子嗽、喘咳、子肿、子气、子满、子烦、五心烦热、烦躁口干、子淋、子痫、胎压膀胱遗尿等
症，更有吐血、衄血、咳血、便血诸症，其因其治可详言欤？夫妇科诸书似少专门，名家所作
每见头绪烦多杂乱无章，如能条分缕晰，俾学人知各门用方之所以然，岂不善欤？
子悬者，怀子六七月胸腹满而胎上悬也。中于气郁者多，紫苏饮一方出许学士《本事
方》中，自注云∶“有妇产数日催生法不验，此必心怀畏惧、气结不行。经谓恐则气下精神
怯，怯则上焦闭，闭则气还，还则下焦胀、气乃不行。爰制此方服之即产，分明紫苏、川芎、陈
皮、腹皮疏气舒郁，归、芍补血，参草补气，皆佐使也。自注又云∶兼治六七月子悬，数有效，
亦疏气开郁之意。有热加芩、栀，胀甚加木香汁、归、术，名和气安胎饮。停滞呕吐加苍、朴，
名加参平胃散；郁多者加味逍遥；子嗽者，妊妇外感风寒则咳，咳久亦易坠胎，古方用宁嗽
散（苏、桑、杏、皮、知、桔、麦、草），亦有土虚不能生金者，归脾；有阴火上炎者六味，斟酌用
之。”以余所用胎前咳四五月不止者，橘饼（一枚） 松子肉（一两） 水糖（三钱）煎服 甚效。喘由外
感者，参苏饮。然火动而喘，孕妇最多，治不外二母、芩、冬，他若腰痛短气，脾虚则母令子
虚，肾气不归元而上乘于肺也，生脉补肺益气汤，补脾须去升、紫为妥，子肿与子气名异而
相类。子气肿下体，子肿肿上体，子满又名胎水，在五六月后，因胎大而腹满遍身浮肿耳。
三症皆属脾虚，或因泄利耗伤、病渴多饮、湿渍脾胃、水渍于胞胎易损伤，急治为宜。治法
不外健脾利水四字，健脾用六君，利水用五皮出入，两方者利气之乌药、香附、紫苏，甚则加
炮姜，古人用五皮，以白术易去桑皮。阎纯玺以为点铁成金手，可类推矣。外此，治水气有
天仙藤（即青木香藤）散（香、附、紫六分，木香二分，陈皮四分）。气虚加参术，血虚加归。
《千金》有鲤鱼汤（重一斤者，橘一分，姜七片） 同煮汁入（术、苓、归、芍）同煎，虚加人参，
此尤下水最捷法。子烦者，心惊胆怯，烦闷不
安，由心肺虚热或积痰于胸，胎动不安，竹叶安胎饮为主方。君以竹叶、条芩、麦冬，臣以枣
仁、远志，佐以四君去苓、四物去芍。渴加竹茹，痰积者以竹叶换竹沥、茯苓，躁甚热壅口
干者加犀角、知母，气虚倍人参。又有因药多致烦不得眠者用知母二两，枣肉丸弹子大，每
日参汤化一丸。又有口干不卧川连一味、米饮调一钱。子淋者，小便淋漓涩少，因气血养胎，
不及敷荣渗道，且胞系于肾，肾中虚热移于膀胱，安荣汤主之，君以灯心、通草、苓皮、参术
补气，归补血，麦冬清肺，去原方之滑石，恶其重镇而滑也，以石斛、山栀代之。如在脉微弱
气陷者，大剂参 。类此者有转胞症，因小便不通，脐下急痛，此由饱食忍尿或忍尿入房，
水气上逆，气逼于胞，屈戾不得舒张所致，非小肠膀胱病，当治其气，所谓胎压膀胱也。补
中益气为主方，去湿者加油炒半夏六分，血虚加芎、地，急用盐汤吐提。又不若稳婆以香油
涂手从产户托起其胎，俾溺之涨解为稳使。此症因虚。子淋之因火者不同，他如遗尿不知胎
满之故，用白薇、白芍，酒调末服三钱。虚者同地丹服。子痫、口噤、项强、肢挛、语謇、痰壅、
人事不省、忽然卒倒，与 同，不可作风治。多因血虚血燥，阴火上炎，鼓动其痰，主以羚
羊角散（钩、枣、独），气虚加（参、 、术），血虚加（归、芍、芩），有用南星（一斤，炭火炕，酒制
合）、琥珀（一两）、朱砂（五钱）猪心血为丸，服五十丸，参汤下。此方通治痫症，胎前亦宜。妊家
诸血症自当作火论，然“胎前宜清”一语不可拘泥，当分晰其火所由来。第一辨虚实，实火
宜清，其中又当分内外。从外感者，风热内郁所化（凉膈加归、地、茅、花），从内发者，肝经
怒火（加味逍遥），膏粱积热，加味清胃（川、连、翘、丹、地、归）；郁结伤脾之火（加味归
脾），虚火。宜补，当分阴阳，有气不摄血者（补中益气），有阴虚火旺者（地、归、二冬、知母、
陈、犀、草、芩、栀、术、苑），有肾经虚火（六味加芩、地），此口鼻血也。二便之血多湿热，便
血（槐榆防归乌梅），尿血导赤加（山栀、发灰、
阿胶、麦、味）。
问∶肺病咳嗽为多，咳字嗽字何解，能分讲欤？咳嗽症不外外感内伤两种，能分别欤？
