女。寸关尺部皆相应。一男一女分形症。有时子死母身存。或即母亡存子命。往来三部通流利。滑数相参皆替替。阴实
阳虚脉得明。遍满胸堂皆逆气。左手太阳浮大男。右手太阴沉细女。诸阳为男诸阴女。指下分明常记取。三部沉正等无
疑。尺内不止真胎妇。夫乘妻兮纵气雾。妻乘夫兮横气助。子乘母兮逆气参。母乘子兮顺气护。小儿日足胎成聚。身热
脉乱无所苦。汗出不食吐逆时。精神结备其中住。滑疾不散三月胎。但疾不散五月母。弦紧牢强滑利安。沉细而微归泉
路。
恶阻 窦汉卿曰。恶阻心下愦闷。吐逆不食。恶闻食气。头眩。四肢百节烦疼。多卧少起。旋复半夏汤。病醋
心。胸中冷。腹痛吐逆。不喜饮。人参半夏汤。胃虚气逆。呕吐不食。缩砂散。戴思恭曰。恶阻俗谓之病儿。盖其人宿
有痰饮。血壅遏而不行。故饮随气上。停滞肝经。肝之味酸。则必喜酸物。金能克木。以辛胜之。小半夏茯苓汤。甚者
二陈汤。有服热药攻膈。闷热成疾。宜荷叶散。李 曰。或大吐。或时吐清水。恶闻食臭。由子宫经络络于胃口。故逢
食气。引动精气冲上。必食吐尽而后精气乃安。亦有误交合而子宫秽甚者。过百日则愈。
胎动不安 陈自明曰。妊娠将养如法。则气血调和。胎得其所。而产亦易。否则胎动气逆。临产亦难。至危矣。
此谓胎气上逼也。又曰。有惊胎者。怀妊将满。胎神已具。坠扑伤胎。甚至下血不省。若欲验其子母安否。当参胎动不
安方论治之。若钩藤汤、紫苏饮、归脾汤、佛手散。随症选用。又曰。胎动不安。重者必致伤坠。若面赤舌青。是儿死
也。面青舌赤。是母死也。唇口色青。两边沫出。子母俱死也。当察而治之。严用和曰。两三月胎动。由子宫久虚。易
令堕胎。宜预服杜仲丸以养胎。若胎动腹痛。易变漏胎。宜如圣汤。又曰心神忡悸。睡中多惊。两胁膨胀。腹满连脐急
痛。
坐卧不宁。气急逼迫。皆由气闷。或为喧呼。至令胎惊。筋骨伤痛。四肢不安。急服大圣散。朱震亨曰。产妇因火动胎。
逆上作喘急者。急用条芩、香附之类为末服之。又曰。漏胎属气虚有热。四物加阿胶、白术、条芩、香附、砂仁、糯米。
李曰。胎动因七情气逆。心腹胀满疼痛。紫苏饮。因外感发热。头痛呕逆。胸胁胀满。安胎饮加柴胡、大腹皮。气血
虚。安胎饮倍参、术。下血者。胶艾芎归汤加砂仁、秦艽、卷柏、杜仲。下血腹痛难忍。或下黄汁如漆如豆汁者。用野
苎根金银花根各五钱酒煎。下血产门痛。黄连末一钱酒下。胎动腹痛。由于寒。理中汤加砂仁、香附。由于热。黄芩汤。
血虚腹痛。四物汤。或平胃散加盐煎汤吞二宜丸。气虚痛。四君子汤加白芍、当归。气实心腹胀痛。香附、枳壳等分为
末白汤下。胎动心痛。因寒。艾叶、小茴、川楝等分煎。因热。二陈去半夏加山栀、黄芩。又曰。胎动。通用古芩术汤
加阿胶。风邪加姜豉。寒加葱白。热加花粉。寒热加柴胡。项强加葱白。温热腹痛加白芍。腹胀加浓朴。下血加艾、地
榆。腰痛加杜仲。惊悸加黄连。烦渴加麦冬、乌梅。思虑太过加茯神。痰呕加旋复花、贝母。或酌用半夏曲。劳役加黄
。气喘去术加香附。便燥加麻仁。素惯难产加枳壳、苏叶。素惯堕胎加杜仲。素血虚加芎、归。此安胎之圣药也。凡
卒有所下。急则一日三五服。缓则五日十日一服。常服安胎易产。所生男女。又无胎毒。
胎漏 李 曰。心腹痛而下血者。为胎动不安。不痛而下血者。为胎漏。二者所由分也。大抵漏胎由热者。下
血必多。内热作渴者。四物加芩、连、白术、益母草。血黑成片。三补丸加香附、白芍。血虚来少。古胶艾汤。或合四
物汤。气虚。四君子汤加黄芩、阿胶。因劳役感寒。致气虚下血欲坠。芎归补中汤。或下血如月信。以致胞干子母俱损
者。用熟地炒干姜各二钱为末米饮服。惟犯房下血者。乃真漏胎也。八物汤加胶艾救之。
妊娠伤寒 朱肱曰。妊妇伤寒。仲景无治法。用药宜有避忌。不可与寻常妇人一概治。伤寒安胎。宜阿胶散、
白术散。憎寒壮热。当发汗。葱白汤。或中时行。洒淅作寒。振栗而悸。或加哕。苏术汤。头痛。嘿嘿不欲饮食。胁下
痛呕逆。痰气。黄龙汤。头目旋疼。壮热心躁。旋复花汤。壮热头疼。呕逆不思饮食。胎不安。麦门冬汤。妊妇发斑变
黑色。栀子大青汤。壮热头疼。心烦呕吐。不下食。芦根汤。伤寒头疼壮热。栀子五物汤。头疼肢节疼。壮热。前胡七
物汤。四日至六日以来。加心腹胀。上气渴不止。食饮不多。腰疼体重。枳实散。妊七月伤寒壮热。赤斑变黑溺血。升
麻六物汤。发热烦闷。葛根一物汤。热病。葱白豉汤。伤暑头痛恶寒。身热躁闷。四肢疼痛。背项拘急。唇口干燥。柴
胡石膏汤。万全曰。妊娠伤寒。专以清热安胎为主。或汗或下。各随脏腑表里所见脉症主治。勿犯胎气。故在表发汗。
香苏散。和解半表里。黄龙汤。在里宜下。三黄解毒汤。此吾家传之秘。活人甚多。陈士铎曰。妊娠临月。忽感少阴经
风邪。恶寒蜷卧手足冷者。不治。少阴肾也。无论传经至少阴。与直中少阴。多不能治。盖少阴肾经。宜温不宜寒。今
风寒入之。则命门火微。而肾宫无非寒气。势必子宫亦寒。手足冷者。脾胃寒极之兆也。其死必矣。幸而胎未下。急以
散
寒救胎汤温之。人参一两。白术二两。肉桂、干姜、炙草各一钱。一剂。不恶寒二剂。手足温不蜷卧。三剂全愈。又妊
娠临月。感少阴经症。恶心腹痛手足厥逆者。不治。亦以寒入肾宫。上侵于心。不独下侵于腹已也。较上症更重。夫肾
水滋心。何以反至克心。盖肾之真水。心借以养。肾之邪水。心得之亡。今肾感寒邪。挟肾水而上凌于心。故心腹两相
作痛。手足一齐厥逆。至急至危。非驱少阴之邪不可。方用回阳救产汤。人参、当归各一两。肉桂、干姜、甘草各一钱。
白术五钱。此方妙在加当归。盖少阴之邪敢上侵于心者。欺心中之无血也。用当归补血。助人参之力以援心。则心中得
