《大全》云∶妊娠体虚受风而太阳之经络后间遇风寒相搏,发则口噤项强,名之曰痉。
又云
∶,其候冒闷不识人,须臾自省,良久复作,谓之风痉,一名子痫,又名子冒,甚则反张
。
立斋云∶前症若心肝风热,用钩藤汤。肝脾血虚,加味逍遥散。肝脾郁怒,加味归脾汤
。气
逆痰滞,紫苏饮。肝火风热,钩藤散。脾郁痰滞,二陈加竹沥、姜汁。若兼症相杂,当参照
子烦门。
《大全》云∶孕妇不语,非病也。间有如此者,不须服药,临产月但服资生丸、四物汤
之类
,产下便能言,亦自然之理,非药之功也。帝曰∶人有重身九而喑,此为何也?歧伯曰∶胞
之络脉绝也。曰∶何以言之?曰∶胞络者,系于肾少阴之脉,贯肾系舌本,故不能言。曰∶
治之奈何?曰∶无治也,当十月复。
《大全》云∶夫肺内主气,外司皮毛,皮毛不密,寒邪乘之则咳嗽(肺属金,为五脏华
盖,
又为娇脏,脏腑受邪则为火,火盛必烁金,故诸脏腑受邪未有不干肺者也)。秋则肺受之,
春则肝受之,夏则心受之,冬则肾受之。其咳不已则传于腑,嗽久不已则伤胎也。
薛氏曰∶前症若秋间风邪伤肺,用金沸草散(杂咳嗽)。夏间火克刑金,用人参平肺散(
杂喘)
。冬间寒邪伤肺,用人参败毒散(杂伤湿)。春间风邪伤肺,参苏饮(杂发热)。若脾肺气虚,
用六君、芎、归、桔梗。若血虚,四物加
桑皮、杏仁、桔梗。肾火上炎,六味丸加五味子煎服。脾胃气虚,风寒所伤,补中益气加桑
皮、杏仁、桔梗。盖肺属辛金,生于己土,咳久不愈者,多因脾土虚而不能生肺气,以致腠
理不密,外复感邪。或因肺气虚而不能生水,以致阴火上炎所致。治法当清肺金、生肾水为
善。
《妇人大全良方》说:妊娠期间身体虚弱,感受风邪,导致太阳经络在后方受到风寒侵袭,风寒相互搏结,发作时出现牙关紧闭、颈项强直的症状,这种病称为“痉”。
又说:其症状表现为头目昏蒙、意识不清甚至不认识人,片刻后自行清醒,过很久又再次发作,这称为“风痉”,也叫“子痫”,或者叫“子冒”,严重时会出现角弓反张(身体向后弯曲如弓状)。
薛己(立斋)说:上述病症如果属于心肝风热,使用钩藤汤。如果是肝脾血虚,使用加味逍遥散。如果是肝脾郁怒,使用加味归脾汤。如果是气逆痰滞,使用紫苏饮。如果是肝火风热,使用钩藤散。如果是脾郁痰滞,使用二陈汤加入竹沥和姜汁。如果兼有其他复杂症状,应当参照“子烦”章节的内容进行处理。
《妇人大全良方》说:孕妇不能说话,并不是疾病。偶尔有这种情况的,不需要服药,到了临产月份只需服用资生丸、四物汤之类的药物,分娩后自然就能说话,这是自然的道理,并非药物的功效。黄帝问:人有怀孕九个月时失音的,这是什么原因?岐伯回答:是因为胞宫的络脉阻滞不通。黄帝问:为什么这样说?岐伯说:胞宫的络脉,连接着肾少阴经脉,贯穿肾脏并联系舌根,所以会导致不能说话。黄帝问:如何治疗?岐伯说:不需要治疗,等到第十个月自然会恢复。
《妇人大全良方》说:肺在内主司气,在外主管皮毛,如果皮毛不致密,寒邪就会乘虚而入导致咳嗽(肺属金,是五脏的华盖,又是娇脏,其他脏腑受邪化为火,火势旺盛必然灼伤肺金,所以其他脏腑受邪没有不波及到肺的)。秋天则是肺受邪,春天则是肝受邪,夏天则是心受邪,冬天则是肾受邪。如果咳嗽不止,病邪会传入腑;如果久嗽不止,则会损伤胎儿。
薛氏说:上述病症如果在秋季因风邪伤肺,使用金沸草散(用于杂病咳嗽)。夏季因火克金,使用人参平肺散(用于杂病喘证)。冬季因寒邪伤肺,使用人参败毒散(用于杂病伤湿)。春季因风邪伤肺,使用参苏饮(用于杂病发热)。如果是脾肺气虚,使用六君子汤加上川芎、当归、桔梗。如果是血虚,使用四物汤加上桑白皮、杏仁、桔梗。如果是肾火上炎,使用六味地黄丸加五味子煎服。如果是脾胃气虚,被风寒所伤,使用补中益气汤加上桑白皮、杏仁、桔梗。大概因为肺属辛金,生于己土,咳嗽久治不愈的人,多是因为脾土虚弱不能生养肺气,导致腠理不致密,外部再次感受邪气。或者是由于肺气虚弱不能生养肾水,导致阴火上炎所致。治疗方法应当以清肺金、生肾水为最佳。
The *Daquan* states: During pregnancy, if the body is deficient and susceptible to wind pathogens, causing the Taiyang meridians to be affected by cold and wind from behind, where cold and wind contend with each other, it manifests as lockjaw (trismus) and stiffness of the neck. This condition is named "Jing" (Spasm).
