朱眷内眷,孕已八月,因送殡受惊,胸膈胀闷,呕逆不入食。城中时师,认为外感,为
之发散,呕恶愈剧。举家恐胎有动,延予诊视。两寸脉
皆洪滑,两尺弱,此亢上不下之候,胸膈胀者,盖由子悬而然,此一剂可瘳也。夫曰∶“胎
妇难任峻剂,觑其呕恶之状,胀闷之势,时刻不 ,一剂曷愈?”予曰∶“请试之。”与温
胆汤加姜汁炒黄连、大腹皮,水煎成送下姜汁益元丸,果一帖而呕止膈宽,即能进食,午后
酣寝,怡然若未始有病者。其夫讶曰∶“温胆汤何神若此,幸详其义。”予曰∶“胎孕之症
,重在足少阳,足少阳者,胆也。病起于惊,气逆痰随,胎气上逼,故脉亢上不下,在《难
经》为溢候,由木火之性上而不下。经曰∶上部有脉,下部无脉,其人当吐,不吐者死。予
故用一剂可愈也。方名温胆者,此温字非温暖之温,乃温存之温。黄连、竹茹清其肝胆之火
,同白茯苓而安心神,益元丸压其痰火下行,火下行而胎因之亦安矣。”筠皋公曰∶“先生
认症真,故投剂确,非神乎?药神乎用也。”
胡邻泉令媛及笄后,患吐血,每吐碗余,下午倦怠,夜分潮热,呕吐不食,大便秘结,
时师
视为阴虚火动,投以滋阴之剂,反加饱闷,背心胀痛。予诊其脉,两寸洪大,两尺弱,知其
有瘀血凝滞,以致新血不得归经,故满而溢也。法当消瘀为主,用白芍药、枳壳、前胡、益
元
散、桃仁、红花、牡丹皮、山栀子、贝母、水煎,临服入萝卜汁一小酒杯。服后呕吐如旧,
大便仍秘,乃以龙荟丸通之,更以石膏三钱,橘红、半夏曲、姜连、茜根、竹茹、黄连、枳
壳各一钱,白茯苓八分,甘草三分,服后大便行三次,吐止食进。后用二陈汤加滑石、丹参
、丹皮、茜根、白芍药、香附。二十剂后,经行热退背胀悉愈。从此经调血不上逆。
The female member of the Zhu family, who was eight months pregnant, suffered from fright while attending a funeral procession. This resulted in distension and oppression in the chest and diaphragm, nausea, vomiting, and inability to eat. The local physicians diagnosed it as an external contraction (exogenous pathogenic factor) and administered dispersing and releasing formulas. Consequently, the nausea and vomiting worsened significantly. Fearing that the fetus might be disturbed, the entire family invited me to examine her. Both cun positions of the pulse were surging and slippery, while both chi positions were weak. This indicates a pattern where hyperactivity is above without descending. The chest distension is likely due to "Zi Xuan" (Fetal Distension, characterized by fetal qi pressing upward causing chest fullness). One dose of medicine would suffice for recovery. Her husband said, "Pregnant women cannot tolerate harsh medicines. Looking at her severe nausea and the constant oppressive distension, which does not relieve even for a moment, how can one dose cure her?" I replied, "Please allow me to try." I prescribed Wendan Tang (Warm the Gallbladder Decoction) with added Coptidis Rhizoma (Huanglian, 黄连) stir-fried with ginger juice and Arecae Pericarpium (Dafupi, 大腹皮). After decocting in water, I had her take Yi Yuan Wan (Benefit Origin Pill) mixed with ginger juice. Indeed, after one dose, the vomiting ceased, the chest became relaxed, she could immediately eat, slept soundly in the afternoon, and appeared as if she had never been ill. Her husband exclaimed in surprise, "How miraculous is Wendan Tang! Please explain the rationale in detail." I said, "In treating pregnancy disorders, the key lies in the Foot-Shaoyang Gallbladder Channel. The Foot-Shaoyang is the Gallbladder. The disease originated from fright, causing rebellious qi and accompanying phlegm, forcing the fetal qi upward. Hence, the pulse shows hyperactivity above without descending. In the *Nan Jing* (Classic of Difficult Issues), this is called the 'Yi Pulse' (Overflowing Pulse), resulting from the nature of Wood and Fire moving upward rather than downward. The Classics state: 'If there is pulse above but no pulse