即子悬
〔薛〕胎上逼心之证，若气逆胎上，用紫苏饮。饮食不甘，兼以四君子。若内热晡
热，兼以逍遥散。若胃火所致，用四君、黄芩、枳壳、柴、栀。若脾郁所致，用归脾汤
加柴、栀、枳壳。一妊妇每因恚怒，其胎上逼，左关脉弦洪，乃肝火内动。用小柴胡
加茯苓、枳壳、山栀而愈。但体倦不食，用六君子调养脾土，加柴胡、枳壳，调和肝气
乃瘥。一妊妇胎上逼，胸满嗳气，饮食少思，此脾气郁滞，用紫苏饮顿安。又用四君
子加枳壳、柴胡、山栀而瘥。程文彬治孕妇七个月，胸膈饱闷，气喘，忽吐出一物如
小肠寸许，举家惊疑其胎烂。程至，诊得寸口脉洪滑，知其气盛血少，胎气凑上，中焦
蓄有湿热，湿生痰，知所吐之物，乃痰结聚，病名子悬。以紫苏饮加芩、连、贝母，十剂获痊。
本事方紫苏饮 治妊娠胎气不和，怀胎近上，胀满疼痛，谓之子悬。兼治临产惊恐，
气结连日不下。（一方无芎，名七宝散。）
紫苏茎叶（一两） 大腹皮 人参 川芎 陈皮 白芍药（各半两） 当归（七钱半）
甘草（二钱半）
上细锉，分作三服，每服用水一盏半，生姜四片，葱白七寸，煎至七分，去渣空心服。
曾有一妇，累日产不下，服遍催生药不验。予曰∶此必坐草太早，心怀一点惧气
结而不行，然非不顺也。《素问》云∶恐则气下。盖恐则精神怯，怯则上焦闭，闭则气还，
还则下焦胀，气乃不行矣。得此药一服便产。及妇人六七月子悬者，予用此数数有验，不
十服胎便近下。
陈良甫治一妇有孕七个月，远归，忽然胎上冲心而痛，坐卧不安，两医治之无效，遂
说胎已死矣，用蓖麻子研烂加麝香调，贴脐中以下之，命在垂亡。召陈诊视，两尺脉绝，
他脉平和。陈问二医，作何证治之？答曰∶死胎也。陈曰∶何以知之？曰∶两尺脉沉绝，以
此知之。陈曰∶此说出何经？二医无答。陈曰，此子悬也。若是胎死，却有辨处，面赤
舌青，子死母活。面青舌赤，吐沫，母死子活。唇口俱青，母子俱死。今面不赤，口不
青，其子未死，是胎上逼心，宜以紫苏饮子治之。至十服，而胎近下矣。
当归汤 治妊娠胎动，荡心闷绝，烦躁口干，横生倒产，上冲下筑，迷闷，唇口青
黑，手足厥冷。产科名保安散。一方无甘草，有川芎。浓朴。《产宝方》有川芎。
当归 阿胶（炒） 甘草（各一两） 人参（一两半） 连根葱白（一根）
上细锉，水二升，煎四味至升半，去滓下葱再煎，减三合，温服。一剂分为二三服。
大圣散 治妊娠忪悸，睡梦多惊，心腹胀满，连脐急痛，胎上逼。（见惊悸）
治胎上逼心烦闷方。又治妊娠六七月以后，胎动困笃。用葱白二七茎，浓煮汁饮之。
若胎未死即安，已死即出，未效再服。（娄全善云∶此方神妙，脉浮滑者宜之。《本草》云∶葱白通
阳气安胎。）
《秘录》治胎动上逼心痛。取艾叶如鸡子大，以头醋四升，煎取二升，分温服。又
治胎上逼心，热痛下血。神曲半斤，捣碎和熟水绞取汁三盅，无进温服，止。
治妊娠遍身痛，或冲心欲死，不能饮食。
白术（五两） 黄芩（二两） 芍药（四两）
上水六升，煮取二升半，分作三服。缘胎有水致痛，兼易产。
文仲、葛氏疗妊娠卒胎上迫心痛方 取弩弦急带之，立愈。
胶艾汤（见血崩。）保生丸（大法。）
Ji Zixuan (Also known as Zixuan).
Xue Ji's discussion: The syndrome of Tai Shang Bi Xin (fetus pressing upward against the heart/chest), if caused by rebellious Qi leading to fetal Qi rushing upward, use Zisu Yin. If accompanied by lack of taste in food, combine with Sijunzi Tang. If there is internal heat and afternoon fever, combine with Xiaoyao San. If caused by Stomach Fire, use Sijunzi Tang plus Huangqin, Zhike, Chaihu, Shanzhi. If caused by Spleen Depression, use Guipi Tang plus Chaihu, Shanzhi, Zhike. One pregnant woman, every time due to anger, had her fetus pressing upward; her left Guan pulse was wiry and surging, indicating Liver Fire stirring internally. She was cured using Xiao Chaihu Tang plus Fuling, Zhike, Shanzhi. However, due to body fatigue and loss of appetite, she used Liujunzi Tang to nourish the Spleen Earth, plus Chaihu and Zhike to harmonize Liver Qi, before recovering. Another pregnant woman had fetal pressure upward, chest fullness and belching, reduced diet and lack of desire; this was Spleen Qi stagnation, treated with Zisu Yin for immediate relief. Then recovered after using Sijunzi Tang plus Zhike, Chaihu, Shanzhi. Cheng Wenbin treated a pregnant woman at seven months, who had chest and diaphragm fullness and oppression, panting, and suddenly vomited an object about one cun long like a small intestine segment; the whole family was terrified, suspecting fetal decay. Upon arrival, Cheng diagnosed the Cun Kou pulse as surging and slippery, knowing that Qi was abundant but Blood deficient, fetal Qi gathered upward, and damp-heat accumulated in the Middle Jiao, generating phlegm from dampness. He identified the vomited object as condensed phlegm, naming the disease Zixuan. He prescribed Zisu Yin plus Huangqin, Lian, Beimu, achieving recovery in ten doses.
