(附论)
夫产伤动于血气。其后虚损未复。而为风冷所伤。血之为性。得冷则凝结。故风冷伤经
血。结于胞络之间。故令月水不通也。凡血结月候不通。则变成血瘕。水血相并。复遇脾胃
衰弱。肌皮虚者。则为水肿也。
方
大黄丸 治产后恶血凝滞。月水不通。
川大黄(一两锉微炒) 桃仁(一两汤浸去皮尖双仁麸炒微黄) 干漆(一两捣碎炒令
烟尽) 赤
水蛭(半两炒令
参(半两去芦头) 当
及合口者微炒去汗) 吴茱萸(一
炒令微黄) 生干地黄(一两) 上为
益母草子散(出圣惠方)治产后恶血积留。经久未消。致月水不通。面色
萎黄。脐腹疼痛。肌瘦无力。
益母草子(一两) 桂心(半两) 当归(三分) 熟干地黄(半两) 大麦 (半两
微炒) 赤芍
(灰半两) 乱发灰(半两)
(一两炒令黄) 麝香(一分研入)
直候干。研入麝香。每服。食前以
虻虫散(出圣惠方)治产后日久月水不通。
虻虫(半两去翅足微炒) 川大黄(三分锉微炒) 乱发灰(半两) 蒲黄(半两) 麒
麟竭(半两)
两) 狗胆(二枚干者)
砂(半两细研水飞过) 上为
虎杖散(出圣惠方)治产后多时月水不调。
虎杖(三分) 牛膝(三分去苗) 苏枋(半两锉) 红蓝花(半两) 莲子心(半两)
当归(三分
(半两) 狗胆(二枚
为散。入研了药令匀。每服。食前温酒调下二钱。
琥珀散(出圣惠方)治产后月水不通。腹胁胀闷。四肢烦疼。饮食减少。
渐觉虚困。
琥珀(一两) 虎杖(三分) 牛膝(一两去苗) 木香(半两) 鳖甲(一两涂醋炙
微黄去裙) 赤
仁(三分去皮尖双仁麸炒黄)
分麸炒微黄去瓤) 上为散。每服三
忌生冷、油腻、苋菜。
牛膝散(出圣惠方)治产后气滞。月水不通。腹胁疼痛。
牛膝(一两去苗) 桂心(半两) 当归(半两锉微炒) 子(一两) 牡丹(半
两) 蓬莪术
仁(半两汤浸去皮尖双仁
盏。入生姜半分。煎至六分
红蓝花散(出圣惠方)治产后月水不通。腹胁刺痛。面色萎黄。时发烦热
。不思饮食。
红蓝花(半两) 琥珀(一两) 川大黄(一两锉碎微炒) 瞿麦(半两) 当归(一
两锉微炒) 桂
两去苗) 桃仁(三分汤浸
食前以温酒调下。
牡丹丸(出圣惠方)治产后月水不通。胁腹滞闷。四肢烦疼。
牡丹(一两) 川大黄(一两锉碎微炒) 赤芍药(一两) 木香(半两) 桃仁(半
两汤浸去皮尖
螬(一分微炒) 瞿
味) 桂心(半两) 上为细
鬼箭羽散(出圣惠方)治产后月水不通。肚腹时痛。四肢烦疼。不欲饮食
。渐觉瘦弱。
鬼箭羽(一两) 川大黄(一两锉碎微炒) 木香(半两) 当归(三分锉微炒) 桂
心(三分) 桃
甲(一两醋涂炙令黄
中盏半。姜入半分。煎至
蛴螬丸(出圣惠方)治产后月水不通。
蛴螬(半两微炒) 虻虫(半两去翅足微炒) 水蛭(半两炒令黄) 桑螵蛸(半两微
炒) 狗胆(二枚干者) 代赭(半两) 川大黄(一两锉微炒) 桃仁(一两汤浸去皮尖
双仁麸炒微黄) 上
赤龙皮散(出圣惠方)治产后滞血在脏。致月水不通。
赤鲤鱼皮(四两烧灰) 虻虫(一分微炒黄去翅足) 水蛭(一分微炒黄) 蒲黄(半
两) 琥珀(
一钱。
砂丸(出圣惠方)治产后月水经久不通。
砂(半两细研) 桂心(半两) 胭脂(一钱研入) 斑蝥(半两去翅足以糯米拌炒
以米黄为度)
三丸。加至五丸。觉脐腹痛。即频服桃仁汤亦通。
子酒(出圣惠方)治产后风冷。留血不去停结。月水闭塞。
子(一斤) 桃仁(二斤汤浸去皮尖双仁麸炒) 大麻仁(一斤) 上用好酒三斗。
同入黄
虎杖煎(出圣惠方)治产后月水不通。
虎杖(一斤锉) 土瓜根汁(半升) 牛膝汁(半升) 上以水五升。渍虎杖一宿。明
旦煎至一升
又方(出圣惠方)治产后月水往来。乍多乍少。仍复不通。时时疼痛。小
