（即子悬）
大全云∶妊娠心腹胀满者，由腹内素有寒气，致令停饮，重因触冷冻饮料发动，与气相争，故
令心腹胀满也。（此虽言寒气停饮所致，然大概阳气壅滞，则令上凑心腹，故以紫苏饮宽气
下气为主，余随症加减）
薛氏曰∶前证若外感风寒，内伤饮食，用藿香正气散；若食伤脾胃，用六君子汤；若阳
气壅滞，胎上逼心，用紫苏饮。
一妊妇饮食停滞，心腹胀满，或用人参养
胃汤加青皮、山楂、枳壳，其胀益甚，其胎上攻，恶心不食，右关脉浮大，按之则弦，此脾土
不足，肝木所侮，用六君子加柴胡、升麻而愈。后小腹痞满，用补中益气，升举脾气而瘥。
一妊妇腹胀，小便不利，吐逆，诸医杂进温胃宽气等药，服之反吐，转加胀满凑心，验
之胎死已久，服下死胎药不能通，因得鲤鱼汤，其论曰∶妊妇通身肿满，或心胸急胀，名曰
胎水。遂去妊妇胸前看之，胸肚不分（须识此症），急以鲤鱼汤三五服，大小便皆下恶水，肿
消胀去，方得分娩死胎。此症盖因怀妊腹大，不自知觉，人人皆谓娠孕如此，终不知胎水之
为患也。
李氏曰∶子悬者，心腹胀满痛也。妊孕四五个月以来，相火养胎，以致胎热，气逆凑心。
心腹胀满疼痛，宜紫苏饮；有郁心腹胀满甚者，加莪术及丁香少许；不食者，芩术汤倍白
术加芍药。
火盛极，一时心气闷绝而死，紫苏饮连进救之。（以火盛极而连进紫苏饮，人恒失之，须
知是气作闷）
此症两尺脉绝者，有误服动胎药，子死腹中，则憎寒，手指唇爪俱青，全以舌为证验，芎
归汤救之。
仲景云∶妇人怀孕六七月，脉弦发热，其胎愈胀，腹痛恶寒者，少腹如扇，所以然者，子
脏寒故也，当以附子汤温其脏。（附子胎前禁用，而此以治脏寒，正所谓有故无殒也）
妇人伤胎，怀身腹满，不得小便，从腰以上重，如有水气状，怀身七月，太阴当养不养，
此心气实，当刺泻劳宫及关元，小便微利则愈。
紫苏饮 治胎气不和，凑上心腹，胀满疼痛，谓之子悬。兼治临产惊恐气结，连日不下。
无川芎名七宝散。
紫苏叶（二钱） 大腹皮 川芎 白芍药 陈皮（去白） 当归（各一钱） 人参 甘草（各五分）
上锉作一服，加生姜三片，葱白七寸，水
煎服。
本事方云∶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》曰∶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。
陈方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，用蓖麻子研烂和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，子母俱死。今面不赤，舌不青，其子未死，是胎上逼
心，宜以紫苏饮治之。至十服，而胎近下矣。
诃黎勒散 疗妊娠心腹胀满，气冲胸膈烦闷，四肢少力，不思饮食。
诃黎勒 赤茯苓 前胡（各一两） 陈皮 大腹皮 桑白皮（各七钱半） 枳壳 川芎 白
术（各半两）
上为粗末，每服四钱，姜三片，枣一枚，水煎服。
保胎和气饮 专治胎前四五个月，身体困倦，气急发热，饮食无味，贪睡头晕等证。
枳壳（四钱） 浓朴 香附子（各三钱） 砂仁 苍术 橘红（各二钱） 苏叶（一钱） 甘草（九分）
小茴香（一钱半）
上锉，分作三服，每服用水一盅半，煎七分服。
瘦胎饮 专治胎前五六个月，胎娠困弱，体重贪睡，食不知味，肚腹胎动。
当归（二钱） 白芍药 益母草 枳壳（各四钱） 砂仁 香附子 益智（各三钱） 甘草（一钱）
上锉，分作三服，每服水一盅半，煎至七
分，空心温服。
枳壳汤 治妇人妊娠胎腹胀。
枳壳（三两） 黄芩（二两，一方只用一两）
上为粗末，每服五钱，水煎服。如腹满，身体沉重，加白术一两。
葱白汤 治胎上逼心烦闷，又治胎动困笃。
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。（葱白安胎，人所未知）
楼全善云∶此方神效，脉浮滑者宜之。《本草》云∶葱白通阳气安胎。
一方 治胎动，上逼心痛。
取艾叶如鸡子大一团，以头醋四升，煎至二升半，温服。
仓公下气汤 治心腹两胁胀闷，饮食少思，四肢无力。
羌活 槟榔 青皮 大腹皮 赤芍药（炒） 甘草（炙） 陈皮 赤茯苓 半夏（姜制） 桑白皮（炒各五分） 桂
心（二分） 紫苏茎（二钱）
上锉，加生姜五片，枣一枚，水煎服。
当归汤 治胎动冲心，烦闷欲死，安胎止痛。
当归（酒洗） 川芎 人参 阿胶 甘草（炙，各一两半） 连根葱白（一握）
上细锉，以水二升，煎四味至升半，去滓，下葱再煎，减三合，入阿胶温服，一剂分为二三服。
大圣散 治妇人怔悸，睡中多惊，腹胁膨胀，坐卧不宁。
白茯苓 川芎 黄 （蜜炙） 当归（酒浸） 麦门冬（去心，各一钱） 人参 甘草（炙） 木香
（不见火，各五分）
上 咀，加生姜五片，水煎服。
治妊娠遍身痛或冲心欲死不能饮食
白术（五两）（此症禁用白术，而此方独用白术为君，非认症之确者不可） 黄芩（二两） 芍
药（四两）
上用水六升煮取二升半，分三服。
一方 治妊娠心下满，气急切痛。
赤茯苓（六分） 桑白皮（五分） 前胡（四分） 郁李仁 槟榔（各三分）
上为细末，以水一升煮取一半，去滓，夜卧服。
