一妇将临月,忽然两目失明,不见灯火,头痛眩晕,项腮肿满,不能转颈,诸治不瘥,
反加危困。偶得消风散服之,病减七八,获安分娩。其眼吊起,人物不辨,乃以四物汤
加荆芥、防风,更服眼科天门冬饮子,二方间服,目渐稍明。大忌酒、面,煎炙、鸡、羊、
鹅、鸭、豆腐、辛辣热物并房劳。此证因怀妊多居火间,衣着太暖,伏热在内,或酒面
炙爆太过,以致胎热也。
天门冬饮子 治妊娠肝经风热,上攻眼目,带吊失明。
天门冬(去心) 知母 茺蔚子 五味子 防风(去芦) 茯苓(去皮) 川羌活(去芦)
人参(各一钱)
上作一服,水二盅,生姜三片,煎至一盅,食后服。
陈良甫记管先生治一妊娠四五个月,脏躁悲伤,遇昼则惨凄泪下,数欠,象若神灵,
如有所凭。医与巫皆无益,与仲景大枣汤,一投而愈。
〔薛〕前证或因寒水攻心,或肺有风邪者,治当审察。一妊妇无故自悲,用大枣
汤二剂而愈。后复患,又用前汤佐以四君子加山栀而安。一妊妇悲哀烦躁,其夫询之,
云∶我无故但自欲悲耳。用淡竹茹汤为主,佐以八珍汤而安。
〔仲景〕妇人脏躁悲伤欲哭,象如神灵所作,数欠伸,甘麦大枣汤主之。
甘麦大枣汤方
甘草(三两) 小麦(一升) 大枣(十枚)
上以水六升,煮取三升,温分三服。亦补脾气。
许学士云∶乡里有一妇人,数欠伸,无故悲泣不止,或谓之有祟,祈禳请祷备至,终
不应,予忽忆《金匮》有一证云∶妇人脏躁悲伤欲哭,象如神灵所作,数欠伸者,宜甘
麦大枣汤。予急令治药,尽剂而愈。古人识病制方,种种绝妙如此。
淡竹茹汤 治妊妇心虚惊悸,脏躁悲伤不止。又治虚烦甚效。
麦门冬(去心) 小麦 半夏(汤泡。各二两半) 人参 白茯苓(各一两半)
甘草(一两)
上锉散,每服四钱,姜五片,枣一枚,淡竹茹一团,如指大,同煎温服。
又方 治胎脏躁,自悲、自哭、自笑。
上以红枣烧存性,米饮调下。
一位孕妇即将临产,突然双目失明,看不见灯火,伴有头痛、眩晕,颈部和腮部肿胀僵硬,无法转动脖子,经过多种治疗均无效,病情反而加重,陷入危重困境。偶然服用消风散后,症状减轻了七八成,得以平安分娩。但她的眼睛向上吊起,无法辨认人物,于是改用四物汤加入荆芥、防风,并配合眼科专用方剂天门冬饮子交替服用,双眼逐渐恢复些许视力。此病期间大忌饮酒、面食,以及油炸烧烤食物、鸡肉、羊肉、鹅肉、鸭肉、豆腐、辛辣温热之物及房事。此证是因为怀孕时多居住在火气重的地方,衣着过于保暖,导致体内伏热蕴结,或因过量食用酒、面、油炸爆炒食物,致使胎热内生。
天门冬饮子:治疗妊娠期间肝经风热上攻眼目,导致眼睑下垂(或眼球上吊)而失明。
处方组成:天门冬(去心)、知母、茺蔚子、五味子、防风(去芦头)、茯苓(去皮)、川羌活(去芦头)、人参(各一钱)。
用法:以上药材作为一服剂量,加水两盅,生姜三片,煎煮至一盅,饭后服用。
陈良甫记载管先生治疗一例妊娠四五个月的妇女,患脏躁悲伤证,白天神情凄惨流泪,频繁打哈欠,症状如同神灵附体,好像有所凭借。医生和巫医都无济于事,给予张仲景的大枣汤(即甘麦大枣汤),服药一次即痊愈。
〔薛己按〕上述病症可能是因为寒水之气攻心,或者肺中有风邪所致,治疗时应当仔细审察。有一位孕妇无故自己感到悲伤,服用大枣汤两剂后痊愈。后来复发,又用前方佐以四君子汤加山栀而安定病情。另一位孕妇悲哀且烦躁,其丈夫询问原因,她说:“我无缘无故只想悲伤。”使用淡竹茹汤为主方,佐以八珍汤而安定病情。
〔张仲景〕妇人脏躁悲伤欲哭,症状像神灵所作所为,频繁打哈欠伸懒腰,用甘麦大枣汤主治。
甘麦大枣汤方:甘草(三两)、小麦(一升)、大枣(十枚)。
用法:以上用水六升,煮取三升药液,分三次温服。此方也能补益脾气。
许学士说:家乡有一位妇人,频繁打哈欠伸懒腰,无缘无故悲伤哭泣不止,有人说是中了邪祟,祈祷祭祀的方法都用尽了,始终不见好转。我突然想起《金匮要略》中有一证候说:“妇人脏躁悲伤欲哭,象如神灵所作,数欠伸者,宜甘麦大枣汤。”我急忙让人抓药,服完一剂后痊愈。古人识别病证、制定方剂,精妙之处竟如此。
淡竹茹汤:治疗孕妇心虚惊悸,脏躁悲伤不止。又对虚烦症状疗效显著。
处方组成:麦门冬(去心)、小麦、半夏(汤泡过,各二两半)、人参、白茯苓(各一两半)、甘草(一两)。
用法:以上锉碎成散剂,每次服用四钱,加生姜五片、大枣一枚、一团淡竹茹(大小如手指),一同煎煮,温服。
另一首方剂:治疗胎脏躁,表现为自悲、自哭、自笑。
用法:以上将红枣烧至存性(保留部分焦黑但内部未完全炭化),用米汤调服。
A pregnant woman, nearing her due date, suddenly lost vision in both eyes, unable to see even lamp light. She suffered from headache, dizziness, and swelling and stiffness of the neck and cheeks, rendering her unable to turn her head. Various treatments failed, and her condition worsened to a critical state. Coincidentally, after taking Xiaofeng San (Wind-Expelling Powder), her symptoms improved by seventy or eighty percent, allowing her to deliver safely. However, her eyelids were retracted upwards, and she could not recognize people. Consequently, Siwu Tang (Four Substances Decoction) was administered with added Jingjie (Schizonepetae Herba) and Fangfeng (Saposhnikoviae Radix), alternating with the ophthalmic formula Tianmendong Yinzi (Asparagi Decoction). Gradually, her vision slightly recovered. Strict avoidance of alcohol, wheat products, fried/roasted foods, chicken, mutton, goose, duck, tofu, spicy/hot substances, and sexual intercourse was required for this case. This syndrome resulted from residing in hot environments during pregnancy, wearing overly warm clothing, leading to latent heat accumulation internally, or excessive consumption of alcohol, wheat, and fried foods, causing fetal heat.
