大全云∶余血奔心,盖是分娩了不便,与童子小便(凡产后血虚,气无所附,则逆而为
火,火上逆而瘀血迫之,则心烦矣。童便,浊阴也,其味苦咸寒,其性就下,降火消瘀,故宜服
之,所谓浊阴出下窍也),并 心下,及卧太速,兼食不相宜之物所致,但能根据方疗之,无不痊可。
薛氏曰∶四物汤加茯神远志,治产后虚烦,十全大补汤尤效,论见发热条。
陈氏曰∶寻常治诸虚烦热者,以竹叶石膏汤、温胆汤,殊不知产后与寻常不同,如石膏
等药不宜轻用,用之必死。
金黄散 治产后恶血冲心,时发烦躁。
玄胡索 蒲黄(各半两) 桂心(二钱半)
上为细末,乌梅煎汤,调下二钱。(蒲黄生用性凉逐瘀,桂心去皮性热行血,乌梅酸收涤
污,用此方不可忘此法,前方以热行血,此方以凉行血,集方者泾渭自分,用方者毋得朱紫不辨)
荷叶散 疗产后七日内宿血不散,时时冲心迷闷。
荷叶(一两七钱半) 玄胡索(二两) 地黄汁(二合)
上用水二升煮二味取六合,下玄胡索,分三服,空心服,忌肉食一日。
川芎散 疗产后余血不尽,奔上冲心,烦闷腹痛。(此方行气行血,不热不寒,较前方是
一天霁色,令人心旷神怡)
川芎 生干地黄 白芍 枳壳(各等分)
上为末,酒调方寸匕,日二服。
集验方 产后血气烦闷。(此方清新简切)
生地黄汁 清酒(各一升)
上二味相和,煎一沸,分为两服。(以上四方,看一方有一方妙用,细玩之,真如山阴道
上行,令人不忍舍去)
经效方 疗产后气虚,冷搏于血,血气结滞,上冲心腹,胀满。(读治症语,便知用药宜
温,所谓寒者热之,留者行之也)
当归 川芎 桂心 吴茱萸 陈皮 生姜(各一两) 白芍(二两)
上 咀,以水三升煮取一升,去滓,空心服。
没药丸 治产后心胸烦躁,恶血不快。(以烦躁二字,似不宜用热药,问到恶血不快,
便是瘀血冲心,而如此温行破血之药必不可少者也,又乌论其烦而不用热药哉)
没药 蛮姜 玄胡索 当归 干漆(炒) 桂心 牛膝 牡丹皮 干姜(各等分)
上为细末,醋煮面糊,丸如桐子大,煎曲汤下十丸至十五丸。
治血气烦闷杂方
生藕汁饮二升,效,竹沥亦得。(连读数方,各呈妙相,如化工天巧,有难描画)
一方 陈白梅槌碎,煎汤饮。(此数方又有淡妆浓抹之致)
一方 蒲黄隔纸炒,每服一钱,东流水煎汤下。用失笑散亦佳。
一方 疗产后余血攻心,或下血不止,心闷面青,冷气欲绝,用羊血一盏顿服,若不定,
更服立效。(藕汁、竹沥虽俱治烦,然清火则同,而破血消痰则异,宜别之。如陈白梅、蒲
黄、失笑散,人皆能之,而羊血之用诚有夺天之力,造方者集方者均种德无涯矣)
以上治余血奔心之剂。
人参当归汤 治产后去血过多,血虚则阴虚,阴虚生内热,以致心烦短气,自汗头痛。
人参 当归 熟地黄 门冬(去心) 肉桂(各二钱) 白芍药(炒,二钱半)
上用水二盅,粳米一合,竹叶十片,煎至一盅,食远服。(此方以四物去川芎,恶其散气
也,用肉桂助其止汗也,但与众药等分,亦须斟酌,而以粳米竹叶加之,治心烦短气之良法
矣,血热加生地尤佳,如肉桂所当去也)血热甚者,加生地黄二钱。
竹叶汤 治产后短气欲绝,心口烦闷。
竹叶(切细) 麦门冬(去心) 小麦(各一升) 甘草(一两) 生姜(二两) 大枣(十二枚)
上切,以水一斗煮竹叶、小麦至八升,去渣,纳余药煮取三升,去渣,温服(此方以小麦
补心,麦门竹叶除烦,甘草大枣益气,安其子并培其母,亦良法也,生姜佐之,更有赞襄之
力,而曰虚悸加参,多多益善,糯米用之,为少力之助,又养阴也)。 虚悸,加人参二两;少
气力,加糯米五合。
甘竹茄汤 治产后内虚,烦热短气。
甘竹茹(一升) 人参 麦门冬(去心) 茯苓 甘草(各一两) 黄芩(三两)
上 咀,以水六升煮取二升,去渣,分三服,日三。(此治虚烦短气神方,虽品味数少,
而药力精专,可法可法。如黄芩又可去取者也)
薤白汤 治产后胸中烦热逆气,(此治胸痹法之变也,原方出自仲景,薤白、半夏所以
