(附论)
夫血性喜温而恶寒。温则宣流。寒则凝涩。妊娠堕胎。恶血不出者。由妊娠宿有风冷在
于胞脏。冷搏恶血。故令不下。令人寒热去来。脐腹满痛。口干燥渴。手足若烦。若血随气
逆上冲于心。或语言狂妄。或迷闷不省。至其病变。不可胜数。宜速以破血下气药治之。血
下乃已。
方
琥珀煮散 治妊娠堕胎后。恶血不出。小腹 痛。
琥珀(研一钱) 没药(研) 蒲黄 当归(去苗切焙) 赤芍药(炒) 姜黄 红蓝
花土瓜
根牛李子 延胡索 牡丹皮(各半两) 上为散。每服三钱。以童子便酒各半盏。同煎至
七分。温服。心腹胀痛。温酒调下二钱。
鉴鼻汤 治妊娠堕胎后。血露不出。心腹疼痛。
铜鉴鼻(另捣细研如粉) 大黄(锉微炒) 生干地黄(微炒) 芍药(各一两) 甘
草(炙锉) 芎 干漆(炒去烟各一钱) 枣(七枚去核焙) 乱发(鸡子大烧灰) 上
咀。每服三钱。水一盏。煎至七分去滓。投入芒硝少许。再煎一二沸。温服。相次更服。
大黄饮 治妊娠堕胎后。血不出。腹中 痛不可忍。
大黄(锉炒) 芍药 黄芩(去黑心) 桃仁(汤浸去皮尖双仁麸炒黄色) 当归(微
炙各一两) 桂(去粗皮) 甘草(炙赤各三钱) 生干地黄(焙一两半) 上 咀。每服
三钱。以水一盏。煎至七分去滓。温服。食顷再服。
牡丹丸 治妊娠堕胎后。血不出。寒热腹痛。
牡丹皮 当归(炙令赤锉) 芍药 白术 鬼箭羽 桂(去粗皮各一两) 大黄(锉炒
三钱) 上为末。炼蜜和丸梧桐子大。每服二十丸。温酒时时服。渐加至三十丸。
大黄汤 治妊娠堕胎后血不出。
大黄(锉炒) 当归(微炙) 甘草(锉炙) 吴茱萸(汤洗炒黄) 牡丹(去心切) 白
芍药(各一两) 上 咀。每服三钱。以水一盏。生姜一钱。拍破。同煎六分去滓。温服。
相次再
服。
桃仁汤 治妊娠堕胎后。血不出。往来寒热。腹痛。
桃仁(汤浸去皮尖双仁麸炒黄色二十枚) 吴茱萸(汤洗炒黄二两) 当归(微炙锉) 黄
(微炙锉) 芍药(各一两) 醍醐(二两) 上除醍醐外。粗捣筛。每服三钱。以生姜
一钱。拍破
红蓝花散 治妊娠堕胎后。血不出。奔心闷绝。不识人。
红蓝花(微熬过) 男子发(烧灰研) 墨(烧通红) 麒麟竭(研) 蒲黄(隔纸炒
各一两) 上为散。以童子小便三四分。调二钱服之。立瘥。
乌金散 治妊娠堕胎后。恶血不出。四肢无力。体热。心胸满烦闷。及诸疾血病。
墨(二两打折二寸挺子烧通赤用好醋一升蘸七次再烧通赤放冷另研为末) 没药(研) 麒
麟竭(各一钱) 麝香(一钱) 上为细散。每服温酒调下一钱。如血迷心。用童子小便和
酒调下二钱。
猪膏饮 治妊娠堕胎后。血不出。抢心痛。烦愦。
猪膏(七合) 白蜜(三合) 生地黄(切二两) 上先将猪膏地黄相和。煎令赤色。
去却地黄。内蜜三合。搅匀。分温二服。相次再服。
白蜜汤 治妊娠堕胎后。恶血不出。
白蜜(二两) 生地黄(汁一盏) 酒(半盏) 上将地黄汁与酒于铜器中煎五十七沸。
入蜜搅匀。分作两服。放温。相次再服。服二剂。百病可愈。
治妊娠堕胎后。败血不出。
墨(三两用炭火烧红以酸醋淬如此三遍以次瓦碗于净地上合令冷取出细研如粉) 没药
(一两另研末) 上合研令极细。再罗过。每服二钱正。以煎醋调下。不拘时。
当归酒 治妊娠堕胎后血不出。
当归(炙令香锉) 芍药(锉炒各二两) 上 咀。每服三钱正。以无灰酒一盏。入生
地黄汁一合。于银器内。慢火煎至七分去滓。温服。以恶血下为度。
治妊娠堕胎后。血不出。小腹满痛。
用羚羊角烧灰细研如面。每服三钱正。不计早晚。以豆淋酒调下。
