凡产后形体劳倦,脾胃俱伤,是以新产之后,禁膏粱,远浓味,食粥茹蔬,乃切务也。不善调
摄之家,惟虑产妇之虚,以多食有益,浓味为补,本不思而强与厌足而复伤,胃虽少纳,脾转运迟,食
停痞塞,嗳酸恶食,良以此也。治当扶元为主,温补气血,健脾助胃,养正兼消,审伤何物,佐以消
导,斯脾气复而转输,滞物行而胃始思谷矣。
加味生化汤 治产后血块未消时,及宿食不消。
川芎(二钱) 川归(五钱) 干姜(四分,制) 甘草(五分,炙)
如伤面食,加神曲一钱,麦芽六分;如伤肉加山楂五分,砂仁五分;伤寒物痛,加吴萸一钱,肉桂
五分;虚加参三钱。
健脾消食生化汤 治产后血块痛除,服此方以消食。
川芎(一钱) 川归(三钱) 甘草(五分,炙) 人参(二钱) 白术(一钱半)
伤面食,加神曲、麦芽各七分;如伤肉,加山植、砂仁各八分。身热不可用黄连、黄芩、黄柏;
大便不通,禁大黄;伤食怒气,不可用耗气。若宿痰胞食,丸药随即进补药。凡年老虚弱人患崩,
宜用升举大补汤。
凡产妇血脱劳伤之甚,气无倚恃,而呼吸息止之违常性矣,世有妄议痰火,反用散气化痰之方,
不亦误乎?夫肺受脾禀,运气生脉,通水道,顺呼吸,清肃上下,调和荣卫,而为平人之常气也。
值产血亡气脱,呼吸短促,言语不相接续,似喘危证,不待诊脉问望自明,智者当知之也。
加参生化汤 治分娩即患气短似喘症,若有血块,不可加 、术。
川芎(二钱) 川归(四钱) 甘草(五分,炙) 干姜(四分,炒黑) 人参(二钱) 桃仁(十
粒,去皮尖)
上煎服,加枣三枚,连进二三帖。
续气养荣汤 治产后气短促,问无血块痛宜服。
川芎(二钱) 川归(四钱) 甘草(五分,炙) 干姜(四分,炒黑) 人参(三钱) 黄
(一钱) 白术(一钱) 陈皮(四分) 熟地(二钱)
如足冷,加熟附子三分,汗多,加麻黄根一钱,浮小麦一撮;渴,加麦冬一钱,五味子十粒;大便
不通,加苁蓉一钱,麻仁一钱;如伤面食,加神曲一钱,麦芽一钱;如伤肉,加山楂五个,砂仁五分。
附方∶滋荣益气复神汤,见上。
凡是产后身体疲劳倦怠,脾胃都受到损伤,因此在刚生产之后,禁止食用油腻精细的食物,远离浓烈厚味的菜肴,喝粥吃蔬菜,这才是至关重要的事情。不善于调养护理的家庭,只担心产妇虚弱,认为多吃东西有益,用浓味食物来进补,本来没有食欲却强行喂食,吃饱后又导致受伤,胃虽然摄入少量食物,但脾脏运化迟缓,食物停滞堵塞,嗳气带有酸味、厌恶进食,原因就在这里。治疗应当以扶持元气为主,温补气血,健脾助胃,在养护正气的同时兼顾消导,仔细审查是伤了什么食物,辅助以消食导滞的药物,这样脾气恢复而转输功能正常,停滞的食物排出后胃才开始想吃谷物了。
加味生化汤:治疗产后血块尚未消除时,以及宿食不消化的情况。
川芎(二钱) 当归(五钱) 干姜(四分,炮制) 甘草(五分,炙烤)
如果因面食积滞,加神曲一钱,麦芽六分;如果因肉食积滞,加山楂五分,砂仁五分;如果因寒凉食物引起疼痛,加吴茱萸一钱,肉桂五分;如果是虚证,加人参三钱。
健脾消食生化汤:治疗产后血块疼痛消除后,服用此方以消化食物。
川芎(一钱) 当归(三钱) 甘草(五分,炙烤) 人参(二钱) 白术(一钱半)
如果因面食积滞,加神曲、麦芽各七分;如果因肉食积滞,加山楂、砂仁各八分。身体发热者不可使用黄连、黄芩、黄柏;大便不通者,禁用大黄;因伤食兼怒气者,不可使用耗损元气的药物。如果有宿痰和胞衣残留,丸药服完后随即进补药。凡是年老体弱之人患崩漏症,宜使用升举大补汤。
凡是产妇因失血过多且劳伤严重,气无所依附,导致呼吸气息停止违背常理的情况,世间有人妄加议论说是痰火作祟,反而使用散气化痰的方剂,这不是错误了吗?肺接受脾的滋养,依靠运气生成脉象,通调水道,顺应呼吸,清肃上下,调和营卫,这是健康人的常态之气。正值分娩时血液流失、气随血脱,呼吸短促,言语不能接续,类似喘息的危重证候,不需要诊脉望诊就能明白,明智的人应当知晓这一点。
加参生化汤:治疗分娩后立即出现气短似喘息症状,如果有血块,不可加白芍、白术。
川芎(二钱) 当归(四钱) 甘草(五分,炙烤) 干姜(四分,炒黑) 人参(二钱) 桃仁(十粒,去皮尖)
以上药材煎煮服用,加红枣三枚,连续服用二三帖。
续气养荣汤:治疗产后气短促,询问无血块疼痛者适宜服用。
川芎(二钱) 当归(四钱) 甘草(五分,炙烤) 干姜(四分,炒黑) 人参(三钱) 黄芪(一钱) 白术(一钱) 陈皮(四分) 熟地黄(二钱)
如果脚冷,加熟附子三分,汗多,加麻黄根一钱,浮小麦一撮;口渴,加麦冬一钱,五味子十粒;大便不通,加肉苁蓉一钱,火麻仁一钱;如果因面食积滞,加神曲一钱,麦芽一钱;如果因肉食积滞,加山楂五个,砂仁五分。
附方:滋荣益气复神汤,见上文。
Whenever postpartum physical fatigue and exhaustion occur, both the Spleen and Stomach are injured. Therefore, immediately after childbirth, it is imperative to prohibit the consumption of rich and greasy foods, avoid strong-flavored dishes, and consume porridge and vegetables. Families that fail to provide proper care often worry about the mother's deficiency, believing that eating more is beneficial and that rich flavors act as tonics. They force-feed the mother when she has no appetite; after overeating, injury occurs. Although the Stomach accepts a small amount of food, the Spleen's transportation and transformation function is slow. Food stagnates and blocks the middle jiao, leading to belching with an acidic taste and aversion to food. This is the cause. Treatment should primarily focus on supporting the Yuan Qi (Original Qi), warming and tonifying Qi and Blood, strengthening the Spleen and assisting the Stomach, nourishing the healthy Qi while simultaneously promoting digestion. One must carefully examine what food was ingested and assist with digestive herbs. In this way, the Spleen Qi recovers and its transportive function normalizes, stagnant food moves, and the Stomach begins to desire grain again.
