黄胆症平人皆有,产后更甚,多致不救。盖甲乙木属肝胆,乃东方资生之气。胆属足少阳,乃半表半里之经。
若外感风寒,内束经络,医治不善,寒湿入胆,久郁为热,扰害清净之府,逼出胆汁,浸淫毛窍,化为黄色,甚
至汗黄、眼黄、便黄如金汁者,甚为费手。治宜加减阴胆汤。阳亏者,加桂附。阴虚者,加归身、熟地。微热者,
加丹皮。
加减阴胆汤
人参(二钱) 软柴胡(一钱) 白芍(酒炒,八分) 炙草(八分) 干姜(一钱) 法夏(一钱)
西党参(姜汁炒,三钱)
饮至十剂,自愈。忌茵陈清寒等药。无力服参,以黄 一钱代之。
产后汗出不止,由劳伤脾,惊伤心,怒伤肝。患此三者,不
宜即加敛汗之药,但令神宁则汗自止。且血块作痛, 、术未可遽加。凡产毕有汗,先服生化汤两贴以消块,即继
服调卫止汗汤。若倦甚而 然汗出,形色俱脱,乃亡阳汗脱也。难拘常法,从权以参 调卫救急。待产母稍有精
神,又减参 以除块痛。若汗多而阴竭阳微,以致筋脉拘急,项强口噤,牙噤发搐,类伤寒痉症者,慎勿作伤寒治,
宜加味生化汤随症加减。汗虽有自汗、盗汗之分,治当兼理血分药品,并宜加味生化汤。余方但非产后盗汗所宜。若
服参 大剂,汗多不止,及头面汗出不止,腰足青色者,不治。
调卫止汗汤
炙 麻黄根 当归(各一钱) 人参(随症加减) 防风(三分) 桂枝 炙草(各五分) 枣(二枚)
水煎。汗多而渴,加麦冬、五味。汗多亡津而小便不利,毋用利水等药。产母多痰,毋用半夏、生姜,只可用
橘红四分。
从权参 调卫汤
人参(三钱) 炙 麻黄根(各一钱五分) 当归(二钱) 桂枝(五分,汗少减之) 防风(三分)
元枣(二枚)
水煎。禁用半夏、生姜、柴胡、芩、知、柏等味。汗出不止,真阳已衰,卫外之阳不固,方内当加附子、枣
仁炒、野术、牡蛎粉,炙 重用为佳。
加味生化汤
川芎(二钱) 当归(六钱) 人参(三钱,如虚倍用) 天麻(八分) 黄 (一钱五分) 炙草(五分)
荆芥(八分) 枣(三枚)
水煎。渴,加麦冬、五味。脉脱,加人参三钱、附子四分。便闭,加麻仁三钱。痰,加竹沥、姜汁。忌葱韭
辛热食物。
黄疸病在普通人身上也会出现,产后更为严重,往往导致无法救治。这是因为甲乙木归属于肝胆,是东方滋生万物之气。胆属于足少阳经,是半表半里的经络。
如果外感风寒,内束经络,治疗不当,寒湿侵入胆腑,日久郁结化为热邪,扰乱伤害清净之府(胆),逼迫胆汁流出,浸淫毛孔,化为黄色,甚至出现汗黄、眼黄、大便黄如金汁的情况,非常难以处理。治疗适宜用加减阴胆汤。阳气亏虚者,加入桂枝、附子。阴虚者,加入当归身、熟地黄。微热者,加入牡丹皮。
加减阴胆汤
人参(二钱) 软柴胡(一钱) 白芍(酒炒,八分) 炙甘草(八分) 干姜(一钱) 法半夏(一钱)
西党参(姜汁炒,三钱)
服用十剂后,疾病自愈。忌用茵陈等清寒药物。无力服用人参的,用黄芪一钱代替。
产后汗出不止,是由于劳累损伤脾脏,惊恐损伤心脏,愤怒损伤肝脏。患有这三种情况,不宜立即使用收敛止汗的药物,只要让心神安宁,汗液自然停止。而且如果有血块作痛,莪术、白术等药不可急于使用。凡是分娩结束后有汗出的,先服用两帖生化汤以消除血块,紧接着继服调卫止汗汤。如果疲倦至极而濈然汗出,神色形态都脱失,这是亡阳汗脱证。不能拘泥于常规方法,权宜之计用参芪调卫汤来救急。待产妇稍微恢复精神,又减少参芪用量以去除血块疼痛。如果汗多导致阴竭阳微,致使筋脉拘急,项背强直,口噤不开,牙齿紧闭抽搐,类似伤寒痉病的症状,千万不要当作伤寒治疗,适宜用加味生化汤随症状加减。汗虽然有自汗、盗汗之分,治疗应当兼顾调理血分的药物,并且适宜用加味生化汤。其他方剂但不适合产后盗汗。如果服用大剂量人参、黄芪,汗多不止,以及头面部汗出不止,腰足呈现青色的,属于不治之症。
调卫止汗汤
炙麻黄根 当归(各一钱) 人参(随症状加减) 防风(三分) 桂枝 炙甘草(各五分) 大枣(二枚)
水煎服。汗多且口渴,加入麦冬、五味子。汗多耗伤津液而小便不利,不要用利水等药物。产妇多痰,不要用半夏、生姜,只可用橘红四分。
从权参芪调卫汤
人参(三钱) 炙麻黄根(各一钱五分) 当归(二钱) 桂枝(五分,汗少时减量) 防风(三分)
元枣(二枚)
水煎服。禁用半夏、生姜、柴胡、黄芩、知母、黄柏等味道。汗出不止,真阳已经衰败,卫外之阳不固,方剂内应当加入附子、炒酸枣仁、野白术、牡蛎粉,重用炙黄芪为佳。