养。而姜、桂无非祛寒荡邪之品。况又有术草之利腰脐而调心腹。有不痛止逆除者乎。又妊妇临月。忽感少阴症者。急
以参术大剂温之。不应则死。此仲景之文也。似乎舍参术无可救矣。吾以为单用参术尚非万全。苟用参术不应。急加附
桂干姜。无不应也。今定一方。名全生救难汤。人参、白术各一两。附子一钱。甘草五分。凡感少阴经之邪者。用此神
效。
孕痈 陈自明曰。治孕痈。用乌药五钱水一钟。煎七分。入牛皮胶一两化服。或苡仁煮汁饮之。注曰。孕痈即
是腹内患痈。如前法不应。宜牡丹皮散、薏苡仁汤。王肯堂曰。大凡孕妇患肚痈。与寻常治法迥异。内用紫苏饮安胎。
勿轻与他药。若临月则儿与脓俱下。若尚远。则脓自大便出。若初起。只服药可消。若痈在外而其症为热。只可用中和
药收功。亦须审轻重用之。恐有误而难救也。万全曰。妊娠咽喉痛者。以东垣凉膈散加牛蒡子一钱。口舌生疮同治。乳
痈。托里解毒汤。背生疮毒。属阳明经也。本方去青皮。加升麻、葛根各一钱。胸前两颊生疮毒。此少阳经也。本方去
白芷。加柴胡、山栀、龙胆草。肩膊胁下生疮毒。太阴经也。本方去青皮。加陈皮、天冬、桔梗、桑皮各一钱。胯内阴
旁生疮毒。厥阴经也。本方去白芷。倍青皮。手足掌内生疮毒。少阴经也。本方去白芷、青皮、花粉。加黄连、黄柏、
木通各一钱。
产前白带 陈士铎曰。产前无白带也。有则难产之兆。即幸而顺生。产后亦有血晕之虞。方用黑豆三合。煎汤
二碗。先用一碗。入白果十个。红枣二十个。熟地一两。山萸、苡仁、山药各四钱。茯苓三钱。泽泻、丹皮各二钱。加
水二碗煎服。一剂或二剂。永不白带。亦通治妇人诸带。无不神效。
预防难产 万全曰。生育者。妇人之常。非病则不必药。惟素有难产之苦。不得不讲求其方。以为保生之计。
其束胎之方。用各不同。如枳壳瘦胎散。及用滑石方。气实多痰者宜之。达生散、束胎丸。气虚少有热者宜之。若不审
其虚实。不若不服之为善也。
双胎品胎鬼胎 朱震亨曰。精气有余。岐而分之。血因分而摄之。故成双胎。若夫男女同孕者。刚日阴时。柔
日阳时。阴阳混杂。不属左。不属右。受气于两岐之间者也。亦有三胎四胎者。犹是而已。张介宾曰。鬼胎者。岂真鬼
气袭人胞宫而成形乎。不过由本妇气质弱。或以邪思蓄注。血随气结而不散。或以冲任滞逆。脉道壅瘀不行。是固内因
之病。而必非外来之邪。盖即血 气瘕之类耳。当即以 瘕法治之。如狐魅异类之遇。则实有所受。而又非鬼胎之谓。
亦当于 瘕类求法治之。又曰。治鬼胎。当以补元为主。而继以去积之药。然补中兼行者。无如决津煎。欲去滞而不猛
峻者。无如通瘀煎。既加调补。而欲直攻其病。则夺命丹、回生丹。皆可酌用。或以当归、红花浓煎汤。送赤金豆亦妙。
胎前不治症 窦汉卿曰。产前咽喉痛。而脉浮者不治。面赤。而目睛上视者不治。面黑汗出者不治。心胸紧满。
吐痰不出者不治。自利不止者不治。气促。四肢厥冷者不治。心中怔忡。胸前红甚。舌卷面赤。目上视者不治。血气攻
心欲绝。面红者不治。自利而喘者不治。潮热往来。时发谵语者不治。胸腹胀急者不治。喉中或雷声。或呛食者不治。
逐月养胎方 徐之才曰。妊娠一月。名胎胚。饮食精熟酸美受御。宜食大麦。毋食腥辛。是谓才正。是月足厥
阴脉养胎。不可针灸其经。足厥阴属肝。主筋及血。一月之时。血行痞涩。不为力事。寝必安静。无令恐畏。是月阴阳
新合。为胎寒多。为痛热多。卒惊。举重腰痛。腹痛胞急。卒有所下。当预安之。宜服乌雌鸡汤。
乌雌鸡（一双治如食法） 茯苓 阿胶（各二两） 吴萸（一升） 麦冬（五合） 人参 白芍 白术（各三两）
甘草 生姜（各一两）
水二斗二升。煮鸡取汁六升。煎药取三升。入酒三升。并阿胶烊尽。取三升。每服一升。日三服。
妊娠二月。名始膏。毋食辛臊。居必静处。男子勿劳。百节皆痛。是为胎始。是月足少阳脉养胎。不可针灸其经。
少阳属胆主精。二月之时。儿精成于胞里。当慎护之。勿惊动也。是月始阴阳踞经。有寒多坏不成。有热即痿悴。中风
寒有所动摇。心满。脐下悬急。腰背强痛。卒有所下。乍寒乍热。宜艾叶汤。
艾叶 丹参 当归 麻黄（各二两） 生姜（六两） 人参 阿胶（各三两） 甘草（四钱） 大枣（十二枚）
水一斗。酒三升。煎三升。化胶。分三服。
妊娠三月。名始胞。此时未有定象。见物而化。欲生男者操弓矢。欲生女者弄珠玑。欲子美好数视璧玉。欲子贤良
端坐清虚。是谓外象而内感者也。是月手心主脉养胎。不可针灸其经。属心。母悲哀思虑惊动。是月为定形。有寒。大
便青。有热。小便难。不赤即黄。卒惊恐忧愁嗔怒喜仆。动干经脉腹满绕脐痛。或腰背痛。卒有所下。宜雄鸡汤。
雄鸡（一只治如食法） 白芍（四两） 黄芩 白术 生姜（各一两） 麦冬（五合） 大枣（十二枚） 甘草 茯
苓人参 阿胶（各二两）
水一斗三升。煮鸡取汁减半。入药煎半。入酒三升。并胶。煎取三升。分三服。一日尽。一方无姜、芩。有川芎、
当归各二两。
妊娠四月。始受水精以成血脉。食宜稻宜鱼。是谓盛血气以通耳目。而行经络。是月手少阳脉养胎。不可针灸其经。
内输三焦。此时儿六腑顺成。当静形体。和心志。节饮食。是月有寒。心下温温欲呕。胸膈满。不欲食。有热。小便难。
数数如淋状。脐下苦急。卒风寒。项颈强痛。寒热。或惊动。身躯腰背腹痛。往来有时。胎上迫胸。心烦不得安。卒有
所下。宜菊花汤。
菊花（五钱） 麦冬（一升） 大枣（十二枚） 人参（两半） 当归 甘草（各二两） 麻黄 阿胶（各三两） 半
夏（四两） 生姜（五两）
水八升。煮入胶。并酒三升。煎三升。分二服。当汗以粉扑之。护风寒四五日。
