（本门诸方宜于前经病门参看。）
所谓阻者，经血既闭，痰水积于中，阻其脏气，不得宣通也。
《金匮》曰:妇人得平脉，阴脉小弱，其人渴不能食,无寒热，名妊娠。于法六十日，当有此证，设有医者治逆，却
一月，加吐下者，则绝之。（娄全善曰∶恶阻者，谓呕吐、恶心、头眩恶食、择食是也。绝之者，谓绝止医治，候其自安
也。尝治一二妊妇恶阻病，呕吐愈治愈逆，因思仲景绝之之旨，遂停药月余自安。大哉！圣人之道也。徐忠可曰∶其期
有未满六十日则胎未成，又加吐利，因医者以安胎为主，见而用条芩、砂仁之类，则脾胃实有受伤处，但当断绝病根为
主，不得泥安胎之说，故曰绝之。）
妇人所食谷味，化为血气，下为月水。凡妊娠之初，月水乍聚，一月为媒，二月为胚，三月为胎，成则男
女上食于母。然在三月相火化胎之候，未能上食于母，血气未用，五谷不化，中气壅实，其为郁滞、痰火、
秽恶之气尽冲于胃，所以恶心有阻也。其候心中愦闷，头眩，四肢懈惰，恶闻食气，多睡少起，酷嗜酸盐
果实者，乃肝肾不足，引以自救也。
凡孕二、三月间，妊妇禀受怯弱，便有阻病，呕逆不食，或心烦闷，状如醉酒，肢体沉重，择食，
恶食，头目昏眩，此乃气血积聚以养胎元，其精血内郁，而秽腐之气上攻于胃，是以呕逆
不能纳食；血既养胎，心失所荣，是以心虚烦闷。法当调血散郁，
用参、术、甘草补中气；桔红、紫苏、木香、生姜散郁气；茯苓、麦冬、黄芩、竹茹清热解烦，名参
桔饮，所谓胎前须顺气者此也。但胎前无寒，胎后无热，至于恶阻呕吐，尤多属热。然亦有因寒
而吐者，乃因病而非因恶阻也，不止则虚矣。当以人参干姜半夏丸主之，不可过用辛药。若吐甚
而愈止愈急者，用仲景法，停药月余自安矣。
《千金方》有半夏茯苓汤、茯苓丸，专治恶阻，比来少有服者，以半夏能动胎，胎初结，虑其辛燥
易散也，须姜汁炒以制其毒。凡恶阻非半夏不能止，故仲景用人参半夏干姜丸。罗谦甫用二陈去
陈皮、甘草，即名半夏茯苓汤。朱丹溪谓肥人多因痰，瘦人多因火，用二陈加减，并治胎前恶阻，
痰逆呕吐，心烦，头眩，恶食俱效。经云有故无殒是也。立斋曰∶半夏乃健脾气，化痰滞主药，
脾胃虚弱呕吐，或痰涎壅滞饮食少、胎不安，必用半夏茯苓汤，倍加白术安胎健脾。常用甚验也。恶阻兼
腰痛者，防胎堕下，尤宜二陈四物，加条芩、白术，和中理脾为主，不可升举。盖呕逆气
已上升，药再上升，则犯有升无降，上更实而下更虚，益促其堕矣。
（本门各类方剂适宜在前面的经脉病证章节中参考查阅。）
所谓“阻”，是指经血已经闭止，痰湿水饮积聚在体内，阻碍了脏腑之气的运行，使其不能宣通。
《金匮要略》说：妇人脉象平和，尺部脉象细小微弱，其人感到口渴但不能进食，没有恶寒发热的症状，这称为妊娠。按照法度，怀孕六十天左右，应当出现这些症状。如果有医生治疗不当，反而过了一段时间，增加了呕吐、腹泻的症状，那么就应该停止治疗。（娄全善说：恶阻，指的是呕吐、恶心、头晕目眩、厌恶食物、挑食等症状。“绝之”，意思是停止医疗干预，等待身体自我恢复安宁。我曾治疗过一两位患有恶阻病的孕妇，越治呕吐越严重，于是思考张仲景“绝之”的深意，便停药一个多月，病情自然痊愈。圣人的道理真是伟大啊！徐忠可说：如果时间未满六十天，则胎元尚未完全形成，又加上呕吐腹泻，因为医生以安胎为主，见到这种情况就使用黄芩、砂仁之类的药物，那么脾胃实际上已经受到了损伤，此时应当以断绝病根为主，不能拘泥于安胎的说法，所以说“绝之”。）
妇女所吃的谷物味道，转化为血气，下行成为月经。凡是怀孕初期，月经刚刚停止，第一个月称为“媒”，第二个月称为“胚”，第三个月称为“胎”，成形后男女胎儿开始从母体摄取营养。然而在第三个月相火化生胎元的阶段，胎儿尚不能向上摄取母体饮食，血气未被大量消耗，五谷难以消化，中焦之气壅滞充实，那些郁滞、痰火、秽浊恶气全都冲犯胃腑，所以产生恶心且有阻滞感。其表现为心中烦闷昏乱，头晕目眩，四肢懈怠无力，厌恶闻到食物的气味，嗜睡少起，特别嗜好酸味和咸味果实，这是肝肾不足，引酸咸以自救的表现。
凡是怀孕二、三个月期间，孕妇体质虚弱怯弱的，就会发生恶阻病，表现为呕吐逆气、不能进食，或者心烦闷乱，状如醉酒，肢体沉重，挑食，厌恶食物，头目昏眩。这是因为气血积聚以滋养胎元，精血在内郁滞，而秽腐之气上攻于胃，所以呕吐逆气不能纳食；血液既已用来养胎，心失所养，所以心虚烦闷。治疗方法应当调和血液、疏散郁滞，用人参、白术、甘草补益中气；桔红、紫苏、木香、生姜疏散郁滞之气；茯苓、麦冬、黄芩、竹茹清热解除烦闷，名为参桔饮，这就是所说的“胎前须顺气”的道理。但是胎前多无寒证，胎后多无热证，至于恶阻呕吐，大多属于热证。然而也有因寒邪引起的呕吐，那是因病而非由恶阻引起，如果不制止就会导致虚损。应当用人参干姜半夏丸主治，不可过度使用辛温药物。如果呕吐非常严重且越止越急的，采用张仲景的方法，停药一个多月自然安宁。
