【妊娠伤寒歌】伤寒头痛连百节,气急冲心溺如血,身热发点紫黑青,壮热不止致胎灭。呕
恶不止与心烦,腰背项强脑痛裂,六七日来烧腹中,小便不通大便结。妊娠染表症伤寒者,
当用带须葱头汤服之,出汗即愈,不可轻用发表药。若误用之,其胎必堕,且母命难保,戒
之慎之。胎前瘟疫,与伤寒同,孕妇伤寒咳嗽,宜二陈加薄荷、白术、川贝。泄泻者,胃苓
汤去参,俟脾胃实后治嗽可也,即参苏饮亦可服。盖风药最易动胎,反为不美,故胎前伤寒
,身热咳嗽者,惟以带须葱白煎汤服之,大能安胎顺气。若胎不安,煎砂仁汤服,汗多,服
参苏饮。干呕,紫苏饮去参加茯苓。吐血,止血丸,或二陈加黄柏、知母、楂炭、白术。如
气血两虚,八物加黄柏、知母。
【妊娠跌仆歌】怀胎跌仆无轻重,遂致伤胎在腹中。已损包胎血上逆,冲心闷痛母魂倾。
妊娠跌仆,或受伤重者,服活血药,又恐伤胎,不服则伤不能去,当何法以治之?曰∶必先
辨其胎之死生。如腹冷舌青者,子死也,以香桂散下之。若未甚分明,以佛手散探之。如胎
伤者,立即堕下,胎无恙者,其痛立止。但痛止之后,尤须视伤之轻重。下药轻者,童便酒
入活血药饮之,血活则伤去,随以紫苏饮加童便、砂仁,缓缓服之;重者只治其伤,勿顾其
胎也。血行胎下,母命保矣。服紫苏饮加枳壳、童便、砂仁尤妙。有孕妇胎前衄血,产后多
不吉,血以养胎,不宜走泄故也。服紫苏饮加黄芩自愈。更有口中见血及大便下血者尤忌。
【妊娠伤寒歌】伤寒引起的头痛牵连全身各关节,呼吸急促且气冲心胸,小便出血,身体发热并出现紫、黑、青色的斑点,持续高热不止会导致胎儿死亡。呕吐恶心不止伴随心烦意乱,腰背颈部僵硬剧烈疼痛,发病六七日后热邪内攻腹部,小便不通畅,大便秘结。孕妇感染外感表证类伤寒病时,应当使用带须葱头煎汤服用,出汗后即可痊愈,不可轻易使用发汗解表的药物。如果误用发汗药,必然导致流产,并且母亲的生命也难以保全,务必谨慎戒除。孕期瘟疫的治法与伤寒相同,孕妇患伤寒伴有咳嗽症状时,适宜使用二陈汤加入薄荷、白术、川贝母。出现泄泻症状者,使用胃苓汤去除人参,待脾胃功能恢复稳固后再治疗咳嗽,也可以使用参苏饮。因为风药最容易扰动胎气,反而不好,所以孕期患伤寒,出现发热咳嗽症状时,只需用带须葱白煎汤服用,能很好地安胎顺气。如果胎气不安,煎服砂仁汤;如果出汗过多,服用参苏饮。干呕症状,使用紫苏饮去掉茯苓。吐血症状,服用止血丸,或者在二陈汤中加入黄柏、知母、山楂炭、白术。如果是气血两虚,使用八物汤加入黄柏、知母。
【妊娠跌仆歌】怀孕期间跌倒或受撞击,无论轻重,都会导致腹中胎儿受损。如果已经损伤胞胎,血液上逆冲心,导致胸闷疼痛,甚至危及母亲生命。孕妇跌倒受伤,如果伤势较重,服用活血药又担心伤害胎儿,不服用则瘀血无法去除,应当用什么方法治疗呢?回答说:必须先辨别胎儿的死生情况。如果腹部发冷、舌色发青,说明胎儿已死,使用香桂散将其排出。如果情况尚不明确,使用佛手散试探。如果胎儿受伤,会立即流产;如果胎儿无恙,疼痛会立刻停止。但在疼痛停止后,仍需观察伤势的轻重。对于伤势较轻者,将童便和酒加入活血药中饮用,血液流通则瘀伤消除,随后缓缓服用加有童便、砂仁的紫苏饮;对于伤势重者,只需治疗外伤,不必顾及胎儿。只要瘀血排出、胎儿随之娩下,母亲的生命就能保住。服用加有枳壳、童便、砂仁的紫苏饮效果更佳。有的孕妇在产前出现鼻出血,产后往往预后不良,因为血液用于滋养胎儿,不宜耗散流失。服用加有黄芩的紫苏饮可自行痊愈。更有口中出血及大便下血的情况,尤其忌讳。
[Song on Cold Damage during Pregnancy] Cold damage causes headache extending to all joints, rapid breathing with qi rushing to the heart, hematuria (blood in urine), fever accompanied by purple, black, or cyanotic macules, and persistent high fever leading to fetal demise. Unremitting vomiting and nausea with mental restlessness, stiffness and severe pain in the waist, back, and neck, heat attacking the abdomen after six or seven days, urinary retention, and constipation. When a pregnant woman contracts an exterior syndrome similar to cold damage, she should take a decoction of green onion bulbs with roots; sweating will lead to recovery. One must not lightly use diaphoretic (sweat-inducing) drugs. If misused, the fetus will inevitably be aborted, and the mother's life may be endangered; beware and be cautious. The treatment for epidemic febrile diseases during pregnancy is the same as for cold damage. For pregnant women with cold damage accompanied by cough, Er Chen Tang (Two-Cured Decoction) added with Bohe (Menthae Haplocalycis Herba), Baizhu (Atractylodis Macrocephalae Rhizoma), and Chuanbei (Fritillariae Cirrhosae Bulbus) is suitable. For diarrhea, Weiling Tang (Gastrointestinal Regulating Decoction) without Renshen (Ginseng Radix et Rhizoma) should be used; treat the cough only after the spleen and stomach have recovered their strength. Can Su Yin (Perilla Decoction) may also be