Jiawei Shenghua Tang (Modified Birth-Expelling Decoction): Treats cases where postpartum blood clots have not yet dissipated and residual food remains undigested.
Chuanxiong Rhizome (2 qian) Danggui Radix (5 qian) Dried Ginger (4 fen, processed) Licorice Root (5 fen, honey-fried)
If the injury is due to wheat products, add Medicated Leaven (1 qian) and Hordeum Sprout (6 fen); if due to meat, add Hawthorn Fruit (5 fen) and Amomum Fruit (5 fen); if pain is caused by cold-damaged food, add Evodia Fruit (1 qian) and Cinnamon Bark (5 fen); if there is deficiency, add Ginseng Radix (3 qian).
Jianpi Xiaoshi Shenghua Tang (Spleen-Strengthening and Food-Digesting Birth-Expelling Decoction): Used after postpartum blood clot pain has subsided to digest food.
Chuanxiong Rhizome (1 qian) Danggui Radix (3 qian) Licorice Root (5 fen, honey-fried) Ginseng Radix (2 qian) Atractylodes Macrocephala Rhizome (1.5 qian)
If injured by wheat products, add Medicated Leaven and Hordeum Sprout (7 fen each); if injured by meat, add Hawthorn Fruit and Amomum Fruit (8 fen each). If the body is hot, do not use Scutellaria Root, Scutellaria Baicalensis Root, or Phellodendron Bark; if constipation exists, do not use Rhubarb Rhizome; if injured by food combined with anger, do not use herbs that deplete Qi. If there is residual phlegm and retained placenta, administer pills followed immediately by tonic medicines. For elderly and weak individuals suffering from metrorrhagia (Beng Lou), Shengju Dabu Tang (Lifting and Great Tonifying Decoction) is suitable.
When a parturient suffers severely from blood loss and labor injury, Qi lacks support, causing respiration to cease abnormally. Some mistakenly attribute this to Phlegm-Fire and prescribe formulas that dissipate Qi and resolve phlegm, which is indeed an error. The Lung receives endowment from the Spleen, relies on the movement of Qi to generate pulses, unblocks water passages, regulates respiration, clears and purifies the upper and lower Jiao, and harmonizes Ying (Nutritive) and Wei (Defensive) Qi, constituting the normal breath of a healthy person. During childbirth, with blood loss and Qi collapse, respiration becomes short and rapid, speech cannot continue, presenting a critical condition resembling asthma. This is evident without pulse diagnosis or observation; the wise should understand this.
Jia Shen Shenghua Tang (Ginseng-Added Birth-Expelling Decoction): Treats immediate onset of shortness of breath resembling asthma after delivery. If blood clots are present, do not add White Peony Root or Atractylodes Macrocephala Rhizome.
Chuanxiong Rhizome (2 qian) Danggui Radix (4 qian) Licorice Root (5 fen, honey-fried) Dried Ginger (4 fen, charred) Ginseng Radix (2 qian) Peach Seed (10 grains, skin and tip removed)
Decoct and take orally. Add three Jujubes. Continue for two or three doses.
Xuqi Yangrong Tang (Qi-Continuing and Nutritive-Tonifying Decoction): Treats postpartum shortness of breath; suitable for cases without blood clot pain.
Chuanxiong Rhizome (2 qian) Danggui Radix (4 qian) Licorice Root (5 fen, honey-fried) Dried Ginger (4 fen, charred) Ginseng Radix (3 qian) Astragalus Root (1 qian) Atractylodes Macrocephala Rhizome (1 qian) Tangerine Peel (4 fen) Prepared Rehmannia Root (2 qian)
If feet are cold, add Prepared Aconite Lateralis Radix (3 fen); if sweating is excessive, add Hemp Root (1 qian) and Floating Wheat (a pinch); if thirsty, add Ophiopogon Tuber (1 qian) and Schisandra Berry (10 grains); if constipated, add Cistanche Stem (1 qian) and Hemp Seed (1 qian); if injured by wheat products, add Medicated Leaven (1 qian) and Hordeum Sprout (1 qian); if injured by meat, add five Hawthorn Fruits and Amomum Fruit (5 fen).
Supplementary Formula: Zirong Yiqi Fushen Tang (Nutritive-Tonifying, Qi-Replenishing, and Spirit-Restoring Decoction), see above.