Chapter 21, Disorders after baby delivery

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 妇人产后病脉证并治第二十一

Chapter 21, Disorders after baby delivery


问曰:新产妇人有三病:一者病痉,二者病郁冒,三者大便难,何谓也?师曰:新产血虚,多汗出,喜中风,故令病痉。亡血复汗,寒多,故令郁冒。亡津液,胃燥,故大便难。

Asked: woman who just had a baby delivery, has three kinds of disorders associated with the delivery. The first is Jing disease (spasm type disease). The second is Yumao disease[1] and the third is hard in bowel movement. What are they? Master: woman who just has delivery is usually weak in the body, has more sweat, so she is easier be attacked by Wind, so easy to have a Jing disease. Such woman loses blood, together with more sweat, the body is easier to be attacked by the Cold, so she is easy to have a Yumao disease. The loss of blood, sweat, all depletes body liquid (the Yingye), the stomach is try so that the bowel movement is hard.


产妇郁冒,其脉微弱,不能食,大便反坚,但头汗出。所以然者,血虚而厥,厥而必冒,冒家欲解,必大汗出;以血虚下厥,孤阳上出,故头汗出。所以产妇喜汗出者,亡阴血虚,阳气独盛,故当汗出,阴阳乃复,大便坚,呕不能食,小柴胡汤主之。病解能食,七、八日更发热者,此为胃实,大承气汤主之。

For woman with Yumao disease, her pulse is weak, cannot eat, the stool is hard, but there is sweat on head. This is because the blood deficiency, which causes reverse cold in hands and feet. The later condition then causes the Yumao condition. Person with the Yumao will have sweat before the condition is to solve. The sweat is due to the floating Yangqi in the head (the cold in residue in the lower part of the body: cold feet). Woman who has easy sweat depleted the Yin and causes blood deficiency. If the woman has nausea and hard to eat, has hard stool, use Xiao Chaihu Tang. If the disorder has been solved but she has fever again after seven to eight days, this condition is fullness condition in the abdomen, use Da Chenqi Tang to solve it.   

柴胡


 Xiao Chaihu Tang (see the version for nausea)
(见呕吐中)


大承气汤

Da Chenqi Tang (see the version for the Jing disease)(见痉病中)


产妇腹中痛,当归生姜羊肉汤主之,并治腹中寒疝,虚劳不足。

For women after delivery has pain in abdomen, use Ganggui Shenjiang Yangyou Tang. This herbal formula can also be used in the treatment of Cold hernia in the abdomen, and weakness condition due to exhausting labor works.

当归生姜羊肉汤方


Danggui Shenjiang Yangrou Tagn (see the version for Cold hernia)
(见寒疝中)


产后腹痛,烦满不得卧,枳实芍药散主之。

If the woman has pain in abdomen after delivery, feels annoyed and fullness in abdomen, and feels hard to fall into sleep, use Zhishi Shaoyao San.

枳实芍药散方

Zhishi Shaoyao San


枳实
(烧令黑,勿太过),  芍药等分

Zhishi (burn to black in color), Shaoyao, equal amount.


右二味,杵为散,服方寸匕,日三服。并主痈脓,以麦粥下之。

Prepare the herbs into powder. Drink 1 gram each time, three times a day. This herbal formula can also be used for the treatment of abscess, drinking barley soup to help swallow.


师曰:产妇腹痛,法当以枳实芍药散。假令不愈者,此为腹中有干血着脐下,宜下瘀血汤主之。亦主经水不利。

Master: for woman after delivery has pain in stomach, Zhishi Shaoyao San should be used. If it does not work, it suggests the presence of dry blood mass adhering under the naval. In this case, change to Xia Yuxue Tang.


下瘀血汤方

Xia Yuxue Tang


大黄
三两,桃仁二十枚,虫(熬,去足)二十枚

Dahuang 45 gram, Taoren 20 badges, Mangchong (processed, remove feet) 20 badges.


右三味,末之,炼蜜和为四丸,以酒一升,煎一丸,取八合,顿服之,新血下如豚肝。

Prepare the herbs into 4 pill with honey. Add one pill and 250 ml wine into a herbal pot. Bring to boil until there is about 80% of the wine left. Drink all the herbal wine. There will be blood in the stool, the color of which is very dark.