《千金方》中有半夏茯苓汤、茯苓丸，专门治疗恶阻，近来很少有人服用，因为认为半夏容易动胎气，胎元初结，担心其辛燥性质容易使胎气散失，需要用姜汁炒制以制约其毒性。大凡恶阻非半夏不能止住，所以张仲景使用人参半夏干姜丸。罗谦甫使用二陈汤去掉陈皮、甘草，即名为半夏茯苓汤。朱丹溪认为肥胖的人多因痰湿，瘦弱的人多因火邪，使用二陈汤加减，并治疗胎前恶阻，对于痰逆呕吐、心烦、头晕、厌恶食物都有效。这正是《内经》所说的“有故无殒”的道理。薛立斋说：半夏是健运脾气、化解痰滞的主药，脾胃虚弱呕吐，或者痰涎壅滞饮食减少、胎元不安，必须使用半夏茯苓汤，加倍加入白术以安胎健脾。常用非常有效。恶阻兼有腰痛的情况，要防止胎堕下，尤其适宜使用二陈汤合四物汤，加入黄芩、白术，以和中理脾为主，不可使用升提药物。因为呕吐逆气已经上升，药物如果再升提，就会犯“有升无降”的错误，上部更实而下部更虚，更加促使流产。
(The various prescriptions in this section are suitable for reference in the preceding chapters on meridian diseases.)
The term "Zu" (Obstruction) refers to the situation where menstrual blood has ceased, and phlegm-fluid accumulates in the middle, obstructing the Qi of the Zang organs, preventing it from circulating freely.
The *Jin Gui Yao Lue* states: "When a woman has a normal pulse, but the Yin pulse (Chi position) is small and weak, and she experiences thirst and inability to eat, without aversion to cold or fever, this is named Pregnancy. According to the method, these symptoms should appear around the sixtieth day. If a physician treats it incorrectly, causing vomiting and purging after a month, one should 'cut off' [the treatment]." (Lou Quanshan said: "E Zu" refers to vomiting, nausea, dizziness, food aversion, and selective eating. "Cut off" means to stop medical intervention and wait for self-recovery. I once treated one or two pregnant women with E Zu; their vomiting worsened with each treatment. Reflecting on Zhang Zhongjing's principle of "cutting off," I stopped medication for over a month, and they recovered naturally. Great is the Way of the Sages! Xu Zhongke said: "If the time is less than sixty days, the fetus is not yet formed, and vomiting/diarrhea occur. Since physicians focus on calming the fetus, using herbs like Huang Qin (Scutellariae Radix) and Sha Ren (Amomi Fructus), the Spleen and Stomach may be injured. One should focus on eliminating the root of the disease rather than adhering strictly to 'calming the fetus,' hence 'cut off.'")
