小产重于大产,盖大产如栗熟自脱,小产如生采,破其皮壳,断自根蒂,岂不重于大产?但
人轻忽致死者多矣。治法宜补形气,生新血,去瘀血。若未足月,痛而欲产,芎归补中汤,
倍加知母止之。若产而血不止,人参黄 汤补之。若产而心腹痛,当归川芎汤主之。胎气弱
而小产者,八珍汤固之。若出血过多而发热,圣愈汤。汗不止,急用独参汤。发热烦躁,肉
筋惕,八珍汤。大渴面赤,脉洪而虚,当归补血汤。身热面赤,脉沉而微,四君姜附。东
垣云∶昼发热而夜安静,是阳气自旺于阳分也;昼安静而夜发热躁,是阳气下陷于阴中也;
如昼夜俱发热者,是重阳无阴也,当峻补其阴。王太仆云∶如大寒而甚,热之不热,是无火
也;热来复去,昼见夜伏,夜发昼止,时节而动,是无火也;如大热而甚,寒之不寒,是无
水也;热动复止,倏忽往来,时动时止,是无水也。若阳气自旺者,补中益气汤。阳气陷于
阴者,四物二连汤。重阳无阴者,四物汤。无火者,八味丸。无水者,六味丸。
治验
一妊娠五月,服剪红丸而堕,腹中胀痛,服破血之剂,益甚,以手按之益痛。余曰∶此峻药
重伤,脾胃受患。用八珍倍人参、黄 、半夏、乳香、没药,二剂而痛止,数剂而痊愈。
吴江庠友史万湖仲子室,年二十余,疫疾堕胎,时咳,服清肺解表,喘急不寐,请治。余以
为脾土虚不能生肺金,药损益甚,先与补中益气加茯苓、半夏、五味、炮姜,四剂渐愈。往
视之,又与八珍加五味及十全大补汤痊愈。
大儿妇张氏素怯弱,嘉靖癸卯四月生女,自乳中患疥疮,年余不愈,遂致羸困。甲辰五月,
遭先母大故,以姑病勉强代执丧礼,旬月,每欲眩仆,一日感气,忽患心脾高肿作疼,手不
可按,而呕吐不止,六脉微细之极。余以为脉虽虚而病形则实,误认诸痛不可补气,乃用青
皮、香附、吴茱等药而愈。继复患疟且堕胎,又投理气行血之药,病去,元气转脱,再投参
补剂不应矣,六脉如丝欲绝,思非附子不能救,非立翁莫能投,迎翁至诊云∶皆理气之剂
,损真之误也。连投参、 、归、术、附子、姜、桂六剂,间用八味丸,五日眠食渐甘,六
脉全复。翁云∶心脾疼痛时,即当服此等药,疟亦不作矣。姑妇皆翁再造,敢述奇功,附于
此门之尾,以为初知药性者之戒。制生陈逊稽颡谨识。
Minor abortion is more severe than major abortion. This is because a major abortion is like a ripe chestnut falling off naturally, whereas a minor abortion is like picking it raw, breaking the shell and severing the root. Is it not more severe than a major abortion? However, many people neglect this and die as a result. The treatment method should focus on tonifying the physical qi (vital energy), generating new blood, and removing blood stasis. If it occurs before full term with abdominal pain and the urge to deliver, Xiong Gui Bu Zhong Tang (Cnidium and Angelica Decoction to Supplement the Middle) should be used, with Zhi Mu (Anemarrhenae Rhizoma) doubled to stop the premature labor. If bleeding continues after delivery, Renshen Huangqi Tang (Ginseng and Astragalus Decoction) should be used to tonify. If there is heart and abdominal pain after delivery, Danggui Chuanxiong Tang (Angelica and Ligusticum Decoction) is the primary prescription. For minor abortion due to weak fetal qi, Bazhen Tang (Eight Treasures Decoction) is used to consolidate. If excessive bleeding leads to fever, Shengyu Tang (Sage for Replenishing Life Decoction) is indicated. If sweating does not stop, Dushen Tang (Single Ginseng Decoction) should be used urgently. For fever with restlessness and muscle twitching, Bazhen Tang (Eight Treasures Decoction) is used. For extreme thirst and red face with a flooding yet empty pulse, Danggui Buxue Tang (Angelica Tonifying Blood Decoction) is prescribed. For body heat and red face with a deep, minute, and faint pulse, Sijunzi Tang (Four Gentlemen Decoction) combined with Ganjiang (Zingiberis Rhizoma Recens) and Fuzi (Aconiti Lateralis Radix Praeparata) is used. Li Dongyuan said: Fever during the day and quietness at night indicates yang qi flourishing in the yang aspect; quietness during the day and fever/restlessness at night indicates yang qi sinking into the yin; fever both day and night indicates excess yang without yin, requiring vigorous tonification of yin. Wang Taipu said: Severe cold that does not respond to warming treatment indicates absence of fire; heat coming and going, appearing by day and hiding by night, occurring seasonally, indicates absence of fire; severe heat that does not respond to cooling treatment indicates absence of water; heat moving then stopping, fluctuating suddenly, indicating absence of water. For cases of self-flourishing yang qi, Buyi Yiqi Tang (Supplementing the Middle and Augmenting the Qi Decoction) is used. For yang qi sinking into yin, Siwu Erlian Tang (Four Substances and Two Lotuses Decoction) is used. For excess yang without yin, Siwu Tang (Four Substances Decoction) is used. For absence of fire, Bawei Wan (Eight Ingredients Pill) is used. For absence of water, Liuwei Wan (Six Ingredients Pill) is used.