外感不外风寒暑湿燥火六气，六气分见于四时，四时皆可以受六淫之邪，能各举其见证治
法欤？内伤不外阳虚阴虚，阳虚者多痰，阴虚者多见血，能各言其见证治法欤？劳风一症，
外感内伤并见，能举其治法欤？先业师论治病莫妙于剖析分明，愈细愈精，曷不剖分而详说
之。
咳者何？谐声也，其音开口而出，仿佛亥字之音，故有声无痰曰咳。嗽则如盥嗽然，有
物在喉，漾漾而出，故从口从敕。后人遂以有痰者谓嗽。然则咳嗽之病何从生？曰病有万
变，要不外内伤外感两端。试言外感。外感者，风寒暑湿燥火尽之。而六者论其常，各主一时
为病。论其变，则四时皆可以受六淫之邪。今且即风寒论感风咳者，鼻塞声重、恶风涕清，
此证也，左脉浮弦，此脉也。而风之中又有辨，春则伤温风，肝木用事则伤肝。而有又中气中
血之别，伤气者为卫（参苏饮、桑菊饮），伤血者为营（芎苏饮）。夏则为热风伤心胞（鸡苏
散），或伤冷风者（香茹饮）；秋为凉风犯肺（败毒散），兼痰者（金沸草散）；冬为寒风伤肾（麻
黄汤加减），兼饮者（桂枝浓朴杏仁汤），倘冬时天热而感寒风（葳蕤汤、阳旦汤）。惟秋冬有
暑湿，如春夏无燥气。他如先伤风而后伤热为热之寒（葳蕤），肺热感寒为寒之热（金沸草
散），嗽而痰出稠粘者脾湿胜（二陈），连嗽无痰者肺燥胜（清燥救肺），此皆外感咳嗽也。内
伤则痰饮。阴虚两种∶痰饮者多阳虚，浅者六安煎，有火者温胆；虚者金水六君煎，阳虚而
不可攻者（玉竹饮子），有痰火者盐降法，喘甚者（降气合贞元）。他若阴虚者阴火上升也，胃
气不清者（麦门冬汤），五更咳甚曾见血者（四阴煎），痰多而浓无胃气者（六君加减），痰少
嗌干胃气未绝者（六味八仙长寿）。凡若此者，所谓隔二隔三之治，土不生金者补脾，木反侮
金者平肝，火上刑心者治心，皆隔一之治也。
Cough during pregnancy (Zisu Ke), wheezing and cough (Chuan Ke), edema during pregnancy (Zi Zhong), Qi stagnation during pregnancy (Zi Qi), fullness during pregnancy (Zi Man), irritability during pregnancy (Zi Fan), heat in the five centers (Wu Xin Fan Re), irritability with dry mouth (Fan Zao Kou Gan), stranguria during pregnancy (Zi Lin), eclampsia of pregnancy (Zi Xian), urinary incontinence due to fetal pressure on the bladder (Tai Ya Pang Guang Yi Niao) and other symptoms, as well as various symptoms such as hematemesis (Tu Xue), epistaxis (Nv Xue), hemoptysis (Ke Xue), and hematochezia (Bian Xue). Can their etiology and treatment be discussed in detail? Books on gynecology seem to lack specialized research; works by famous masters often have numerous threads that are messy and disorganized. If they could be analyzed clearly and systematically, enabling students to understand the rationale behind the formulas used in each department, would this not be beneficial?
