产后刚、柔二痉,以五积加麝香煎服。盖痉者,口噤不开,背强,面如痫状,摇头马鸣,身反
折,气息如绝者是也。
产后半身不遂,言语蹇涩,恍惚不定,以天麻散治之。
【天麻散】天麻 朱砂(水飞) 防风 羌活(各一两) 僵蚕(炒,七钱半) 干蝎(炒) 白附子(炮)
五灵脂(炒,各半两) 雄雀粪(炒) 牛黄(另研,各二钱半)
上为细末,糯米饭为丸,如桐子大,每服二三十丸,薄荷酒送下,日进二服。
产后恶露不净,半身肉战,半身出汗,用二四汤加桃仁、红花、山楂、姜汁治之。
产后麻木,血少也,宜生血补虚为主,以八物汤治之。
产后中风恶候歌(与男子同看)∶中风恶候要君知,眼合肝亡手撒脾,心绝口开肺鼻鼾,肾家将绝定尿遗。
凡初产伤寒,切不可用小柴胡,因有黄芩,容易停血,恐伤人也,宜参苏饮为佳。
【参苏饮】人参 紫苏 枳壳 桔梗 葛根 前胡 甘草 橘红 半夏 茯苓 木香 生姜
产后中寒,以理中汤治之,如恶露未尽,去参;宜用五个散,此方不论吐泄有无,皆可服也。
产后伤寒脉象论诀∶产后伤寒热病临,脉细四肢暖者生,脉大忽然肢逆冷,便是神仙医不醒。
盖热病之脉,固当洪大,但产后血气俱虚,亦所不宜,勿以阳病见阴脉论也。
产后内伤与暑病者,与常人同治,故不书汤药也。
产后恶露未尽,而兼伤风咳嗽、腹痛者,必行血理气为先,轻则以四乌汤,川芎为君,重则以二四
汤;如不解,以五个散加行血之剂治之;如兼泻者,亦以五个散治之,但姜、桂少用为上。若恶露既尽,
小腹不痛,而伤风头疼者,不拘咳嗽痰有无,无汗
者,旋覆花汤治之;不咳嗽而重感者,芎苏散治之;虚汗出者,参苏饮;内伤而泻者,但以五个散治之,
不必用行血之药也。
产后劳碌,感冒,头痛寒热者,宜服三元散。
产后重感伤风,骨节皮肤皆痛,未汗,宜服败毒散治之;若虚者,只可服五个散;若恶露净后,兼
痰饮,十分虚者,宜用参苏饮治之。若产后虚甚而着风,不可专与之发散,必须逍遥散治之,其效虽迟,
渐解无失也。
产后蓐劳,寒热头疼者,宜增减柴胡汤治之。
产后伤风,寒热者,以五积散治之。
产后伤风,寒热,咳嗽,喘急,痰涎壅盛者,以旋覆花汤,见汗则止,有汗勿服。
产后血虚寒热者,治之以逍遥散。
若寒热往来者,宜小柴胡汤主之。
若久坐、多语、劳力,头目四肢寒痛,寒热如疟,名曰蓐劳,以茯苓散治之。
【茯苓散】茯苓 当归 川芎 白芍 人参 熟地 黄 肉桂
用猪腰子一只(去膜),生姜二片,大枣二枚,水二钟,煎汤代水煎前药。
产后冒寒,头痛发热,足冷者,以芎苏散,或五积散亦可。
产后偏正头痛,宜川芎茶调散治之;又不若败毒散之尤胜,合五积散,原治败血流经之剂耳。
【川芎茶调散】川芎 荆芥 白芷 甘草 羌活 防风 薄荷 细辛
等份为细末,用茶煎浓调服。
一方加香附。
产后大发热者,必用炮姜治之,何也?此热非有余之邪,乃阴虚生热也,故干姜炮用之。其入肺则
利气,入肝则生血,其妙在此也。
产后大失血,阴血暴亡,必大发热,名曰阴虚发热。此阴字,正谓气血之阴,若以凉药正治必毙。
正所谓症象白虎,误服白虎必死。此时偏不用四物汤何也?有形之物,不能速化几希之气,急用独参汤,
或当归补血汤,无形生出有形来,阳生阴长之妙,不可不知也。
【当归补血汤】黄 (炙,一两) 当归(酒洗,二钱)
空腹服。
产后日晡发热转甚,非柴胡不能治,以八物汤加柴胡,或四物汤合小柴胡汤治之亦可。
产后咳嗽痰盛者,宜旋覆花汤治之;如血未尽,则先治血,后发散可也;或二四汤加消食药为善。
痰火怔忡嘈杂,宜茯苓半夏汤。
【茯苓半夏汤】茯苓 半夏 黄连 黄芩 熟地 当归 川芎 香附 杏仁 栝蒌 竹沥
产后食盐太早而咳嗽者,此症难治,不轻与药。
产后恶露上流肺经,咳嗽,与平人同治,以二母汤去参为妙。
【二母汤】知母 贝母 茯苓 桃仁 人参 杏仁
产后嗽喘者,此乃危急之疾,若不嗽而独喘者尤甚,不宜与药;不得已,以二四汤加姜汁、红花、
山楂、枳壳之类。
古曰∶诸喘皆凶。若败血上熏于肺而喘者,名曰孤阳绝阴,此症难治,勉用夺命丹。
【夺命丹】(佚)
若伤食感寒而喘急者,宜用五积散治之。若伤风寒痰喘者,旋覆花汤治之。
产后劳碌,发干咳嗽者,以二四汤加活血药治之。若恶露已尽,宜知母茯苓汤,或八物汤加黄柏、
知母治之,或用鸡苏散。
产后哮喘,遇产而发者,宜以宁肺汤治之。
【宁肺汤】杏仁 阿胶 半夏 细辛 乌梅 大枣 甘草 陈皮 茯苓 苏子 桑皮 枳壳 生姜
产后外感兼泻者,以五个散加行血药。
产后血泻者,以胃苓汤加山楂、神曲、半夏治之;若腹痛拒按者,加消食药;如有恶露,加活血药治之。
产后食泻者,宜养胃汤;如恶露不尽者,以五个散加桃仁、红花治之。
产后寒泻者,宜五积散;如恶露已尽,用白芍,亦不必用活血药也。若咳嗽者,姜、桂少用,即
理中汤亦可。
产后伤食者,如恶露未尽,以四乌汤加消食药;若泻者,以五个散治之;若恶露去多者,宜五苓
散;若恶露去多而不泻者,宜养胃汤治之。
产后冷热不调,上吐下泻,名曰霍乱,渴而饮水者,宜五苓散;寒多不饮水者,以理中汤治之;霍
乱吐泻,又宜藿香正气散。
产后呕吐,如恶露未尽者,以二四汤加活血药。
产后疟疾,如恶露未尽者,以五积散加桃仁、红花、山楂、神曲治之;如已尽者,以养胃汤加消食
药治之,盖疟虽不泻,然须预防脾胃为要,故用此剂也;如兼泻者,用之尤妙;热多寒少,以生熟饮、养
胃汤治之;久而不已者,以七宝饮治之。
【生熟饮】肉豆蔻 草果 浓朴 半夏 甘草 陈皮 大枣
加生姜一半生用,一半湿纸裹煨熟用,和前药煎服。
【七宝饮】青皮 陈皮 甘草 当归 浓朴 草果 槟榔
产后恶露未尽而痢,以胃苓汤加桃仁,虽日夜去百次,服之可验。如饱闷,加红花、当归,而滑肠
者禁用,可服神曲、五个散亦可。
产后恶露尽而痢者,以胃苓汤加半夏、神曲治之。
产后不拘赤白痢者,以胃苓汤一方而可治也;虽有食积,多服几剂自愈。
产后冷热痢者,宜黄连阿胶丸。
【黄连阿胶丸】黄连(去须,三两) 阿胶(碎炒,一两) 茯苓(去皮,二两)
上以黄连、茯苓为细末,水熬阿胶为丸,如桐子大,每服三十丸,空腹米饮送下。
产后痢疾,渴饮无度,宜用麦门冬、乌梅煎汤,或用冬瓜汁亦可。
产后赤白痢者,宜服香连术苓散,又以四君子汤加黄 、粟壳治之。
【四君子汤】人参 白术 茯苓 甘草
