妊娠谵语,为脏腑热极之候,急宜童便时时灌之。不应,用生地黄黄连汤,清其血中之火,庶胎得安。
脉实者,加酒大黄下之,下迟则伤胎也。亦有伤胎胎下
而下血,心神无主而谵语,虽用峻补,亦难有效,其治法方药俱载产后妄言妄见门。若孕妇证见舌青者,
其子已死腹中,急当下之。若双胎一生一死者,必腹中半边冷、半边热。如母患热证,脏腑热甚蒸其胎,儿
因致死,但服黑神散加生蒲黄以暖其胎,则胎即出矣。胎未死,井泥涂脐以护胎气,多有保全者。
生地黄黄连汤 治失血后燥热螈 ,脉数盛者。
生地(二钱) 防风 川芎(各八分) 当归(一钱五分) 黄连(七分) 黄芩(炒) 山栀(炒
黑。各一钱) 赤芍(一钱)
水煎服。
血证黑神散 治吐血衄血,屡发不止。
炮姜 肉桂(各一两) 熟地(四两) 当归 蒲黄(筛净,炒黑。各三两) 白芍(酒制) 炙草(各二两)
上为散,每服四钱。用黑豆半合,微炒香,淋酒半盏,和水半盏,煎一半,入童便半杯和服。
气虚加人参三两,炙黄 六两,以固卫气,庶无营脱之患。一方,
熟地、蒲黄、炮姜、归、芍、桂心各二两,炙草三钱,黑豆二合五勺,炒,去皮。共为末,每服二钱,
童便和酒下。世以豆去壳,同药为散,不知豆之功全在壳也。
妊娠期间出现谵语(神志不清,胡言乱语),是脏腑热邪极盛的表现,应立即频繁灌服童便(童子尿)。如果无效,使用生地黄黄连汤,以清除血分中的火热之邪,从而使胎儿得以安宁。
脉象实有力的,加入酒制大黄进行攻下治疗,若攻下不及时则会损伤胎儿。也有因外伤导致流产、胎堕后出血不止,心神失守而出现谵语的,此时即使使用峻猛的补益药物,也难以见效,其治法与方药均记载在“产后妄言妄见”章节中。如果孕妇证候表现为舌色发青的,说明胎儿已在腹中死亡,必须立即攻下排出死胎。如果是双胎,一个存活一个死亡的,必然出现腹部半边冷、半边热的症状。如果母亲患有热证,脏腑热邪炽盛熏蒸胎儿,导致胎儿致死,只需服用黑神散加生蒲黄以温暖胞胎,胎儿即可排出。如果胎儿未死,可用井底泥涂抹肚脐以保护胎气,多数情况下可以保全胎儿。
生地黄黄连汤:治疗失血后出现的燥热抽搐(筋脉拘急挛缩)、脉象数而盛大者。
处方组成:生地黄(二钱)、防风、川芎(各八分)、当归(一钱五分)、黄连(七分)、黄芩(炒制)、山栀(炒至黑色,各一钱)、赤芍(一钱)。
用法:水煎服。
血证黑神散:治疗吐血、鼻衄(鼻出血),反复发作不止者。
处方组成:炮姜、肉桂(各一两)、熟地黄(四两)、当归、蒲黄(筛净,炒至黑色,各三两)、白芍(酒制)、炙甘草(各二两)。
用法:以上药物研为散剂,每次服用四钱。用黑豆半合,微炒出香味,淋入黄酒半盏,加水半盏,煎至一半量,再加入童便半杯混合服用。
若属气虚者,加人参三两,炙黄芪六两,以固护卫气,从而避免营气脱失的祸患。
另一配方:熟地黄、蒲黄、炮姜、当归、白芍、桂心各二两,炙甘草三钱,黑豆二合五勺,炒制后去皮。共研为末,每次服用二钱,用童便和酒送服。世人常将豆子去壳,同药物一起研成散剂,这是错误的,因为黑豆的功效全在于豆壳。
Delirium during pregnancy is a sign of extreme heat in the zang-fu organs. It should be treated urgently by frequently administering child's urine (Tongbian). If ineffective, use Shengdi Huang Lian Tang (Rehmannia and Coptis Decoction) to clear the fire in the blood, so that the fetus may be secured.
