产后伤脬,此缘稳婆之故。以白芨散治之。
白芨散∶白芨、凤凰衣、桑螵蛸,等分入猪脬内。煮烂食之。
产后四肢浮肿,皮肤光莹,脾虚不能制水,肾虚不能行水故也。当大补气血为主,佐以
苍术、白术、茯苓等药,虚加人参、木通,热加麦冬、条芩。若因风冷湿气伤表,无汗而肿
,宜加姜皮、半夏、苏叶及五皮散以微表之,使水气从皮毛而出。然后以补剂调理。
利水益气汤∶人参、白术各三钱,白芍、茯苓各一钱,陈皮六分,木瓜八分,苍术、浓
朴、苏叶、木通、腹皮各一钱。
五加皮散∶加皮、腹皮、苓皮、骨皮、姜皮。
产后劳瘵症,皆由嗜欲无节,起居不时,以致真阴耗竭,虚火上炎。或蒸而热,或往来
寒热、似疟非疟,或咳血咯血、自汗盗汗,或心神恍惚,梦与鬼交,或经水闭塞,日渐羸瘦
,皆缘阴虚生热所致,热郁积久,变成虚怯。宜清热止嗽,润肺泻火,滋补真阴,以复其元
。患此者必须寡欲内养,方能有效,否则不治。
保真汤∶川芎一钱,当归、生地、白术各二钱,麦冬一钱,天冬一钱五分,川贝、茯苓
各五分,桔梗八分,五味十粒,骨皮一钱,炙甘草四分,枣二枚,水煎。虚加人参一钱,黄
六分。胃弱加茯苓、山药各二钱,砂仁三粒。
加味大造丸∶生地一钱,人参、当归、山药、杞子各一两,知母一钱五分,石斛(酒蒸)
、麦冬各八钱,银胡六钱,龟板五钱,共为末,炼蜜为丸如桐子大,早晚服。
以上两方,但举其概,至辨症施治,全在临时取裁。如补中益气汤、六味、肾气丸、八
珍汤、十全大补汤、还少丹、逍遥散加芎、归,此数方俱可治劳瘵,因症选用可也。
产后伤脬,这是由于接生婆(稳婆)操作不当所致。用白芨散来治疗它。
白芨散:由白芨、凤凰衣、桑螵蛸组成,各取等份放入猪脬(猪膀胱)内。煮烂后食用。
产后四肢浮肿,皮肤光亮莹润,这是因为脾虚不能制约水湿,肾虚不能运化水液造成的。应当以大补气血为主,辅以苍术、白术、茯苓等药物;气虚加用人参、木通,热象加用麦冬、黄芩。如果是因为风冷湿气侵袭体表,无汗且浮肿,适宜加入姜皮、半夏、苏叶以及五皮散来轻微发汗解表,使水气从皮毛排出。然后再用补益剂进行调理。
利水益气汤:人参、白术各三钱,白芍、茯苓各一钱,陈皮六分,木瓜八分,苍术、厚朴、苏叶、木通、腹皮各一钱。
五加皮散:五加皮、大腹皮、茯苓皮、地骨皮、生姜皮。
产后劳瘵症,都是由于房事不节制,起居没有规律,导致真阴耗竭,虚火上炎。或者出现蒸蒸发热,或者寒热往来、像疟疾又不是疟疾,或者咳血咯血、自汗盗汗,或者心神恍惚、梦见与鬼交合,或者月经闭塞,日渐消瘦,这些都是因为阴虚生热所致,热邪郁积日久,变成虚怯之证。适宜清热止咳,润肺泻火,滋补真阴,以恢复元气。患此病的人必须寡欲内养,才能见效,否则无法治愈。
保真汤:川芎一钱,当归、生地、白术各二钱,麦冬一钱,天冬一钱五分,川贝母、茯苓各五分,桔梗八分,五味子十粒,地骨皮一钱,炙甘草四分,大枣二枚,加水煎服。气虚加人参一钱,黄芪六分。胃弱加茯苓、山药各二钱,砂仁三粒。
加味大造丸:生地一钱,人参、当归、山药、枸杞子各一两,知母一钱五分,石斛(酒蒸)、麦冬各八钱,银柴胡六钱,龟板五钱,共研为细末,炼蜜制成如梧桐子大小的丸药,早晚服用。
以上两个方子,只是列举其大概,至于辨证施治,全在于临证时灵活裁度。如补中益气汤、六味地黄丸、肾气丸、八珍汤、十全大补汤、还少丹、逍遥散加川芎、当归,这几个方子都可以治疗劳瘵,根据症状选用即可。
Postpartum bladder injury is caused by the mishandling of midwives. It is treated with Baiji San (White Rhizoma Bletillae Powder).
Baiji San: Consists of equal parts of Baiji (Rhizoma Bletillae), Fenghuangyi (Ootheca Mantidis), and Sangpiaoxiao (Spermium Cataplexidis), placed inside a pig bladder. Boil until soft and consume.