产后气虚下痢,宜用当归芍药汤。
产后血痢,宜三黄熟艾汤。
【三黄熟艾汤】黄连 黄柏 黄芩 艾叶 大枣
产后痢疾脉诀∶产后痢疾,脉息须知∶细小者生,洪大不取;欲绝附骨,无事断之;产后须细,痢
疾尤宜;浮钩洪大,必死无疑。
产后下痢,宜用参粟散。
【参粟散】人参 粟壳 白术 甘草 肉桂 当归 乌梅 苍术 枳壳 诃子
产后感寒而腹痛者,以理中汤去人参以治之。
产后因受气而小腹胀痛者,以分气紫苏饮;如停食,加消食药治之。
产后败血攻心,而胃口痛甚者,宜延胡散。单胃口痛者,以养胃汤治之。
产后腰痛而下注两腹,痛如锥刺入骨者,败血未尽而停住经络也,肾虚者,以四物汤加黄柏,或五
个散治之;盖此药能除败血、去风湿也;如净后作痛者,以四物汤治之则愈矣。
若产后去血过多而腰痛者,至月外者,以补中益气汤及内补汤治之。
产后半边腰痛者,多因侧卧,以致败血流于一边故也,以四乌汤,或二四汤加红花、桃仁治之。若
非血而痛者,只因受气而痛,以二四汤并补中益气去参,加活血药治之,如不嗽者,加香附治之。
产后皮肉痛者,此外感也,若恶露未尽,先服行血药,后服芎苏散;若血已尽,服芎苏散,然此药
乃发汗之剂,不可多服。
产后骨痛者,若恶露未尽,宜五个散治之;如故,以四乌汤、二四汤治之;如小腹痛者,加活血
药;若恶露已尽,宜用增减柴胡汤治之。
产后遍身骨节疼痛,或因气滞,或因血凝,或感风寒,或初产血气未和,或蓐劳、血少,皆能作痛
也,故腰背不能转侧,手足不能运动,身热头痛,俨如伤寒色样。若作伤寒治之,其变症不浅,宜五积加
羌活,入醋煎,效,或韭白亦可。若蓐劳而筋骨不利者,用逍遥散以治之。
产后血气刺痛,小腹宿冷 癖者,宜葱白散。
【葱白散】葱白 肉桂 三棱 蓬术 人参 熟地 当归 白芍 浓朴 神曲 青皮 木香 麦芽
干姜 茯苓 川芎 川楝子 小茴香
产后发呃,败血未尽而不行也,宜用行血药;如已净而呃者,多是受冻,宜顺气调胃为上,如紫苏饮之类。
产后呃逆不已,乃胃寒而气不顺也,宜丁香散治之,或单橘皮汤,或用肉桂、姜汁,以火炙热,用
手承擦摩背上。
【丁香散】丁香 白蔻仁 伏龙肝
为细末,用吴茱萸汤调下(或桃仁汤亦可)。
产后呕逆不已,以君陈丸治之。若腹痛胀满,呕逆不定,多因是食,宜丁香消食之剂;是痰者,宜
旋覆花汤;是寒者,以理中汤加木香、青皮、半夏、陈皮治之。
【君陈丸】人参 白术 茯苓 甘草 半夏 陈皮 藿香 砂仁
产后腹胀满不定,此由败血散于脾胃也。若脾受之,则不能运化精微而成腹胀;胃受之,则不能受
纳五谷而生呕吐也,明矣,平胃散、安胃汤主之。
【安胃汤】半夏 橘红 生姜 甘草 神曲 藿香
产后吞酸水者,宜七气汤。
【七气汤】人参 肉桂 半夏 甘草 生姜
产后腹胀,必利小水为主,若遍身胀者,宜木香流气饮治之。
【木香流气饮】木香 甘草 陈皮 青皮 草果 丁香 浓朴 藿香 木通 人参 槟榔 白芷 香附
肉桂 蓬术 大腹皮 苏叶 麦冬 木瓜 白术 半夏 茯苓 菖蒲 生姜
产后沐浴太早,或感风湿而筋脉拘急,骨节疼痛者,以五积散加木瓜、吴茱萸煎服。
产后四肢浮肿而腹大者,此乃气食也,宜紫苏
饮加消食药。若身热者,当防其有血也。盖产后浮肿多端∶或胎前肿至产后者,或产后着风寒而肿者,或
内伤生冷而肿满者,或因败血化水而肿满肠鸣者,或因血虚气滞而浮肿者,切不可专用导药,宜辨其虚实
而治之。虽见虚,又不可便用重补,须治其气,气顺理其血,血活则气血和而病得效矣。然顺气之药,当
以黑龙丹、黑神丸、五积散、紫苏饮调经之剂。
【黑龙丹】(佚)
【黑神丸】(佚)
产后两足忽肿疼者,肿是湿而疼是热,恐成香港脚而有患也,以当归定痛散治之。若红肿者,恐生毒
疮,以皮之热与不热为辨也。
【当归定痛散】人参 当归 葛根 黄芩 羌活 茵陈 知母 茯苓 猪苓 泽泻 苍术 甘草 防风 升麻
产后肚大筋青,小水多不利者,或食生冷,或淤血停滞而带伤者,治以胃苓汤,起剂加桃仁、红
花、杏仁、苏叶、赤芍、归尾,或五个散加桃仁、红花、赤芍消食之剂,或紫苏饮加行血消食药尤妙,内加
木香愈佳,总身有热者不忌也,盖木香亦能清热也。
产后因气,或得寒物,恶露凝住,腹胀如鼓而疼痛者,以四乌汤治之。凡胎前以分气饮,产后则服五个散。
产后耳忽聋、目忽昏者,血气不足也,宜十全大补汤。
产后目肿赤而痛者,以四物加生地、黄连治之。
产后吐血、嗽血、咯血,恐血气冲心,急用延胡汤治之。
产后鼻衄,宜紫苏饮入童便治之,或荆芥散入童便。
产后尿血者,以四物汤加凉血药治之,或八正散。
产后小便闭者,以四物汤去地黄,加入赤茯苓、木通、竹叶之类,或用五苓散去桂枝,加入木香、滑
石冶之;若甚者,以八正散治之。
产后小便不通,腹胀如鼓者,用炒盐加麝香少许,填平脐中,再以葱白一束,切片如指浓,安盐
上,又以艾柱满葱饼,以火灸之,觉腹内有热时,小便即通。
产后大小便俱不通者,如恶露已净,以四物汤加黄芩、生地、木通、枳壳、栀子(炒);如未尽
者,以五个散加桃仁、赤芍、归尾、红花治之。
产后大便闭者,宜玉烛散,或麻仁丸,或五仁丸,或四物汤加枳壳、青皮,或苏子、麻仁煮粥食之,并妙。
【玉烛散】地黄 当归 白芍 川芎 大黄 枳实 浓朴
【麻仁丸】人参 大黄 麻仁 枳壳
蜜丸,酒服。
【五仁丸】杏仁 麻仁 郁李仁 桃仁 松子仁
产后大便闭结而小便自利者,宜用无违散。
【无违散】当归 白芍 麻仁 山楂 神曲 枳壳 青皮
产后刚痉和柔痉,用五积散加麝香煎服。所谓痉证,是指牙关紧闭不能张开,背部僵硬,面部表情像癫痫发作一样,摇头发出马嘶般的声音,身体向后反折,气息微弱好像断绝一样的症状。
产后半身不遂,言语蹇涩不清,神志恍惚不定,用天麻散治疗。
【天麻散】天麻、朱砂(水飞法处理)、防风、羌活(各一两)、僵蚕(炒制,七钱半)、干蝎(炒制)、白附子(炮制)、五灵脂(炒制,各半两)、雄雀粪(炒制)、牛黄(另研细,各二钱半)。
以上药物研成细末,用糯米饭做成丸药,大小如梧桐子,每次服用二三十丸,用薄荷酒送下,每天服用两次。
产后恶露排出不净,半身肌肉颤抖,半身出汗,用二四汤加桃仁、红花、山楂、姜汁治疗。
产后肢体麻木,是因为血虚,应当以生血补虚为主,用八物汤治疗。
