薛立斋曰∶鬼胎证,因七情相干,脾肺亏损,气血虚弱,行失常道,冲任违乖致之。乃元气不足,病气有
余也。若见经候不调,就行调补。庶免此证。治法,以补元气为主,佐以雄黄丸、斩鬼丹之类行散之。
薛立斋曰∶一妇人经闭八月,肚腹渐大,面色或青或黄,用胎证药不应。诊视之,面青脉涩,寒热往来,
肝经血病也。面黄腹大,少食倦体,脾经血病也。此郁怒伤脾肝之证,非胎也。不信,仍用治胎散,不验,用
加味归脾、逍遥二药愈。
慎斋按∶以上四条,序孕妇有鬼胎之证也。
罗谦甫曰∶有女子月事不下,腹如怀子状,医者不知《内经》有肠覃、石瘕之病名,而疑为妊孕。经云∶
肠覃者,寒气客于肠外,与卫气相抟,气不得荣,因有所系,瘕而内着,恶气乃起,息肉乃生。其始生,大如
鸡卵,稍以益大,至其大如怀子状,久则离岁,按之则坚,推之则移,月事以时下,此其候也。夫肠者,大肠
也。覃者,延也。大肠以传导为事,肺之腑也。肺主卫,卫为气,得热则泄,得寒则泣。今寒客大肠,故卫气
不荣,有所系止,而结瘕在内贴着,延久不已,是名肠覃。气散则清,气聚则浊,结为瘕聚。所以恶气发起,
息肉乃生,小渐益大,至期而鼓,其腹如怀子状。此气病而血未病,故月事不断,应时而下,本非胎孕,可以此为
验辨,木香通气散主之。
薛立斋说:鬼胎证,是由于七情相互干扰,导致脾肺亏损,气血虚弱,运行失去常道,冲任二脉失调所致。这是元气不足,而病邪有余的表现。如果见到月经不调,就应当进行调补。这样才能避免这种病症。治疗方法,以补益元气为主,辅以雄黄丸、斩鬼丹等方剂来行气散结。
薛立斋说:有一位妇人闭经八月,腹部逐渐增大,面色有时发青有时发黄,使用安胎药物无效。诊察发现,面青色且脉象涩滞,寒热往来,这是肝经血分病变。面色发黄、腹部膨大、食欲减退、身体疲倦,这是脾经血分病变。这是郁怒损伤脾肝的证候,并非怀孕。患者不信,仍然使用治胎散,无效后,改用加味归脾汤和逍遥散两种药物治愈。
罗谦甫说:有女子月经不来,腹部像怀孕的样子,医生不了解《内经》中有肠覃、石瘕的病名,而怀疑是妊娠。经文说:肠覃,是寒气客居在肠外,与卫气相互搏结,气不能正常荣养,因而有所羁绊,形成积块并附着在内,恶气于是产生,息肉于是生成。刚开始时,大小如鸡蛋,逐渐增大,直到大得像怀孕的样子,时间长久超过一年,按压它则坚硬,推动它则移动,月经按时来潮,这就是它的征候。所谓“肠”,是指大肠。“覃”通“延”,意为延长。大肠以传导为功能,是肺的腑属。肺主卫气,卫气属于气,遇到热则泄散,遇到寒则凝泣。现在寒气客居大肠,所以卫气不能正常荣养,有所羁绊停止,而在内结成积块贴着,拖延日久不愈,这就叫做肠覃。气散则清,气聚则浊,凝结成为瘕聚。所以恶气发起,息肉生成,逐渐增大,到了时期腹部胀大,形状像怀孕。这是气病而血未病,所以月经不断,按时而下,本来不是胎孕,可以以此作为验证辨别,主治方剂为木香通气散。
Xue Lizhai stated: The syndrome of "Ghost Fetus" (Guifai) is caused by the mutual interference of the Seven Emotions, leading to deficiency and damage of the Spleen and Lung, weakness of Qi and Blood, deviation from normal circulation, and dysfunction of the Chong and Ren vessels. It represents a state where Yuan Qi (Primary Qi) is insufficient while pathogenic factors are excessive. If menstrual irregularities are observed, regulation and tonification should be initiated immediately to prevent this condition. The treatment principle focuses on tonifying Yuan Qi, assisted by formulas such as Xionghuang Wan (Realgar Pill) or Zhangui Dan (Ghost-Slaying Cinnabar) to promote Qi movement and dissipate stagnation.
Xue Lizhai stated: A woman had amenorrhea for eight months with gradual abdominal enlargement. Her complexion alternated between cyanotic and sallow. Medications intended for fetal stabilization were ineffective. Upon examination, her face was cyanotic, pulse was choppy (Se), and she experienced alternating chills and fever, indicating a blood pathology in the Liver Meridian. Her sallow complexion, abdominal distension, poor appetite, and fatigue indicated a blood pathology in the Spleen Meridian. This was a syndrome of Spleen and Liver injury due to depression and anger, not pregnancy. Disbelieving this, she continued using Zhitai San (Fetus-Treating Powder) without success. She was eventually cured using Jiawei Guipi Tang (Modified Return the Spleen Decoction) and Xiaoyao San (Free and Easy Wanderer Powder).
Shenzhen's Commentary: The above four cases describe the occurrence of Ghost Fetus syndrome in pregnant women.
Luo Qianfu stated: There was a female patient with amenorrhea whose abdomen resembled pregnancy. Physicians, unfamiliar with the disease names Changqin (Intestinal Polyp/Tumor) and Shijia (Stone Mass) from the *Neijing* (*Inner Canon*), suspected pregnancy. The Classic states: Changqin occurs when cold pathogens lodge outside the intestines and contend with Wei Qi (Defensive Qi). Qi fails to nourish properly, becomes bound, forms a mass that adheres internally, evil Qi arises, and polyps generate. Initially small like a chicken egg, it gradually enlarges until the abdomen resembles pregnancy. After more than a year, it feels firm upon pressure but moves upon pushing. Menstruation continues regularly; this is its characteristic sign. "Chang" refers to the Large Intestine. "Qin" implies extension or prolongation. The Large Intestine governs conduction and is the Fu organ of the Lung. The Lung governs Wei Qi. Wei Qi, being Qi, disperses with heat and coagulates with cold. Now, cold lodges in the Large Intestine, causing Wei Qi to fail in nourishment, becoming bound, and forming an internal adherent mass. Prolonged persistence constitutes Changqin. When Qi scatters, it is clear; when Qi gathers, it is turbid. Coagulation forms masses. Thus, evil Qi arises, polyps generate, and they gradually enlarge until the abdomen distends like pregnancy. This is a Qi pathology without Blood involvement; hence menstruation remains regular and timely. It is fundamentally not pregnancy and can be distinguished thus. The primary formula is Muxiang Tongqi San (Costus Regulating Qi Powder).