答曰。四时有不正之气。如春夏亦有寒温时。秋冬亦有暄暑时。是故一岁之中。病无长幼。
率相似者。此则时行之气。俗谓之天行。若春温暖而清气折之。则责邪在肝。夏应暑而寒气
折之。则责邪在心。秋应凉而反大热折之。则责邪在肺。冬应寒而反大温折之。则责邪在肾
。仲景云。冬温之毒。与伤寒大异。盖伤寒者。因冒寒而作也。其候发热恶寒。头疼腰脊痛
。其脉浮紧。无汗者可发汗。宜服麻黄汤。脉浮缓而有汗者。可解肌。宜服桂枝汤。切详麻
黄桂枝皆能堕胎。以此言之。则妊娠伤寒。常人之治法大不相侔也。
十全散。即败毒散。又名人参羌活散。治伤寒瘟疫。
人参 白茯苓 羌活 独活 甘草(炙) 川芎 枳壳 柴胡 白术 桔梗(各等分)
上 咀。每服三钱。水盏半。姜五片。薄荷七叶。煎七分。热服。如头疼发热连二服。汗出
即愈。
阿胶散。治妊娠妇伤寒安胎。
阿胶 桑寄生 吴白术 人参(各等分)
上为细末。每服二钱。煎糯米饮调下。不拘时。
罩胎散
卷荷叶(一两焙干) 蚌粉花
上为细末。每服二钱。入蜜少许。新汲水调下。食前服。
严氏第十问。妊娠妇外感风寒。浑身壮热。眼晕头眩者何。曰。盖因风寒客于皮肤。伤于营
卫。或洗项背。或当风取凉。致令头目昏痛。憎寒发热。甚致心胸烦闷。大抵产前二命。所
以不可轻易妄投汤剂。感冒之初。止宜进芎苏饮以发散表邪。其病自愈。
芎苏饮。
川芎 紫苏叶 白芍药 白术 麦门冬 陈皮 干姜(各一两) 甘草(炙半两)
上 咀。每服四钱。水盏半。姜三片。葱白一寸。煎八分。温服不拘时。
Answer: The four seasons possess abnormal Qi (vital energy), such as cold or warm conditions occurring during spring and summer, and warm or hot conditions occurring during autumn and winter. Therefore, throughout the year, regardless of age, patients often present with similar symptoms; this is referred to as the "seasonal epidemic Qi" (Shi Xing Zhi Qi), commonly known as "Tian Xing" (Heavenly Transmission). If the clear/cold pathogen overcomes the expected warmth of spring, the pathology is attributed to the Liver; if cold pathogen overcomes the expected heat of summer, the pathology is attributed to the Heart; if excessive heat overcomes the expected coolness of autumn, the pathology is attributed to the Lung; if excessive warmth overcomes the expected cold of winter, the pathology is attributed to the Kidney. Zhang Zhongjing stated: The toxin of Winter Warmth differs significantly from Cold Damage (Shang Han). Cold Damage arises from exposure to cold pathogens. Its manifestations include fever, aversion to cold, headache, pain in the waist and spine, a floating-tight pulse, and absence of sweating. For those without sweat, diaphoresis (sweating therapy) may be induced, and Mahuang Tang (Ephedra Decoction) is appropriate. For those with a floating-slow pulse and presence of sweat, muscle-releasing therapy may be applied, and Guizhi Tang (Cinnamon Twig Decoction) is appropriate. Carefully examined, both Mahuang (Ephedrae Herba) and Guizhi (Cinnamomi Ramulus) have the potential to cause abortion. Thus, it can be said that the treatment for Cold Damage during pregnancy differs greatly from that of ordinary individuals.
Shiquan San (Ten Complete Powder), also known as Baidu San (Defeat Poison Powder) or Renshen Qianghuo San (Ginseng and Notopterygium Powder), treats Cold Damage and plague.
Ingredients: Renshen (Ginseng Radix et Rhizoma), Baifuling (Poria), Qianghuo (Notopterygii Rhizoma et Radix), Duhuo (Angelicae Pubescentis Radix), Gancao (Glycyrrhizae Radix et Rhizoma, prepared), Chuanxiong (Ligustici Chuanxiong Rhizoma), Zhiqiao (Aurantii Fructus), Chaihu (Bupleuri Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Jiegeng (Platycodonis Radix) (all in equal parts).
Preparation and Administration: Cut the herbs into small pieces. Take 3 qian per dose, add 1.5 cups of water, 5 slices of ginger, and 7 leaves of bohe (Menthae Haplocalycis Herba), decoct until reduced to 0.7 cup, and take hot. If headache and fever persist, take two doses consecutively; recovery occurs upon sweating.
Ejiao San (Donkey-hide Gelatin Powder) treats Cold Damage in pregnant women to calm the fetus.
Ingredients: Ejiao (Colla Corii Asini), Sangjisheng (Taxilli Cacuminis), Wu Baizhu (Atractylodis Macrocephalae Rhizoma processed with bran/wine), Renshen (Ginseng Radix et Rhizoma) (all in equal parts).
Preparation and Administration: Grind into fine powder. Take 2 qian per dose, mix with glutinous rice decoction, and ingest at any time.
Zao Tai San (Fetal-Covering Powder)
Ingredients: Juan Heye (Nelumbinis Folium, rolled and dried, 1 liang), Bangfenhua (Concha Tridacnae Pulvis).
Preparation and Administration: Grind into fine powder. Take 2 qian per dose, add a little honey, mix with fresh drawn water, and take before meals.
Question 10 by Yan Shi: Why do pregnant women suffering from external contraction of wind-cold experience high fever, dizziness, and vertigo? Answer: This is due to wind-cold lodging in the skin and damaging Ying (Nutritive) and Wei (Defensive) Qi. It may result from washing the neck and back or cooling off in the wind, leading to dizziness and head pain, aversion to cold with fever, and even chest and heart irritability. Generally speaking, since there are two lives before birth (mother and fetus), one must not casually administer herbal decoctions. At the initial stage of a cold, only Xiongsu Yin (Ligusticum and Perilla Drink) should be taken to disperse exterior pathogens, after which the illness will resolve spontaneously.
Xiongsu Yin (Ligusticum and Perilla Drink)
Ingredients: Chuanxiong (Ligustici Chuanxiong Rhizoma), Zi Su Ye (Perillae Folium), Baishaoyao (Paeoniae Radix Alba), Baizhu (Atractylodis Macrocephalae Rhizoma), Maimendong (Ophiopogonis Tuber), Chenpi (Citri Reticulatae Pericarpium), Jiangjiang (Zingiberis Rhizoma, dried), Gancao (Glycyrrhizae Radix et Rhizoma, prepared, half liang) (the first seven ingredients each 1 liang).
Preparation and Administration: Cut the herbs into small pieces. Take 4 qian per dose, add 1.5 cups of water, 3 slices of ginger, and 1 cun of scallion white (Congbai), decoct until reduced to 0.8 cup, and take warm at any time.