〔丹〕阳施阴化,胎孕乃成。血气虚损,不足营养,其胎自堕。或劳怒伤情,内火便
动,亦能堕胎。推原其本,皆因于热,火能消物,造化自然。《病源》乃谓风冷伤于子脏
而堕,此未得病情者也。予见贾氏妇,但有孕至三月左右必堕,诊其脉,左手大而无力,
重取则涩,知其血少也。以其妙年,只补中气,使血自荣。时正夏初,教以浓煎白术汤
下黄芩末一钱,服三四十帖,遂得保全其生,因而思之,堕因内热而虚者,于理为多,曰
热曰虚,当分轻重。盖孕至三月,正属相火,所以易堕,不然何以黄芩、熟艾、阿胶等为
安胎妙药耶?好生之工,幸无轻视。一妇年三十余,或经住或成形未具,其胎必堕,察
其性急多怒,色黑气实,此相火太盛,不能生气化胎,反食气伤精故也。因令住经第二
月,用黄芩、白术、当归、甘草,服至三月尽止药,后生一子。一妇经住三月后,尺
脉或涩或微弱,其妇却无病,知是子宫真气不全,故阳不施,阴不化,精血虽凝,终不
成形。至产血块或产血胞。一妇腹渐大如怀子,至十月求易产药,察其神色甚困难,与
之药,不数日生白虫半桶。盖由妇之元气太虚,精血虽凝,不能成胎而为秽腐,蕴积之
久,湿化为热,湿热生虫,理之所有,亦须周十月之气,发动而产,终非佳兆。其妇不
及月死。湿热生虫,譬之沟渠污浊,积久不流,则诸虫生于其间矣。
汪石山治一妇长瘦,色黄白,性躁急、年三十余,常患堕胎,已七八见矣。诊其脉,皆
柔软无力,两尺虽浮而弱,不任寻按。曰∶此因胎堕太多,气血耗甚,胎无滋养,故频堕,
譬之水涸而禾枯,土削而木倒也。况三月五月,正属少阳火动之时,加以性躁而急发之,
故堕多在三五七月也。宜大补阴汤去桂加黄柏、黄芩煎服,仍用研末蜜丸服之,庶可保
生,服半年胎固而生二子。
钱仲阳治一孕妇病,医言胎且堕。钱曰∶妊者五脏传养,率六旬乃更,候其月偏补之,
何必堕。已而母子皆全。
陈斗岩治一妇有胎四月堕下,逾旬腹肿发热,气喘,脉洪盛,面赤口鼻舌青黑。陈
诊之曰∶脉洪盛者,胎未堕也。面赤,心火盛而血干也。舌青口鼻黑,肝既绝而胎死矣。
内外皆曰胎堕久矣。复诊色脉如前,以蛇蜕煎汤下平胃散加芒硝、归尾一倍服之。须臾,
腹鸣如雷,腰腹阵痛,复一死胎随下,病亦
愈。
程仁甫治一妇,年近四十,禀气素弱,自去其胎,五日内渐渐腹胀如鼓,至心前上,吐
不能食,用补药不效。诊六脉微弱,但只叫胀死,此乃损伤脾气而作胀,然急则治其标,
若泥丹溪法恐缓不及事矣。用桃仁承气加枳实、浓朴,倍硝、黄,煎服四分,吐去其一,
次早仍不通,事急,又服琥珀丸三钱,至申时大通,胀减,但体倦四肢无力,口不知味,
发热,再用参、 、归、芍、楂、术、陈皮八剂而安。
江应宿治汪镐妻,三十五岁,厌产误服打胎药,下血如崩旬余,腹痛一阵即行,或
时鼻衄,诸药不效。诊得六脉数而微弦,乃厥阳之火泛逆,投四物换生地黄,加阿胶、炒
黑山栀、蒲黄,一剂愈。
薛氏云∶大抵治法,须审某月属某经育养而药之。
