产后中风惟大补,火气风痰末治之,十全大补为主剂,临证详参佐使宜。
【注】产后气血大虚,虽患中风,惟宜大补。即有火热、风痰、气闭,亦当末治。总
以十全大补汤主之,临证详参其火气风痰而佐使之。
十全大补汤(方见首卷)
加味八珍汤
新产血虚多汗出,易中风邪痉病成,口噤项强身反折,八珍 附桂防风;摇头气促汗不止,两手撮空莫望生。
【注】产后血气不足,脏腑皆虚,多汗出,
腠理不密,风邪乘虚袭入,遂成痉证。手三阳之筋结于颔颊,风入颔颊则口噤。阴阳经
络周环于身,风中经络,则头项、肩背强直,如角弓反张之状。产后患此,皆属虚象。惟
宜用八珍汤加黄 、附子、肉桂,大补其阴阳,少佐防风以治之。若见头摇喘促,汗出
不止,两手撮空者,则为真气去,邪气独留,必死之候,故曰莫望生也。
八珍汤(方见首卷)
加味八珍汤
阴血去多阳气炽,筋无所养致抽搐,发热恶寒烦又渴,八珍丹地钩藤钩。抽搐无力戴眼折,大汗不止命将休。
【注】产后血去大多,阳气炽盛,筋无所养,必致螈 抽搐、发热恶寒、心烦口渴,不
宜作风治,惟当气血兼补,用八珍汤加丹皮、生地、钩藤钩治之。若无力抽搐,戴眼反折,
大汗不止者,则为不治之证,故曰命将休也。
八珍汤(方见首卷)
产后中风应以大补气血为主,火热、风痰等邪气应作为次要考虑。以十全大补汤(Shiquan Dabu Decoction)为主要方剂,临证时需详细参考并适宜地配伍佐使药。
【注】产后气血严重亏虚,即使患中风,也应当以大补为主。即便存在火热、风痰或气闭的情况,也应将其置于次要地位治疗。始终以十全大补汤(Shiquan Dabu Decoction)为主方,临证时根据火热、风痰的具体情况,适当添加佐使药进行调理。
十全大补汤(Shiquan Dabu Decoction)(方剂见首卷)
加味八珍汤(Jiawei Bazhen Decoction)
新近分娩后血虚且多汗出,容易感受风邪而发展为痉病(Jing Disease, Spasm Disorder),出现牙关紧闭、项背强直、身体反折等症状,可用八珍汤(Bazhen Decoction)加入黄芪(Huangqi, Astragali Radix)、附子(Fuzi, Aconiti Lateralis Radix Praeparata)、肉桂(Rougui, Cinnamomi Cortex)及防风(Fangfeng, Saposhnikoviae Radix)。若出现摇头、气促、汗出不止,两手撮空者,则预后不良,难以救治。
【注】产后气血不足,脏腑功能皆虚弱,导致多汗出,腠理(Cou Li, Pores and Intercellular Spaces)不紧密,风邪乘虚侵入,从而形成痉病(Jing Disease, Spasm Disorder)。手三阳经的筋脉结聚于下颌和面颊,风邪侵入此处则导致牙关紧闭。阴阳经络环绕全身,风邪中于经络,则头项、肩背强直,呈现如角弓反张(Jiaogong Fanzhang, Opisthotonos)的状态。产后患此病,均属虚证表现。应当使用八珍汤(Bazhen Decoction)加入黄芪(Huangqi, Astragali Radix)、附子(Fuzi, Aconiti Lateralis Radix Praeparata)、肉桂(Rougui, Cinnamomi Cortex),大补阴阳,少佐防风(Fangfeng, Saposhnikoviae Radix)以祛风治之。若见到头摇、喘促、汗出不止、两手撮空的症状,则是真气耗散、邪气独留的表现,属于必死的征候,所以说“莫望生”(难以指望生存)。
八珍汤(Bazhen Decoction)(方剂见首卷)
加味八珍汤(Jiawei Bazhen Decoction)
阴血流失过多导致阳气炽盛,筋脉失去滋养而引发抽搐(Chou Chu, Convulsion/Twitching),伴有发热恶寒、心烦口渴,不应按风证治疗,只当气血双补,用八珍汤(Bazhen Decoction)加入丹皮(Danpi, Moutan Cortex)、生地(Shengdi, Rehmanniae Radix)及钩藤钩(Goutenggou, Uncariae Ramulus cum Uncis)。若抽搐无力、戴眼(Daiyan, Upward Deviation of Eyes)反折,大汗不止者,则生命垂危。
【注】产后失血过多,阳气相对炽盛,筋脉得不到滋养,必然导致抽搐(Chou Chu, Convulsion/Twitching)、发热恶寒、心烦口渴,不宜当作外风证治疗,只应当气血兼补,使用八珍汤(Bazhen Decoction)加入丹皮(Danpi, Moutan Cortex)、生地(Shengdi, Rehmanniae Radix)、钩藤钩(Goutenggou, Uncariae Ramulus cum Uncis)来治疗。若出现无力抽搐、戴眼(Daiyan, Upward Deviation of Eyes)反折、大汗不止的情况,则属于不治之证,所以说“命将休”(生命即将终结)。
八珍汤(Bazhen Decoction)(方剂见首卷)
Postpartum wind-stroke should primarily be treated with substantial tonification; fire-heat, wind-phlegm, and other pathogenic factors are secondary considerations. The principal formula is Shiquan Dabu Decoction (Ten Complete Tonic Decoction), and in clinical practice, adjuvant and guiding herbs (Zuo Shi) should be carefully selected based on the specific presentation.