妊娠五月。始受火精以成其气。卧必晏起。沐浴浣衣。深其居处。浓其衣服。食稻粱。羹牛羊。和菜萸。调五味。
是谓养气以定五脏。是月足太阴脉养胎。不可针灸其经。属脾。此时儿四肢皆成。毋太饥饱。毋食干燥炙热。毋太劳倦。
是月有热。苦头眩心乱呕吐。有寒。苦腹满痛。小便数。卒有恐怖。四肢疼。寒热。胎动无常处。腹痛。闷顿欲仆。卒
有所下。宜阿胶汤。
阿胶（四两） 人参（一两） 生姜（六两） 当归 白芍 甘草 黄芩（各二两） 旋复花（二合） 吴萸（七
合） 麦冬（二升）
水九升。煎半入胶。并酒三升。煎三升半。分四服。日三夜一。先食服。
妊娠六月。始受金精以成其筋。身欲小劳毋逸。出游于野。食鸟兽肉。是谓变腠理纫筋以养其力。以坚背膂。是月
Background Information
Book: *Fuke Yuchi* (Jade Ruler of Gynecology)
Author: Shen Jin'ao
Dynasty: Qing
Chapter: Prenatal Care (Part 2/3)
Category: Women and Children
Text Translation
Women. The Cun, Guan, and Chi positions on both wrists all respond correspondingly. One can distinguish the signs for a male or female fetus. Sometimes the fetus dies while the mother survives. Or the mother may die while the fetus survives. If the pulse flows smoothly and freely through the three positions (Cun, Guan, Chi), with slippery (Hua) and rapid (Shu) pulses intermixed and distinct (Ti Ti), it indicates clear differentiation between Yin excess and Yang deficiency. If rebellious Qi fills the chest, it is a sign of pathology. On the left hand, if the Taiyang position is floating and large, it indicates a male fetus. On the right hand, if the Taiyin position is deep and fine, it indicates a female fetus. All Yang pulses indicate males; all Yin pulses indicate females. Remember this clearly under your fingers. If the three positions are deep and regular without doubt, but the Chi position does not stop, it confirms a true pregnant woman. When the husband overcomes the wife, it involves excessive Qi mist. When the wife overcomes the husband, it involves horizontal Qi assistance. When the child overcomes the mother, it involves rebellious Qi interference. When the mother overcomes the child, it involves protective compliant Qi. When the fetal period is complete, the fetus gathers form. If the body is hot and the pulse is chaotic, there is no suffering. During times of sweating, anorexia, and vomiting/rebellious Qi, spiritual essence gathers and resides within. A slippery and rapid pulse that does not scatter indicates a three-month fetus. A merely rapid pulse that does not scatter indicates a five-month fetus, where the mother's condition is stable. String-tight, firm, strong, slippery, and smooth pulses indicate safety. Deep, fine, and minute pulses lead to the underworld (death).