腹里急。下引腰身
用鹿角末服。以温酒调下三钱。
又方(出圣惠方)
用生地黄汁三升。煮取二升服之。一方酒煎。
又方(出圣惠方)
用饮人乳汁三合。
(附论)
分娩时损伤了血气。此后虚损尚未恢复,又受到风冷邪气的侵袭。血液的特性是遇到寒冷就会凝结,因此风冷邪气损伤经脉中的血液,使其凝结在胞宫络脉之间,从而导致月经不通畅。凡是血液凝结导致月经停闭的,会演变成血瘕(腹内结块)。如果水湿与瘀血相互搏结,再加上脾胃功能衰弱、肌肤腠理虚弱的人,就会发生水肿。
方剂
大黄丸:治疗产后恶露凝滞,月经不通。
川大黄(一两,锉碎后微炒)、桃仁(一两,汤浸去皮尖及双仁,麸炒至微黄)、干漆(一两,捣碎炒至烟尽)、赤水蛭(半两,炒)、人参(半两,去芦头)、当归(半两,切,合口者微炒去汗)、吴茱萸(一两,炒至微黄)、生干地黄(一两)。以上药物研为细末,炼蜜为丸,如梧桐子大。每服食前以温酒送下二十丸。忌生冷、油腻、苋菜。
益母草子散(出自《圣惠方》):治疗产后恶血积留,经久未消,导致月经不通,面色萎黄,脐腹疼痛,肌肉消瘦无力。
益母草子(一两)、桂心(半两)、当归(三分)、熟干地黄(半两)、大麦(半两,微炒)、赤芍药(半两)、乱发灰(半两)、干漆(一两,炒令黄色)、麝香(一分,研入)。以上药物研为散剂,加入研匀的麝香。每服食前以温水调下二钱。
虻虫散(出自《圣惠方》):治疗产后日久月经不通。
虻虫(半两,去翅足,微炒)、川大黄(三分,锉碎微炒)、乱发灰(半两)、蒲黄(半两)、麒麟竭(半两)、狗胆(二枚,干燥者)、砂(半两,细研,水飞过)。以上药物研为散剂,加入研匀的药物令其均匀。每服食前以温酒调下二钱。
虎杖散(出自《圣惠方》):治疗产后长时间月经不调。
虎杖(三分)、牛膝(三分,去苗)、苏枋(半两,锉)、红蓝花(半两)、莲子心(半两)、当归(三分)、牡丹皮(半两)、狗胆(二枚)。以上药物研为散剂,加入研匀的药物令其均匀。每服食前以温酒调下二钱。忌生冷、油腻、苋菜。
琥珀散(出自《圣惠方》):治疗产后月经不通,腹胁胀闷,四肢烦疼,饮食减少,逐渐感到虚弱困倦。
琥珀(一两)、虎杖(三分)、牛膝(一两,去苗)、木香(半两)、鳖甲(一两,涂醋炙至微黄,去裙边)、赤芍药(三分,去皮尖,双仁,麸炒黄)、桃仁(三分,去皮尖,双仁,麸炒微黄,去瓤)。以上药物研为散剂。每服三钱,食前以温酒调下。忌生冷、油腻、苋菜。
牛膝散(出自《圣惠方》):治疗产后气滞,月经不通,腹胁疼痛。
牛膝(一两,去苗)、桂心(半两)、当归(半两,锉碎微炒)、莪术(一两)、牡丹皮(半两)、蓬莪术(半两,汤浸去皮尖,双仁,麸炒微黄)、红蓝花(半两)。以上药物研为散剂。每服三钱,食前以水一盏,入生姜半分,煎至六分,去滓温服。
红蓝花散(出自《圣惠方》):治疗产后月经不通,腹胁刺痛,面色萎黄,时常发作烦热,不思饮食。
红蓝花(半两)、琥珀(一两)、川大黄(一两,锉碎微炒)、瞿麦(半两)、当归(一两,锉碎微炒)、桂心(半两)、牛膝(半两,去苗)、桃仁(三分,汤浸去皮尖,双仁,麸炒微黄)。以上药物研为散剂。每服食前以温酒调下二钱。
牡丹丸(出自《圣惠方》):治疗产后月经不通,胁腹滞闷,四肢烦疼。
牡丹皮(一两)、川大黄(一两,锉碎微炒)、赤芍药(一两)、木香(半两)、桃仁(半两,汤浸去皮尖,双仁,麸炒微黄)、蛴螬(一分,微炒)、瞿麦(半两)、桂心(半两)。以上药物研为细末,炼蜜为丸,如梧桐子大。每服食前以温酒送下二十丸。
鬼箭羽散(出自《圣惠方》):治疗产后月经不通,肚腹时而疼痛,四肢烦疼,不欲饮食,逐渐感到瘦弱。
