虞氏曰∶《脉经》云∶诊其脉,手少阴之脉动甚者,妊子也。盖手少阴,心脉
也,心主血脉故也。又肾为胞门子户。尺中肾脉,按之不绝,当妊子也。又妇人妊
娠一月之时,足厥阴脉养之,二月足少阳脉养之,三月手厥阴脉养之,四月手少阳
脉养之,五月足太阴脉养之,六月足阳明脉养之,七月手太阴脉养之,八月手阳明
脉养之,九月足少阴脉养之,十月足太阳脉养之,是以诸经脉各养三十日也。若夫
至期当养之经,虚实不调,则胎孕为之不安,甚则下血而堕矣。夫手足十二经,气
血盈亏不同,如手足厥阴、太阳少气多血,手足太阴、少阴少血多气,手足少阳气
多血少,手足阳明气盛血多。安胎之法,宜各按月根据经,视其气血虚实而调之,庶
无胎堕之患。其或感冒风寒,别生异证,又宜各按法而调治之。
洁古云∶治胎产之病,从厥阴经论之,是主气生化之源也。厥阴与少阳为表里,
故治法无犯胃气及上二焦。有三禁∶不可汗,不可下,不可利小便。发汗则伤上焦
之阳,利大便则脉数而动脾,利小便则内亡津液,胃中枯燥。制药之法,能不犯此
三禁,则荣卫自和而寒热止矣。如气弱则黄 ,血刺痛而和以当归,腹中疼而加之芍
药。大抵产病天行,从小柴胡增损。杂证从四物增损。宜详察脉证而用之。
虞氏说:《脉经》记载:诊察患者的脉象,如果手少阴心经的脉搏跳动特别明显(动甚),就是怀孕的迹象。这是因为手少阴经属于心脉,而心主司血脉的缘故。另外,肾是胞宫(子宫)和子户(孕育胎儿之处)。如果尺部(手腕内侧后方,候肾气)的肾脉按之不绝、有力,也应当判断为怀孕。
此外,妇女在妊娠第一个月时,由足厥阴肝经滋养;第二个月由足少阳胆经滋养;第三个月由手厥阴心包经滋养;第四个月由手少阳三焦经滋养;第五个月由足太阴脾经滋养;第六个月由足阳明胃经滋养;第七个月由手太阴肺经滋养;第八个月由手阳明大肠经滋养;第九个月由足少阴肾经滋养;第十个月由足太阳膀胱经滋养。因此,各条经脉各自负责滋养三十天。如果遇到该当滋养的月份,经脉气血虚实不调,就会导致胎孕不安,严重时会出现阴道出血甚至流产。
手足十二经脉的气血盈亏情况各不相同:如手足厥阴经和手足太阳经,特点是气少血多;手足太阴经和手足少阴经,特点是血少气多;手足少阳经,特点是气多血少;手足阳明经,特点是气盛血多。安胎的方法,应当根据每个月份所对应的经脉,观察其气血的虚实情况进行调理,这样才能避免流产的祸患。如果孕妇感冒风寒,产生其他病症,又应当分别按照相应的方法进行调治。
洁古(张元素)说:治疗胎产疾病,应从厥阴经来论述,因为厥阴经是气机生化之源。厥阴经与少阳经互为表里,所以治疗方法不能损伤胃气及上中二焦(上焦指心肺,中焦指脾胃)。有三项禁忌:不可发汗,不可攻下,不可通利小便。发汗会损伤上焦的阳气;通利大便会使脉数且扰动脾气;通利小便会导致体内津液亡失,使胃中干燥。制药的原则,如果不触犯这三项禁忌,那么营卫之气自然调和,寒热症状就会停止。例如,气虚则加入黄芪,血刺痛则配合当归,腹中疼痛则加入芍药。大抵产后遭遇时行疫病,从小柴胡汤加减化裁;杂病从四物汤加减化裁。应当详细诊察脉象和证候后使用。
Yu stated: The *Mai Jing* (Pulse Classic) records: When examining the pulse, if the pulse of the Hand-Shaoyin (Heart) meridian beats vigorously (excessively active), it indicates pregnancy. This is because the Hand-Shaoyin belongs to the Heart meridian, and the Heart governs the blood vessels. Furthermore, the Kidney serves as the gate of the Bao Palace (uterus) and the house of the fetus. If the Kidney pulse at the Chi position (wrist cun-chi-kuan location, reflecting kidney qi) remains unceasing upon pressure, it should also be judged as pregnancy.
Moreover, during the first month of a woman's pregnancy, the Foot-Jueyin Liver meridian nourishes the fetus; in the second month, the Foot-Shaoyang Gallbladder meridian; in the third month, the Hand-Jueyin Pericardium meridian; in the fourth month, the Hand-Shaoyang Sanjiao (Triple Burner) meridian; in the fifth month, the Foot-Taiyin Spleen meridian; in the sixth month, the Foot-Yangming Stomach meridian; in the seventh month, the Hand-Taiyin Lung meridian; in the eighth month, the Hand-Yangming Large Intestine meridian; in the ninth month, the Foot-Shaoyin Kidney meridian; and in the tenth month, the Foot-Taiyang Bladder meridian. Thus, each meridian is responsible for nourishing for thirty days. If, during the designated month of nourishment, the meridian's Qi and Blood are not balanced (deficiency or excess), the pregnancy will become unstable, potentially leading to vaginal bleeding and miscarriage.
The twelve meridities of the hands and feet differ in their abundance and deficiency of Qi and Blood. For instance, the Hand-Foot Jueyin and Hand-Foot Taiyang meridians are characterized by little Qi and much Blood; the Hand-Foot Taiyin and Hand-Foot Shaoyin meridians by little Blood and much Qi; the Hand-Foot Shaoyang meridians by much Qi and little Blood; and the Hand-Foot Yangming meridians by abundant Qi and much Blood. The method for stabilizing the fetus should follow the specific meridian corresponding to each month, adjusting based on the deficiency or excess of Qi and Blood, thereby avoiding the risk of miscarriage. If the pregnant woman contracts wind-cold or develops other symptoms, treatment should be adjusted according to the respective methods.
Jiegu (Zhang Yuansu) stated: In treating diseases related to pregnancy and childbirth, one should discuss them from the perspective of the Jueyin meridian, as it is the source of Qi generation and transformation. Jueyin and Shaoyang are exterior-interior pairs; therefore, treatment methods must not damage the Stomach Qi or the Upper and Middle Jiao (Upper Jiao refers to Heart and Lung; Middle Jiao refers to Spleen and Stomach). There are three prohibitions: do not induce sweating, do not purge downward, and do not promote urination. Inducing sweating damages the Yang Qi of the Upper Jiao; purging downward causes rapid pulse and disturbs Spleen Qi; promoting urination leads to the loss of internal Body Fluids, resulting in dryness of the Stomach. The principle of preparing medicine is that if these three prohibitions are not violated, Ying (Nutritive) and Wei (Defensive) Qi will naturally harmonize, and chills and fever will cease. For example, if Qi is weak, add Huangqi (Astragali Radix); if there is stabbing pain due to Blood stasis, combine with Danggui (Angelicae Sinensis Radix); if there is abdominal pain, add Shaoyao (Paeoniae Radix). Generally, postpartum conditions caused by epidemic pathogens are treated by modifying Xiao Chaihu Tang (Minor Bupleurum Decoction); miscellaneous disorders are treated by modifying Siwu Tang (Four Substance Decoction). One should carefully examine the pulse and symptoms before applying these treatments.