右 产后数载,经事不行,然于当至之期,辄腰腹作痛,有欲行不行之势。此冲气不和,冲脉不利,理宜
宣通营卫。兹以喉证之后,余毒未清,不得不为兼顾也。
磨郁金(五分) 光杏仁(三钱) 生牛膝(三钱) 炒川断肉(三钱) 射干(四分) 蜜炙香附(二钱)
大贝母(二钱) 卷柏(一钱五分) 延胡索(一钱) 桃仁(二钱) 橘络(二钱红花汤拌炒)
右 胎前痛痢,因病而产,产后痢仍不止,里急后重,粕腻色赤而黑。气瘀交阻,极重之证。备方以冀造化。
延胡索(一钱五分) 砂仁(后入七分) 茯苓(四钱) 楂炭(三钱) 乌药(一钱五分) 煨木香(五分
)广皮(一钱) 赤砂糖(五钱上三味同炒枯研末绢包入煎) 泽兰(二钱) 伏龙肝(一两煎汤代水)
另用楂炭三钱,赤砂糖六钱,二味同炒枯研末,米饮为丸如桐子大,每服三钱,药汁送下。
复诊 痛坠已退,腹满亦减,然痢数仍在十次以外。气瘀未化,而脾虚气弱,不克厘清。虽见转机,尚不
足恃。
于术(土炒二钱) 煨木香(五分) 延胡索(酒炒一钱五分) 土炒陈皮(一钱) 泽泻(一钱五分) 茯苓
(四钱) 桂枝(五分) 赤芍(土炒一钱五分) 泽兰叶(二钱) 伏龙肝(一两五钱煎汤代水)仍用前法楂炭
砂糖丸。
三诊 恶露稍鬯,痛痢渐止。出险履夷,殆所谓天授,非人力也。
土炒于术(二钱) 酒炒延胡(一钱五分) 楂炭(三钱) 炮姜(五分) 砂仁(七分) 泽兰叶(二钱)
茯苓(三钱) 丹参(二钱) 降香(一钱五分) 桂枝(五分)
右 产后不慎,营卫气血不宣。势入损途,有鞭长莫及之虞。
延胡索(二钱) 蒲黄(二钱) 桃仁(二钱) 酒炒红花(一钱五分) 炒赤芍(二钱) 泽兰叶(二钱)
徭桂(一钱) 川芎(一钱)
上药醋浸一宿煎。另用西血珀二分,空心先服。
右 产后不时发热,腹中作痛。营虚挟滞未清,久恐延损。
延胡索 广郁金 乌药 楂炭 降香 砂仁 炒青蒿 西血珀 制香附
刘(右) 产后两月,下痢不止,色黄而腻,身热脉濡。气湿不宣,恐成休息。
广皮 煨木香 泽泻 南楂炭(赤砂糖三钱同炒枯研末绢包入煎) 茯苓
炒枳实 乌药 生薏仁 赤芍(甘草三分煎汤收入) 砂仁
右 产后恶露未清,营气阻滞,营失流畅,气聚成形,腹中痛胀,寒热往来。脉数而弦恐从实变虚,而至难复。
醋炒柴胡 延胡索 金铃子 台乌药 焦麦芽 当归炭 炒赤芍 川郁金 南楂炭 震灵丹
马(右) 新产之后,气逆如喘,痰多白腻,不能着卧。心悸汗出,耳鸣头晕,悉与气逆之轻重而为出入。夫
产后发喘,历代名贤咸以为阴虚虚火克金,肺气欲绝,最为危险之候。救援之法,则有生脉。阅前方按
法施治,应验不验。详询起居,知胎前与初产之时,曾以湿巾揩身,窍毫疏泄,百脉弛张之际,其水寒之
气,袭于外则应于内,内经谓形寒饮冷则伤肺,以其两寒相感,中外皆伤,故气逆而上行,经文如此,与
病大致相符。今诊六脉虚微,右寸关沉弦。半身以上疹 密布。外无感触,安得有此。云翁先生所见独
精,药归平淡,转比生脉等方稍有起色。兹从其意,略再扩充,作背城之一。但病在危急,平反前方,济与
不济,非所计也方草商之。
旋复花(二钱) 光杏仁(三钱) 川桂枝(五分) 地骨皮(一钱五分与川桂枝同炒) 紫丹参(二钱)
僵蚕(一钱五分) 茯苓(四钱) 橘红(一钱)
王(右) 产后旬日,外感风邪,头痛发热,得汗不解,两日来恶露涩少,少腹作痛,按之微硬,牵引腰尻,动
辄作痛。脉数浮大,左部沉迟。风邪袭于外,气瘀阻于内,恐成时证。姑疏风而宣通营卫。
全当归 酒炒荆芥 川芎 五灵脂 蓬莪术 台乌药
延胡索 紫丹参 泽泻 楂肉炭 乳香 没药 益母草(煎汤代水)
某(右) 产后腹痛有形,临圊更甚,自汗便秘。此恶露未清,营郁气滞也。
延胡索 金铃子 焦楂炭 炒赤芍 火麻仁 乌药
香附 归尾 香橼皮 上徭桂(饭丸)
凡产后瘀行之期,男胎约半月,女胎须一月,恶露方清。稍稍自汗,不妨汗则血之所化,自汗而并无烦扰之象
者,不必治其汗也。(清儒附志)
韦(右) 小产之后,气血两亏,胃呆少纳,头痛眩晕心悸,腰酸带下。拟补气和营熄肝。
奎党参(三钱) 炒木瓜皮(一钱五分) 杭白芍(酒炒一钱五分) 浓杜仲(三钱) 炙甘草(三分) 酒炒
当归(二钱) 茯苓神(各二钱) 生熟谷芽(各二钱) 黑豆衣(三钱) 玫瑰花(二朵)
二诊 甘以益胃,酸以制木,胃纳稍起,心悸眩晕亦减,然带下不止。前法再参固摄。
奎党参(三钱) 生山药(三钱) 黑豆衣(三钱) 炙黑草(三分) 浓杜仲(三钱) 炒木瓜皮(一钱五分)
牡蛎(五钱) 潼沙苑(盐水炒三钱) 池菊(一钱五分) 茯神(三钱)
三诊 心悸已定,胃纳不馨,带下眩晕。再和中健脾,以退为进。
制半夏(一钱五分) 范志曲(炒一钱五分) 陈皮(一钱) 砂仁(五分) 莲须(一钱) 炒山药(三钱)
炒于术(二钱) 潼沙苑(盐水炒三钱) 资生丸(四钱二次服) 牡蛎(四钱)
王(右) 怀孕七月,忽然头痛发痉,神昏不语名曰子痫。都缘胎热有余火风鸱,张胎受热迫,竟至胎坠。
乃小产之后,恶露不行,神糊妄语。脉象弦紧。此由败血上冲,极为危险。拟方请商。
丹参(二钱) 酒炒荆芥(一钱五分) 五灵脂(酒炒三钱) 全归(三钱) 泽兰(三钱) 川芎(一钱)
延胡索(酒炒一钱五分) 赤苓(三钱) 西血珀末(蜜调冲六分) 生蒲黄(一钱五分) 热童便(半杯冲)
益母草(煎汤代水)
周(右) 产后恶露未行,气血凝滞,腹中有形作痛,临圊更甚。脉细关弦。气升汗出不止。此营滞阻气,气
滞为液,液泄为汗。宜宣通和化,所谓通则不痛也。
延胡索 金铃子 焦楂炭 炒赤芍 火麻仁 乌药 香附 归尾 香橼皮 上徭桂(饭丸)
汗为血之液,夺血者无汗,此指脱血者言也。产后瘀露,乃有余之血,非脱血可比。初产百脉沸腾,阴虚阳亢,啜
热汤饮而津津汗出者,此卫气流通,阳从汗泄,身体自觉舒和。金匮云亡阴血,虚阳气独盛,故当汗出,阴阳乃
复,此之谓也。若绝无汗,则卫气闭塞,必将有发热之症矣。所以产妇宜微汗,而不宜无汗,宜有汗而不宜多汗。
案中荣滞阻气数语,得古圣之粗髓而融化之,言言金玉,字字珠玑,直足与金匮相颉颃矣。(文涵志)
二诊 上逆之气稍平,而临圊仍然腹痛,大便艰涩。血燥气滞。前法参入子和玉烛散出入。
炙生地 酒炒归身 制香附 金铃子 延胡索 川朴 缩砂仁 炒赤芍 酒炒上湘军(后入二钱) 徭桂(
饭丸)
三诊 脉弦稍收,便稍转润,临圊作痛亦减。足见血燥气滞,府浊因而不泄。前法再参破浊。
金铃子 九节菖蒲 川朴 郁金 藿香 延胡 磨沉香 炒赤芍 香附 砂仁 火麻仁
四诊 痛势已定,惟临圊尚觉不爽。的是血凝气滞,不能上交少阳,而反下陷于太阴也。前法再进一筹。
醋炒柴胡(五分) 金铃子(一钱五分) 楂炭(三钱) 香附(二钱) 杭白芍(三钱) 醋炒青皮
(一钱) 当归(二钱) 砂仁(五分) 乌药(一钱五分)
卢(右) 胃痛日久不止,经来淋沥,少腹坠痛,两足酸楚,不能步履。营血不足,营滞未楚。调治不易。
生熟蒲黄 元胡索 茜草炭 乌贼骨 制香附 白蒺藜 全当归 川断肉 川芎 乌药 降香