鬼箭羽(一两)、川大黄(一两,锉碎微炒)、木香(半两)、当归(三分,锉碎微炒)、桂心(三分)、桃仁(半两,汤浸去皮尖,双仁,麸炒微黄)、鳖甲(一两,醋涂炙令黄色,去裙边)。以上药物研为散剂。每服三钱,食前以水一中盏半,入生姜半分,煎至六分,去滓温服。
蛴螬丸(出自《圣惠方》):治疗产后月经不通。
蛴螬(半两,微炒)、虻虫(半两,去翅足,微炒)、水蛭(半两,炒令黄色)、桑螵蛸(半两,微炒)、狗胆(二枚,干燥者)、代赭石(半两)、川大黄(一两,锉碎微炒)、桃仁(一两,汤浸去皮尖,双仁,麸炒微黄)。以上药物研为细末,炼蜜为丸,如梧桐子大。每服食前以温酒送下二十丸。
赤龙皮散(出自《圣惠方》):治疗产后瘀血在脏,导致月经不通。
赤鲤鱼皮(四两,烧灰)、虻虫(一分,微炒黄,去翅足)、水蛭(一分,微炒黄)、蒲黄(半两)、琥珀(一钱)。以上药物研为散剂。每服食前以温酒调下二钱。
硇砂丸(出自《圣惠方》):治疗产后月经经久不通。
硇砂(半两,细研)、桂心(半两)、胭脂(一钱,研入)、斑蝥(半两,去翅足,以糯米拌炒,以米黄色为度)。以上药物研为细末,炼蜜为丸,如绿豆大。每服食前以温酒送下三丸,加至五丸。若感觉脐腹痛,即频繁服用桃仁汤也可通经。
桃仁酒(出自《圣惠方》):治疗产后风冷,留血不去停结,月经闭塞。
桃仁(一斤,汤浸去皮尖,双仁,麸炒)、大麻仁(一斤)。以上药物与上好酒三斗,同入锅中煎煮。
虎杖煎(出自《圣惠方》):治疗产后月经不通。
虎杖(一斤,锉碎)、土瓜根汁(半升)、牛膝汁(半升)。以上药物以水五升,浸泡虎杖一夜,明早煎至一升,去滓温服。
又一方(出自《圣惠方》):治疗产后月经往来,忽多忽少,仍然不通,时时疼痛,小腹拘急,牵引腰身。
用鹿角末,以温酒调下三钱。
又一方(出自《圣惠方》)
用生地黄汁三升,煮取二升服用。另一方法是用酒煎服。
又一方(出自《圣惠方》)
用人乳汁三合饮用。
(Attached Discussion)
Childbirth injures the blood and qi. Subsequently, if the deficiency and damage have not yet recovered, and one is injured by wind-cold pathogenic factors, the nature of blood is to coagulate when exposed to cold. Therefore, wind-cold injuring the meridional blood causes it to coagulate between the uterine collaterals, resulting in amenorrhea (cessation of menstruation). Whenever blood coagulation leads to menstrual obstruction, it transforms into a blood mass (blood accumulation forming a palpable lump). If water-dampness and blood stasis combine, and this occurs in individuals with weakened spleen and stomach functions and deficient muscle and skin layers, edema (swelling due to fluid retention) will develop.
