(附霍乱)
陈霞山治一妇,产后伤食,致胃虚不纳谷,四十余日,闻谷气药气俱呕,以参、苓、白术、炒曲各一钱,
陈皮、藿香各五分,炙甘草三分,砂仁五分,陈米一合,用沸汤二碗,泡伏龙肝末澄清汁煎药服而安。
薛立斋治一产妇,患腹胀,满闷呕吐,因败血散于脾胃,不能运化所致。或用抵当,(疑是抵圣汤。)败
血已下,前症益甚,小腹重坠,似欲去后。薛谓脾气虚而下陷,用补中益气汤加炮姜温补脾气,重坠如失。又
用六君子汤而安。
一产妇停食霍乱,用藿香正气散之类已愈。后胸腹膨胀,饮食稍过即呕吐,或作泄泻,此脾胃虚极,用六
君子汤加木香治之渐愈。后因饮食失调,兼恚怒,患霍乱,胸腹大痛,手足逆冷,用附子散,又用八味丸以补
土母而康。设泥痛无补法,而用辛散,或用平补之剂,必致不起。
陆养愚治臧舜田内人,脾胃素常不实,产后因怒,大便泄泻。或以胃苓汤加归、芍投之,势日甚,且汗出
气喘,脉气散大。或谓此非产后泄泻所宜,宜勿药。陆曰∶脉虽大,而按之不甚空,尚有一二分生意。用人参
理中汤加诃子、肉果。已煎矣,忽传人事已不省,再诊之,浮按虚数,沉按如丝,手足逆厥。或谓今夜决不能
延,乃辞去。陆令前药急以加附子一钱,一剂汗止泻减,再剂病减七分。去附子加归、芍,数剂起。
王 如治一产妇,弥月泻,年余不愈,六脉沉迟,此元气下陷,寒湿太甚症也。然汤药犹湿也,以湿治湿
可乎?遂用参、 、苓、术、肉蔻、升麻、防风、甘草,用猪肚一枚,入莲肉一斤,好酒煮烂,捣和为丸,日
进而安。
陈三农治一妇,产后滑泄,勺水粒米不容,实时泻下,半月余矣,六脉濡而弱,此产时劳力伤脾也。若用
汤药,恐滋胃湿,遂以参苓白术散加肉桂、生姜、枣肉为丸,服愈。(雄按∶今秋石北涯仲媳,胎前患泄泻,
娩后泻如漏水,不分遍数,恶露不行,专科束手。余视其脉,左弦数,右大而不空,口苦不饥,小溲全无,
以白头翁汤合伏龙肝丸治之,一剂而减,三啜而瘳。)
薛立斋治一产妇,大便不实,饮食少思,五更或清晨遗屎,此中气虚寒,脾肾不足,用补中益气送四神丸
而痊。
张子和治李德卿妻,因产后病泄年余,四肢瘦乏,皆断为死症。张曰∶两手脉皆微小,乃利病之生脉,况
洞泄属肝经,肝木克土而成。此病亦是肠 , 者,肠中有积水也。先以舟车丸四十五粒,又以无忧散三四钱,
下四五行。又进导饮丸,渴则调以五苓散,再与胃风汤调之,半月而能行,一月而安健。
(附霍乱)
陈霞山治疗一位妇人,产后因饮食积滞损伤,导致胃气虚弱无法受纳食物,四十多天来,闻到谷物气味和药味都会呕吐。处方用党参、茯苓、白术、炒神曲各一钱,陈皮、藿香各五分,炙甘草三分,砂仁五分,陈米一合,用沸水两碗浸泡伏龙肝末澄清后的汁液来煎煮药物服用,病情得以安定。
薛立斋治疗一位产妇,患有腹胀,胸闷呕吐,这是因为败血散落于脾胃,不能运化所致。有人使用抵当汤(疑为抵圣汤),败血虽已下行,但之前的症状更加严重,小腹沉重下坠,感觉想要解大便。薛立斋认为这是脾气虚弱而下陷,使用补中益气汤加炮姜温补脾气,沉重下坠感消失。随后又用六君子汤而痊愈。
另一位产妇因停食引发霍乱,使用藿香正气散之类的方剂已经痊愈。后来出现胸腹部膨胀,饮食稍多即呕吐,有时发生泄泻,这是脾胃极度虚弱,使用六君子汤加木香治疗逐渐好转。后来因为饮食失调,加上愤怒,患霍乱,胸腹剧烈疼痛,手足逆冷,使用附子散,后又用八味丸以补益脾土之母(肾)而康复。如果拘泥于“痛无补法”的说法,而使用辛散药物,或使用平补的方剂,必定会导致死亡。
陆养愚治疗臧舜田的妻子,脾胃素来不实,产后因发怒,导致大便泄泻。有人用胃苓汤加当归、芍药投服,病情日益加重,且出汗气喘,脉象散大。有人说这不是产后泄泻所宜用的药,建议不要用药。陆养愚说:脉象虽然大,但重按并不十分空虚,尚有一二分生机。使用人参理中汤加诃子、肉豆蔻。药已经煎好,忽然传来病人人事不省的消息,再次诊察,轻取脉虚数,重按如丝,手足逆冷。有人说今晚肯定不能延续生命,于是告辞离去。陆养愚命令将前药急加附子一钱,一剂后汗止泻减,再剂后病势减轻七分。去掉附子加入当归、芍药,数剂后起床。
王如治疗一位产妇,满月后腹泻,一年多不愈,六脉沉迟,这是元气下陷,寒湿太甚的症状。然而汤药仍然属于湿性,用湿治湿可以吗?于是用党参、[缺字]、茯苓、白术、肉豆蔻、升麻、防风、甘草,用一个猪肚,放入莲肉一斤,用好酒煮烂,捣碎混合做成丸药,每日进服而安。
陈三农治疗一位妇人,产后滑泄,连勺水粒米都容不下,随即泻下,半个多月了,六脉濡弱,这是产时劳力伤脾所致。如果使用汤药,恐怕滋腻胃湿,于是用参苓白术散加肉桂、生姜、枣肉做成丸药,服用后痊愈。(雄按:今年秋天石北涯的二儿媳,胎前患泄泻,分娩后泻如漏水,不分次数,恶露不行,专科医生束手无策。我视其脉,左弦数,右大而不空,口苦不饥,小便全无,用白头翁汤合伏龙肝丸治疗,一剂而减轻,三服而痊愈。)
薛立斋治疗一位产妇,大便不成形,饮食少思,五更或清晨遗屎,这是中气虚寒,脾肾不足,用补中益气汤送服四神丸而痊愈。
张子和治疗李德卿的妻子,因产后患病泄泻一年多,四肢瘦乏,都被断定为死症。张子和说:两手脉皆微小,这是利病之后产生的脉象,况且洞泄属于肝经,肝木克土而成。此病也是肠澼(痢疾),澼者,肠中有积水也。先用舟车丸四十五粒,又以无忧散三四钱,下四五次。又进导饮丸,渴则调以五苓散,再用胃风汤调理,半月而能行走,一月而安康。
(Attached: Huoluan [Cholera-like disease])
