产后大便秘涩,以其失血亡阴,津液不足而然,宜济川煎加减主之。及后立斋法俱妙。
济川煎(见《新方八阵·补阵》)凡病涉虚损而大便闭结不通,则硝黄攻击等剂必不可用,若势有不得
不通者,宜此主之,此用通于补也。
当归(三五钱) 牛膝(二钱) 肉苁蓉(酒洗去咸二、三钱) 泽泻(一钱半) 升麻(五七分或一钱)
枳壳(一钱,虚甚者不必用)
水一钟半,煎八分,食前服。如气虚者,但加人参无碍。如有火加黄芩。如肾虚加熟地。
立斋曰∶前证若计其日期,饮食已多,即用药通之,祸在反掌之间矣。必待其腹满觉胀,欲去不能者,
此乃结在大肠,宜用猪胆汁润之。若服苦寒疏通,反伤中气,通而不止,或成他证。若去血过多,用十全大补
汤;血虚火燥,用加味四物汤;气血俱虚,用八珍汤。虽数日不通,饮食如常,腹中如故,仍用八珍加桃仁、
杏仁治之。若泥其日期饮食之多而通之,则误矣。
十全大补汤(见调经论外备用方)
加味四物汤(见经不调)
八珍汤(见经不调)
《良方》黄龙汤 产后外感(见调经论外备用方)。
《良方》交加散 产后中风(见经痛论外方)。
海藏 愈风汤(见《古方八阵·和阵》)一名举卿古拜散。治一切失血筋脉紧急,产后或汗后搐搦。
荆芥穗(为细末)
上先炒大豆黄卷,以酒沃之,去黄卷,取净汁调前末三四钱服之。轻者一服,重者二、三服即止。气虚者
忌服。童便调亦可。
交加散(见《古方八阵·和阵》)产后类风不省人事。治 或战振或产后不省人事,口吐
痰涎。
当归 荆芥穗(等分)
上为细末,每服二钱,水一钟,酒少许,煎七分,灌服,神效。
《良方》七珍汤(见《妇人规古方》)治产后不语。
人参 石菖蒲 生地 川芎(各一两) 细辛(七钱) 防风 朱砂(另研各半两)
上为末,每服一钱,薄荷汤调服。
补脬饮(见《妇人规古方》)治产后伤动,脬破不能小便而淋沥。
生黄丝绢(一尺剪碎) 白牡丹皮根 白芨(各一钱,俱为末)
用水一碗,同煮至绢烂如饧,空心顿服,服时不得作声,作声则不效。
人参汤 产后诸虚(见调经论外备用方)。
《良方》麻黄根汤(见《妇人规古方》)治产后虚汗不止,身热发渴,惊悸不安。
麻黄根 人参 黄 (炒) 当归 牡蛎( 粉) 甘草
上每服四、五钱,水煎服。
《良方》趁痛散(见《妇人规古方》)治产后骨节疼痛,发热头重,四肢不举。
牛膝(酒炒) 甘草(炒) 薤白(各一两) 当归 白术(炒) 黄 (炒) 桂心 独活(加姜各半两)
上每服半两,水煎。
加味小柴胡汤 乳母肝火发热(见经不调)。
产后大便秘结涩滞,是因为失血导致阴液亏损,津液不足所致,适宜用济川煎加减来主治。以及薛立斋(薛己)的方法都非常精妙。
济川煎(见《新方八阵·补阵》)凡是疾病涉及虚损而大便闭结不通的,那么硝石、大黄等攻下剂绝对不能使用;如果形势上不得不通,适宜用此方主治,这是寓通于补的方法。
当归(三五钱),牛膝(二钱),肉苁蓉(酒洗去咸味二、三钱),泽泻(一钱半),升麻(五七分或一钱),枳壳(一钱,气虚甚者不必用)。
用水一钟半,煎至八分,饭前服用。如气虚者,只加人参无妨。如有火邪加黄芩。如肾虚加熟地黄。
薛立斋说:上述病症如果计算日期,饮食已经很多,就用药通便,祸患就在反掌之间了。必须等到腹部胀满感觉憋胀,想排便却排不出的时候,这才是燥屎结在大肠,适宜用猪胆汁润肠通便。如果服用苦寒疏通的药物,反而损伤中气,导致通泄不止,或者变成其他病症。如果失血过多,用十全大补汤;血虚火燥,用加味四物汤;气血俱虚,用八珍汤。虽然数日不通便,但饮食正常,腹中如常,仍然用八珍汤加桃仁、杏仁治疗。如果拘泥于日期和饮食多而强行通便,那就错了。
十全大补汤(见调经论外备用方)
加味四物汤(见经不调)
八珍汤(见经不调)
《良方》黄龙汤 产后外感(见调经论外备用方)。
《良方》交加散 产后中风(见经痛论外方)。
海藏(张元素弟子张璧,号海藏)愈风汤(见《古方八阵·和阵》),又名举卿古拜散。治疗一切失血导致的筋脉紧急,产后或发汗后出现的抽搐痉挛。
荆芥穗(研为细末)
先炒大豆黄卷,用酒浇淋,去掉豆卷,取纯净汁液调和前述药末三四钱服用。轻症服一次,重症服两三次即止。气虚者忌服。用童便调服也可以。
交加散(见《古方八阵·和阵》)产后类中风神志昏迷。治疗战栗颤抖或产后神志不清,口吐痰涎。
研为细末,每次服用二钱,水一钟,少许酒,煎至七分,灌服,效果神奇。
人参,石菖蒲,生地,川芎(各一两),细辛(七钱),防风,朱砂(另研各半两)
研为末,每次服用一钱,薄荷汤调服。
补脬饮(见《妇人规古方》)治疗产后受伤动胎,膀胱破裂不能小便而淋漓不尽。
用水一碗,同煮至绢烂如糖浆状,空腹顿服,服药时不得出声,出声则无效。
人参汤 产后诸虚(见调经论外备用方)。
《良方》麻黄根汤(见《妇人规古方》)治疗产后虚汗不止,身热发渴,惊悸不安。
每次服用四、五钱,水煎服。
《良方》趁痛散(见《妇人规古方》)治疗产后骨节疼痛,发热头重,四肢无力抬举。
牛膝(酒炒),甘草(炒),薤白(各一两),当归,白术(炒),黄芪(炒),桂心,独活(加生姜各半两)
每次服用半两,水煎。
Postpartum constipation with dryness and difficulty in defecation is caused by blood loss leading to Yin deficiency and insufficient body fluids. It is appropriate to treat it with Jichuan Decoction (Ji Chuan Jian) modified. The methods of Xue Lizhai (Xue Ji) are also excellent.
