吴氏 产后不寐,心虚不安,此去血多,而心神失养也。仿养心汤意,熟地、枣仁、茯神、柏子仁、
麦冬、潞参、五味子、炙草、白芍、三服愈。
樊 馆课神劳,心虚生热,治以天王补心丹。
汪氏 病久失调,延成虚损,怔忡汗出,手足心热,坐起眩晕,善饥无寐。诊左寸虚散,右寸关虚弦,
两尺稍大。此阴亏火炎之渐,惟营虚生内热,故手足如烙,寤烦神失安,故汗液自泄。虚阳挟风上蒙清窍,故
头目眩晕,肝阳肆横,阳明当其冲,风火消铄故善饥。滋液熄风,全用柔剂,归脾汤去 、术、木香、归、姜。
加白芍、丹皮、熟地、甘菊(炒),六服渐安。去丹皮、甘菊,再加山药、柏子仁,晚服六味丸全愈。
殷氏 吐红夜嗽,舌 心惕,自汗不寐,晡寒食减,脘痞不舒,脉虚芤,两寸浮,此营损及卫也。用黄精、
柏子霜、生 、炙草、杞子、枣仁、茯神、白芍、川贝、龙眼肉、小麦煎汤缓服。当晚稳寐,三剂汗收嗽定矣。又
十余服,诸症俱愈。
贡氏 惊悸恍惚,不饥不食不寐,脉虚促。病因怒恐而得,胆火上冒则头眩心忡,胸脘刺痛,气结,
呵欠怯冷,倏烦热多惊,皆阳越失镇,服药鲜效,总由治失其要。先镇浮阳,再议和阴。牡蛎、龙骨(俱 研
二钱)、磁石(一钱)、柏子仁、连翘心(各五分)、茯神、生枣仁(各二钱)、三服症象大减,改用羚羊
角(六分)、嫩桑叶(三钱)、熟地、枣仁、茯神、白芍(各二钱)、小麦(一合)、麦冬、半夏(各钱半),
数服能寐思食矣。
族女 产后心虚善恐,见闻错妄,此由肝胆怯也。用酸枣仁汤养阴血。枣仁、潞参、当归、茯神、熟地、
远志、莲子、炙草。服稍定,时恍惚,不思食,去熟地,加竹茹、菖蒲。服渐瘳。
吴氏,产后失眠,心气虚弱而心神不安,这是因为失血过多,导致心神失去滋养。仿照养心汤的方意,使用熟地黄、酸枣仁、茯神、柏子仁、麦冬、党参、五味子、炙甘草、白芍,服用三剂后痊愈。
樊某,因馆课(教书)劳累过度,心虚而生内热,治疗采用天王补心丹。
汪氏,患病日久调养不当,拖延成虚损证,出现怔忡(心跳剧烈)、出汗、手足心发热,坐起时眩晕,容易饥饿且无法入睡。诊察左寸脉虚散,右寸关脉虚弦,两尺脉稍大。这是阴液亏损、虚火上炎的征兆,只因营血虚弱产生内热,所以手足像被烙铁烫过一样;睡醒后心烦、神志不安,所以汗液自行外泄;虚阳挟带风邪上蒙清窍,所以头目眩晕;肝阳肆意横行,阳明胃经当其冲要,风火消烁津液故而易饥。治疗以滋阴生津、平息内风为主,全用柔润之剂,选用归脾汤去掉人参、白术、木香、当归、生姜。加入白芍、牡丹皮、熟地黄、甘菊花(炒制),服用六剂后逐渐安稳。去掉牡丹皮、甘菊花,再加入山药、柏子仁,晚上服用六味地黄丸,完全痊愈。
殷氏,咳血夜间咳嗽,舌中心跳动惊惕,自汗且失眠,傍晚怕冷食欲减退,胃脘部痞塞不舒,脉象虚芤,两寸脉浮,这是营血损伤波及卫气的表现。使用黄精、柏子霜、生黄芪、炙甘草、枸杞子、酸枣仁、茯神、白芍、川贝母、龙眼肉、小麦煎汤缓慢服用。当晚即能安稳入睡,三剂药后汗止嗽定。又服用十余剂,所有症状全部痊愈。
贡氏,惊悸恍惚,不思饮食且失眠,脉象虚促。病因愤怒和惊恐所致,胆火上逆则头晕心慌,胸脘刺痛,气机郁结,呵欠怕冷,突然感到烦热且多惊,这些都是阳气外越失去镇摄的表现,服药很少见效,总归是治疗没有抓住关键。先镇压浮越之阳,再议调和阴液。使用牡蛎、龙骨(均研细末,各二钱)、磁石(一钱)、柏子仁、连翘心(各五分)、茯神、生酸枣仁(各二钱),服用三剂后症状大幅减轻,改用羚羊角(六分)、嫩桑叶(三钱)、熟地黄、酸枣仁、茯神、白芍(各二钱)、小麦(一合)、麦冬、半夏(各一钱半),数剂药后便能入睡并想吃东西了。
族中女子,产后心虚易受惊吓,见闻错乱妄动,这是由于肝胆怯弱所致。使用酸枣仁汤来滋养阴血。药物组成:酸枣仁、党参、当归、茯神、熟地黄、远志、莲子、炙甘草。服用后稍见安定,但时常恍惚,不想吃东西,去掉熟地黄,加入竹茹、石菖蒲。服用后逐渐好转。
Ms. Wu suffered from insomnia after childbirth, with a deficient heart and uneasy spirit; this was due to excessive blood loss causing the heart spirit to lose nourishment. Following the principle of Yangxin Tang (Nourish Heart Decoction), prepared Rehmanniae Radix (Shudi), Ziziphi Spinosae Semen (Zaoren), Poria (Fushen), Platycladi Semen (Baiziren), Ophiopogonis Radix (Maidong), Codonopsis Radix (Lushen), Schisandrae Fructus (Wuweizi), Glycyrrhizae Radix et Rhizoma Preparata (Zhigancao), and Paeoniae Radix Alba (Baishao) were used. The condition was cured after three doses.