产后中风恶候歌诀(与男子中风对照参考):中风的危重征候你要知晓,眼睛闭合是肝气亡失,手撒不收是脾气衰竭,心脏绝症表现为口张不开,肺脏绝症表现为鼻鼾声,肾脏将绝必定出现遗尿。
凡是刚生产完感受伤寒,切不可用小柴胡汤,因为方中有黄芩,容易导致瘀血停滞,恐怕伤害人体,宜用参苏饮为好。
【参苏饮】人参、紫苏、枳壳、桔梗、葛根、前胡、甘草、橘红、半夏、茯苓、木香、生姜。
产后感受寒邪,用理中汤治疗,如果恶露未尽,去掉人参;宜用五个散,这个方子不论是否有呕吐腹泻,都可以服用。
产后伤寒脉象论诀:产后患伤寒热病时,脉象细小且四肢温暖的是可生之兆,脉象宏大却突然四肢逆冷,即使是神仙医生也难以救醒。
大概热病的脉象,本来应当洪大,但产后气血俱虚,也不适宜见到洪大脉,不要按照阳病见阴脉的理论来论述。
产后内伤饮食与中暑病,治疗方法与常人相同,所以不记录具体汤药方剂。
产后恶露未尽,又兼有伤风咳嗽、腹痛的,必须先行血理气为先,轻症用四乌汤,川芎为君药,重症用二四汤;如果病情不解,用五个散加行血药物治疗;如果兼有腹泻,也用五个散治疗,但生姜、肉桂要少用为上策。如果恶露已经排尽,小腹不痛,而伤风引起头痛的,不管有没有咳嗽痰液,无汗的用旋覆花汤治疗;不咳嗽但再次感邪重的,用芎苏散治疗;虚汗出的,用参苏饮;内伤饮食导致腹泻的,只用五个散治疗,不必用行血药物。
产后再次感受伤风,骨节皮肤都疼痛,尚未出汗的,宜服用败毒散治疗;如果是体虚者,只可服用五个散;如果恶露排净后,兼有痰饮,十分虚弱的,宜用参苏饮治疗。如果产后极度虚弱又感受风邪,不可专门使用发散药物,必须用逍遥散治疗,虽然见效慢,但逐渐解除也不会失误。
产后伤风,出现寒热、咳嗽、喘急、痰涎壅盛的,用旋覆花汤治疗,见到出汗就停药,有汗者勿服。
如果久坐、多说话、用力劳作,头目四肢寒冷疼痛,寒热像疟疾一样,名叫蓐劳,用茯苓散治疗。
【茯苓散】茯苓、当归、川芎、白芍、人参、熟地黄、肉桂。
用猪腰子一个(去掉内膜),生姜两片,大枣两枚,水两碗,煎汤代替水来煎煮前面的药物。
产后冒受寒邪,头痛发热,脚冷的,用芎苏散,或者五积散也可以。
产后偏头痛或正头痛,宜用川芎茶调散治疗;但这不如败毒散效果更好,合用五积散,原本就是治疗败血流经的方剂。
【川芎茶调散】川芎、荆芥、白芷、甘草、羌活、防风、薄荷、细辛。
等份研成细末,用浓茶煎调服用。
一方加入香附。
产后大发热的,必须用炮姜治疗,为什么呢?这种热不是有余的邪气,而是阴虚产生的热,所以用干姜炮制后使用。它入肺则利气,入肝则生血,妙处就在这里。
产后大失血,阴血突然亡失,必然大发热,名叫阴虚发热。这个“阴”字,正是指气血之阴,如果用凉药正治必死无疑。
正所谓症状像白虎汤证,误服白虎汤必死。此时为什么偏偏不用四物汤呢?因为有形的物质,不能迅速化生几希之气,急需使用独参汤,或者当归补血汤,让无形生出有形来,这是阳生阴长的奥妙,不可不知。
【当归补血汤】黄芪(炙,一两)、当归(酒洗,二钱)。
空腹服用。
产后日晡时(下午3-5点)发热加重,非柴胡不能治疗,用八物汤加柴胡,或者四物汤合小柴胡汤治疗也可以。
产后咳嗽痰多的,宜用旋覆花汤治疗;如果血未尽,则先治血,后发散也可以;或者用二四汤加消食药较好。
痰火引起的怔忡、嘈杂感,宜用茯苓半夏汤。
【茯苓半夏汤】茯苓、半夏、黄连、黄芩、熟地黄、当归、川芎、香附、杏仁、瓜蒌、竹沥。
产后恶露上流至肺经,引起咳嗽的,与普通人同治,用二母汤去掉人参为妙。
【二母汤】知母、贝母、茯苓、桃仁、人参、杏仁。
产后咳嗽气喘的,这是危急的疾病,如果不咳而单独气喘的更严重,不宜给药;不得已的情况下,用二四汤加姜汁、红花、山楂、枳壳之类。
古语说:各种气喘都是凶险的。如果是败血上熏于肺而气喘的,名叫孤阳绝阴,此症难治,勉强用夺命丹。
【夺命丹】(已佚失)
如果是伤食感寒而喘急的,宜用五积散治疗。如果是伤风寒痰喘的,用旋覆花汤治疗。
产后因劳累,引发干咳的,用二四汤加活血药治疗。如果恶露已尽,宜用知母茯苓汤,或者八物汤加黄柏、知母治疗,或者用鸡苏散。
产后哮喘,遇产而发的,宜用宁肺汤治疗。
【宁肺汤】杏仁、阿胶、半夏、细辛、乌梅、大枣、甘草、陈皮、茯苓、苏子、桑白皮、枳壳、生姜。
产后血性腹泻的,用胃苓汤加山楂、神曲、半夏治疗;如果腹痛拒按的,加消食药;如果有恶露的,加活血药治疗。
产后食积腹泻的,宜用养胃汤;如果恶露不尽的,用五个散加桃仁、红花治疗。
产后寒性腹泻的,宜用五积散;如果恶露已尽,用白芍,也不必用活血药了。如果有咳嗽的,生姜、肉桂少用,即使用理中汤也可以。
产后伤食的,如果恶露未尽,用四乌汤加消食药;如果腹泻的,用五个散治疗;如果恶露去得多的,宜用五苓散;如果恶露去得多而不腹泻的,宜用养胃汤治疗。
产后冷热不调,上吐下泻,名叫霍乱,口渴想喝水的,宜用五苓散;寒多不想喝水的,用理中汤治疗;霍乱吐泻,又宜用藿香正气散。
产后疟疾,如果恶露未尽的,用五积散加桃仁、红花、山楂、神曲治疗;如果已尽的,用养胃汤加消食药治疗,大概疟疾虽然不腹泻,但预防脾胃受损是要紧的,所以用这些药剂;如果兼有腹泻的,用这些药尤其巧妙;热多寒少的,用生熟饮、养胃汤治疗;久治不愈的,用七宝饮治疗。
【生熟饮】肉豆蔻、草果、厚朴、半夏、甘草、陈皮、大枣。
加生姜一半生用,一半湿纸包裹煨熟用,和前药一起煎服。
【七宝饮】青皮、陈皮、甘草、当归、厚朴、草果、槟榔。
产后恶露未尽而患痢疾的,用胃苓汤加桃仁,即使一天一夜跑一百次厕所,服用后可见效。如果饱闷,加红花、当归,而滑肠者禁用,可以服用神曲、五个散也可以。
产后不管赤白痢疾,用胃苓汤一方就可以治疗;虽然有食积,多服几剂也会自愈。
产后冷热痢疾的,宜用黄连阿胶丸。
【黄连阿胶丸】黄连(去须,三两)、阿胶(碎炒,一两)、茯苓(去皮,二两)。
以上将黄连、茯苓研成细末,用水熬化阿胶做成丸药,大小如梧桐子,每次服用三十丸,空腹米饮送下。
产后痢疾,渴饮无度的,宜用麦门冬、乌梅煎汤,或者用冬瓜汁也可以。
产后赤白痢疾的,宜服用香连术苓散,又以四君子汤加黄芪、罂粟壳治疗。
【四君子汤】人参、白术、茯苓、甘草。
产后血痢的,宜用三黄熟艾汤。
【三黄熟艾汤】黄连、黄柏、黄芩、艾叶、大枣。