"Zixuan" refers to a condition occurring in the sixth or seventh month of pregnancy, characterized by fullness in the chest and abdomen, with the fetus feeling as if suspended upwards. It is mostly caused by Qi stagnation. The formula Zisu Yin (Perilla Decoction) comes from Xu Boxue's *Ben Shi Fang* (Formulas of Ability), which notes: "In cases where delivery fails after several days, it is likely due to fear causing Qi knotting and stagnation. The classics state 'fear causes Qi to descend'; when spirit is timid, the Upper Jiao closes; when closed, Qi returns; when returned, the Lower Jiao becomes distended, and Qi cannot move. Thus, this formula was created; upon ingestion, delivery occurs immediately. Clearly, Perilla Leaf (Zi Su Ye), Ligusticum Rhizome (Chuan Xiong), Tangerine Peel (Chen Pi), and Areca Peel (Fu Pi) regulate Qi and relieve depression; Angelica Sinensis (Dang Gui) and White Peony Root (Bai Shao) nourish Blood; Ginseng (Ren Shen) and Licorice Root (Gan Cao) tonify Qi; all serve as assistants. The note further states: 'Also treats Zixuan in the sixth or seventh month, effective multiple times, reflecting the intent of regulating Qi and opening depression.' If there is heat, add Scutellaria Root (Huang Qin) and Gardenia Fruit (Zhi Zi); for severe distension, add Aromatic Rush Juice (Mu Xiang Zhi), Dang Gui, and Atractylodes Macrocephala Rhizome (Bai Zhu), named Heqi Antifetal Disturbance Decoction (Heqi Antai Yin). For stagnation and vomiting, add Atractylodes Rhizome (Cang Zhu) and Magnolia Bark (Hou Po), named Jiacan Pingwei San; for severe depression, use Jiawei Xiaoyao San; for pregnancy cough, if the pregnant woman contracts wind-cold and coughs, prolonged coughing may easily lead to miscarriage. Ancient formulas use Ningsou San (Perilla Leaf, Mulberry Bark, Apricot Kernel, Tangerine Peel, Anemarrhena Rhizome, Platycodon Root, Ophiopogon Tuber, Licorice Root). There are also cases of Spleen Earth deficiency failing to generate Lung Metal, treated with Guipi Tang; cases of Yin fire flaming upward are treated with Liuwei Dihuang Wan, used with discretion." According to my experience, for pregnancy cough lasting four to five months, using one Orange Peel Cake (Jubing), one ounce of Pine Seed Kernel (Songzi Rou), and three qian of Rock Sugar (Shuitang) decocted and taken orally is very effective. Wheezing caused by external contraction is treated with Renshen Su Yin (Ginseng and Perilla Decoction). However, wheezing caused by Fire movement is most common in pregnant women; treatment generally involves Ermu San (Two Mother Powder), Huang Qin, and Asparagus Tuber (Tian Dong). Regarding lower back pain and shortness of breath, if due to Spleen deficiency, the mother affects the child (Spleen is the mother, Lung is the child), and Kidney Qi fails to return to its origin but floats up to attack the Lung, treat with Shengmai Bufeiyiqi Tang (Shengmai Lung-Tonifying and Qi-Boosting Decoction); when tonifying the Spleen, it is advisable to remove Cimicifuga