又方
以当归二两酒煮下。
(附论)
血液本性喜欢温暖而厌恶寒冷。温暖则流通宣散,寒冷则凝滞涩结。妊娠期间发生堕胎后,恶露(产后残留的瘀血)排出不畅,是因为孕妇体内素有风冷之邪滞留于胞宫及脏腑之间。寒邪与瘀血相互搏结,导致恶露无法下行。这会引起患者出现忽冷忽热的症状,脐部及腹部胀满疼痛,口舌干燥且口渴,手足感到烦扰不适。如果血液随着气机逆乱上冲至心脏,或者出现言语狂妄、神志昏迷不省人事等症状,其病变情况不可胜数。应当迅速使用破血行气的药物进行治疗,直到瘀血排出为止。
方剂:
琥珀煮散:治疗妊娠堕胎后,恶露不出,小腹胀痛。
琥珀(研磨一钱)、没药(研磨)、蒲黄、当归(去苗、切片、焙干)、赤芍药(炒制)、姜黄、红蓝花、土瓜根、牛李子、延胡索、牡丹皮(以上各半两)。将上述药材制成散剂。每次服用三钱,用童便和酒各半盏,共同煎煮至七分量,温服。若心腹胀痛,用温酒调服二钱。
鉴鼻汤:治疗妊娠堕胎后,恶露不尽,心腹疼痛。
铜鉴鼻(另捣细研如粉状)、大黄(锉碎微炒)、生干地黄(微炒)、芍药(以上各一两)、甘草(炙后锉碎)、川芎、干漆(炒至无烟,以上各一钱)、大枣(七枚去核焙干)、乱发(鸡蛋大小,烧成灰)。将药材切碎。每次服用三钱,加水一盏,煎煮至七分,去渣,投入少许芒硝,再煮沸一两次,温服。随后再次服用。
大黄饮:治疗妊娠堕胎后,瘀血不出,腹中疼痛难以忍受。
大黄(锉碎炒制)、芍药、黄芩(去黑心)、桃仁(热水浸泡去皮尖及双仁,麸炒至黄色)、当归(微炙,以上各一两)、桂枝(去粗皮)、甘草(炙至赤色,以上各三钱)、生干地黄(焙干一两半)。将药材切碎。每次服用三钱,加水一盏,煎煮至七分,去渣,温服。进食片刻后再服。
牡丹丸:治疗妊娠堕胎后,瘀血不出,伴有寒热及腹痛。
牡丹皮、当归(炙至赤色并锉碎)、芍药、白术、鬼箭羽、桂枝(去粗皮,以上各一两)、大黄(锉碎炒制三钱)。将药材研为末,用炼蜜调和制成梧桐子大小的丸剂。每次服用二十丸,用温酒送服,不时服用,逐渐增加至三十丸。
大黄汤:治疗妊娠堕胎后瘀血不出。
大黄(锉碎炒制)、当归(微炙)、甘草(锉碎炙制)、吴茱萸(热水洗后炒黄)、牡丹(去心切片)、白芍药(以上各一两)。将药材切碎。每次服用三钱,加水一盏,生姜一钱拍破,共同煎煮至六分,去渣,温服。随后再次服用。
桃仁汤:治疗妊娠堕胎后,瘀血不出,往来寒热,腹痛。
桃仁(热水浸泡去皮尖及双仁,麸炒至黄色,二十枚)、吴茱萸(热水洗后炒黄,二两)、当归(微炙锉碎)、黄芪(微炙锉碎)、芍药(以上各一两)、醍醐(二两)。除醍醐外,将其他药材粗捣筛过。每次服用三钱,加生姜一钱拍破,同煎...(原文此处似有缺漏或排版问题,依文意理解为煎煮后加入醍醐或随证服用,但根据格式要求忠实翻译原文结构)... 红蓝花散:治疗妊娠堕胎后,瘀血不出,血气上奔致胸闷窒息,不识人。
红蓝花(微熬过)、男子头发(烧成灰研磨)、墨(烧至通红)、麒麟竭(研磨)、蒲黄(隔纸炒,以上各一两)。将药材制成散剂。用童便三四分,调服二钱,立效。
乌金散:治疗妊娠堕胎后,恶露不出,四肢无力,身体发热,心胸满闷烦乱,以及各类血病。
墨(二两,折断成二寸长的段,烧至通赤,用好醋一升蘸七次,再烧至通赤,放冷后另研为末)、没药(研磨)、麒麟竭(以上各一钱)、麝香(一钱)。将药材制成细散。每次用温酒调服一钱。若因血迷心窍,用童便和酒调服二钱。
猪膏饮:治疗妊娠堕胎后,瘀血不出,抢心痛(心前区剧烈疼痛),烦闷昏乱。