Clinical Case Record
A pregnant woman at five months gestation took Jianhong Wan (Red-Clipping Pill) and miscarried, suffering from abdominal distension and pain. After taking blood-breaking agents, her condition worsened, and pain increased upon palpation. I stated: This is severe injury caused by harsh medicines affecting the spleen and stomach. I used Bazhen Tang (Eight Treasures Decoction) with doubled Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Banxia (Pinelliae Rhizoma), Ruxiang (Olibanum), and Moyao (Myrrha), which stopped the pain in two doses and cured her in several doses.
The wife of the second son of Shi Wanhu, a scholar from Wujiang, was over twenty years old. She miscarried due to an epidemic disease and had frequent coughs. After taking lung-clearing and exterior-releasing medicines, she suffered from wheezing urgency and insomnia. Upon consultation, I believed this was due to deficient spleen earth failing to generate lung metal, and previous medications exacerbated the condition. I first prescribed Buyi Yiqi Tang (Supplementing the Middle and Augmenting the Qi Decoction) with added Fuling (Poria), Banxia (Pinelliae Rhizoma), Wuweizi (Schisandrae Fructus), and Paojiang (Prepared Zingiberis Rhizoma). After four doses, she gradually improved. Upon subsequent visit, she took Bazhen Tang (Eight Treasures Decoction) with Wuweizi (Schisandrae Fructus) and Shiquan Dabu Tang (Ten Significant Great Tonifying Decoction) and recovered completely.
The eldest son's wife, Ms. Zhang, was constitutionally weak. In the fourth month of the Gui-Mao year of Jiajing, she gave birth to a daughter. She developed scabies during lactation, which persisted for over a year, leading to emaciation and exhaustion. In the fifth month of the Jia-Chen year, she encountered the death of her mother-in-law. Due to her husband's illness, she reluctantly performed mourning rites on his behalf. Within a month, she frequently felt dizzy and nearly fainted. One day, after contracting external pathogenic factors, she suddenly suffered from high swelling and pain in the heart and spleen regions, unable to tolerate touch, accompanied by incessant vomiting. Her six pulses were extremely minute and fine. I considered that although the pulse was deficient, the disease presentation was excess. Misinterpreting the principle that "all pain should not be treated with qi-tonifying herbs," they used Qingpi (Citri Reticulatae Pericarpium Viride), Xiangfu (Cyperi Rhizoma), and Wuzhuyu (Evodiae Fructus), which cured her. Subsequently, she contracted malaria and miscarried again. She was given qi-regulating and blood-moving medicines. Although the disease subsided, her yuan qi (original qi) became depleted. Further administration of ginseng tonics was ineffective. Her six pulses were thread-like and nearly absent. I reasoned that only Fuzi (Aconiti Lateralis Radix Praeparata) could save her, and only Liweng (Xue Ji) could prescribe it appropriately. I invited Liweng to diagnose. He stated: These were errors caused by qi-regulating agents damaging true yuan qi. He consecutively administered Renshen (Ginseng Radix et Rhizoma), Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuzi (Aconiti Lateralis Radix Praeparata), Jiang (Zingiberis Rhizoma), and Guizhi (Cinnamomi Ramulus) for six doses, interspersed with Bawei Wan (Eight Ingredients Pill). Within five days, her sleep and appetite improved, and her six pulses fully recovered. Liweng said: When she experienced heart and spleen pain, she should have taken these medicines immediately, and the malaria would not have occurred. Both the mother-in-law and daughter-in-law were reborn by Liweng. I dare to recount this miraculous achievement, attaching it to the end of this section, as a warning for those newly learning herb properties. Chen Sun, a student, bows and records this carefully.