Morning Sickness (Emzu)
Dou Hanqing stated: Emzu manifests as oppression in the epigastrium, vomiting and inability to eat, aversion to food odors, dizziness, irritability and pain in all limbs and joints, excessive sleepiness with little rising. Use Xuanfu Banxia Tang (Inula and Pinellia Decoction). If the disease presents with craving for vinegar, coldness in the chest, abdominal pain, vomiting/rebellious Qi, and dislike of drinking, use Renshen Banxia Tang (Ginseng and Pinellia Decoction). For stomach deficiency with rebellious Qi causing vomiting and anorexia, use Suosha San (Amomum Powder). Dai Sigong stated: Emzu is commonly called "bing er" (disease of the child). This is because the person has pre-existing phlegm-fluid retention. Blood is stagnant and fails to circulate. Thus, fluids rise with Qi and stagnate in the Liver Meridian. The flavor of the Liver is sour, so there is necessarily a preference for sour foods. Metal controls Wood; therefore, pungent flavors overcome it. Use Xiao Banxia Fuling Tang (Minor Pinellia and Poria Decoction). For severe cases, use Erchen Tang (Two-Cured Decoction). Some take hot medicines to attack the diaphragm, leading to stifling heat and illness; Heye San (Lotus Leaf Powder) is suitable. Li Chan stated: Either severe vomiting or occasional vomiting of clear fluid, with aversion to food odors. This occurs because the uterine meridians connect to the stomach opening. Thus, encountering food odors stimulates the Jing-Qi to rush upward. Only after the food is completely vomited will the Jing-Qi settle. There are also cases where improper intercourse causes severe uterine turbidity; after one hundred days, it heals.
Restless Fetus (Taidong Bu'an)
Chen Ziming stated: If pregnancy is nurtured according to proper methods, then Qi and Blood harmonize, the fetus rests in its place, and childbirth is easy. Otherwise, the fetus moves and Qi rebels, making labor difficult and extremely dangerous. This is called fetal Qi pressing upward. He also said: There is "Jing Tai" (Startled Fetus). When pregnancy is nearly full and the fetal spirit is formed, falling or trauma injures the fetus, even leading to bleeding and unconsciousness. To verify whether the mother and child are safe, refer to the discussions and treatments for Restless Fetus. Select from Gouteng Tang (Uncaria Decoction), Zisu Yin (Perilla Drink), Guipi Tang (Spleen-Restoring Decoction), or Foshou San (Buddha's Hand Powder) according to symptoms. He also said: Severe Restless Fetus inevitably leads to injury or miscarriage. If the face is red and the tongue is cyan, the fetus is dead. If the face is cyan and the tongue is red, the mother is dead. If the lips and mouth are cyan with foam at the corners, both mother and fetus are dead. Observe and treat accordingly. Yan Yonghe stated: Restless Fetus in the second or third month is due to long-term uterine deficiency, which easily leads to miscarriage. It is advisable to take Duzhong Wan (Eucommia Pill) in advance to nourish the fetus. If Restless Fetus involves abdominal pain, it may change into Lou Tai (Leaking Fetus/Bleeding). Use Rusheng Tang (Like the Sage Decoction). He also said: Palpitations, frequent startles during sleep, distension of the hypochondrium, abdominal fullness with urgent pain connecting to the umbilicus, restlessness in sitting and lying, shortness of breath and pressure, are all caused by Qi stagnation or noise/shouting, leading to fetal fright. Pain in bones and tendons, discomfort in limbs. Take Daisheng San (Great Sage Powder) urgently. Zhu Zhenheng stated: If a parturient woman has fire stirring the fetus, causing rebellious Qi and wheezing/shortness of breath, urgently use powdered Huangqin (Scutellaria Root) and Xiangfu (Cyperi Rhizoma). He also said: Lou Tai belongs to Qi deficiency with Heat. Use Siwu Tang (Four-Substance Decoction) plus Ejiao (Donkey-Hide Gelatin), Baizhu (Atractylodis Macrocephalae Rhizoma), Huangqin, Xiangfu, Sharen (Amomi Fructus), and Nuomi (Glutinous Rice). Li Chan stated: Restless Fetus due to emotional Qi rebellion causes heart and abdominal fullness and pain. Use Zisu Yin. Due to external contraction with fever, headache, vomiting/rebellious Qi, and chest/hypochondriac fullness, use Antai Yin (Fetus-Calming Drink) plus Chaihu (Bupleuri Radix) and Dafupi (Arecae Pericarpium). For Qi and Blood deficiency, double the Ren Shen (Ginseng) and Baizhu in Antai Yin. For bleeding, use Jiao'ai Xionggui Tang (Ejiao, Coptis, Chuanxiong and Angelica Decoction) plus Sharen, Qinjiao (Gentianae Macrophyllae Radix), Juanbai (Selaginella Tamariscina), and Duzhong (Eucommiae Cortex). For severe bleeding and unbearable abdominal pain, or discharge of yellow fluid like lacquer or bean juice, decoct Ye Zhu Gen (Wild Ramie Root) and Jinyinhua Gen (Honeysuckle Root) each 5 qian in wine. For bleeding with vulvar pain, take 1 qian of Huanglian (Coptidis Rhizoma) powder with wine. Restless Fetus with abdominal pain due to Cold: Lizhong Tang (Regulate the Middle Decoction) plus Sharen and Xiangfu. Due to Heat: Huangqin Tang (Scutellaria Decoction). Blood deficiency abdominal pain: Siwu Tang. Or Pingwei San (Stomach-Pacifying Powder) taken with salt-decocted water swallowing Eryi Wan. Qi deficiency pain: Sijunzi Tang (Four-Gentlemen Decoction) plus Baishao (Paeoniae Radix Alba) and Danggui (Angelicae Sinensis Radix). Qi excess with heart/abdominal fullness and pain: Equal parts Xiangfu and Zhike (Aurantii Fructus Immaturus) powdered, taken with white water. Restless Fetus with heart pain due to Cold: Equal parts Ai Ye (Artemisiae Argyi Folium), Xiao Hui (Foeniculi Fructus), and Chuan Lian (Toosendan Fructus) decocted. Due to Heat: Erchen Tang minus Banxia, plus Zhizi (Gardeniae Fructus) and Huangqin. Also: For Restless Fetus, generally use Gu Qinshu Tang (Ancient Scutellaria and Atractylodes Decoction) plus Ejiao. For Wind pathogen, add Jiang (Fresh Ginger) and Chi (Fermented Soybean). For Cold, add Cong Bai (Scallion White). For Heat, add Huafen (Trichosanthis Radix). For Cold-Heat complex, add Chaihu. For neck stiffness, add Cong Bai. For warm-heat abdominal pain, add Baishao. For abdominal distension, add Houpo (Magnoliae Officinalis Cortex). For bleeding, add Ai Ye and Diyü (Sanguisorbae Radix). For lower back pain, add Duzhong. For fright/palpitations, add Huanglian. For vexation/thirst, add Maidong (Ophiopogonis Radix) and Wumei (Mume Fructus). For excessive thinking, add Fushen (Poria Cum Radice). For phlegm/vomiting, add Xuanfuhua (Inulae Flos) and Beimu (Fritillariae Bulbus), or酌情 use Banxia Qu (Pinellia Fermented Leaven). For fatigue/labor, add Huangqi (Astragali Radix). For asthma, remove Baizhu and add Xiangfu. For dry stool, add Maren (Cannabis Semen). For habitual difficult labor, add Zhike and Suz Ye (Perillae Folium). For habitual miscarriage, add Duzhong. For chronic blood deficiency, add Chuanxiong and Danggui. This is the holy medicine for calming the fetus. For sudden bleeding, take 3-5 doses daily in acute cases, or 1 dose every 5-10 days in mild cases. Regular use calms the fetus and eases childbirth. The born children will have no fetal toxins.
Fetal Leakage (Tailou)
Li Chan stated: Bleeding with heart/abdominal pain is Restless Fetus. Bleeding without pain is Fetal Leakage. This is the distinction. Generally, leakage due to Heat involves heavy bleeding. With internal heat and thirst, use Siwu Tang plus Huangqin, Lian (Coptidis Rhizoma), Baizhu, and Yimucao (Leonuri Herba). If blood is black and clotted, use Sanbu Wan (Three-Tonic Pill) plus Xiangfu and Baishao. If blood deficiency results in scant flow, use Gu Jiao'ai Tang (Ancient Ejiao Decoction) or combine with Siwu Tang. For Qi deficiency, use Sijunzi Tang plus Huangqin and Ejiao. Due to fatigue contracting Cold, leading to Qi deficiency, bleeding, and impending miscarriage, use Xionggui Buzhong Tang (Chuanxiong and Angelica Supplement the Middle Decoction). Or if bleeding resembles menstruation, causing the uterus to dry and injuring both mother and fetus, use Shudi (Rehmanniae Radix Preparata) and Chao Ganjiang (Fried Zingiberis Rhizoma) each 2 qian powdered, taken with rice drink. Only bleeding due to sexual intercourse is true Fetal Leakage. Save it with Bawu Tang (Eight-Ingredient Decoction) plus Jiao'ai (Ejiao and Ai Ye).
Pregnancy with Cold Damage (Shanghan)
Zhu Gong stated: For pregnant women with Shanghan, Zhang Zhongjing provided no treatment method. Medications must avoid禁忌 (contraindications). Do not treat them uniformly as ordinary women. For Shanghan with fetus-calming, use Ejiao San (Donkey-Hide Gelatin Powder) and Baizhu San (Atractylodes Macrocephala Powder). For aversion to cold and high fever, induce sweating with Congbai Tang (Scallion Juice Decoction). Or if contracted epidemic pathogens, feeling chilly, shivering, palpitations, or adding hiccups, use Sushu Tang (Perilla and Atractylodes Decoction). For headache, muteness, lack of appetite, hypochondriac pain, vomiting/rebellious Qi, and phlegm-Qi, use Huanglong Tang (Yellow Dragon Decoction). For spinning headache, high fever, and mental restlessness, use Xuanfuhua Tang (Inula Flower Decoction). For high fever, headache, vomiting/rebellious Qi, anorexia, and fetal unrest, use Maimendong Tang (Ophiopogon Decoction). For pregnant women with macules turning black, use Zhizi Daqing Tang (Gardenia and Isatis Decoction). For high fever, headache, vexation, vomiting, and anorexia, use Lugen Tang (Reed Rhizome Decoction). For Shanghan headache and high fever, use Zhizi Wuwu Tang (Gardenia Five-Ingredient Decoction). For headache and joint pain with high fever, use Qianhu Qiwwu Tang (Peucedanum Seven-Ingredient Decoction). From day four to six, adding epigastric/abdominal fullness, rebellious Qi, unquenchable thirst, poor intake, lower back pain, and heaviness, use Zhishi San (Immature Bitter Orange Powder). At seven months of pregnancy with Shanghan high fever, red macules turning black, and hematuria, use Shengma Liuwu Tang (Cimicifuga Six-Ingredient Decoction). For fever with vexation/stuffiness, use Gegen Yiwu Tang (Pueraria Single-Ingredient Decoction). For heat diseases, use Congbai Chi Tang (Scallion and Fermented Soybean Decoction). For summerheat injury with headache, aversion to cold, body heat, restlessness/stuffiness, limb pain, neck/back stiffness, and dry lips/mouth, use Chaihu Shigao Tang (Bupleurum and Gypsum Decoction). Wan Quan stated: Pregnancy Shanghan focuses primarily on clearing heat and calming the fetus. Whether inducing sweat or purging, treat according to the pulse and symptoms of the interior/exterior and Zang-Fu organs. Do not harm the fetal Qi. Thus, for exterior