Postpartum edema of the four limbs with shiny skin is due to Spleen deficiency failing to control water and Kidney deficiency failing to transform water. The treatment should primarily focus on greatly tonifying Qi and Blood, supplemented with herbs such as Cangzhu (Rhizoma Atractylodis Chinensis), Baizhu (Rhizoma Atractylodis Macrocephalae), and Fuling (Poria). For deficiency, add Renshen (Radix Ginseng) and Mutong (Caulis Akebiae); for heat, add Maidong (Radix Ophiopogonis) and Huangqin (Radix Scutellariae). If caused by wind-cold-dampness invading the exterior, presenting with anhidrosis and edema, it is appropriate to add Jiangpi (Pericarpium Zingiberis Recens), Banxia (Rhizoma Pinelliae), Ziye (Folium Perillae), and Wupi San (Five Peel Powder) to induce mild diaphoresis, allowing water qi to exit through the skin and hair. Subsequently, regulate with tonic formulas.
Lishui Yiqi Tang (Water-Draining Qi-Boosting Decoction): Renshen (Radix Ginseng) and Baizhu (Rhizoma Atractylodis Macrocephalae) 3 qian each; Shaoyao (Radix Paeoniae Alba) and Fuling (Poria) 1 qian each; Chenpi (Pericarpium Citri Reticulatae) 6 fen; Mugua (Fructus Chaenomelis) 8 fen; Cangzhu (Rhizoma Atractylodis Chinensis), Houpo (Cortex Magnoliae Officinalis), Ziye (Folium Perillae), Mutong (Caulis Akebiae), and Fupi (Pericarpium Citri Reticulatae Viride) 1 qian each.
Wujiapi San (Eleven-Cortex Powder): Wujiapi (Cortex Acanthopanacis Senticosi), Fupi (Pericarpium Citri Reticulatae Viride), Lingpi (Poria with Hostwood), Gupi (Cortex Lycii), Jiangpi (Pericarpium Zingiberis Recens).
Postpartum Laozai (Consumption Syndrome) results from unrestrained sexual desires and irregular daily routines, leading to exhaustion of True Yin and flaming up of Deficient Fire. Symptoms may include steaming fever, alternating chills and fever resembling malaria but not quite so, hemoptysis or spitting blood, spontaneous sweating and night sweats, mental confusion, dreams of intercourse with spirits, amenorrhea, and progressive emaciation. All these are caused by Yin deficiency generating heat; prolonged stagnation of heat transforms into a condition of deficiency and weakness. Treatment should clear heat and stop coughing, moisten the lungs and drain fire, tonify True Yin, and restore vitality. Patients must practice sexual restraint and internal nourishment for efficacy; otherwise, the condition is incurable.
Baozhen Tang (Preserve Truth Decoction): Chuanxiong (Rhizoma Chuanxiong) 1 qian; Danggui (Radix Angelicae Sinensis), Shengdi (Radix Rehmanniae Preparata), and Baizhu (Rhizoma Atractylodis Macrocephalae) 2 qian each; Maidong (Radix Ophiopogonis) 1 qian; Tiantong (Radix Asparagi) 1.5 qian; Chuanbei (Bulbus Fritillariae Cirrhosae) and Fuling (Poria) 0.5 qian each; Jiegeng (Radix Platycodonis) 0.8 qian; Wuweizi (Fructus Schisandrae Chinensis) 10 grains; Gupi (Cortex Lycii) 1 qian; Zhigancao (Radix Glycyrrhizae Preparata) 0.4 qian; Dazao (Fructus Jujubae) 2 pieces. Decoct in water. Add Renshen (Radix Ginseng) 1 qian and Huangqi (Radix Astragali) 0.6 qian for deficiency. Add Fuling (Poria) and Shanyao (Rhizoma Dioscoreae) 2 qian each, and Sharen (Fructus Amomi Rotundus) 3 grains for weak stomach.
Jiawei Dazao Wan (Modified Great Creation Pill): Shengdi (Radix Rehmanniae Preparata) 1 qian; Renshen (Radix Ginseng), Danggui (Radix Angelicae Sinensis), Shanyao (Rhizoma Dioscoreae), and Gouqi (Fructus Lycii) 1 liang each; Zhimu (Cortex Phellodendri) 1.5 qian; Shihu (Caulis Dendrobii) (steamed with wine) and Maidong (Radix Ophiopogonis) 8 qian each; Yinhu (Radix Bupleuri) 6 qian; Guiban (Carapax et Plastrum Testudinis) 5 qian. Grind into fine powder, mix with refined honey, and form pills the size of paulownia seeds. Take morning and evening.
The above two formulas are merely general examples. Differentiation and treatment depend entirely on clinical judgment. Formulas such as Buzhong Yiqi Tang (Tonify the Middle and Boost Qi Decoction), Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill), Shenqi Wan (Kidney Qi Pill), Bazhen Tang (Eight-Treasure Decoction), Shiquan Dabu Tang (Ten-Ingredient Great Tonifying Decoction), Huanshao Dan (Restore Youth Pellet), and Xiaoyao San (Free and Easy Wanderer Powder) plus Chuanxiong and Danggui can all be used to treat Laozai, selected according to specific symptoms.