Prescriptions
Dahuang Wan (Rhubarb Pill): Treats postpartum lochia stagnation and amenorrhea.
Chuan Dahuang (Rhizoma Rhei, 1 liang, crushed and lightly stir-fried), Taoren (Semen Persicae, 1 liang, soaked in water, peeled, de-veined, double-kernel removed, bran-fried until slightly yellow), Ganqi (Resina Draconis, 1 liang, pounded and fried until smoke ceases), Chishui Shizhi (Hirudo, half liang, fried), Renshen (Radix Ginseng, half liang, rhizome removed), Danggui (Radix Angelicae Sinensis, half liang, sliced; those with closed ends are lightly fried to remove moisture), Wuzhuyu (Fructus Evodiae, 1 liang, fried until slightly yellow), Shenggan Dihuang (Radix Rehmanniae Preparata, 1 liang). The above ingredients are ground into fine powder, mixed with honey to form pills the size of wutong seeds. Take 20 pills before meals with warm wine. Avoid raw, cold, greasy foods, and amaranth.
Yimucaozi San (Motherwort Seed Powder) (from *Taiping Shenghui Fang*): Treats postpartum accumulation of evil blood that persists for a long time without dissipating, leading to amenorrhea, sallow complexion, pain in the umbilical and abdominal regions, emaciation, and weakness.
Yimucaozi (Semen Leonuri, 1 liang), Guixin (Cortex Cinnamomi, half liang), Danggui (Radix Angelicae Sinensis, 3 fen), Shugan Dihuang (Radix Rehmanniae Preparata, half liang), Damai (Frumentum Hordei, half liang, lightly fried), Chishaoyao (Radix Paeoniae Rubra, half liang), Luangfa Hui (Ash of Human Hair, half liang), Ganqi (Resina Draconis, 1 liang, fried until yellow), Shexiang (Moschus, 1 fen, ground and added). The above ingredients are ground into powder, and the ground Moschus is incorporated evenly. Take 2 qian before meals with warm water.
Mengchong San (Bleeding Fly Powder) (from *Taiping Shenghui Fang*): Treats amenorrhea persisting for a long time after childbirth.
Mengchong (Musca Blepharis, half liang, wings and feet removed, lightly fried), Chuan Dahuang (Rhizoma Rhei, 3 fen, crushed and lightly fried), Luangfa Hui (Ash of Human Hair, half liang), Puhuang (Pollen Typhae, half liang), Qilinjie (Santalum Rubrum, half liang), Goudan (Bile Canis, 2 dried gallbladders), Naosha (Sal Ammoniac, half liang, finely ground and washed with water). The above ingredients are ground into powder, and the pre-ground ingredients are mixed in evenly. Take 2 qian before meals with warm wine.
Huzhang San (Polygoni Cuspidati Powder) (from *Taiping Shenghui Fang*): Treats irregular menstruation persisting for a long time after childbirth.
Huzhang (Rhizoma Polygoni Cuspidati, 3 fen), Niuxi (Radix Achyranthis Bidentatae, 3 fen, radixlets removed), Sufang (Lignum Santali Rubrum, half liang, crushed), Honglanhua (Flos Carthami Tinctorii, half liang), Lianzixin (Plumula Nelumbinis, half liang), Danggui (Radix Angelicae Sinensis, 3 fen), Mudanpi (Cortex Moutan, half liang), Goudan (Bile Canis, 2). The above ingredients are ground into powder, and the pre-ground ingredients are mixed in evenly. Take 2 qian before meals with warm wine. Avoid raw, cold, greasy foods, and amaranth.
Hupo San (Amber Powder) (from *Taiping Shenghui Fang*): Treats postpartum amenorrhea accompanied by distension and oppression in the abdomen and hypochondrium, painful limbs, reduced appetite, and gradual feelings of weakness and fatigue.
