《产宝》云∶产后虚羸者,皆由产后亏损血气所致,须当慎起居,节饮食,六淫七情,
调养百日,庶保无疾。若中年及难产者,毋论日期,必须调养平复,方可涉喧,否则气
血复伤,虚羸之证作矣。
〔薛〕前证产伤气血者,用八珍汤。饮食伤胃者,用四君子汤。停食伤脾者,用六
君子汤。劳伤元气者,用补中益气汤。若嗳气觉有药味者,此药复伤胃也。但用四君子
汤徐徐少饮,以调脾胃。若胃气一健,血气自生,诸证自愈矣。
〔丹〕产后补虚
人参 白术(各一钱) 黄 归身尾(各五分) 川芎(半两) 陈皮(三分)
上水煎服。如有寒,加干姜三分,茯苓一钱。
保命三元汤 治产日久,虚劳而脉浮大者。即小柴胡合四物也。
治产后日久,虚劳针灸不效者,三合散。(此四君子、四物、小柴胡三方合和是也。)
白术 川当归 芍药 黄 茯苓 熟地黄(各一两) 柴胡 人参(各一两半)
黄芩 半夏 甘草(各六钱) 川芎(一两)
上为粗末,每服一两,水一盅半,煎服,日三。
当归羊肉汤 治产后虽无疾者,但觉虚弱,兼心腹痛。
肥羊肉(一斤,去脂,水一斗,煮取八升,去肉) 当归(五两) 黄 (四两) 生姜(六两)
上以肉汁煮三味,取二升五合,分为四服。若觉恶露不尽,加桂三两。恶露下多,加
芎三两。有寒,加茱萸一两。有气,加细辛二两,有热,加生地黄汁二合。
《保命》治产妇虚劳不能食。十全散,(即十全大补汤。)
十全大补汤 治诸脏亏损,气血俱虚,恶寒发热;或自汗盗汗,便血吐血;或大便不
实,饮食少思;或胸腹作痛,口舌生疮;或耳目不明,牙齿不固。
人参 白术 白茯苓 黄 当归 熟地黄(酒洗,蒸焙) 白芍药(炒) 川芎(各一钱) 肉
桂甘草(炙,各五分)
上姜、枣水煎服。
当归建中汤(见前腹痛。)
云岐治产后虚损,饮食不下。四物加建中、人参、白术、茯苓主之。
疗产后大虚,心腹急痛,血气上抢心,气息乏,补益方。
黄 白术 当归 人参 甘草(各二两) 生姜(四两)
先以白羊肉三斤去膜,水一斗九升,煮肉取汁五升,下诸药,煮三升,分三服。
〔冷劳〕
〔大〕夫产则血气劳伤,脏腑虚弱,而风冷客之,冷搏于血气,血气不能温于肌肤,
使人虚乏疲顿,致羸损不平复,若久不平复,风冷入于子脏,则胞脏冷,使人无子。
〔薛〕前证若血气虚弱,用八珍汤。血气虚寒,用十全大补汤。胃气虚弱,用补中
益气汤。脾气虚弱,用六君子汤。命门火衰,用八味丸肝脾血虚,用加味逍遥散。肝脾郁
怒,用加味归脾汤。
《产宝》疗产后风虚,羸瘦劳弱,不生肌肉。
黄 当归 芍药 人参(各三分) 桂心 甘草 川芎 生姜(各四分) 大枣(十二枚)
上九味,水七升,煮三升,分温三服。
疗产后虚劳,骨节疼痛,头痛汗不出。
当归 人参 生姜(各二两) 黄 (三两) 淡豉(三合) 猪肾(二枚) 粳米(三合)
薤白(三合)
上水一斗五升,先煮猪肾取六升,下诸药煮取二升,分为三服。
又方 猪肾一双,煮,入葱、豉作 ,如常食之。
《产宝》记载:产后出现身体虚弱消瘦的症状,都是由于分娩后气血亏损所致。应当谨慎安排日常生活起居,节制饮食,避免六淫(风、寒、暑、湿、燥、火六种外感病邪)和七情(喜、怒、忧、思、悲、恐、惊七种情志变化)的干扰,调养一百天,这样才能保证不生病。如果是中年产妇或难产者,不论经过多少时间,必须等到身体完全调养恢复平静后,才能接触喧闹环境,否则气血再次受伤,虚羸的病证就会发作。
〔薛己〕上述病症中,因产伤导致气血亏虚的,使用八珍汤。因饮食不当损伤胃气的,使用四君子汤。因食物停滞损伤脾脏的,使用六君子汤。因劳累损伤元气的,使用补中益气汤。如果出现打嗝且觉得药味不适的情况,这是药物再次损伤了胃气。此时只需用四君子汤慢慢少量饮用,以调理脾胃。如果胃气一旦强健,气血自然生成,各种症状自然痊愈。
〔张从正〕产后补虚方:
人参、白术(各一钱)、黄芪、当归身尾(各五分)、川芎(半两)、陈皮(三分)。
以上药材用水煎服。如果有寒象,加干姜三分,茯苓一钱。
保命三元汤:治疗产后日久,虚劳且脉象浮大的情况。即小柴胡汤与四物汤合方。
治疗产后日久,虚劳针灸无效的情况,使用三合散。(这是由四君子汤、四物汤、小柴胡汤三方合并而成。)
