吕沧洲治经历哈散侍人,病喘不得卧,众作肺气受风邪治之。吕诊之,气口盛于人迎一
倍,厥阴弦动而疾,两尺俱短而离经,(诊法妙绝)因告之曰∶病盖得之毒药动血,以致胎死
不下,奔迫而上冲,非风寒作喘也,乃用催生汤加芎、归,煮二三升服之,夜半果下一死胎,
喘即止。哈散密嘱曰∶病外家诚有怀,以室人见嫉,故药去之,众所不知也。众惭而去。
平安散 治妊娠上气喘急,大便不通,呕
吐不食,腹胁胀痛。
川芎 木香(各一钱半) 陈皮 熟地黄(洗) 干姜(炮) 生姜 浓朴(制炒) 甘草
(各一钱)
上作一服,水二盅,入烧盐一捻,煎至一盅,不拘时服。
桔梗汤 马兜铃散(并见前咳嗽条)
大全云∶妊娠吐血者,皆由脏腑有伤。凡忧思惊怒,皆伤脏腑,气逆于上,血随而溢,心
闷胸满,久而不已,心闷甚者死。妊娠病此,多堕胎也。
薛氏曰∶前证若肝经怒火,先用小柴胡加山栀、生地,次用前药合四物,后用加味逍遥
散;肝经风热,防风子苓丸;心经有热,朱砂安神丸;心气不足,补心汤;思虑伤心,妙香散;
胃经有火,犀角地黄汤;膏粱积热,加味清胃散;郁结伤脾,加味归脾汤;肺经有火,黄芩清肺饮。
河间生地黄散 治吐血、衄血、咯血、溺血、下血诸见血,无寒皆属于热,但血家证,皆
宜服此药。
生地黄 熟地黄 枸杞子 地骨皮 天门冬 黄 白芍药 黄芩 甘草(各等分)
上 咀,每服一两,水煎服。(黄 益气,枸杞助阳,似于血症当斟酌,然与诸药同用,
则又助气益血耳)如脉微、身凉、恶风,每两加桂半钱。如下血加地榆。
局方必胜散 治男子妇人血妄流溢,吐血、衄血、呕血、咯血。
熟干地黄 小蓟(并根用) 人参 蒲黄(微炒) 当归(去芦) 川芎 乌梅肉(各一两)
上件捣罗为粗末,每服五钱,水煎温服。(此方有人参、芎、归、乌梅,血症新起不可轻试)
吕沧洲治疗经历哈散侍从人员的疾病,患者患喘证不能平卧,众人将其作为肺气受风邪来治疗。吕沧洲诊察发现,气口脉(寸口脉)比人迎脉(颈部动脉)盛大一倍,厥阴脉(肝经脉象)弦动且急促,两尺脉(肾脉)均短促且偏离正常经度,(诊断方法精妙绝伦),于是告诉他们说:这病大概是由于服用毒药导致出血,致使胎死腹中无法排出,气血奔迫向上冲逆,并非风寒引起的喘证,于是使用催生汤加川芎、当归,煮取二三升服用,半夜果然排出一枚死胎,喘证随即停止。哈散私下嘱咐说:病人的外室妾确实有孕,因为正妻嫉妒,所以用药使其流产,这是众人所不知道的。众人羞愧地离开了。
平安散 治疗妊娠期间上气喘急,大便不通,呕吐不进食,腹部和胁肋胀痛。
川芎、木香(各一钱半)、陈皮、熟地黄(洗净)、干姜(炮制)、生姜、浓朴(制炒)、甘草(各一钱)。
以上药材作一服量,加水二盅,放入烧盐一捻,煎至一盅,不拘泥于固定时间服用。
《大全》说:妊娠吐血,都是由于脏腑受损。凡是忧愁思虑、惊恐愤怒,都会损伤脏腑,气机逆乱于上,血液随之溢出,心中烦闷胸部胀满,如果长久不愈,心闷严重会导致死亡。妊娠期间患此病,大多会导致堕胎。
薛氏说:上述病症如果是肝经怒火引起,先用小柴胡汤加山栀、生地,接着用前面的药物合四物汤,最后用加味逍遥散;如果是肝经风热,用防风子苓丸;心经有热,用朱砂安神丸;心气不足,用补心汤;思虑伤心,用妙香散;胃经有火,用犀角地黄汤;膏粱厚味积热,用加味清胃散;郁结伤脾,用加味归脾汤;肺经有火,用黄芩清肺饮。
河间生地黄散 治疗吐血、衄血(鼻出血)、咯血、溺血(尿血)、下血(便血)等各种出血症状,无寒证皆属于热证,只要是血证患者,都适宜服用此药。
生地黄、熟地黄、枸杞子、地骨皮、天门冬、黄芪、白芍药、黄芩、甘草(各等分)。
以上药材切碎,每服一两,水煎服。(黄芪益气,枸杞助阳,似乎对于血症应当斟酌使用,然而与其他药物同用,则是辅助气益血的作用)。如果脉微、身凉、恶风,每两药加桂枝半钱。如果下血加地榆。
局方必胜散 治疗男子妇人血液妄行流溢,吐血、衄血、呕血、咯血。
熟干地黄、小蓟(连根使用)、人参、蒲黄(微炒)、当归(去芦头)、川芎、乌梅肉(各一两)。
以上药材捣碎成粗末,每服五钱,水煎温服。(此方含有人参、川芎、当归、乌梅,血症新发不可轻易尝试)。
Lu Cangzhou treated a servant of the official Hasan, who suffered from asthma and could not lie flat. The majority of physicians treated it as lung qi affected by wind pathogen. Lu’s pulse diagnosis revealed that the Qi Kou (Cunkou pulse) was one-fold stronger than the Ying Ren pulse (carotid artery), the Jue Yin (Liver channel) pulse was wiry, moving, and rapid, while both Chi pulses (Kidney pulses) were short and deviated from the normal Jing (meridian) pattern. (The diagnostic method was exquisitely subtle). He informed them: "This illness likely resulted from toxic drugs causing bleeding, leading to a dead fetus retained in the uterus. The rushing blood forced upward, rather than asthma caused by wind-cold." He prescribed Cui Sheng Tang (Delivery Decoction) with added Xiong (Chuanxiong Rhizome) and Gui (Danggui Radix Angelicae Sinensis), boiled to obtain two or three sheng, which the patient took. At midnight, a dead fetus was indeed expelled, and the asthma ceased immediately. Hasan privately confessed: "The patient's concubine was indeed pregnant, but due to jealousy from the principal wife, she was given abortifacient drugs. This was unknown to others." The other physicians left in shame.
