产后劳伤气血,脏腑虚损,不能运化食物,及冷风相乘,以致阴阳升降不顺,清浊乱于肠胃,冷热不调,邪正
相搏,上吐下泻,名曰霍乱。若块痛未除,宜生化六和汤。块痛已止,宜藿香温胃散。
生化六和汤
川芎(二钱) 当归(四钱) 黑姜 炙草 陈皮(各四分) 砂仁(六分) 茯
苓(一钱) 姜(一片)
水煎。
藿香温胃散
当归 白术(各三钱) 姜炭 藿香 陈皮(各四分) 浓朴(八分) 人参(一钱) 炙草(三分)
姜(一片)
水煎。若手足冷逆,加附子三分。
胎前素弱,产后又亏,胃难纳谷,脾不健运。或因伤食而停滞,或因血虚而便闭,误进消耗等药,胃气益损,
满闷益增,气不升降,滋热助积,郁积之久,遂成膨胀。治当审其误用何物,如误用耗气药,宜益气汤。误用消
导药,宜健脾汤。误用攻下药,宜养生化滞汤。
益气汤
人参 白术 当归(各三钱) 川芎 白芍(各八分) 茯苓(一钱五分) 陈皮 浓朴(各四分) 苏梗
炙草(各五分) 腹皮(六分) 木香(二分) 磨萝卜子(三分) 木通(五分)
健脾汤
人参 白术 当归 茯苓 白芍 神曲(各一钱) 川芎(七分) 陈皮(四分) 炙草 砂仁(各五分)
腹皮(五分)
伤食,加麦芽五分。伤冷物,腹大痛,加吴茱萸一钱。
养生化滞汤
川芎(二钱) 当归(四钱) 人参(一钱五分,胀甚者,减半) 白芍 茯苓(各一钱) 白术(二钱,
胀甚倍用) 桃仁(十粒) 腹皮(四分) 苁蓉(酒洗,一钱五分)
如块痛,即将本汤送三消丸一钱。方附后。病剧者,须服至数十帖。
按∶产后胀症最为难治。如服前方不效,非大剂金匮肾气汤不能去其病。若虑方内熟地之滞,则用姜汁、砂仁
拌炒,桂、附更当重用。再加川椒目、蒲种壳、冬瓜子,以利水化气。或加浮萍为引,以开鬼门,多服益善。俟
胀消后,则用六君子、八珍等汤调理,可以撤消去根。此经验已多,故附增之。
产后因劳累损伤气血,导致脏腑虚损,无法运化食物,加之冷风侵袭,致使阴阳升降失调,清浊之气在肠胃中混乱,冷热不调,邪气与正气相互搏结,出现上吐下泻的症状,这种病症称为霍乱。如果腹部块状疼痛尚未消除,适宜使用生化六和汤;如果块状疼痛已经停止,适宜使用藿香温胃散。
生化六和汤
川芎(二钱) 当归(四钱) 黑姜 炙甘草 陈皮(各四分) 砂仁(六分) 茯苓(一钱) 生姜(一片)
用水煎服。
藿香温胃散
当归 白术(各三钱) 姜炭 藿香 陈皮(各四分) 厚朴(八分) 人参(一钱) 炙甘草(三分)
生姜(一片)
用水煎服。如果出现手足冰冷逆冷的症状,加入附子三分。
产前体质原本虚弱,产后又加亏损,胃难以受纳谷物,脾脏不能健运。可能是因为饮食积滞,也可能是因为血虚导致便秘,误用了耗伤正气的药物,使得胃气更加受损,胀闷感更加增加,气机不升不降,滋生热邪助长积滞,郁积日久,最终形成膨胀(腹胀)。治疗应当审查之前误用了什么药物:如果误用了耗气药,适宜使用益气汤;如果误用了消导药,适宜使用健脾汤;如果误用了攻下药,适宜使用养生化滞汤。
益气汤
人参 白术 当归(各三钱) 川芎 白芍(各八分) 茯苓(一钱五分) 陈皮 厚朴(各四分) 苏梗 炙甘草(各五分) 大腹皮(六分) 木香(二分) 磨萝卜子(三分) 木通(五分)
健脾汤
人参 白术 当归 茯苓 白芍 神曲(各一钱) 川芎(七分) 陈皮(四分) 炙甘草 砂仁(各五分) 大腹皮(五分)
如果是饮食积滞,加入麦芽五分;如果是受寒物所致,腹部胀大且疼痛,加入吴茱萸一钱。
养生化滞汤
川芎(二钱) 当归(四钱) 人参(一钱五分,若胀甚者,减半用量) 白芍 茯苓(各一钱) 白术(二钱,若胀甚则加倍使用) 桃仁(十粒) 大腹皮(四分) 肉苁蓉(酒洗,一钱五分)
如果有块状疼痛,立即用本汤送服三消丸一钱。方剂附在后面。病情严重者,需要服用几十帖。
按语:产后的胀症是最难治疗的。如果服用前面的方剂无效,必须使用大剂量的金匮肾气汤才能去除疾病。如果担心方中熟地黄过于滋腻碍胃,则用姜汁、砂仁拌炒,桂枝、附子更应当重用。再加入川椒目、蒲种壳、冬瓜子,以利水化气。或者加入浮萍作为引经药,以开鬼门(发汗),多服用效果更佳。等到胀消之后,则使用六君子汤、八珍汤等方剂进行调理,可以彻底根除疾病。这是经验之谈,所以附加增补于此。
Postpartum labor damages Qi and Blood, leading to deficiency and impairment of the Zang-Fu organs, resulting in the inability to transform and transport food. Coupled with invasion by cold wind, this causes disorder in the ascending and descending of Yin and Yang, confusion of clear and turbid Qi in the intestines and stomach, imbalance of cold and heat, and struggle between pathogenic factors and healthy Qi. This manifests as vomiting and diarrhea, a condition named Huoluan (Cholera-like syndrome). If abdominal mass pain persists, Shenghua Liuhe Tang (Life-Generating Six-Harmony Decoction) is appropriate. If the mass pain has ceased, Huoxiang Wenwei San (Agastache Stomach-Warming Powder) is appropriate.
