大全云∶夫产后小便数者,乃气虚不能制故也。
薛氏曰∶前证若因稳婆不慎,以致胞损,而小便淋沥者,用八珍汤以补气血;若因膀胱
气虚,而小便频数,当补脾肺;若膀胱阴虚,而小便淋沥者,须补脾肾。
一产妇小便频数,时忽寒战,乃属脾肺虚弱,用补中益气加山茱、山药为主,佐以桑螵
蛸散而愈。后患发热晡热,盗汗自汗,月水不调,用加味逍遥散而安。
一产妇患前证,吐痰发热,日晡作渴,此膀胱阴虚,用补中益气汤及六味丸而愈。又患
痢后小便频数,手足俱冷,属阳气虚寒,用前汤及八味丸而瘳。
桑螵蛸散 治产后阳气虚弱,小便频数及遗尿。(治气虚频数遗尿)
桑螵蛸(三十个,炒) 鹿茸(酥炙) 黄 (各三两)
牡蛎( ) 人参 浓仆 赤石脂(各二两)
上为末,每服二钱,空心粥饮调下。
《外台》方无浓朴、石脂,有甘草、生姜。
栝蒌汤 疗产后小便数兼渴。(此治虚热)
栝蒌根 人参(各三两) 黄连 桑螵蛸 甘草(炙) 生姜(各二两) 大枣(五十枚)
上细切,用水七升煮二升半,分三服,忌猪肉冷水。
补遗方 疗产后小便数及遗尿。(此命门药也,专主缩小便,虚寒者宜之)
益智仁为末,米饮调服。
陈氏曰∶妇人产蓐,产理不顺,致伤膀胱,遗尿无时。
丹溪云∶尝见收生者不谨,损破产妇尿脬,致病淋沥,遂成废疾。一日有徐妇,年壮难
产得此,因思肌肉破伤,在外者宜可补完,胞虽在腹,恐亦可治,遂诊其脉虚甚,予曰∶难产
之由,多是气虚,产后血气尤虚,试与峻补。因以参 为君,芎归为臣,桃仁、陈皮、黄 、茯
苓为佐(妙在有破血之药),煎以猪羊胞中汤,极饥时饮之,但剂小率用一两,至一月而安。
盖令气血骤长,其胞自完,恐稍缓亦难成功矣。
薛氏曰∶前证若脾肺阳虚,用补中益气汤加益智;若肝肾阴虚,用六味地黄丸;若肝肾
之气虚寒,用八味地黄丸。
一产妇小便不禁,二年不愈,面色或青赤,或黄白,此肝脾气虚血热,用加味逍遥散
为主,渐愈,佐以六味地黄丸而痊。后因怒小便自遗,大便不实,左目顿紧,面色顿赤,仍用
前散,佐以六君子汤,以清肝火生肝血培脾土而痊。
千金方 治产后小便不禁。(以下七方悉有至理,考之本草,乃见方不虚立,集次有条,
醒心会意者当自得之)
白薇 芍药(各等分)
上为末,温酒调下方寸匕。日三服。
又方 治产后小便不禁。
桑螵蛸(半两,炙) 龙骨(一两)
上为末,每服二钱,粥饮调下。
鸡内金散 治产后溺床失禁。
用雄鸡 一具并肠洗,烧为末,温酒调服方寸匕。
广济方 疗产后小便不禁。
用鸡尾毛烧灰存性,酒调下一钱匕,日三服。
黄 当归汤 妇人产后尿不禁,面微浮,略发热于午后,此膀胱为坐婆所伤。
黄 归身尾(归尾破血) 芍药(各一钱半) 白术(一钱) 人参 陈皮(各五分) 甘草(炙,少许)
上水煎,热服之。
固脬散 治妇人临产时伤手脬破,小便不禁。
黄丝绢(自然黄者,染黄者不用,取三尺,以炭灰汁煮极烂,以绢水洗去灰令净) 黄蜡(半两) 蜜(一
两) 白茅根 马屁勃(为末,各二钱)(黄绢煮烂固脬,黄蜡护膜生肌,茅根破血止血,马勃塞虚漏之隙)
上用水二升再煎至二盏,空心顿服。
补脬饮 治产后伤动脬破,终日不小便,但淋沥不干。
生熟绢(黄色者,一尺) 白牡丹根皮 白及(各二钱)(丹皮破血,白及补敛)
上用水一碗,煎至绢烂如饧,服之。
薛氏说:上述病症如果是因为接生婆不慎,导致膀胱受损,而小便淋漓不尽的,用八珍汤来补益气血;如果是因膀胱气虚,而小便频数的,应当补益脾肺;如果是膀胱阴虚,而小便淋漓的,必须补益脾肾。
有一位产妇小便频数,时而突然寒战,这属于脾肺虚弱,用补中益气汤加山茱萸、山药为主药,佐以桑螵蛸散而痊愈。后来出现发热、傍晚发热、盗汗自汗、月经不调的症状,用加味逍遥散而安定。