The food eaten by women transforms into Blood and Qi, flowing downward as menstruation. In early pregnancy, when menstruation ceases, the first month is called "Mei," the second "Pei," and the third "Tai." Once formed, the male or female fetus begins to nourish itself from the mother. However, during the third month, when the Ministerial Fire transforms the fetus, it cannot yet take nutrition from the mother's diet. The Blood and Qi are not yet heavily utilized, and grains are not fully digested. The Middle Qi becomes stagnant and full. The resulting stagnation, Phlegm-Fire, and foul odors all rush to the Stomach, causing nausea and obstruction. Symptoms include mental restlessness, dizziness, flaccidity of the four limbs, aversion to food odors, excessive sleep with little rising, and a strong craving for sour and salty fruits. This indicates insufficiency of the Liver and Kidney, drawing upon sour and salty flavors for self-rescue.
In the second and third months of pregnancy, if the woman's constitution is weak, she will suffer from E Zu, characterized by retching, inability to eat, mental irritability, feeling drunk, heavy limbs, selective eating, food aversion, and dizziness. This occurs because Blood and Qi accumulate to nourish the Fetal Origin. The Essence and Blood stagnate internally, while foul and putrid Qi attacks the Stomach upward, causing retching and inability to ingest food. Since Blood is used to nourish the fetus, the Heart loses its nourishment, leading to Heart deficiency and mental irritability. The treatment method should harmonize Blood and dissipate stagnation. Use Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), and Gancao (Glycyrrhizae Radix et Rhizoma) to tonify Middle Qi; Juhong (Citri Reticulatae Pericarpium Rubrum), Zisu (Perillae Folium), Muxiang (Aucklandiae Radix), and Shengjiang (Zingiberis Rhizoma Recens) to disperse stagnant Qi; Fuling (Poria), Maidong (Ophiopogonis Radix), Huang Qin (Scutellariae Radix), and Zhuru (Bambusae Caulis in Taenia) to clear Heat and relieve irritability. This formula is named Shenjie Yin, illustrating the principle that "Qi must be regulated during pregnancy." Generally, there is no Cold before pregnancy, and no Heat after pregnancy. However, E Zu and vomiting mostly belong to Heat. Yet, there are cases of vomiting due to Cold, which are caused by disease rather than E Zu. If not stopped, it leads to Deficiency. One should use Renshen Ganjiang Banxia Wan (Ginseng, Dried Ginger, and Pinellia Pill). Do not overuse acrid-warm herbs. If vomiting is severe and stopping it makes it worse, follow Zhang Zhongjing's method: stop medication for over a month, and it will settle naturally.
The *Qian Jin Fang* contains Banxia Fuling Tang (Pinellia and Poria Decoction) and Fuling Wan (Poria Pill), specifically treating E Zu. Recently, few people use them because Banxia (Pinelliae Rhizoma) is believed to disturb the fetus. Since the fetus is newly formed, its acrid-drying nature might scatter the fetal Qi. It must be stir-fried with Jiangzhi (Ginger Juice) to mitigate its toxicity. Indeed, only Banxia can stop E Zu, which is why Zhang Zhongjing used Renshen Banxia Ganjiang Wan (Ginseng, Pinellia, and Dried Ginger Pill). Luo Qianfu used Er Chen Tang (Two-Cured Decoction) removing Chenpi (Citri Reticulatae Pericarpium) and Gancao (Glycyrrhizae Radix et Rhizoma), naming it Banxia Fuling Tang. Zhu Danxi stated that obese people often have Phlegm, while thin people often have Fire. He used modified Er Chen Tang to treat pre-pregnancy E Zu, proving effective for Phlegm-retention vomiting, mental irritability, dizziness, and food aversion. This aligns with the Classic saying: "If there is an existing pathogen, there will be no injury." Xue Lizhai said: "Banxia is the main herb for strengthening Spleen Qi and resolving Phlegm stagnation. For Spleen-Stomach weakness with vomiting, or Phlegm-saliva congestion with poor appetite and unstable fetus, Banxia Fuling Tang must be used, with doubled Baizhu (Atractylodis Macrocephalae Rhizoma) to calm the fetus and strengthen the Spleen. It is commonly very effective." When E Zu is accompanied by lower back pain, one must guard against miscarriage. Er Chen Tang combined with Siwu Tang (Four-Substance Decoction), plus Huang Qin (Scutellariae Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma), is especially suitable, focusing on harmonizing the Middle and regulating the Spleen. Avoid ascending herbs. Since retching causes Qi to rise, using ascending herbs would violate the principle of "ascending without descending," making the Upper more excess and the Lower more deficient, thereby hastening miscarriage.