If the pulse is excess, add Jiu Dahuang (Rhubarb processed with wine) to purge; delaying purgation will damage the fetus. There are also cases where trauma causes miscarriage, followed by bleeding, and delirium due to the loss of mastery over the heart-mind. Even with strong tonification, efficacy is difficult to achieve. The treatment methods and formulas for such cases are recorded in the section on "Postpartum Delirium and Hallucinations." If a pregnant woman presents with a bluish tongue, it indicates the fetus has died in the uterus, and immediate purgation is required. In cases of twins where one is alive and the other dead, there must be coldness on one half of the abdomen and heat on the other. If the mother suffers from a heat syndrome, excessive internal heat steams the fetus, causing its death. Administer Heishen San (Black Divine Powder) with added Sheng Puhuang (Raw Lygodii Spora) to warm the uterus, and the fetus will be expelled. If the fetus is not yet dead, apply well mud to the umbilicus to protect fetal qi; many cases can be preserved.
Shengdi Huang Lian Tang (Rehmannia and Coptis Decoction): Treats dryness-heat and convulsions (spasms) after blood loss, with a rapid and full pulse.
Ingredients: Sheng Di Huang (Rehmanniae Radix, 2 qian), Fang Feng (Saposhnikoviae Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma, each 8 fen), Dang Gui (Angelicae Sinensis Radix, 1.5 qian), Huang Lian (Coptidis Rhizoma, 7 fen), Huang Qin (Scutellariae Radix, stir-fried), Shan Zhi (Gardeniae Fructus, stir-fried until black, each 1 qian), Chi Shao (Paeoniae Radix Rubra, 1 qian).
Usage: Decoct in water and take orally.
Xuezheng Heishen San (Blood Syndrome Black Divine Powder): Treats hematemesis (vomiting blood) and epistaxis (nosebleed) that recur incessantly.
Ingredients: Pao Jiang (Zingiberis Rhizoma Preparatum), Rou Gui (Cinnamomi Cortex, each 1 liang), Shu Di Huang (Prepared Rehmanniae Radix, 4 liang), Dang Gui (Angelicae Sinensis Radix), Pu Huang (Lygodii Spora, sifted clean, stir-fried until black, each 3 liang), Bai Shao (Paeoniae Radix Alba, wine-processed), Zhi Cao (Glycyrrhizae Radix et Rhizoma Preparata, each 2 liang).
Usage: Grind into powder. Take 4 qian per dose. Use Dou Hei (Sojae Semen Nigrum, half he), lightly stir-fried until fragrant, pour half zhan of wine over it, add half zhan of water, decoct until half remains, then mix with half cup of Tongbian (child's urine) and take.
For qi deficiency, add Ren Shen (Ginseng Radix, 3 liang) and Zhi Huang Qi (Astragali Radix Preparata, 6 liang) to secure defensive qi, thereby avoiding the risk of collapse of nutritive qi.
Another formula: Shu Di Huang (Prepared Rehmanniae Radix), Pu Huang (Lygodii Spora), Pao Jiang (Zingiberis Rhizoma Preparatum), Dang Gui (Angelicae Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Gui Xin (Cinnamomi Ramulus, each 2 liang), Zhi Cao (Glycyrrhizae Radix et Rhizoma Preparata, 3 qian), Dou Hei (Sojae Semen Nigrum, 2.5 shao), stir-fried and peeled. Grind all into powder. Take 2 qian per dose, with Tongbian (child's urine) and wine. It is common practice to remove the bean shells and mix them with the herbs as powder, but this is incorrect, as the efficacy of Dou Hei lies entirely in the shell.