妊娠胎气伤动者,凡跌扑、怒气、虚弱、劳倦、药食、误犯、房室不慎,皆能致之。若因母病而胎动,
但治其母,若因胎动而母病,但安其胎。轻者转动不安,或微见血,察其不甚,速宜安之,用前安胎及卒然
下血等法。若腹痛血多,腰酸下坠,势有难留者,无如决津煎、五物煎助其血而落之,最为妥当。
决津煎(见经期腹痛)
五物煎(见血寒论外方)
若其势甚而舌青面赤,胀满呕恶或冷气上逼者,儿已死矣。若面青吐沫舌赤,是母死也。若面舌唇
吻俱青,口中沫出,是母子俱死也。若胎已死,当速去其胎以救其母。气血虚者,惟用决津煎最妙。如不应,
而胀痛上
逼,势不容缓者,急用平胃散一两,酒水各半,投朴硝五钱,热服之。或用朴硝一两,以童便调服,则逐而
下矣。下后随证调补之。如无胀急,则但用决津煎加朴硝,则死胎自下。
平胃散(见安胎)
凡气血衰弱,无以滋养其胎,或母有弱病,度其终
不能成者,莫若下之,以免他患。宜桂心散,或用下胎短剧方。
《良方》桂心散(见《妇人规古方》)治妊娠因病胎不能安者,可下之。
桂心 栝蒌 牛膝 瞿麦(各五分或一钱) 当归(一钱或二、三钱)
上,水煎。
下胎短剧方(见《妇人规古方》)
用麦 一升,擂碎,水二升,煮一升,服之即下,神效。按∶麦 能损气破血如此,故凡脾胃虚弱及饮食
不化者不宜用,明矣。又方∶用牛膝一两,酒一钟,煎七分,作二服,即下。
When the fetal qi is injured and agitated during pregnancy, causes such as falls or blows, anger, physical weakness, fatigue, improper medication or diet, violation of taboos, and imprudent sexual intercourse can all lead to this condition. If the fetal agitation is caused by the mother's illness, treat only the mother; if the mother's illness is caused by fetal agitation, stabilize only the fetus. In mild cases characterized by restlessness or slight bleeding, observe that the condition is not severe and promptly apply stabilization methods, such as those for stabilizing the fetus and sudden bleeding mentioned previously. If there is abdominal pain with heavy bleeding, soreness and weakness in the lower back with a bearing-down sensation, indicating that the fetus cannot be retained, Juejin Decoction (Juejin Jian) and Wuwu Decoction (Wuwu Jian) are most appropriate to assist blood flow and induce expulsion.
Juejin Decoction (See section on Abdominal Pain during Menstruation)
Wuwu Decoction (See External Formulas in the Discussion on Blood-Cold)
If the condition is severe, presenting with a bluish tongue, red face, abdominal distension and fullness, vomiting, nausea, or upward rushing of cold qi, the fetus has died. If the face is blue, there is foaming at the mouth, and the tongue is red, the mother has died. If the face, tongue, lips, and corners of the mouth are all blue, and foam issues from the mouth, both mother and fetus have died. If the fetus has died, it must be expelled quickly to save the mother. For those with deficiency of Qi and Blood, using Juejin Decoction is best. If ineffective, and distension/pain rushes upward requiring urgent intervention, administer Pingwei San (Pingwei Powder) 1 liang, mixed with half wine and half water, adding Puxiao (Natrii Sulfas, 朴硝) 5 qian, taken hot. Alternatively, use Puxiao 1 liang, mixed with urine from an uncircumcised boy (Tongbian, 童便), which will expel the contents downward. After expulsion, tonify according to the syndrome. If there is no urgency or distension, simply use Juejin Decoction added with Puxiao, and the dead fetus will pass naturally.
Pingwei San (See Stabilizing the Fetus section)
In cases where Qi and Blood are weak and unable to nourish the fetus, or where the mother suffers from chronic weakness such that conception cannot ultimately succeed, it is better to induce abortion to avoid further complications. Guixin San (Guixin Powder) or Xia Tai Duanju Fang (Xia Tai Duanju Formula) should be used.
*Liufang* Guixin San (See *Furen Gui Ancient Formulas*) treats cases where the fetus cannot be stabilized due to illness during pregnancy; inducing abortion is appropriate.
Guixin (Cinnamomi Cortex, 桂心), Gualou (Trichosanthis Fructus, 栝蒌), Niuxi (Achyranthis Bidentatae Radix, 牛膝), Qumai (Dianthi Herba, 瞿麦) (each 5 fen or 1 qian), Danggui (Angelicae Sinensis Radix, 当归) (1 qian or 2-3 qian).
Decoct with water.
Xia Tai Duanju Fang (See *Furen Gui Ancient Formulas*)
Use Maiya (Hordei Fructus Germinatus, 麦芽) 1 sheng, crushed, boiled in 2 sheng of water until reduced to 1 sheng. Taking this will cause expulsion immediately, with miraculous effect. Note: Maiya damages Qi and breaks Blood so severely that it is clearly unsuitable for those with weak Spleen-Stomach or indigestion. Another formula: Use Niuxi 1 liang, boil in one zhong of wine until reduced to seven-tenths, divide into two doses, which will cause expulsion.