治逆气,栝蒌根、麦门所以治烦热,人参、甘草补虚,知母石膏之加,非热甚不用,盖为血虚
所忌故也)
薤白 半夏 人参 甘草(各一两) 栝蒌根(二两) 麦门冬(半斤)
热甚,加知母、石膏。
上 咀,以水一斗三升煮取四升,去滓,分五服,日三夜二。
芍药栀豉汤 治产后虚烦不得眠。
白芍 当归 栀子(各五钱) 香豉(半合)
上用水二盅半先煮前三味,得二盅,纳香豉煮取一盅半,去滓,分二服,温服。(此虽云
岐法,不若仲景酸枣汤稳当。仲景治伤寒虚烦不眠,有栀子豉汤,而此加白芍、当归者,乃云
岐变伤寒法,以治产后也。人常谓伤寒方可通于杂症,有是哉)
以上治血气虚烦之剂。
仲景二物黄芩汤 妇人在草蓐,自发露得风,四肢苦烦热,头痛者,与小柴胡汤,头不
痛,但烦者,此汤主之(要在风字上看,以头痛不痛为法)。
黄芩(一两) 苦参(二两)(此大苦寒之剂,与产后非宜,意者热病成烦欤,要以但烦二字上
体贴) 干地黄(四两)
上三味,以水八升煮取二升,温服一升,多吐下虫。
竹皮大丸 治妇人产后中虚,烦乱呕逆,安中益气。
生竹茹 石膏(各二分) 桂枝 白薇(各一分) 甘草
上五味为末,枣肉和,丸如弹子大,以饮服一丸,日三夜二服(中虚症不可用石膏,烦
乱不可用桂枝,而此方以甘草七分发众药六分,又以枣而为丸,仍以一丸饮下,可想见
其立方之微,用药之难,审虚实之不易也,仍饮服者,尤虑夫虚虚之祸耳,用是方者亦当深
省)。有热倍白薇,烦喘加柏实一分。
以上治中风烦热之剂。
经验方 治产后烦躁,此重可去怯之义。
禹余粮一枚,状如酸馅者,入地埋一半,四面紧筑,用炭一秤,发顶火一斤, 去火三
分耗二为度,用湿土罨一宿,方取出,打去
外面一层,只用里内细研,水淘澄五七度,将纸衬干,再研数千遍,用甘草汤调二钱匕,只
一服,立效。
《大全》说:产后余血奔心,大概是因为分娩后恶露排出不畅,与饮用童子小便(凡是产后血虚,气无所依附,就会逆乱化为火,火气上逆逼迫瘀血,就会导致心烦。童子尿属于浊阴之品,味道苦、咸、寒,性质趋下,能降火消瘀,所以适宜服用,这就是所说的“浊阴出下窍”的道理),以及仰卧速度过快,兼吃不相宜的食物所导致。只要能够根据方剂治疗,没有不能痊愈的。
薛氏说:用四物汤加茯神、远志,治疗产后虚烦,十全大补汤尤其有效,论述见发热条。
陈氏说:平常治疗各种虚烦热的病症,多用竹叶石膏汤、温胆汤,却不知道产后与平常不同,像石膏等药不宜轻易使用,使用了必然致死。
金黄散:治疗产后恶血冲心,时常发作烦躁。
玄胡索、蒲黄(各半两)、桂心(二钱半)。
以上研为细末,用乌梅煎汤,调服二钱。(蒲黄生用性凉以逐瘀,桂心去皮性热以行血,乌梅酸收以涤除污秽,使用此方不可忘记这些法度,前方用热药行血,此方用凉药行血,收集方剂的泾渭分明,使用者不得混淆黑白)
荷叶散:治疗产后七日内宿血不散,时时冲心导致迷闷。
荷叶(一两七钱半)、玄胡索(二两)、地黄汁(二合)。
以上用水二升煮前两种药,取六合药液,加入玄胡索,分三次服用,空腹服用,忌食肉食一天。
川芎散:治疗产后余血不尽,奔上冲心,烦闷腹痛。(此方行气行血,不热不寒,比前面的方子如雨后初晴般清爽,令人心旷神怡)
川芎、生干地黄、白芍、枳壳(各等分)。
以上研为末,用酒调服方寸匕,每日两次。
集验方:治疗产后血气烦闷。(此方清新简切)
生地黄汁、清酒(各一升)。
以上两味相和,煎沸一次,分为两份服用。(以上四方,看一方有一方的妙用,仔细玩味,真像在山路上行进,令人不忍舍弃)
经效方:治疗产后气虚,冷邪搏结于血,血气结滞,上冲心腹,胀满。(读治症的文字,便知道用药宜温,这就是所谓的“寒者热之,留者行之”)
当归、川芎、桂心、吴茱萸、陈皮、生姜(各一两)、白芍(二两)。
以上切碎,用水三升煮取一升,去渣,空腹服用。
