产后手足冷厥。发由阴气虚。阳气亦虚故也。经曰阳气衰于下则为寒厥。厥气上行。满脉去
则神气浮越。去身而散也。
川芎(一钱) 当归 人参(各三钱) 姜炭 炙甘草(各五分) 黄 (一钱) 水煎服。服后厥
。俟块痛已除仍用参 加桃仁(十五粒) 姜水煎服。如渴加人参(
一钱) 麦冬(一钱) 五味子(十粒) 手足微冷。加熟附子(五分) 痰加橘红(五分) 竹沥(
半杯) 姜汁(二匙) 汗多加黄 (一钱) 血块痛加肉桂(五分) 虚甚加人参(一二钱)
大便不通。加麻仁(一钱五分) 再服五仁丸。慎勿用承气汤。至如热厥。不可用白虎汤。寒
厥不可用四逆汤。盖产后厥症。气血两虚。多脉脱。用药必须大补。少佐姜附以回阳也。
产后诸症。俱用生化汤加减。如前条兼症。药味附载者。后有兼症。可仿而用之。下不备
产后气短。似喘非喘。气不接续。或兼热。或兼痰。或痰热俱兼。皆危急症也。治当大补血
兼头痛发热之症。惟当重产。专门治伤寒者。慎勿发散。丹溪云产后
切不可发表是也。
川芎 枣仁(各一钱) 当归(一钱五分) 姜炭(四分) 炙草(五分) 桃仁(十五粒) 人参(
加人参(一二钱) 枣汤煎服。如脉与形脱将绝。加人参(三四钱) 频
灌救。如汗不止。加人参麦冬(各一钱) 汗多痰甚。加人参(三钱) 竹沥(半杯) 姜汁(三
匙) 杏仁(十粒) 汗多、喘嗽、声重,加桔梗。杏仁。(各五分) 无汗喘嗽。加半夏(一钱)
杏仁(十粒) 桔梗(五分) 汗不止。三四帖后。加黄 (一钱)
如产后,汗出气短。
产后出现手足冰冷厥逆的症状,其发病原因是阴气虚弱,阳气也随之虚弱。医经中说:“阳气在下部衰微,就会发生寒厥。”厥逆之气向上冲行,充斥脉道,导致神气浮越散乱,脱离身体而消散。
川芎(一钱)、当归、人参(各三钱)、姜炭、炙甘草(各五分)、黄芪(一钱),用水煎服。服药后若厥逆症状缓解,待血块疼痛消除后,仍用人参方剂,加入桃仁(十五粒),用姜水煎服。如果口渴,加人参(一钱)、麦冬(一钱)、五味子(十粒);如果手足轻微发冷,加熟附子(五分);如果有痰,加橘红(五分)、竹沥(半杯)、姜汁(两匙);如果出汗多,加黄芪(一钱);如果血块疼痛,加肉桂(五分);如果虚损严重,加人参(一至二钱);如果大便不通,加火麻仁(一钱五分),并再服用五仁丸。千万不要使用承气汤。至于热厥证,不可使用白虎汤;寒厥证不可使用四逆汤。这是因为产后厥症,气血都虚弱,多见脉象微弱欲绝,用药必须大补气血,稍加生姜、附子以回阳救逆。产后各种病症,都使用生化汤加减治疗。如前条所述的兼症,药味已附载在后方中。后面如有其他兼症,可以仿照此法使用,此处不再赘述。
产后出现气短,似喘非喘,气息不能接续。或者兼有发热,或者兼有痰湿,或者痰与热同时兼有,这些都是危急的病症。治疗应当大补气血。兼有头痛发热的症状时,要重视产后体质特点。专门治疗伤寒的医生,千万不要使用发散解表的方法。朱丹溪说:产后切不可使用发表药物,就是这个道理。
川芎、酸枣仁(各一钱)、当归(一钱五分)、姜炭(四分)、炙甘草(五分)、桃仁(十五粒)、人参(用量视情况而定),用大枣汤煎服。如果脉象和形体脱失,气息将绝,加人参(三至四钱),频繁灌服以急救。如果汗出不止,加人参、麦冬(各一钱);如果汗多且痰盛,加人参(三钱)、竹沥(半杯)、姜汁(三匙)、杏仁(十粒);如果汗多、喘咳、声音重浊,加桔梗、杏仁(各五分);如果没有汗且喘咳,加半夏(一钱)、杏仁(十粒)、桔梗(五分)。如果汗出不止,服用三四帖后,加黄芪(一钱)。如果是产后汗出、气短的情况。
Postpartum coldness and cold extremities (Jue syndrome) arise from deficiency of Yin Qi, which leads to concomitant deficiency of Yang Qi. The classics state: "When Yang Qi is deficient in the lower part, it results in Cold Jue." When Jue Qi ascends, it fills the meridians, causing Shen Qi (Spirit Qi) to float and scatter, detaching from the body and dissipating.