服此方后,下血球形如长芋,坠痛乃减,盖小产也。小产亦宜服苦草汤。(正蒙附志)
二诊 热势渐退,少腹痛坠亦定。再和营而除陈布新。
当归 川芎 桑寄生 酒炒荆芥 白蒺藜 秦艽 丹参 炒川断 茯神 泽兰
三诊 少腹坠痛渐定,营卫渐通,手足酸痛大退。再除陈布新,宣通络坠。
怀牛膝 酒炒荆芥 当归 秦艽 川芎 桑寄生 酒炒红花 川断 丹参 泽兰
四诊 小产仅二旬耳,当风纳凉,视同儿戏。言者谆谆,听者藐藐,岂值头疼身热而已哉。姑以轻剂疏之。
川芎 当归 秦艽 续断 丹参 桑寄生
牛膝 僵蚕 玉竹 苏子 酒炒荆芥
李(右) 胎前感风,产后不彻,咳嗽三月有余,痰多口腻,凛寒内热,汗出不能左卧。脉象细数微滑。久咳
损肺,阴阳之二气有偏,气即为火,液即为痰,证入损门,非才疏者所能言治也。
南沙参(三钱) 光杏仁(三钱) 蛤粉(三钱) 炒苏子(三钱) 炙紫菀(一钱) 川贝母(一钱五
分) 旋复花(二钱) 白茯苓(三钱) 盐水炒橘红(一钱)
二诊 咳嗽虽减,然仍不能左卧,大便旬日方行,心悸目昏,凛热汗出。皆属损象,不敢言治。
北沙参(四钱) 川贝母(二钱) 光杏仁(三钱) 炒枣仁(三钱) 生山药(三钱) 大天冬(三钱)
生白芍(一钱五分) 当归炭(一钱五分) 炒怀牛膝(三钱) 炙款冬(二钱) 茯神(三钱) 都气丸(三钱开水
先送下)
朱(右) 产后匝月,少腹坠痛,腿股腰尻作酸带下阵阵,向来并有结块同下,腹满不舒,胃钝少纳,脉象
弦紧。此由旬日之间恶露停留,旋虽复至,而脉络已滞,遂令瘀浊化带。恐其崩败。
全当归(酒炒二钱) 川断肉(三钱) 茜草炭(一钱) 白蒺藜(三钱) 茯神(三钱) 川贝(一钱)
乌贼骨(三钱) 紫丹参(二钱) 泽兰叶(一钱五分) 南枣(三枚)
改方加炒熟地四钱,乌药一钱五分,香附二钱。
二诊 带下稍减,少腹仍痛。还是瘀浊未清。
全当归(二钱) 白蒺藜(三钱) 制香附(二钱) 乌贼骨(三钱) 川断肉(三钱) 紫丹参(二钱)
台乌药(一钱五分) 茜草炭(一钱五分) 生熟谷芽(各一钱) 鲍鱼片(酒洗二钱)
三诊 稍下紫瘀,少腹坠痛已定,带下亦减。然胃仍少纳,头巅作痛。再参和中泄木。
白蒺藜(三钱) 乌贼骨(三钱) 全当归(酒炒二钱) 川芎(一钱) 黑豆衣(三钱) 茜草炭(一钱五分)
佩兰叶(一钱五分) 池菊(一钱五分) 生熟谷芽(各一钱) 鲍鱼(酒洗二钱)
四诊 瘀露通行,带下已止,而外感风邪,咳嗽痰多音塞。肝气郁发,胸脘作痛。再平肝调气,参以疏风。
粉前胡(一钱) 象贝(二钱) 乌贼骨(二钱) 冬桑叶(一钱) 陈香橼皮(一钱) 炒杏仁(三钱)
橘红(一钱) 牛蒡子(三钱) 制香附(二钱) 砂仁壳(五分)
郑(右) 因痢而产,产后痢仍不止,腹痛里急后重,恶露不行,少腹按之硬痛,所下之色。夹杂瘀黑,杳不
思纳,胸脘不舒。脉滞而硬。此暑湿热三气郁阻肠中,瘀露不行,府气更加郁结。胎前下痢,产后不止之
条,古人言之郑重,非虚语也。勉拟通化一法,以希天佑。
木香(七分) 乌药(一钱五分) 泽兰(二钱) 土炒白芍(二钱) 五灵脂(酒炒二钱) 生蒲黄(五分)
乳香(去油六分) 延胡(二钱) 山楂(四钱赤砂糖七钱拌炒绢包) 赤白苓(各二钱) 炮姜(五分)
伏龙肝(一两五钱煎汤代水) 又 楂肉(四钱) 赤砂糖(七钱二味拌炒枯研细为丸每服三钱)
二诊 投剂之后,屡下紫黑瘀块,少腹亦舒,圊数顿减其半。然临圊犹然后重,气坠不爽,全不思纳,胸
中似乎有物哽塞,由此而饮食更觉妨碍。脉虚无力,苔白少华。恶露既通,府中之阻滞稍宣,而中阳结
痹。虽得转机,尚不足恃也。
台参须(六分) 乌药(一钱五分) 广皮(一钱) 苏木(五分) 酒炒延胡(一钱五分) 赤砂糖(五钱)
楂炭(二钱与砂糖同炒包煎) 熟附片(五分) 公丁香(二分) 茯苓(二钱) 乳香(五分)
粳米(一两包煎) 伏龙肝(一两煎汤代水)
改方 服方哽塞处觉灼热微痛,去参须丁香。
三诊 头面遍身发出赤 ,口渴较前稍定。暑热之气,藉得外越。无如少腹结块虽消,而按之尚觉作
痛,下痢虽大减疏,然昼夜犹然在二十次左右。少腹之痛松,则胸中之痛甚,上下互相联系。良以冲瘀
未清,则冲气逆上,盖冲脉起于气街,而布散于胸中,所以此响而彼应也。鼓棹迎风,茫茫涯岸。再为宣
瘀,以冀冲脉得通,胸中得旷,若能安谷则昌。
细生地(姜汁炒炭四钱) 酒炒归尾(二钱) 生牛膝(三钱) 五灵脂(酒炒三钱) 炙乳香(五分)
单桃仁(去皮尖打三钱) 台乌药(一钱五分) 元胡索(一钱五分) 生蒲黄(七分) 赤白苓(各二钱)
生米仁(四钱) 生熟木香(各三分) 人参回生丹(一丸分二次化服)
改方去回生丹,加橘白一钱香稻根须五钱玫瑰花二朵得效。(正蒙附志)
【右侧记录】产后数年,月经未来潮,但在原本应该来潮的时期,腰部和小腹会疼痛,呈现出想要来潮却未能畅行的状态。这是冲脉之气不和,冲脉运行不利,按理应当宣通营卫气血。但鉴于此前有咽喉病症,余毒尚未清除,不得不兼顾处理。
磨郁金(五分) 光杏仁(三钱) 生牛膝(三钱) 炒川断肉(三钱) 射干(四分) 蜜炙香附(二钱)
大贝母(二钱) 卷柏(一钱五分) 延胡索(一钱) 桃仁(二钱) 橘络(二钱,用红花汤拌炒)
【右侧记录】产前患有腹痛和痢疾,因病导致早产,产后痢疾仍然不止,伴有里急后重感,大便稀薄黏腻,颜色红黑相间。气滞与血瘀相互交阻,属于极重的病证。预备此方以期待自然造化之力能挽救。
延胡索(一钱五分) 砂仁(后下七分) 茯苓(四钱) 楂炭(三钱) 乌药(一钱五分) 煨木香(五分) 广皮(一钱) 赤砂糖(五钱,以上三味同炒至枯焦研成细末,用绢布包入煎剂中) 泽兰(二钱) 伏龙肝(一两,煎汤代替水煎药)
另取山楂炭三钱,赤砂糖六钱,两味同炒至枯焦研成细末,用米饮送服制成梧桐子大小的丸药,每次服用三钱,用药汁送下。
复诊 疼痛下坠感已消退,腹部胀满也减轻,然而每日排便次数仍在十次以上。气滞血瘀尚未化解,且脾气虚弱,难以厘清调理。虽然见到转机,但尚不足以依赖。
于术(土炒二钱) 煨木香(五分) 延胡索(酒炒一钱五分) 土炒陈皮(一钱) 泽泻(一钱五分) 茯苓(四钱) 桂枝(五分) 赤芍(土炒一钱五分) 泽兰叶(二钱) 伏龙肝(一两五钱,煎汤代替水煎药)仍沿用前法制作的山楂炭砂糖丸。
三诊 恶露稍微通畅,腹痛和痢疾逐渐停止。脱离险境,步入平安,这大概是所谓的天赐良机,非人力所能强求。
土炒于术(二钱) 酒炒延胡(一钱五分) 楂炭(三钱) 炮姜(五分) 砂仁(七分) 泽兰叶(二钱)
茯苓(三钱) 丹参(二钱) 降香(一钱五分) 桂枝(五分)
【右侧记录】产后不慎护理,导致营卫气血不能宣通。病情趋向虚损之路,恐怕力所不及,难以救治。
延胡索(二钱) 蒲黄(二钱) 桃仁(二钱) 酒炒红花(一钱五分) 炒赤芍(二钱) 泽兰叶(二钱)
徭桂(一钱) 川芎(一钱)
上述药物醋浸一夜后煎煮。另取西血珀二分,空腹先服用。
【右侧记录】产后不时发热,腹部疼痛。营血亏虚兼夹瘀滞未清,日久恐怕演变为虚损之证。