Fan suffered from mental fatigue due to teaching duties, leading to internal heat generated by heart deficiency. Treatment employed Tianwang Buxin Dan (Emperor of Heaven's Special Pill to Tonify the Heart).
Ms. Wang had been ill for a long time without proper regulation, which progressed into a consumptive disorder. Symptoms included palpitations (Zhengchong), sweating, heat in the palms and soles, dizziness upon sitting up, excessive hunger, and inability to sleep. Palpation revealed a deficient and scattered pulse at the left Cun position, a deficient and wiry pulse at the right Cun and Guan positions, and slightly large pulses at both Chi positions. This indicated the onset of yin deficiency with flaming fire. Since nutritive blood deficiency generates internal heat, the hands and feet felt as if scorched; wakefulness accompanied by vexation and an unsettled spirit caused spontaneous sweating; deficient yang carrying wind upward clouded the clear orifices, causing dizziness of the head and eyes; hyperactive liver yang surged forward, impacting the Stomach channel where wind and fire consumed fluids, leading to excessive hunger. The treatment focused on nourishing fluids and extinguishing wind, using entirely soft and moistening agents. Guipi Tang (Restore the Spleen Decoction) was modified by removing Codonopsis Radix (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu), Aucklandiae Radix (Muxiang), Angelicae Sinensis Radix (Danggui), and Zingiberis Rhizoma (Jiang). Added were Paeoniae Radix Alba (Baishao), Paeoniae Moutan Cortex (Danpi), Prepared Rehmanniae Radix (Shudi), and Chrysanthemi Flos (Ganju, stir-fried). After six doses, the patient gradually stabilized. Danpi and Ganju were removed, and Dioscoreae Rhizoma (Shanyao) and Platycladi Semen (Baiziren) were added. Taking Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) at night led to complete recovery.
Yin presented with hemoptysis, nocturnal cough, twitching of the center of the tongue, spontaneous sweating, insomnia, aversion to cold in the late afternoon, reduced appetite, epigastric fullness and discomfort, a deficient and knotted pulse, and floating pulses at both Cun positions. This indicated damage to nutritive blood extending to defensive qi. Huangjing (Polygonati Rhizoma), Baiziren Shuang (Platycladi Semen Frost), raw Astragali Membranacei Radix (Huangqi), Glycyrrhizae Radix et Rhizoma Preparata (Zhigancao), Lycii Fructus (Qizi), Ziziphi Spinosae Semen (Zaoren), Poria (Fushen), Paeoniae Radix Alba (Baishao), Fritillariae Cirrhosae Bulbus (Chuanbei), Longan Arillus (Longyanrou), and Triticum Aestivum (Xiaomai) were decocted together for slow administration. She slept peacefully that night, and after three doses, sweating ceased and the cough settled. After more than ten additional doses, all symptoms resolved.
Gong presented with palpitations, fright, and mental confusion, lack of appetite, refusal to eat, insomnia, and a deficient and rapid-intermittent pulse. The etiology was anger and fear. Gallbladder fire surging upward caused dizziness and palpitations, stabbing pain in the chest and epigastrium, qi stagnation, yawning, aversion to cold, sudden vexation and heat, and frequent fright. These were all signs of yang floating away without restraint. Medication had little effect because the treatment missed the key point. First, the floating yang was suppressed, followed by plans to harmonize yin. Oyster Shell (Muli) and Dragon Bone (Longgu), both finely ground (2 qian each), Magnetitum (Cishi, 1 qian), Platycladi Semen (Baiziren), Forsythiae Fructus Heart (Lianqiao Xin, 5 fen each), Poria (Fushen), and raw Ziziphi Spinosae Semen (Sheng Zaoren, 2 qian each) were administered. After three doses, symptoms significantly decreased. The prescription was changed to Antelope Horn (Lingyangjiao, 6 fen), tender Mulberry Leaf (Sanye, 3 qian), Prepared Rehmanniae Radix (Shudi), Ziziphi Spinosae Semen (Zaoren), Poria (Fushen), and Paeoniae Radix Alba (Baishao) (each 2 qian), Triticum Aestivum (Xiaomai, 1 he), Ophiopogonis Radix (Maidong), and Pinelliae Rhizoma Preparatum (Banxia) (each 1.5 qian). After several doses, she could sleep and desire food.
A female relative of the clan suffered from heart deficiency and excessive fear after childbirth, with delusions and hallucinations regarding what she saw and heard. This was due to timidity of the Liver and Gallbladder. Suanzaoren Tang (Sour Jujube Seed Decoction) was used to nourish yin and blood. Ingredients: Ziziphi Spinosae Semen (Zaoren), Codonopsis Radix (Lushen), Angelicae Sinensis Radix (Danggui), Poria (Fushen), Prepared Rehmanniae Radix (Shudi), Polygalae Radix (Yuanzhi), Nelumbinis Semen (Lianzi), and Glycyrrhizae Radix et Rhizoma Preparata (Zhigancao). After taking it, she stabilized somewhat but still experienced occasional confusion and loss of appetite. Prepared Rehmanniae Radix (Shudi) was removed, and Bamboo Shavings (Zhuru) and Acori Tatarinowii Rhizoma (Changpu) were added. Gradually, she improved.