Rhizome (Sheng Ma) and Schizonepeta Spike (Jing Jie). Zi Zhong and Zi Qi differ in name but are similar in nature. Zi Qi swelling is in the lower body; Zi Zhong swelling is in the upper body. Zi Man, also known as Taishui (Fetal Water), occurs after the fifth or sixth month, where the large fetus causes abdominal fullness and generalized edema. These three conditions all belong to Spleen deficiency, possibly due to diarrhea consumption, excessive drinking due to thirst, dampness soaking the Spleen and Stomach, or water soaking the fetal sac causing damage; urgent treatment is appropriate. The treatment method boils down to tonifying the Spleen and promoting urination. Tonify the Spleen with Liujunzi Tang (Six Gentlemen Decoction); promote urination with Wupi Yin (Five Peel Decoction) modified. Add Aquilaria Wood (Wuyao), Cyperus Rhizome (Xiang Fu), and Perilla Leaf (Zi Su) to regulate Qi; if severe, add Prepared Ginger (Pao Jiang). Ancients used Wupi Yin, replacing Mulberry Bark (Sang Bai Pi) with Atractylodes Macrocephala Rhizome (Bai Zhu). Yan Chunxi considered this a golden touch, applicable by analogy. Additionally, for treating water qi, Tianxianteng San (Akebia Vine Powder) is used (Cyperus Rhizome, Perilla Leaf 6 fen each, Aromatic Rush 2 fen, Tangerine Peel 4 fen). Add Ginseng and Atractylodes Macrocephala Rhizome for Qi deficiency; add Angelica Sinensis for Blood deficiency. *Qianjin Fang* has Liji Tang (Carpsoup): use a one-jin carp, one part Tangerine Peel, seven slices of Ginger, boil together to obtain juice, then add Atractylodes Macrocephala Rhizome, Poria, Angelica Sinensis, and White Peony Root to decoct. Add Ginseng for deficiency. This is particularly the fastest method to drain water.
Zi Fan refers to heart palpitations, timidity, irritability, and restlessness, caused by deficiency-heat in the Heart and Lung or phlegm accumulation in the chest, leading to fetal unrest. Zhuye Antai Yin (Bamboo Leaf Fetal-Calming Decoction) is the main formula. The Sovereign herbs are Bamboo Leaf (Zhuye), Scutellaria Root (Huang Qin), and Ophiopogon Tuber (Maidong); the Minister herbs are Sour Jujube Seed (Suan Zaoren) and Polygala Root (Yuanzhi); the Assistant herbs are Si Junzi Tang minus Poria (Lingzhi) and Siwu Tang minus White Peony Root (Baishao). Add Bamboo Sheath (Zhuru) for thirst; for phlegm accumulation, replace Bamboo Leaf with Bamboo Sap (Zhuli) and Poria (Fuling); for severe agitation, heat congestion, and dry mouth, add Rhinoceros Horn (Xijiao - note: usually substituted with Buffalo Horn in modern practice) and Anemarrhena Rhizome (Zhimu); double Ginseng for Qi deficiency. Another case involves irritability and insomnia caused by excessive medication, treated with two liang of Anemarrhena Rhizome, made into pills the size of a bullet with jujube flesh, taking one pill daily dissolved in Ginseng decoction. Another case involves dry mouth and inability to lie down, treated with one qian of Coptis Rhizome (Huanglian) mixed with rice water.