猪脂油(七合)、白蜜(三合)、生地黄(切二两)。先将猪脂油和地黄混合,煎至红色,去掉地黄,加入三合蜂蜜,搅匀,分两次温服,随后再次服用。
白蜜汤:治疗妊娠堕胎后,恶露不出。
白蜜(二两)、生地黄(取汁一盏)、酒(半盏)。先将地黄汁与酒在铜器中煎煮五十七沸,加入蜂蜜搅匀,分作两服,放温后服用,随后再次服用。服用两剂,百病可愈。
治疗妊娠堕胎后,败血不出。
墨(三两,用炭火烧红,以酸醋淬火如此三次,依次放在瓦碗中扣在干净地面上使其冷却,取出细研如粉)、没药(一两,另研为末)。将两者混合研至极细,再筛选一遍。每次正服二钱,用煎过的醋调服,不拘时间。
当归酒:治疗妊娠堕胎后瘀血不出。
当归(炙至香并锉碎)、芍药(锉碎炒制,以上各二两)。将药材切碎。每次正服三钱,用无灰酒一盏,加入生地黄汁一合,在银器内,用慢火煎至七分,去渣,温服。以恶血排出为度。
治疗妊娠堕胎后,瘀血不出,小腹胀痛。
用羚羊角烧成灰,细研如面粉状。每次正服三钱,不分早晚,用豆淋酒调服。
又一方:
用当归二两,用酒煮后服用。
(Attached Discussion)
Blood naturally prefers warmth and dislikes cold. Warmth promotes circulation and flow, while cold causes stagnation and obstruction. After abortion during pregnancy, if lochia (residual blood after childbirth) fails to discharge, it is due to wind-cold pathogens previously residing in the uterus and viscera. The cold pathogen clashes with stagnant blood, preventing its downward movement. This manifests as alternating chills and fever, fullness and pain in the umbilical and abdominal regions, dry mouth and throat, and restlessness in the hands and feet. If blood follows rebellious Qi and rushes upward to affect the Heart, or if there is delirious speech, coma, or unconsciousness, the pathological changes are countless. It is advisable to promptly treat with blood-breaking and Qi-moving medications until the blood is discharged.
Prescriptions:
Hupo Decoction (Amber Boiled Powder): Treats post-abortion retention of lochia with lower abdominal pain.