Tianmendong Yinzi (Asparagi Decoction): Treats wind-heat in the Liver Meridian during pregnancy attacking the eyes, causing eyelid retraction and blindness.
Ingredients: Tianmendong (Asparagi Radix, heart removed), Zhimu (Anemarrhenae Rhizoma), Chongweizi (Ecliptae Fructus), Wuweizi (Schisandrae Fructus), Fangfeng (Saposhnikoviae Radix, rhizome removed), Fuling (Poria, peel removed), Chuan Qianghuo (Notopterygii Rhizoma et Radix, rhizome removed), Renshen (Ginseng Radix et Rhizoma; each 1 qian).
Administration: These ingredients constitute one dose. Add two cups of water and three slices of Shengjiang (Zingiberis Rhizoma Recens). Decoct until one cup remains. Take after meals.
Chen Liangfu recorded that Mr. Guan treated a pregnant woman at four to five months gestation suffering from Zangzao (Visceral Agitation) with sadness and weeping. During the day, she appeared desolate and tearful, frequently yawning, resembling spirit possession or being influenced by external entities. Neither physicians nor shamans were effective. Administering Zhang Zhongjing's Dazao Tang (Jujube Decoction, i.e., Ganmai Dazao Tang) cured her after one dose.
[Xue Ji's Commentary] The aforementioned syndromes may be caused by Cold-Water Qi attacking the Heart or Wind-Evil in the Lungs; treatment requires careful examination. One pregnant woman who felt inexplicable sadness was cured after two doses of Dazao Tang. Upon recurrence, the same decoction combined with Sijunzi Tang (Four Gentlemen Decoction) plus Zhizi (Gardeniae Fructus) stabilized her condition. Another pregnant woman suffered from sorrow and irritability. When questioned by her husband, she stated, "I simply feel like crying for no reason." Using Danzhuru Tang (Bamboo Shavings Decoction) as the main formula, supplemented by Bazhen Tang (Eight Treasures Decoction), her condition stabilized.
[Zhang Zhongjing] For women suffering from Zangzao (Visceral Agitation), sadness, desire to cry, symptoms resembling spirit possession, and frequent yawning/stretching, Ganmai Dazao Tang (Wheat, Jujube, and Licorice Decoction) is indicated.
Formula for Ganmai Dazao Tang: Gancao (Licorice Radix et Rhizoma, 3 liang), Xiaomai (Tritici Fructus, 1 sheng), Dazao (Ziziphi Jujubae Fructus, 10 pieces).
Administration: Add six liters of water, boil to obtain three liters. Divide into three warm doses. This formula also tonifies Spleen Qi.
Xu Xueshi said: In my hometown, there was a woman who frequently yawned and stretched, weeping incessantly without cause. Some suggested she was possessed by evil spirits, and various prayers and exorcisms were performed to no avail. I suddenly recalled a syndrome from *Jin Gui Yao Lue*: "Women suffering from Zangzao (Visceral Agitation), sadness, desire to cry, resembling spirit possession, with frequent yawning and stretching, should use Ganmai Dazao Tang." I urgently ordered the preparation of the medicine. After completing one course, she was cured. The ancients' understanding of diseases and formulation of prescriptions were so exquisite.
Danzhuru Tang (Bamboo Shavings Decoction): Treats Heart deficiency with palpitations and fright in pregnant women, and persistent Zangzao (Visceral Agitation) with sadness. It is also highly effective for severe deficiency-related vexation.
Ingredients: Maimendong (Ophiopogonis Radix, heart removed), Xiaomai (Tritici Fructus), Banxia (Pinelliae Rhizoma, soaked in boiling water; each 2.5 liang), Renshen (Ginseng Radix et Rhizoma), Baifuling (Poria, each 1.5 liang), Gancao (Licorice Radix et Rhizoma, 1 liang).
Administration: Coarsely powder the ingredients. Each dose uses 4 qian, along with 5 slices of Shengjiang (Zingiberis Rhizoma Recens), one Dazao (Ziziphi Jujubae Fructus), and a ball of Danshu Zhu Ru (Bamboo Shavings) roughly the size of a finger. Decoct together and take warm.
Another Formula: Treats fetal Zangzao (Visceral Agitation) manifesting as spontaneous sadness, crying, and laughing.
Administration: Roast red dates until they retain their nature but are charred on the outside (burnt to preserve efficacy). Mix with rice water and ingest.