人参 当归(各二钱) 黄 (一钱五分) 白术 麻黄根 牡蛎(各一钱) 桂枝 炙甘草(各
五分) 浮小麦(一撮)
如虚脱汗多。手足冷。加熟附子(一片) 姜枣(四分) 渴加麦冬。五味子(各六分) 肥白人产
后多汗。加竹沥。姜汁以清痰火。若恶风寒。加防风(五分) 血块不痛。加熟地(三钱) 暮
服八味丸。(六味加五味子炙黄 。)
凡产后汗不止。由产亡阴血。而阳气偏盛故也。内经云。阳加于阴则发汗。因而遇风。变为
螈者有之矣。其治尤难。是以产后多汗之家。更宜谨避风寒也。
产后睡梦中汗多。醒来即止。犹盗瞰人睡而出盗。谓之盗汗。此非自汗之比。在杂症论云。
自汗阳亏。盗汗阴亏。然当归六黄汤。又非产后盗汗方也。治当兼血分药品调理之。乃称善
人参(二钱) 当归(三钱) 熟地(一钱五分) 麻黄根 黄连(酒炒各五分) 浮小麦(一大撮)
牡蛎( 研五分) 小麦面(炒黄研)
凡产后口燥咽干而渴。或兼小便不利。由产时失血。或汗多所致。是无水也。夫水谷入胃。
脾肺散精。清气为津液。其气通心。受火色变为血。下行膀胱为小便。值产亡血而又汗多。
且劳倦伤脾。不能为胃行其津液。生化之气不运。渗泄之令不行。是以上无津液。而有嗌干
燥渴之症。下气不升。而有胃肾闭关之候。治法必当助脾益肺。升举气血。则气化流行。阳升
阴降。水入经而为血为液。谷入胃而气长脉行。自然津液充而便利调矣。若认咽干口燥为火
。而用芩、连、栀、柏以降之。认小便闭涩为水滞。而用五苓散以通之。皆非也。必因其劳
损而温之益之。因其渴燥而濡之行之。量度病情。而施治无失也。
人参、当归(各二钱)、黄芪(一钱五分)、白术、麻黄根、牡蛎(各一钱)、桂枝、炙甘草(各五分)、浮小麦(一撮)。
如果虚脱且汗出过多,手足冰冷,加熟附子(一片)、生姜和大枣(四分);口渴加麦冬、五味子(各六分);体型肥胖的产妇多汗,加竹沥、姜汁以清化痰火。如果有恶风寒的症状,加防风(五分);有血块但不疼痛,加熟地黄(三钱);晚上服用八味丸(由六味地黄丸加五味子、炙黄芪组成)。
大凡产后汗出不止,是因为生产时亡失阴血,导致阳气偏盛所致。《内经》说:“阳加于阴则发汗。”如果因此又感受风邪,可能转变为抽搐(瘛疭),这种情况治疗尤为困难。所以产后多汗的人,更应当谨慎避开风寒。
产后在睡梦中出汗多,醒来即停止,就像盗贼趁人睡觉时出来偷窃一样,称为盗汗(Dàohàn, Night Sweats)。这不同于自汗(Zìhàn, Spontaneous Sweating)。在杂病论中说:自汗是阳气亏虚,盗汗是阴液亏虚。然而,当归六黄汤(Danggui Liuhuang Tang)并不是治疗产后盗汗的方剂。治疗应当兼顾血分的药物进行调理,这样才恰当。
人参(二钱)、当归(三钱)、熟地黄(一钱五分)、麻黄根、黄连(酒炒,各五分)、浮小麦(一大撮)、牡蛎(研碎,五分)、小麦面(炒黄后研碎)。
大凡产后口燥咽干而口渴,或者兼有小便不利,是由于分娩时失血,或者汗出过多所致,这是体内津液枯竭的表现。水谷进入胃中,由脾和肺散布精微物质,清气转化为津液,其气上通于心,受心火之色变化而变为血液,下行至膀胱成为小便。正值生产亡血而又汗多,加上劳累疲倦损伤脾气,不能为胃传输津液,生化之气不运行,渗泄的功能不执行,所以上部没有津液,出现咽喉干燥口渴的症状;下部气机不升,出现胃肾闭塞不通的征候。治疗方法必须帮助脾胃、补益肺气,升举气血,那么气化功能流行,阳气上升,阴液下降,水进入经脉成为血和液,食物进入胃中则气长脉行,自然津液充盈而大小便调畅。如果把咽干口燥认为是火邪,而用黄芩、黄连、栀子、黄柏来降火;把小便闭涩认为是水湿停滞,而用五苓散(Wuling San)来通利,都不正确。必须根据劳损的情况来温补益养,根据口渴干燥的情况来滋润通行,衡量病情的轻重,施治才不会失误。
Ren Shen (Ginseng Radix), Dang Gui (Angelicae Sinensis Radix) (each 2 qian), Huang Qi (Astragali Membranacei Radix) (1.5 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Ma Huang Gen (Ephedrae Herbae Radix et Rhizoma), Mu Li (Ostreae Concha) (each 1 qian), Gui Zhi (Cinnamomi Ramulus), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma) (each 0.5 qian), Fu Xiao Mai (Tritici Levis Fructus) (a pinch).
