答曰。妊娠心中愤闷头运。四肢烦痛。懈堕不欲执作。恶闻食气。欲啖咸酸果实。多睡少起
者。世云恶食。又云恶字。是也。乃至三四月以上。大剧者不能自胜举也。此繇妇人元本虚
羸
。血气不足。肾气又弱。兼当风饮冷太过。心下有痰水。水渍于脏。故心烦愤闷。气挟而呕
吐也。挟风则头目运。此名恶阻。所谓阻者。经血既闭。痰水积于中。阻其脏气。不得宣通
也。
竹茹汤。治初有妊。择食呕逆。头痛颠倒。寒热烦闷。
陈皮 人参 白术 麦门冬(各一两) 甘草(炙一钱) 浓朴 茯苓(各半两) 淡竹茹(先刮
下临煎旋入一本有淡竹一钱)
上 咀。每服四钱。水盏半。入姜竹茹各一块如栗大。拍破。同煎八分。频服。去滓温服。
茯苓丸。治妊娠阻病。心中烦愦。头目眩重。恶闻食气。呕逆吐闷。
葛根 枳壳 白术 甘草(炙各二两) 赤茯苓 人参 干姜 肉桂 陈皮 半夏(各一两)
上为细末。蜜丸桐子大。每服五十丸。温米饮空心送下。
小地黄丸。治妊娠酸心吐清水。腹痛不能饮食。
人参 干姜(炮各等分)
上为末。用生地黄汁丸。桐子大。每服五十丸。食前服。
半夏茯苓汤。治妊娠恶阻。心中愤闷。头目眩晕。四肢怠惰。百节烦疼。痰逆呕吐。嫌
闻食气。好啖酸咸。多卧少起。不进饮食。
半夏 白茯苓 熟地(酒浸各一两八钱) 陈皮 细辛 人参 芍药 川芎 紫苏 桔梗 甘
草(以上各一两二钱)
上每服四钱。水二盏。姜七片。煎七分。空腹服。有热烦渴。口生疮者。去陈皮细辛。加前
胡知母。腹冷下痢者。去地黄。入桂心。胃中虚热。大小便秘涩者。加大黄一两八钱。去地
黄。加黄芩。
四七汤。治同前方。见二十八问中。
二陈汤。治妊娠恶阻。产后饮食不进。
半夏 陈皮(各五两) 白茯苓(三两) 甘草(二两)
上 咀。每服四钱。水盏半。姜七片。乌梅一枚。煎六分。去滓热服。不拘时。
白术散。治妊妇宿风冷。胎痿不长。或失于腠理。动伤胎气。多致损胎等疾。
牡蛎(二钱) 蜀椒(去目炒出汗三分) 白术 芎 (各四钱)
上为细末。每二钱温酒空心服。腹痛加白芍药。心毒痛加川芎。心烦呕吐加细辛一两。半夏
五十粒。消渴者以大麦汁调服。兼治室女带下诸疾。常服则保护胎藏。
人参散。治初妊恶食。呕吐痰逆。
人参(一两) 枳壳(炒三钱) 浓朴(半两) 甘草(半两)
上为细末。每服二钱。百沸汤调下。空心食前日三服。
严氏第十三问。妊娠头目眩。视物不见。腮项结核者。何也。曰。盖因胎气有伤。肝脏毒热
上攻。太阳穴痛。呕逆。背项拘急。致令头晕生花。若加涎壅。危在片时。宜急服消风散主
之。
消风散
石膏( ) 甘菊花 防风 荆芥穗 羌活 羚羊角 川芎 大豆黄卷(炒) 当归(酒浸) 白
芷(各一两) 甘草(炙半两)
上 咀。每服四钱。水盏半。入好茶半钱。煎八分。通口服。食前。
答：妊娠期间出现心中烦闷、头晕、四肢酸痛倦怠、不想劳作、厌恶食物气味、想吃咸酸果实、嗜睡少动等症状，世人称之为“恶食”或“恶子”，正是此证。甚至到了怀孕三四月以上，病情严重者，身体虚弱到无法支撑自己起身。这是因为妇人原本体质虚弱羸弱，气血不足，肾气也虚弱，加上受风邪侵袭、过食生冷，导致心下有痰饮停聚，水湿浸渍脏腑，所以心烦意乱、胸闷；气机上逆则呕吐。夹带风邪则头晕目眩。这叫做“恶阻”。所谓“阻”，是指经血闭止后，痰饮水湿积聚在体内，阻碍了脏腑之气的宣通运行。
竹茹汤：治疗刚怀孕时择食、呕吐逆气、头痛剧烈、寒热交替、烦闷不适。
陈皮、人参、白术、麦门冬（各一两），甘草（炙一钱），浓朴、茯苓（各半两），淡竹茹（先刮下，临煎时旋入；另一版本有淡竹一钱）。
以上药物切碎。每次服用四钱，加水一盏半，放入生姜和竹茹各一块如栗子大小，拍破，同煎至八分满，频繁服用，去渣温服。
茯苓丸：治疗妊娠阻病，心中烦乱昏沉，头目眩晕沉重，厌恶食物气味，呕吐逆气，吐后胸闷。
葛根、枳壳、白术、甘草（炙，各二两），赤茯苓、人参、干姜、肉桂、陈皮、半夏（各一两）。
以上研为细末，用蜂蜜制成梧桐子大小的丸药。每次服用五十丸，空腹时用温米汤送服。
小地黄丸：治疗妊娠时心中泛酸、吐出清水、腹痛不能进食。
人参、干姜（炮制，各等分）。
以上研为末，用生地黄汁制作成梧桐子大小的丸药。每次服用五十丸，饭前服用。
半夏茯苓汤：治疗妊娠恶阻，心中烦闷，头目眩晕，四肢怠惰无力，全身关节酸痛，痰气上逆呕吐，厌恶闻食物气味，喜好食用酸咸之物，嗜卧少起，不进饮食。
半夏、白茯苓、熟地黄（酒浸，各一两八钱），陈皮、细辛、人参、芍药、川芎、紫苏、桔梗、甘草（以上各一两二钱）。
以上每次服用四钱，加水二盏，生姜七片，煎至七分，空腹服用。若有热象、烦躁口渴、口舌生疮者，去掉陈皮、细辛，加入前胡、知母。若腹部冷痛、下痢者，去掉地黄，加入桂心。若胃中虚热、大小便便秘涩滞者，加入大黄一两八钱，去掉地黄，加入黄芩。
