产后胁痛,此恶血为患也。宜四物汤倍川芎、当归,加鬼箭羽、红花、延胡索各一钱。若左胁痛,宜养血佐
肝丸。若右胁痛,宜推气养血丸。
四物汤
熟地黄 当归(各三钱) 白芍(二钱) 川芎(一钱)
水煎服。
养血佐肝丸
香附(醋制,二两) 当归 川芎 白芍(酒炒) 陈皮 半夏(酒炒) 白术(蜜炙) 青皮(酒炒)
神曲(炒)
萝卜子(炒) 牡丹皮 红花 茯苓(各一两) 柴胡(酒炒) 桃仁(去皮尖,各八钱) 草龙胆(酒洗,六钱)
三棱 蓬术(俱醋炒,各五钱)
为末,酒丸,白汤下百丸。
推气养血丸
香附(童便制,二两) 当归 川芎 白芍(酒炒) 白术(蜜炙) 青皮(酒炒) 陈皮 枳实 乌药
浓朴(姜汁炒) 神曲 干姜(炒黑) 白芥子(炒,各一两) 三棱 蓬术(俱醋炒,各八钱) 麦芽(炒)
肉桂(各六钱) 木香(三钱)
为末,醋丸,米饮下百丸。
产后阳气虚弱,而寒从中生,或寒由外入以致心腹作痛,呕吐不食,四肢厥冷,宜大岩蜜汤或九蜜煎。若
恶露不尽,心腹撮痛,宜乌金散。
大岩蜜汤
生地黄 当归 白芍(炒) 干姜(炒) 吴茱萸(炒) 桂心 独活 小草(即远志叶) 甘草(各一钱,炒)
细辛(五分)
水煎服。
九蜜煎
当归、熟地黄(各三钱) 白芍(酒炒焦) 茯苓(各一钱五分) 炙甘草 干姜(炒) 肉桂 细辛(各一钱)
吴茱萸(制,五分)
水煎服。
乌金散
蒲黄 赤芍 干姜 肉桂 当归 熟地黄 甘草(各一钱) 黑豆(炒,四钱)
上为末,每服二钱,童便、温酒调下。
产后胁痛,是由于恶露(产后余血)滞留所致。适宜使用四物汤,加倍川芎和当归的用量,并加入鬼箭羽、红花、延胡索各一钱。如果左侧胁肋疼痛,适宜使用养血佐肝丸。如果右侧胁肋疼痛,适宜使用推气养血丸。
四物汤
熟地黄 当归(各三钱) 白芍(二钱) 川芎(一钱)
用水煎煮后服用。
养血佐肝丸
香附(醋制,二两) 当归 川芎 白芍(酒炒) 陈皮 半夏(酒炒) 白术(蜜炙) 青皮(酒炒)
神曲(炒)
萝卜子(炒) 牡丹皮 红花 茯苓(各一两) 柴胡(酒炒) 桃仁(去皮尖,各八钱) 草龙胆(酒洗,六钱)
三棱 蓬术(均用醋炒,各五钱)
研磨成粉末,用酒制成丸剂,用白开水送服一百丸。
推气养血丸
香附(童便制,二两) 当归 川芎 白芍(酒炒) 白术(蜜炙) 青皮(酒炒) 陈皮 枳实 乌药
浓朴(姜汁炒) 神曲 干姜(炒黑) 白芥子(炒,各一两) 三棱 蓬术(均用醋炒,各八钱) 麦芽(炒)
肉桂(各六钱) 木香(三钱)
研磨成粉末,用醋制成丸剂,用米汤送服一百丸。
产后阳气虚弱,导致寒气从体内产生,或者寒气由外部侵入从而引起心腹部疼痛,伴有呕吐、不能进食、四肢冰冷等症状,适宜使用大岩蜜汤或九蜜煎。如果恶露排出不尽,心腹部有紧缩性疼痛,适宜使用乌金散。
大岩蜜汤
生地黄 当归 白芍(炒) 干姜(炒) 吴茱萸(炒) 桂心 独活 小草(即远志叶) 甘草(各一钱,炒)
细辛(五分)
用水煎煮后服用。
九蜜煎
当归、熟地黄(各三钱) 白芍(酒炒焦) 茯苓(各一钱五分) 炙甘草 干姜(炒) 肉桂 细辛(各一钱)
吴茱萸(制,五分)
用水煎煮后服用。
乌金散
蒲黄 赤芍 干姜 肉桂 当归 熟地黄 甘草(各一钱) 黑豆(炒,四钱)
以上药物研磨成粉末,每次服用二钱,用童便(男孩的小便)、温酒调匀后服用。
Postpartum hypochondriac pain is caused by the retention of lochia (residual blood after childbirth). It is appropriate to use Siwu Tang (Four Substances Decoction) with doubled amounts of Chuanxiong Rhizome (Chuanxiong) and Angelicae Sinensis Radix (Danggui), adding one qian each of Arisaematis Cum Bile (Guijianyu), Carthami Flos (Honghua), and Corydalis Rhizoma (Yanhusuo). If the pain is on the left side, Yangxue Zuogan Wan (Nourishing Blood and Assisting Liver Pill) is appropriate. If the pain is on the right side, Tuiqi Yangxue Wan (Pushing Qi and Nourishing Blood Pill) is appropriate.
