〔《本》紫苏饮 治妊娠胎气不和,怀胎近上,胀满疼痛,谓之子悬。兼治临产惊恐气结,连日不下。
紫苏茎叶(一两) 大腹皮 人参 川芎 陈皮 白芍(各半两) 当归(三分) 甘草(一分)
上细锉,分作三服。每服用水一盏半,生姜四片,葱白七寸,煎至七分,去渣,空心服。
曾有累日妇人产不下,服遍催生药不验。予曰∶此必坐草太早,心怀下一点惧,气结而不行,然非不顺也。
《素问》云∶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。陈良甫云∶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,加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?两尺脉沉
绝,以此知之。陈曰∶此说出在何经?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,母子俱死。今面不赤,口不青,其子未死,是胎上
逼心,宜以紫苏饮子治之,至十服而胎遂下矣。
〔《大》〕治胎上逼心烦闷方,并治胎动困笃。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。(此方神妙,脉浮滑者宜之。本草云∶葱白,通阳气安胎。)
〔《秘录》〕胎动上迫心痛。取艾叶如鸡子大,以头醋四升,煎取二升,分温服。治胎上逼心,热痛下
血。神曲半斤,捣碎,和熟水绞取汁三钟,无时温服,止。
〔《大》〕治妊娠遍身痛,或冲心欲死,不能饮食。
白术(五两) 黄芩(二两) 芍药(四两)
上水六升,煮取二升半,分作三服,缘胎有水致痛,兼易产。
【《本草》】紫苏饮:治疗妊娠期间胎气不和,胎儿位置偏上,导致腹部胀满疼痛,称为“子悬”。同时兼治临产时因惊恐导致的气机郁结,致使多日无法分娩。
紫苏茎叶(一两) 大腹皮 人参 川芎 陈皮 白芍(各半两) 当归(三分) 甘草(一分)
将上述药材切碎,分为三次服用。每次服用用水一盏半,生姜四片,葱白七寸,煎煮至剩余七分药液,滤去药渣,空腹服用。
曾有一位妇女连续数日无法分娩,服用了各种催生药物均无效。我说:“这一定是因为坐草(准备分娩)太早,心中存有一点恐惧,导致气机郁结而不运行,但这并非产道不顺。”
《素问》说:“恐则气下。”大概是因为恐惧会导致精神怯弱,精神怯弱则上焦闭塞,上焦闭塞则气机返还,气机返还则下焦胀满,气机因此不再运行。服用此药一次后便顺利分娩。对于怀孕六七个月出现子悬的妇女,我多次使用此方都有疗效,不超过十服,胎儿位置就会下降。陈良甫曾说:治疗一位怀孕七个月的妇女,从远方归来,突然感觉胎儿上冲心脏并疼痛,坐卧不安,两位医生医治无效,于是声称胎儿已经死亡。用蓖麻子研烂,加入麝香调和贴敷于脐中以下部位以促使胎儿下行,当时产妇生命垂危。请陈良甫诊治,发现其两尺脉绝(摸不到),其他脉搏平和。陈良甫询问两位医生将其诊断为何种证候,回答说:“是死胎。”陈良甫问:“怎么知道的?”回答说:“两尺脉沉伏绝迹,据此知道。”陈良甫问:“这种说法出自哪部经典或哪条经络理论?”两位医生无言以对。陈良甫说:“这是子悬病。如果是死胎,是有辨别特征的:面赤舌青,是子死母活;面青舌赤,吐沫,是母死子活;唇口都发青,是母子俱死。现在患者面色不赤,口唇不发青,说明胎儿未死,这是胎上逼心,适宜用紫苏饮治疗,服到第十次时胎儿就生下来了。”
【《大观本草》】治疗胎上逼心导致心烦闷的方子,并治疗胎动困重危急。用葱白十四根,浓煮取汁饮用,如果胎儿未死就会安胎,如果已死则会排出。若未见效,再服用。(此方神妙,脉象浮滑者适宜使用。本草记载:葱白,能通阳气安胎。)
【《秘录》】治疗胎动上迫引起的心痛。取艾叶如鸡蛋大小,用头醋四升,煎取二升,分次温服。治疗胎上逼心,热痛伴下血。神曲半斤,捣碎,与熟水混合绞取汁液三钟,随时温服,直至症状停止。
【《大观本草》】治疗妊娠期间全身疼痛,或者气冲心脏几乎致死,不能饮食。
白术(五两) 黄芩(二两) 芍药(四两)
用水六升,煮取二升半,分为三次服用,这是因为胎中有水湿导致疼痛,兼有易产的功效。
[Bencao] Zisu Yin (Perilla Decoction): Treats disharmony of fetal Qi during pregnancy, where the fetus is positioned high, causing abdominal distension and pain, known as "Zixuan" (Fetal Suspension). It also treats Qi stagnation due to fright during labor, resulting in failure to deliver for several days.