Ping An San (Peaceful Peace Powder) treats asthma and urgency during pregnancy, constipation, vomiting, inability to eat, and distending pain in the abdomen and hypochondrium.
Xiong (Chuanxiong Rhizome), Mu Xiang (Aucklandiae Radix) (each 1.5 qian); Chen Pi (Citri Reticulatae Pericarpium), Shu Di Huang (Rehmanniae Radix Praeparata), Gan Jiang (Zingiberis Rhizoma), Sheng Jiang (Zingiberis Rhizoma Recens), Nong Po (Magnoliae Officinalis Cortex), Gan Cao (Glycyrrhizae Radix et Rhizoma) (each 1 qian).
Take as one dose, add two zhong of water, insert a pinch of burnt salt, decoct until one zhong remains. Take at any time without restriction.
Jie Geng Tang (Platycodon Decoction) and Ma Dou Ling San (Aristolochiae Fructus Powder) (both see previous cough section).
Da Quan states: Hematemesis during pregnancy is always due to injury of the Zang-Fu organs. Sorrow, worry, fright, and anger all injure the Zang-Fu, causing Qi to rebel upward, with blood following to overflow. There is chest oppression and fullness; if prolonged and unhealed, severe chest oppression leads to death. Pregnancy complicated by this condition often results in miscarriage.
Dr. Xue stated: For the aforementioned symptoms, if caused by Liver channel fire anger, first use Xiao Chai Hu Tang (Minor Bupleurum Decoction) with added Shan Zhi (Gardeniae Fructus) and Sheng Di Huang (Rehmanniae Radix); subsequently use the previous formula combined with Si Wu Tang (Four Substances Decoction); finally use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder). If caused by Liver channel wind-heat, use Fang Feng Zi Ling Wan (Saposhnikoviae and Scutellaria Pill). If Heart channel has heat, use Zhu Sha An Shen Wan (Cinnabar Calming Spirit Pill). If Heart Qi is insufficient, use Bu Xin Tang (Tonify Heart Decoction). If worry injures the Heart, use Miao Xiang San (Miraculous Fragrance Powder). If Stomach channel has fire, use Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction). If accumulation of heat from rich food causes issues, use Jia Wei Qing Wei San (Modified Clear Stomach Powder). If constraint injures the Spleen, use Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction). If Lung channel has fire, use Huang Qin Qing Fei Yin (Scutellaria Lung-Clearing Infusion).
He Jian's Sheng Di Huang San (Rehmannia Powder) treats hematemesis, epistaxis, hemoptysis, hematuria, and lower bleeding (hematochezia/melena) and various other hemorrhages. Non-cold conditions all belong to heat; for all blood disorders, this medicine is suitable.
Sheng Di Huang (Rehmanniae Radix), Shu Di Huang (Rehmanniae Radix Praeparata), Gou Qi Zi (Lycii Fructus), Di Gu Pi (Lycii Cortex), Tian Men Dong (Asparagi Radix), Huang Qi (Astragali Radix), Bai Shao Yao (Paeoniae Radix Alba), Huang Qin (Scutellariae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma) (equal parts).
Coarsely crush the above ingredients. Take one liang per dose, decoct in water and take orally. (Huang Qi tonifies Qi, Gou Zi assists Yang; these should be considered cautiously in blood disorders, but when used with other herbs, they assist Qi and nourish Blood). If the pulse is faint, body is cool, and there is aversion to wind, add Ban Qian (0.5 qian) of Gui Zhi (Cinnamomi Ramulus) per liang of herbs. If lower bleeding occurs, add Di Yu (Sanguisorbae Radix).
Ju Fang Bi Sheng San (Victorious Victory Powder from the Bureau Formulary) treats men and women with reckless blood flow, including hematemesis, epistaxis, hematemesis, and hemoptysis.
Shu Gan Di Huang (Prepared Dry Rehmanniae Radix), Xiao Ji (Cirsii Herba, using roots), Ren Shen (Ginseng Radix), Pu Huang (Typhae Pollinis, lightly stir-fried), Dang Gui (Angelicae Sinensis Radix, removed radicle), Chuan Xiong (Chuanxiong Rhizome), Wu Mei Rou (Mume Fructus Flesh) (each 1 liang).
Pound the above ingredients into a coarse powder. Take five qian per dose, decoct in water and take warm. (This formula contains Ren Shen, Chuan Xiong, Dang Gui, and Wu Mei; it should not be lightly tried in newly onset blood disorders).