另一位产妇患上述病症,吐痰发热,傍晚口渴,这是膀胱阴虚,用补中益气汤及六味丸而痊愈。后来又患痢疾后小便频数,手足俱冷,属于阳气虚寒,用前一方剂及八味丸而病愈。
桑螵蛸散 治疗产后阳气虚弱,小便频数及遗尿。(治疗气虚导致的频数遗尿)
桑螵蛸(三十个,炒制) 鹿茸(酥炙) 黄芪(各三两)
牡蛎(煅) 人参 浓朴 赤石脂(各二两)
以上药物研为末,每次服用二钱,空腹时用米粥汁调服。
《外台秘要》中的方子没有浓朴、石脂,有甘草、生姜。
栝蒌汤 治疗产后小便频数兼有口渴。(此方治疗虚热)
栝蒌根 人参(各三两) 黄连 桑螵蛸 甘草(炙) 生姜(各二两) 大枣(五十枚)
以上药物细切,用水七升煮取二升半,分三次服用,忌食猪肉和冷水。
补遗方 治疗产后小便频数及遗尿。(此方是命门药,专门主治缩小便,虚寒者适宜使用)
益智仁研为末,用米饮调服。
陈氏说:妇女在产褥期,生产调理不顺,导致损伤膀胱,遗尿无时。
丹溪说:我曾见接生者不谨慎,损伤产妇膀胱,致病小便淋漓,遂成废疾。有一天有位徐姓妇女,年轻但难产得了此病,我想肌肉破伤,在体表的可以修补完整,膀胱虽在腹内,恐怕也可以治疗,于是诊察她的脉象非常虚弱,我说:难产的原因,多是气虚,产后血气尤其虚弱,试着给予峻补。因此以人参、黄芪为君药,川芎、当归为臣药,桃仁、陈皮、黄芪、茯苓为佐药(妙在有破血之药),用猪羊膀胱汤煎煮,在极度饥饿时饮用,但剂量小,通常用一两,到一个月而平安。大概让气血迅速增长,其膀胱自然修复,恐怕稍慢也难以成功。
薛氏说:上述病症如果脾肺阳虚,用补中益气汤加益智仁;如果肝肾阴虚,用六味地黄丸;如果肝肾之气虚寒,用八味地黄丸。
一位产妇小便不禁,两年不愈,面色有时青赤,有时黄白,这是肝脾气虚血热,用加味逍遥散为主药,逐渐痊愈,佐以六味地黄丸而康复。后来因为发怒导致小便自遗,大便不成形,左眼突然紧绷,面色突然发红,仍用前一方剂,佐以六君子汤,以清肝火、生肝血、培脾土而痊愈。
千金方 治疗产后小便不禁。(以下七个方子都有至理,考证本草,才见方剂不虚立,收集次序有条理,醒心领会的人应当自得其中道理)
白薇 芍药(各等分)
以上研为末,温酒调服一方寸匕。每日三次服用。
又一方 治疗产后小便不禁。
桑螵蛸(半两,炙) 龙骨(一两)
以上研为末,每次服用二钱,粥饮调服。
鸡内金散 治疗产后溺床失禁。
用雄鸡一只连同肠道洗净,烧成末,温酒调服一方寸匕。
广济方 治疗产后小便不禁。
用鸡尾毛烧灰存性,酒调服一钱匕,每日三次服用。
黄芪当归汤 妇人产后尿不禁,面部微浮,午后略发热,这是膀胱被坐婆所伤。
黄芪 归身尾(归尾破血) 芍药(各一钱半) 白术(一钱) 人参 陈皮(各五分) 甘草(炙,少许)
以上用水煎煮,热服。
固脬散 治疗妇人临产时伤手脬破,小便不禁。
黄丝绢(自然黄色的,染黄的不用,取三尺,用炭灰汁煮极烂,用绢水洗去灰令净) 黄蜡(半两) 蜜(一两) 白茅根 马屁勃(研为末,各二钱)(黄绢煮烂固脬,黄蜡护膜生肌,茅根破血止血,马勃塞虚漏之隙)
以上用水二升再煎至二盏,空腹顿服。
补脬饮 治疗产后伤动脬破,终日不小便,但淋沥不干。
生熟绢(黄色者,一尺) 白牡丹根皮 白及(各二钱)(丹皮破血,白及补敛)
以上用水一碗,煎至绢烂如饴糖状,服用。
The *Daquan* states: Frequent urination after childbirth is caused by Qi deficiency failing to control and retain urine.