济生芎 补中汤 治怀孕血气虚弱,不能卫养,以致数月而堕,名曰半产。(每见妇人
孕不能满十月而损堕,得服此遂安全。)
芎 五味子 阿胶(蛤粉炒) 干姜(炮,各一钱) 黄 (去芦,蜜炙) 当归(酒浸)
白芍药 白术(各一钱半) 杜仲(去粗皮,炒去丝) 人参 木香(不见火) 甘草(各五分,炙)
上作一服,水二盅,煎至一盅,不拘时服。
阿胶汤 治妊娠数堕胎,小腹 痛不可忍。
阿胶(炙燥) 熟干地黄(焙) 艾叶(微炒) 芎 当归(切,焙) 杜仲(去粗皮,炙,锉)
白术(各一两)
上 咀,每服四钱,水一盏半,枣三枚,擘破,同煎至八分,去滓食前温服。
杜仲丸 治妊娠三两个月,胎动不安,防其欲堕,宜预服之。
杜仲(姜制,炒去丝) 续断(酒浸,各二两)
为末,煮枣肉杵丸梧子大。每服七十丸,米饮下。
四制艾附丸 治妇人数堕胎,由气不升降,所以胎气不固,尤宜服此。
香附(杵去毛,净一斤,分四分,一分酒浸,一分醋,一分童便,一分盐水,各浸七日,取出焙干)
为细末,醋煮糊和丸梧子大,每服七十丸,空心温酒下。肥人只根据本方,瘦人加泽
兰叶、赤茯苓各二两。
一方 用香附子(一斤) 艾叶(四两) 当归(二两。俱用醋煮)
《删繁方》治妊娠怀胎数落而不结实,或冷或热,百病之源。(《经心录》同。)
甘草 黄 人参 川芎 白术 地黄 吴茱萸(各等分) (一方有当归、干姜。)
上为末,空心温酒调二钱。忌菘菜、桃、李、雀肉、醋物。
〔娄〕按∶丹溪论俱是虚热而无寒者,今姑存此一方,以俟施之于千百而一者也。醋
附丸 治数堕胎。(方见血崩。)
《千金》疗妊娠三个月,胎欲堕方。 灸膝下一寸,七壮。妊子不成,时时受胎后漏
下五色,疼痛。灸胞门。(关门左边二寸,名胞门,右边二寸,名子户。)
〔胎堕后为半产〕
夫妊娠日月未足,胎气未全而产者,谓之半产。盖由妊妇冲任气虚,不能滋养于胎,
胎气不固,或 扑闪坠,致气血损动,或因热病温疟之类,皆令半产。仲景谓寒虚相搏,
此名为革,妇人则半产漏下是也。又云∶半产俗呼小产,或三四月,或五六月,皆为半
产,以男女成形故也。或因忧恐悲哀暴怒,或因劳力打扑损动,或触冒暑热,忌黑神散,恐
犯热药转生他疾。宜玉烛散、和经汤之类。《便产须知》云∶小产不可轻视,将养十倍于
正产可也。又云∶半产即肌肉腐烂,补其虚损,生其肌肉,益其气血,去其风邪,养其
脏气,将养过于正产十倍,无不平复,宜审之。
〔薛〕小产重于大产,盖大产如栗熟自脱,小产如生采破其皮壳,断其根蒂也。但
人轻忽致死者多。治法宜补形气,生新血,去瘀血。若未足月,痛而欲产,芎归补中汤倍
加知母止之。若产而血不止,人参黄 汤补之。若产而心腹痛,当归川芎汤主之。胎气
弱而小产者,八珍汤固之。若出血过多而发热,圣愈汤。汗不止,急用独参汤。发热烦
躁,肉 筋惕,八珍汤。大渴面赤,脉洪而虚,当归补血汤。身热面赤,脉沉而微,四
君、姜、附。东垣云∶昼发热而夜安静,是阳气自旺于阳分也,昼安静而夜发热,是阳
