产后泻痢,气血暴虚,必用生化汤加减。然致病之由,虽系湿热,多由饮食伤脾而起,
故重申余意,另立十方于后。
一、产后泻黄色,乃脾土真气虚也。宜补中益气汤加木香四分,煨肉果一枚,炮姜四分
二、产后久泻不止,元气下陷,大便不禁,肛门如脱,宜服六君子汤加木香四分,煨肉
果一枚,炮姜四分,可加升麻五分。
三、产后伤面食,六君子汤加麦芽。伤谷食,加君子汤加神曲。
四、产后伤肉食,六君子汤加山楂、砂仁各五分,神曲一钱。
五、产后胃气虚弱,泻痢完谷不化,六君子汤加木香三分,肉果一枚。
六、产后泻痢脾虚,四肢浮肿,补中益气汤加皮散,或六君子汤加五皮散。
七、产后诸症兼呕者,宜加藿香一钱,痰多加半夏八分。
八、产后以前诸症兼小便短涩者,加茯苓一钱,泽泻五分,灯心十二根。
九、产后泄泻不止,加莲子十粒,石榴皮一钱。
十、产后患赤痢,久而不止,用人参二钱,香连丸二钱,同服即愈。勿多用木香、姜汁
之类,盖热则血愈行也。方内可加地榆。
以上十方,须问块痛已除,方可服之。
人之胃腑,为五谷之海,水谷之精,上输肝肺,分布五脏,化为气血,荣润百骸。产后
劳伤脾胃,正气亏折则邪气易乘,入于肠胃,则气逆呕吐而食不下矣。若七日内呕吐不止,
全不纳谷,血块未除,治当消块,佐以温药,宜服安胃行血汤,若痛已除而呕不止、不纳谷
者,宜服加减六味汤及后温胃和中饮。若呕而气血不足、食物不能如常,宜服补中和胃汤。
安胃止血汤∶芎 一钱,当归四钱,人参一钱,桃仁十粒,姜炭、炙甘草各五分,藿
香、砂仁各四分,姜三片(有汗勿用)。
加减六物汤∶川芎一钱,当归二钱,山药一钱五分,人参一钱,茯苓一钱,藿香五分,
豆仁、姜炭各四分,扁豆二钱,陈皮三分,炙甘草五分,姜三片,呕止去豆仁。
温中和胃汤∶人参、茯苓各一钱,当归、扁豆各二钱,陈皮、炙甘草、藿香、丁香各三
分,姜三片。呕止去丁香,受寒加吴萸。
补中和胃汤∶人参、白术、扁豆、当归各二钱,茯苓一钱,山药一钱五分,炙甘草、陈
皮,炮姜各四分,水煎。
产后出现泄泻或痢疾,是因为气血突然严重亏虚,必须使用生化汤进行加减治疗。然而致病的原因,虽然与湿热有关,但大多是由饮食损伤脾胃引起的,因此重申我的观点,在后面另外列出十个方剂。
一、产后大便呈黄色,这是脾土真气虚弱所致。适宜服用补中益气汤,加入木香四分,煨肉果一枚,炮姜四分。
二、产后长期泄泻不止,元气下陷,大便失禁,肛门感觉像要脱出一样,适宜服用六君子汤,加入木香四分,煨肉果一枚,炮姜四分,可以再加升麻五分。
三、产后因食用面食受伤,在六君子汤中加入麦芽。因食用谷物受伤,在六君子汤中加入神曲。(注:原文“加君子汤”疑为笔误,结合上下文及中医常识,此处应指六君子汤底方加味,故译为六君子汤加神曲)。
四、产后因食用肉食受伤,在六君子汤中加入山楂、砂仁各五分,神曲一钱。
五、产后胃气虚弱,泄泻痢疾且大便中有未消化的食物,在六君子汤中加入木香三分,肉果一枚。
六、产后泄泻痢疾属脾虚,伴有四肢浮肿,可用补中益气汤加五皮散,或者用六君子汤加五皮散。
七、产后各种病症兼有呕吐的,适宜加入藿香一钱,痰多者加入半夏八分。
八、产后以前所述的诸症兼有小便短少涩痛的,加入茯苓一钱,泽泻五分,灯心草十二根。
十、产后患赤痢(脓血便),日久不止,用人参二钱,香连丸二钱,一同服用即可痊愈。不要多用木香、姜汁之类的药物,因为热邪会使血液运行更加迅疾。方中可加入地榆。
以上十个方剂,必须先询问腹部块状疼痛是否已经消除,才可以服用。
人的胃腑,是五谷汇聚的大海,水谷中的精微物质,向上输送到肝和肺,分布到五脏,转化为气血,滋养润泽全身骨骼肢体。产后劳累损伤脾胃,正气亏损折损,则邪气容易乘虚而入,侵入肠胃,就会导致气逆呕吐而无法进食。如果在七日内呕吐不止,完全不能进食,且血块尚未清除,治疗应当消除血块,辅以温性药物,适宜服用安胃行血汤。如果疼痛已经消除但呕吐不止、不能进食的,适宜服用加减六味汤以及后面的温胃和中饮。如果呕吐且气血不足、食物不能正常消化,适宜服用补中和胃汤。
安胃止血汤:川芎一钱,当归四钱,人参一钱,桃仁十粒,姜炭、炙甘草各五分,藿香、砂仁各四分,生姜三片(有汗者勿用)。
加减六物汤:川芎一钱,当归二钱,山药一钱五分,人参一钱,茯苓一钱,藿香五分,豆仁、姜炭各四分,扁豆二钱,陈皮三分,炙甘草五分,生姜三片,呕吐停止后去掉豆仁。
温中和胃汤:人参、茯苓各一钱,当归、扁豆各二钱,陈皮、炙甘草、藿香、丁香各三分,生姜三片。呕吐停止后去掉丁香,受寒者加入吴茱萸。
Postpartum diarrhea or dysentery occurs due to a sudden and severe deficiency of Qi and Blood; therefore, Shenghua Decoction (Life-restoring Decoction) must be used with modifications. However, although the etiology involves damp-heat, it mostly arises from dietary injury to the Spleen. Thus, reiterating my previous point, I list ten additional formulas below.
