大全云∶妊娠饮食生冷,脾胃不能克化,致令心腹疼痛。若血分病,则色赤;气分病,则
色白;血气俱病,则赤白相杂。若热乘大肠,血虚受患,则成血痢也。
薛氏曰∶治痢之法,当参前篇,其下黄水,乃脾土亏损,真气下陷也,当升补中气;若黄
而兼青,乃肝木克脾土,宜平肝补脾;若黄而
兼白,乃子令母虚,须补脾胃;若黄而兼黑,是水反侮土矣,必温补脾胃,若黄而兼赤,乃心
母益子,但用补中益气;若肠胃虚弱,风邪客之,用胃风汤,或胎气不安,急补脾胃而自安
矣。凡安胎之药,当临病制宜,不必拘用阿胶、艾叶之类。(重坠起于久病,故为下元气虚,而
以补中、六君治之。若非久病者,犹当以安胎为主也)
地官胡成甫之内,妊娠久痢,自用消导理气之剂,腹内重坠,胎气不安,又用阿胶、艾叶
之类不应。余曰∶腹重坠,下元气虚也,胎动不安,内热盛也,遂用补中益气汤而安,又用六
君子汤痊愈。
壶仙翁治汤总兵夫人妊娠病痢不止,翁诊其脉虚而滑,两关若涩,此由胎气不和,相
火炎上而有热,似痢实非痢也,乃用黄芩、白术以安胎,四物、生地黄以调血,数剂而安。
白术汤(一名三物汤) 治孕妇下痢脓血。
白术 黄芩 当归(各等分)
上 咀,每服三钱至四钱,水二盏,煎至一盏,去渣温服,日夜三次。嗽者,加桑白
皮,食后服之。
当归芍药汤 治妊娠腹中绞痛,下痢赤白。
白芍药 白茯苓 当归 川芎 泽泻(各五钱) 白术(七分半)
上为细末,温酒或米饮,任意调服。一方无川芎,有条芩、甘草、黄连、木香、槟榔, 咀煎服。
黄连汤 治妊娠下痢赤白,脓血不止。
黄连(八分) 浓朴(制) 阿胶 当归 干姜(各六分) 黄柏 艾叶(各四分)
上为细末,空心米饮调下方寸匕,日三服。
蒙姜黄连丸 治妊娠下痢赤白,谷道肿痛,冷热皆可服。
干姜(炮) 黄连 缩砂仁(炮) 川芎 阿胶(蛤粉炒) 白术(各一两) 乳香(二钱,另研)
枳壳(去白
麸炒,半两)
上为末,用乌梅三个取肉,入少醋糊同杵丸,如桐子大,每服四十丸。白痢,干姜汤下,
赤痢,甘草汤下,赤白痢,干姜、甘草汤下。一方有木香二钱。
三黄熟艾汤 治妊娠挟热下痢。
黄连 黄芩 黄柏 熟艾(各等分)
上锉,每服五钱,水煎服。呕加橘皮、生姜。(以三黄汤加熟艾治热痢,加橘皮、生姜治
呕,俱妙)
归 汤 治妊娠下痢腹痛,(须审腹痛是有余否)小便涩滞。
黄 当归(焙,各一两) 糯米(一合)
上细切,分四服,水煎服。
大宁散 治妊娠下痢赤白,灰色,泄泻疼痛,垂死者。
黑豆(二十粒) 甘草(二寸半,生炙各半) 粟壳(二个去顶,半生半炒)
上为粗末,作一服,加生姜三片,水煎,食前服,神效。
浓朴散 治妊娠下痢,黄水不绝。
浓朴(姜汁制) 黄连(各三两) 肉豆蔻(五个,连皮用)
上锉,水煎,徐徐服。一方肉豆蔻止用一枚。
鸭蛋汤 治妇人胎前产后赤白痢。
生姜(年少者百钱,老者二百钱,重取自然汁) 鸭蛋(一个打碎,入姜汁内搅匀)
上二味,煎至八分,入蒲黄三钱,煎五七沸,空心温服,立效。
二黄散 治妊娠下赤白,绞刺疼痛。
鸡子(一枚,乌鸡者佳,倾出清留黄用) 黄丹(一钱,入鸡子壳内,同黄搅匀,以浓纸糊牢,
盐泥固济,火上煨干)
上研为细末,每服二钱,米饮调下。一服愈者是男,二服愈者是女。
The *Wenke Baiwen* (Questions and Answers on Gynecology) states: If pregnant women consume raw or cold food, the Spleen and Stomach fail to transform and transport it, leading to pain in the heart and abdomen. If the disease is in the Blood aspect, the stool will be red; if in the Qi aspect, the stool will be white; if both Qi and Blood are diseased, red and white will be mixed. If heat pathogens invade the Large Intestine, combined with Blood deficiency, it becomes a bloody dysentery.