没药丸:治疗产后心胸烦躁,恶血不畅。(仅凭“烦躁”二字,似乎不宜用热药,但问到“恶血不快”,便是瘀血冲心,而如此温通破血的药必不可少,又何况因为烦躁就不使用热药呢?)
没药、蛮姜、玄胡索、当归、干漆(炒)、桂心、牛膝、牡丹皮、干姜(各等分)。
以上研为细末,用醋煮面糊,制成梧桐子大小的丸药,煎曲汤送服十丸至十五丸。
治疗血气烦闷的杂方:
生藕汁饮二升,有效,竹沥也可以。(连续数方,各呈妙相,如化工天巧,难以描画)
一方:陈白梅捶碎,煎汤饮用。(这几方又有淡妆浓抹的风致)
一方:蒲黄隔纸炒,每服一钱,东流水煎汤送下。使用失笑散也很好。
一方:治疗产后余血攻心,或下血不止,心闷面青,冷气欲绝,用羊血一盏顿服,如果不定,再服立效。(藕汁、竹沥虽然都治烦,但清火相同,而破血消痰则不同,应当区分。如陈白梅、蒲黄、失笑散,人们都能做到,而羊血的使用确实有夺天工之力,造方者和集方者都种下了无边的福德)
以上是治疗余血奔心的药剂。
人参当归汤:治疗产后去血过多,血虚则阴虚,阴虚生内热,以致心烦短气,自汗头痛。
人参、当归、熟地黄、门冬(去心)、肉桂(各二钱)、白芍药(炒,二钱半)。
以上用水二盅,粳米一合,竹叶十片,煎至一盅,饭后服用。(此方以四物汤去掉川芎,是厌恶它耗散气机,用肉桂帮助止汗,但与众药等分,也须斟酌,加上粳米、竹叶,是治疗心烦短气的良法,血热加生地黄尤其好,如肉桂就应当去掉)血热甚重的,加生地黄二钱。
竹叶汤:治疗产后短气欲绝,心口烦闷。
竹叶(切细)、麦门冬(去心)、小麦(各一升)、甘草(一两)、生姜(二两)、大枣(十二枚)。
以上切碎,用水一斗煮竹叶、小麦至八升,去渣,纳入其余药物煮取三升,去渣,温服。(此方以小麦补心,麦门冬、竹叶除烦,甘草、大枣益气,安其子并培其母,也是良法,生姜佐助,更有赞襄之力,如果说虚悸加人参,多多益善,糯米用来作为少力之助,又能养阴)。虚悸,加人参二两;少气力,加糯米五合。
甘竹茹汤:治疗产后内虚,烦热短气。
甘竹茹(一升)、人参、麦门冬(去心)、茯苓、甘草(各一两)、黄芩(三两)。
以上切碎,用水六升煮取二升,去渣,分三次服用,每日三次。(这是治疗虚烦短气的神方,虽然品味数量少,而药力精专,值得效法。如黄芩又可去取者也)
薤白汤:治疗产后胸中烦热逆气。(这是治疗胸痹法的变通,原方出自张仲景,薤白、半夏所以治逆气,栝蒌根、麦门冬所以治烦热,人参、甘草补虚,知母、石膏的加入,不是热甚不用,因为是血虚所忌讳的缘故)
薤白、半夏、人参、甘草(各一两)、栝蒌根(二两)、麦门冬(半斤)。
热甚,加知母、石膏。
以上切碎,用水一斗三升煮取四升,去渣,分五次服用,日三夜二。
芍药栀豉汤:治疗产后虚烦不得眠。
白芍、当归、栀子(各五钱)、香豉(半合)。
以上用水二盅半先煮前三味,得二盅,纳香豉煮取一盅半,去渣,分两次服用,温服。(这虽然是岐伯之法的变化,不如张仲景的酸枣汤稳当。张仲景治疗伤寒虚烦不眠,有栀子豉汤,而此方加白芍、当归,乃是云岐子变化伤寒法,用来治疗产后病。人们常说伤寒方可通用于杂症,难道是这样吗?)
以上是治疗血气虚烦的药剂。
张仲景二物黄芩汤:妇人在产褥期,自发露受风,四肢苦烦热,头痛者,与小柴胡汤,头不痛,但烦者,此汤主之(关键在于从“风”字上看,以头痛与否为辨证方法)。
黄芩(一两)、苦参(二两)(这是大苦寒的药剂,与产后情况不相宜,意思是热病成烦吗?要以“但烦”二字来体贴理解)干地黄(四两)。
以上三味,用水八升煮取二升,温服一升,多吐下虫。
竹皮大丸:治疗妇人产后中虚,烦乱呕逆,安中益气。
生竹茹、石膏(各二分)、桂枝、白薇(各一分)、甘草。
以上五味为末,枣肉调和,制成弹子大小的丸药,用饮水送服一丸,日三夜二服(中虚症不可用石膏,烦乱不可用桂枝,而此方以甘草七分发众药六分,又以枣肉为丸,仍以一丸饮水送下,可想见其立方之微妙,用药之难,审虚实之不易,仍然用饮水送服,更是担心虚虚之祸啊,使用此方的人也应当深思)。有热倍白薇,烦喘加柏实一分。
