答曰。阳施则别。阳者气也。阴化则搏。阴者血也。二情交畅。血气和调。故令
有子也。经云。肝主藏血。故一月谓之血凝。阴气方始凝结。足厥阴肝经养之。肝与胆合。
二月为之胚。兆未成器。犹之胚也。足少阴胆经养之。三月阳神为魂。手心主胞经络养之。
且经者常也。天真之气。与之流通。故三旬一见。今既三月不行。所以谓之居经也。
白术散。调补冲任。扶养胎气。治妊娠宿有风冷。胎痿不长。或失于调理。动伤胎气。多致
损堕。怀妊常服。壮气益血。保护胎藏。
牡蛎(三分) 白术(四分) 芎 (四分) 蜀椒(去目及闭口者炒出汗三分)
上为细末。每服二钱。温酒空心调服。
内补当归丸
熟地(酒浸洗九蒸九晒焙干二两) 当归(去芦洗切焙微炒一两)
上为细末。蜜丸桐子大。每服五十丸。温酒下。予尝观许学士论。枳壳散四物汤。内补当归
丸。此三方皆载之。在人用之何如耳。大率妊娠。惟在抑阳助阴。素问云。阴搏阳别。为之
有子。盖关前为阳。关后为阴。尺中之脉。按之搏手而不绝者。妊子也。妇人平居。阳气微
盛无害。及其妊子。
则方闭经。遂以养胎。若阳盛搏之。则经脉妄行。胎乃不固。素问所谓阴虚阳搏谓之崩也。
抑阳助阴之方甚多。然胎前药唯恶群队。若阴阳交杂。别生他病。惟是枳壳散所以抑阳。四
物汤所以助阴。故尔。枳壳散差寒。若单服之。恐有胎寒腹痛之病。以内补丸佐之。则阳不
致强。阴不致弱。阴阳调和。有益胎嗣。此前人未尝论及也。
四物汤
当归 熟地 白芍 川芎(各等分)
上 咀每服四钱。水二盏。煎八分。去滓温服。不拘时。
枳壳散
枳壳(二两) 甘草(一两)
上为细末。每服二钱。百沸汤点服。空心食前三服。
Answer: Yang qi (vital energy) exerts its function and separates; Yang refers to Qi. Yin blood transforms and condenses; Yin refers to Blood. When the emotions of Yin and Yang interact harmoniously, and Qi and Blood are balanced, conception occurs. The classics state: "The Liver stores Blood." Therefore, the first month of pregnancy is called "Blood Coagulation" (Xue Ning), as Yin Qi begins to condense at this stage, nourished by the Foot-Jueyin Liver Meridian. The Liver and Gallbladder are interiorly-exteriorly related. In the second month, the embryo forms; although the form is not yet complete, it resembles an embryo, nourished by the Foot-Shaoyang Gallbladder Meridian. In the third month, the Yang Spirit becomes the Hun (Ethereal Soul), nourished by the Hand-Jueyin Pericardium Meridian.
The term "Jing" (Menstruation) implies regularity; Tianzhen Qi (Innate Vital Energy) circulates with it, hence menstruation typically occurs every thirty days. Now, since menstruation has ceased for three months, it is termed "Ju Jing" (Resident Menstruation).
Baizhu San (Atractylodes Macrocephala Powder): Regulates and tonifies the Chong and Ren vessels, nurturing fetal Qi. It treats conditions in pregnancy where there is pre-existing wind-cold pathogen, leading to fetal wasting or stunted growth, or when improper care injures fetal Qi, often resulting in miscarriage. Regular use during pregnancy strengthens Qi and benefits Blood, protecting the fetal organ.
Ingredients: Oyster Shell (Muli, 3 fen), Atractylodes Macrocephala Rhizome (Baizhu, 4 fen), Szechuan Lovage Rhizome (Chuanxiong, 4 fen), Sichuan Pepper (Shujiao, remove eyes and closed-mouth ones, stir-fry until oil appears, 3 fen).
Grind all ingredients into a fine powder. Take 2 qian per dose, mixed with warm wine on an empty stomach.
Neibu Danggui Wan (Internal-Nourishing Angelica Pill)
Ingredients: Prepared Rehmannia Root (Shudi, soaked in wine, washed, steamed nine times, dried nine times, then baked dry, 2 liang), Angelica Sinensis Root (Danggui, remove radicle, wash, slice, bake dry and lightly stir-fry, 1 liang).
Grind into a fine powder, mix with honey to make pills the size of tung tree seeds. Take 50 pills per dose, swallowed with warm wine.
I have observed Scholar Xu's discussion regarding Zhike San (Bitter Orange Powder), Siwu Tang (Four Substances Decoction), and Neibu Danggui Wan. These three formulas are recorded here; the key lies in how they are applied. Generally, in pregnancy, the principle is to suppress Yang and assist Yin. The *Suwen* states: "When Yin pulse beats distinctly while Yang is separate, it indicates pregnancy." Broadly speaking, the pulse anterior to the Guan position belongs to Yang, and posterior to Guan belongs to Yin. If the Chi position pulse feels forceful against the fingers without ceasing, it indicates pregnancy. For women in their normal state, slight deficiency or excess of Yang Qi causes no harm. However, upon pregnancy, menstruation ceases, and the focus shifts to nourishing the fetus. If Yang Qi is excessive and clashes with Yin, the meridians may bleed erratically, and the fetus will become unstable. This corresponds to what the *Suwen* calls: "Yin deficiency with Yang pounding leads to metrorrhagia" (Beng).
There are many formulas to suppress Yang and assist Yin. However, medications used during pregnancy should avoid chaotic combinations. If Yin and Yang herbs are mixed indiscriminately, other diseases may arise. Zhike San is used to suppress Yang, while Siwu Tang is used to assist Yin. Zhike San is slightly cold in nature; if taken alone, it may cause fetal coldness and abdominal pain. Therefore, Neibu Danggui Wan is used as an adjunct, ensuring Yang does not become too strong and Yin does not become too weak, achieving Yin-Yang harmony which benefits the offspring. This point was previously unaddressed by predecessors.
Siwu Tang (Four Substances Decoction)
Ingredients: Angelica Sinensis Root (Danggui), Prepared Rehmannia Root (Shudi), White Peony Root (Baishao), Szechuan Lovage Rhizome (Chuanxiong) (equal parts).
Cut the herbs. Take 4 qian per dose, add two zhan of water, decoct until reduced to eight-tenths, strain, and take warm. Time is not restricted.
Zhike San (Bitter Orange Powder)
Ingredients: Bitter Orange Fruit (Zhike, 2 liang), Licorice Root (Gancao, 1 liang).
Grind into a fine powder. Take 2 qian per dose, mixed with boiling water. Take three times before meals and on an empty stomach.