产后痢疾脉诀:产后患痢疾,脉息需要知晓:脉象细小者主生,脉象洪大者不取;脉象欲绝且按之附骨,无需断言死亡;产后脉须细,患痢疾尤其适宜;脉象浮钩洪大,必死无疑。
产后下痢,宜用参粟散。
【参粟散】人参、粟壳、白术、甘草、肉桂、当归、乌梅、苍术、枳壳、诃子。
产后因受气而导致小腹胀痛的,用分气紫苏饮;如果停食,加消食药治疗。
产后败血攻心,导致胃口剧痛的,宜用延胡散。单是胃口痛的,用养胃汤治疗。
产后腰痛并向下注及两腹,痛如锥刺入骨的,是败血未尽而停留在经络中,肾虚的,用四物汤加黄柏,或者五个散治疗;大概这些药物能去除败血、祛除湿风湿邪;如果排净后作痛的,用四物汤治疗就会痊愈。
如果产后失血过多而腰痛,超过一个月的,用补中益气汤及内补汤治疗。
产后半边腰痛的,多因侧卧,导致败血流于一边所致,用四乌汤,或者二四汤加红花、桃仁治疗。如果不是血瘀而痛,只因受气而痛,用二四汤并补中益气汤去掉人参,加活血药治疗,如果不咳嗽的,加香附治疗。
产后皮肉疼痛的,这是外感,如果恶露未尽,先服行血药,后服芎苏散;如果血已尽,服芎苏散,然而此药是发汗的药剂,不可多服。
产后骨痛的,如果恶露未尽,宜用五个散治疗;如果无效,用四乌汤、二四汤治疗;如果小腹痛的,加活血药;如果恶露已尽,宜用加减柴胡汤治疗。
产后遍身骨节疼痛,或因气滞,或因血凝,或感风寒,或初产血气未调和,或蓐劳、血少,都能引起疼痛,所以腰背不能转侧,手足不能运动,身热头痛,俨然像伤寒的样子。如果当作伤寒治疗,其变症不浅,宜用五积散加羌活,入醋煎服,有效,或者韭白也可以。如果是蓐劳而筋骨不利的,用逍遥散治疗。
产后血气刺痛,小腹宿冷积聚癖块的,宜用葱白散。
【葱白散】葱白、肉桂、三棱、莪术、人参、熟地黄、当归、白芍、厚朴、神曲、青皮、木香、麦芽、干姜、茯苓、川芎、川楝子、小茴香。
产后发呃逆,败血未尽而不行的,宜用行血药;如果已净而呃逆的,多是受冻,宜顺气调胃为上,如紫苏饮之类。
产后呃逆不已,是胃寒而气不顺的,宜用丁香散治疗,或者单用橘皮汤,或者用肉桂、姜汁,用火烤热,用手承接擦拭摩背。
【丁香散】丁香、白蔻仁、伏龙肝。
研成细末,用吴茱萸汤调下(或者桃仁汤也可以)。
产后呕逆不已,用君陈丸治疗。如果腹痛胀满,呕逆不定,多因是食积,宜用丁香消食之剂;是痰的,宜用旋覆花汤;是寒的,用理中汤加木香、青皮、半夏、陈皮治疗。
【君陈丸】人参、白术、茯苓、甘草、半夏、陈皮、藿香、砂仁。
产后腹胀满不定,这是由于败血散于脾胃所致。如果脾受之,则不能运化精微而成腹胀;胃受之,则不能受纳五谷而生呕吐,这很明显,平胃散、安胃汤主治。
【安胃汤】半夏、橘红、生姜、甘草、神曲、藿香。
产后吞酸水的,宜用七气汤。
【七气汤】人参、肉桂、半夏、甘草、生姜。
产后腹胀,必须以通利小便为主,如果遍身胀的,宜用木香流气饮治疗。
【木香流气饮】木香、甘草、陈皮、青皮、草果、丁香、厚朴、藿香、木通、人参、槟榔、白芷、香附、肉桂、莪术、大腹皮、苏叶、麦冬、木瓜、白术、半夏、茯苓、石菖蒲、生姜。
产后沐浴太早,或感受风湿而筋脉拘急,骨节疼痛的,用五积散加木瓜、吴茱萸煎服。
产后四肢浮肿而腹大的,这是气食阻滞,宜用紫苏饮加消食药。如果身热的,应当防备有瘀血。大概产后浮肿有多种原因:有的胎前肿至产后,有的产后着风寒而肿,有的内伤生冷而肿满,有的因败血化水而肿满肠鸣,有的因血虚气滞而浮肿,切不可专用导水药,宜辨别虚实而治疗。虽然见虚,又不可便用重补,须调理其气,气顺则理其血,血活则气血和而病得效矣。然而顺气之药,当以黑龙丹、黑神丸、五积散、紫苏饮等调经药剂为主。
【黑龙丹】(已佚失)
【黑神丸】(已佚失)
产后两足忽然肿痛,肿是湿而疼是热,恐怕形成香港脚而有病患,用当归定痛散治疗。如果红肿的,恐怕生毒疮,以皮的热与不热来辨别。
【当归定痛散】人参、当归、葛根、黄芩、羌活、茵陈、知母、茯苓、猪苓、泽泻、苍术、甘草、防风、升麻。
产后肚大筋青,小便多不利的,或食生冷,或淤血停滞而带伤的,治以胃苓汤,起剂加桃仁、红花、杏仁、苏叶、赤芍、归尾,或者五个散加桃仁、红花、赤芍消食之剂,或者紫苏饮加行血消食药尤其好,内加木香更佳,总身有热者不忌,大概木香也能清热。
产后因气,或得寒物,恶露凝住,腹胀如鼓而疼痛的,用四乌汤治疗。凡胎前用分气饮,产后则服五个散。
产后耳朵忽然聋、眼睛忽然昏花的,是血气不足,宜用十全大补汤。
产后小便闭的,用四物汤去掉地黄,加入赤茯苓、木通、竹叶之类,或者用五苓散去桂枝,加入木香、滑石治疗;如果严重的,用八正散治疗。
产后小便不通,腹胀如鼓的,用炒盐加少许麝香,填平脐中,再以葱白一束,切片如手指厚,放在盐上,又以艾柱填满葱饼,用火灸之,觉得腹内有热时,小便即通。
产后大小便俱不通的,如果恶露已净,用四物汤加黄芩、生地、木通、枳壳、栀子(炒);如果未尽的,用五个散加桃仁、赤芍、归尾、红花治疗。
产后大便闭结的,宜用玉烛散,或者麻仁丸,或者五仁丸,或者四物汤加枳壳、青皮,或者苏子、麻仁煮粥食之,都很妙。
【玉烛散】地黄、当归、白芍、川芎、大黄、枳实、厚朴。
【麻仁丸】人参、大黄、麻仁、枳壳。
蜜丸,酒服。
【五仁丸】杏仁、麻仁、郁李仁、桃仁、松子仁。
Postpartum rigid and flaccid spasms are treated with Wuji San (Five Accumulations Powder) added with Moschus (She Xiang, 麝香) decocted for oral administration. Spasm refers to the condition where the jaw is tightly closed and cannot open, the back is stiff, the facial expression resembles epilepsy, the head shakes while making sounds like a neighing horse, the body arches backward, and the breath is faint as if severed.
