朱肱曰。妊娠伤寒。安胎。宜阿胶散、白术散。妊娠伤寒。憎寒发热。当发其汗。宜葱白汤。
妊娠伤寒。头痛。憎寒壮热。身痛项强。宜芎苏散。妊娠伤寒。头疼发热。遍身疼痛。宜紫苏散。
亦治胎气不和。凑上心腹。胀满疼痛。谓之子悬。能安活胎。亦下损胎。
王好古曰。若妊娠伤寒中风。表虚自汗。头疼项强。身热恶寒。脉浮而弱。太阳经病。宜表虚
六合汤。若妊娠伤寒。头痛身热。无汗。脉紧。太阳经病。宜表实六合汤。若妊娠伤寒中风温之气。
肢节烦疼。脉浮而热。头痛者。太阳标病也。宜风温六合汤。若妊娠伤寒下后。过经不愈。湿毒发
斑如锦纹。宜升麻六合汤。若妊娠伤寒。胸胁满痛而脉弦。少阳症。宜柴胡六合汤。若妊娠伤寒。
大便硬。小便赤。气满而脉沉数。太阳阳明本病也。急下之。宜大黄六合汤。若妊娠伤寒。汗下后。
咳嗽不止。宜人参六合汤。若妊娠伤寒后。虚痞胀满者。阳明本虚也。宜浓朴六合汤。若妊娠伤
寒汗下后。不得眠。宜栀子六合汤。若妊娠伤寒。蒸蒸而烦。脉长而大。宜石膏六合汤。若妊娠伤
寒。小便不利。太阳本病也。宜茯苓六合汤。若妊娠伤寒。太阳本病。小便赤如血者。宜琥珀六合
汤。若妊娠伤寒。汗下后。血漏不止。胎气损动者。宜胶艾六合汤。若妊娠伤寒。四肢拘急。身凉。
微汗。腹中痛。脉沉而迟。少阴病也。宜附子六合汤。若妊娠伤寒。蓄血症。不宜用坠胎药下之。
宜四物大黄汤下之。若妇人妊娠或蓄血。抵当桃仁勿妄施。要教子母俱无损。大黄四物对分之。此
乃歌诀也。
楼英曰。妇人有孕伤寒。脉浮头重。腹中切痛。宜桂枝芍药当归汤。妊娠伤寒。自利。腹中痛。
饮食不下。脉沉者。太阴经病也。宜芍药汤。妇人有孕。发斑变黑色。宜栀子大青汤。
吴绶曰。孕妇伤寒。六经治例皆同。但要安胎为主。凡药中有犯胎者。切不可用。如藿香正气
散、十味芎苏散、小柴胡汤之类。有半夏能犯胎。如用。须去之。若痰多呕逆。必欲用之。半夏麴
则可。凡川乌、附子、天雄、肉桂、干姜、大黄、芒硝、芫花、甘遂、大戟、蜀漆、虻虫、水蛭、
桃仁、丹皮、干漆、赭石、瞿麦、牛膝等类。皆动胎药。必不可犯。大抵妊娠伤寒。合用汤剂。必
加黄芩、白术二味。能安胎也。或以二味为末。白汤调下二三钱亦可。如孕妇素弱。加四物汤佐之。
且如用小柴胡。去半夏。加白术。合四物汤。可以保胎除热。其效如神。余皆仿此。
Zhu Gong stated: In cases of cold damage (Shanghan) during pregnancy, it is necessary to stabilize the fetus. It is appropriate to use Ejiao San (Donkey-Hide Gelatin Powder) and Baizhu San (Atractylodes Macrocephala Powder). In cases of cold damage during pregnancy presenting with aversion to cold and fever, diaphoresis (sweating method) should be employed; Congbai Tang (Scallin Decoction) is appropriate.
In cases of cold damage during pregnancy presenting with headache, severe aversion to cold and high fever, body pain, and neck stiffness, Xiong Su San (Ligusticum and Perilla Powder) is appropriate. In cases of cold damage during pregnancy presenting with headache, fever, and generalized body pain, Zisu San (Perilla Leaf Powder) is appropriate.
(Zisu San) also treats disharmony of fetal qi, where qi rushes upward to the heart and abdomen causing distension, fullness, and pain, a condition known as "Zixuan" (Fetal Suspension). It can stabilize and preserve the fetus, and prevent miscarriage.