四七汤：功效同上前方，详见第二十八问中。
二陈汤：治疗妊娠恶阻，产后饮食不进。
半夏、陈皮（各五两），白茯苓（三两），甘草（二两）。
以上切碎。每次服用四钱，加水一盏半，生姜七片，乌梅一枚，煎至六分，去渣热服，不拘时间。
白术散：治疗妊妇素有风寒，胎萎不长，或因腠理不固，动伤胎气，多导致损胎等疾病。
牡蛎（二钱），蜀椒（去目，炒出汗，三分），白术、川芎（各四钱）。
以上研为细末。每次服用二钱，空腹用温酒送服。腹痛加白芍药；心腹剧痛加川芎；心烦呕吐加细辛一两、半夏五十粒；消渴者用大麦汁调服。兼治室女带下诸疾。常服可保护胎藏。
人参散：治疗初孕恶食，呕吐痰逆。
人参（一两），枳壳（炒三钱），浓朴（半两），甘草（半两）。
以上研为细末。每次服用二钱，用滚开水调服，空腹及饭前每日三次服用。
严氏第十三问：妊娠期间头目眩晕，视物不见，腮部颈部淋巴结肿大，是怎么回事？回答说：大概是因为胎气受损，肝脏毒热上攻，导致太阳穴疼痛，呕吐逆气，背部和颈部拘急僵硬，致使头晕眼花。如果再加上痰涎壅盛，片刻间就有生命危险。应当立即服用消风散主治。
消风散
石膏（未注明剂量，依上下文推测可能缺漏或需根据具体版本补全，此处按原文留空或视为通用量，但通常古籍中若无注则可能为等分或特定量，此处严格忠实原文空白），甘菊花、防风、荆芥穗、羌活、羚羊角、川芎、大豆黄卷（炒）、当归（酒浸）、白芷（各一两），甘草（炙半两）。
以上切碎。每次服用四钱，加水一盏半，加入好茶半钱，煎至八分，空腹前通口服下。
Answer: During pregnancy, if one experiences mental restlessness and oppression, dizziness, soreness and pain in the four limbs, lassitude and unwillingness to work, aversion to food odors, craving for salty and sour fruits, excessive sleepiness with little rising, this is commonly referred to as "aversion to food" or "aversion to conception," which is indeed the condition. Even by the third or fourth month of pregnancy, in severe cases, the patient may be too weak to support themselves. This arises because the woman's original constitution is deficient and emaciated, with insufficient Qi and Blood, and weak Kidney Qi. Additionally, exposure to wind and excessive consumption of cold drinks have led to the accumulation of phlegm and fluid below the heart, where water dampness infiltrates the Zang organs. Thus, there is mental vexation and oppression; when Qi rebels upward, it causes vomiting. When accompanied by wind, it results in dizziness and vertigo of the head and eyes. This is named "E Zu" (Morning Sickness/Obstruction). The term "obstruction" refers to the fact that after the menstrual blood has ceased, phlegm and fluid accumulate in the middle jiao, obstructing the diffusion and circulation of the Qi of the Zang organs.