Amber (1 qian, ground), Myrrh (ground), Pteris Vittatae Spora (Puhuang), Angelicae Sinensis Radix (Danggui, removed roots, sliced, dried), Red Peony Root (Chishaoyao, stir-fried), Turmeric Rhizome (Jianghuang), Safflower Flos (Honglanhua), Trichosanthes Root (Tugua Gen), Prunus Salicina Seed (Nuzi Li), Corydalis Rhizome (Yanhusuo), Moutan Cortex (Mudanpi) (each half liang). Grind into powder. Take 3 qian per dose. Boil with 0.5 cup of urine from an uncircumcised boy and wine together until reduced to 0.7 volume. Take warm. For heart and abdominal distension/pain, take 2 qian mixed with warm wine.
Jianbi Decoction: Treats post-abortion incomplete expulsion of lochia with heart and abdominal pain.
Copper Mirror Nose (Tongjianbi, separately pounded fine like powder), Rheum Palmatum Rhizoma et Radix (Dahuang, cut and slightly stir-fried), Rehmanniae Radix Preparata (Sheng Gan Dihuang, slightly stir-fried), Paeoniae Radix (Shaoyao) (each 1 liang), Glycyrrhizae Radix et Rhizoma (Gancao, roasted and cut), Ligusticum Chuanxiong Rhizoma (Xiong), Drynariae Rhizoma (Ganqi, stir-fried until smoke disappears, each 1 qian), Jujubae Fructus (Zao, 7 pieces, pitted and dried), Hairs (Luankoufa, egg-sized, burnt to ash). Cut herbs. Take 3 qian per dose. Add 1 cup water, boil to 0.7 volume, strain. Add a small amount of Natrii Sulfas (Mangxiao), boil for 1-2 more boils. Take warm. Follow up with subsequent doses.
Dahuang Drink: Treats post-abortion retention of blood with unbearable abdominal pain.
Rheum Palmatum Rhizoma et Radix (Dahuang, cut and stir-fried), Paeoniae Radix, Scutellariae Radix (Huangqin, remove black heart), Persicae Semen (Taoren, soaked in hot water, peel and tip removed, double kernel removed, bran-roasted yellow), Angelicae Sinensis Radix (Danggui, slightly roasted, each 1 liang), Cinnamomi Ramulus (Gui, remove rough bark), Glycyrrhizae Radix et Rhizoma (Gancao, roasted red, each 3 qian), Rehmanniae Radix Preparata (Sheng Gan Dihuang, dried 1.5 liang). Cut herbs. Take 3 qian per dose. Add 1 cup water, boil to 0.7 volume, strain. Take warm. Re-administer after a meal interval.
Mudan Pill: Treats post-abortion retention of blood with chills/fever and abdominal pain.
Moutan Cortex, Angelicae Sinensis Radix (roasted red and cut), Paeoniae Radix, Atractylodis Macrocephalae Rhizoma (Baizhu), Araliae Chinensis Ramulus (Guijianyu), Cinnamomi Ramulus (Gui, remove rough bark) (each 1 liang), Rheum Palmatum Rhizoma et Radix (Dahuang, cut and stir-fried 3 qian). Grind into powder. Mix with refined honey to make pills the size of paulownia seeds. Take 20 pills per dose with warm wine, taken intermittently. Gradually increase to 30 pills.
Dahuang Decoction: Treats post-abortion retention of blood.
Rheum Palmatum Rhizoma et Radix (Dahuang, cut and stir-fried), Angelicae Sinensis Radix (Danggui, slightly roasted), Glycyrrhizae Radix et Rhizoma (Gancao, cut and roasted), Evodiae Fructus (Wuzhuyu, washed in hot water and stir-fried yellow), Moutan Cortex (Mu Dan, remove heart and slice), White Peony Root (Baishaoyao) (each 1 liang). Cut herbs. Take 3 qian per dose. Add 1 cup water, 1 qian ginger root (smashed), boil to 0.6 volume, strain. Take warm. Re-administer subsequently.
Taoren Decoction: Treats post-abortion retention of blood with alternating chills/fever and abdominal pain.