Xue Ji (Mr. Xue) said: The method for treating dysentery should refer to the previous chapter. If yellow water is discharged, it is due to Spleen Earth deficiency and sinking of true Qi, requiring lifting and tonifying Middle Qi; if yellow is mixed with green, it is Liver Wood overacting on Spleen Earth, suitable for soothing the Liver and tonifying the Spleen; if yellow is mixed with white, it indicates the child causing the mother's deficiency (referring to the generative cycle where the child organ affects the mother organ), requiring tonification of the Spleen and Stomach; if yellow is mixed with black, it is Water counter-acting Earth (Kidney Water insulting Spleen Earth), requiring warming and tonifying the Spleen and Stomach; if yellow is mixed with red, it involves the Heart Mother benefiting the Child (Heart Fire generating Spleen Earth), using only Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction); if the Intestines and Stomach are weak and Wind pathogens lodge therein, use Weifeng Tang (Stomach Wind Decoction); or if fetal qi is unsettled, urgently tonify the Spleen and Stomach, and the fetal qi will settle naturally. All herbs for calming the fetus should be adapted to the specific condition, without rigidly adhering to herbs like Ejiao (Donkey-hide Gelatin) or Aye (Mugwort Leaf). (Abdominal heaviness and bearing-down sensation arises from chronic illness, thus belonging to deficiency of Lower Yuan Qi, treated with Buzhong Yiqi Tang and Liujunzi Tang. If not a chronic illness, one should still prioritize calming the fetus.)
The wife of Hu Chengfu, an official of the Land Department, suffered from chronic dysentery during pregnancy. After self-administering digestive and Qi-regulating agents, she experienced abdominal heaviness and fetal unrest. Subsequent treatment with Ejiao and Aye was ineffective. I stated: Abdominal heaviness indicates deficiency of Lower Yuan Qi; fetal unrest indicates excessive internal heat. Thus, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) was used to calm the fetus, followed by Liujunzi Tang (Six Gentlemen Decoction) for complete recovery.
Huxianweng treated the夫人 (Lady) of Commander Tang for persistent dysentery during pregnancy. His pulse diagnosis revealed a deficient and slippery pulse, with a choppy quality at both Guan positions. This was due to disharmony of fetal qi, with Ministerial Fire flaming upward causing heat; it resembled dysentery but was not truly dysentery. He used Huangqin (Scutellariae Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma) to calm the fetus, Siwu Tang (Four Substance Decoction) and Shengdihuang (Rehmanniae Radix) to regulate Blood. After several doses, the condition stabilized.
Baizhu Tang (also known as Sanwu Tang): Treats pregnant women with dysenteric discharge of pus and blood.
Ingredients: Baizhu (Atractylodis Macrocephalae Rhizoma), Huangqin (Scutellariae Radix), Danggui (Angelicae Sinensis Radix) in equal parts.
Preparation and Administration: Coarsely crush. Take 3-4 qian per dose, add 2 liang of water, decoct to 1 liang, remove dregs, and take warm. Three times daily. For cough, add Sangbaipi (Mori Cortex) and take after meals.
Danggui Shaoyao Tang: Treats pregnancy with colicky abdominal pain and dysenteric discharge of red and white.
Ingredients: Baishaoyao (Paeoniae Radix Alba), Baifuling (Poria), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Zexie (Alismatis Rhizoma) each 5 qian; Baizhu (Atractylodis Macrocephalae Rhizoma) 0.75 qian.
Preparation and Administration: Grind into fine powder. Mix with warm wine or rice water as desired. Another version excludes Chuanxiong and includes Tiaohuangqin (Scutellariae Radix prepared with honey), Gancao (Glycyrrhizae Radix et Rhizoma), Huanglian (Coptidis Rhizoma), Muxiang (Aucklandiae Radix), and Binglang (Arecae Semen), crushed and decocted.
Huanglian Tang: Treats pregnancy with dysenteric discharge of red and white, continuous pus and blood.
Ingredients: Huanglian (Coptidis Rhizoma) 8 fen; Houpo (Magnoliae Officinalis Cortex) processed, Ejiao (Asini Corii Colla), Danggui (Angelicae Sinensis Radix), Jiangtang (Zingiberis Rhizoma) each 6 fen; Huangbai (Phellodendri Cortex), Aye (Artemisiae Argyi Folium) each 4 fen.