Chuanxiong Rhizome (1 qian), Danggui Radix (3 qian), Renshen Radix (3 qian), Jiangtan Charred Zingiberis Rhizoma (0.5 qian), Zhigancao Prepared Glycyrrhizae Radix et Rhizoma (0.5 qian), Huangqi Astragali Radix (1 qian). Decoct in water and take orally. After administration, if Jue symptoms subside, once blood stasis pain is relieved, continue using a formula with Renshen, adding Taoren Prunus Seed (15 grains), decocted in ginger water. If thirst occurs, add Renshen (1 qian), Maidong Ophiopogonis Radix (1 qian), Wuweizi Schisandrae Fructus (10 grains). If hands and feet are slightly cold, add Shufu Aconiti Lateralis Radix Praeparata (0.5 qian). If phlegm is present, add Juhong Exocarpium Citri Reticulatae Viride (0.5 qian), Zhuli Bamboo Sap (half cup), Jiangzhi Ginger Juice (2 spoons). If sweating is excessive, add Huangqi (1 qian). If blood stasis pain persists, add Rougu cinnamon Twig (0.5 qian). If deficiency is severe, add Renshen (1-2 qian). If bowel obstruction occurs, add Mahuang Ren Hemp Seed (1.5 qian), and subsequently administer Wuren Wan Five Seeds Pill. Do not use Chengqi Tang (Gastrointestinal Draining Decoction). Regarding Heat Jue, Baihu Tang (White Tiger Decoction) must not be used; for Cold Jue, Sini Tang (Frigid Extremities Decoction) must not be used. This is because postpartum Jue syndrome involves dual deficiency of Qi and Blood, often presenting with pulse depletion. Medication must strongly tonify, with slight additions of Shengjiang Fresh Ginger and Fuzi Prepared Aconite Root to restore Yang. Various postpartum conditions should be treated by modifying Shenghua Tang (Birth Recovery Decoction). As noted in previous sections, accompanying symptoms and their corresponding herbs are listed. For other accompanying symptoms later, one may follow this pattern; details are omitted here.
Postpartum shortness of breath, resembling panting but not true panting, with interrupted breathing. It may be accompanied by heat, or by phlegm, or by both phlegm and heat; all these are critical conditions. Treatment requires strong tonification of Blood and Qi. When accompanied by headache and fever, one must prioritize the postpartum constitution. Physicians specializing in Shanghan (Cold Damage) must strictly avoid dispersing and releasing methods. Danxi stated that postpartum patients must absolutely not be treated with exterior-releasing drugs, which is correct.
Chuanxiong (1 qian), Zaoren Spatholobi Semen (1 qian), Danggui (1.5 qian), Jiangtan (0.4 qian), Zhigancao (0.5 qian), Taoren (15 grains), Renshen (dosage varies). Decoct in jujube soup and take orally. If pulse and form are depleted and life force is nearly extinct, add Renshen (3-4 qian) and administer frequently to rescue. If sweating does not stop, add Renshen and Maidong (each 1 qian). If sweating is profuse and phlegm is severe, add Renshen (3 qian), Zhuli (half cup), Jiangzhi (3 spoons), Xingren Apricot Seed (10 grains). If sweating, panting, coughing, and heavy voice occur, add Jiegeng Platycodon Root and Xingren (each 0.5 qian). If there is no sweat with panting and coughing, add Banxia Pinelliae Tuber (1 qian), Xingren (10 grains), Jiegeng (0.5 qian). If sweating does not cease, after three to four doses, add Huangqi (1 qian). In cases of postpartum sweating and shortness of breath.