安胎和气饮 治胎冷，腹痛引两胁，小便频数，大便虚滑。
诃子（面裹煨，去核） 白术（各二钱） 陈皮（去白） 高良姜（炒） 木香（不见火） 白芍药
陈米（炒） 甘草（炙，各一钱）
上作一服，生姜五片，水煎服，忌生冷之物。
仲景附子汤 妇人怀妊六七月，脉弦发热，其胎愈胀，腹痛恶寒者，少腹如扇。所以然
者，子脏寒故也，当以此汤温其脏。
附子（二枚，炮去皮，破八片） 白术（四两） 茯苓 芍药 人参（二两）
上五味，以水八升煮取三升，去渣，温服一升，日三服。
(Also known as Zi Xuan / Fetal Distension)
*Da Quan* records: During pregnancy, if one experiences fullness and distension in the heart and abdomen, it is due to pre-existing cold qi in the abdomen causing fluid retention. This is further triggered by exposure to cold food or drinks, where the cold-fluid competes with the qi, resulting in heart and abdominal distension. (Although this describes causes related to cold qi and fluid retention, generally speaking, when yang qi becomes obstructed and rushes upward to the heart and abdomen, *Zisu Yin* (Perilla Decoction) is used as the primary formula to broaden the qi and direct it downward. Other herbs are added or subtracted according to symptoms.)
Xue Ji stated: For the aforementioned conditions, if caused by external contraction of wind-cold and internal injury from diet, use *Huoxiang Zhengqi San* (Patchouli Powder for Rectifying Qi); if diet injures the spleen and stomach, use *Liujunzi Tang* (Six Gentlemen Decoction); if yang qi is obstructed and the fetus presses upward against the heart, use *Zisu Yin*.
A pregnant woman suffered from food stagnation, causing heart and abdominal distension. Someone administered *Renshen Yangwei Tang* (Ginseng Decoction for Nourishing the Stomach) augmented with Qingpi (Green Tangerine Peel), Shanzha (Hawthorn Fruit), and Zhike (Bitter Orange). The distension worsened, the fetus attacked upward, nausea occurred, and appetite was lost. The pulse at the right Guan position was floating and large, but string-taut upon deep pressure. This indicated deficiency of Spleen Earth being overacted upon by Liver Wood. She recovered after taking *Liujunzi Tang* augmented with Chaihu (Bupleurum Root) and Shengma (Cimicifuga Rhizome). Later, she experienced痞满 (fullness and stuffiness) in the lower abdomen, which resolved after using *Buzhong Yiqi Tang* (Decoction for Supplementing the Middle and Augmenting the Qi) to raise the Spleen Qi.
