产后中风,由产时伤动血气,劳损脏腑,未曾平复,早起劳动,致气虚而风邪乘
之,冷气客于皮肤经络,疼痹羸乏,不任少气。凡筋脉挟寒,则挛急 僻,挟温则纵缓
虚弱。若入诸脏,恍惚惊悸,随其所伤脏腑经络而生病焉。然《大全》曰∶妇人以荣血
为主,因产血下太多,气无所主,唇青肉冷汗出,目眩神昏,命在须臾,此虚极生风
也。若以风药治之则误矣。不问何候,大与温补,十全大补汤加附子,令人推正其身,
一人夹正其面,挖开口灌之,如不得下,令侧其面出之仍灌,热者,又冷又灌,数次即
能下,少倾苏,此立斋法也。
产后血虚,角弓反张,病名曰痉。痉者,劲也。阴气暴虚,阴虚内热,热极生
风,故外现如风假症,实阴血不足,无以养筋所致。厥阴大虚之候,宜益阴补血,血长
而虚风自灭也。
产后中风口噤,是血气虚而风入颔,颊口之筋也。于三阳之筋结于颔,产前劳损脏
腑,伤于筋脉,风乘之,则三阳之筋脉偏虚,得风冷则急,故冷口噤。更有心气虚
极,不能为语而口噤者,惟有峻补之中,兼以通调心气之药。
产后角弓反张者,因气血耗损,腠理不密,汗出过多,神无所主,筋骨失养,而有
此虚象也。乃气血虚极,宜大剂参、桂、 、术、归、地、温养之,不应,再加附子
倍人参,名参附汤,犹未应,乃药力未到,宜多用之。
产后中风,是因为分娩时损伤了气血,劳损了脏腑,身体尚未恢复平复,就过早起床劳作,导致气虚而风邪趁机侵袭。寒气客居在皮肤和经络中,引起疼痛、痹阻、消瘦乏力,无法承受轻微的气短。凡是筋脉夹杂寒邪,就会发生痉挛拘急、口眼歪斜;夹杂温(热)邪,则表现为松弛缓弱、身体虚弱。如果病邪侵入各个脏腑,就会出现神志恍惚、惊悸不安等症状,根据所伤害的脏腑经络不同而产生相应的疾病。然而《大全》中说:妇女以荣血为主,因为分娩时失血过多,气失去了依附的主宰,出现嘴唇发青、肌肉发冷、出汗、头晕眼花、神志昏迷,生命危在旦夕,这是极度虚弱而生内风。如果用治风药来治疗就错了。不论有什么证候,都应当给予大剂量的温补,使用十全大补汤加入附子,让人将患者身体摆正,一人扶正其面部,挖开嘴巴灌药,如果药液下不去,让患者侧脸使药液流出后再灌,如果是热症,又冷又灌,多次之后就能喝下去,过一会儿苏醒,这是薛立斋的方法。
产后血虚,出现角弓反张的症状,病名叫做痉病。“痉”的意思是强劲僵硬。阴气突然虚弱,阴虚导致内热,热极生风,所以外表看起来像外感风邪的假象,实际上是阴血不足,无法滋养筋脉所致。这是厥阴经极度虚弱的表现,应当益阴补血,血液生长充盈后,虚风自然熄灭。
产后中风口噤(牙关紧闭),是气血虚弱而风邪侵入下颌、面颊和口部的筋脉。三阳经的筋脉结于下颌,产前劳损脏腑,伤及筋脉,风邪乘虚而入,导致三阳经的筋脉偏于虚弱,遇到风冷就会拘急,所以导致牙关紧闭。更有甚者,心气极度虚弱,不能言语而导致口噤,只有在峻补之中,兼用通调心气的药物。
产后角弓反张,是因为气血耗损,腠理不紧密,出汗过多,神志无所主宰,筋骨失去滋养,而出现这种虚象。这是气血极度虚弱,应当使用大剂量的人参、桂枝、[缺字]、白术、当归、地黄进行温养,如果不见效,再加附子并加倍人参用量,名为参附汤,如果仍然不见效,那是药力未到,应该多用此方。
Postpartum wind-stroke arises from the injury to Qi and Blood during childbirth, damaging the Zang-Fu organs. If the body has not yet recovered and one rises early to labor, Qi deficiency allows Wind pathogen to take advantage. Cold Qi lodges in the skin and meridians, causing pain, Bi syndrome (painful obstruction), emaciation, and fatigue, making one unable to bear even slight shortness of breath. When tendons and vessels are combined with Cold, spasms and contractures or facial paralysis occur; when combined with Warmth (Heat), they present as flaccidity, laxity, and weakness. If the pathogen enters the Zang-Fu organs, it causes mental confusion and palpitations, generating diseases according to the specific Zang-Fu organs and meridians injured. However, *Da Quan* states: Women rely primarily on Ying Blood. Due to excessive blood loss during childbirth, Qi loses its master anchor, leading to cyanotic lips, cold flesh, sweating, dizziness, coma, and life hanging by a thread. This is internal Wind generated by extreme deficiency. Treating this with Wind-dispelling herbs would be a mistake. Regardless of the symptoms, major warming and tonification should be administered. Use Shiquan Dabu Tang (Complete Ten Tonifying Decoction) added with Fuzi (Aconite Lateral Root). Have someone straighten the patient's body, another hold the face upright, open the mouth, and administer the decoction. If it cannot go down, tilt the head sideways to let it drain out, then continue administering. For heat patterns, administer while hot and cold alternately; after several times, it can be swallowed, and the patient will recover consciousness shortly. This is the method of Xue Lizhai.
Postpartum blood deficiency causing opisthotonos (rigid arching of the back like a bow) is named Jing disease (Spasm). "Jing" means stiffness and strength. Sudden deficiency of Yin Qi leads to Yin deficiency and internal Heat; extreme Heat generates Wind. Thus, external signs mimic Wind pathogen, but it is actually due to insufficient Yin Blood failing to nourish the tendons. This is a sign of extreme deficiency of the Jueyin channel. One should benefit Yin and tonify Blood; once Blood grows, the deficient Wind will naturally extinguish.
Postpartum wind-stroke with trismus (lockjaw) occurs because Qi and Blood are deficient, allowing Wind to enter the tendons of the mandible, cheeks, and mouth. The tendons of the Three Yang channels knot at the mandible. Prior to childbirth, damage to Zang-Fu organs injures the tendons and vessels. Wind takes advantage of this, causing the tendons and vessels of the Three Yang channels to become relatively weak. Upon encountering Wind-Cold, they contract, resulting in lockjaw. Furthermore, if Heart Qi is extremely deficient, speech is impossible, leading to lockjaw. In such cases, within vigorous tonification, one must simultaneously use herbs that unblock and regulate Heart Qi.
Postpartum opisthotonos results from the depletion of Qi and Blood, loose interstices (couli), excessive sweating, loss of mental mastery, and failure of bones and tendons to receive nourishment, presenting as this deficiency pattern. It indicates extreme deficiency of Qi and Blood. Large doses of Renshen (Ginseng Root), Guizhi (Cinnamon Twig), [missing character], Baizhu (Atractylodes Macrocephala Rhizome), Danggui (Angelica Sinensis Root), and Dihuang (Rehmannia Root) should be used for warming and nourishing. If there is no response, add Fuzi (Aconite Lateral Root) and double the dose of Renshen, named Shenfu Tang (Ginseng and Aconite Decoction). If still no response, it is because the medicinal power has not yet taken effect; one should continue using it in larger amounts.