白术、川当归、芍药、黄芪、茯苓、熟地黄(各一两)、柴胡、人参(各一两半)、黄芩、半夏、甘草(各六钱)、川芎(一两)。
以上药材制成粗末,每次服用一两,加水一盅半,煎煮后服用,每日三次。
当归羊肉汤:治疗产后即使没有疾病,但感觉虚弱,兼有心腹疼痛的情况。
肥羊肉(一斤,去掉脂肪,用水一斗,煮取八升,去肉留汁)、当归(五两)、黄芪(四两)、生姜(六两)。
以上用肉汁煮这三味药,取二升五合,分为四次服用。如果觉得恶露不尽,加桂三两。如果恶露排出过多,加川芎三两。如果有寒,加茱萸一两。如果有气滞,加细辛二两;如果有热,加生地黄汁二合。
十全大补汤:治疗各脏腑亏损,气血俱虚,出现恶寒发热;或自汗盗汗,便血吐血;或大便不实,饮食减少思虑;或胸腹作痛,口舌生疮;或耳目不明,牙齿不固。
人参、白术、白茯苓、黄芪、当归、熟地黄(酒洗,蒸焙)、白芍药(炒)、川芎(各一钱)、肉桂、甘草(炙,各五分)。
以上用姜、枣水煎服。
当归建中汤(见前文腹痛条下)。
云岐治疗产后虚损,饮食不下。用四物汤加上建中汤、人参、白术、茯苓主治。
治疗产后大虚,心腹急痛,血气上冲心脏,气息微弱乏力的补益方。
黄芪、白术、当归、人参、甘草(各二两)、生姜(四两)。
先用白羊肉三斤去掉筋膜,用水一斗九升,煮肉取汁五升,放入诸药,煮取三升,分三次服用。
〔冷劳〕
〔大论〕妇女分娩时血气劳伤,脏腑虚弱,风冷之邪侵袭,冷邪搏结于血气之中,血气不能温煦肌肤,使人虚乏疲顿,导致身体消瘦损耗不能恢复。如果长久不能恢复,风冷进入子宫,则胞宫寒冷,使人不孕。
〔薛己〕上述病症中,如果血气虚弱,使用八珍汤。血气虚寒,使用十全大补汤。胃气虚弱,使用补中益气汤。脾气虚弱,使用六君子汤。命门火衰,使用八味丸。肝脾血虚,使用加味逍遥散。肝脾郁怒,使用加味归脾汤。
《产宝》治疗产后风虚,身体消瘦劳弱,不长肌肉。
黄芪、当归、芍药、人参(各三分)、桂心、甘草、川芎、生姜(各四分)、大枣(十二枚)。
以上九味药,用水七升,煮取三升,分三次温服。
治疗产后虚劳,骨节疼痛,头痛无汗。
当归、人参、生姜(各二两)、黄芪(三两)、淡豆豉(三合)、猪肾(二枚)、粳米(三合)、薤白(三合)。
以上用水一斗五升,先煮猪肾取六升,放入诸药煮取二升,分为三次服用。
According to *Chanbao* (Precious Prescriptions for Childbirth): Postpartum emaciation and debility are all caused by the depletion of Qi and Blood after childbirth. One must be cautious in daily life and diet, avoid the Six Evils (Wind, Cold, Summer-heat, Dampness, Dryness, Fire) and Seven Emotions (Joy, Anger, Worry, Pensiveness, Sorrow, Fear, Fright), and maintain recuperation for one hundred days to ensure freedom from disease. For women of middle age or those who have experienced difficult labor, regardless of the time elapsed, they must wait until their body has fully recovered and stabilized before exposing themselves to noisy environments; otherwise, Qi and Blood will be injured again, and the syndrome of postpartum emaciation and debility will manifest.