Another pregnant woman had abdominal distension, difficulty urinating, and vomiting. Various physicians administered mixed medicines for warming the stomach and broadening the qi; instead, she vomited more, and the distension intensified, rushing to the chest and heart. Examination revealed the fetus had been dead for a long time. Medicines to expel the dead fetus failed to work. Upon receiving *Liyu Tang* (Carp Decoction), the text states: "If a pregnant woman has generalized edema or urgent distension in the chest and heart, it is called Tai Shui (Fetal Water)." Examining the area between the chest and abdomen, the boundaries were indistinct (this symptom must be recognized). Urgently administering three to five doses of *Liyu Tang*, foul water was discharged through both bowels and urine. The swelling subsided, and the distension cleared, allowing for the delivery of the dead fetus. This condition likely arose because the pregnant woman did not perceive the abdominal enlargement, assuming all pregnancies present this way, thus failing to recognize the harm of Fetal Water.
Li Shi stated: Zi Xuan refers to pain, fullness, and distension in the heart and abdomen. From the fourth or fifth month of pregnancy onwards, the Ministerial Fire nourishes the fetus, leading to fetal heat and rebellious qi rushing to the heart. Heart and abdominal distension and pain are treated with *Zisu Yin*; if severe distension and fullness are caused by constraint, add Ezhu (Curcuma Zedoaria Rhizome) and a small amount of Dingxiang (Clove). If there is no appetite, use Qinshu Tang (Scutellaria and Atractylodes Decoction) with doubled Baizhu (Atractylodes Macrocephala Rhizome) and added Shaoyao (Peony Root).
If fire qi is extremely excessive, sudden death may occur due to stifled heart qi; continuous administration of *Zisu Yin* can save the patient. (People often overlook the need for continuous administration of *Zisu Yin* when fire is extremely excessive; one must understand that this is due to qi causing stifling.)
If the Chi pulses at both wrists are absent, and there has been an error in administering abortive drugs resulting in a dead fetus in the uterus, the patient will shiver with cold, and the fingers, lips, and nails will turn blue. The tongue diagnosis is the key verification; *Xionggui Tang* (Angelica and Ligusticum Decoction) is used for rescue.
Zhang Zhongjing said: In women pregnant for six or seven months, if the pulse is string-taut and accompanied by fever, the fetus becomes more distended. If there is abdominal pain and aversion to cold, with the lower abdomen feeling cool like a fan blowing, it is because the Zi Zang (uterus) is cold. One should use *Fuzi Tang* (Aconite Decoction) to warm the uterus. (Fuzi is usually contraindicated before birth, but here it treats uterine cold, exemplifying the principle that 'if there is a cause, there is no harm'.)
If a woman injures her pregnancy, experiencing abdominal fullness, inability to urinate, heaviness from the waist up, resembling water accumulation, and at seven months of pregnancy, the Taiyin stage fails to nourish properly, indicating excess Heart Qi, one should needle Laogong (Pericardium 8) and Guanyuan (Conception Vessel 4) to drain. Recovery occurs when urination becomes slightly free.
*Zisu Yin* treats disharmony of fetal qi rushing to the heart and abdomen, causing distension and pain, known as Zi Xuan. It also treats panic and qi knotting during labor preventing delivery for several days. Without Chuanxiong, it is called Qibao San (Seven-Treasure Powder).
Ingredients: Zisu Ye (Perilla Leaf, 2 qian), Dafupi (Areca Peel), Chuanxiong (Ligusticum Rhizome), Baishaoyao (White Peony Root), Chenpi (Tangerine Peel, pith removed), Danggui (Angelica Sinensis Root) (each 1 qian), Renshen (Ginseng Root), Gancao (Licorice Root) (each 5 fen).
Crush into coarse powder for one dose. Add 3 slices of Shengjiang (Fresh Ginger) and 7 cun of Congbai (Scallion White). Decoct in water and take warm.
*Benshi Fang* records: Once, a woman failed to deliver repeatedly despite trying various parturition-promoting medicines without effect. I said: This is likely due to lying down too early and harboring fear, causing qi knotting and stagnation, though the birth canal itself is not obstructed. *Suwen* states: 'Fear causes qi to sink.' Fear makes the spirit timid; timidity closes the Upper Jiao; closure causes qi to return; returning qi causes Lower Jiao distension, stopping its movement. After taking this medicine, delivery occurred immediately. I have frequently verified this formula for Zi Xuan in women at six or seven months of pregnancy; within ten doses, the fetus descends.