If there is collapse with excessive sweating and cold hands and feet, add Shu Fu Zi (Prepared Aconiti Lateralis Radix) (one slice), Sheng Jiang (Zingiberis Rhizoma Recens) and Da Zao (Jujubae Fructus) (0.4 qian); if thirsty, add Mai Dong (Ophiopogonis Radix) and Wu Wei Zi (Schisandrae Chinensis Fructus) (each 0.6 qian); for obese postpartum women with excessive sweating, add Zhu Li (Bambusae Succus) and Jiang Zhi (Zingiberis Juice) to clear phlegm-heat. If there is aversion to wind and cold, add Fang Feng (Saposhnikoviae Radix) (0.5 qian); if there are blood stasis masses without pain, add Shu Di Huang (Rehmanniae Radix Preparata) (3 qian); take Ba Wei Wan (Eight-Ingredient Pill with Rehmannia) at night (composed of Liu Wei Di Huang Wan plus Wu Wei Zi and Zhi Huang Qi).
Generally, persistent sweating after childbirth is caused by the loss of Yin blood during delivery, leading to an excess of Yang. The *Neijing* states: "When Yang acts upon Yin, sweat is produced." If this is followed by exposure to wind, it may transform into convulsions (Chizhong, clonic spasms), a condition that is particularly difficult to treat. Therefore, postpartum women with excessive sweating should be especially careful to avoid wind and cold.
Excessive sweating during sleep in postpartum women, which stops upon waking, is called Dao Han (Night Sweats), likened to a thief stealing while one sleeps. This differs from Zi Han (Spontaneous Sweating). In the discussion on miscellaneous diseases, it is stated: Spontaneous sweating indicates Yang deficiency, while night sweats indicate Yin deficiency. However, Danggui Liuhuang Tang (Angelica Six-Huang Decoction) is not the appropriate formula for treating postpartum night sweats. Treatment should incorporate herbs regulating the Blood level to be effective.
Ren Shen (Ginseng Radix) (2 qian), Dang Gui (Angelicae Sinensis Radix) (3 qian), Shu Di Huang (Rehmanniae Radix Preparata) (1.5 qian), Ma Huang Gen (Ephedrae Herbae Radix et Rhizoma), Huang Lian (Coptidis Rhizoma, wine-fried) (each 0.5 qian), Fu Xiao Mai (Tritici Levis Fructus) (a large pinch), Mu Li (Ostreae Concha, crushed) (0.5 qian), Xiao Mai Mian (Tritici Vulgaris Farina, fried yellow and crushed).
Generally, dry mouth, dry throat, and thirst after childbirth, or accompanied by dysuria, are caused by blood loss during delivery or excessive sweating, resulting in a lack of fluids. When food and water enter the stomach, the Spleen and Lung distribute the essence; the clear Qi transforms into Jin Ye (Body Fluids). This Qi connects to the Heart, where it takes on the color of Fire and transforms into Blood, flowing down to the Bladder to become urine. During childbirth, when blood is lost and sweating is excessive, combined with fatigue damaging the Spleen, the Spleen fails to transport fluids for the Stomach. The Qi of transformation and transportation does not move, and the function of seepage and excretion ceases. Consequently, there is no fluid above, leading to symptoms of dry throat and thirst; below, Qi does not ascend, leading to signs of closure between the Stomach and Kidney. The treatment method must assist the Spleen and benefit the Lung, raising Qi and Blood. Then, Qi transformation will circulate, Yang ascends and Yin descends; water enters the meridians to become blood and fluids, grain enters the stomach to nourish Qi and promote pulse flow, naturally replenishing fluids and regulating urination and defecation. If dry throat and mouth are mistaken for Fire and treated with Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Zhi Zi (Gardeniae Fructus), and Huang Bo (Phellodendri Cortex) to drain fire; or if urinary obstruction is mistaken for Water stagnation and treated with Wuling San (Five-Ingredient Powder with Poria) to promote diuresis, both are incorrect. One must warm and tonify according to the damage from overwork, and moisten and promote flow according to thirst and dryness, measuring the condition carefully to ensure accurate treatment.