syndrome inducing sweat, use Xiangsu San (Cyperi and Perilla Powder). For harmonizing half-exterior/half-interior, use Huanglong Tang. For interior syndrome requiring purging, use Sanhuang Jiedu Tang (Three-Yellow Detoxification Decoction). This is a secret passed down in my family, saving many people. Chen Shiduo stated: At term, if suddenly contracting Shaoyin meridian wind-pathogen, with aversion to cold, curling up, and cold hands/feet, it is incurable. Shaoyin corresponds to the Kidney. Whether transmitted to Shaoyin or directly attacking Shaoyin, it is mostly incurable. The Shaoyin Kidney Meridian prefers warmth and dislikes cold. Now wind-cold enters, weakening the Fire of the Gate of Vitality (Mingmen). The Kidney Palace is filled with cold Qi, inevitably making the Uterus cold. Cold hands/feet are a sign of extreme Spleen/Stomach cold. Death is certain. Fortunately, if the fetus has not been expelled, urgently warm it with Sanhan Jiutai Tang (Dispel Cold and Save Fetus Decoction): Ren Shen 1 liang, Baizhu 2 liang, Rougui (Cinnamomi Cortex), Ganjiang (Zingiberis Rhizoma), and Zhi Cao (Prepared Licorice) each 1 qian. One dose. If no longer averse to cold, two doses. Hands/feet warm, no curling, three doses for full recovery. Also, at term, contracting Shaoyin symptoms with nausea, abdominal pain, and cold extremities (Jue Ni), it is incurable. This is also due to cold entering the Kidney Palace, invading the Heart upwards, not just affecting the abdomen below. This is more severe than the above case. Kidney Water nourishes the Heart; why does it counteract it? The True Water of the Kidney is borrowed by the Heart for nourishment. The Evil Water of the Kidney causes the Heart to perish. Now the Kidney contracts cold pathogen, carrying Kidney Water to overwhelm the Heart. Thus, heart and abdomen both hurt, and extremities become cold simultaneously. Extremely urgent and critical. Must expel the Shaoyin pathogen. Use Huiyang Jiuchan Tang (Restore Yang and Save Childbirth Decoction): Ren Shen and Danggui each 1 liang, Rougui, Ganjiang, and Gancao each 1 qian, Baizhu 5 qian. The brilliance of this formula lies in adding Danggui. The reason Shaoyin pathogen dares to invade the Heart is that it bullies the lack of Blood in the Heart. Danggui tonifies Blood, assisting Ren Shen to support the Heart. Thus, the Heart is nourished. Ginger and Cinnamon are herbs to dispel cold and sweep away pathogen. Moreover, Baizhu and Gancao benefit the waist/umbilicus and regulate heart/abdomen. How could pain not stop and rebellion not be removed? Also, pregnant women at term suddenly contracting Shaoyin syndrome: urgently warm with large doses of Ren Shen and Baizhu. If ineffective, death ensues. This is from Zhang Zhongjing's text. It seems only Ren Shen and Baizhu can save. I believe using only Ren Shen and Baizhu is not yet perfect. If they are ineffective, urgently add Fuzi (Aconiti Lateralis Radix Preparata), Rougui, and Ganjiang. There will be no ineffectiveness. Now established a formula named Quansheng Jiunan Tang (Complete Life Saving Decoction): Ren Shen and Baizhu each 1 liang, Fuzi 1 qian, Gancao 5 fen. For any contracting Shaoyin pathogen, use this with miraculous effect.
Pregnancy Abscess (Yun Yong)
Chen Ziming stated: To treat Yun Yong, use Wuyao (Linderae Radix) 5 qian, decoct in one cup of water until 70% remains. Add Niupijiao (Cowhide Gelatin) 1 liang to dissolve and take. Or decoct Yiren (Coicis Semen) juice to drink. Note: Yun Yong is an abscess inside the abdomen. If the above methods fail, use Mudanpi San (Moutan Bark Powder) or Yiyiren Tang (Coix Seed Decoction). Wang Kentang stated: Generally, pregnant women with abdominal abscesses require vastly different treatment from ordinary cases. Internally use Zisu Yin to calm the fetus. Do not lightly use other drugs. If near term, the baby and pus are expelled together. If far from term, the pus exits via stool. If just starting, medication alone can resolve it. If the abscess is external and symptoms are heat, only neutral-cooling medications can conclude treatment. Must assess severity. Fear error and difficulty in rescue. Wan Quan stated: For pregnant women with sore throat, use Dongyuan's Liangge San (Cool the Diaphragm Powder) plus Niubangzi (Arctii Fructus) 1 qian. Treat mouth/tongue ulcers similarly. For Ru Yong (Breast Abscess), use Tuoli Jiedu Tang (Support Interior and Detoxify Decoction). For sores/toxins on the back, belonging to the Yangming Meridian: Remove Qingpi (Citri Reticulatae Pericarpium) from the base formula, add Shengma (Cimicifugae Rhizoma) and Gegen (Puerariae Radix) each 1 qian. For sores/toxins on the chest and cheeks, belonging to the Shaoyang Meridian: Remove Baizhi (Angelicae Dahuricae Radix), add Chaihu, Zhizi, and Longdancao (Gentianae Radix). For sores/toxins on shoulders/arms/hypochondrium, belonging to the Taiyin Meridian: Remove Qingpi, add Chenpi (Citri Reticulatae Pericarpium), Tiandong (Asparagi Radix), Jiegeng (Platycodonis Radix), and Sangbai (Mori Cortex) each 1 qian. For sores/toxins in groin/genital area, belonging to the Jueyin Meridian: Remove Baizhi, double Qingpi. For sores/toxins on palms/soles, belonging to the Shaoyin Meridian: Remove Baizhi, Qingpi, and Huafen, add Huanglian, Huangbai (Phellodendri Cortex), and Mutong (Akebiae Caulis) each 1 qian.