1. Postpartum yellow stool indicates a deficiency of the true Qi of the Spleen Earth. It is appropriate to use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with added Muxiang (Aucklandiae Radix), 4 fen, Wei Rougu (Nutmeg, roasted), one piece, and Paojiang (Prepared Ginger), 4 fen.
2. Postpartum chronic diarrhea that does not cease, with sinking of Yuan Qi (Primal Qi), incontinence of feces, and a sensation of anal prolapse, is suitable for treatment with Liujunzi Tang (Six Gentlemen Decoction) with added Muxiang (Aucklandiae Radix), 4 fen, Wei Rougu (Nutmeg, roasted), one piece, and Paojiang (Prepared Ginger), 4 fen; Shengma (Cimicifugae Rhizoma), 5 fen, may also be added.
3. For postpartum injury caused by consuming wheat products, add Maiya (Hordei Fructus Germinatus) to Liujunzi Tang (Six Gentlemen Decoction). For injury caused by consuming rice/grain products, add Shenqu (Massa Medicata Fermentata) to Liujunzi Tang (Six Gentlemen Decoction).
4. For postpartum injury caused by consuming meat, add ShanZha (Crataegi Fructus) and Sharen (Amomi Fructus Rotundus), each 5 fen, and Shenqu (Massa Medicata Fermentata), 1 qian, to Liujunzi Tang (Six Gentlemen Decoction).
5. For postpartum weak Stomach Qi, resulting in diarrhea/dysentery with undigested food in the stool, add Muxiang (Aucklandiae Radix), 3 fen, and Rougu (Nutmeg), one piece, to Liujunzi Tang (Six Gentlemen Decoction).
6. For postpartum diarrhea/dysentery due to Spleen deficiency accompanied by edema of the four limbs, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Wupi San (Five Barks Powder), or Liujunzi Tang (Six Gentlemen Decoction) plus Wupi San (Five Barks Powder).
7. For various postparten conditions accompanied by vomiting, add Huoxiang (Agastaches Herba), 1 qian; if there is excessive phlegm, add Banxia (Pinelliae Rhizoma Preparatum), 8 fen.
8. For the aforementioned postparten conditions accompanied by scanty and difficult urination, add Fuling (Poria), 1 qian, Zexie (Alismatis Rhizoma), 5 fen, and Dengxincao (Junci Medulla), 12 strands.
9. For unceasing postparten diarrhea, add Lianzi (Nelumbinis Semen), 10 grains, and Shiliupi (Punicae Pericarpium), 1 qian.