Chen Fangfu treated a woman pregnant for seven months who returned from a long journey. Suddenly, fetal qi rushed to the heart causing pain, restlessness, and ineffective treatment by two other physicians who declared the fetus dead. They applied a paste of Castor Bean (Bimazi) and Musk to the navel to induce expulsion, leaving the mother in critical condition. Chen examined her: the Chi pulses were absent, while other pulses were peaceful. Chen asked how they diagnosed it. They replied: Dead fetus. Chen asked why. They said: Deep and absent Chi pulses. Chen asked the source of this theory. They had no answer. Chen said: This is Zi Xuan. If the fetus were dead, there would be distinguishing signs: red face and blue tongue indicate fetal death with maternal survival; blue face and red tongue with foaming indicate maternal death with fetal survival; blue lips and mouth indicate death of both. Here, the face is not red, the tongue is not blue, so the fetus is alive. The fetal qi is pressing against the heart; treat with *Zisu Yin*. After ten doses, the fetus descended.
*Helile San* (Terminalia Powder) treats pregnancy-related heart and abdominal distension, qi rushing to the chest and diaphragm causing stifling, weakness in the four limbs, and loss of appetite.
Ingredients: Helile (Terminalia Chebula Fruit), Chi Fuling (Red Poria), Qianhu (Peucedanum Root) (each 1 liang), Chenpi, Dafupi, Sangbaipi (Mulberry Bark) (each 7.5 qian), Zhike, Chuanxiong, Baizhu (each 0.5 liang).
Grind into coarse powder. Take 4 qian per dose with 3 slices of ginger and one jujube. Decoct in water.
*BaoTai Heqi Yin* (Fetus-Nourishing and Qi-Harmonizing Decoction) specifically treats conditions during the fourth to fifth month of pregnancy such as body fatigue, rapid breathing, fever, tasteless appetite, lethargy, and dizziness.
Ingredients: Zhike (4 qian), Houpo (Magnolia Bark), Xiangfuzi (Cyperus Rhizome) (each 3 qian), Sharen (Amomum Fruit), Cangzhu (Atractylodes Lancea Rhizome), Juhong (Ponkan Peel) (each 2 qian), Suye (Perilla Leaf, 1 qian), Gancao (Licorice Root, 9 fen).
Xiaohuixiang (Fennel Seed, 1.5 qian).
Crush and divide into three doses. Decoct each dose in 1.5 zhong of water until reduced to 0.7 zhong. Take warm.
*Shoutai Yin* (Fetus-Thinning Decoction) specifically treats conditions during the fifth to sixth month of pregnancy such as weak fetal development, heavy body, lethargy, loss of taste, and fetal movement in the abdomen.
Ingredients: Danggui (Angelica Sinensis Root, 2 qian), Baishaoyao, Yimucao (Motherwort Herb), Zhike (Bitter Orange) (each 4 qian), Sharen, Xiangfuzi, Yizhi (Alpinia Oxyphylla Fruit) (each 3 qian), Gancao (Licorice Root, 1 qian).
Crush and divide into three doses. Decoct each dose in 1.5 zhong of water until reduced to 0.7 zhong. Take warm on an empty stomach.
*Zhike Tang* (Bitter Orange Decoction) treats fetal abdominal distension in pregnant women.
Ingredients: Zhike (3 liang), Huangqin (Scutellaria Root) (2 liang, some formulas use 1 liang).
Grind into coarse powder. Take 5 qian per dose. Decoct in water. If abdominal distension and heavy body occur, add Baizhu (1 liang).
*Congbai Tang* (Scallion White Decoction) treats fetal qi rushing upward causing heart vexation and stifling, and also treats severe fetal restlessness.
Use fourteen stalks of Congbai (Scallion White). Boil thickly and drink the juice. If the fetus is alive, it calms; if dead, it is expelled. Repeat if ineffective. (The fetaling property of Scallion White is unknown to many.)
Lou Quanshan said: This formula is miraculous; it is suitable for those with floating and slippery pulses. *Bencao* states: Scallion White unblocks yang qi and fetuses the fetus.
One prescription treats fetal restlessness and pain pressing against the heart.
Take a ball of Aiye (Mugwort Leaf) the size of a chicken egg. Boil in 4 sheng of first-run vinegar until reduced to 2.5 sheng. Take warm.