延胡索 广郁金 乌药 楂炭 降香 砂仁 炒青蒿 西血珀 制香附
刘氏(右侧记录) 产后两个月,下痢不止,大便色黄黏腻,身体发热,脉象濡软。气机与湿邪不得宣散,恐怕形成休息痢(久治不愈的痢疾)。
广皮 煨木香 泽泻 南楂炭(与赤砂糖三钱同炒至枯焦研末,用绢布包入煎剂中) 茯苓
炒枳实 乌药 生薏仁 赤芍(用甘草三分煎汤收纳入煎剂中) 砂仁
【右侧记录】产后恶露未清,营气阻滞,营血失去流畅,气聚结成有形之物,导致腹部疼痛胀满,寒热往来。脉象数而弦,恐怕由实证转为虚证,而至难以恢复。
醋炒柴胡 延胡索 金铃子 台乌药 焦麦芽 当归炭 炒赤芍 川郁金 南楂炭 震灵丹
马氏(右侧记录) 新产之后,气逆上冲如同喘息,痰多且白腻,无法平卧。心悸出汗,耳鸣头晕,这些都随着气逆程度的轻重而变化。对于产后发喘,历代名医都认为这是阴虚、虚火克伐肺金,肺气欲绝,是最为危险的征候。救援的方法,通常使用生脉散。查阅前方按照此法治疗,但未见疗效。详细询问起居情况,得知在胎前及刚生产时,曾用湿毛巾擦拭身体,此时毛孔疏泄,百脉弛张之际,水寒之气侵袭体表则影响体内,《内经》说“形寒饮冷则伤肺”,因为两寒相感,内外皆伤,所以气逆上行,经文如此论述,与病情大致相符。如今诊察六脉虚微,右寸关脉沉弦。半身以上皮疹密布。若无外感,怎会有此症状?云翁先生见解独到,用药平淡,反而比生脉散等方剂稍有起色。现遵从他的意思,略加扩充,作为背城借一(决一死战)的方案。但病情危急,推翻前方,能否救活,已不在考虑范围内。仅草拟此方供商讨。
旋复花(二钱) 光杏仁(三钱) 川桂枝(五分) 地骨皮(一钱五分,与川桂枝同炒) 紫丹参(二钱)
僵蚕(一钱五分) 茯苓(四钱) 橘红(一钱)
王氏(右侧记录) 产后十日,外感风邪,头痛发热,出汗后症状未解,近两天恶露涩少,小腹疼痛,按压时感觉微硬,牵引腰部和臀部,动不动就疼痛。脉象数而浮大,左部脉沉迟。风邪侵袭于外,气滞血瘀阻于内,恐怕形成时行疾病。暂且疏风并宣通营卫气血。
全当归 酒炒荆芥 川芎 五灵脂 蓬莪术 台乌药
延胡索 紫丹参 泽泻 楂肉炭 乳香 没药 益母草(煎汤代替水煎药)
某氏(右侧记录) 产后腹痛且有形块,如厕时更甚,自汗,便秘。这是恶露未清,营血郁滞,气机不畅所致。
延胡索 金铃子 焦楂炭 炒赤芍 火麻仁 乌药
香附 归尾 香橼皮 上徭桂(饭丸)
凡是产后瘀血排出的期限,男胎约半个月,女胎需一个月,恶露才能排清。若有轻微自汗,不妨碍,因为汗是血液所化生的,自汗而没有烦躁不安的现象,不必治疗其汗。(清代儒者附记)
韦氏(右侧记录) 小产之后,气血两亏,胃纳呆滞,食欲减退,头痛眩晕心悸,腰酸带下。拟定补气调和营血、平息肝风的治法。
奎党参(三钱) 炒木瓜皮(一钱五分) 杭白芍(酒炒一钱五分) 浓杜仲(三钱) 炙甘草(三分) 酒炒
当归(二钱) 茯苓神(各二钱) 生熟谷芽(各二钱) 黑豆衣(三钱) 玫瑰花(二朵)
二诊 甘味药以补益脾胃,酸味药以制约肝木,胃纳稍有好转,心悸眩晕也减轻,然而带下仍未止。前方法再配合固摄之法。
奎党参(三钱) 生山药(三钱) 黑豆衣(三钱) 炙黑草(三分) 浓杜仲(三钱) 炒木瓜皮(一钱五分)
牡蛎(五钱) 潼沙苑(盐水炒三钱) 池菊(一钱五分) 茯神(三钱)
三诊 心悸已安定,胃纳不佳,带下眩晕。再调和脾胃,健脾益气,以退为进。
制半夏(一钱五分) 范志曲(炒一钱五分) 陈皮(一钱) 砂仁(五分) 莲须(一钱) 炒山药(三钱)
炒于术(二钱) 潼沙苑(盐水炒三钱) 资生丸(四钱,分两次服用) 牡蛎(四钱)
王氏(右侧记录) 怀孕七月,忽然头痛抽搐,神志昏迷不语,名为子痫。都因胎热有余,火动生风,胎儿受热逼迫,竟致胎堕。
于是小产之后,恶露不行,神志模糊胡言乱语。脉象弦紧。这是由于败血上冲,极为危险。拟定方剂请商榷。
丹参(二钱) 酒炒荆芥(一钱五分) 五灵脂(酒炒三钱) 全归(三钱) 泽兰(三钱) 川芎(一钱)
延胡索(酒炒一钱五分) 赤苓(三钱) 西血珀末(蜜调冲服六分) 生蒲黄(一钱五分) 热童便(半杯冲服)
益母草(煎汤代替水煎药)
周氏(右侧记录) 产后恶露未行,气血凝滞,腹中有形块作痛,如厕时更甚。脉细关弦。气机上逆,汗出不止。这是营血阻滞阻碍气机,气滞导致津液外泄为汗。应当宣通和化,所谓通则不痛。
延胡索 金铃子 焦楂炭 炒赤芍 火麻仁 乌药 香附 归尾 香橼皮 上徭桂(饭丸)
汗是血的液体,夺血者无汗,这是指大量失血的情况而言。产后瘀露,是多余的血液,不可与脱血相比。初产时百脉沸腾,阴虚阳亢,喝热汤饮而津津汗出者,这是卫气流通,阳气随汗发泄,身体自觉舒和。《金匮要略》说亡阴血,虚阳气独盛,故当汗出,阴阳乃复,说的就是这个道理。若绝无汗,则卫气闭塞,必将出现发热症状。所以产妇宜微汗,而不宜无汗,宜有汗而不宜多汗。案中的“荣滞阻气”数语,得古圣之粗髓而融化之,言言金玉,字字珠玑,足以与《金匮要略》相抗衡。(文涵志附记)
二诊 上逆之气稍平,但如厕时仍然腹痛,大便艰涩。血燥气滞。前方法参考子和玉烛散加减。
炙生地 酒炒归身 制香附 金铃子 延胡索 川朴 缩砂仁 炒赤芍 酒炒上湘军(后下二钱) 徭桂(饭丸)
三诊 脉弦稍收敛,大便稍转润,如厕作痛也减轻。足见血燥气滞,腑中浊气因而不得排泄。前方法再配合破浊之法。
金铃子 九节菖蒲 川朴 郁金 藿香 延胡 磨沉香 炒赤芍 香附 砂仁 火麻仁
四诊 痛势已定,只是如厕时仍觉不爽。确是血凝气滞,不能上交少阳,反而下陷于太阴。前方法再进一步。
醋炒柴胡(五分) 金铃子(一钱五分) 楂炭(三钱) 香附(二钱) 杭白芍(三钱) 醋炒青皮
(一钱) 当归(二钱) 砂仁(五分) 乌药(一钱五分)
卢氏(右侧记录) 胃痛日久不止,经期淋漓不尽,少腹坠痛,两足酸楚,不能行走。营血不足,营血滞留未清。调治不易。
生熟蒲黄 元胡索 茜草炭 乌贼骨 制香附 白蒺藜 全当归 川断肉 川芎 乌药 降香
服用此方后,排出球形如长芋状的瘀血块,坠痛才减轻,原来是发生了小产。小产也适宜服用苦草汤。(正蒙附记)
二诊 热势渐退,少腹痛坠也已安定。再调和营血,祛除陈旧,布发生新。
当归 川芎 桑寄生 酒炒荆芥 白蒺藜 秦艽 丹参 炒川断 茯神 泽兰
三诊 少腹坠痛渐安,营卫渐通,手足酸痛大减。再祛除陈旧,布发生新,宣通络脉坠滞。
怀牛膝 酒炒荆芥 当归 秦艽 川芎 桑寄生 酒炒红花 川断 丹参 泽兰
四诊 小产仅二十天,当风纳凉,视同儿戏。说话的人谆谆告诫,听的人漠不关心,难道仅仅是头疼身热而已吗?姑且用轻剂疏解。
川芎 当归 秦艽 续断 丹参 桑寄生
牛膝 僵蚕 玉竹 苏子 酒炒荆芥
李氏(右侧记录) 胎前感受风邪,产后未彻底治愈,咳嗽三月有余,痰多口腻,怕冷内热,出汗不能左侧卧。脉象细数微滑。久咳损伤肺脏,阴阳二气有偏颇,气即为火,液即为痰,证入损门,非才疏学浅者所能言治。