Shenghua Liuhe Tang (Life-Generating Six-Harmony Decoction)
Chuanxiong Rhizome (2 qian) Danggui Radix (4 qian) Heijiao (Black Ginger) Zhigancao (Honey-fried Licorice Root) Chenpi (Dried Tangerine Peel) (each 4 fen) Sharen (Amomum Fruit) (6 fen) Fuling (Poria) (1 qian) Shengjiang (Fresh Ginger Slice) (1 piece)
Decoct in water and take orally.
Huoxiang Wenwei San (Agastache Stomach-Warming Powder)
Danggui Radix Baizhu (Atractylodes Macrocephala Rhizome) (each 3 qian) Jiangtan (Charred Ginger) Huoxiang (Patchouli Herb) Chenpi (Dried Tangerine Peel) (each 4 fen) Houpo (Magnolia Bark) (8 fen) Renshen (Ginseng Radix) (1 qian) Zhigancao (Honey-fried Licorice Root) (3 fen) Shengjiang (Fresh Ginger Slice) (1 piece)
Decoct in water and take orally. If there is coldness and reversal in the hands and feet, add Fuzi (Prepared Aconite Lateralis Radix) 3 fen.
If the constitution was weak before pregnancy and further depleted after delivery, the Stomach struggles to receive grain, and the Spleen fails to transport effectively. This may be due to food stagnation or constipation from Blood deficiency. Mistaken use of draining medicines further damages Stomach Qi, increasing fullness and oppression. Qi fails to ascend and descend; heat generates and aids accumulation. Long-term stagnation eventually leads to Zhanghang (Abdominal Distension). Treatment requires identifying the mistaken medication used: if Qi-draining medicines were mistakenly used, Yiqi Tang (Qi-Benefiting Decoction) is appropriate; if digestive-promoting medicines were mistakenly used, Jianpi Tang (Spleen-Strengthening Decoction) is appropriate; if purgative medicines were mistakenly used, Yangsheng Huazhi Tang (Nourishing-Life Resolving-Stasis Decoction) is appropriate.
Yiqi Tang (Qi-Benefiting Decoction)
Renshen (Ginseng Radix) Baizhu (Atractylodes Macrocephala Rhizome) Danggui Radix (each 3 qian) Chuanxiong Rhizome Baishao (White Peony Root) (each 8 fen) Fuling (Poria) (1.5 qian) Chenpi (Dried Tangerine Peel) Houpo (Magnolia Bark) (each 4 fen) Sugeng (Perilla Stem) Zhigancao (Honey-fried Licorice Root) (each 5 fen) Fupi (Areca Peel) (6 fen) Muxiang (Costus Root) (2 fen) Moluobozzi (Ground Radish Seed) (3 fen) Mutong (Akebia Stem) (5 fen)
Jianpi Tang (Spleen-Strengthening Decoction)
Renshen (Ginseng Radix) Baizhu (Atractylodes Macrocephala Rhizome) Danggui Radix Fuling (Poria) Baishao (White Peony Root) Shenqu (Medicated Leaven) (each 1 qian) Chuanxiong Rhizome (7 fen) Chenpi (Dried Tangerine Peel) (4 fen) Zhigancao (Honey-fried Licorice Root) Sharen (Amomum Fruit) (each 5 fen) Fupi (Areca Peel) (5 fen)
For food stagnation, add Maiya (Barley Sprout) 5 fen. For cold-induced injury with abdominal distension and pain, add Wuzhuyu (Evodia Fruit) 1 qian.
Yangsheng Huazhi Tang (Nourishing-Life Resolving-Stasis Decoction)
Chuanxiong Rhizome (2 qian) Danggui Radix (4 qian) Renshen (Ginseng Radix) (1.5 qian, reduce by half if distension is severe) Baishao (White Peony Root) Fuling (Poria) (each 1 qian) Baizhu (Atractylodes Macrocephala Rhizome) (2 qian, double dose if distension is severe) Taoren (Peach Kernel) (10 grains) Fupi (Areca Peel) (4 fen) Congrong (Cistanche Stem) (washed in wine, 1.5 qian)
If there is mass pain, immediately administer Sanxiao Wan (Three-Reduction Pill) 1 qian with this decoction. The formula is attached later. In severe cases, it must be taken for dozens of doses.
Note: Postpartum distension is the most difficult to treat. If the preceding formulas are ineffective, a large dose of Jin Kui Shenqi Tang (Golden Cabinet Kidney-Qi Decoction) is required to eliminate the disease. If concerned about the cloying nature of Shudihuang (Prepared Rehmannia Root), stir-fry it with Ginger Juice and Sharen (Amomum Fruit). Guizhi (Cinnamon Twig) and Fuzi (Prepared Aconite Lateralis Radix) should be used in heavier doses. Additionally, add Chuanjiaomu (Sichuan Pepper Seed), Puzhongke (Buckthorn Shell), and Dongguazi (Winter Melon Seed) to promote diuresis and transform Qi. Alternatively, add Fuping (Wolffia Herb) as a guiding drug to open the "Ghost Gate" (sweat pores); taking more is beneficial. After the distension subsides, regulate with Liujunzi Tang (Six-Gentlemen Decoction) or Bazhen Tang (Eight-Treasure Decoction) to eradicate the root cause. This is based on extensive experience, so it is added here.