Persicae Semen (Taoren, soaked in hot water, peel and tip removed, double kernel removed, bran-roasted yellow, 20 seeds), Evodiae Fructus (Wuzhuyu, washed in hot water and stir-fried yellow, 2 liang), Angelicae Sinensis Radix (Danggui, slightly roasted and cut), Astragali Membranacei Radix (Huangqi, slightly roasted and cut), Paeoniae Radix (Shaoyao) (each 1 liang), Ghee (Tihu, 2 liang). Except for ghee, coarsely crush and sieve other herbs. Take 3 qian per dose. Add 1 qian ginger root (smashed)... [Text continues to next prescription structure] Honglanhua San: Treats post-abortion retention of blood with blood rushing to the heart causing suffocation and loss of consciousness.
Safflower Flos (Honglanhua, slightly roasted), Male Hair (Nan Zi Fa, burnt to ash and ground), Ink Stick (Mo, burnt red), Dragon's Blood (Qilinjie, ground), Pteris Vittatae Spora (Puhuang, stir-fried over paper) (each 1 liang). Grind into powder. Mix with 3-4 fen of urine from an uncircumcised boy, take 2 qian. Immediate recovery expected.
Wujin San: Treats post-abortion retention of lochia, weakness in four limbs, body heat, chest fullness and irritability, and various blood diseases.
Ink Stick (Mo, 2 liang, broken into 2-inch segments, burnt red, dipped 7 times in 1 sheng of good vinegar, burnt red again, cooled, separately ground to powder), Myrrh (Mo Yao, ground), Dragon's Blood (Qilinjie) (each 1 qian), Moschus (Shexiang, 1 qian). Grind into fine powder. Take 1 qian per dose mixed with warm wine. If blood confuses the Heart, take 2 qian mixed with urine from an uncircumcised boy and wine.
Zhigao Drink: Treats post-abortion retention of blood, stabbing heart pain, and severe irritability/confusion.
Porcine Fat (Zhigao, 7 he), White Honey (Baimi, 3 he), Rehmanniae Radix Recens (Sheng Dihuang, cut 2 liang). First mix porcine fat and Rehmanniae Radix Recens, boil until red color appears. Remove Rehmanniae Radix Recens, add 3 he honey, mix well. Divide into two warm doses. Re-administer subsequently.
Baimi Decoction: Treats post-abortion retention of lochia.
White Honey (Baimi, 2 liang), Juice of Rehmanniae Radix Recens (Sheng Dihuang Zhi, 1 cup), Wine (Ban Zhang). First boil juice of Rehmanniae Radix Recens and wine in a copper vessel for 57 boils. Add honey, mix well. Divide into two doses. Take when warm. Re-administer subsequently. Two courses can cure hundred diseases.
Treating post-abortion retention of foul blood.
Ink Stick (Mo, 3 liang, burnt red in charcoal fire, quenched in sour vinegar three times, placed sequentially in clay bowls inverted on clean ground to cool, taken out and ground fine like powder), Myrrh (Mo Yao, 1 liang, separately ground to powder). Mix and grind extremely fine, then sieve. Take exactly 2 qian per dose, mixed with boiled vinegar. Time is not restricted.
Danggui Wine: Treats post-abortion retention of blood.
Angelicae Sinensis Radix (Danggui, roasted fragrant and cut), Paeoniae Radix (Shaoyao, cut and stir-fried) (each 2 liang). Cut herbs. Take exactly 3 qian per dose. Add 1 cup non-distilled wine, 1 he juice of Rehmanniae Radix Recens. In a silver vessel, slowly boil to 0.7 volume, strain. Take warm. Continue until lochia is discharged.
Treating post-abortion retention of blood with lower abdominal fullness and pain.
Burn Antelope Horn (Lingyangjiao) to ash, grind fine like flour. Take exactly 3 qian per dose, regardless of time. Mix with Doulin Wine (bean-dripping wine) to take.
Another Prescription:
Take 2 liang of Angelicae Sinensis Radix (Danggui), boiled in wine, and administer.