It further states: The symptoms include dizziness, mental confusion, and loss of consciousness where the patient does not recognize people. After a short while, they regain awareness spontaneously, but the episode recurs after a long interval. This is called "Feng Jing" (Wind Spasm), also known as "Zi Xian" (Eclampsia of Pregnancy), or "Zi Mao". In severe cases, it may present with opisthotonos (arching of the back).
Li Zhai (Xue Ji) states: For the aforementioned symptoms, if caused by Wind-Heat in the Heart and Liver, use Gouteng Tang (Uncaria Decoction). If due to Blood Deficiency in the Liver and Spleen, use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder). If due to Stagnation and Anger in the Liver and Spleen, use Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction). If due to Qi Rebellion and Phlegm Stagnation, use Zisu Yin (Perilla Infusion). If due to Liver Fire and Wind-Heat, use Gouteng San (Uncaria Powder). If due to Spleen Stagnation and Phlegm Stagnation, use Er Chen Tang (Two-Aged Powder) added with Zhuli (Bamboo Sap) and Jiangzhi (Ginger Juice). If there are mixed accompanying symptoms, one should refer to the section on "Zi Fan" (Pregnancy Restlessness).
The *Daquan* states: An孕妇's inability to speak is not necessarily a disease. Occasionally, this occurs; medication is not required. In the month preceding delivery, simply administering drugs such as Zisheng Wan (Nourishing Life Pills) or Siwu Tang (Four Substances Decoction) will allow speech to return naturally after childbirth. This is a natural principle, not a result of medicinal efficacy. The Yellow Emperor asked: Why do some women lose their voice during the ninth month of pregnancy? Qibo answered: It is because the collaterals of the uterus are obstructed. The Emperor asked: How do you explain this? Qibo said: The uterine collaterals connect to the Shaoyin meridian of the Kidney, which passes through the Kidney and connects to the root of the tongue; therefore, speech is impaired. The Emperor asked: How should it be treated? Qibo said: No treatment is needed; it will recover naturally in the tenth month.
The *Daquan* states: The Lung governs Qi internally and controls the skin and hair externally. If the skin and hair are not dense, Cold pathogens can invade, leading to Ke Sou (Cough). (The Lung belongs to Metal and is the canopy of the five Zang organs; it is also a delicate organ. When other Zang-Fu organs are invaded by pathogens, they transform into Fire. Excessive Fire inevitably scorches Metal; thus, pathogenic invasion of any Zang-Fu organ invariably affects the Lung.) In autumn, the Lung is affected; in spring, the Liver; in summer, the Heart; in winter, the Kidney. If coughing persists, the pathogen transmits to the Fu organs; if chronic coughing persists, it damages the fetus.
Shi (Xue) states: For the aforementioned symptoms, if Wind pathogens injure the Lung in autumn, use Jin Fei Cao San (Boiling Dust Grass Powder) for miscellaneous coughs. In summer, if Fire overacts on Metal, use Renshen Pingfei San (Ginseng Lung-Pacifying Powder) for miscellaneous wheezing. In winter, if Cold pathogens injure the Lung, use Renshen Baidu San (Ginseng Rescue the Toxicity Powder) for miscellaneous dampness injuries. In spring, if Wind pathogens injure the Lung, use Shen Su Yin (Ginseng and Perilla Infusion) for miscellaneous fevers. If there is Qi and Blood Deficiency in the Spleen and Lung, use Liu Jun Zi Tang (Six Gentlemen Decoction) plus Chuanxiong, Danggui, and Jiegeng. If there is Blood Deficiency, use Siwu Tang plus Sangbai pi, Xingren, and Jiegeng. If Kidney Fire flares upward, use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) added with Wuweizi, decocted and taken orally. If there is Qi Deficiency in the Spleen and Stomach injured by Wind-Cold, use Buzhong Yiqi Tang (Middle-Boosting Qi-Invigorating Decoction) plus Sangbaipi, Xingren, and Jiegeng. Generally, the Lung belongs to Xin Metal, born from Ji Earth. Chronic coughs that do not heal are often due to Spleen Earth deficiency failing to generate Lung Qi, leading to loose interstices and secondary external pathogenic invasion. Or, it may be due to Lung Qi deficiency failing to generate Kidney Water, resulting in the flaming up of Yin Fire. The treatment method should prioritize clearing Lung Metal and generating Kidney Water.