Hupo (Electrum, 1 liang), Huzhang (Rhizoma Polygoni Cuspidati, 3 fen), Niuxi (Radix Achyranthis Bidentatae, 1 liang, radixlets removed), Muxiang (Radix Aucklandiae, half liang), Biejia (Carapax et Plastrum Testudinis, 1 liang, coated with vinegar and fried until slightly yellow, skirt edges removed), Chishaoyao (Radix Paeoniae Rubra, 3 fen, peeled, double-kernel removed, bran-fried until yellow), Taoren (Semen Persicae, 3 fen, peeled, de-veined, double-kernel removed, bran-fried until slightly yellow, pith removed). The above ingredients are ground into powder. Take 3 qian before meals with warm wine. Avoid raw, cold, greasy foods, and amaranth.
Niuxi San (Achyranthes Powder) (from *Taiping Shenghui Fang*): Treats postpartum qi stagnation and amenorrhea accompanied by abdominal and hypochondriac pain.
Niuxi (Radix Achyranthis Bidentatae, 1 liang, radixlets removed), Guixin (Cortex Cinnamomi, half liang), Danggui (Radix Angelicae Sinensis, half liang, crushed and lightly fried), Ezhu (Rhizoma Curcumae Longae, 1 liang), Mudanpi (Cortex Moutan, half liang), Peng'ezhu (Rhizoma Curcumae Phaeocaulis, half liang, soaked in water, peeled, de-veined, double-kernel removed, bran-fried until slightly yellow), Honglanhua (Flos Carthami Tinctorii, half liang). The above ingredients are ground into powder. Take 3 qian before meals, decocted with 1 cup of water and half a slice of fresh ginger until reduced to 0.6 cups, then strain and take warm.
Honglanhua San (Carthamus Powder) (from *Taiping Shenghui Fang*): Treats postpartum amenorrhea accompanied by stabbing pain in the abdomen and hypochondrium, sallow complexion, occasional irritability and fever, and loss of appetite.
Honglanhua (Flos Carthami Tinctorii, half liang), Hupo (Electrum, 1 liang), Chuan Dahuang (Rhizoma Rhei, 1 liang, crushed and lightly fried), Qumai (Herba Dianthi, half liang), Danggui (Radix Angelicae Sinensis, 1 liang, crushed and lightly fried), Guixin (Cortex Cinnamomi, half liang), Niuxi (Radix Achyranthis Bidentatae, half liang, radixlets removed), Taoren (Semen Persicae, 3 fen, soaked in water, peeled, de-veined, double-kernel removed, bran-fried until slightly yellow). The above ingredients are ground into powder. Take 2 qian before meals with warm wine.
Mudan Wan (Tree Peony Pill) (from *Taiping Shenghui Fang*): Treats postpartum amenorrhea accompanied by stagnation and oppression in the hypochondrium and abdomen, and painful limbs.
Mudanpi (Cortex Moutan, 1 liang), Chuan Dahuang (Rhizoma Rhei, 1 liang, crushed and lightly fried), Chishaoyao (Radix Paeoniae Rubra, 1 liang), Muxiang (Radix Aucklandiae, half liang), Taoren (Semen Persicae, half liang, soaked in water, peeled, de-veined, double-kernel removed, bran-fried until slightly yellow), Qicao (Tenebrio Molitor Larva, 1 fen, lightly fried), Qumai (Herba Dianthi, half liang), Guixin (Cortex Cinnamomi, half liang). The above ingredients are ground into fine powder, mixed with honey to form pills the size of wutong seeds. Take 20 pills before meals with warm wine.
Guijianyu San (Eucommia Twig Powder) (from *Taiping Shenghui Fang*): Treats postpartum amenorrhea accompanied by intermittent abdominal pain, painful limbs, anorexia, and gradual emaciation.
Guijianyu (Ramulus Eucommiae, 1 liang), Chuan Dahuang (Rhizoma Rhei, 1 liang, crushed and lightly fried), Muxiang (Radix Aucklandiae, half liang), Danggui (Radix Angelicae Sinensis, 3 fen, crushed and lightly fried), Guixin (Cortex Cinnamomi, 3 fen), Taoren (Semen Persicae, half liang, soaked in water, peeled, de-veined, double-kernel removed, bran-fried until slightly yellow), Biejia (Carapax et Plastrum Testudinis, 1 liang, coated with vinegar and fried until yellow, skirt edges removed). The above ingredients are ground into powder. Take 3 qian before meals, decocted with 1.5 cups of water and half a slice of fresh ginger until reduced to 0.6 cups, then strain and take warm.
