发热头痛气喘,面如朱妆,元阳不能自固也。唇青肉冷,目眩神昏,虚极生风也。口眼 斜,气血俱虚,不能荣养
筋脉也。汗出不止,血虚腠理不密也。角弓反张,血虚体弱,风入诸阳之经也。牙关紧急,口噤不开,血气空虚,风入
颌颊口之筋也。筋脉拘急而为 ;弛纵而为 。阴血去多,阳火炽盛,肝木枯而筋无所主也。顽痹不仁,羸乏少气,脏
腑虚损,风冷客于经络皮肤也。或肝经血燥而挟风热也。总宜大补气血为主,或加荆、防、姜、附、钩藤、天麻一二味
亦可,切忌姜、葱并风药,以致不救。
气虚,四君子汤加味用之。(补四)
血虚,四物汤加味用之。(补七)
气血两虚,十全大补汤。(补三十九)
如血痛未除,生化汤加味用之。(和二十四)
遍身疼痛,手足瘫痪,血虚有风痰,生化汤加姜汁、竹沥。(和二十四)
阴虚内热,热盛生风,四物用生地加丹皮、麦冬。(补七)
摇头马鸣,身反折,气如绝,汗如雨,两手摸空,不治。
心者,君主之官,神明出焉,外应于舌。舌,声之机。产后虚弱,致败血停蓄,上干于心,心窍闭塞,故神志不能
明。又心气通于舌,气闭则舌强不语;有热痰迷塞心窍,则不能言;肾之别脉,上入于心,系舌本,虚则不能言;脾之
脉是动,病舌本强不能言;大肠之脉散舌下,风热入于大肠则不语。
目闭不语,痰气郁滞也。孤风散,生白矾一钱,热水调下。若瘀血壅滞,琥珀散。
琥珀 花蕊石 郁金 朱砂 研末,童便好酒下一钱。
血气痛上冲于心,生化汤。(和二十四)
气闭不语,七珍散。(散三十)
风火,加味逍遥散。(补二十一)
发热、头痛、气喘,面色红赤如涂朱砂,这是元阳之气不能自我固摄的表现。嘴唇发青、肌肉寒冷、头晕眼花、神志昏迷,这是极度虚弱而生内风所致。口眼歪斜,是气血俱虚,无法濡养筋脉的结果。汗出不止,是因为血虚导致腠理(皮肤毛孔及纹理)不致密。角弓反张(身体向后弯曲如弓状),是血虚体弱,风邪侵入诸阳经所致。牙关紧急、口噤不开(牙齿紧闭无法张开),是血气空虚,风邪侵入下颌、面颊及口部筋脉所致。筋脉拘挛抽搐称为“瘛疭”;筋脉松弛无力称为“弛纵”。阴血流失过多,阳气火邪炽盛,导致肝木干枯而筋脉失去主宰。肢体顽固麻木不知痛痒、身体消瘦乏力、气息短少,是脏腑虚损,风寒之邪客居于经络和皮肤所致。或者是肝经血燥而夹杂风热。总体治疗应以大补气血为主,或者加入荆芥、防风、干姜、附子、钩藤、天麻中的一两味药也可以,切忌使用生姜、葱白以及发散风邪的药物,以免导致病情恶化无法挽救。
气虚者,使用四君子汤加味服用。(参考补益篇第四则)
血虚者,使用四物汤加味服用。(参考补益篇第七则)
气血两虚者,使用十全大补汤。(参考补益篇三十九则)
如果瘀血疼痛未消除,使用生化汤加味服用。(参考和解篇第二十四则)
全身疼痛,手足瘫痪,这是血虚伴有风痰,使用生化汤加入姜汁、竹沥。(参考和解篇第二十四则)
阴虚内热,热盛生风,使用四物汤中用生地黄,并加入牡丹皮、麦冬。(参考补益篇第七则)
出现摇头、马鸣声(类似驴叫的声音)、身体反折、气息微弱似断绝、大汗如雨、双手在空中摸索动作,这些属于不治之症。
心,是君主之官,神明由此产生,外部对应于舌头。舌,是发声的关键机关。产后身体虚弱,导致败血停滞蓄积,向上干扰心脏,使心窍闭塞,所以神志不能清明。另外,心气通达于舌,气机闭塞则舌体僵硬而不能言语;如果有热痰迷塞心窍,则不能说话;肾的别络,上行进入心中,系连舌根,肾虚则不能言语;脾的经脉发生变动,病症表现为舌根强硬不能言语;大肠的经脉散布于舌下,风热侵入大肠则导致不语。
眼睛闭合且不能言语,是痰气郁滞所致。使用孤风散,取生白矾一钱,用热水调服。如果是瘀血壅滞,使用琥珀散。
琥珀、花蕊石、郁金、朱砂,研成粉末,用童子尿和好酒送服一钱。
血气疼痛上冲于心,使用生化汤。(参考和解篇第二十四则)
气闭导致不语,使用七珍散。(参考散剂篇第三十则)
风火证,使用加味逍遥散。(参考补益篇第二十一则)
Fever, headache, and panting, with a face red as if painted with cinnabar, indicate that the Primordial Yang (Yuan Yang) fails to consolidate itself. Cyanosis of the lips, cold flesh, vertigo, and coma result from extreme deficiency generating internal Wind. Deviation of the mouth and eyes occurs because both Qi and Blood are deficient and fail to nourish the sinews and vessels. Unremitting sweating is due to Blood deficiency causing the Cou Li (pores and skin texture) to be loose. Opisthotonos (arching of the back like a bow) happens when Blood deficiency and physical weakness allow Wind pathogens to enter the Yang meridians. Lockjaw and inability to open the mouth occur because empty Qi and Blood allow Wind pathogens to invade the sinews of the jaw, cheeks, and mouth. Sinew spasm and twitching are termed "Chi Zhong" (spasms); flaccidity and relaxation are termed "Chi Zong". Excessive loss of Yin Blood and blazing Yang Fire cause the Liver Wood to wither, leaving the sinews without control. Stubborn numbness, emaciation, and shortness of breath indicate visceral deficiency where Cold-Dampness lodges in the meridians and skin. Alternatively, it may be Liver channel Blood dryness complicated by Wind-Heat. Generally, treatment should focus on greatly tonifying Qi and Blood; adding one or two herbs such as Jingjie (Schizonepeta), Fangfeng (Saposhnikovia), Shengjiang (Dried Ginger), Fuzi (Aconite), Gouteng (Uncaria), or Tianma (Gastrodia) is also acceptable. One must strictly avoid Shengjiang (Fresh Ginger), Congbai (Scallion White), and Wind-dispersing drugs to prevent fatal outcomes.