南沙参(三钱) 光杏仁(三钱) 蛤粉(三钱) 炒苏子(三钱) 炙紫菀(一钱) 川贝母(一钱五分) 旋复花(二钱) 白茯苓(三钱) 盐水炒橘红(一钱)
二诊 咳嗽虽减,但仍不能左侧卧,大便十天一次,心悸目昏,怕冷发热出汗。皆属损象,不敢言治。
北沙参(四钱) 川贝母(二钱) 光杏仁(三钱) 炒枣仁(三钱) 生山药(三钱) 大天冬(三钱)
生白芍(一钱五分) 当归炭(一钱五分) 炒怀牛膝(三钱) 炙款冬(二钱) 茯神(三钱) 都气丸(三钱开水先送下)
朱氏(右侧记录) 产后满月,少腹坠痛,腿股腰尻作酸带下阵阵,向来并有结块同下,腹满不舒,胃钝少纳,脉象弦紧。这是由于十日内恶露停留,随即虽又复至,而脉络已滞,遂令瘀浊化为带下。恐怕崩漏败坏。
全当归(酒炒二钱) 川断肉(三钱) 茜草炭(一钱) 白蒺藜(三钱) 茯神(三钱) 川贝(一钱)
乌贼骨(三钱) 紫丹参(二钱) 泽兰叶(一钱五分) 南枣(三枚)
改方加炒熟地四钱,乌药一钱五分,香附二钱。
二诊 带下稍减,少腹仍痛。还是瘀浊未清。
全当归(二钱) 白蒺藜(三钱) 制香附(二钱) 乌贼骨(三钱) 川断肉(三钱) 紫丹参(二钱)
台乌药(一钱五分) 茜草炭(一钱五分) 生熟谷芽(各一钱) 鲍鱼片(酒洗二钱)
三诊 稍下紫瘀,少腹坠痛已定,带下亦减。然而胃仍少纳,头巅作痛。再配合和中泄木之法。
白蒺藜(三钱) 乌贼骨(三钱) 全当归(酒炒二钱) 川芎(一钱) 黑豆衣(三钱) 茜草炭(一钱五分)
佩兰叶(一钱五分) 池菊(一钱五分) 生熟谷芽(各一钱) 鲍鱼(酒洗二钱)
四诊 瘀露通行,带下已止,而外感风邪,咳嗽痰多音塞。肝气郁发,胸脘作痛。再平肝调气,配合疏风。
粉前胡(一钱) 象贝(二钱) 乌贼骨(二钱) 冬桑叶(一钱) 陈香橼皮(一钱) 炒杏仁(三钱)
橘红(一钱) 牛蒡子(三钱) 制香附(二钱) 砂仁壳(五分)
郑氏(右侧记录) 因痢疾而生产,产后痢疾仍不止,腹痛里急后重,恶露不行,少腹按压硬痛,所下之色夹杂瘀黑,完全不想进食,胸脘不舒。脉滞而硬。这是暑湿热三气郁阻肠中,瘀露不行,腑气更加郁结。胎前下痢,产后不止的情况,古人言之郑重,并非虚语。勉强拟定通化一法,以希天佑。
木香(七分) 乌药(一钱五分) 泽兰(二钱) 土炒白芍(二钱) 五灵脂(酒炒二钱) 生蒲黄(五分)
乳香(去油六分) 延胡(二钱) 山楂(四钱,赤砂糖七钱拌炒绢包) 赤白苓(各二钱) 炮姜(五分)
伏龙肝(一两五钱,煎汤代替水煎药) 又 楂肉(四钱) 赤砂糖(七钱,二味拌炒枯研细为丸,每服三钱)
二诊 投药之后,屡次排出紫黑瘀块,少腹亦舒,如厕次数顿减一半。然而如厕后仍有后重感,气坠不爽,完全不想进食,胸中似乎有物哽塞,由此饮食更觉妨碍。脉虚无力,苔白少华。恶露既通,腑中之阻滞稍宣,而中阳结痹。虽得转机,尚不足以依赖。
台参须(六分) 乌药(一钱五分) 广皮(一钱) 苏木(五分) 酒炒延胡(一钱五分) 赤砂糖(五钱)
楂炭(二钱,与砂糖同炒包煎) 熟附片(五分) 公丁香(二分) 茯苓(二钱) 乳香(五分)
粳米(一两,包煎) 伏龙肝(一两,煎汤代替水煎药)
改方 服药后哽塞处觉灼热微痛,去掉参须丁香。
三诊 头面遍身发出赤疹,口渴较前稍定。暑热之气,藉得外越。无奈少腹结块虽消,而按压尚觉作痛,下痢虽大减疏,然昼夜犹然在二十次左右。少腹之痛松,则胸中之痛甚,上下互相联系。良以冲瘀未清,则冲气逆上,盖冲脉起于气街,而布散于胸中,所以此处响彼处应。鼓棹迎风,茫茫涯岸。再为宣瘀,以冀冲脉得通,胸中得旷,若能安谷则昌。
细生地(姜汁炒炭四钱) 酒炒归尾(二钱) 生牛膝(三钱) 五灵脂(酒炒三钱) 炙乳香(五分)
单桃仁(去皮尖打三钱) 台乌药(一钱五分) 元胡索(一钱五分) 生蒲黄(七分) 赤白苓(各二钱)
生米仁(四钱) 生熟木香(各三分) 人参回生丹(一丸分二次化服)
改方去掉回生丹,加橘白一钱香稻根须五钱玫瑰花二朵得效。(正蒙附记)
[Right] Several years postpartum, menstruation has not resumed. However, at the expected time of onset, there is pain in the lower back and abdomen, presenting a sensation of wanting to flow but failing to do so smoothly. This indicates disharmony of the Chong (Penetrating) vessel Qi and obstruction of the Chong vessel. Theoretically, it is appropriate to promote the circulation of Ying (Nutritive) and Wei (Defensive) Qi. Given that there was a recent throat disorder with residual toxins not yet cleared, a concurrent treatment approach is necessary.
Ground Jinyin (Goldthread Fruit) (5 fen), Guang Xingren (Bitter Apricot Seed) (3 qian), Sheng Niuxi (Achyranthes Root) (3 qian), Chao Chuanduan Rou (Dried Stem of Teasel Root) (3 qian), Shegan (Belamcanda Rhizome) (4 fen), Mi Zhi Xiangfu (Cyperus Rhizome honey-fried) (2 qian), Dabeimu (Fritillaria Bulb) (2 qian), Juanbai (Selaginella) (1.5 qian), Yanhusuo (Corydalis Rhizome) (1 qian), Taoren (Peach Kernel) (2 qian), Juluo (Tangerine Pith) (2 qian, stir-fried with Honghua Red Flower Decoction).
[Right] During pregnancy, she suffered from abdominal pain and dysentery, leading to premature birth. Postpartum, the dysentery persisted, characterized by tenesmus and stools that were thin, sticky, red, and black. Qi stagnation and blood stasis were intermingled, constituting a severe condition. This prescription is prepared hoping for natural recovery.
