妊妇有胎不动腹不疼,而小便中时常有血流出者,人以为血虚胎漏也,谁知是气虚不能摄血乎!夫血只能荫胎,
而胎中之荫血,必赖气以卫之,气虚下陷,则荫胎之血亦随气而陷矣。然则气虚下陷,而血未尝虚,似不应与气同
陷也。不知气乃血之卫,血赖气以固,气虚则血无凭根据,无凭根据必燥急,燥急必生邪热;血寒则静,血热则动,动
则外出而莫能遏,又安得不下流乎!倘气不虚而血热,则必大崩,而不止些微之漏矣。治法宜补其气之不足,而泄
其火之有余,则血不必止而自无不止矣。
方用助气补漏汤。
人参(一两) 白芍(五钱,酒炒) 黄芩(三钱,酒炒黑) 生地(二钱,酒炒黑) 益母草(一钱) 续断
(二钱) 甘草(一钱)
水煎服。一剂而血止,二剂再不漏矣。此方用人参以补阳气,用黄芩以泄阴火。火泄则血不热而无欲动之机,
气旺则血有根据而无可漏之窍,气血俱旺而和协,自然归经而各安其所矣,又安有漏泄之患哉!
眉批∶补血不用当归妙,以当归之香燥也。
歌括∶妊娠胎安腹不痛,小便时时血水淋。
气虚下陷胎方漏,补气泄火法最精。
助气补漏白芍参,生地益母枯黄芩。
续断甘草同煎滚,二剂漏止胎可荫。
妊妇怀胎至七八个月,忽然儿啼腹中,腰间隐隐作痛,人以为胎热之过也,谁知是气虚之故乎!治宜大补其
气,
方用扶气止啼汤。
人参(一两) 黄 (一两,生用) 麦冬(一两,去心) 当归(五钱,酒洗) 橘红(五分) 甘草(一钱)
花粉(一钱)
水煎服。一剂而啼即止,二剂不再啼。此方用人参、黄 、麦冬以补肺气,使肺气旺,则胞胎之气亦旺,胞胎之气
旺,则胞中之子气有不随母之气以为呼吸者,未之有也。
眉批∶黄 用嫩黄 ,不可用箭 ,箭 系北口外苜蓿根。
歌括∶妊妇怀胎七八月,忽然儿在腹中鸣。
腰间隐隐常作痛,母气虚甚此病生。
扶气止啼人参烹,黄 当归麦门冬。
橘红甘草天花粉,肺气健旺子无声。
妊娠妇女胎动不安但腹部不疼痛,小便中时常有血液流出,人们认为是血虚导致的胎漏(妊娠期阴道少量出血),哪里知道这是气虚不能固摄血液的缘故!血液只能滋养胎儿,而胎儿所依赖的血液,必须依靠气来护卫它。气虚下陷,那么滋养胎儿的血液也会随着气一起下陷。既然气虚下陷,而血液本身并未虚弱,似乎不应该与气一同下陷。却不知道气是血的护卫,血依赖气来固摄,气虚则血失去依托,没有依托必然变得燥急,燥急必然产生邪热;血寒则静止,血热则妄动,妄动则向外溢出而无法遏制,又怎能不向下流淌呢!如果气不虚而只是血热,那一定会发生大出血(崩漏),而不会仅仅是少量的渗漏。治疗方法应当补益不足之气,清泄有余之火,那么血不必刻意止住而自然能止住。
方剂用助气补漏汤。
人参(一两) 白芍(五钱,酒炒) 黄芩(三钱,酒炒黑) 生地(二钱,酒炒黑) 益母草(一钱) 续断(二钱) 甘草(一钱)
水煎服。服用一剂后血止,服用两剂后不再渗漏。此方用人参来补益阳气,用黄芩来清泄阴火。火气清泄则血不热而没有妄动的趋势,气旺盛则血有依托而没有渗漏的孔隙,气血都旺盛且和谐,自然回归经脉并各安其位,又怎么会有渗漏的祸患呢!