Postpartum hemiplegia, dysarthria, and mental restlessness are treated with Tianma San (Gastrodia Powder).
[Tianma San] Gastrodiae Rhizoma (Tianma), Cinnabar (Zhu Sha, processed by water levigation), Saposhnikoviae Radix (Fangfeng), Notopterygii Rhizoma et Radix (Qianghuo) (each 1 liang), Bombyx Batryticatus (Jiangcan, stir-fried, 7 qian 5 fen), Scorpio (Ganxie, stir-fried), Typhonii Rhizoma Praeparatum (Baifuzi, processed), Trogopteri Dung (Wulingzhi, stir-fried, each 0.5 liang), Excrement of Male Sparrow (Xiongquefen, stir-fried), Bovis Calculus (Niuhuang, separately ground, each 2 qian 5 fen).
The above ingredients are pulverized into fine powder, formed into pills with glutinous rice paste, sized like wu-tzu seeds. Each dose is 20–30 pills, taken with mint wine, twice daily.
Postpartum incomplete expulsion of lochia, half-body muscle tremors, and half-body sweating are treated with Er Si Tang added with Persicae Semen (Taoren), Carthami Flos (Honghua), Crataegi Fructus (Shanzha), and Zingiberis Rhizoma Recens (Jiangzhi).
Postpartum numbness is due to blood deficiency; treatment should primarily focus on generating blood and tonifying deficiency, using Ba Wu Tang (Eight Substance Decoction).
Song on Severe Signs of Wind-Stroke Postpartum (refer to male wind-stroke for comparison): Know the severe signs of wind-stroke: eyes closed indicate Liver Qi exhaustion; hand flaccidity indicates Spleen Qi failure; mouth agape indicates Heart Qi exhaustion; snoring from the nose indicates Lung Qi exhaustion; incontinence indicates impending Kidney Qi exhaustion.
For early postpartum Cold Damage, Xiao Chai Hu Tang (Minor Bupleurum Decoction) must not be used because it contains Scutellariae Radix (Huangqin), which easily causes blood stasis and may harm the patient; Shen Su Yin (Ginseng and Perilla Drink) is preferred.
[Shen Su Ren] Ginseng Radix et Rhizoma (Renshen), Perillae Folium (Zisu), Aurantii Fructus Immaturus (Zhike), Platycodonis Radix (Jiegeng), Puerariae Radix (Gegen), Peucedani Radix (Qianhu), Glycyrrhizae Radix et Rhizoma (Gancao), Citri Reticulatae Pericarpium (Juhong), Pinelliae Rhizoma Preparatum (Banxia), Poria (Fuling), Aucklandiae Radix (Muxiang), Zingiberis Rhizoma Recens (Shengjiang).
Postpartum Cold invasion is treated with Lizhong Tang (Regulate the Middle Decoction); if lochia is not yet complete, remove Ginseng Radix et Rhizoma (Renshen); Wuge San (Five Powders) is suitable, as this formula can be taken regardless of whether vomiting or diarrhea is present.
Pulse Diagnosis Verse for Postpartum Cold Damage: When postpartum Cold Damage fever approaches, a fine pulse with warm limbs indicates survival; a large pulse with sudden cold limbs indicates even a divine physician cannot revive.
Generally, fever pulses should be surging and large, but since postpartum Qi and Blood are both deficient, a large pulse is unsuitable; do not interpret this merely as Yang disease presenting with Yin pulse.
Postpartum internal injury and summerheat diseases are treated similarly to non-postpartum cases, so specific formulas are not recorded here.
If postpartum lochia is incomplete and accompanied by wind-cold cough and abdominal pain, promoting blood circulation and regulating Qi should be prioritized. For mild cases, Si Wu Tang (Four Substance Decoction) with Chuanxiong as the sovereign herb is used; for severe cases, Er Si Tang is used. If unresolved, Wuge San with blood-invigorating herbs is applied. If accompanied by diarrhea, Wuge San is also used, but Ginger and Cinnamon should be used sparingly. Once lochia is complete and abdominal pain ceases, if wind-cold headache occurs regardless of cough or phlegm: for anhidrosis, Xuanfu Hua Tang (Inula Flower Decoction) is used; for heavy re-infection without cough, Xiong Su San (Ligusticum and Perilla Powder) is used; for spontaneous sweating, Shen Su Yin is used; for internal injury with diarrhea, only Wuge San is used, without blood-invigorating herbs.
For postpartum fatigue combined with wind-cold causing headache and chills/fever, Yuan San (Three Origin Powder) is appropriate.
For postpartum re-infection with wind-cold causing pain in joints and skin without sweating, Bai Du San (Overcome Toxin Powder) is used; for deficiency patterns, only Wuge San is suitable. After lochia clears, if complicated by phlegm-fluid retention and extreme deficiency, Shen Su Yin is used. If postpartum deficiency is severe with wind invasion, do not use purely dispersing herbs; Xiaoyao San (Free and Easy Wanderer Powder) is required. Although efficacy is slow, gradual resolution ensures no error.
For postpartum Ru Lao (childbed labor disease) with chills, fever, and headache, modified Chai Hu Tang is used.
For postpartum wind-cold with chills and fever, Wuji San is used.
For postpartum wind-cold with chills, fever, cough, wheezing, and copious phlegm, Xuanfu Hua Tang is used; stop when sweating occurs, and do not use if sweating is already present.
For postpartum blood deficiency with chills and fever, Xiaoyao San is used.
For alternating chills and fever, Xiao Chai Hu Tang is the primary treatment.
For prolonged sitting, excessive talking, or physical exertion leading to cold pain in head, eyes, and limbs, with malaria-like chills and fever, termed Ru Lao, Fuling San is used.
[Fuling San] Poria (Fuling), Angelicae Sinensis Radix (Danggui), Chuanxiong Rhizoma (Chuanxiong), Paeoniae Radix Alba (Baishao), Ginseng Radix et Rhizoma (Renshen), Rehmanniae Radix Preparata (Shudihuang), Cinnamomi Cortex (Rougui).
Decoct one pig kidney (membrane removed), two slices of fresh ginger, and two jujubes in two bowls of water to make a decoction, then use this liquid to decoct the herbal ingredients.
For postpartum cold exposure with headache, fever, and cold feet, Xiong Su San or Wuji San may be used.
For postpartum lateral or central headache, Chuanxiong Chatiao San is indicated; however, Bai Du San is superior, especially when combined with Wuji San, originally designed to treat blood stasis in meridians.
[Chuanxiong Chatiao San] Chuanxiong Rhizoma (Chuanxiong), Schizonepetae Spica (Jingjie), Angelicae Dahuricae Radix (Baizhi), Glycyrrhizae Radix et Rhizoma (Gancao), Notopterygii Rhizoma et Radix (Qianghuo), Saposhnikoviae Radix (Fangfeng), Menthae Haplocalycis Herba (Bohe), Asari Radix et Rhizoma (Xixin).