Yanhusuo (Corydalis Rhizome) (1.5 qian), Sharen (Amomum Fruit) (add later, 7 fen), Fuling (Poria) (4 qian), Zhata (Charred Hawthorn Fruit) (3 qian), Wuyao (Lindera Root) (1.5 qian), Wei Muxiang (Sandalwood Root baked), Guangpi (Tangerine Peel) (1 qian), Chishatang (Red Sugar) (5 qian; mix the above three ingredients, stir-fry until charred, grind into powder, wrap in silk, and add to decoction), Zelan (Agastache Herb) (2 qian), Fulonggan (Dragon's House Soil) (1 liang, decoct water for cooking herbs).
Separately, take Zhata (Charred Hawthorn Fruit) 3 qian and Chishatang (Red Sugar) 6 qian, stir-fry together until charred, grind into powder, make pills the size of paulownia seeds with rice drink, take 3 qian per dose, washed down with herbal decoction.
Second visit: Pain and bearing-down sensation have subsided, abdominal fullness has decreased, but defecation frequency remains over ten times daily. Qi stagnation and blood stasis have not resolved, and Spleen Qi deficiency prevents clear differentiation. Although signs of improvement appear, reliance on them is premature.
Yuzhu (Atractylodes Macrocephala Rhizome, earth-fried) (2 qian), Wei Muxiang (Sandalwood Root baked) (5 fen), Yanhusuo (Corydalis Rhizome wine-fried) (1.5 qian), Tuchao Chenpi (Tangerine Peel earth-fried) (1 qian), Zexie (Alisma Rhizome) (1.5 qian), Fuling (Poria) (4 qian), Guizhi (Cinnamon Twig) (5 fen), Chishao (Red Peony Root, earth-fried) (1.5 qian), Zelan Ye (Agastache Leaf) (2 qian), Fulonggan (Dragon's House Soil) (1.5 liang, decoct water for cooking herbs). Continue using the previously mentioned Zhata Chishatang pills.
Third visit: Lochia discharge has slightly smoothed out, abdominal pain and dysentery are gradually stopping. Escaping danger and walking on level ground, this seems to be heaven-sent rather than human effort.
Yuzhu (Atractylodes Macrocephala Rhizome, earth-fried) (2 qian), Yanhu (Corydalis Rhizome, wine-fried) (1.5 qian), Zhata (Charred Hawthorn Fruit) (3 qian), Paojiang (Prepared Ginger) (5 fen), Sharen (Amomum Fruit) (7 fen), Zelan Ye (Agastache Leaf) (2 qian), Fuling (Poria) (3 qian), Danshen (Salvia Root) (2 qian), Jiangxiang (Dalbergia Odoriferous Lignum) (1.5 qian), Guizhi (Cinnamon Twig) (5 fen).
[Right] Negligence after childbirth led to failure of Ying (Nutritive) and Wei (Defensive) Qi and Blood to circulate freely. The condition trends towards deficiency damage, with fears of being beyond reach.
Yanhusuo (Corydalis Rhizome) (2 qian), Puhuang (Lygodium Spore) (2 qian), Taoren (Peach Kernel) (2 qian), Honghua (Carthamus Flower, wine-fried) (1.5 qian), Chishao (Red Peony Root, stir-fried) (2 qian), Zelan Ye (Agastache Leaf) (2 qian), Yao Gui (Cinnamon Bark) (1 qian), Chuanxiong (Ligusticum Rhizome) (1 qian).