Chen Xiashan treated a woman who, after childbirth, suffered from food stagnation injury, resulting in weak stomach Qi unable to accept food. For over forty days, she vomited upon smelling grain or medicine odors. The prescription used Dangshen (Codonopsis Radix), Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma), and Chaoqu (Stir-fried Medicated Leaven) each at one qian; Chenpi (Citri Reticulatae Pericarpium) and Huoxiang (Agastaches Herba) each at five fen; Zhigancao (Glycyrrhizae Radix et Rhizoma Preparatum) at three fen; Sharen (Amomi Fructus) at five fen; and Chenmi (Aged Rice) at one he. These were decocted using the clarified juice of Fulonggan (Dragon's House Earth) soaked in two bowls of boiling water, and the patient recovered.
Xue Lizhai treated a postpartum woman suffering from abdominal distension, fullness, and vomiting. This was caused by residual blood dispersing into the spleen and stomach, impairing transformation and transportation. Someone used Didang Tang (Rescue the Urgent Decoction) [suspected to be Disheng Tang], and although the residual blood was expelled, the previous symptoms worsened, with heavy bearing down in the lower abdomen, resembling the urge to defecate. Xue Liuzhai reasoned that this was deficiency of Spleen Qi with sinking, and prescribed Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Paojiang (Prepared Ginger) to warm and tonify Spleen Qi, resolving the bearing-down sensation. Subsequently, Liu Junzi Tang (Six Gentlemen Decoction) was used for recovery.
Another postpartum woman suffered from Huoluan due to retained food, which had healed with Huoxiang Zhengqi San (Agastache Powder to Rectify the Qi). Later, chest and abdominal distension occurred, with vomiting when diet slightly exceeded limits, or occasional loose stools. This indicated extreme deficiency of the Spleen and Stomach. She was treated with Liu Junzi Tang (Six Gentlemen Decoction) plus Muxiang (Aucklandiae Radix), gradually improving. Later, due to dietary irregularity and anger, she contracted Huoluan with severe chest and abdominal pain and cold extremities. Fuzi San (Aconite Powder) was used, followed by Bawei Wan (Eight-Ingredient Pill) to tonify the mother of Earth (Kidney), leading to health. If one adheres strictly to the rule "pain has no tonification method" and uses acrid-dispersing agents or mild tonics, death would likely ensue.