以上是治疗中风烦热的药剂。
经验方:治疗产后烦躁,这是重可去怯的意思。
禹余粮一枚,形状像酸馅的,入地埋一半,四面紧筑,用炭一秤,发顶火一斤,烧去火三分耗损二分为度,用湿土覆盖一宿,才取出,打去外面一层,只用里面部分细研,水淘澄五七次,将纸衬干,再研数千遍,用甘草汤调服二钱匕,只一服,立效。
The *Daquan* states: Postpartum blood rushing to the heart is generally caused by incomplete expulsion of lochia after delivery, combined with drinking child's urine (whenever postpartum blood deficiency occurs, Qi has no attachment and rebels into fire; as fire rises, it forces stagnant blood upward, causing mental restlessness. Child's urine is a turbid yin substance; its taste is bitter, salty, and cold, and its nature tends downward, capable of descending fire and resolving stasis, thus it is suitable for consumption, which is what is meant by "turbid yin exits through the lower orifices"). It may also be caused by lying down too quickly and consuming incompatible foods. If treated according to the formulas, recovery is assured.
Xue Shi said: Siwu Tang (Four Substances Decoction) added with Fushen (Poria with Hostwood) and Yuanzhi (Polygala Root) treats postpartum deficiency-related mental restlessness; Shiquan Dabu Tang (Perfect Ten Tonifying Decoction) is especially effective. See the section on fever for discussion.
Chen Shi said: For ordinary cases of various deficiency-heat mental restlessness, Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction) and Wendan Tang (Gallbladder-Warming Decoction) are commonly used. However, one must not ignore that postpartum conditions differ from ordinary ones. Drugs like Shigao (Gypsum Fibrosum) should not be used lightly; doing so can be fatal.