Qicao Wan (Tenebrio Molitor Larva Pill) (from *Taiping Shenghui Fang*): Treats postpartum amenorrhea.
Qicao (Tenebrio Molitor Larva, half liang, lightly fried), Mengchong (Musca Blepharis, half liang, wings and feet removed, lightly fried), Shuizhi (Hirudo, half liang, fried until yellow), Sangpiaoxiao (Oötheca Mantidis, half liang, lightly fried), Goudan (Bile Canis, 2 dried gallbladders), Daizhe (Haematitum, half liang), Chuan Dahuang (Rhizoma Rhei, 1 liang, crushed and lightly fried), Taoren (Semen Persicae, 1 liang, soaked in water, peeled, de-veined, double-kernel removed, bran-fried until slightly yellow). The above ingredients are ground into fine powder, mixed with honey to form pills the size of wutong seeds. Take 20 pills before meals with warm wine.
Chilongpi San (Red Carp Skin Powder) (from *Taiping Shenghui Fang*): Treats postpartum blood stasis in the zang organs causing amenorrhea.
Chiliyu Pi (Cutis Cyprini Carassii, 4 liang, burned to ash), Mengchong (Musca Blepharis, 1 fen, lightly fried until yellow, wings and feet removed), Shuizhi (Hirudo, 1 fen, lightly fried until yellow), Puhuang (Pollen Typhae, half liang), Hupo (Electrum, 1 qian). The above ingredients are ground into powder. Take 2 qian before meals with warm wine.
Naosha Wan (Sal Ammoniac Pill) (from *Taiping Shenghui Fang*): Treats prolonged postpartum amenorrhea.
Naosha (Sal Ammoniac, half liang, finely ground), Guixin (Cortex Cinnamomi, half liang), Yanzhi (Vermilion, 1 qian, ground and added), Banmao (Mylabris, half liang, wings and feet removed, stir-fried with glutinous rice until the color turns like rice husk). The above ingredients are ground into fine powder, mixed with honey to form pills the size of mung beans. Take 3 pills before meals with warm wine, increasing to 5 pills. If umbilical and abdominal pain is felt, frequently taking Taoren Tang (Persica Decoction) can also induce menstruation.
Taoren Jiu (Persica Wine) (from *Taiping Shenghui Fang*): Treats postpartum wind-cold causing retained blood to stagnate and clot, resulting in menstrual obstruction.
Taoren (Semen Persicae, 1 jin, soaked in water, peeled, de-veined, double-kernel removed, bran-fried), Dama Ren (Semen Cannabis, 1 jin). Combine with 3 dou of high-quality wine and simmer in a pot.
Huzhang Jian (Polygoni Cuspidati Decoction) (from *Taiping Shenghui Fang*): Treats postpartum amenorrhea.
Huzhang (Rhizoma Polygoni Cuspidati, 1 jin, crushed), Tugua Gen Zhi (Succus Radices Trichosanthis Kirilowii, half sheng), Niuxi Zhi (Succus Radicis Achyranthis Bidentatae, half sheng). Soak Rhizoma Polygoni Cuspidati in 5 sheng of water overnight. On the next morning, decoct until 1 sheng remains, strain, and take warm.
Another Prescription (from *Taiping Shenghui Fang*): Treats postpartum menstruation coming and going, fluctuating in volume, remaining obstructed, with frequent pain and urgency in the lower abdomen radiating to the waist and body.
Use Luzhao Mo (Cornu Cervi Pantotrichum Powder), taken with 3 qian mixed in warm wine.
Another Prescription (from *Taiping Shenghui Fang*)
Use 3 sheng of fresh Shengdihuang Zhi (Succus Radicis Rehmanniae Recens), boiled down to 2 sheng, and take. Another method is to decoct with wine.
Another Prescription (from *Taiping Shenghui Fang*)
Drink 3 he of human breast milk.