Pre-delivery Leukorrhea
Chen Shiduo stated: There should be no leukorrhea before delivery. If present, it is a sign of difficult labor. Even if birth is successful, there is risk of postpartum blood fainting. Formula: Heidou (Black Soybean) 3 he. Decoct into two bowls of soup. First use one bowl, add Baiguo (Ginkgo Biloba Seed) 10, Hongzao (Jujubae Fructus) 20, Shudi (Rehmanniae Radix Preparata) 1 liang, Shanyuzhu (Corni Fructus), Yiren, and Shanyao (Dioscoreae Rhizoma) each 4 qian, Fuling (Poria) 3 qian, Zexie (Alismatis Rhizoma) and Danpi (Moutan Cortex) each 2 qian. Add two bowls of water, decoct and take. One or two doses. Never again have leukorrhea. Also treats all types of leukorrhea in women with miraculous effect.
Prevention of Difficult Labor
Wan Quan stated: Childbearing is normal for women. If not diseased, no medicine is needed. Only for those with a history of difficult labor must we seek formulas as a plan for preserving life. Their fetus-binding formulas vary. Such as Zhike Shoutai San (Immature Bitter Orange Fat-Reducing Powder) and formulas using Huashi (Talcum). Suitable for those with Qi excess and much phlegm. Dasheng San (Reaching Life Powder) and Shutai Wan (Fetus-Binding Pill). Suitable for those with Qi deficiency and slight heat. If not assessing deficiency/excess, it is better not to take them.
Twins, Pin Tai, Ghost Fetus
Zhu Zhenheng stated: When Jing-Qi is abundant, it splits and divides. Blood follows to nourish it, thus forming twins. Regarding male and female conceived together: Yang days/Yin hours, Yin days/Yang hours. Yin and Yang mix. Not belonging to left or right. Conceiving Qi between the two branches. There are also triplets or quadruplets, still the same principle. Zhang Jiebin stated: Is Ghost Fetus truly ghost Qi invading the uterus to form shape? No. It is due to the woman's weak constitution, or evil thoughts accumulating. Blood knots with Qi and does not disperse. Or Chong and Ren meridians stagnate/rebel, vessel pathways blocked. This is definitely an internal cause disease, not an external pathogen. It is essentially similar to Blood Mass (Xue Jia) and Qi Mass (Qi Jia). Should be treated as such. Encounters with fox/spirit anomalies are real acquisitions, not Ghost Fetus. Also seek treatment in the Xue Jia/Qi Jia category. Also said: Treating Ghost Fetus should focus on tonifying Yuan (Primordial Qi), followed by resolving accumulation. However, for tonifying while resolving, nothing beats Juejin Jian (Crossing the Ford Decoction). For resolving stasis without being harsh, nothing beats Tongyu Jian (Unblocking Stasis Decoction). After adding regulation/tonification, if wanting to directly attack the disease, Duoming Dan (Life-Seizing Pill) and Huisheng Dan (Life-Returning Pill) can be酌情 used. Or decoct Danggui and Honghua (Carthami Flos) strongly, sending Chijin Dou (Red Gold Beans) with it is also excellent.
Untreatable Conditions in Pregnancy
Dou Hanqing stated: Pre-delivery sore throat with floating pulse: untreatable. Red face with eyes looking upward: untreatable. Black face with sweating: untreatable. Tight/fullness in heart/chest, unable to spit phlegm: untreatable. Unstopping diarrhea: untreatable. Shortness of breath with cold extremities: untreatable. Palpitations, very red chest, curled tongue, red face, eyes looking upward: untreatable. Blood/Qi attacking Heart欲绝 (desiring extinction), red face: untreatable. Diarrhea with asthma/wheezing: untreatable. Tidal fever alternating, occasional delirium: untreatable. Chest/abdominal fullness/urgency: untreatable. Thunderous sounds in throat, or choking on food: untreatable.
Monthly Fetal Nourishing Formulas
Xu Zhicai stated: Pregnancy Month 1, named Tai Pei (Fetal Embryo). Diet should be refined, cooked, sour, and delicious. Eat barley. Do not eat raw/spicy. This is called Cai Zheng. In this month, the Foot Jueyin Meridian nourishes the fetus. Do not acupuncture/moxibustion this meridian. Foot Jueyin belongs to Liver, governing sinews and blood. At one month, blood flow is obstructed/stagnant. Do not do strenuous work. Sleep must be quiet. Do not allow fear. In this month, Yin and Yang newly combine. Many fetal colds, many painful heats. Sudden fright, lifting heavy objects, lower back pain, abdominal pain, uterine urgency, sudden bleeding. Must preventively calm it.适宜服用 Wuci Ji Tang (Female Black Chicken Decoction).