For Qi deficiency, use Si Jun Zi Tang (Four Gentlemen Decoction) with modifications. (Ref: Tonification 4)
For Blood deficiency, use Si Wu Tang (Four Substance Decoction) with modifications. (Ref: Tonification 7)
For simultaneous Qi and Blood deficiency, use Shi Quan Da Bu Tang (Ten Significant Great Tonifying Decoction). (Ref: Tonification 39)
If blood stasis pain persists, use Sheng Hua Tang (Generate the New Decoction) with modifications. (Ref: Harmonization 24)
For generalized body pain and limb paralysis due to Blood deficiency with Wind-Phlegm, use Sheng Hua Tang added with Jiangzhi (Ginger Juice) and Zhuli (Bamboo Sap). (Ref: Harmonization 24)
For Yin deficiency with internal heat, where excessive heat generates Wind, use Si Wu Tang substituting Sheng Di Huang (Rehmannia Root) and adding Dan Pi (Moutan Bark) and Mai Dong (Ophiopogon Tuber). (Ref: Tonification 7)
Shaking head, braying sounds, body opisthotonos, gasping as if dying, profuse sweating like rain, and picking at empty air are signs of incurability.
The Heart is the Sovereign Official, from which Shen Ming (Spiritual Consciousness) emerges, externally corresponding to the tongue. The tongue is the mechanism of speech. Postpartum weakness leads to stagnation of residual blood, which disturbs the Heart upward, blocking the Heart orifices, thus clouding consciousness. Furthermore, Heart Qi connects to the tongue; if Qi is blocked, the tongue becomes stiff and mute. If hot phlegm confuses and blocks the Heart orifices, speech is lost. The collateral branch of the Kidney enters the Heart and ties to the root of the tongue; deficiency here causes muteness. Movement disorders of the Spleen meridian manifest as stiffness of the tongue root and inability to speak. The Large Intestine meridian scatters under the tongue; Wind-Heat entering the Large Intestine causes muteness.
Closed eyes and muteness indicate stagnation of Phlegm-Qi. Use Gu Feng San (Solitary Wind Powder): take 1 qian of Bai Fan (Alumen) mixed with warm water and taken orally. If caused by blood stasis obstruction, use Hu Po San (Amber Powder).
Grind Hu Po (Amber), Hua Rui Shi (Pyrite), Yu Jin (Curcuma Aromatica Rhizome), and Zhu Sha (Cinnabar) into powder. Take 1 qian with Tong Bian (Boy's Urine) and good wine.
For Blood-Qi pain rushing up to the Heart, use Sheng Hua Tang. (Ref: Harmonization 24)
For muteness due to Qi closure, use Zhen Zhen San (Seven Treasures Powder). (Ref: Powders 30)
For Wind-Fire patterns, use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder). (Ref: Tonification 21)