Jinhuang San (Golden Yellow Powder): Treats postpartum evil blood rushing to the heart, causing intermittent irritability.
Yanhusuo (Corydalis Rhizome), Puhuang (Lygodii Spora) (each 0.5 liang); Guixin (Cinnamon Twig Bark) (2.5 qian).
Grind into fine powder. Mix with decoction of Wumei (Mume Fructus) and take 2 qian. (Raw Puhuang is cool in nature and resolves stasis; peeled Guixin is hot in nature and promotes blood circulation; Wumei is sour and astringent, cleansing filth. When using this formula, do not forget these principles. The previous formula uses heat to move blood; this formula uses coolness to move blood. The compilers have clearly distinguished them; users must not confuse black with white.)
Heye San (Lotus Leaf Powder): Treats residual blood remaining within seven days postpartum, occasionally rushing to the heart causing dizziness and oppression.
Heye (Nelumbinis Folium) (1 liang 7 qian 5 fen); Yanhusuo (2 liang); Dihuang Zhi (Rehmanniae Juice) (2 he).
Boil the first two ingredients in 2 sheng of water until reduced to 6 he. Add Yanhusuo. Divide into three doses. Take on an empty stomach. Avoid meat for one day.
Chuanxiong San (Sichuan Lovage Powder): Treats incomplete expulsion of residual blood postpartum, rushing up to the heart, causing mental oppression and abdominal pain. (This formula moves Qi and blood without being hot or cold. Compared to the previous formula, it is refreshing like clear skies after rain, bringing joy to the mind.)
Chuanxiong (Ligusticum Chuanxiong Rhizome), Sheng Gan Dihuang (Fresh Rehmanniae Radix), Baishao (White Peony Root), Zhike (Aurantii Fructus) (each equal parts).
Grind into powder. Mix with wine and take a "fangcun bi" (measure approx. 1 cubic inch) twice daily.
Jiyan Fang (Collected Effective Formula): Treats postpartum blood-Qi mental oppression. (This formula is fresh and concise.)
Sheng Dihuang Zhi (Fresh Rehmanniae Juice), Qingjiu (Clear Wine) (each 1 sheng).
Mix the two ingredients, boil once, divide into two doses. (Each of the above four formulas has its unique efficacy. Studying them carefully is like traveling along the road to Shanyin; one finds it hard to leave.)
Jingxiao Fang (Classic Effective Formula): Treats postpartum Qi deficiency where cold pathogens contend with blood, causing blood-Qi stagnation rushing to the heart and abdomen, resulting in distension and fullness. (Reading the symptom description reveals that warming herbs are indicated, following the principle "treat cold with heat, treat retention with movement.")
Danggui (Angelica Sinensis Radix), Chuanxiong, Guixin, Wuzhuyu (Evodiae Fructus), Chenpi (Citri Reticulatae Pericarpium), Shengjiang (Zingiberis Rhizoma Recens) (each 1 liang); Baishao (2 liang).
Cut into pieces. Boil in 3 sheng of water until reduced to 1 sheng. Strain and take on an empty stomach.
Myrrh Pill (Moyao Wan): Treats postpartum chest and heart irritability and sluggish evil blood. (At first glance, "irritability" might suggest avoiding hot herbs. However, "sluggish evil blood" indicates blood stasis rushing to the heart, making warm, moving, and breaking-stasis herbs essential. How could one avoid hot herbs due to irritability?)
Moyao (Myrrha), Manjiang (Alpinia Katsumadai Rhizome), Yanhusuo, Danggui, Ganqi (Drynariae Rhizoma - stir-fried), Guixin, Niuxi (Achyranthis Bidentatae Radix), Mudanpi (Moutan Cortex), Ganjiang (Zingiberis Rhizoma) (each equal parts).
Grind into fine powder. Use vinegar-boiled wheat paste to form pills the size of paulownia seeds. Take 10-15 pills with decoction of Qu (Medicated Leaven).
Miscellaneous Formulas for Treating Blood-Qi Mental Oppression:
Drink 2 sheng of Sheng Ou Zhi (Fresh Lotus Rhizome Juice). Effective. Zhuli (Bambusa Textile Var. Plukenetii Caulis Sap) is also acceptable. (Reading these consecutive formulas, each displays its unique brilliance, like the subtle workmanship of nature, difficult to depict.)