Female Black Chicken (a pair, prepared as food)
Fuling, Ejiao (each 2 liang)
Wuyu (1 sheng)
Maidong (5 he)
Ren Shen, Baishao, Baizhu (each 3 liang)
Gancao, Shengjiang (each 1 liang)
Water 2 dou 2 sheng. Boil chicken to get 6 sheng juice. Decoct medicine to get 3 sheng. Add wine 3 sheng. Melt Ejiao completely. Get 3 sheng. Take 1 sheng per dose, three times daily.
Pregnancy Month 2, named Shi Gao (Beginning Paste). Do not eat spicy/fishy. Live in quiet places. Men should not labor. All joints hurt. This is the beginning of the fetus. In this month, the Foot Shaoyang Meridian nourishes the fetus. Do not acupuncture/moxibustion this meridian. Shaoyang belongs to Gallbladder, governing essence. At two months, fetal essence forms in the uterus. Protect carefully. Do not startle. In this month, Yin and Yang begin to occupy the meridians. Cold often ruins formation. Heat causes withering. Contracting wind-cold causes shaking. Epigastric fullness, hanging urgency below umbilicus, stiff/painful back. Sudden bleeding, alternating cold/heat.适宜服用 Aiye Tang (Mugwort Leaf Decoction).
Aiye, Danshen, Danggui, Mahuang (each 2 liang)
Shengjiang (6 liang)
Ren Shen, Ejiao (each 3 liang)
Gancao (4 qian)
Dazao (12 pieces)
Water 1 dou, wine 3 sheng. Decoct to 3 sheng. Melt gelatin. Divide into three doses.
Pregnancy Month 3, named Shi Bao (Beginning Cells). At this time, no fixed image. Transforms upon seeing things. Wanting a boy, handle bow/arrows. Wanting a girl, play with pearls/jades. Wanting beautiful child, frequently look at jade discs. Wanting virtuous child, sit upright in purity. This is external image affecting internally. In this month, the Hand Jueyin (Pericardium) Meridian nourishes the fetus. Do not acupuncture/moxibustion this meridian. Belongs to Heart. Mother grieving/sorrowful/thinking/startled. This month determines form. Cold: green stool. Heat: difficult urination, either red or yellow. Sudden fright/terror/sorrow/anger/excitement/falling. Disturbs meridians, abdominal fullness, pain around umbilicus, or lower back pain. Sudden bleeding.适宜服用 Xiongji Tang (Male Chicken Decoction).
Male Chicken (one, prepared as food)
Baishao (4 liang)
Huangqin, Baizhu, Shengjiang (each 1 liang)
Maidong (5 he)
Dazao (12 pieces)
Gancao, Fuling, Ren Shen, Ejiao (each 2 liang)
Water 1 dou 3 sheng. Boil chicken to halve juice. Add medicine, decoct half. Add wine 3 sheng and gelatin. Decoct to 3 sheng. Divide into three doses. Finish in one day. Another version has no Jiang/Qin, but has Chuanxiong and Danggui each 2 liang.
Pregnancy Month 4, begins receiving Water Essence to form blood vessels. Food should be rice and fish. This is called enriching Blood/Qi to open ears/eyes and move meridians. In this month, the Hand Shaoyang Meridian nourishes the fetus. Do not acupuncture/moxibustion this meridian. Internally connects to Sanjiao. At this time, fetal six fu organs smoothly form. Calm body, harmonize mind, regulate diet. In this month, Cold: epigastric warmth/desire to vomit, chest/diaphragm fullness, anorexia. Heat: difficult urination, frequent like strangury, suffering urgency below umbilicus. Sudden wind-cold: neck/stiffness, cold/heat, or startle. Body/back/abdominal pain, occurring at intervals. Fetus pressing on chest, vexation, inability to rest. Sudden bleeding.适宜服用 Juhua Tang (Chrysanthemum Decoction).
Juhua (5 qian)
Maidong (1 sheng)
Dazao (12 pieces)
Ren Shen (1.5 liang)
Danggui, Gancao (each 2 liang)
Mahuang, Ejiao (each 3 liang)
Banxia (4 liang)
Shengjiang (5 liang)
Water 8 sheng. Boil, add gelatin, and wine 3 sheng. Decoct to 3 sheng. Divide into two doses. When sweating, apply powder. Protect from wind-cold for 4-5 days.
Pregnancy Month 5, begins receiving Fire Essence to form Qi. Wake up late. Bathe and wash clothes. Deepen residence, thicken clothes. Eat rice/millet, mutton/beef soup, mix with cornel, adjust five flavors. This is called nourishing Qi to stabilize five Zang organs. In this month, the Foot Taiyin Meridian nourishes the fetus. Do not acupuncture/moxibustion this meridian. Belongs to Spleen. At this time, fetal limbs are formed. Do not be too hungry/full. Do not eat dry/roasted/hot food. Do not be too fatigued. In this month, Heat: suffering dizziness, mental confusion, vomiting. Cold: suffering abdominal fullness/pain, frequent urination. Sudden terror, limb pain, cold/heat. Fetus moves unpredictably, abdominal pain, suffocation/collapse. Sudden bleeding.适宜服用 Ejiao Tang (Donkey-Hide Gelatin Decoction).
Ejiao (4 liang)
Ren Shen (1 liang)
Shengjiang (6 liang)
Danggui, Baishao, Gancao, Huangqin (each 2 liang)
Xuanfuhua (2 he)
Wuyu (7 he)
Maidong (2 sheng)
Water 9 sheng. Decoct half, add gelatin, and wine 3 sheng. Decoct to 3.5 sheng. Divide into four doses. Three times day, once night. Take before meals.
Pregnancy Month 6, begins receiving Metal Essence to form sinews. Body desires slight labor, not idleness. Travel in wild. Eat bird/beast meat. This is called changing pores and binding sinews to nourish strength, to strengthen back/spine. In this month