产后气血空虚,真元未复,一有劳动则寒热交作,食少不寐,头目并四肢胀痛,或日轻夜重,或一日好一日
歹,变症不一,名曰蓐劳,最难治。大凡阳虚则恶寒,阴虚则恶热,清阳不升则头目痛,血不足以荣养则四肢
痹痛,宜用八珍汤补之。若脾虚食少,呕恶多痰,用六君子汤加炮姜以温中宫,诸症自可全退,然非参不可。若
一见前症,寒热表散则失之远所矣。以初产数日不可梳头洗面,劳动者也。因其骨节尚未斗准,筋脉易以损伤,
不可因体健而大意也。常有缠绵难愈,日久成痨,或致废疾者。如体本坚实,安得有此故,又当别论。
八珍汤 六君子汤(俱见前)。
《指掌》有白茯苓汤、羊肉汤等方,皆治蓐劳之病用者,亦甚有理,因此附于后,以备择用。
白茯苓散
茯苓(二两) 人参 炙黄 当归 川芎 白芍(酒炒) 熟地 桂心(各五钱)
以上八味共为末。用猪腰一对,去油膜净,姜三片,枣二枚,水煎。姜枣腰取水碗半,去渣,入前药末五钱,
再煎服。
仲景羊肉汤
精羊肉(一斤) 当归(五两) 黄 (四两) 生姜(三两)
水八升,先煮羊肉、生姜,取汁五升,入归 再煎,减至三升,每日服七合。
人参鳖甲散
人参(五钱) 鳖甲(炙一两) 淮牛膝 炙黄 茯苓 桑寄生 当归 桂心 白芍(炒) 桃仁 川断
甘草 熟地 麦冬(各五钱)
共为末和匀,另用猪腰一对,去膜净,加姜(三片),枣(二枚),水(三碗),煮取汤一大碗,入前药
末(三钱),又加葱白(一寸),乌梅(三个),荆芥(三分),再
煎,温服。日日如此,以服完药末即愈。
产后气血虚弱,真元尚未恢复,一旦有劳作,就会出现寒热交替发作、食欲减退、失眠、头部眼睛及四肢胀痛等症状,或者表现为白天轻晚上重,或者一天好一天坏,变症不一,这种病称为蓐劳(产后因虚劳引起的疾病),最难治疗。大凡阳气虚弱则怕冷,阴血不足则怕热,清阳之气不能上升则头目疼痛,血液不足以荣养肢体则四肢痹痛,适宜使用八珍汤(补气养血方剂)来补益。如果脾虚导致食欲减退,呕吐恶心且痰多,使用六君子汤(健脾益气化痰方剂)加入炮姜以温补中焦脾胃,各种症状自然可以完全消退,然而非用人参不可。如果一见到前面的症状,就用发散表邪的方法治疗,那就偏离治疗原则很远了。因为刚生产后几天不宜梳头洗脸,这是劳作的表现。因为此时骨节尚未稳固,筋脉容易受损,不要因为身体看似健壮就大意。常有缠绵难愈,日久形成痨病,或者导致残疾的情况。如果体质本来坚实,怎么会有这种情况呢?这又当别论。
《指掌》中有白茯苓汤、羊肉汤等方剂,都是治疗蓐劳病的,也很有道理,因此附在后面,以备选择使用。
白茯苓散
茯苓(二两) 人参 炙黄芪 当归 川芎 白芍(酒炒) 熟地黄 桂心(各五钱)
以上八味药共研为末。用猪腰一对,去掉油膜洗净,生姜三片,大枣二枚,加水煎煮。取姜枣猪腰汁半碗,去渣,加入前面药末五钱,再煎服。
仲景羊肉汤
精羊肉(一斤) 当归(五两) 黄芪(四两) 生姜(三两)
用水八升,先煮羊肉和生姜,取汁五升,加入当归再煎,减至三升,每日服用七合。
人参鳖甲散
人参(五钱) 鳖甲(炙一两) 淮牛膝 炙黄芪 茯苓 桑寄生 当归 桂心 白芍(炒) 桃仁 川断 甘草 熟地黄 麦冬(各五钱)
共研为末混合均匀,另外用猪腰一对,去掉膜洗净,加生姜(三片),大枣(二枚),水(三碗),煮取汤一大碗,加入前面药末(三钱),再加葱白(一寸),乌梅(三个),荆芥(三分),再煎,温服。每天如此,直到服完药末即痊愈。
Postpartum Qi and Blood are deficient, and the True Yuan (True Origin/Vital Energy) has not yet recovered. Once exertion occurs, alternating chills and fever will manifest, accompanied by poor appetite, insomnia, distending pain in the head, eyes, and limbs, or symptoms that are lighter during the day and heavier at night, or fluctuating from good to bad days. The variations are numerous; this condition is named "Rulao" (Postpartum Deficiency Consumption), which is extremely difficult to treat. Generally speaking, Yang deficiency leads to aversion to cold, while Yin deficiency leads to aversion to heat. If Clear Yang fails to ascend, head and eye pain occur; if Blood is insufficient to nourish the limbs, Bi syndrome (obstruction causing pain/numbness) in the limbs results. It is appropriate to use Bazhen Tang (Eight Treasures Decoction) to tonify. If Spleen deficiency causes poor appetite, vomiting, nausea, and excessive phlegm, Liu Junzi Tang (Six Gentlemen Decoction) with Pao Jiang (Prepared Ginger) should be used to warm the Middle Jiao (Middle Burner/Spleen-Stomach area), and all symptoms will naturally recede; however, Renshen (Ginseng) is indispensable. If one sees the aforementioned symptoms and uses methods to disperse the exterior, it would deviate significantly from the correct treatment principle. This is because within a few days after