加味生化汤
川芎(二钱) 当归(六钱) 人参(三钱,如体虚加倍使用) 天麻(八分) 黄芪(一钱五分) 炙甘草(五分)
荆芥(八分) 大枣(三枚)
水煎服。口渴,加入麦冬、五味子。脉象微弱欲绝,加入人参三钱、附子四分。大便闭塞,加入火麻仁三钱。有痰,加入竹沥、姜汁。忌食葱、韭菜及辛辣温热食物。
Jaundice can occur in healthy individuals, but it is more severe postpartum and often leads to untreatable conditions. This is because Jia-Yi Wood (associated with the Liver and Gallbladder) belongs to the East, representing the vital energy that nourishes all things. The Gallbladder belongs to the Foot-Shaoyang meridian, which is a half-exterior, half-interior channel.
If external Wind-Cold invades and binds the meridians internally, and medical treatment is improper, Cold-Dampness enters the Gallbladder. Over time, it stagnates and transforms into Heat, disturbing and damaging the "Clear Palace" (Gallbladder), forcing bile out. The bile permeates the hair follicles and pores, turning yellow. In severe cases, sweat, eyes, and stool may turn yellow like golden juice, making treatment very difficult. The appropriate treatment is Jiajian Yindan Decoction (Modified Yin-Gallbladder Decoction). For those with Yang deficiency, add Guizhi Tang (Cinnamon Twig Decoction) components (Guizhi/Cinnamomi Ramulus and Fuzii Radix Preparata); for Yin deficiency, add Danggui Sheng (Radix Angelicae Sinensis body) and Shudihuang (Rehmanniae Radix Preparata); for slight heat, add Danpi (Moutan Cortex).
Jiajian Yindan Decoction (Modified Yin-Gallbladder Decoction)
Renshen (2 qian)
Chaihu (1 qian)
Baishao (0.8 qian, stir-fried with wine)
Zhigancao (0.8 qian, honey-fried)
Ganjiang (1 qian)
Faxia (1 qian)
Xidangshen (3 qian, stir-fried with ginger juice)
Take ten doses; the condition will resolve spontaneously. Avoid using cold-clearing herbs such as Yinchen (Artemisiae Scopariae Herba). If unable to afford Renshen, substitute with Huangqi (1 qian).