眉批:补血不用当归很巧妙,因为当归气味香燥。
歌诀:妊娠胎安腹不痛,小便时时血水淋。
气虚下陷胎方漏,补气泄火法最精。
助气补漏白芍参,生地益母枯黄芩。
续断甘草同煎滚,二剂漏止胎可荫。
妊娠妇女怀胎至七八个月时,忽然胎儿在腹中啼哭,腰间隐隐作痛,人们以为是胎热的过错,哪里知道这是气虚的缘故呢!治疗应当大补其气,方剂用扶气止啼汤。
人参(一两) 黄芪(一两,生用) 麦冬(一两,去心) 当归(五钱,酒洗) 橘红(五分) 甘草(一钱) 花粉(一钱)
水煎服。服用一剂后啼哭即止,服用两剂后不再啼哭。此方用人参、黄芪、麦冬来补益肺气,使肺气旺盛,那么胞胎的气也旺盛,胞胎的气旺盛,那么胞中的子气有不跟随母亲的气来进行呼吸的,这种情况是不存在的。
眉批:黄芪要用嫩黄芪,不可用箭芪,箭芪是指北口外生长的苜蓿根。
歌诀:妊妇怀胎七八月,忽然儿在腹中鸣。
腰间隐隐常作痛,母气虚甚此病生。
扶气止啼人参烹,黄芪当归麦门冬。
橘红甘草天花粉,肺气健旺子无声。
Pregnant women whose fetus is not moving and who experience no abdominal pain, yet have blood flowing from the urethra from time to time, are often thought by people to suffer from fetal leakage (vaginal bleeding during pregnancy) due to blood deficiency. Little do they know that this is actually caused by Qi deficiency failing to control the blood! Blood can only nourish the fetus, but the blood nourishing the fetus must rely on Qi to guard it. When Qi is deficient and sinks downward, the blood that nourishes the fetus will also sink along with the Qi. However, if Qi is deficient and sinking while the blood itself is not deficient, one might think it should not sink together with the Qi. The truth is that Qi acts as the guardian of blood, and blood relies on Qi for consolidation. When Qi is deficient, blood loses its foundation; without a foundation, it becomes dry and urgent, leading to the generation of pathogenic heat. Cold blood remains still, while hot blood moves erratically; when it moves, it flows outward uncontrollably, how could it not flow downward? If Qi were not deficient but the blood were merely hot, there would be severe hemorrhage (Beng Lou), not just slight leakage. The treatment method should tonify the insufficiency of Qi and drain the excess fire, so that the blood will stop naturally without needing specific hemostatic measures.
The formula used is Zugu Bulou Tang (Assisting Qi and Stopping Leakage Decoction).
Ren Shen (Ginseng Radix et Rhizoma) (1 liang), Bai Shao (White Peony Root) (5 qian, stir-fried with wine), Huang Qin (Scutellariae Radix) (3 qian, stir-fried black with wine), Sheng Di Huang (Rehmanniae Radix Praeparata) (2 qian, stir-fried black with wine), Yi Mu Cao (Leonuri Herba) (1 qian), Xu Duan (Dipsaci Radix) (2 qian), Gan Cao (Licorice Root) (1 qian).
Decoct in water and take orally. After one dose, the bleeding stops; after two doses, there is no further leakage. This formula uses Ren Shen to tonify Yang Qi and Huang Qin to drain Yin Fire. Once the fire is drained, the blood is no longer hot and lacks the tendency to move erratically; once Qi is vigorous, the blood has a foundation and no pores for leakage. With both Qi and blood vigorous and harmonious, they naturally return to their meridians and remain in their proper places, thus avoiding any risk of leakage!
Marginal note: It is ingenious not to use Dang Gui for nourishing blood, because Dang Gui is aromatic and drying.
Verse:
During pregnancy, the fetus is stable and the abdomen does not hurt,
Yet blood and fluid drip frequently from the urine.
When Qi deficiency causes sinking, fetal leakage occurs,
Tonifying Qi and draining fire is the most precise method.
Zugu Bulou contains Bai Shao and Ren Shen,
Sheng Di, Yi Mu Cao, and dried Huang Qin.
Boil Xu Duan and Gan Cao together,
Two doses stop the leakage and nourish the fetus.
When a pregnant woman reaches seven or eight months of gestation, the fetus suddenly cries within the abdomen, accompanied by dull pain in the waist. People attribute this to fetal heat, little knowing it is actually due to Qi deficiency! The treatment should heavily tonify Qi using Fuxi Ziti Tang (Supporting Qi and Stopping Crying Decoction).
Ren Shen (Ginseng Radix et Rhizoma) (1 liang), Huang Qi (Astragali Radix) (1 liang, raw), Mai Dong (Ophiopogonis Tuber) (1 liang, heart removed), Dang Gui (Angelicae Sinensis Radix) (5 qian, washed with wine), Ju Hong (Citri Reticulatae Pericarpium Rubrum) (5 fen), Gan Cao (Licorice Root) (1 qian), Hua Fen (Trichosanthis Radix) (1 qian).
Decoct in water and take orally. After one dose, the crying stops immediately; after two doses, it does not recur. This formula uses Ren Shen, Huang Qi, and Mai Dong to tonify Lung Qi. When Lung Qi is vigorous, the Qi of the Chong and Ren vessels (uterus) also becomes vigorous. When the Qi of the uterus is vigorous, it is impossible for the fetal Qi not to follow the mother's Qi for respiration.
Marginal note: Use tender Huang Qi, not Jian Qi (Arrow Astragalus); Jian Qi refers to the root of Alfalfa grown outside the northern passes.
Verse:
In the seventh or eighth month of pregnancy,
Suddenly the child cries within the belly.
Dull pain often arises in the waist,
This disease arises when maternal Qi is severely deficient.
Fuxi Ziti decocts Ren Shen,
Huang Qi, Dang Gui, and Mai Men Dong.
Ju Hong, Gan Cao, and Tian Hua Fen,
When Lung Qi is robust, the child falls silent.