Ben Shi Fang Zisu Yin: Treats pregnancy where fetal Qi is disharmonious, the fetus positioned high, causing distension and pain, termed Zixuan. Also treats fright during labor, where Qi knots and delivery does not proceed for days. (One formula without Xiong, named Qibao San.)
Zisu Jingye (Perilla Stem and Leaf) (1 liang) Dafupi, Renshen, Chuanxiong, Chenpi, Baishao (each 0.5 liang), Danggui (0.75 liang), Gancao (0.25 liang).
Finely chop the above, divide into three doses. Each dose uses 1.5 cups of water, 4 slices of Shengjiang, and 7 cun of Congbai. Decoct until 70% remains, remove dregs, and take on an empty stomach.
Once, a woman repeatedly failed to deliver despite trying all parturition-inducing medicines. I said: This must be because she sat too early, harboring a bit of fear Qi that knotted and did not move, yet it is not obstructed delivery. The *Suwen* states: Fear causes Qi to sink. Generally, fear makes the spirit timid; timidity causes the Upper Jiao to close; closure causes Qi to return; returning causes Lower Jiao distension, and Qi fails to move. With one dose of this medicine, she delivered. For women at six or seven months experiencing Zixuan, I have frequently used this formula with verified efficacy; within ten doses, the fetus moves downward.
Chen Liangfu treated a pregnant woman at seven months who, after returning from a long journey, suddenly had fetal Qi rushing up to the heart causing pain, restlessness in sitting and lying. Two doctors failed to treat her, claiming the fetus was dead, and applied castor paste mixed with musk to the navel to force descent, leaving her life in peril. Chen was summoned. Her Chi pulses were absent, while other pulses were peaceful. Chen asked the two doctors how they diagnosed it. They replied: Dead fetus. Chen asked: How do you know? They replied: The Chi pulses are deep and absent, thus we know. Chen asked: Which classic text does this statement come from? The two doctors had no answer. Chen said: This is Zixuan. If the fetus were dead, there are distinguishing signs: red face and blue tongue indicate dead fetus and living mother; blue face and red tongue with foaming indicate dead mother and living fetus; blue lips and mouth indicate both die. Now her face is not red, lips not blue, so the fetus is alive. It is Tai Shang Bi Xin, suitable for treatment with Zisu Yin Zi. After ten doses, the fetus moved downward.
Danggui Tang: Treats pregnancy fetal movement, distressing the heart with suffocation, irritability, dry mouth, transverse presentation, breech birth, upward rush and downward pounding, confusion, cyanotic lips and mouth, cold extremities. In obstetrics, known as Bao'an San. One formula lacks Gancao, has Chuanxiong, Houpo. *Chanbao Fang* has Chuanxiong.
Danggui, Ejiao (stir-fried), Gancao (each 1 liang), Renshen (1.5 liang), Lian gen Congbai (one stalk).
Finely chop, add 2 sheng of water, decoct the four ingredients until 1.5 sheng remains, remove dregs, add Congbai, decoct again until reduced by 3 he, take warm. Divide one dose into two or three servings.
Dasheng San: Treats pregnancy palpitations, frequent fright in dreams, heart and abdominal distension, urgent pain extending to the umbilicus, fetal pressure upward. (See Jingji chapter).
Formula for treating fetal pressure upward causing heart vexation and stuffiness. Also treats fetal movement becoming severe after six or seven months of pregnancy. Use fourteen stalks of Congbai, decoct strongly and drink the juice. If the fetus is not dead, it calms; if dead, it expels. Repeat if ineffective. (Lou Quanshan says: This formula is miraculous, suitable for floating and slippery pulses. *Bencao* states: Congbai unblocks Yang Qi and calms the fetus.)
*Milu* treats fetal movement pressing upward causing heart pain. Take Aiye the size of a chicken egg, decoct in 4 sheng of first vinegar until 2 sheng remains, take warm in divided doses. Also treats fetal pressure upward with heat, pain, and bleeding. Take Shenqu 0.5 jin, crush, mix with cooked water, squeeze out 3 zhong of juice, take warm without advancing food, stop when effective.
Treats pregnancy generalized body pain, or rushing to the heart causing death-like sensation, inability to eat.
Baizhu (5 liang), Huangqin (2 liang), Shaoyao (4 liang).
Add 6 sheng of water, decoct until 2.5 sheng remains, divide into three doses. Because the fetus has water causing pain, it also facilitates easy delivery.
Wenzhong and Ge Shi treat sudden fetal pressure upward causing heart pain in pregnancy. Tie a tight crossbow string around oneself, immediate cure.
Jiao'ai Tang (See Bengang chapter). Baosheng Wan (Da Fa chapter).