Wang Haogu stated: If it is wind-stroke accompanying cold damage during pregnancy, manifesting as exterior deficiency with spontaneous sweating, headache, neck stiffness, fever, aversion to cold, and a floating and weak pulse, it is a Taiyang meridian disease. It is appropriate to use Biaoxu Liuhe Tang (Exterior Deficiency Six-Harmony Decoction). If cold damage during pregnancy presents with headache, fever, anhidrosis (absence of sweat), and a tight pulse, it is a Taiyang meridian disease. It is appropriate to use Biaoshi Liuhe Tang (Exterior Excess Six-Harmony Decoction). If cold damage during pregnancy involves wind-warmth pathogens, presenting with painful joints, floating and hot pulse, and headache, this is a Biao (Branch/Manifestation) disease of the Taiyang meridian. It is appropriate to use Fengwen Liuhe Tang (Wind-Warmth Six-Harmony Decoction). If after purgation for cold damage during pregnancy, the pathogen has passed beyond one meridian without resolution, and damp-toxin erupts as mottled rash resembling brocade patterns, Shengma Liuhe Tang (Cimicifuga Six-Harmony Decoction) is appropriate. If cold damage during pregnancy presents with chest and hypochondriac fullness/pain and a wiry pulse, it is a Shaoyang syndrome. It is appropriate to use Chaihu Liuhe Tang (Bupleurum Six-Harmony Decoction). If cold damage during pregnancy presents with hard stool, red urine, abdominal fullness, and a deep and rapid pulse, this is a Ben (Root/Etiology) disease of Taiyang and Yangming. Urgent purgation is required; Dahuang Liuhe Tang (Rhubarb Six-Harmony Decoction) is appropriate. If after sweating and purgation for cold damage during pregnancy, cough persists, Renshen Liuhe Tang (Ginseng Six-Harmony Decoction) is appropriate. If after cold damage during pregnancy, deficiency-type epigastric fullness and distension occur, this is Yangming root deficiency. Nongpo Liuhe Tang (Magnolia Bark Six-Harmony Decoction) is appropriate. If after sweating and purgation for cold damage during pregnancy, insomnia occurs, Zhizi Liuhe Tang (Gardenia Six-Harmony Decoction) is appropriate. If cold damage during pregnancy presents with steaming heat and irritability, and a long and large pulse, Shigao Liuhe Tang (Gypsum Six-Harmony Decoction) is appropriate. If cold damage during pregnancy presents with difficult urination, this is a Taiyang root disease. Fuling Liuhe Tang (Poria Six-Harmony Decoction) is appropriate. If cold damage during pregnancy, being a Taiyang root disease, presents with urine red as blood, Hupo Liuhe Tang (Amber Six-Harmony Decoction) is appropriate. If after sweating and purgation for cold damage during pregnancy, vaginal bleeding continues incessantly and fetal qi is damaged and unsettled, Jiao'ai Liuhe Tang (Colla Corii Asini and Mugwort Six-Harmony Decoction) is appropriate. If cold damage during pregnancy presents with limb spasms and rigidity, cool body, slight sweating, abdominal pain, and a deep and slow pulse, this is a Shaoyin disease. Fuzi Liuhe Tang (Aconite Six-Harmony Decoction) is appropriate. In cases of cold damage during pregnancy with blood stasis syndrome, drugs that cause miscarriage should not be used for purgation. Sili Dahuang Tang (Four Substances and Rhubarb Decoction) is appropriate for purgation. There is a verse: "For pregnant women or those with blood stasis, do not recklessly apply Didang Tang or Tao Ren. To ensure no harm to mother and child, divide Da Huang and Si Wu Tang equally." This is the content of that verse.
Lou Ying stated: When a woman with pregnancy contracts cold damage, presenting with a floating pulse, heavy head, and cutting pain in the abdomen, Guizhi Shaoyao Danggui Tang (Cinnamon Twig, Peony, and Angelica Decoction) is appropriate. In cases of cold damage during pregnancy presenting with spontaneous diarrhea, abdominal pain, inability to eat, and a deep pulse, this is a Taiyin meridian disease. Shaoyao Tang (Peony Decoction) is appropriate. When a woman with pregnancy develops macules that turn black, Zhizi Daqing Tang (Gardenia and Isatis Decoction) is appropriate.
Wu Shou stated: For pregnant women with cold damage, the treatment principles for the six meridians are generally the same, but stabilizing the fetus must be the primary goal. Any medication that harms the fetus must absolutely not be used. For example, Huoxiang Zhengqi San, Shiwei Xiongsu San, and Xiaochaihu Tang contain Banxia (Pinellia Tuber), which can harm the fetus; if used, Banxia must be removed. If there is excessive phlegm and vomiting necessitating the use of Banxia, Banxia Qu (Fermented Pinellia) may be used. All herbs such as Chuanwu (Chuanwu Rhizome), Fuzi (Prepared Aconite Root Lateralis), Tianxiong (Tianxiong Radix), Rougui (Cinnamon Bark), Ganjiang (Dried Ginger), Dahuang (Rhubarb Root and Rhizome), Mangxiao (Mirabilite), Yuanhua (Kadua Flower), Gansui (Euphorbia Kansui Root), Daji (Euphorbia Pekinensis Root), Shuqi (Phytolacca Root), Mengchong (Male Leech), Shuizhi (Leech), Taoren (Peach Seed), Danpi (Moutan Cortex), Ganqi (Dried Lacquer), Zhesi (Hematitum), Qumai (Dianthus Herb), Niuxi (Achyranthes Root), etc., are all fetotoxic drugs and must absolutely not be used. Generally, in decoctions for cold damage during pregnancy, Huangqin (Scutellaria Root) and Baizhu (Atractylodes Macrocephala Rhizome) must be added, as they stabilize the fetus. Alternatively, these two herbs can be powdered and taken with warm water, 2-3 qian. If the pregnant woman is constitutionally weak, Siwu Tang (Four Substances Decoction) can be added as an adjunct. For instance, when using Xiaochaihu Tang, remove Banxia, add Baizhu, and combine with Siwu Tang to stabilize the fetus and clear heat; the effect is miraculous. Other cases should follow this pattern.