乌梅三百个 细辛六两 干姜十两 黄连一筋 当归四两 附子（炮）六两 川椒（
去汗）四两 桂枝六两 人参六两 黄蘖六两
右十味，异捣筛，合治之，以苦酒渍乌梅一宿，去核蒸之，五升米下，饭熟捣成泥，
和药令相得，内臼中，与蜜杵二千下，圆如梧桐子大。先食，饮服十圆，日三服，稍
加至二十圆，禁生冷滑臭等食。
【集解】
李□曰：乌梅味酸，黄连、黄柏味苦，桂枝、蜀椒、干姜、细辛、味辛以蛔得酸则止
，得苦则安，得甘则动于上，得辛则伏于下也。然胃气虚寒，人参、附子以温补之，
吐亡津液，当归以辛润之，则蛔厥可愈矣。
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师曰：妇人得平脉，阴脉小弱，其人渴，不能食，无寒热，名妊娠，桂枝汤主之。于
法六十日，当有此证，设有医治逆者，□一月加吐下者，则绝之。
【注】
妇人经断得平脉，无寒热，则内外无病，其人渴不能食，乃妊娠恶阻之渐也。故阴脉
虽小弱，亦可断为有孕。但恶阻，于法六十日当有此证，设医不知是孕，而治逆其法
，□一月即有此证也。若更加吐下者，则宜绝止医药，听其自愈可也。然脉平无寒热
，用桂枝汤，与妊娠渴不能食者不合，且文义断续不纯，其中必有脱简。
【集注】
徐彬曰：平脉者，不见病脉，一如平人也。阴脉小弱者，脉形小不大，软弱无力，非
细也。诸脉既平，而独下焦阴脉，微见不同，是中、上二焦无病，乃反见渴不能食之
证，则渴非上焦之热，不能食亦非胃家之病矣。少阳有嘿嘿不欲食之证，今无寒热亦
无少阳表证可疑矣。是渴乃阴火上炽，不能食乃恶心阻食，阴脉小乃胎元蚀气，故曰
：名妊娠也。
李□曰：此节病证，即妊娠恶阻是也。寸为阳脉主气，尺为阴脉主血，阴脉小弱者，
血不足也，血以养胎，则液竭而渴。又脾为坤土，厚德载物，胎气赖以奠安，不能食
者，脾气弱也。凡有他病而渴不能食者，脉必不平而有寒热，今虽不能食，反得平脉
，又无寒热，故主妊娠。
Three hundred sour plums (Umei, 乌梅), six liang of Asarum (Xixin, 细辛), ten liang of dried ginger (Ganjiang, 干姜), one jin of Coptis Rhizome (Huanglian, 黄连), four liang of Angelica Sinensis Radix (Danggui, 当归), six liang of Aconite Root (Fuzi, 附子) processed, four liang of Zanthoxylum Pericarpium (Chuanjiao, 川椒) with perspiration removed, six liang of Cinnamon Twig (Guizhi, 桂枝), six liang of Codonopsis Radix (Renshen, 人参), and six liang of Phellodendron Bark (Huangbai, 黄柏).
The above ten herbs are separately pounded and sifted, then mixed together. Soak the sour plums in vinegar for one night, remove the pits, and steam them. Add five sheng of rice water (the liquid obtained from cooking rice), and when the rice is cooked, pound it into a paste. Mix this paste thoroughly with the herbal powder, place it in a mortar, add honey, and pound two thousand times until uniform. Shape into pills the size of paulownia seeds. Take before meals, drinking ten pills each time, three times a day. Gradually increase the dosage to twenty pills. Avoid consuming cold, raw, slippery, or foul-smelling foods.
[Ji Jie - Collected Explanations]
Li [Name Redacted] stated: Sour plums are sour in flavor; Coptis Rhizome and Phellodendron Bark are bitter; Cinnamon Twig, Sichuan Pepper, dried ginger, and Asarum are acrid. Roundworms cease movement upon encountering sourness, become tranquil upon encountering bitterness, move upward upon encountering sweetness, and subside downward upon encountering acridity. However, since the stomach qi is deficient and cold, Codonopsis Radix and processed Aconite Root are used to warm and tonify. Since vomiting has depleted body fluids, Angelica Sinensis Radix is used to moisten with its acrid nature. Thus, roundworm-induced syncope (Hui Jue, 蛔厥) can be cured.
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The Master said: When a woman presents with a normal pulse, but the yin pulse (typically felt at the chi position) is slightly weak, and she experiences thirst and an inability to eat, without chills or fever, this is termed pregnancy. Gui Zhi Tang (Cinnamon Twig Decoction) should be administered. According to standard practice, these symptoms typically appear around the sixtieth day of gestation. If medical intervention is misapplied causing adverse reactions, or if vomiting and diarrhea worsen within a month, treatment should be discontinued, allowing the condition to resolve spontaneously.
[Zhu - Annotation]
When a woman’s menstruation ceases and a normal pulse is found, without chills or fever, it indicates that there is no internal or external disease. Her thirst and inability to eat are early signs of nausea and vomiting during pregnancy (E Zu, 恶阻). Therefore, even though the yin pulse is slightly weak, pregnancy can be diagnosed. However, according to standard practice, E Zu symptoms typically manifest around the sixtieth day of gestation. If a physician fails to recognize the pregnancy and applies incorrect treatments, or if these symptoms appear within a month, and especially if vomiting and diarrhea occur, medication should be stopped, and spontaneous recovery should be awaited. Nevertheless, using Gui Zhi Tang for a patient with a normal pulse and no chills/fever does not align well with the symptoms of pregnancy-related thirst and anorexia. The text appears disjointed, suggesting there may be missing passages (Tuo Jian, 脱简).
[Ji Zhu - Collected Commentaries]
Xu Bin stated: A "normal pulse" means no pathological pulse signs are present, resembling that of a healthy person. "Yin pulse slightly weak" refers to a pulse that is neither large nor forceful, but soft and weak, rather than fine. Since all other pulses are normal, only the lower jiao yin pulse shows slight deviation, indicating that the middle and upper jiao are free of disease. The occurrence of thirst and anorexia despite normal pulses elsewhere suggests that the thirst is not due to heat in the upper jiao, nor is the anorexia due to stomach pathology. Shaoyang syndrome presents with a desire to avoid food, but here, the absence of chills and fever rules out Shaoyang exterior syndrome. Thus, the thirst is caused by flaming up of yin fire, the anorexia by nausea obstructing food intake, and the small yin pulse by the fetal origin consuming qi and blood. Hence, it is termed pregnancy.
Li [Name Redacted] stated: This section describes the syndrome of nausea and vomiting during pregnancy (E Zu). The cun position represents the yang pulse governing qi, while the chi position represents the yin pulse governing blood. A weak yin pulse indicates blood deficiency. Blood nourishes the fetus; thus, fluid depletion leads to thirst. Furthermore, the spleen belongs to Kun Earth, possessing great virtue to carry things, and fetal stability relies on the spleen. Inability to eat stems from spleen qi weakness. In cases of other diseases causing thirst and anorexia, the pulse is invariably abnormal accompanied by chills or fever. Here, although eating is difficult, the pulse is normal and there are no chills or fever; therefore, it is diagnosed as pregnancy.