below, the person should vomit; if they do not vomit, death ensues.' Therefore, I predicted that one dose would suffice. The name 'Wendan' (Warm the Gallbladder) uses the character 'Wen' not in the sense of warmth, but in the sense of gentleness and preservation. Coptidis Rhizoma (Huanglian, 黄连) and Bamboo Shavings (Zhuru, 竹茹) clear the fire of the Liver and Gallbladder, combined with Poria (Fuling, 茯苓) to calm the Shen (Spirit). Yi Yuan Wan guides the phlegm-fire downward. Once the fire descends, the fetus becomes tranquil." Mr. Yungao said, "Your diagnosis was precise, thus your prescription was accurate. Is it the medicine that is miraculous, or the application of the medicine?"
Ms. Hu Linquan, after reaching adulthood, suffered from hematemesis (vomiting blood), expelling over a bowl each time. She experienced fatigue in the afternoon, tidal fever at midnight, vomiting, anorexia, and constipation. Contemporary physicians attributed this to Yin deficiency with hyperactive fire and administered yin-nourishing prescriptions. However, this exacerbated abdominal fullness and caused distending pain in the back. Upon examining her pulse, both cun positions were surging and large, while both chi positions were weak. I determined that there was stagnant blood causing new blood to fail to return to its vessels, leading to overflow. The treatment principle should focus on resolving stasis. I used Paeoniae Radix Alba (Baishao, 白芍), Aurantii Fructus (Zhiqiao, 枳壳), Peucedani Radix (Qianhu, 前胡), Yi Yuan San (Benefit Origin Powder), Persicae Semen (Taoren, 桃仁), Carthami Flos (Honghua, 红花), Moutan Cortex (Mudanpi, 牡丹皮), Gardeniae Fructus (Shanzhizi, 山栀子), and Fritillariae Bulbus (Beimu, 贝母), decocted in water. Just before administration, a small cup of radish juice was added. After taking the medicine, the vomiting persisted, and constipation remained. Therefore, I used Longhui Wan (Dragon Bile Pill) to promote bowel movement, followed by a prescription containing Gypsum Fibrosum (Shigao, 石膏) 3 qian, Citri Reticulatae Pericarpium (Juhong, 橘红), Pinelliae Fermentatae (Banxiaqu, 半夏曲), Ginger-processed Coptidis Rhizoma (Jianglian, 姜连), Rubia Cordifolia Root (Qigen, 茜根), Bamboo Shavings (Zhuru, 竹茹), Coptidis Rhizoma (Huanglian, 黄连), Aurantii Fructus (Zhiqiao, 枳壳) each 1 qian, Poria (Fuling, 茯苓) 8 fen, and Glycyrrhizae Radix et Rhizoma (Gancao, 甘草) 3 fen. After ingestion, three bowel movements occurred, hematemesis stopped, and appetite returned. Subsequently, Erchen Tang (Two-Cured Decoction) was used with additions of Talcum (Huashi, 滑石), Salviae Miltiorrhizae Radix (Danshen, 丹参), Moutan Cortex (Mudanpi, 牡丹皮), Rubia Cordifolia Root (Qigen, 茜根), Paeoniae Radix Alba (Baishao, 白芍), and Cyperi Rhizoma (Xiangfu, 香附). After twenty doses, menstruation resumed, fever subsided, and back distension completely resolved. From then on, menstruation became regular, and blood ceased to rebel upward.