Equal parts pulverized, taken with strong tea infusion.
One variation adds Cyperi Rhizoma (Xiangfu).
For severe postpartum fever, Pao Jiang (Processed Ginger) must be used. Why? This heat is not excess pathogen but heat generated by Yin deficiency; thus, dried ginger is processed and used. It benefits Qi in the Lungs and generates Blood in the Liver; this is its妙处 (subtlety).
Severe postpartum hemorrhage leads to sudden loss of Yin Blood, causing high fever termed "Yin Deficiency Fever." The term "Yin" here refers to the Yin aspect of Qi and Blood. Using cooling herbs for direct treatment will cause death.
This presents as White Tiger Syndrome; misusing Bai Hu Tang will be fatal. Why is Si Wu Tang not used here? Because tangible substances cannot quickly transform subtle Qi. Urgently use Du Shen Tang (Single Ginseng Decoction) or Dang Gui Bu Xue Tang (Angelica Tonify Qi Decoction) to generate tangible form from intangible Qi, illustrating the wonder of Yang generating Yin.
[Dang Gui Bu Xue Tang] Astragali Radix (Huangqi, honey-fried, 1 liang), Angelicae Sinensis Radix (Danggui, wine-washed, 2 qian).
Take on an empty stomach.
Postpartum afternoon fever worsening requires Chai Hu; use Ba Wu Tang plus Chai Hu, or combine Si Wu Tang with Xiao Chai Hu Tang.
For postpartum cough with copious phlegm, Xuanfu Hua Tang is suitable; if blood is not cleared, treat blood first, then disperse exterior; or use Er Si Tang with digestive herbs.
For palpitations and epigastric discomfort caused by Phlegm-Fire, Fuling Banxia Tang is used.
[Fuling Banxia Tang] Poria (Fuling), Pinelliae Rhizoma (Banxia), Coptidis Rhizoma (Huanglian), Scutellariae Radix (Huangqin), Rehmanniae Radix Preparata (Shudihuang), Angelicae Sinensis Radix (Danggui), Chuanxiong Rhizoma (Chuanxiong), Cyperi Rhizoma (Xiangfu), Armeniacae Semen Amarum (Xingren), Trichosanthis Fructus (Gualou), Bamboo Juice (Zhuli).
Early salt intake postpartum causing cough is difficult to treat; medication should be administered cautiously.
If postpartum lochia flows upward to the Lung Meridian causing cough, treat as normal persons, preferably using Er Mu Tang removing Ginseng Radix et Rhizoma (Renshen).
[Er Mu Tang] Anemarrhenae Rhizoma (Zhimu), Fritillariae Thunbergii Bulbus (Beimu), Poria (Fuling), Persicae Semen (Taoren), Ginseng Radix et Rhizoma (Renshen), Armeniacae Semen Amarum (Xingren).
Postpartum cough and asthma are critical conditions; isolated asthma without cough is more severe and generally contraindicates medication. If unavoidable, use Er Si Tang added with fresh ginger juice, Carthami Flos (Honghua), Crataegi Fructus (Shanzha), and Aurantii Fructus Immaturus (Zhike).
Ancient texts state: All asthmatic conditions are ominous. If asthma is caused by stagnant blood steaming the Lungs, it is called "Solitary Yang and Absolute Yin," which is difficult to treat; tentatively use Duoming Dan.
[Duoming Dan] (Lost)
If asthma is caused by food stagnation and cold invasion, Wuji San is used. For wind-cold-phlegm asthma, Xuanfu Hua Tang is used.
For postpartum fatigue-induced dry cough, use Er Si Tang with blood-invigorating herbs. If lochia is complete, use Zhimu Fuling Tang or Ba Wu Tang added with Phellodendri Cortex (Huangbai) and Anemarrhenae Rhizoma (Zhimu), or Jisu San.
For postpartum asthma triggered by childbirth, Ningfei Tang is used.
[Ningfei Tang] Armeniacae Semen Amarum (Xingren), Euphorbiae Pekinensis Radix (Ejiao - *Note: Text says Ejiao, usually Donkey-hide gelatin, but listed with herbs*), Pinelliae Rhizoma Preparatum (Banxia), Asari Radix et Rhizoma (Xixin), Mume Fructus (Wumei), Zizyphi Fructus (Dazao), Glycyrrhizae Radix et Rhizoma (Gancao), Citri Reticulatae Pericarpium (Chenpi), Poria (Fuling), Perillae Fructus (Suzi), Mori Cortex (Sangpi), Aurantii Fructus Immaturus (Zhike), Zingiberis Rhizoma Recens (Shengjiang).
For postpartum exterior infection with diarrhea, use Wuge San with blood-invigorating herbs.
For postpartum bloody diarrhea, Weiling Tang added with Crataegi Fructus (Shanzha), Massae Fermentatae Medicinalis (Shenqu), and Pinelliae Rhizoma Preparatum (Banxia) is used; if abdominal pain resists pressure, add digestive herbs; if lochia is present, add blood-invigorating herbs.
For postpartum food stagnation diarrhea, Yangwei Tang is used; if lochia is incomplete, use Wuge San added with Persicae Semen (Taoren) and Carthami Flos (Honghua).
For postpartum cold diarrhea, Wuji San is used; if lochia is complete, use Paeoniae Radix Alba (Baishao), and blood-invigorating herbs are unnecessary. If cough is present, use Ginger and Cinnamon sparingly, or Lizhong Tang is acceptable.
For postpartum food injury: if lochia is incomplete, use Si Wu Tang with digestive herbs; if diarrhea occurs, use Wuge San; if lochia loss is heavy, use Wuling San; if lochia loss is heavy without diarrhea, use Yangwei Tang.
For postpartum cold-heat imbalance causing vomiting and diarrhea, termed Huoluan (Cholera-like syndrome): if thirsty and drinking water, use Wuling San; if cold predominates and no thirst, use Lizhong Tang; for Huoluan vomiting/diarrhea, Huoxiang Zhengqi San is also suitable.
For postpartum vomiting, if lochia is incomplete, use Er Si Tang with blood-invigorating herbs.
For postpartum malaria, if lochia is incomplete, use Wuji San added with Persicae Semen (Taoren), Carthami Flos (Honghua), Crataengi Fructus (Shanzha), and Massae Fermentatae Medicinalis (Shenqu); if complete, use Yangwei Tang with digestive herbs. Preventing Spleen/Stomach damage is key in malaria treatment. If accompanied by diarrhea, these formulas are excellent. For heat-dominant/mild-chill patterns, Shengshu Yin and Yangwei Tang are used; for chronic cases, Qibao Yin is used.
[Shengshu Yin] Myristicae Semen (Roudoukou), Tsaoko Fructus (Caoguo), Magnoliae Officinalis Cortex (Houpo), Pinelliae Rhizoma (Banxia), Glycyrrhizae Radix et Rhizoma (Gancao), Citri Reticulatae Pericarpium (Chenpi), Zizyphi Fructus (Dazao).
Add fresh ginger: half raw, half roasted in wet paper. Decoct together.
[Qibao Yin] Tangerine Green Peel (Qingpi), Tangerine Peel (Chenpi), Licorice (Gancao), Angelica (Danggui), Magnolia Bark (Houpo), Tsaoko (Caoguo), Areca Seed (Binglang).
For postpartum dysentery with incomplete lochia, Weiling Tang added with Persicae Semen (Taoren) is effective even with frequent stools. For fullness, add Carthami Flos (Honghua) and Angelicae Sinensis Radix (Danggui); avoid if loose stools exist; Massae Fermentatae Medicinalis (Shenqu) or Wuge San may be used.