[Xue Ji] For the aforementioned syndromes caused by injury to Qi and Blood during childbirth, use Bazen Tang (Eight Treasures Decoction). For stomach injury due to improper diet, use Sijunzi Tang (Four Gentlemen Decoction). For spleen injury due to food stagnation, use Liujunzi Tang (Six Gentlemen Decoction). For Yuan Qi (Original Qi) injury due to overexertion, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). If belching occurs with a distaste for the medicinal taste, this indicates that the medicine is further injuring the Stomach Qi. In such cases, only use Sijunzi Tang (Four Gentlemen Decoction), drinking it slowly and in small amounts to regulate the Spleen and Stomach. Once Stomach Qi becomes robust, Qi and Blood will naturally generate, and all symptoms will heal spontaneously.
[Zhang Congzheng] Postpartum Tonification Formula:
Renshen (Ginseng Radix), Baizhu (Atractylodis Rhizoma) (each 1 qian); Huangqi (Astragali Radix), Dangguiweishen (Radix Angelicae Sinensis caulis and radix) (each 5 fen); Chuanxiong (Ligustici Chuanxiong Rhizoma) (0.5 liang); Chenpi (Citri Reticulatae Pericarpium) (3 fen).
Decoct with water and take orally. If there are signs of Cold, add Ganjiang (Zingiberis Rhizoma) 3 fen and Fuling (Poria) 1 qian.
Baoming Sanyuan Tang (Three Origins Decoction of Baoming): Treats prolonged postpartum condition with deficiency-labor and a floating, large pulse. This is a combination of Xiaochaihu Tang (Minor Bupleurum Decoction) and Siwu Tang (Four Substances Decoction).
For prolonged postpartum deficiency-labor where acupuncture is ineffective, use Sanhe San (Three Harmonies Powder). (This is a combination of Sijunzi Tang [Four Gentlemen Decoction], Siwu Tang [Four Substances Decoction], and Xiaochaihu Tang [Minor Bupleurum Decoction].)
Baizhu (Atractylodis Rhizoma), Chuan Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix), Huangqi (Astragali Radix), Fuling (Poria), Shudihuang (Rehmanniae Radix Praeparata) (each 1 liang); Chaihu (Bupleuri Radix), Renshen (Ginseng Radix) (each 1.5 liang); Huangqin (Scutellariae Radix), Banxia (Pinelliae Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma) (each 6 qian); Chuanxiong (Ligustici Chuanxiong Rhizoma) (1 liang).
Grind into coarse powder. Take 1 liang per dose, decoct with 1.5 zhong of water, and take orally three times a day.
Danggui Yangrou Tang (Angelica Mutton Decoction): Treats postpartum weakness accompanied by heart and abdominal pain, even if no other disease is present.
Fei Yangrou (Fat Mutton, 1 jin, remove fat, boil in 1 dou of water to obtain 8 sheng, discard meat); Danggui (Angelicae Sinensis Radix) (5 liang); Huangqi (Astragali Radix) (4 liang); Shengjiang (Zingiberis Rhizoma Recens) (6 liang).
Boil these three ingredients in the mutton broth to obtain 2.5 sheng, divide into four doses. If lochia remains incomplete, add Rougui (Cinnamomi Cortex) 3 liang. If lochia discharge is excessive, add Chuanxiong (Ligustici Chuanxiong Rhizoma) 3 liang. If there is Cold, add Zhuyu (Corni Fructus) 1 liang. If there is Qi stagnation, add Xixin (Asari Radix et Rhizoma) 2 liang; if there is Heat, add Shengdihuang (Rehmanniae Radix) juice 2 he.
*Baoming Ji* treats postpartum deficiency-labor with inability to eat. Shiquan San (Ten Complete Powder), which is Shiquan Dabu Tang (Great Tonifying Decoction of Ten Ingredients).
Shiquan Dabu Tang (Great Tonifying Decoction of Ten Ingredients): Treats deficiency of various Zang-Fu organs, simultaneous deficiency of Qi and Blood, aversion to cold and fever; spontaneous sweating and night sweats; blood in stool or vomit; loose stools and loss of appetite; chest and abdominal pain; mouth and tongue ulcers; blurred vision and hearing; and loose teeth.