Soak the above herbs in vinegar overnight before decocting. Separately, take Xixuepo (Western Blood Amber) 2 fen, take on an empty stomach first.
[Right] Intermittent fever and abdominal pain after childbirth. Ying (Nutritive) Blood deficiency with lingering stagnation; prolonged duration may lead to deficiency damage.
Yanhusuo (Corydalis Rhizome), Guang Yujin (Curcuma Aromatica Rhizome), Wuyao (Lindera Root), Zhata (Charred Hawthorn Fruit), Jiangxiang (Dalbergia Odoriferous Lignum), Sharen (Amomum Fruit), Qinghao (Artemisia Annua, stir-fried), Xixuepo (Western Blood Amber), Zhi Xiangfu (Cyperus Rhizome processed).
Liu (Right): Two months postpartum, persistent dysentery with yellow, sticky stools, body heat, and a soggy pulse. Qi and Dampness fail to circulate; fear of developing Rest Dysentery (chronic dysentery).
Guangpi (Tangerine Peel), Wei Muxiang (Sandalwood Root baked), Zexie (Alisma Rhizome), Nan Zhata (Charred Hawthorn Fruit mixed with 3 qian Chishatang, stir-fried until charred, ground, wrapped in silk, added to decoction), Fuling (Poria).
Zhishi (Immature Bitter Orange, stir-fried), Wuyao (Lindera Root), Yiren (Coix Seed, raw), Chishao (Red Peony Root, added via Gancao Licorice Root decoction 3 fen), Sharen (Amomum Fruit).
[Right]: Lochia discharge remained uncleaned after childbirth, causing Ying Qi obstruction and loss of smooth flow. Qi aggregation formed palpable masses, resulting in abdominal pain and distension, alternating chills and fever. Pulse was rapid and wiry, suggesting a shift from excess to deficiency, potentially irrecoverable.
Chaihu (Bupleurum Root, vinegar-fried), Yanhusuo (Corydalis Rhizome), Jinlingzi (Melia Toosendan Fruit), Tai Wuyao (Lindera Root), Maiya (Barley Sprout, scorched), Danggui (Angelica Sinensis, charred), Chishao (Red Peony Root, stir-fried), Yujin (Curcuma Aromatica Rhizome), Nan Zhata (Charred Hawthorn Fruit), Zhenling Dan (Shaking Spirit Pill).
Ma (Right): Immediately postpartum, rebellious Qi causes wheezing, profuse white sticky phlegm, inability to lie flat. Palpitations, sweating, tinnitus, and dizziness vary with the severity of Qi rebellion. Historically, postpartum asthma is considered due to Yin deficiency with deficient fire attacking Metal (Lung), indicating impending Lung Qi exhaustion—a critical state. Rescue methods typically employ Shengmai San (Generate the Pulse Powder). Previous prescriptions following this method failed. Inquiry revealed use of wet towels for bathing during late pregnancy and immediately postpartum. With pores open and vessels relaxed, cold-dampness invaded externally affecting internally. As stated in the Neijing, "cold form and cold drinks injure the Lung," as dual cold sensations injure both interior and exterior, causing Qi to rebel upward. This aligns with the pathology. Current pulse is weak and minute; Right Cun and Guan positions are deep and wiry. Rash densely covers the upper half of the body. Without external pathogenic factors, how could this occur? Mr. Yunweng’s insight is unique; his mild prescriptions showed slight improvement compared to Shengmai San. Following his intent, I expand slightly for a last-ditch effort. Given the critical nature, efficacy is uncertain. Drafted for discussion.
Xuanfuhua (Inula Flower) (2 qian), Guang Xingren (Bitter Apricot Seed) (3 qian), Chuan Guizhi (Cinnamon Twig) (5 fen), Digupi (Morus Cortex, stir-fried with Chuan Guizhi) (1.5 qian), Danshen (Salvia Root) (2 qian), Jiangcan (Bombyx Batryticatus) (1.5 qian), Fuling (Poria) (4 qian), Juhong (Citrus Reticulata Red Peel) (1 qian).
Wang (Right): Ten days postpartum, contracted Wind pathogen externally. Headache and fever persisted despite sweating. For two days, lochia discharge was scant and sluggish, with lower abdominal pain, slight hardness upon pressure, radiating to lower back and buttocks, exacerbated by movement. Pulse was rapid, floating, and large; Left position was deep and slow. Wind pathogen attacks externally, Qi stagnation and Blood stasis obstruct internally; fear of becoming a seasonal disease. Tentatively dispel Wind and promote Ying/Wei circulation.
Danggui (Angelica Sinensis, whole), Jingjie (Schizonepeta Spike, wine-fried), Chuanxiong (Ligusticum Rhizome), Wulingzhi (Trogopterus Dung), Ezhu (Curcuma Zedoaria Rhizome), Tai Wuyao (Lindera Root).
Yanhusuo (Corydalis Rhizome), Danshen (Salvia Root), Zexie (Alisma Rhizome), Zhrou Tan (Charred Hawthorn Flesh), Ruxiang (Frankincense), Moyao (Myrrh), Yimucao (Leonurus Herb, decoct water for cooking herbs).
Certain Case (Right): Postpartum abdominal pain with palpable mass, worse during defecation, spontaneous sweating, constipation. This is uncleared lochia, Ying Blood stagnation, and Qi obstruction.
Yanhusuo (Corydalis Rhizome), Jinlingzi (Melia Toosendan Fruit), Jiao Zhata (Scorched Charred Hawthorn Fruit), Chishao (Red Peony Root, stir-fried), Huomaren (Hemp Seed), Wuyao (Lindera Root).
Xiangfu (Cyperus Rhizome), Guiwei (Angelica Sinensis Tail), Xiangyuanpi (Citron Peel), Shang Yao Gui (Superior Cinnamon Bark, pill with rice paste).
Generally, the period for expelling uterine blood varies: male fetus approx. half a month, female fetus one month, for lochia to clear. Mild spontaneous sweating is acceptable as sweat is derived from blood; if no restlessness accompanies it, treatment for sweating is unnecessary. (Recorded by a Qing Dynasty Scholar).
Wei (Right): After miscarriage, Qi and Blood are doubly deficient. Stomach function is dull with poor appetite, headache, vertigo, palpitations, sore lower back, and leukorrhea. Plan to tonify Qi, harmonize Ying, and extinguish Liver wind.
Qidangshen (Codonopsis Root, Kui brand), Mugoupi (Quince Peel, stir-fried), Baishao (White Peony Root, wine-fried), Duzhong (Eucommia Bark), Gancao (Licorice Root, honey-fried), Danggui (Angelica Sinensis, wine-fried), Fushen (Poria with Hostwood), Guya (Grain Sprout, raw and cooked), Doukouyi (Black Soybean Coat), Meiguihua (Rose Flower).
Second visit: Sweet flavors benefit the Stomach, sour flavors restrain Wood (Liver). Appetite slightly improved, palpitations and vertigo reduced, but leukorrhea persists. Modify previous method to include astringent strategies.
Qidangshen (Codonopsis Root, Kui brand), Shanyao (Dioscorea Rhizome), Doukouyi (Black Soybean Coat), Heicao (Licorice Root, charred), Duzhong (Eucommia Bark), Mugoupi (Quince Peel, stir-fried), Muli (Oyster Shell), Tongshayuan (Astrocallis Seed, salt-water fried), Chiju (Chrysanthemum), Fushen (Poria with Hostwood).
Third visit: Palpitations stabilized, poor appetite, leukorrhea, and vertigo persist. Harmonize Middle Jiao and strengthen Spleen, retreating to advance.
