《内经》言手少阴脉动甚谓之有子,阴搏阳别谓之有子,曰动、曰搏,皆有力之象也;而《金匮》复以“阴脉小弱,
其人渴,不能食,无寒热”者为妊娠,二说何其相反耶?盖《内经》所云者,一谓手中之少阴肾脉,血聚气盛故脉动,
一谓阴得胎气而强,故阴脉搏指,而阳脉反与之有别,此皆于三月之胎诊之始验。其《金匮》所云者,谓下焦之气血骤
为胎蚀,暂似有亏,故脉小弱,此惟于两月左右验之,过此则不然矣,是以下文有“于法六十日当有此证”句。由是观
之,二书似反而实同也,然更以《千金》所云“初时寸微小,呼吸五至,三月而尺数”之语,合而参之,斯得圆通之妙
焉。
尝读喻西昌书,有曰“迩来习医者众,医学愈荒,无方之书全不考究,有方之书奉为灵宝”云云,可知吾侪之学问,
全在乎无方之书为根本也,然而《典》、《坟》具在,蕴奥良多,何以考之,何以究之哉?聊纪数则,以为引伸之鉴。
丹溪曰∶方书瘦胎饮一论,为湖阳公主作也,予族妹苦于难产,予甚悯焉,视其形肥而勤于针HT ,构思旬日,忽
自
悟曰,此正与湖阳公主相反。彼奉养之人,其气必实,耗其气使和平,故易产。今形肥,知其气虚,久坐,知其不运,
今其有孕至五六月,遂于大全方紫苏饮加补气药,与十数贴,因得男儿甚快。烈按同一难产,而有虚实之别,补气之方,
反从瘦胎饮悟出。故凡前贤议论,必明其正义,又必于反面构思,方不为其所囿,可见读书不可独泥于正面也。
The *Huangdi Neijing* (Yellow Emperor's Inner Canon) states that a pronounced pulsation in the Shou Shaoyin (Hand Shaoyin Heart Meridian) pulse indicates pregnancy, and that a Yin pulse that beats forcefully while being distinct from the Yang pulse also indicates pregnancy; both "pulsation" (Dong) and "beating forcefully" (Bo) are manifestations of a strong pulse. However, the *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) further describes pregnancy as presenting with a "small and weak Yin pulse," thirst, inability to eat, and absence of aversion to cold or fever. Why are these two theories so contradictory? It is likely that what the *Neijing* refers to is: one instance where the Shaoyin pulse at the wrist (associated with Kidney essence in some contexts, though textually linked to Heart meridian dynamics here) moves due to blood accumulation and vigorous Qi; another instance where the Yin aspect becomes strong due to fetal Qi, causing the Yin pulse to beat against the fingers, while the Yang pulse differs from it. These signs typically become evident starting around the third month of gestation. As for what the *Jingui* describes, it refers to the sudden consumption of Qi and Blood in the Lower Jiao by the fetus, leading to a temporary deficiency, hence the small and weak pulse. This is only verifiable around the second month of gestation; beyond this period, it is no longer the case, which is why the text later states, "According to the method, within sixty days, such symptoms should appear." From this perspective, the two books seem contradictory but are actually consistent. Furthermore, integrating the statement from the *Qianjin Yaofang* (Prescriptions Worth a Thousand Gold) that "initially the Cun (inch) position is minute and slight, with five pulses per breath, and by the third month, the Chi (cubit) position becomes rapid," allows one to achieve a comprehensive and flexible understanding.
I once read the works of Yu Chang (courtesy name Xichang), who said, "In recent times, many people study medicine, yet medical knowledge declines; they do not investigate texts without prescriptions, yet revere texts containing prescriptions as sacred treasures." This reveals that our scholarly foundation must lie in theoretical texts rather than those merely listing prescriptions. Although classics like the *Shangshu* (Book of Documents) and *Sanfen* (Three Fens) exist, containing profound mysteries, how can we examine and explore them? I briefly record several points here as a guide for further reflection.
Zhu Danxi stated: The discussion on "Shoutai Yin" (Fetus-Thinning Decoction) in medical formularies was created for Princess Huyang. My clan sister suffered from difficult labor, and I pitied her greatly. Observing that she was obese and diligent in acupuncture treatments, after pondering for ten days, I suddenly realized: Her condition is exactly opposite to that of Princess Huyang. Those who live in luxury have substantial Qi; dissipating their excess Qi brings it to harmony, facilitating easy delivery. Now, this patient is obese, indicating Qi deficiency; sedentary lifestyle suggests stagnant Qi transport. Since she was five to six months pregnant, I added Qi-tonifying herbs to the Zisu Yin (Perilla Decoction) from the *Daquan Fang* (Complete Formulas). After administering more than ten doses, she happily delivered a healthy son. Tang Dalie adds: In cases of difficult labor, there is a distinction between deficiency and excess syndromes. A Qi-tonifying formula was derived from the logic of the Fetus-Thinning Decoction. Therefore, when discussing the arguments of former sages, one must understand their correct principles and also consider the opposite perspective to avoid being confined by them. This shows that reading requires looking beyond the obvious surface meaning.