One formula: Crush aged white plums (Chen Baimei), decoct, and drink. (These formulas possess both simple and elaborate elegance.)
One formula: Stir-fry Puhuang between paper. Take 1 qian per dose, washed down with decoction of flowing water from the east. Using Shixiao San (Dispel Stagnation Powder) is also excellent.
One formula: Treats postpartum residual blood attacking the heart, or continuous bleeding, with mental oppression, cyanotic face, and sensation of cold Qi about to extinguish life. Drink 1 zhan of Sheep Blood (Yang Xue) in one go. If symptoms persist, take again for immediate effect. (While Ou Zhi and Zhuli both treat irritability by clearing fire, their actions on breaking stasis and resolving phlegm differ; they should be distinguished. While Chen Baimei, Puhuang, and Shixiao San are common, the use of Sheep Blood truly possesses miraculous power. Both the creator and compiler of these formulas have accumulated boundless merit.)
The above are agents for treating residual blood rushing to the heart.
Renshen Danggui Tang (Ginseng and Angelica Decoction): Treats excessive blood loss postpartum leading to blood deficiency and Yin deficiency, generating internal heat, resulting in mental restlessness, shortness of breath, spontaneous sweating, and headache.
Renshen (Ginseng Radix), Danggui, Shu Dihuang (Prepared Rehmanniae Radix), Maidong (Ophiopogonis Radix - remove heart), Rougui (Cinnamon Bark) (each 2 qian); Baishao Yao (White Peony Root - stir-fried) (2.5 qian).
Boil in 2 zhong of water with 1 he of Jingmi (Glutinous Rice) and 10 leaves of Zhuye (Bamboo Leaf) until reduced to 1 zhong. Take after meals. (This formula removes Chuanxiong from Siwu Tang because it disperses Qi; it uses Rougui to help stop sweating. However, using it in equal proportion with other herbs requires caution. Adding Jingmi and Zhuye is a good method for treating mental restlessness and shortness of breath. If blood heat is present, adding Sheng Dihuang is better, and Rougui should then be removed.) For severe blood heat, add 2 qian of Sheng Dihuang.
Zhuye Tang (Bamboo Leaf Decoction): Treats postpartum shortness of breath nearing extinction and chest/heart oppression.
Zhuye (cut finely), Maidong (remove heart), Xiaomai (Wheat) (each 1 sheng), Gancao (Licorice Root) (1 liang), Shengjiang (2 liang), Dazao (Jujube) (12 pieces).
Cut ingredients. Boil Zhuye and Xiaomai in 1 dou of water until reduced to 8 sheng. Strain. Add remaining herbs and boil until reduced to 3 sheng. Strain and take warm. (This formula uses Xiaomai to tonify the Heart, Maidong and Zhuye to relieve irritability, Gancao and Dazao to tonify Qi, thereby calming the "child" [Heart] and nourishing the "mother" [Spleen/Stomach]. This is also a good method. Shengjiang assists, providing additional support. If there is deficiency palpitations, add 2 liang of Renshen; if there is lack of strength, add 5 he of Nuomi (Glutinous Rice) to assist in nourishing Yin.)
Ganzhuru Tang (Sweet Bamboo Sheath Decoction): Treats postpartum internal deficiency, irritability, heat, and shortness of breath.
Ganzhuru (Bambusa Textile Var. Plukenetii Caulis) (1 sheng), Renshen, Maidong (remove heart), Fuling (Poria), Gancao (each 1 liang), Huangqin (Scutellariae Radix) (3 liang).
Cut ingredients. Boil in 6 sheng of water until reduced to 2 sheng. Strain. Divide into three doses, taken three times daily. (This is a divine formula for treating deficiency-heat and shortness of breath. Although few in number, the medicinal power is precise and concentrated, worthy of emulation. Huangqin may be adjusted or omitted depending on the case.)
Xiebai Tang (Allium Macrostemon Decoction): Treats postparturition chest irritability, heat, and rebellious Qi. (This is a variation of the method for treating Chest Bi [obstruction]. The original formula comes from Zhang Zhongjing. Xiebai and Banxia treat rebellious Qi; Gualougen (Trichosanthis Radix) and Maidong treat irritability and heat; Renshen and Gancao tonify deficiency. Zhimu and Shigao are added only when heat is severe, as they are contraindicated for blood deficiency.)