Banxia (Pinellia Tuber, processed), Zhiqu (Medicated Leaven, stir-fried), Chenpi (Tangerine Peel), Sharen (Amomum Fruit), Lianxu (Lotus Stamen), Shanyao (Dioscorea Rhizome, stir-fried), Yuzhu (Atractylodes Macrocephala Rhizome, stir-fried), Tongshayuan (Astrocallis Seed, salt-water fried), Zisheng Wan (Nourishing Life Pill), Muli (Oyster Shell).
Wang (Right): At seven months gestation, sudden headache and convulsions, unconsciousness, named Zi Xian (Eclampsia). Due to excessive fetal heat generating internal wind, forcing the fetus downward, resulting in miscarriage. Post-miscarriage, lochia did not flow, confusion and delirium occurred. Pulse wiry and tight. This is due to foul blood rushing upward, extremely dangerous. Prescription proposed for consultation.
Danshen (Salvia Root), Jingjie (Schizonepeta Spike, wine-fried), Wulingzhi (Trogopterus Dung, wine-fried), Danggui (Angelica Sinensis, whole), Zelan (Agastache Herb), Chuanxiong (Ligusticum Rhizome), Yanhusuo (Corydalis Rhizome, wine-fried), Chiling (Poria, red part), Xixuepo Powder (mixed with honey, taken orally), Puhuang (Lygodium Spore), Tongbian (Hot Child Urine), Yimucao (Leonurus Herb, decoct water for cooking herbs).
Zhou (Right): Postpartum lochia did not flow, Qi and Blood stagnated, abdominal mass painful, worse during defecation. Pulse fine, Guan position wiry. Qi rebelling, continuous sweating. This is Ying stagnation obstructing Qi, Qi stagnation transforming fluids into sweat. Should promote circulation and transformation, as "free flow implies no pain."
Yanhusuo (Corydalis Rhizome), Jinlingzi (Melia Toosendan Fruit), Jiao Zhata (Scorched Charred Hawthorn Fruit), Chishao (Red Peony Root, stir-fried), Huomaren (Hemp Seed), Wuyao (Lindera Root), Xiangfu (Cyperus Rhizome), Guiwei (Angelica Sinensis Tail), Xiangyuanpi (Citron Peel), Shang Yao Gui (Superior Cinnamon Bark, pill with rice paste).
Sweat is the fluid of Blood; those who lose Blood have no sweat, referring to massive hemorrhage. Postpartum lochia is surplus blood, unlike massive hemorrhage. At first birth, hundred vessels boil, Yin deficiency Yang hyperactivity, drinking hot soup induces sweating; this is Wei Qi circulating, Yang escaping via sweat, body feels comfortable. Jin Gui says loss of Yin Blood leads to solitary excess of Yang, thus sweating occurs to restore Yin-Yang balance. If absolutely no sweat, Wei Qi is blocked, fever will ensue. Thus, postpartum women should have slight sweat, not no sweat; some sweat is better than excessive sweat. The phrase "Ying stagnation obstructing Qi" in this case absorbs ancient wisdom, worthy of comparison with Jin Gui Yao Lue. (Recorded by Wenhan).
Second visit: Rebellious Qi slightly calmed, but abdominal pain persists during defecation, stool is dry and difficult. Blood dryness and Qi stagnation. Modify previous method incorporating Hezi's Yuzhu San variations.
Shengdi (Rehmannia Root, honey-fried), Danggui Shen (Angelica Sinensis Body, wine-fried), Xiangfu (Cyperus Rhizome, processed), Jinlingzi (Melia Toosendan Fruit), Yanhusuo (Corydalis Rhizome), Houpo (Magnolia Bark), Sharen (Amomum Fruit), Chishao (Red Peony Root, stir-fried), Junghuang (Rhubarb Root, wine-fried, add later), Yao Gui (Cinnamon Bark, pill with rice paste).
Third visit: Wiry pulse slightly restrained, stool moistening, pain during defecation reduced. Confirms Blood dryness and Qi stagnation, preventing expulsion of turbid waste. Further modify previous method to break down turbidity.
Jinlingzi (Melia Toosendan Fruit), Shichangpu (Acorus Rhizome), Houpo (Magnolia Bark), Yujin (Curcuma Aromatica Rhizome), Huoxiang (Patchouli Herb), Yanhu (Corydalis Rhizome), Chenxiang (Aquilaria Wood, ground), Chishao (Red Peony Root, stir-fried), Xiangfu (Cyperus Rhizome), Sharen (Amomum Fruit), Huomaren (Hemp Seed).
Fourth visit: Pain stabilized, but discomfort persists during defecation. Indeed, Blood coagulation and Qi stagnation fail to ascend to Shaoyang, instead sinking to Taiyin. Advance previous method further.
Chaihu (Bupleurum Root, vinegar-fried), Jinlingzi (Melia Toosendan Fruit), Zhata (Charred Hawthorn Fruit), Xiangfu (Cyperus Rhizome), Baishao (White Peony Root), Qingpi (Green Tangerine Peel, vinegar-fried), Danggui (Angelica Sinensis), Sharen (Amomum Fruit), Wuyao (Lindera Root).
Lu (Right): Chronic stomach pain, menstrual dripping, lower abdominal bearing-down pain, soreness in legs unable to walk. Ying Blood insufficient, Ying stagnation unresolved. Difficult to treat.
Puhuang (Lygodium Spore, raw and cooked), Yuanhusuo (Corydalis Rhizome), Qiancao (Madder Root, charred), Haihegu (Cuttlefish Bone), Xiangfu (Cyperus Rhizome, processed), Bilibi (Tribulus Fruit), Danggui (Angelica Sinensis, whole), Chuanduan (Dipsacus Root), Chuanxiong (Ligusticum Rhizome), Wuyao (Lindera Root), Jiangxiang (Dalbergia Odoriferous Lignum).
After taking this formula, expelled ball-shaped clots like long taro, bearing-down pain reduced, indicating miscarriage. Miscarriage also benefits from Kucao Tang (Bitter Grass Decoction). (Recorded by Zhengmeng).
Second visit: Heat subsiding, lower abdominal pain and bearing-down stabilized. Harmonize Ying and remove old to generate new.
Danggui (Angelica Sinensis), Chuanxiong (Ligusticum Rhizome), Sangjisheng (Taxillus Branch), Jingjie (Schizonepeta Spike, wine-fried), Bilibi (Tribulus Fruit), Qinjiao (Gentiana Macrophylla Root), Danshen (Salvia Root), Chuanduan (Dipsacus Root, stir-fried), Fushen (Poria with Hostwood), Zelan (Agastache Herb).
Third visit: Lower abdominal bearing-down pain stabilizing, Ying and Wei circulating, limb soreness greatly reduced. Remove old, generate new, promote collateral flow.
Niuxi (Achyranthes Root), Jingjie (Schizonepeta Spike, wine-fried), Danggui (Angelica Sinensis), Qinjiao (Gentiana Macrophylla Root), Chuanxiong (Ligusticum Rhizome), Sangjisheng (Taxillus Branch), Honghua (Carthamus Flower, wine-fried), Chuanduan (Dipsacus Root), Danshen (Salvia Root), Zelan (Agastache Herb).
Fourth visit: Only twenty days post-miscarriage, exposed to wind and coolness carelessly. Advice ignored, resulting in more than just headache and fever. Use light agents to disperse.
Chuanxiong (Ligusticum Rhizome), Danggui (Angelica Sinensis), Qinjiao (Gentiana Macrophylla Root), Xuduan (Dipsacus Root), Danshen (Salvia Root), Sangjisheng (Taxillus Branch).
Niuxi (Achyranthes Root), Jiangcan (Bombyx Batryticatus), Yuzhu (Polygonatum Rhizome), Suzi (Perilla Fruit), Jingjie (Schizonepeta Spike, wine-fried).