Jichuan Decoction (See *New Formulas Eight Arrays · Tonifying Array*): For any disease involving deficiency and damage where constipation occurs, harsh purgatives such as Mirabilite (Natrii Sulfas) and Rhubarb (Rhei Radix et Rhizoma) must absolutely not be used. If the condition necessitates unblocking, this formula should be used as the primary treatment; this method embodies "unblocking through tonification."
Angelicae Sinensis Radix (Danggui) (3-5 qian), Achyranthis Bidentatae Radix (Niuxi) (2 qian), Cistanches Herba (Roucongrong) (washed with wine to remove saltiness, 2-3 qian), Alismatis Rhizoma (Zexie) (1.5 qian), Cimicifugae Rhizoma (Shengma) (5-7 fen or 1 qian), Aurantii Fructus (Zhiqiao) (1 qian, omit if Qi deficiency is severe).
Add 1.5 zhong of water, decoct until 0.8 zhong remains, take before meals. If there is Qi deficiency, adding Ginseng Radix et Rhizoma (Renshen) is harmless. If there is Fire, add Scutellariae Radix (Huangqin). If there is Kidney deficiency, add Rehmanniae Radix Preparata (Shudihuang).
Xue Lizhai said: Regarding the above symptoms, if one calculates the days and notes that food intake has been substantial, using medication to induce defecation will bring disaster in an instant. One must wait until abdominal distension is felt, with a sensation of needing to defecate but being unable to do so; this indicates fecal impaction in the Large Intestine (Da Chang), and it is appropriate to use Pig Bile (Zhuyedan) to moisten the intestines. If bitter-cold unblocking herbs are taken, it will instead damage Middle Qi (Zhong Qi), leading to uncontrollable diarrhea or other complications. If blood loss was excessive, use Shiquan Dabu Decoction (Shiquan Dabu Tang); if Blood deficiency with Fire dryness exists, use Jiawei Siwu Decoction (Jiawei Siwu Tang); if both Qi and Blood are deficient, use Bazhen Decoction (Bazhen Tang). Even if defecation does not occur for several days, provided appetite is normal and the abdomen feels unchanged, continue treating with Bazhen Decoction plus Prunus Persica Semen (Taoren) and Armeniacae Semen Amarum (Xingren). If one rigidly adheres to the number of days and high food intake to force defecation, it is an error.