Postpartum continuous sweating arises from labor injuring the Spleen, fright injuring the Heart, and anger injuring the Liver. In these three cases, one should not immediately administer astringent antiperspirant drugs. Instead, calming the Spirit (Shen) will naturally stop the sweating. Furthermore, if there is pain due to blood stasis masses, Ezhu (Curcumae Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma) should not be added hastily. Generally, after delivery, if sweating occurs, first administer two doses of Shenghua Tang (Life-Restoring Decoction) to eliminate blood stasis, followed immediately by Tiaowei Zhihan Tang (Regulating Defense and Stopping Sweat Decoction). If exhaustion is severe with profuse sweating, and both spirit and complexion are depleted, this is "Yang Collapse with Sweat Loss." One must not adhere strictly to standard methods; instead, use Canqi Tiaowei Tang (Ginseng and Astragalus Regulating Defense Decoction) as an emergency measure. Once the mother regains some vitality, reduce the dosage of Ginseng and Astragalus to address blood stasis pain. If excessive sweating leads to Yin exhaustion and Yang weakness, causing tendon constriction, neck stiffness, locked jaw, teeth clenching, and convulsions resembling Shaoyang-Jingue (Spasm Syndrome of Cold Damage), do not treat it as Cold Damage. Instead, use Jiawei Shenghua Tang (Modified Life-Restoring Decoction) adjusted according to symptoms. Although sweating is divided into spontaneous sweating and night sweats, treatment should simultaneously regulate the Blood level, and Jiawei Shenghua Tang is suitable. Other formulas are generally unsuitable for postpartum night sweats. If large doses of Renshen and Huangqi are taken yet sweating remains uncontrollable, or if head and face sweating is incessant accompanied by cyanosis of the waist and feet, the condition is untreatable.
Tiaowei Zhihan Tang (Regulating Defense and Stopping Sweat Decoction)
Zhimahuanggen (Rhizoma Imperatae, processed)
Danggui (each 1 qian)
Renshen (dosage adjusted to symptoms)
Fangfeng (0.3 qian)
Guizhi
Zhigancao (each 0.5 qian)
Dazao (2 pieces)
Decoct in water. If sweating is excessive with thirst, add Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Fructus). If excessive sweating depletes fluids leading to difficult urination, do not use diuretic drugs. If the mother has much phlegm, avoid Banxia (Pinelliae Rhizoma) and Shengjiang (Zingiberis Rhizoma Recens); only Ju Hong (Citri Reticulatae Pericarpium Rubrum, 0.4 qian) may be used.
Canqi Tiaowei Tang (Ginseng and Astragalus Regulating Defense Decoction - Emergency Use)
Renshen (3 qian)
Zhimahuanggen (each 1.5 qian)
Danggui (2 qian)
Guizhi (0.5 qian, reduce if sweating is less)
Fangfeng (0.3 qian)
Yuanzao (2 pieces)
Decoct in water. Contraindicated: Banxia, Shengjiang, Chaihu, Huangqin (Scutellariae Radix), Zhimu (Anemarrhenae Rhizoma), Huangbai (Phellodendri Cortex). If sweating is incessant indicating decline of True Yang and failure of Defensive Yang to secure the exterior, add Fuzi (Aconiti Lateralis Radix Preparata), Chao Suanzaoren (Ziziphi Spinosae Semen, fried), Ye Zhu (Atractylodis Rhizoma), and Muli Fen (Concha Ostreae powder). Using a heavy dose of Zhi Huangqi (Processed Astragali Radix) is best.
Jiawei Shenghua Tang (Modified Life-Restoring Decoction)
Chuanxiong (2 qian)
Danggui (6 qian)
Renshen (3 qian, double if deficient)
Tianma (0.8 qian)
Huangqi (1.5 qian)
Zhigancao (0.5 qian)
Jingjie (0.8 qian)
Dazao (3 pieces)
Decoct in water. If thirsty, add Maidong and Wuweizi. If pulse is faint/absent, add Renshen (3 qian) and Fuzi (0.4 qian). If constipated, add Haren (Semen Cannabis, 3 qian). If phlegm is present, add Zhuli (Bambusa Textilis Caulis Sap) and Jiangzhi (Zingiberis Rhizoma Recens Juice). Avoid scallion, leek, and spicy-hot foods.