Xiebai (Allii Macrostemonis Bulbus), Banxia (Pinelliae Rhizoma), Renshen, Gancao (each 1 liang), Gualougen (2 liang), Maidong (0.5 jin).
If heat is severe, add Zhimu (Anemarrhenae Rhizoma) and Shigao (Gypsum Fibrosum).
Cut ingredients. Boil in 1.3 dou of water until reduced to 4 sheng. Strain. Divide into five doses, taken three times during the day and twice at night.
Shaoyao Zhichi Tang (Peony and Fermented Soybean Decoction): Treats postpartum deficiency-heat insomnia.
Baishao, Danggui, Zhizi (Gardeniae Fructus) (each 5 qian), Xiangchi (Fermented Soybean) (0.5 he).
Boil the first three ingredients in 2.5 zhong of water until reduced to 2 zhong. Add Xiangchi and boil until reduced to 1.5 zhong. Strain. Divide into two doses, take warm. (Although this is attributed to the methods of Qi Bo, it is not as stable as Zhang Zhongjing's Suanzaoren Tang. Zhang Zhongjing used Zhizi Chi Tang for deficiency-heat insomnia in Shanghan diseases. Here, Baishao and Danggui are added, representing a modification by Yun Qizi to treat postpartum conditions based on Shanghan methods. People often say Shanghan formulas can be applied to miscellaneous diseases; is this true?)
The above are agents for treating blood-Qi deficiency-heat.
Zhang Zhongjing's Erwu Huangqin Tang (Two-Ingredient Scutellaria Decoction): When a woman in the puerperal period exposes herself to wind, suffering from vexatious heat in the four limbs and headache, Xiao Chaihu Tang (Minor Bupleurum Decoction) is given. If there is no headache but only irritability, this decoction is the primary treatment. (Key is to focus on the character "wind," distinguishing by the presence or absence of headache.)
Huangqin (1 liang), Kushen (Sophorae Flavescentis Radix) (2 liang). (This is a strongly bitter-cold formula, generally unsuitable for postpartum conditions. It implies that the irritability stems from heat disease. One must interpret this based on the phrase "only irritability.") Sheng Dihuang (4 liang).
Boil the three ingredients in 8 sheng of water until reduced to 2 sheng. Take 1 sheng warm. May cause vomiting or purging of worms.
Zhupi Dawan (Large Bamboo Skin Pill): Treats women postpartum with middle-jiao deficiency, mental chaos, nausea, and vomiting; stabilizes the middle and tonifies Qi.
Sheng Zhuru (Fresh Bamboo Residue), Shigao (each 2 fen), Guizhi (Cinnamon Twig), Baiwei (Cleisostomatis Herba) (each 1 fen), Gancao (Licorice Root).
Grind the five ingredients into powder. Mix with jujube pulp to form pills the size of a bullet. Take one pill with water, three times during the day and twice at night. (Middle-jiao deficiency should not use Shigao; mental chaos should not use Guizhi. However, in this formula, Gancao constitutes seven-tenths of the total weight, and the pill is formed with jujube pulp and taken with water. This reflects the subtlety of prescription design, the difficulty of herb selection, and the challenge of assessing deficiency and excess. Taking it with water further prevents the harm of "treating deficiency as deficiency." Users of this formula should reflect deeply.) If there is heat, double Baiwei. If there is irritability and panting, add 1 fen of Baishi (Platycladi Semen).
The above are agents for treating wind-stroke with irritability and heat.
Empirical Formula: Treats postpartum irritability. This applies the principle that "heavy substances dispel fear/trepidation."
Take one piece of Yuyuliang (Halloysitum Rubrum), shaped like a sour bun. Bury half of it in the ground, compacting the soil tightly around it. Burn one cheng of charcoal and one jin of hair from the top of the head. Burn until three-tenths are consumed and two-tenths remain lost. Cover with wet earth overnight. Then retrieve, remove the outer layer, and grind the inner part finely. Wash and clarify with water five to seven times. Dry on paper, then grind thousands of times more. Mix with Gancao decoction and take 2 qian bi. One dose brings immediate effect.