Mr. Xue stated: If the aforementioned symptoms are due to an obstetrician's negligence causing bladder damage, resulting in dribbling urine, use Bazhen Tang (Eight Treasure Decoction) to tonify Qi and Blood; if it is due to Bladder Qi deficiency with frequent urination, one should tonify the Spleen and Lung; if it is due to Bladder Yin deficiency with dribbling urine, one must tonify the Spleen and Kidney.
A postpartum woman experienced frequent urination and sudden chills, which belonged to Spleen and Lung Qi deficiency. She was treated primarily with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Cornus officinalis Fruit (Shanzhuyu) and Dioscorea Rhizome (Shanyao), assisted by Sangpiaoxiao San (Mantis Egg-case Powder), and recovered. Later, she suffered from fever, afternoon fever, night sweats, spontaneous sweating, and irregular menstruation, which were resolved using Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder).
Another postpartum woman suffered from the aforementioned condition, with expectoration of phlegm, fever, and thirst in the late afternoon, indicating Bladder Yin deficiency. She was cured using Buzhong Yiqi Tang and Liuwei Wan (Six-Ingredient Pill with Rehmannia). Subsequently, she suffered from frequent urination after dysentery, with cold hands and feet, belonging to Yang Qi deficiency and cold. She was treated with the aforementioned decoction and Bawei Wan (Eight-Ingredient Pill) and recovered.
Sangpiaoxiao San treats postpartum Yang Qi weakness, frequent urination, and enuresis. (Treats frequency and enuresis due to Qi deficiency.)
Sangpiaoxiao (Mantis Egg-case) (30 pieces, stir-fried), Lurong (Deer Antler without Horn, prepared with butter), Huangqi (Astragalus Root) (each 3 liang);
Muli (Oyster Shell, calcined), Renshen (Ginseng Root), Houpo (Magnolia Bark), Chishizhi (Red Halloysite) (each 2 liang).
Grind all into powder. Take 2 qian per dose, mixed with millet porridge drink on an empty stomach.
The formula in *Waitai Miyao* lacks Houpo and Chishizhi, but includes Gancao (Licorice Root) and Shengjiang (Fresh Ginger).
Gualou Tang treats postpartum frequent urination accompanied by thirst. (This treats deficient heat.)
Gualougen (Trichosanthes Root), Renshen (Ginseng Root) (each 3 liang); Huanglian (Coptis Rhizome), Sangpiaoxiao (Mantis Egg-case), Gancao (Licorice Root, honey-fried), Shengjiang (Fresh Ginger) (each 2 liang); Dazao (Jujube Fruit) (50 pieces).
Cut finely. Boil in 7 sheng of water until reduced to 2.5 sheng. Divide into three doses. Avoid pork, cold water, and cold foods.
Supplementary Formula treats postpartum frequent urination and enuresis. (This is a Mingmen [Gate of Life] herb, specifically for reducing urination, suitable for deficiency-cold.)
Yizhiren (Bitter Apricot Seed) ground into powder, taken with millet drink.
Mr. Chen stated: During the puerperium, if delivery management is improper, leading to bladder injury, enuresis occurs at any time.
Danxi stated: I have seen midwives being careless, damaging the parturient's urinary bladder, causing dribbling urine and becoming disabled. One day, a Mrs. Xu, young but suffering from difficult labor, contracted this disease. I reasoned that although muscle tears can be repaired externally, the bladder, though inside the abdomen, might also be treatable. Upon examining her pulse, which was extremely weak, I said: The cause of difficult labor is mostly Qi deficiency; postpartum Qi and Blood are especially deficient. Let us try vigorous tonification. Therefore, we used Renshen (Ginseng Root) and Huangqi (Astragalus Root) as Sovereign herbs, Chuanxiong (Szechwan Lovage Rhizome) and Danggui (Angelica Sinensis Root) as Ministers, and Taoren (Peach Kernel), Chenpi (Tangerine Peel), Huangqi (Astragalus Root), Fuling (Poria) as Assistants (the brilliance lies in including blood-breaking herbs). It was decocted in pig or sheep bladder soup and drunk when extremely hungry. Although the dosage was small, typically 1 liang, she recovered within a month. This allowed Qi and Blood to grow rapidly, so the bladder naturally healed; perhaps delaying would have made success difficult.
