牛膝(半两) 甘草 薤白(各一分) 当归 桂心 白术 黄 独活 生姜(各半
两)
上 咀,每服半两。水三盏,煎至盏半,去滓,食前服。
陈无择评曰∶趁痛散不特治产后气弱血滞,兼能治太阳经感风头痛、腰背痛,自汗发热
。若其感寒伤食,忧恐惊怒,皆致身疼发热、头痛,况有蓐劳诸证尤甚,趁痛散皆不能疗,
不若五积散入醋煎,用却不妨。(五积散方见《和剂局方》)
论曰∶肾主腰脚。产后腰痛者,为女人肾位系于胞,产则劳伤肾气,损动胞络;虚未平
复而风冷客之,冷气乘腰,故令腰痛也。若寒冷邪气连滞背脊,则痛久未已;后忽有
娠,必致损动。盖胞络属肾,肾主腰故也。
疗产后风冷,腰痛不可转。
独活 川芎 芍药 桂心 续断 生姜 桑寄生(各六分) 当归 防风(各八分)
上 咀,以水三升,煮取一升,去滓,空心分二服。
疗产后虚冷,血气流入腰腿,痛不可转。
败酱 当归(各八分) 川芎 芍药 桂心(各六分)
上 咀,水二升,煮取八合,空心,分温二服。并忌葱。
疗妇人产后余血不尽,血流入腰脚疼痛,胸满气急,两胁痛方。
生姜(一斤) 淡竹叶(一升,切)
上二味,以水二升,煮取一升,去滓,分温二服。
《千金》疗产后中风,腰背强痛,中风烦热、苦渴,头身皆重。此因风冷所致及伤寒。
牛膝(半两) 甘草 薤白(各一分) 当归 桂心 白术 黄芩 独活 生姜(各半两)
以上药材切碎,每次服用半两。加水三盏,煎煮至一盏半,滤去药渣,饭前服用。
陈无择评论说:趁痛散不仅治疗产后气虚血滞,还能治疗太阳经受风引起的头痛、腰背痛,以及自汗发热。如果是感受寒邪或饮食损伤,或因忧恐惊怒导致的身疼发热、头痛,况且还有蓐劳等各种病症更为严重,趁痛散都不能治疗,不如用五积散加醋煎服,这样使用并无妨碍。(五积散的方子见《和剂局方》)
论述说:肾主管腰部和脚部。产后腰痛,是因为女性的肾脏位置与胞宫相连,分娩时劳伤肾气,损伤胞络;身体虚弱尚未恢复时,风冷之邪侵袭,冷气乘虚侵入腰部,所以导致腰痛。如果寒冷邪气连滞于背脊,则疼痛长久不愈;之后如果再次怀孕,必定会导致损伤。这是因为胞络属于肾,而肾主管腰部。
治疗产后受风冷,腰痛不能转动。
独活 川芎 芍药 桂心 续断 生姜 桑寄生(各六分) 当归 防风(各八分)
以上药材切碎,用水三升,煮取一升,滤去药渣,空腹时分两次服用。
治疗产后虚冷,血气流入腰腿,疼痛不能转动。
败酱草 当归(各八分) 川芎 芍药 桂心(各六分)
以上药材切碎,用水二升,煮取八合,空腹,分两次温服。并忌食葱。
治疗妇人产后余血未尽,血液流入腰脚引起疼痛,胸部胀满气急,两侧胁肋疼痛的方子。
生姜(一斤) 淡竹叶(一升,切碎)
以上两味药,用水二升,煮取一升,滤去药渣,分两次温服。
Radix Achyranthis Bidentatae (Niuxi, 牛膝) (half liang), Radix Glycyrrhizae (Gancao), Bulbus Allii Macrostemonis (Xiebai) (each one fen), Radix Angelicae Sinensis (Danggui), Cortex Cinnamomi (Guixin), Rhizoma Atractylodis Macrocephalae (Baizhu), Radix Scutellariae (Huangqin), Radix Angelicae Pubescentis (Duhuo), Rhizoma Zingiberis Recens (Shengjiang) (each half liang).
The above herbs are coarsely chopped. Take half a liang per dose. Add three cups of water, decoct until one and a half cups remain, remove the dregs, and take before meals.
Chen Wuyue commented: Chentong San not only treats postpartum Qi deficiency and blood stasis, but also treats headache, lower back pain, spontaneous sweating, and fever caused by wind invading the Taiyang meridian (Taiyang meridian disease). If the condition is caused by cold invasion or food stagnation, or by worry, fear, shock, or anger leading to body ache, fever, and headache, let alone more severe conditions such as postpartum consumption (Rulao), Chentong San cannot treat them. It is better to use Wuji San (Five Accumulations Powder) decocted with vinegar, which is safe to use. (See Wuji San formula in *Heji Jufang*).
It is stated: The Kidney governs the waist and legs. Lower back pain after childbirth occurs because the Kidney channel connects with the uterus (Bao); childbirth damages Kidney Qi and injures the Bao collateral; when the deficiency has not yet recovered, wind-cold pathogens invade, and cold qi attacks the waist, causing lower back pain. If cold pathogenic qi lingers in the spine, the pain persists for a long time; if pregnancy occurs subsequently, it will inevitably cause damage. This is because the Bao collateral belongs to the Kidney, and the Kidney governs the waist.
To treat postpartum wind-cold causing lower back pain with inability to turn:
Radix Angelicae Pubescentis (Duhuo), Radix Chuanxiong (Chuanxiong), Radix Paeoniae Alba (Shaoyao), Cortex Cinnamomi (Guixin), Radix Dipsaci (Xuduan), Rhizoma Zingiberis Recens (Shengjiang), Ramulus Taxilli (Sangjisheng) (each six fen), Radix Angelicae Sinensis (Danggui), Radix Saposhnikoviae (Fangfeng) (each eight fen).
The above herbs are coarsely chopped. Add three sheng of water, boil to obtain one sheng, remove the dregs, and divide into two doses to take on an empty stomach.
To treat postpartum deficiency-cold where blood and qi flow into the waist and legs, causing pain with inability to turn:
Herba Patriniae (Baijiangcao), Radix Angelicae Sinensis (Danggui) (each eight fen), Radix Chuanxiong (Chuanxiong), Radix Paeoniae Alba (Shaoyao), Cortex Cinnamomi (Guixin) (each six fen).
The above herbs are coarsely chopped. Add two sheng of water, boil to obtain eight ge, and divide into two warm doses to take on an empty stomach. Avoid green onions.
Formula for treating residual blood after childbirth that flows into the waist and feet causing pain, chest fullness, shortness of breath, and pain in both hypochondria:
Rhizoma Zingiberis Recens (Shengjiang) (one jin), Folium Bambusae in Templa (Danzhuye) (one sheng, cut).
The above two ingredients are added with two sheng of water, boiled to obtain one sheng, the dregs removed, and divided into two warm doses.
*Qianjin Fang* treats postpartum wind-stroke with stiffness and pain in the waist and back, restlessness and heat from wind-stroke, extreme thirst, and heaviness of the head and body. This is caused by wind-cold and cold damage (Shanghan).