[Note] After childbirth, Qi and Blood are severely deficient. Even if wind-stroke occurs, treatment must focus on substantial tonification. Even if there are manifestations of fire-heat, wind-phlegm, or Qi stagnation, these should be addressed secondarily. Always use Shiquan Dabu Decoction (Ten Complete Tonic Decoction) as the main formula, adjusting with adjuvant and guiding herbs according to the presence of fire-heat, wind-phlegm, etc.
Shiquan Dabu Decoction (Ten Complete Tonic Decoction) (See formula in Volume 1)
Modified Bazhen Decoction (Eight Treasure Decoction Plus)
Following recent delivery, Blood deficiency often leads to profuse sweating, making the body susceptible to wind-pathogen invasion, which may develop into Jing Disease (Spasm Disorder). Symptoms include trismus (lockjaw), stiffness of the neck and back, and opisthotonos (body arching backward like a bow). Treatment involves Bazhen Decoction (Eight Treasure Decoction) supplemented with Huangqi (Astragali Radix), Fuzi (Prepared Aconite Root), Rougui (Cinnamon Bark), and Fangfeng (Saposhnikovia Root). If symptoms progress to head shaking, shortness of breath, incessant sweating, and "picking at empty air" (involuntary hand movements without purpose), the prognosis is poor, and survival is unlikely.
[Note] Postpartum Qi and Blood insufficiency leads to weakness of the Zang-Fu organs. Profuse sweating results in loose Cou Li (skin pores and interstices), allowing wind-pathogens to invade due to deficiency, thereby forming Jing Disease (Spasm Disorder). The sinews of the three Yang meridians of the hand converge at the jaw and cheeks; wind entering this area causes trismus. The Yin and Yang meridians circulate around the body; wind invading the meridians causes stiffness in the head, neck, shoulders, and back, resembling opisthotonos. Such cases after childbirth are all characterized by deficiency. One should use Bazhen Decoction (Eight Treasure Decoction) added with Huangqi (Astragali Radix), Fuzi (Prepared Aconite Root), and Rougui (Cinnamon Bark) to substantially tonify Yin and Yang, with a small amount of Fangfeng (Saposhnikovia Root) to dispel wind. If head shaking, panting, incessant sweating, and picking at empty air appear, it indicates the dissipation of True Qi and the retention of pathogenic factors alone, which is a fatal sign; hence, it is said that survival cannot be expected.
Bazhen Decoction (Eight Treasure Decoction) (See formula in Volume 1)
Modified Bazhen Decoction (Eight Treasure Decoction Plus)
Excessive loss of Yin-Blood leads to hyperactive Yang, causing the sinews to lose nourishment and resulting in convulsions. Accompanying symptoms include fever, aversion to cold, irritability, and thirst. This should not be treated as an external wind condition but rather as a need to tonify both Qi and Blood. Use Bazhen Decoction (Eight Treasure Decoction) added with Danpi (Moutan Cortex), Shengdi (Rehmannia Root), and Goutenggou (Uncaria Hook). If convulsions are weak, accompanied by Daiyan (upward deviation of the eyes) and opisthotonos, along with incessant sweating, life is in imminent danger.
[Note] Excessive blood loss postpartum leads to relative hyperactivity of Yang. Without sufficient nourishment, the sinews inevitably lead to convulsions, fever, aversion to cold, irritability, and thirst. It should not be treated as wind-stroke but requires simultaneous tonification of Qi and Blood. Use Bazhen Decoction (Eight Treasure Decoction) added with Danpi (Moutan Cortex), Shengdi (Rehmannia Root), and Goutenggou (Uncaria Hook). If convulsions are weak, with Daiyan (upward deviation of the eyes) and opisthotonos, and incessant sweating occur, it constitutes an incurable condition; hence, it is said that life is about to end.
Bazhen Decoction (Eight Treasure Decoction) (See formula in Volume 1)