10. For postparten red dysentery (dysentery with blood/pus) that persists for a long time, use Renshen (Ginseng Radix et Rhizoma), 2 qian, and Xianglian Wan (Costus and Coptis Pill), 2 qian, taken together for cure. Avoid using large amounts of Muxiang (Aucklandiae Radix) or Jiangzhi (Ginger Juice), as heat causes blood to flow more rapidly. Diyü (Sanguisorbae Radix) may be added to the formula.
The above ten formulas should only be administered after confirming that abdominal mass pain has been resolved.
The human Stomach Fu organ is the sea of the five grains. The essence derived from water and grain is transported upward to the Liver and Lung, distributed among the five Zang organs, transformed into Qi and Blood, and nourishes all bones and tissues. Postparten labor and fatigue injure the Spleen and Stomach; when Zheng Qi (Upright Qi) is depleted, pathogenic factors easily invade. If they enter the intestines and stomach, they cause rebellious Qi leading to vomiting and inability to eat. If vomiting persists without cessation for seven days, complete refusal of food, and blood masses have not yet been cleared, treatment should focus on resolving blood masses assisted by warm herbs; Anwei Xingxue Tang (Stomach-Calming and Blood-Moving Decoction) is appropriate. If pain has ceased but vomiting persists and food cannot be retained, Jiawei Liuwei Tang (Modified Six-Ingredient Decoction) and Wenwei Hezhong Yin (Warm the Stomach and Harmonize the Middle Infusion) listed below are appropriate. If vomiting occurs alongside Qi and Blood deficiency and inability to digest food normally, Buchong Hezhong Tang (Tonify the Middle and Harmonize the Stomach Decoction) is appropriate.
Anwei Zhixue Tang (Stomach-Calming and Hemostatic Decoction): Xiong (Chuanxiong Rhizome), 1 qian; Danggui (Angelicae Sinensis Radix), 4 qian; Renshen (Ginseng Radix et Rhizoma), 1 qian; Taoren (Persicae Semen), 10 grains; Jiangtan (Charred Ginger), Zhigancao (Prepared Licorice Root), each 5 fen; Huoxiang (Agastaches Herba), Sharen (Amomi Fructus Rotundus), each 4 fen; Shengjiang (Fresh Ginger), 3 slices (do not use if sweating is present).
Jiawei Liuwu Tang (Modified Five-Ingredient Decoction - *Note: Text says Liuwu/Liuwei, likely referring to a variation of Six Gentlemen or similar base*): Chuanxiong (Chuanxiong Rhizome), 1 qian; Danggui (Angelicae Sinensis Radix), 2 qian; Shanyao (Dioscoreae Rhizoma), 1.5 qian; Renshen (Ginseng Radix et Rhizoma), 1 qian; Fuling (Poria), 1 qian; Huoxiang (Agastaches Herba), 5 fen; Douren (likely Douchi or similar fermented bean, context suggests digestive aid), Jiangtan (Charred Ginger), each 4 fen; BianDou (Faba Seed), 2 qian; Chenpi (Citri Reticulatae Pericarpium), 3 fen; Zhigancao (Prepared Licorice Root), 5 fen; Shengjiang (Fresh Ginger), 3 slices. Remove Douren once vomiting ceases.
Wenzhong Hewei Tang (Warm the Middle and Harmonize the Stomach Decoction): Renshen (Ginseng Radix et Rhizoma), Fuling (Poria), each 1 qian; Danggui (Angelicae Sinensis Radix), BianDou (Faba Seed), each 2 qian; Chenpi (Citri Reticulatae Pericarpium), Zhigancao (Prepared Licorice Root), Huoxiang (Agastaches Herba), Dingxiang (Caryophylli Flos), each 3 fen; Shengjiang (Fresh Ginger), 3 slices. Remove Dingxiang (Clove) once vomiting ceases; add Wuyu (Evodiae Fructus) if cold invasion is suspected.
Buchong Hewei Tang (Tonify the Middle and Harmonize the Stomach Decoction): Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), BianDou (Faba Seed), Danggui (Angelicae Sinensis Radix), each 2 qian; Fuling (Poria), 1 qian; Shanyao (Dioscoreae Rhizoma), 1.5 qian; Zhigancao (Prepared Licorice Root), Chenpi (Citri Reticulatae Pericarpium), Paojiang (Prepared Ginger), each 4 fen. Decoct in water.