Li (Right): Contracted Wind prenatally, incompletely treated postpartum. Coughing for over three months, profuse sticky phlegm, aversion to cold with internal heat, sweating preventing left-side lying. Pulse fine, rapid, slightly slippery. Chronic cough damages Lung, Yin and Yang Qi imbalance, Qi becomes Fire, Fluids become Phlegm, entering Deficiency Gate. Beyond the capability of the incompetent.
Shashen (Glehnia Root), Xingren (Apricot Seed), Ge Fen (Clam Powder), Su Zi (Perilla Fruit, stir-fried), Ziwan (Adenophora Root, honey-fried), Beimu (Fritillaria Bulb), Xuanfuhua (Inula Flower), Fuling (Poria), Juhong (Citrus Reticulata Red Peel, salt-water fried).
Second visit: Cough reduced but still cannot lie on left side, bowel movement once every ten days, palpitations, blurred vision, chills and sweating. All indicate deficiency damage; dare not claim cure.
Beishashen (Pseudostellaria Root), Beimu (Fritillaria Bulb), Xingren (Apricot Seed), Zaoren (Ziziphus Seed, stir-fried), Shanyao (Dioscorea Rhizome), Tiantong (Asparagus Tuber), Baishao (White Peony Root, raw), Danggui Tan (Angelica Sinensis, charred), Niuxi (Achyranthes Root, stir-fried), Kuidong (Farfola Flower, honey-fried), Fushen (Poria with Hostwood), Duqi Wan (Nine-Ingredient Pill with Rehmannia).
Zhu (Right): One month postpartum, lower abdominal bearing-down pain, soreness in thighs/lower back/buttocks, intermittent leukorrhea, usually accompanied by mass discharge, abdominal fullness, dull stomach, poor appetite, pulse wiry and tight. Due to lochia retention for ten days, then resuming flow, but vessels stagnant, turning turbid stasis into leukorrhea. Fear of collapse/hemorrhage.
Danggui (Angelica Sinensis, wine-fried), Chuanduan (Dipsacus Root), Qiancao (Madder Root, charred), Bilibi (Tribulus Fruit), Fushen (Poria with Hostwood), Beimu (Fritillaria Bulb), Haihegu (Cuttlefish Bone), Danshen (Salvia Root), Zelan Ye (Agastache Leaf), Nanzao (Chinese Date).
Modified formula adds Shudi (Rehmannia Root, stir-fried), Wuyao (Lindera Root), Xiangfu (Cyperus Rhizome).
Second visit: Leukorrhea slightly reduced, lower abdominal pain persists. Turbid stasis not yet cleared.
Danggui (Angelica Sinensis), Bilibi (Tribulus Fruit), Xiangfu (Cyperus Rhizome, processed), Haihegu (Cuttlefish Bone), Chuanduan (Dipsacus Root), Danshen (Salvia Root), Wuyao (Lindera Root), Qiancao (Madder Root, charred), Guya (Grain Sprout, raw and cooked), Baoyu Pian (Abalone Slice, wine-washed).
Third visit: Slight purple stasis discharged, lower abdominal pain stabilized, leukorrhea reduced. However, poor appetite and vertex headache persist. Harmonize Middle and drain Wood.
Bilibi (Tribulus Fruit), Haihegu (Cuttlefish Bone), Danggui (Angelica Sinensis, wine-fried), Chuanxiong (Ligusticum Rhizome), Doukouyi (Black Soybean Coat), Qiancao (Madder Root, charred), Peilan (Aglaia Herb), Chiju (Chrysanthemum), Guya (Grain Sprout, raw and cooked), Baoyu (Abalone, wine-washed).
Fourth visit: Lochia flowing, leukorrhea stopped, but contracted Wind externally, cough with profuse phlegm and hoarseness. Liver Qi depression manifesting, chest/epigastric pain. Calm Liver, regulate Qi, combine with Wind-dispelling.
Qianhu (Peucedanum Root), Xiangbei (Fritillaria Thunbergii Bulb), Haihegu (Cuttlefish Bone), Sangye (Mulberry Leaf), Xiangyuanpi (Citron Peel), Xingren (Apricot Seed, stir-fried), Juhong (Citrus Reticulata Red Peel), Niubangzi (Arctium Fruit), Xiangfu (Cyperus Rhizome, processed), Sharen Qiao (Amomum Fruit Shell).
Zheng (Right): Delivered due to dysentery; postpartum dysentery persisted, abdominal pain with tenesmus, lochia not flowing, lower abdominal hard/painful on pressure, stools mixed with dark stasis, complete anorexia, chest/epigastric discomfort. Pulse stagnant and hard. Summerheat, Dampness, and Heat pathogens obstruct intestines, lochia blocked, Fu Qi further constrained. Pre-pregnancy dysentery persisting postpartum is a serious matter noted by ancients. Tentatively propose dredging and transforming method to hope for heavenly aid.
Muxiang (Aucklandia Root), Wuyao (Lindera Root), Zelan (Agastache Herb), Baishao (White Peony Root, earth-fried), Wulingzhi (Trogopterus Dung, wine-fried), Puhuang (Lygodium Spore), Ruxiang (Frankincense, de-oiled), Yanhu (Corydalis Rhizome), Shanzha (Hawthorn Fruit mixed with Chishatang, stir-fried, wrapped in silk), Chibaoling (Red and White Poria), Paojiang (Prepared Ginger), Fulonggan (Dragon's House Soil). Also: Zharon (Charred Hawthorn Flesh), Chishatang (Red Sugar), stir-fried until charred, ground into powder, make pills, take 3 qian each.
Second visit: After medication, frequent passage of purple-black clots, lower abdomen relieved, defecation frequency halved. However, tenesmus persists, Qi bearing down, anorexia, chest sensation of obstruction hindering diet. Pulse weak, coating white and lusterless. Lochia flowing, intestinal obstruction slightly cleared, but Middle Yang blocked. Improvement seen but unreliable.
Renshen Xu (Ginseng Rootlet), Wuyao (Lindera Root), Guangpi (Tangerine Peel), Sumu (Sappan Wood), Yanhu (Corydalis Rhizome, wine-fried), Chishatang (Red Sugar), Zhata (Charred Hawthorn Fruit mixed with sugar, wrapped), Fupian (Prepared Aconite Root), Dingxiang (Clove), Fuling (Poria), Ruxiang (Frankincense), Jingmi (Rice Grain, wrapped), Fulonggan (Dragon's House Soil).
Modified: Burning pain at obstruction site after taking medicine, remove Renshen Xu and Dingxiang.
Third visit: Red rash on head/face/body, thirst slightly relieved. Summerheat dissipating externally. Despite reduction in lower abdominal mass and dysentery frequency (still ~20 times/day), lower abdominal pain relief correlates with increased chest pain. Upper and lower connected. Unclear Chong stasis causes Chong Qi to rebel upward; Chong vessel originates at Qichong and spreads to chest, hence resonance. Rowing against wind, boundless shores. Again promote stasis resolution to unblock Chong and clear chest.若能安谷则昌 (If able to digest food, prosperity follows).
Shengdi (Rehmannia Root, ginger juice charred), Danggui Wei (Angelica Sinensis Tail, wine-fried), Niuxi (Achyranthes Root), Wulingzhi (Trogopterus Dung, wine-fried), Ruxiang (Frankincense, honey-fried), Taoren (Peach Kernel, peeled/pitted), Wuyao (Lindera Root), Yuansu (Corydalis Rhizome), Puhuang (Lygodium Spore), Chibaoling (Red and White Poria), Yiren (Coix Seed), Muxiang (Aucklandia Root, raw and cooked), Renshen Huisheng Dan (Ginseng Revival Pill).
Modified: Remove Huisheng Dan, add Ju Bai (Tangerine White), Xiangdao Gen Xu (Perfume Rice Rootlets), Meiguihua (Rose Flower). Effective. (Recorded by Zhengmeng).