Mr. Xue stated: If the aforementioned symptoms are due to Spleen and Lung Yang deficiency, use Buzhong Yiqi Tang added with Yizhiren (Bitter Apricot Seed); if due to Liver and Kidney Yin deficiency, use Liuwadihuang Wan (Six-Ingredient Pill with Rehmannia); if due to Liver and Kidney Qi deficiency and cold, use Baweidihuang Wan (Eight-Ingredient Pill with Rehmannia).
A postpartum woman suffered from urinary incontinence for two years without cure. Her complexion was sometimes blue-red, sometimes yellow-white, indicating Liver and Spleen Qi deficiency with Blood heat. She was treated primarily with Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder), gradually recovering, and assisted by Liuwadihuang Wan (Six-Ingredient Pill with Rehmannia) for full recovery. Later, due to anger, she experienced spontaneous urinary leakage, loose stools, sudden tightness in the left eye, and flushed complexion. She was still treated with the previous powder, assisted by Liujunzi Tang (Six Gentlemen Decoction), to clear Liver fire, generate Liver Blood, and fortify Spleen Earth, resulting in recovery.
Qianjin Fang treats postpartum urinary incontinence. (The following seven formulas contain profound principles; verifying them with Materia Medica reveals they are not established in vain, and their collection is orderly. Those who awaken their minds and comprehend the meaning will understand naturally.)
Baiwei (Cynanchum Atratum Root), Shaoyao (Peony Root) (equal parts).
Grind into powder. Mix with warm wine and take one fangcun bi (square-inch spoonful). Take three times daily.
Another formula treats postpartum urinary incontinence.
Sangpiaoxiao (Mantis Egg-case, half liang, roasted), Longgu (Fossilized Bones, 1 liang).
Grind into powder. Take 2 qian per dose, mixed with porridge drink.
Jineijin San treats postpartum bedwetting and incontinence.
Use one male chicken along with its intestines, wash clean, roast into powder. Mix with warm wine and take one fangcun bi.
Guangji Fang treats postpartum urinary incontinence.
Roast chicken tail feathers to ash but preserve their nature. Mix with wine and take one qian bi. Take three times daily.
Huangqi Danggui Tang treats postpartum urinary incontinence in women, with slight facial edema and slight fever in the afternoon, indicating the bladder was injured by the midwife.
Huangqi (Astragalus Root), Dangguiwe (Angelica Sinensis Root tip, which breaks blood stasis), Shaoyao (Peony Root) (each 1.5 qian); Baizhu (Atractylodes Macrocephala Rhizome, 1 qian); Renshen (Ginseng Root), Chenpi (Tangerine Peel) (each 0.5 qian); Gancao (Licorice Root, honey-fried, a little).
Decoct in water and take hot.
Guopao San treats urinary incontinence in women when the bladder is ruptured during delivery due to manual intervention.
Huang sijuan (Yellow silk fabric, natural yellow only, not dyed; take 3 chi, boil thoroughly in charcoal ash juice, wash with silk water to remove ash completely), Huangla (Yellow Beeswax, half liang), Mi (Honey, 1 liang); Baimaogen (Imperata Rhizome), Mapibo (Bleeding Mushroom) (ground into powder, each 2 qian) (Boiled yellow silk consolidates the bladder; beeswax protects membranes and generates flesh; Imperata root breaks blood and stops bleeding; Bleeding mushroom fills void leaks).
Decoct in 2 sheng of water until reduced to 2 zhan. Take in one dose on an empty stomach.
Bupao Yin treats postpartum bladder rupture, where there is no urination for the whole day, but only continuous dribbling.
Shengshu sijuan (Yellow silk fabric, 1 chi); Baimudan Genpi (White Tree Peony Root Bark), Baiji (Bletilla Rhizome) (each 2 qian) (Moutan bark breaks blood; Bletilla tonifies and astringes).
Decoct in one bowl of water until the silk dissolves like syrup. Take orally.