*Canggong Xiaqi Tang* (Master Canggong's Qi-Descending Decoction) treats distension and stifling in the heart, abdomen, and hypochondrium, poor appetite, and limb weakness.
Ingredients: Qianghuo (Notopterygium Rhizome), Binglang (Betel Nut), Qingpi (Green Tangerine Peel), Dafupi, Chishaoyao (Red Peony Root, stir-fried), Gancao (Licorice Root, honey-fried), Chenpi, Chifuling (Red Poria), Banxia (Pinellia Tuber, ginger-processed), Sangbaipi (Mulberry Bark, stir-fried) (each 5 fen), Guixin (Cinnamon Twig, 2 fen), Zisu Jing (Perilla Stem, 2 qian).
Crush and add 5 slices of ginger and one jujube. Decoct in water.
*Danggui Tang* (Angelica Decoction) treats fetal restlessness rushing to the heart, extreme vexation, for fetaling and pain relief.
Ingredients: Danggui (Angelica Sinensis Root, wine-washed), Chuanxiong, Renshen, Ejiao (Donkey-hide Gel), Gancao (Licorice Root, honey-fried) (each 1.5 liang), Liancong Bai (Scallion White with roots, one handful).
Finely crush. Add 2 sheng of water. Decoct the four ingredients until reduced to 1.5 sheng. Strain, add scallion, and decoct again until reduced by 3 he. Add Ejiao and take warm. Divide one dose into two or three servings.
*Dasheng San* (Great Sage Powder) treats palpitations, frequent startle during sleep, abdominal and hypochondriac distension, and restlessness.
Ingredients: Baifuling (White Poria), Chuanxiong, Huangqi (Astragalus Root, honey-fried), Danggui (Angelica Sinensis Root, wine-soaked), Maidong (Ophiopogon Tuber, core removed) (each 1 qian), Renshen, Gancao (Licorice Root, honey-fried), Muxiang (Aucklandia Root, not exposed to fire) (each 5 fen).
Crush and add 5 slices of ginger. Decoct in water.
For treating generalized body pain during pregnancy or rushing to the heart causing death-like state and inability to eat:
Baizhu (Atractylodes Macrocephala Rhizome, 5 liang) (Note: Baizhu is usually contraindicated in this condition, but this formula uses it as the sovereign herb; only use if the diagnosis is accurate.) Huangqin (Scutellaria Root, 2 liang), Shaoyao (Peony Root, 4 liang).
Add 6 sheng of water. Boil to obtain 2.5 sheng. Divide into three doses.
One prescription treats pregnancy-related epigastric fullness, urgent qi and cutting pain.
Chifuling (Red Poria, 6 fen), Sangbaipi (Mulberry Bark, 5 fen), Qianhu (Peucedanum Root, 4 fen), Yuliren (Prunus Armeniaca Seed), Binglang (Betel Nut) (each 3 fen).
Grind into fine powder. Add 1 sheng of water. Boil to obtain half. Strain and take before sleep.
*Antai Heqi Yin* (Fetus-Securing and Qi-Harmonizing Decoction) treats cold womb, abdominal pain radiating to the hypochondrium, frequent urination, and loose stools.
Hezi (Terminalia Chebula Fruit, baked in flour, pitted), Baizhu (each 2 qian), Chenpi (pith removed), Gaoliangjiang (Galangal Rhizome, stir-fried), Muxiang (Aucklandia Root, not exposed to fire), Baishaoyao, Chenmi (Aged Rice, stir-fried), Gancao (Licorice Root, honey-fried) (each 1 qian).
Combine for one dose. Add 5 slices of ginger. Decoct in water. Avoid raw and cold foods.
*Zhongjing Fuzi Tang* (Zhang Zhongjing's Aconite Decoction): For women pregnant six or seven months, with string-taut pulse, fever, increased fetal distension, abdominal pain, aversion to cold, and lower abdomen feeling cool like a fan. This is due to cold in the Zi Zang (uterus). Warm the uterus with this decoction.
Ingredients: Fuzi (Prepared Aconite Root, 2 pieces, peeled and broken into 8 pieces), Baizhu (4 liang), Fuling (Poria), Shaoyao (Peony Root), Renshen (Ginseng Root, 2 liang).
These five ingredients. Add 8 sheng of water. Boil to obtain 3 sheng. Strain. Take 1 sheng warm, three times daily.