产后疟疾,宜分别施治,有寒热相兼,有热多寒少,草果饮子,或青皮饮,寒多,养胃汤,
或四兽饮之类。
草果饮
草果(一钱) 川芎(一钱) 紫苏(一钱) 白芷(一钱) 良姜(七分) 甘草(八分) 陈皮(八
分) 青皮(一钱)
水煎。
四兽饮
人参(一钱) 白术(一钱,炒) 陈皮(一钱二分) 茯苓(一钱二分) 甘草(五分) 草果(八
分) 乌梅(三个) 半夏(六分)
加姜枣,水煎服。
胜金丹
常山(四两,酒蒸) 尖槟榔(一两)
共为末,醋糊丸,未发时,先吞三十丸,至五更再吞十五丸,温酒送下,丸如菀豆大。发时
切不可服。
养胃汤(见胎前)
产后血气大亏,纵有寒,不可大发汗,芎归汤加人参、苏叶、葛根微汗之。故郑氏只用带须
葱煎汤服。如热不止,黄龙汤加芎、归。大热不得已,加知母、黄连。可攻可温者,临时斟
酌,不可妄投峻剂,耗损真元也,慎之。
产后泄泻,小便不利而泻,此阴阳不分之故,宜胃苓汤,腹痛是食积,宜加消食药。恶露不
行,宜行血。若外感风寒而内伤饮食者,宜养胃汤。恶露已净,不必活血,如未净,加归尾
、桃仁之类。如久泻不止,养胃汤,加肉桂、肉果。如挟寒腹痛肠鸣,小水清白不浊,口不
渴,加肉果炒白芍。如热泻,肠垢口渴,时痛时泻,火也,宜姜炒黄连、木通。或泻或不泻
,或多或少者,痰也。肯堂云∶产后泻痢,不可混治,以补脾为主,如白术茯苓神曲甘草陈
皮之类,兼以消食理气之剂。
君苓汤
白术(二钱,炒) 茯苓(二钱) 猪苓(一钱) 泽泻(一钱)
水煎服。
胃苓汤(即君苓汤加平胃散)
产后疟疾,应当根据具体情况分别施治。有的表现为寒热交替发作,有的表现为热多寒少,可使用草果饮子或青皮饮;若寒象较重,则使用养胃汤,或者四兽饮之类的方剂。
草果饮
草果(一钱) 川芎(一钱) 紫苏(一钱) 白芷(一钱) 良姜(七分) 甘草(八分) 陈皮(八分) 青皮(一钱)
加水煎煮服用。
四兽饮
人参(一钱) 白术(一钱,炒制) 陈皮(一钱二分) 茯苓(一钱二分) 甘草(五分) 草果(八分) 乌梅(三个) 半夏(六分)
加入生姜和大枣,加水煎煮后服用。
胜金丹
常山(四两,用酒蒸制) 尖槟榔(一两)
共同研磨成粉末,用醋调糊制成丸药。在疟疾未发作时,先吞服三十丸,到五更天再吞服十五丸,用温酒送下,药丸大小如菟丝子般大。疟疾发作时绝对不可服用。
养胃汤(参见胎前章节)
产后气血大量亏损,即使有外感寒邪,也不可以使用强烈的发汗法,可用芎归汤加入人参、苏叶、葛根,使其微微出汗。所以郑氏只用带根的葱煎汤服用。如果发热不止,可用黄龙汤加入川芎、当归。如果高热不得已而为之,可加入知母、黄连。可以根据病情选择攻下或温补的方法,临时斟酌决定,不可随意投用峻猛的药物,以免耗损人体真元之气,务必谨慎。
产后泄泻,小便不通利且伴有腹泻,这是阴阳之气不能分清的原因,适宜使用胃苓汤。腹痛是由于食积引起,适宜加入消食药。恶露排出不畅,适宜使用行血药物。如果是外感风寒且内伤饮食导致的,适宜使用养胃汤。恶露已经排净,就不必使用活血药物,如果尚未排净,可加入当归尾、桃仁等药物。如果久泻不止,使用养胃汤,加入肉桂、肉豆蔻。如果夹杂寒邪导致腹痛肠鸣,小便清白不浑浊,口不渴,可加入炒制的肉豆蔻和白芍。如果是热性腹泻,大便黏腻且有口渴症状,时而疼痛时而腹泻,属于火证,适宜使用姜炒黄连、木通。或者有时腹泻有时不腹泻,或者腹泻量或多或少,这是痰湿所致。肯堂说:产后泻痢,不可混淆治疗,应以补脾为主,如白术、茯苓、神曲、甘草、陈皮等药物,兼用消食理气的药剂。
Malaria occurring after childbirth should be treated differently according to specific conditions. Some cases present with alternating chills and fever, while others have more heat than chills; Caoguo Yinzi (Grass Cardamom Decoction) or Qingpi Yin (Green Peel Decoction) may be used. If chills are predominant, Yangwei Tang (Stomach-Nourishing Decoction) or formulas similar to Sishou Yin (Four Beasts Decoction) should be employed.