Zhuru Tang (Bamboo Shavings Decoction): Treats early pregnancy with selective eating, vomiting and rebellious Qi, severe headache, alternating chills and fever, and mental restlessness.
Chenpi (Citri Reticulatae Pericarpium), Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), Maimendong (Ophiopogonis Radix) (each 1 liang), Gancao (Licorice Root, honey-fried, 1 qian), Houpo (Magnoliae Officinalis Cortex), Fuling (Poria) (each 0.5 liang), Danzhuru (Bambusae Caulis in Taeniam, scraped first and added during decoction; another version includes 1 qian of Danchu) [Note: WHO standard terms used].
Crush the herbs. Take 4 qian per dose, add 1.5 cups of water, place a piece of fresh ginger and a piece of bamboo shavings each the size of a chestnut, crush them, and decoct together until reduced to 0.8 parts. Drink frequently, remove the dregs, and take warm.
Fuling Wan (Poria Pill): Treats pregnancy obstruction disease, characterized by mental confusion and heaviness, dizziness and heavy sensation in the head and eyes, aversion to food odors, vomiting and rebellious Qi, and post-vomiting chest fullness.
Gegen (Puerariae Lobatae Radix), Zhike (Aurantii Fructus Immaturus), Baizhu (Atractylodis Macrocephalae Rhizoma), Gancao (Licorice Root, honey-fried, each 2 liang), Chifuling (Red Poria), Renshen (Ginseng Radix et Rhizoma), Ganjiang (Zingiberis Rhizoma Recens), Rougui (Cinnamomi Cortex), Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma) (each 1 liang).
Grind into fine powder, make pills with honey the size of tung seeds. Take 50 pills per dose, swallow with warm rice broth on an empty stomach.
Xiao Dihuang Wan (Minor Rehmannia Pill): Treats pregnancy with acid regurgitation, vomiting clear water, abdominal pain, and inability to eat.
Renshen (Ginseng Radix et Rhizoma), Ganjiang (Zingiberis Rhizoma Recens, processed) (equal parts).
Grind into powder, make pills using juice of fresh Shengdihuang (Rehmanniae Radix) the size of tung seeds. Take 50 pills per dose before meals.
Banxia Fuling Tang (Pinellia and Poria Decoction): Treats pregnancy E Zu, mental restlessness and oppression, dizziness and vertigo of the head and eyes, lassitude of the four limbs, general joint soreness, rebellious phlegm and vomiting, aversion to food odors, preference for sour and salty tastes, lying down much and rising little, and loss of appetite.
Banxia (Pinelliae Rhizoma), Baifuling (White Poria), Shudihuang (Prepared Rehmanniae Radix, wine-soaked, each 1 liang 8 qian), Chenpi (Citri Reticulatae Pericarpium), Xixin (Asari Radix et Rhizoma), Renshen (Ginseng Radix et Rhizoma), Shaoyao (Paeoniae Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Zisu (Perillae Folium), Jiegeng (Platycodonis Radix), Gancao (Licorice Root) (each 1 liang 2 qian above).