Lu Yangyu treated the wife of Zang Shuntian, whose Spleen and Stomach were inherently deficient. After childbirth, anger induced diarrhea. Someone administered Weiling Tang (Stomach-Ling Decoction) with Danggui (Angelicae Sinensis Radix) and Shaoyao (Paeoniae Radix), causing worsening condition, sweating, panting, and a scattered, large pulse. Some suggested withholding medication as it was unsuitable for postpartum diarrhea. Lu stated: "Although the pulse is large, deep pressure reveals it is not entirely empty, retaining a trace of vitality." Ren Shen Lizhong Tang (Ginseng Regulate the Middle Decoction) with Hezi (Terminalia Chebulae Fructus) and Rouguo (Myristicae Semen) was prescribed. While the decoction was ready, news arrived that the patient had lost consciousness. Re-examination showed a floating, deficient, rapid pulse, and a deep, thread-like pulse, with cold extremities. Others predicted death that night and left. Lu ordered the addition of one qian of Fuzi (Aconiti Lateralis Radix Preparata) to the decoction. After one dose, sweating stopped and diarrhea decreased; after two doses, the illness reduced by seventy percent. Fuzi was removed, Danggui and Shaoyao added, and after several doses, she recovered.
Wang Ru treated a postpartum woman with diarrhea persisting for over a year since confinement. The six pulses were deep and slow, indicating sinking of Yuan Qi (Primal Qi) and excessive cold-dampness. Since decoctions are wet in nature, using wet to treat wet is inappropriate. Thus, Dangshen (Codonopsis Radix), [missing character], Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma), Roukou (Myristicae Semen), Shengma (Cimicifugae Rhizoma), Fangfeng (Saposhnikoviae Radix), and Gancao (Glycyrrhizae Radix et Rhizoma) were used. One pig stomach was stuffed with one jin of Lotus Seeds, boiled well in good wine, mashed, and formed into pills. Daily administration led to recovery.
Chen Sansan treated a woman with postpartum slippery diarrhea, unable to retain even a spoonful of water or rice grains, evacuating immediately, lasting over half a month. The six pulses were soggy and weak, indicating Spleen injury from labor during childbirth. Decoctions might aggravate Stomach dampness, so Shenling Baizhu San (Ginseng, Poria, and Atractylodes Macrocephala Powder) with Rougui (Cinnamomi Cortex), Shengjiang (Zingiberis Rhizoma Recens), and Jujube flesh was made into pills, curing the patient. (Xiong's Note: This autumn, the second daughter-in-law of Shi Beiya suffered diarrhea before pregnancy, and after delivery, diarrhea flowed like leaking water without frequency limit, with lochia retention. Specialists were helpless. I observed her pulse: left wiry and rapid, right large but not empty, bitter taste in mouth, lack of appetite, and complete absence of urination. I treated her with Baitouweng Tang (Pulsatillae Decoction) combined with Fulonggan Wan (Dragon's House Earth Pill). Symptoms reduced after one dose and resolved after three doses.)
Xue Lizhai treated a postpartum woman with loose stools, poor appetite, and involuntary stool passage at dawn or early morning. This was due to deficiency-cold of Middle Qi and insufficiency of Spleen and Kidney. Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) was used to deliver Sishen Wan (Four Miracles Pill), resulting in cure.
Zhang Zihe treated the wife of Li Deqing, who had suffered postpartum diarrhea for over a year, with emaciated limbs. All physicians deemed it a fatal case. Zhang said: "Both hands show minute and small pulses, which arise after purgation. Moreover, Dongxie (profuse diarrhea) belongs to the Liver Meridian, where Liver Wood overacts on Earth. This disease is also Changpi (dysentery); Pi implies accumulation of fluid in the intestines." First, Zhouche Wan (Boat Cart Pill) 45 pills were given, followed by Wuyou San (Carefree Powder) 3-4 qian, inducing four to five bowel movements. Then, Daoyin Wan (Guiding and Leading Pill) was advanced. When thirsty, Wuling San (Five-Ingredient Powder with Poria) was mixed. Finally,weifeng Tang (Wind-Stomach Decoction) regulated the condition. Within half a month, she could walk; within a month, she was healthy.