产后七、八日,无太阳证,少腹坚痛,此恶露不尽,热在里,结在膀胱也。不大便,烦躁发热,切脉微实,再倍发热,日晡时烦躁者不食,食则谵语,至夜即愈,宜大承气汤主之。

If a women just had baby delivery for seven or eight days, no any signs of Taiyang stage, but feels pain and hard in the lower abdomen, this condition is due to hosting blood there that is due to the stick of Fire in the urine bladder. On the other side, there is also a situation in which a woman feels annoyed/impatient, fever, no bowel movement. Her pulse is mild strong. For this who feels annoyed/impatience in the evening also feels no appetite, and has Chattering syndrome after eating, which symptoms stop upon night. In this case, use Da Chenqi Tang.[2]

产后风续之,数十日不解,头微痛,恶寒,时时有热,心下闷,干呕,汗出,虽久,阳旦证续在耳,可与阳旦汤。(桂枝汤加黄芩)

After baby delivery, the woman is attacked by the Wind. She feels mild headache, chilly, and hot from time to time, bloating in the upper abdomen, nausea, sweat. All are there for tens of days. In this case, use Yangdan Tang, which is the Guizhi Tang plus Huangqin.  

阳旦汤方

Yangdan Tang


桂枝汤内加黄芩桂枝汤方见下利中。

Add Huangqin into the Guizhi Tang. (Guizhi Tang: see the version for Diarrhea)


产后中风,  (病痉者),发热面正赤,喘而头痛,竹叶汤主之。

After baby delivery, the woman is attacked by the Wind and has Jing disease. She feels fever, red and hot on her face, asthma and headache. In this case, use Zhuye Tang

竹叶汤方

Zhuye Tang


竹叶 
一把,葛根  三两,防风  一两,桔梗桂枝人参甘草  各一两,附子(炮)一枚,大枣  十五枚,生姜  三两

Zhuye 62 gram, Gegen 45 gram, Fangfeng 15 gram, Jiegen 15 gram, Guizhi 15 gram, Guizhi 15 gram, Renshen 15 gram, Gancao 15 gram, Fuzi (processed) 35 gram, Chinese date 15 badges, fresh ginger 45 gram.


右十味,以水一斗,煮取二升半,分温三服,温覆使汗出。颈项强,用大附子一枚,破之如豆大,前药扬去沫。呕者,加大半夏半升洗。

Add the herbs and 2500 ml water into a herbal pot. Bring to boil and keep in mild boiling until there is 300 ml water left. Drink one third of the herbal tea each time, three times a day. Cover the body to make sweat. If the person has tightness in the neck, use a big Fuzi (about 45 gram), cut it into small pieces as soya bean size. When boiling, remove the upper floating residue. If the person has nausea, add big Banxia 124 gram.


妇人乳中虚,烦乱,呕逆,安中益气,竹皮大丸主之。

If the women has no enough milk in breasts, and feels annoyed/impatient, nausea, use Zhupi Da Wan to harmony the Qi in the body.

竹皮大丸方

Zhupi Da Wan


竹茹二分,石膏二分,桂枝一分,甘草七分,白薇一分

Zhuru 8 gram, Shigao 15 gram, Guizhi 8 gram, Gancao 49 gram, Baiwei 8 gram.


右五味,末之,枣肉和丸,弹子大,以饮服一丸,日二夜二服。有热者,倍白薇。喘者,加柏实一分。

Prepare the herbs into pill with Chinese date mud as a size of 0.1 cm diameter. Drink one pill each time, twice during daytime, and twice at night. If the woman has fever, double the amount of Baiwei. If she has asthma, add Boshi 8 gram.  


产后下利及虚极,白头翁甘草阿胶汤主之。

If the woman has diarrhea and feels very weak after baby delivery, use Baitouwen jia Gancao Ajiao Tang.

白头翁甘草阿胶汤方

Baitouwen jia Gancao Ajiao Tang.


白头翁
甘草阿胶各二两,秦皮黄连,蘖皮各三两

Baitouwen 30 gram, Gancao 30 gram, Ajiao 30 gram, Qinpi 45 gram, Huanglian 45 gram, Yinpi 45 gram.


右六味,以水七升,煮取二升半,内胶,令消尽,分温三服。

Add the herbs (except Ajiao) and 1750 ml water into a herbal pot. Bring to boiling and keep in mild boiling until there is about 300 ml herbal tea left. Add the Ajiao in, stir it until it is well melted. Drink one third of the herbal tea each time, three times a day.



[1] Yumao: the person feels dizzy and cloudy in vision.

[2] This paragraph tells two clinic conditions. The first one is the Fire in the urine bladder. The second one is the Fullness condition in the abdomen.