Preparation and Administration: Grind into fine powder. Take one fangcunbi (a measure approx. 1 cubic inch) with rice water on an empty stomach, three times daily.
Mengjiang Huanglian Wan: Treats pregnancy with dysenteric discharge of red and white, swelling and pain in the anal region. Suitable for both cold and heat patterns.
Ingredients: Jiangtang (Zingiberis Rhizoma) processed, Huanglian (Coptidis Rhizoma), Suosharen (Amomi Fructus Rotundus) processed, Chuanxiong (Ligustici Chuanxiong Rhizoma), Ejiao (Asini Corii Colla) fried with clam powder, Baizhu (Atractylodis Macrocephalae Rhizoma) each 1 liang; Ruxiang (Olibanum) 2 qian, separately ground; Zhike (Aurantii Fructus) de-albified and bran-fried, 0.5 liang.
Preparation and Administration: Grind into powder. Take flesh from three Wumei (Mume Fructus), mix with a little vinegar paste, and pound into pills the size of tung tree seeds. Take 40 pills per dose. For white dysentery, take with Jiangtang (Zingiberis Rhizoma) decoction; for red dysentery, with Gancao (Glycyrrhizae Radix et Rhizoma) decoction; for red and white dysentery, with Jiangtang and Gancao decoction. Another version includes Muxiang (Aucklandiae Radix) 2 qian.
Sanhuang Shuai Ai Tang: Treats pregnancy with dysentery complicated by heat.
Ingredients: Huanglian (Coptidis Rhizoma), Huangqin (Scutellariae Radix), Huangbai (Phellodendri Cortex), Shuai Ai (Artemisiae Argyi Folium processed) in equal parts.
Preparation and Administration: Cut into pieces. Take 5 qian per dose, decoct in water. For vomiting, add Jupi (Citri Reticulatae Pericarpium) and Shengjiang (Zingiberis Rhizoma Recens). (Using Sanhuang Tang with Shuai Ai treats heat dysentery; adding Jupi and Shengjiang treats vomiting, both are excellent.)
Gui Tang: Treats pregnancy with dysentery, abdominal pain (must ascertain if the pain is due to excess), and difficult urination.
Ingredients: Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix) roasted, each 1 liang; Nuomi (Oryza Sativa Glutinosa) 1 he.
Preparation and Administration: Finely cut. Divide into four doses, decoct in water, and take.
Daning San: Treats pregnancy with dysenteric discharge of red and white, grayish color, diarrhea with pain, approaching death.
Ingredients: Heidou (Phaseoli Semen Nigrum) 20 grains; Gancao (Glycyrrhizae Radix et Rhizoma) 2.5 cun, half raw and half roasted; Susu (Elaeocarpi Fructus) 2 pieces, tops removed, half raw and half roasted.
Preparation and Administration: Grind into coarse powder. Prepare as one dose, add 3 slices of Shengjiang (Zingiberis Rhizoma Recens), decoct in water, and take before meals. Extremely effective.
Houpo San: Treats pregnancy with dysentery, continuous discharge of yellow water.
Ingredients: Houpo (Magnoliae Officinalis Cortex) processed with ginger juice, Huanglian (Coptidis Rhizoma) each 3 liang; Roudoukou (Myristicae Semen) 5 pieces, used with skin.
Preparation and Administration: Cut into pieces, decoct in water, and take slowly. Another version uses only 1 piece of Roudoukou (Myristicae Semen).
Yadan Tang: Treats women with red and white dysentery before or after childbirth.
Ingredients: Shengjiang (Zingiberis Rhizoma Recens) 100 qian for young ginger, 200 qian for old ginger (extract natural juice); Yadan (Anatis Ovum) 1 egg, broken and mixed well with ginger juice.
Preparation and Administration: Decoct the two ingredients to 8/10 volume, add Puhuang (Typhae Pollen) 3 qian, boil for 5-7 boils, take warm on an empty stomach. Immediate effect.
Erhuang San: Treats pregnancy with red and white dysentery, cramping and stabbing pain.
Ingredients: Jizi (Galli Ovum) 1 egg, preferably from a black-bone chicken, pour out the white and keep the yolk; Huangdan (Minii Oxidum Rubrum) 1 qian, placed inside the eggshell, mixed well with the yolk, sealed tightly with thick paper and salt mud, and baked dry over fire.
Preparation and Administration: Grind into fine powder. Take 2 qian per dose, mixed with rice water. If cured after one dose, it is a boy; if cured after two doses, it is a girl.