Zilin refers to dribbling, scanty, and painful urination. Because Qi and Blood nourish the fetus, they fail to moisten the channels, and since the fetal sac connects to the Kidney, deficiency-heat in the Kidney transfers to the Bladder. Anrong Tang (Anning Decoction) is the main formula. The Sovereign herbs are Rapeseed Stem (Dengxincao), Tetrapanax Pith (Tongcao), Poria Skin (Lingpi), Ginseng, and Atractylodes Macrocephala Rhizome to tonify Qi; Angelica Sinensis to nourish Blood; Ophiopogon Tuber to clear Lung heat. Remove Talcum (Huashi) from the original formula because of its heavy, sedative, and slippery nature, replacing it with Dendrobium Stem (Shihu) and Gardenia Fruit (Zhizi). In cases of weak pulse and sinking Qi, use a large dose of Ginseng. A similar condition is Zhuanbao (Reversed Bladder), characterized by inability to urinate and acute pain below the umbilicus. This is caused by holding urine after a full meal or intercourse, causing water qi to reverse upward, pressing on the bladder, preventing expansion. It is not a disease of the Small Intestine or Bladder itself, but should be treated by regulating Qi, known as fetal pressure on the bladder. Buzhong Yiqi Tang (Tonify the Middle and Boost Qi Decoction) is the main formula. To dispel dampness, add Oil-fried Pinellia Tuber (You Banxia) 6 fen; for Blood deficiency, add Ligusticum Rhizome (Chuanxiong) and Rehmannia Root (Shudi). For urgent cases, induce vomiting with salt water to lift Qi. Alternatively, it is more stable for the midwife to apply sesame oil to her hands and lift the fetus from the vaginal opening to relieve the pressure on the bladder. This condition is due to deficiency. Zilin caused by Fire is different. Other cases include urinary incontinence unaware of fetal fullness, treated with Gentian Root (Baiwei) and White Peony Root (Baishao), taken as powder mixed with wine, three qian per dose. For deficiency, take with Rehmannia Root (Dihuang) and Moutan Cortex (Danpi).
Zixian (Eclampsia) presents with locked jaw, stiff neck, limb spasms, slurred speech, phlegm obstruction, loss of consciousness, and sudden collapse. It is similar to epilepsy and should not be treated as Wind syndrome. It is mostly due to Blood deficiency and dryness, with Yin fire flaming upward, stirring phlegm. Lingyangjiao San (Antelope Horn Powder) is the main formula (Uncaria Ramulus cum Uncis, Jujube, Saussurea Root). Add Ginseng, Astragalus Membrane Root, and Atractylodes Macrocephala Rhizome for Qi deficiency; add Angelica Sinensis, White Peony Root, and Scutellaria Root for Blood deficiency. Some use Star Arisaema Rhizome (Nanxing - one jin, dried over charcoal fire, processed with wine), Amber (Hupo - one liang), and Cinnabar (Zhusha - five wu) with Pig Heart Blood to make pills, taking fifty pills washed down with Ginseng decoction. This formula treats epilepsy generally and is suitable for pregnancy.
All bleeding disorders in pregnancy should be discussed in terms of Fire. However, the saying "clearing is suitable before birth" should not be rigidly applied; one must distinguish the source of the Fire. First, differentiate deficiency and excess. Excess Fire should be cleared, further divided into internal and external. External sources transform from internal constraint of Wind-Heat (Liangge San plus Angelica Sinensis, Rehmannia Root, White Imperata Rhizome Flower); internal sources arise from Liver Fire (Jiawei Xiaoyao San), accumulation of heat from rich food (Jiawei Qingwei San: Ligusticum Rhizome, Coptis Rhizome, Forsythia Fruit, Moutan Cortex, Rehmannia Root, Angelica Sinensis); Fire from depression injuring the Spleen (Jiawei Guipi Tang). Deficiency Fire should be tonified, differentiated by Yin and Yang. Cases where Qi fails to control Blood are treated with Buzhong Yiqi Tang; cases of Yin deficiency with Fire hyperactivity are treated with Rehmannia Root, Angelica Sinensis, Asparagus Tuber, Ophiopogon Tuber, Anemarrhena Rhizome, Tangerine Peel, Rhinoceros Horn, Licorice Root, Scutellaria Root, Gardenia Fruit, Atractylodes Macrocephala Rhizome, and Dodder Seed; Kidney deficiency Fire is treated with Liuwei Dihuang Wan plus Scutellaria Root and Rehmannia Root. These refer to bleeding from the mouth and nose. Bleeding from the bowels and urine is mostly due to Damp-Heat. Hematochezia is treated with Sophora Flower, Ulmus Bark, Saposhnikovia Root, Angelica Sinensis, and Chinese Plum Seed; Hematuria is treated with Daochi San plus Gardenia Fruit, Burnt Hair, Donkey-hide Gelatin, Ophiopogon Tuber, and Schisandra Berry.