For postpartum dysentery after lochia clearance, Weiling Tang added with Pinelliae Rhizoma Preparatum (Banxia) and Massae Fermentatae Medicinalis (Shenqu) is used.
For postpartum red-white dysentery, Weiling Tang alone is sufficient; even with food stagnation, multiple doses lead to self-healing.
For postpartum cold-heat dysentery, Huanglian Ejiao Wan is used.
[Huanglian Ejiao Wan] Coptidis Rhizoma (Huanglian, de-stammed, 3 liang), Euphorbiae Pekinensis Radix (Ejiao, crushed and fried, 1 liang), Poria (Fuling, peeled, 2 liang).
Pulverize Huanglian and Fuling; melt Ejiao with water to form pills sized like wu-tzu seeds. Take 30 pills with rice drink on an empty stomach.
For postpartum dysentery with excessive thirst, Ophiopogonis Tubera (Maidong) and Mume Fructus (Wumei) decoction, or Winter Melon Juice (Dongguazhi) is used.
For postpartum red-white dysentery, Xianglian Shuling San is used, along with Sijunzi Tang added with Astragali Radix (Huangqi) and Papaveris Pericarpium (Yingsuke).
[Sijunzi Tang] Ginseng Radix et Rhizoma (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu), Poria (Fuling), Glycyrrhizae Radix et Rhizoma (Gancao).
For postpartum Qi-deficiency dysentery, Danggui Shaoyao Tang is used.
For postpartum bloody dysentery, Sanhuang Shuai Ai Tang is used.
[Sanhuang Shuai Ai Tang] Coptidis Rhizoma (Huanglian), Phellodendri Cortex (Huangbai), Scutellariae Radix (Huangqin), Artemisiae Argyi Folium (Aiye), Zizyphi Fructus (Dazao).
Pulse Verse for Postpartum Dysentery: Postpartum dysentery pulses must be known: Fine/small pulses indicate life; surging/large pulses are unfavorable. Pulse欲绝 (approaching extinction) at the bone does not necessarily mean death. Postpartum pulses should be fine; dysentery particularly favors fine pulses. Floating, hook-like, or surging/large pulses indicate certain death.
For postpartum dysentery, Can Su San is used.
[Can Su San] Ginseng Radix et Rhizoma (Renshen), Papaveris Pericarpium (Suke), Atractylodis Macrocephalae Rhizoma (Baizhu), Glycyrrhizae Radix et Rhizoma (Gancao), Cinnamomi Cortex (Rougui), Angelicae Sinensis Radix (Danggui), Mume Fructus (Wumei), Atractylodis Rhizoma (Cangzhu), Aurantii Fructus Immaturus (Zhike), Terminalia Chebula Retzii Fructus (Hezi).
For postpartum abdominal pain due to cold invasion, Lizhong Tang removing Ginseng Radix et Rhizoma (Renshen) is used.
For postpartum lower abdominal distension and pain due to Qi stagnation, Fenqi Zisu Yin is used; if food stagnation exists, add digestive herbs.
For postpartum stagnant blood attacking the Heart causing severe epigastric pain, Yanhu San is used. Isolated epigastric pain is treated with Yangwei Tang.
For postpartum lower back pain radiating to both abdomen, piercing like needles, indicating stagnant blood in meridians with Kidney deficiency, use Si Wu Tang added with Phellodendri Cortex (Huangbai) or Wuge San, as these remove stagnant blood and dispel wind-damp. If pain occurs after lochia clears, Si Wu Tang alone cures it.
For postpartum lower back pain due to excessive blood loss lasting over a month, Buzhong Yiqi Tang and Neibu Tang are used.
For unilateral postpartum lower back pain, often due to side-sleeping causing blood stasis on one side, use Si Wu Tang or Er Si Tang added with Carthami Flos (Honghua) and Persicae Semen (Taoren). If pain is due to Qi stagnation rather than blood, use Er Si Tang combined with Buzhong Yiqi Tang removing Ginseng Radix et Rhizoma (Renshen) plus blood-invigorating herbs; add Cyperi Rhizoma (Xiangfu) if no cough.
For postpartum skin and muscle pain due to exterior infection: if lochia is incomplete, take blood-invigorating herbs first, then Xiong Su San; if lochia is complete, take Xiong Su San directly. Note: Xiong Su San is a diaphoretic and should not be overdosed.
For postpartum bone pain: if lochia is incomplete, use Wuge San; if ineffective, use Si Wu Tang or Er Si Tang; if lower abdominal pain exists, add blood-invigorating herbs. If lochia is complete, use modified Chai Hu Tang.
For generalized postpartum joint pain due to Qi stagnation, Blood coagulation, wind-cold invasion, initial postpartum Qi/Blood disharmony, Ru Lao, or blood deficiency: symptoms include inability to turn waist/back or move limbs, fever, headache, resembling Cold Damage. Treating as Cold Damage leads to complications. Use Wuji San added with Notopterygii Rhizoma et Radix (Qianghuo), decocted with vinegar, or use Leek Whites (Jiu Bai). For Ru Lao with tendon/bone stiffness, use Xiaoyao San.
For postpartum stabbing blood-Qi pain and chronic cold masses in lower abdomen, Congbai San is used.
[Congbai San] Allii Fistulosi Bulbus (Congbai), Cinnamomi Cortex (Rougui), Sparganii Rhizoma (Sanleng), Curcumae Longae Rhizoma (Ezhu), Ginseng Radix et Rhizoma (Renshen), Rehmanniae Radix Preparata (Shudihuang), Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Baishao), Magnoliae Officinalis Cortex (Houpo), Massae Fermentatae Medicinalis (Shenqu), Citrus Aurantium (Qingpi), Aucklandiae Radix (Muxiang), Malto (Maiya), Zingiberis Rhizoma (Ganjiang), Poria (Fuling), Chuanxiong Rhizoma (Chuanxiong), Toosendan Fructus (Chuanlianzi), Foeniculi Fructus (Xiaohuixiang).
Postpartum hiccups due to incomplete stagnant blood require blood-invigorating herbs. If hiccups occur after lochia clears, likely due to cold exposure; regulate Qi and harmonize Stomach is best, e.g., Zisu Yin.
Persistent postpartum hiccups indicate Stomach Cold and Qi disharmony; Dingxiang San is used, or single Chenpi Tang, or Cinnamomi Cortex (Rougui) and Zingiberis Rhizoma Recens (Jiangzhi) heated and rubbed on the back.
[Dingxiang San] Caryophylli Flos (Dingxiang), Amomi Fructus Rotundus (Baokouren), Dragon's Liver Earth (Fulonggan).
Pulverize, take with Evodiae Fructus Decoction (or Persicae Semen Decoction).
Persistent postpartum retching/vomiting is treated with Junchen Wan. If abdominal pain/distension with irregular vomiting is due to food, use Dingsiang digestive formula; if due to phlegm, use Xuanfu Hua Tang; if due to cold, use Lizhong Tang added with Aucklandiae Radix (Muxiang), Citrus Aurantium (Qingpi), Pinelliae Rhizoma Preparatum (Banxia), and Citri Reticulatae Pericarpium (Chenpi).
[Junchen Wan] Ginseng Radix et Rhizoma (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu), Poria (Fuling), Glycyrrhizae Radix et Rhizoma (Gancao), Pinelliae Rhizoma Preparatum (Banxia), Citri Reticulatae Pericarpium (Chenpi), Pogostemonis Herba (Huoxiang), Amomi Fructus (Sharen).
Indefinite postpartum abdominal distension is caused by stagnant blood scattering in Spleen/Stomach. Spleen involvement causes failure to transform essence leading to distension; Stomach involvement causes failure to receive grains leading to vomiting. Pingwei San and Anwei Tang are primary treatments.