Radix et Folium Perillae (1 liang), Fructus Citri Grandis (Dafupi), Radix Ginseng (Renshen), Radix Chuanxiong (Chuanxiong), Cortex Citri Reticulatae (Chenpi), Radix Paeoniae Alba (Baishao) (each half liang), Radix Angelicae Sinensis (Danggui) (3 fen), Radix Glycyrrhizae Uralensis (Gancao) (1 fen).
Finely chop the above herbs, divide into three doses. For each dose, use 1.5 cups of water, 4 slices of fresh ginger, and 7 cun of scallion white. Decoct until 0.7 cup remains, remove dregs, and take on an empty stomach.
There was once a woman who had been unable to deliver for several days; various parturition-inducing medicines proved ineffective. I said: "This must be because she prepared for delivery too early, harboring a slight fear in her heart, causing Qi stagnation and immobility, but this is not due to obstructed birth."
The *Suwen* states: "Fear causes Qi to sink." Generally, fear leads to spiritual timidity; timidity causes closure of the Upper Jiao; closure of the Upper Jiao causes Qi to return; when Qi returns, the Lower Jiao becomes distended, and Qi ceases to move. After taking this medicine once, delivery occurred. For women at six or seven months of pregnancy suffering from Zixuan, I have frequently used this formula with success; within ten doses, the fetus descends. Chen Liangfu stated: He treated a woman pregnant for seven months who, upon returning from a long journey, suddenly felt the fetus rushing up to her heart causing pain, making her restless in sitting and lying down. Two physicians failed to treat her and claimed the fetus was dead. They applied a paste of crushed castor beans mixed with musk below the umbilicus to induce expulsion, and the patient's life was in peril. Chen examined her, finding the Chi pulse (Kidney pulse) absent while other pulses were peaceful. Chen asked the two physicians what syndrome they diagnosed. They replied: "Dead fetus." Chen asked: "How do you know?" They answered: "The Chi pulse is deep and absent, thus we know." Chen asked: "From which classic or meridian theory does this statement originate?" The two physicians had no answer. Chen said: "This is Zixuan. If it were a dead fetus, there would be distinguishing signs: red face and blue tongue indicate death of the fetus and survival of the mother; blue face, red tongue, and foaming indicate death of the mother and survival of the fetus; blue lips and mouth indicate death of both. Currently, her face is not red, and her mouth is not blue, indicating the fetus is alive. This is 'Fetus Rushing to the Heart,' suitable for treatment with Zisu Yin. After ten doses, the fetus was delivered."
[Daguang Bencao] Formula for treating Fetal Rushing to the Heart causing mental restlessness and oppression, and also for critical fetal movement distress. Use fourteen stalks of scallion white, decoct strongly to obtain juice and drink. If the fetus is alive, it will calm; if dead, it will be expelled. If ineffective, take again. (This formula is miraculous, suitable for those with floating and slippery pulses. Materia Medica states: Scallion white unblocks Yang Qi and calms the fetus.)
[Milu] For fetal movement pressing upward causing heart pain. Take mugwort leaves the size of a chicken egg, decoct in four sheng of first-run vinegar to obtain two sheng, divide and take warm. For fetal rushing to the heart, heat-pain with bleeding. Half a jin of Shenqu (Medicated Leaven), crush, mix with cooked water, squeeze out three zhong of juice, take warm at any time until symptoms stop.
[Daguang Bencao] For pregnancy involving whole-body pain, or Qi rushing to the heart nearly causing death, inability to eat.
Rhizoma Atractylodis Macrocephalae (Baizhu) (5 liang), Cortex Scutellariae (Huangqin) (2 liang), Radix Paeoniae (Shaoyao) (4 liang).
Use six sheng of water, decoct to obtain 2.5 sheng, divide into three doses. This addresses pain caused by fluid retention in the fetus and facilitates easy delivery.