Caoguo Yin (Grass Cardamom Decoction)
Caoguo (Tsaoko Fructus, 1 qian) Chuanxiong (Rhizoma Ligustici Chuanxiong, 1 qian) Zisu (Perillae Folium, 1 qian) Baizhi (Radix Angelicae Dahuricae, 1 qian) Liangjiang (Rhizoma Alpiniae Officinarum, 7 fen) Gancao (Radix Glycyrrhizae Uralensis, 8 fen) Chenpi (Pericarpium Citri Reticulatae, 8 fen) Qingpi (Pericarpium Citri Reticulatae Viride, 1 qian)
Decoct in water and take.
Sishou Yin (Four Beasts Decoction)
Renshen (Radix Ginseng, 1 qian) Baizhu (Rhizoma Atractylodis Macrocephalae, 1 qian, stir-fried) Chenpi (Pericarpium Citri Reticulatae, 1.2 qian) Fuling (Poria, 1.2 qian) Gancao (Radix Glycyrrhizae Uralensis, 5 fen) Caoguo (Tsaoko Fructus, 8 fen) Wumei (Fructus Mume, 3 pieces) Banxia (Rhizoma Pinelliae Ternatae, 6 fen)
Add fresh ginger and Chinese jujube, decoct in water, and take.
Shengjin Dan (Victory Gold Pill)
Changshan (Radix Dichroae, 4 liang, steamed with wine) Jianbinglang (Arecae Semen, 1 liang)
Grind together into powder, make pills using vinegar paste. Before the onset of malaria, swallow thirty pills first, and at wugeng time (early morning), swallow another fifteen pills, taken down with warm wine. The pills should be as large as rabbit seeds. Do not take during an attack.
Yangwei Tang (Stomach-Nourishing Decoction) (See section on Prenatal Conditions)
After childbirth, blood and qi are severely depleted. Even if there is external cold, strong diaphoresis (sweating therapy) must not be used. Instead, Xiongui Tang (Cyathula and Angelica Decoction) can be added with Renshen (Radix Ginseng), Ziye (Perillae Folium), and Gegen (Puerariae Radix) to induce mild sweating. Therefore, Zheng Shi only uses scallions with roots decocted in water for consumption. If fever persists, Huanglong Tang (Yellow Dragon Decoction) can be added with Chuanxiong (Rhizoma Ligustici Chuanxiong) and Danggui (Angelicae Sinensis Radix). If high fever is unavoidable, Zhimu (Anemarrhenae Rhizoma) and Huanglian (Coptidis Rhizoma) can be added. One may choose between purgative or warming methods based on the situation, deciding temporarily; do not recklessly administer harsh agents that deplete the body's true yuan (vital energy). Exercise caution.
Diarrhea after childbirth, accompanied by difficult urination and diarrhea, is due to the failure of yin and yang to separate properly. Weiling Tang (Gastrointestinal Regulating Decoction) is suitable. Abdominal pain indicates food stagnation, so digestive-resolving herbs should be added. If lochia (postpartum discharge) is not flowing smoothly, blood-invigorating herbs are appropriate. If caused by external wind-cold and internal dietary injury, Yangwei Tang (Stomach-Nourishing Decoction) is suitable. If lochia has cleared completely, blood-invigorating herbs are unnecessary; if not fully cleared, add Dangguiwei (Angelicae Sinensis Radix Cauda) and Taoren (Persicae Semen). If chronic diarrhea persists, use Yangwei Tang (Stomach-Nourishing Decoction) with Rougui (Cinnamomi Cortex) and Rouguo (Myristicae Semen). If accompanied by cold-induced abdominal pain and borborygmus, with clear and non-turbid urine and no thirst, add stir-fried Rouguo (Myristicae Semen) and Baishao (Paeoniae Radix Alba). For hot diarrhea with sticky stool, thirst, intermittent pain and diarrhea, which indicates fire syndrome, use Jiangchao Huanglian (Coptidis Rhizoma stir-fried with ginger) and Mutong (Akebiae Caulis). Intermittent diarrhea with varying amounts suggests phlegm-dampness. Kentang stated: Diarrhea and dysentery after childbirth should not be treated indiscriminately; the primary approach should be strengthening the spleen, using herbs such as Baizhu (Rhizoma Atractylodis Macrocephalae), Fuling (Poria), Shenqu (Massa Medicata Fermentata), Gancao (Radix Glycyrrhizae Uralensis), and Chenpi (Pericarpium Citri Reticulatae), combined with agents that resolve food stagnation and regulate qi.
Junling Tang (Lord Poria Decoction)
Baizhu (Rhizoma Atractylodis Macrocephalae, 2 qian, stir-fried) Fuling (Poria, 2 qian) Zhuling (Polyporus, 1 qian) Zexie (Alismatis Rhizoma, 1 qian)
Decoct in water and take.
Weiling Tang (Gastrointestinal Regulating Decoction) (This is Junling Tang plus Pingwei San [Powder to Maintain Stability])