Take 4 qian per dose, add 2 cups of water and 7 slices of ginger, decoct until 0.7 parts remain, take on an empty stomach. If there are heat signs, irritability, thirst, and mouth ulcers, remove Chenpi and Xixin, add Qianhu (Peucedani Radix) and Zhimu (Anemarrhenae Rhizoma). If there is cold abdomen and diarrhea, remove Dihuang, add Guixin (Cinnamomi Ramulus). If there is deficiency-heat in the stomach with constipation of both large and small bowels, add Dahuang (Rhei Radix et Rhizoma, 1 liang 8 qian), remove Dihuang, add Huangqin (Scutellariae Radix).
Siqi Tang (Four-Seven Decoction): Same efficacy as the preceding formula; see Question 28.
Erchen Tang (Two-Aged Decoction): Treats pregnancy E Zu and loss of appetite after childbirth.
Banxia (Pinelliae Rhizoma), Chenpi (Citri Reticulatae Pericarpium) (each 5 liang), Baifuling (White Poria, 3 liang), Gancao (Licorice Root, 2 liang).
Crush the herbs. Take 4 qian per dose, add 1.5 cups of water, 7 slices of ginger, and 1 dark plum (Wumei), decoct until 0.6 parts remain, remove dregs and take hot, at any time.
Baizhu San (Atractylodes Powder): Treats pregnant women with chronic wind-cold, fetal wasting and failure to grow, or due to insecure couli (pores/skin texture) damaging fetal Qi, often leading to diseases damaging the fetus.
Muli (Concha Ostreae, 2 qian), Shujiao (Zanthoxyli Pericarpium, remove eyes, stir-fry until sweat appears, 3 fen), Baizhu (Atractylodis Macrocephalae Rhizoma), Xiong (Ligustici Chuanxiong Rhizoma) (each 4 qian).
Grind into fine powder. Take 2 qian per dose on an empty stomach with warm wine. For abdominal pain, add Baishaoyao (White Peony Root); for severe heart/abdominal pain, add Chuanxiong; for mental vexation and vomiting, add Xixin (Asari Radix et Rhizoma, 1 liang) and Banxia (Pinelliae Rhizoma, 50 grains); for thirst, mix with barley juice. Also treats leukorrhea in unmarried women. Regular use protects the fetal storehouse.
Renshen San (Ginseng Powder): Treats early pregnancy aversion to food, vomiting, and rebellious phlegm.
Renshen (Ginseng Radix et Rhizoma, 1 liang), Zhike (Aurantii Fructus Immaturus, stir-fried, 3 qian), Houpo (Magnoliae Officinalis Cortex, 0.5 liang), Gancao (Licorice Root, 0.5 liang).
Grind into fine powder. Take 2 qian per dose mixed with boiling water, three times daily on an empty stomach and before meals.
Question 13 from Yan Shi: Why does pregnancy cause dizziness and vertigo of the head and eyes, blindness, and lymph node swelling in the cheeks and neck? Answer: It is likely due to damage to fetal Qi, causing toxic heat from the Liver to attack upwards, resulting in pain in the temporal region, vomiting and rebellious Qi, stiffness and tension in the back and neck, leading to dizziness and visual spots. If accompanied by phlegm obstruction, life is in danger within moments. One should immediately administer Xiaofeng San (Wind-Expelling Powder) as the main treatment.
Xiaofeng San (Wind-Expelling Powder)
Shigao (Gypsum Fibrosum - dosage missing in source), Juhua (Chrysanthemi Flos), Fangfeng (Saposhnikoviae Radix), Jingjiesui (Schizonepetae Spica), Qianghuo (Notopterygii Rhizoma et Radix), Lingyangjiao (Saigae Tataricae Cornu), Chuanxiong (Ligustici Chuanxiong Rhizoma), Dadouhuangjuan (Sojae Semen Praeparatum, stir-fried), Danggui (Angelicae Sinensis Radix, wine-soaked), Baizhi (Angelicae Dahuricae Radix) (each 1 liang), Gancao (Licorice Root, honey-fried, 0.5 liang).
Crush the herbs. Take 4 qian per dose, add 1.5 cups of water and 0.5 qian of good tea, decoct until 0.8 parts remain, take orally before meals.