Postpartum acid regurgitation is rare, possibly occurring due to long-standing illness weakening the Spleen and Stomach. After lochia clears, Erchen Tang or Siwu Tang can be used with Jiangzhi Chao Huanglian (Ginger-fried Scutellariae Radix) and Wuzhuyu (Evodiae Fructus).
Postpartum trismus and muteness (silence with locked jaws) is caused by evil blood enveloping and confusing the Heart orifices. There is no need for fear; simply taking Bazhen San (Eight-Treasure Powder) will lead to natural recovery within a month. In cases confused by phlegm affecting the Heart orifices, Erchen Tang and Siwu Tang added with Zhuli (Bambusa Textilis Caulis in Nacre) and Jiangzhi (Fresh Ginger Juice) are very effective. For muteness caused by wind invasion postpartum, Xiaoxuming Tang (Minor Xu-Ming Decoction) is the primary formula, added with ginger juice; this method is most stable and yields rapid results.