Question: Lung diseases often involve coughing. How do we explain the characters "Ke" (cough) and "Sou" (phlegm expectoration)? Can they be distinguished? Coughing syndromes fall into two categories: external contraction and internal injury. Can they be distinguished? External contraction involves the six Qi: Wind, Cold, Summer-heat, Dampness, Dryness, and Fire. These six Qi appear in the four seasons, and the six pathogenic factors can affect the body in any season. Can you list the manifestations and treatments for each? Internal injury involves Yang deficiency and Yin deficiency. Yang deficiency often presents with Phlegm; Yin deficiency often presents with Blood issues. Can you describe the manifestations and treatments for each? Laofeng (Labor Wind) involves both external and internal factors. Can you provide its treatment? My former master argued that nothing is better than precise analysis; the finer, the more refined. Why not analyze and explain in detail?
What is "Ke"? It is a phonetic character. The sound comes out with an open mouth, resembling the sound of the character "Hai". Therefore, "Ke" refers to cough without phlegm. "Sou" resembles rinsing; there is something in the throat, bubbling out. Hence, it contains the radical for mouth and the component "Chi". Later generations came to call coughing with phlegm "Sou". So, where does the disease of coughing come from? I say: diseases have ten thousand variations, but essentially fall into two ends: internal injury and external contraction. Let us discuss external contraction. External contraction encompasses Wind, Cold, Summer-heat, Dampness, Dryness, and Fire. Discussing them normally, each dominates a specific season. Discussing their variations, the six pathogenic factors can affect the body in any season. Now, let us discuss Wind-Cold. For Wind-induced cough: nasal congestion, heavy voice, aversion to wind, clear discharge. This is the syndrome; the left pulse is floating and wiry. Within Wind, there are distinctions: in Spring, Warm Wind injures the Liver Wood; there is a difference between affecting Qi and affecting Blood. Affecting Qi involves the Wei level (Renshen Su Yin, Sangju Yin); affecting Blood involves the Ying level (Xiong Su Yin). In Summer, Hot Wind injures the Pericardium (Jisu San), or Cold Wind (Xiangru Yin); in Autumn, Cool Wind attacks the Lung (Baidu San), with Phlegm (Jinfecao San); in Winter, Cold Wind injures the Kidney (Mahuang Tang modified), with Fluid retention (Guizhi Houpo Xingren Tang). If it is warm in Winter but Cold Wind is contracted (Weirui Tang, Yangdan Tang). Only Autumn and Winter have Summer-heat and Dampness, just as Spring and Summer do not have Dryness. Others include contracting Wind first then Heat (Hot-Wind Cold: Weirui Tang); Lung Heat contracting Cold (Cold-Wind Heat: Jinfecao San); cough with thick sticky phlegm indicates Spleen Dampness predominance (Erchen Tang); continuous cough without phlegm indicates Lung Dryness predominance (Qingzao Jiufei Tang). These are all externally contracted coughs. Internally injured coughs involve Phlegm-Fluid and Yin Deficiency. Phlegm-Fluid is mostly due to Yang deficiency; mild cases use Liu'an Jian; with Fire, use Wendan Tang. For deficiency, use Jinshui Liujun Jian. For Yang deficiency where attacking is contraindicated, use Yuzhu Yinzi; for Phlegm-Fire, use Salt-lowering method; for severe wheezing, combine Jiangqi Tang and Zhenyuan Yin. Others: Yin deficiency with rising Yin Fire; unclear Stomach Qi (Maimendong Tang); severe cough at dawn with blood history (Siyin Jian); profuse thick phlegm with no Stomach Qi (Liujunzi Tang modified); scanty phlegm, dry throat, Stomach Qi not yet exhausted (Liuwei Dihuang Wan combined with Baxian Changshou Wan). All these represent the treatment of "separated two or three organs": when Earth does not generate Metal, tonify the Spleen; when Wood insults Metal, calm the Liver; when Fire punishes the Heart, treat the Heart. These are all treatments separated by one organ.