26.妊娠有病当攻下, 衰其大半而止之, 经云有故而无殒, 与病适当
又何疑.
【注】凡孕妇素有症瘕旧疾, 或有新病应攻下者, 但攻其大半, 余俟
其自消, 不可尽攻. 经云: 有故无殒. 言药虽峻, 有病则病受之, 不
能伤胎也. 攻其大半, 与病相当, 又何疑于有妊必不可攻之说耶?
八珍汤 六君子汤
27.胎萎不长失滋养, 气血不足宜八珍, 脾虚胃弱六君子, 谷化精微
气血生.
【注】妊娠五, 六个月, 胎萎不长, 由于妊母禀赋虚弱. 若属气血两
虚者, 宜用八珍汤; 若脾虚胃弱者, 宜用六君子汤. 但使饮食强壮,
俾水谷运化精微, 则气血日生而胎自长矣!
八珍汤 六君子汤 方俱见首卷
28.子瘖声哑细无音, 非谓绝然无语声, 九月胎盛阻其脉, 分娩之后
自然通.
【注】妊娠九月, 孕妇声音细哑不响, 谓之子瘖. 非似子哑, 绝然无
语也. 盖少阴之脉络于舌本, 九月肾脉养胎, 至其时胎盛阻遏其脉,
不能上至舌本, 故声音细哑. 待分娩之后, 肾脉上通, 其音自出矣.
黄连煎
29.腹内钟鸣与儿哭, 子啼之证出偶然, 空房鼠穴土能治, 黄连煎汤
亦可捐.
【注】孕妇腹内有钟声, 或婴儿在内啼哭者, 名曰子啼. 古书虽载其
证,然不轻见, 或偶然有之. 古方用空房中鼠穴土, 同川黄连煎汤,
名黄连煎, 饮之自愈.
26. 妊娠期间患病应当使用攻下法治疗,但病势消退大半时就应停止用药。《内经》说:“有故无殒”(有病邪存在就不会造成伤害),药物与病邪相当,又有什么可怀疑的呢?
【注】凡是孕妇素来患有症瘕(腹内结块)等旧疾,或者有新的疾病需要使用攻下法治疗的,只攻伐病邪的大半部分,剩余的让身体自行消除,不可彻底攻尽。《内经》说:“有故无殒”。意思是虽然药性峻猛,但有病邪存在时,药力主要作用于病邪,不会伤害胎儿。攻伐病邪大半,使药力与病邪相当,又何必怀疑“怀孕后绝对不能使用攻下法”的说法呢?
27. 胎儿发育迟缓萎缩是因为缺乏滋养,气血不足适宜服用八珍汤;脾虚胃弱则用六君子汤,通过运化水谷精微来生成气血。
【注】妊娠五、六个月时,胎儿发育迟缓萎缩,是由于孕妇先天禀赋虚弱所致。如果属于气血两虚的情况,适宜使用八珍汤;如果是脾虚胃弱的情况,适宜使用六君子汤。只要使饮食强壮,让水谷运化出精微物质,那么气血就会每日滋生,胎儿自然就能生长了!
28. 子瘖表现为声音细哑细微无声,并非指完全不能说话或没有声音。这是因为九月胎气旺盛阻碍了经脉,分娩之后自然会通畅。
【注】妊娠第九个月,孕妇声音细哑不响亮,称为“子瘖”。这不像失音那样完全不能说话。因为足少阴肾经的脉络连接于舌根,九月时肾脉负责养胎,到了这个时候,胎气旺盛阻碍了经脉,导致经脉不能上达舌根,所以声音细哑。等到分娩之后,肾脉重新上通,声音自然就恢复了。
29. 腹内发出钟鸣声和婴儿啼哭声,这是“子啼”证候,多属偶然发生。空屋中的鼠穴土能治疗此病,用黄连煎汤也可以饮用治疗。
【注】孕妇腹内有钟声,或者感觉像婴儿在体内啼哭的,名叫“子啼”。古书虽然记载了这个证候,但不常见,或者是偶尔发生的。古方使用空房屋中的鼠穴土,配合川黄连煎汤,名为“黄连煎”,饮用后即可自愈。
26. When a pregnant woman is ill, purgative methods should be employed; however, treatment should cease when the pathogenic factor has been reduced by more than half. The *Classic of Internal Medicine* states: "Where there is pathology, there is no miscarriage" (when a disease entity exists, harsh drugs will not harm the fetus). Since the medication matches the disease, what doubt remains?
[Annotation] In cases where a pregnant woman has pre-existing conditions such as mass formations (abdominal masses) or new illnesses requiring purgation, only attack more than half of the pathogenic factor, allowing the remainder to resolve spontaneously; do not exhaustively purge. The *Classic of Internal Medicine* states: "Where there is pathology, there is no miscarriage." This means that although the medicinal properties are potent, if a disease entity exists, the drug acts upon the disease and does not injure the fetus. By attacking more than half of the pathogen, matching the drug's strength to the disease, why doubt the assertion that pregnancy absolutely prohibits purgative therapy?
Bazhen Decoction (Eight Treasure Decoction), Liujunzi Decoction (Six Gentlemen Decoction)
27. Fetal atrophy and failure to grow result from lack of nourishment; for deficiency of both Qi and Blood, Bazhen Decoction is indicated. For Spleen deficiency and Stomach weakness, Liujunzi Decoction is used to transform grain essence into Qi and Blood.
[Annotation] During the fifth and sixth months of pregnancy, fetal atrophy and failure to grow occur due to the mother's congenital weakness. If the condition belongs to deficiency of both Qi and Blood, Bazhen Decoction (Eight Treasure Decoction) is appropriate. If it involves Spleen deficiency and Stomach weakness, Liujunzi Decoction (Six Gentlemen Decoction) is appropriate. As long as dietary intake strengthens the body, allowing the transformation of food and drink into essence, Qi and Blood will be generated daily, and the fetus will naturally grow!
Bazhen Decoction (Eight Treasure Decoction), Liujunzi Decoction (Six Gentlemen Decoction) - Formulas are found in the first volume.
28. Zi Yin (Fetal Aphonia) presents with a thin, hoarse, and faint voice without sound; this does not mean a complete absence of speech. It occurs because the fullness of the fetus in the ninth month obstructs the meridians, but natural patency returns after delivery.
[Annotation] In the ninth month of pregnancy, if a pregnant woman's voice becomes thin, hoarse, and lacks resonance, it is called Zi Yin (Fetal Aphonia). This is not akin to total aphonia where no sound can be produced. The Foot-Shaoyin Kidney Meridian connects to the base of the tongue. In the ninth month, the Kidney Meridian nourishes the fetus. At this time, the fullness of the fetus obstructs the meridian, preventing it from ascending to the base of the tongue, resulting in a thin, hoarse voice. After delivery, the Kidney Meridian reconnects upward, and the voice naturally recovers.
Huanglian Decoction
29. Bell-like sounds within the abdomen and cries of an infant indicate Zi Ti (Fetal Crying), a syndrome that arises occasionally. Soil from rat holes in empty houses can treat this; Huanglian Decoction (Coptis Decoction) drunk as a soup is also effective.
[Annotation] If a pregnant woman hears bell-like sounds in her abdomen or feels like an infant is crying inside, it is named Zi Ti (Fetal Crying). Although ancient texts record this syndrome, it is rarely seen and may occur occasionally. Ancient prescriptions use soil from rat holes in empty rooms, decocted with Sichuan Huanglian (Coptidis Rhizoma), named Huanglian Decoction (Coptis Decoction); drinking it leads to spontaneous recovery.