childbirth, one should not comb hair or wash the face, as these constitute exertion. Since the bone joints have not yet stabilized and the sinews and vessels are prone to injury, one must not be careless just because the body appears robust. There are often cases that linger and are hard to cure, developing into consumption over time, or even leading to disability. If the constitution was originally solid, how could such a situation arise? This warrants separate discussion.
Bazhen Tang and Liu Junzi Tang (both seen previously).
Zhang's Finger Guide contains formulas such as Baifuran San (White Poria Powder) and Yangrou Tang (Mutton Decoction), all used for treating Rulao, which are also quite reasonable. Therefore, they are appended here for reference and selection.
Baifuran San (White Poria Powder)
Fuling (Poria, 2 liang), Renshen (Ginseng), Zhi Huangqi (Honey-fried Astragalus), Danggui (Angelica Sinensis), Chuanxiong (Ligusticum), Baishao (White Peony Root, wine-fried), Shudi (Prepared Rehmannia), Guixin (Cinnamon Twig Heart) (each 5 qian).
The above eight herbs are ground together into powder. Use one pig kidney, cleaned of oil membranes, along with three slices of Shengjiang (Fresh Ginger) and two dates (Dazao). Decoct in water. Take half a bowl of the liquid from the ginger, date, and kidney decoction, strain out the dregs, add five qian of the aforementioned herb powder, and decoct again before taking.
Zhongjing Yangrou Tang (Zhang Zhongjing's Mutton Decoction)
Lean mutton (1 jin), Danggui (Angelica Sinensis, 5 liang), Huangqi (Astragalus, 4 liang), Shengjiang (Fresh Ginger, 3 liang).
Use eight sheng of water. First decoct the mutton and fresh ginger, obtaining five sheng of juice. Add Danggui and decoct again until reduced to three sheng. Take seven he daily.
Renshen Biejia San (Ginseng and Softshell Turtle Powder)
Renshen (Ginseng, 5 qian), Biejia (Softshell Turtle Shell, roasted 1 liang), Huai Niuxi (Achyranthes Bidentata), Zhi Huangqi (Honey-fried Astragalus), Fuling (Poria), Sangjisheng (Taxillus), Danggui (Angelica Sinensis), Guixin (Cinnamon Twig Heart), Baishao (White Peony Root, stir-fried), Taoren (Peach Kernel), Chuanduan (Dipsacus), Gancao (Licorice), Shudi (Prepared Rehmannia), Maidong (Ophiopogon) (each 5 qian).
Grind all into powder and mix evenly. Separately, use one pig kidney, cleaned of membranes, add three slices of Shengjiang (Fresh Ginger), two dates (Dazao), and three bowls of water. Boil to obtain one large bowl of soup. Add three qian of the aforementioned herb powder, along with one cun of Congbai (Scallion White), three Wumei (Dark Plum), and three fen of Jingjie (Schizonepeta). Decoct again and take warm. Repeat daily until the entire powder course is completed, at which point the patient will recover.