[Anwei Tang] Pinelliae Rhizoma Preparatum (Banxia), Citri Reticulatae Pericarpium (Juhong), Zingiberis Rhizoma Recens (Shengjiang), Glycyrrhizae Radix et Rhizoma (Gancao), Massae Fermentatae Medicinalis (Shenqu), Pogostemonis Herba (Huoxiang).
Postpartum acid regurgitation is treated with Qi Qi Tang.
[Qi Qi Tang] Ginseng Radix et Rhizoma (Renshen), Cinnamomi Cortex (Rougui), Pinelliae Rhizoma Preparatum (Banxia), Glycyrrhizae Radix et Rhizoma (Gancao), Zingiberis Rhizoma Recens (Shengjiang).
Postpartum abdominal distension primarily requires promoting urination. Generalized swelling is treated with Muxiang Liuqi Yin.
[Muxiang Liuqi Yin] Aucklandiae Radix (Muxiang), Glycyrrhizae Radix et Rhizoma (Gancao), Citri Reticulatae Pericarpium (Chenpi), Citrus Aurantium (Qingpi), Tsaoko Fructus (Caoguo), Caryophylli Flos (Dingxiang), Magnoliae Officinalis Cortex (Houpo), Pogostemonis Herba (Huoxiang), Akebiae Caulis (Mutong), Ginseng Radix et Rhizoma (Renshen), Arecae Semen (Binglang), Angelicae Dahuricae Radix (Baizhi), Cyperi Rhizoma (Xiangfu), Cinnamomi Cortex (Rougui), Curcumae Longae Rhizoma (Ezhu), Arecae Pericarpium (Dafupi), Perillae Folium (Suye), Ophiopogonis Tubera (Maidong), Chaenomelis Fructus (Mugua), Atractylodis Macrocephalae Rhizoma (Baizhu), Pinelliae Rhizoma Preparatum (Banxia), Poria (Fuling), Acori Tatarinowii Rhizoma (Changpu), Zingiberis Rhizoma Recens (Shengjiang).
Early postpartum bathing or wind-damp invasion causing tendon spasm and joint pain is treated with Wuji San added to Chaenomelis Fructus (Mugua) and Evodiae Fructus (Wuzhuyu).
Postpartum limb edema with abdominal distension is due to Qi and Food stagnation; Zisu Yin with digestive herbs is used. If fever is present, suspect blood stasis. Postpartum edema has many causes: antepartum edema persisting postpartum, wind-cold invasion, internal cold injury, stagnant blood transforming to water, or Blood deficiency with Qi stagnation. Do not solely use diuretics; differentiate deficiency/excess. Even in deficiency, avoid heavy tonification initially; regulate Qi first, then Blood. Qi regulation agents include Heilong Dan, Heishen Wan, Wuji San, and Zisu Yin.
[Heilong Dan] (Lost)
[Heishen Wan] (Lost)
Sudden painful swelling of both feet postpartum indicates dampness (swelling) and heat (pain), risking Hong Kong Foot (Gouty arthritis); Danggui Dongtong San is used. Red/swollen areas suggest toxic sores; distinguish by skin temperature.
[Danggui Dongtong San] Ginseng Radix et Rhizoma (Renshen), Angelicae Sinensis Radix (Danggui), Puerariae Radix (Gegen), Scutellariae Radix (Huangqin), Notopterygii Rhizoma et Radix (Qianghuo), Imperatae Rhizoma (Yichen), Anemarrhenae Rhizoma (Zhimu), Poria (Fuling), Polypori Umbilicati (Zhuling), Alismatis Rhizoma (Zexie), Atractylodis Rhizoma (Cangzhu), Glycyrrhizae Radix et Rhizoma (Gancao), Saposhnikoviae Radix (Fangfeng), Cimicifugae Rhizoma (Shengma).
Postpartum abdominal distension with prominent veins and difficult urination, due to cold/raw food or blood stasis, is treated with Weiling Tang. Initial dose adds Persicae Semen (Taoren), Carthami Flos (Honghua), Armeniacae Semen Amarum (Xingren), Perillae Folium (Suye), Paeoniae Radix Rubra (Chishao), and Angelicae Sinensis Radix Tail (Guiwei). Alternatively, Wuge San with blood-invigorating/digestive herbs, or Zisu Yin with blood-invigorating/digestive herbs is excellent. Adding Aucklandiae Radix (Muxiang) is better; it is safe even with fever as Muxiang clears heat.
Postpartum abdominal drum-like distension and pain due to Qi or cold causing lochia stagnation is treated with Si Wu Tang. Antepartum uses Fenqi Yin; postpartum uses Wuge San.
Sudden postpartum deafness and blurred vision indicate Qi/Blood deficiency; Shiquan Dabu Tang is used.
Postpartum red, swollen, painful eyes are treated with Si Wu Tang added to Rehmanniae Radix (Shengdi) and Coptidis Rhizoma (Huanglian).
Postpartum hematemesis, hemoptysis, or spitting blood, fearing Blood-Qi rushing to Heart, requires urgent Yantu Tang.
Postpartum epistaxis is treated with Zisu Yin added to Child's Urine (Tongbian), or Jingjie San added to Child's Urine.
Postpartum hematuria is treated with Si Wu Tang added to blood-cooling herbs, or Bazheng San.
Postpartum urinary retention is treated with Si Wu Tang removing Rehmanniae Radix (Dihuang), adding Poria cocos (Chifuling), Akebiae Caulis (Mutong), and Laminated Leaf Tea (Zhuye). Or Wuling San removing Cinnamomi Ramulus (Guizhi), adding Aucklandiae Radix (Muxiang) and Talcum (Huashi). Severe cases use Bazheng San.
For postpartum urinary retention with drum-like abdominal distension: fill umbilicus with fried salt mixed with a little Moschus (Shexiang). Place sliced green onion (Congbai) on salt. Fill with moxa cones on the onion cake and moxa until abdominal warmth is felt, then urination resumes.
For postpartum simultaneous retention of urine and feces: if lochia is clear, use Si Wu Tang added to Scutellariae Radix (Huangqin), Rehmanniae Radix (Shengdi), Akebiae Caulis (Mutong), Aurantii Fructus Immaturus (Zhike), and Gardeniae Fructus (Zhizi, fried). If lochia is incomplete, use Wuge San added with Persicae Semen (Taoren), Paeoniae Radix Rubra (Chishao), Angelicae Sinensis Radix Tail (Guiwei), and Carthami Flos (Honghua).
Postpartum constipation is treated with Yuzhu San, Mahuang Wan, Wuren Wan, or Si Wu Tang added to Aurantii Fructus Immaturus (Zhike) and Citrus Aurantium (Qingpi). Or eat porridge cooked with Perillae Fructus (Suzi) and Cannabis Fructus (Maren).
[Yuzhu San] Rehmanniae Radix (Dihuang), Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Baishao), Chuanxiong Rhizoma (Chuanxiong), Rheomi Radix et Rhizoma (Dahuang), Zizyphi Fructus Immaturus (Zhishi), Magnoliae Officinalis Cortex (Houpo).
[Maren Wan] Ginseng Radix et Rhizoma (Renshen), Rheomi Radix et Rhizoma (Dahuang), Cannabis Fructus (Maren), Aurantii Fructus Immaturus (Zhike).
Honey pills, taken with wine.
[Wuren Wan] Armeniacae Semen Amarum (Xingren), Cannabis Fructus (Maren), Pruni Semen (Yuliren), Persicae Semen (Taoren), Pine Nut (Songziren).
Postpartum constipation with free urination is treated with Wuwei San.
[Wuwei San] Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Baishao), Cannabis Fructus (Maren), Crataegi Fructus (Shanzha), Massae Fermentatae Medicinalis (Shenqu), Aurantii Fructus Immaturus (Zhike), Citrus Aurantium (Qingpi).