Renshen (Ginseng Radix), Baizhu (Atractylodis Rhizoma), Baifuling (Poria cum Risus), Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), Shudihuang (Rehmanniae Radix Praeparata) (washed in wine, steamed and dried), Baishaoyao (Paeoniae Radix Alba) (stir-fried), Chuanxiong (Ligustici Chuanxiong Rhizoma) (each 1 qian); Rougui (Cinnamomi Cortex), Gancao (Glycyrrhizae Radix et Rhizoma) (honey-fried, each 5 fen).
Decoct with water containing Ginger and Jujube, and take orally.
Danggui Jianzhong Tang (Angelica Decoction to Establish the Middle) (See previous section on Abdominal Pain).
Yunqi treated postpartum deficiency damage with inability to ingest food. He prescribed Siwu Tang (Four Substances Decoction) combined with Jianzhong Tang (Establish the Middle Decoction), Renshen (Ginseng Radix), Baizhu (Atractylodis Rhizoma), and Fuling (Poria).
Tonifying formula for treating severe postpartum deficiency, acute heart and abdominal pain, Qi and Blood rushing upward to the Heart, and weak breathing.
Huangqi (Astragali Radix), Baizhu (Atractylodis Rhizoma), Danggui (Angelicae Sinensis Radix), Renshen (Ginseng Radix), Gancao (Glycyrrhizae Radix et Rhizoma) (each 2 liang); Shengjiang (Zingiberis Rhizoma Recens) (4 liang).
First, take 3 jin of white lamb meat, remove membranes, boil in 1.9 dou of water to obtain 5 sheng of broth. Add the herbs, boil down to 3 sheng, and divide into three doses.
[Cold Lao (Consumption due to Cold)]
[Da Lun]: Childbirth causes labor and injury to Qi and Blood, leading to weakness of the Zang-Fu organs. Wind-Cold pathogens invade, and Cold clashes with Qi and Blood. The Qi and Blood fail to warm the skin and muscles, causing emptiness, fatigue, and exhaustion, resulting in emaciation and failure to recover. If recovery is delayed, Wind-Cold enters the Zi Zang (Uterus), causing coldness of the Bao Zang (Womb), leading to infertility.
[Xue Ji] For the aforementioned syndromes: If Qi and Blood are deficient, use Bazen Tang (Eight Treasures Decoction). If Qi and Blood are deficient and cold, use Shiquan Dabu Tang (Great Tonifying Decoction of Ten Ingredients). If Stomach Qi is deficient, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). If Spleen Qi is deficient, use Liujunzi Tang (Six Gentlemen Decoction). If Mingmen Fire (Fire of the Gate of Life) is declining, use Bawei Wan (Eight-Ingredient Pill). If Liver and Spleen Blood are deficient, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). If Liver and Spleen are constrained by anger, use Jiawei Guipi Tang (Modified Restore the Spleen Decoction).
*Chanbao* treats postpartum Wind-Deficiency, emaciation, labor weakness, and failure to generate flesh.
Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), Shaoyao (Paeoniae Radix), Renshen (Ginseng Radix) (each 3 fen); Guixin (Cinnamomi Cortex), Gancao (Glycyrrhizae Radix et Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), Shengjiang (Zingiberis Rhizoma Recens) (each 4 fen); Dazao (Jujubae Fructus) (12 pieces).
These nine ingredients, decocted in 7 sheng of water to yield 3 sheng, are taken in three divided warm doses.
Treats postpartum deficiency-labor with bone and joint pain, headache, and absence of sweat.
Danggui (Angelicae Sinensis Radix), Renshen (Ginseng Radix), Shengjiang (Zingiberis Rhizoma Recens) (each 2 liang); Huangqi (Astragali Radix) (3 liang); Danshi (Sojae Semen Preparatum) (3 he); Zhu Shen (Porcinus Ren) (2 pieces); Jingmi (Oryzae Sativa Granum) (3 he); Xiebai (Allii Macrostemonis Bulbus) (3 he).
Using 1.5 dou of water, first boil the pig kidneys to obtain 6 sheng. Add the herbs and boil down to 2 sheng, dividing into three doses.
Another prescription: Boil a pair of pig kidneys, add Scallion and Fermented Soybean to make a soup, and eat as usual.