Shiquan Dabu Decoction (See Supplementary Formulas for Menstrual Disorder Theory)
Jiawei Siwu Decoction (See Irregular Menstruation)
Bazhen Decoction (See Irregular Menstruation)
*Liangfang* Huanglong Decoction (Huanglong Tang) for Postpartum External Contraction (See Supplementary Formulas for Menstrual Disorder Theory).
*Liangfang* Jiaojiao Powder (Jiaojiao San) for Postpartum Wind Stroke (See Supplementary Formulas for Menstrual Pain Theory).
Haizang (Zhang Bi) Yufeng Decoction (Yufeng Tang) (See *Ancient Formulas Eight Arrays · Harmonizing Array*), also known as Juqing Gubai San. Treats all cases of tendon and vessel tension due to blood loss, including convulsions and spasms after childbirth or after sweating.
Schizonepetae Spica (Jingjie Sui) (ground into fine powder).
First stir-fry Soybean Sprout (Dadou Huangjuan), pour wine over it, remove the sprouts, and use the clear juice to mix with 3-4 qian of the aforementioned powder. Take orally. Mild cases stop after one dose; severe cases stop after two or three doses. Contraindicated for those with Qi deficiency. Mixing with Child's Urine (Tongbian) is also acceptable.
Jiaojiao Powder (Jiaojiao San) (See *Ancient Formulas Eight Arrays · Harmonizing Array*) for Postpartum Wind-like Syndrome with Loss of Consciousness. Treats shivering/trembling or postpartum unconsciousness with foaming at the mouth.
Angelicae Sinensis Radix (Danggui), Schizonepetae Spica (Jingjie Sui) (equal parts).
Grind into fine powder. Take 2 qian per dose with 1 zhong of water and a little wine, decoct until 0.7 zhong remains, and administer via gavage. Effect is miraculous.
*Liangfang* Qizhen Decoction (Qizhen Tang) (See *Furen Gui Ancient Formulas*) for Postpartum Aphasia.
Ginseng Radix et Rhizoma (Renshen), Acori Tatarinowii Rhizoma (Shichangpu), Rehmanniae Radix (Shengdi), Ligusticum Chuanxiong Rhizoma (Chuanxiong) (each 1 liang), Asari Radix et Rhizoma (Xixin) (7 qian), Saposhnikoviae Radix (Fangfeng), Cinnabaris (Zhusha) (separately ground, each half liang).
Grind into powder. Take 1 qian per dose, mixed with Mint Decoction (Bohe Tang).
Bupao Yin (Bupao Yin) (See *Furen Gui Ancient Formulas*) for Postpartum Injury causing Bladder (Pao) rupture, inability to urinate, and dribbling.
Raw Yellow Silk Gauze (Shenghuangsi Juan) (1 chi, cut into pieces), White Tree Peony Bark Root (Baimudan Pi Gen), Bletillae Rhizoma (Baiji) (each 1 qian, all ground into powder).
Simmer in 1 bowl of water until the silk gauze dissolves like syrup. Take on an empty stomach in one dose. Do not make noise while taking it; making noise renders it ineffective.
Renshen Decoction (Renshen Tang) for Various Deficiencies After Childbirth (See Supplementary Formulas for Menstrual Disorder Theory).
*Liangfang* Mahuanggen Decoction (Mahuanggen Tang) (See *Furen Gui Ancient Formulas*) for Postpartum Profuse Spontaneous Sweating, Fever with Thirst, Palpitations, and Restlessness.
Ephedrae Radix et Rhizoma Root (Mahuanggen), Ginseng Radix et Rhizoma (Renshen), Astragali Radix (Huangqi) (stir-fried), Angelicae Sinensis Radix (Danggui), Ostreae Concha (Muli) (calcined powder), Glycyrrhizae Radix et Rhizoma (Gancao).
Take 4-5 qian per dose, decoct in water and drink.
*Liangfang*chentong San (Chentong San) (See *Furen Gui Ancient Formulas*) for Postpartum Joint Pain, Fever with Heavy Head, and Inability to Lift Limbs.
Achyranthis Bidentatae Radix (Niuxi) (wine-fried), Glycyrrhizae Radix et Rhizoma (Gancao) (stir-fried), Allii Macrostemonis Bulbus (Xiebai) (each 1 liang), Angelicae Sinensis Radix (Danggui), Atractylodis Macrocephalae Rhizoma (Baizhu) (stir-fried), Astragali Radix (Huangqi) (stir-fried), Cinnamomi Cortex (Guixin), Actaeae Radix (Duhuo) (add Ginger, each half liang).
Take half liang per dose, decoct in water.
Jiawei Xiaochaihu Decoction (Jiawei Xiaochaihu Tang) for Lactating Mother's Liver Fire Fever (See Irregular Menstruation).