taken. Wind-dispelling drugs are most likely to disturb the fetus, which is undesirable. Therefore, for pregnant women with cold damage presenting fever and cough, only a decoction of green onion whites with roots should be taken, which greatly helps to calm the fetus and regulate qi. If the fetus is unsettled, decoct Sharen (Amomi Fructus) and take it. If there is excessive sweating, take Can Su Yin (Perilla Decoction). For dry retching, use Zisu Yin (Perilla Decoction) without Fuling (Poria). For hematemesis (vomiting blood), take Zhixue Wan (Hemostatic Pill) or Er Chen Tang (Two-Cured Decoction) added with Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma), Zhata (Zizyphi Fructus Carbonized), and Baizhu (Atractylodis Macrocephalae Rhizoma). In cases of both qi and blood deficiency, Ba Wu Tang (Eight-Ingredient Decoction) added with Huangbai (Phellodendri Cortex) and Zhimu (Anemarrhenae Rhizoma) is indicated.
[Song on Trauma/Falls during Pregnancy] Falls or trauma during pregnancy, regardless of severity, can cause injury to the fetus in the womb. If the gestational sac is damaged, blood rebels upward to the heart, causing chest oppression and pain, potentially endangering the mother's life. When a pregnant woman falls or suffers trauma, if the injury is severe, taking blood-invigorating drugs might harm the fetus, but not taking them leaves the pathogenic stasis unresolved. What method should be used? The answer is: one must first distinguish whether the fetus is alive or dead. If the abdomen is cold and the tongue is cyanotic, the fetus is dead; use Xiang Gui San (Cinnamon and Costus Powder) to expel it. If the condition is not clear, use Fo Shou San (Buddha's Hand Powder) to probe. If the fetus is injured, it will abort immediately; if the fetus is unharmed, the pain will cease instantly. However, after the pain ceases, the severity of the injury must still be assessed. For mild injuries, administer blood-invigorating drugs mixed with children's urine (Tongbian) and wine; once blood circulation is restored and stasis removed, slowly take Zisu Yin (Perilla Decoction) added with Tongbian (Children's Urine) and Sharen (Amomi Fructus). For severe injuries, treat the trauma only, disregarding the fetus. Once the blood flow resumes and the fetus is expelled, the mother's life is preserved. Taking Zisu Yin (Perilla Decoction) added with Zhike (Aurantii Fructus), Tongbian (Children's Urine), and Sharen (Amomi Fructus) is particularly effective. Some pregnant women experience epistaxis (nosebleed) before delivery, which often leads to poor prognosis postpartum, because blood is needed to nourish the fetus and should not leak away. Taking Zisu Yin (Perilla Decoction) added with Huangqin (Scutellariae Radix) can lead to self-recovery. Bleeding from the mouth and hematochezia (blood in stool) are especially contraindicated.