Siwu Tang (Four Substances Decoction)
Prepared Rehmanniae Radix (Shudihuang), Angelicae Sinensis Radix (Danggui) (each 3 qian), Paeoniae Radix Alba (Baishao) (2 qian), Chuanxiong Rhizome (Chuanxiong) (1 qian).
Decoct in water and take orally.
Yangxue Zuogan Wan (Nourishing Blood and Assisting Liver Pill)
Cyperi Rhizoma (Xiangfu) (vinegar-processed, 2 liang), Angelicae Sinensis Radix (Danggui), Chuanxiong Rhizome (Chuanxiong), Paeoniae Radix Alba (Baishao) (wine-fried), Citri Reticulatae Pericarpium (Chenpi), Pinelliae Rhizoma (Banxia) (wine-fried), Atractylodis Macrocephalae Rhizoma (Baizhu) (honey-fried), Aurantii Fructus Immaturus (Qingpi) (wine-fried),
Mysostei Fructus (Shenqu) (stir-fried),
Brassicae Napae Semen (Luobozǐ) (stir-fried), Moutan Cortex (Mudanpi), Carthami Flos (Honghua), Poria (Fuling) (each 1 liang), Bupleuri Radix (Chaihu) (wine-fried), Persicae Semen (Taoren) (skin and tip removed, each 8 qian), Gentianae Scabrae Radix et Rhizoma (Caolongdan) (wine-rinsed, 6 qian),
Sparganii Rhizoma (Sanleng), Curcumae Zedoariae Rhizoma (Pengzhu) (both vinegar-fried, each 5 qian).
Grind into powder, form pills with wine, and take 100 pills with plain boiled water.
Tuiqi Yangxue Wan (Pushing Qi and Nourishing Blood Pill)
Cyperi Rhizoma (Xiangfu) (child's urine-processed, 2 liang), Angelicae Sinensis Radix (Danggui), Chuanxiong Rhizome (Chuanxiong), Paeoniae Radix Alba (Baishao) (wine-fried), Atractylodis Macrocephalae Rhizoma (Baizhu) (honey-fried), Aurantii Fructus Immaturus (Qingpi) (wine-fried), Citri Reticulatae Pericarpium (Chenpi), Aurantii Fructus (Zhishi), Linderae Radix (Wuyao),
Magnoliae Officinalis Cortex (Nongpou) (ginger juice-fried), Mysostei Fructus (Shenqu), Zingiberis Rhizoma Recens (Ganjiang) (charred stir-fried), Sinapis Albae Semen (Baijiezi) (stir-fried, each 1 liang), Sparganii Rhizoma (Sanleng), Curcumae Zedoariae Rhizoma (Pengzhu) (both vinegar-fried, each 8 qian), Malto (Maiya) (stir-fried),
Cinnamomi Cortex (Rougui) (each 6 qian), Aucklandiae Radix (Muxiang) (3 qian).
Grind into powder, form pills with vinegar, and take 100 pills with rice drink.
Postpartum yang qi deficiency leads to cold generating from within, or external cold invading, resulting in heart and abdominal pain accompanied by vomiting, inability to eat, and cold limbs. In such cases, Dayanmi Tang (Great Rock Honey Decoction) or Jumi Jian (Nine Honey Decoction) is appropriate. If lochia remains incomplete and there is a pinching pain in the heart and abdomen, Wujin San (Golden Metal Powder) is appropriate.
Dayanmi Tang (Great Rock Honey Decoction)
Rehmanniae Radix (Shengdihuang), Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Baishao) (stir-fried), Zingiberis Rhizoma Recens (Ganjiang) (stir-fried), Evodiae Fructus (Wuzhuyu) (stir-fried), Cinnamomi Ramulus (Guixin), Angelicae Pubescentis Radix (Duhuo), Polygalae Radix (Xiaocao, i.e., leaves of Polygala tenuifolia), Glycyrrhizae Radix et Rhizoma (Gancao) (each 1 qian, stir-fried),
Asari Radix et Rhizoma (Xixin) (0.5 fen).
Decoct in water and take orally.
Jumi Jian (Nine Honey Decoction)
Angelicae Sinensis Radix (Danggui), Prepared Rehmanniae Radix (Shudihuang) (each 3 qian), Paeoniae Radix Alba (Baishao) (wine-fried until scorched), Poria (Fuling) (each 1.5 qian), Glycyrrhizae Radix et Rhizoma Praeparata cum Melle (Zhi Gancao), Zingiberis Rhizoma Recens (Ganjiang) (stir-fried), Cinnamomi Cortex (Rougui), Asari Radix et Rhizoma (Xixin) (each 1 qian),
Evodiae Fructus (Wuzhuyu) (processed, 0.5 fen).
Decoct in water and take orally.
Wujin San (Golden Metal Powder)
Pollen Typhae (Puhuang), Paeoniae Radix Rubra (Chishao), Zingiberis Rhizoma Recens (Ganjiang), Cinnamomi Cortex (Rougui), Angelicae Sinensis Radix (Danggui), Prepared Rehmanniae Radix (Shudihuang), Glycyrrhizae Radix et Rhizoma (Gancao) (each 1 qian), Sojae Semen Nigrum (Heidou) (stir-fried, 4 qian).
Grind the above into powder. Take 2 qian per dose, mixed with child's urine (tongbian) and warm wine.