气下陷于阴中也,如昼夜俱发热者,是重阳无阴也。当峻补其阴。王太仆云∶如大寒而
甚,热之不热,是无火也。热来复去,昼见夜伏,夜发昼止,时节而动,是无火也。如
大热而甚,寒之不寒。是无水也。热动复止,倏忽往来,时动时止,是无水也。若阳气自
旺者,补中益气汤,阳气陷于阴者,四物二连汤。重阳无阴者,四物汤,无火者,八味
丸。无水者,六味丸。一妊妇五月服剪红丸堕胎,腹中胀痛,服破血药益甚,手按之
愈痛。余曰∶此峻药重伤,脾胃受患,用八珍倍参、 、半夏、乳、没,二剂痛止,数
剂全愈。史仲子室,年甫二十,疫胎堕,时咳,服清肺解表,喘急不寐,请视。余曰∶脾
土虚不能生肺金,药重损之,与补中益气加茯苓、半夏、五味、炮姜,四剂渐愈;再往
视,又与八珍加五味及十全大补汤而全愈。陈氏妇张,素怯弱,生女自乳,因病疥年余,
遂致羸困,复因执丧礼劳顿,数欲眩仆。一日感气,忽患心脾高肿作疼,手不可按,呕
吐不止,六脉微细之极。陈翁自以脉虽虚而病形则实,误臆诸痛不可补气,乃用青皮、香
附、吴萸等药而愈。继复患疟且堕胎,又自投理气行血之药,病去元气转脱,再投参、
补剂不应矣。六脉如丝欲绝,思非附子不能起,因亟请薛诊之,云∶此由理气损真之误
也。连投参、 、归、术、附子、姜、桂六剂,间用八味丸五日,眠食渐甘,六脉全复。
薛谕之云∶向使心脾疼时即服此药,疟亦不作矣。一妊妇堕胎,昏愦不省,自汗发搐,
时吐痰,自用养血化痰之剂,昏愦不省,痰涎涌出,彼以为中风,欲用祛风化痰。予曰∶
此属脾气虚寒所致,遂用十全大补加炮姜二十余剂,寻愈。
生地黄汤 治妊娠胎气损动,气血不调,或 扑闪坠,以致胎堕,堕后恶滞不尽,腹
中痛。
生干地黄(焙,一两) 大黄(暴,煨) 芍药 白茯苓(去黑皮) 当归(切炒)
细辛(去苗) 甘草(炙) 黄芩(去黑皮) 桂(去粗皮。各半两)
上 咀,每服五钱匕,水一盏半,入生姜、大枣拍碎,同煎至一盏,去滓不拘时温服。
人参汤 治半产后血下过多,心惊体颤,头目运转,或寒或热,脐腹虚胀疼痛。
人参 麦门冬(去心,焙) 生干地黄(焙) 当归(洗,焙) 芍药 黄
白茯苓(去皮) 甘草(炙。各一两)
咀,每服三钱,水一盏,煎至七分,去滓食前温服。
〔大〕堕胎后复损经脉,而下血不止,甚则烦闷至死,皆以调补胃气为主。
〔薛〕前证若肝经血热,用四物、参术、山栀。肝经风热,用防风、黄芩丸,肝经怒
火,用加味逍遥散。脾经气虚,用四君、归、地。脾经郁滞,用加味归脾汤。气滞不和,用
紫苏饮。骨气下陷,用补中益气汤。
人参黄 汤 治小产气虚,血下不止。
人参 黄 (炒) 当归 白术(炒) 白芍药(炒) 艾叶(各一钱) 阿胶(炒,二钱)
上作一剂,水煎服。
治妊娠损动,下血不止,腹痛,宜服此。
阿胶(一两,炒) 艾叶(半两)
水一大盏,煎六分,去滓空心服。
治妊娠损动下血不止方。
甘草(一两,炙) 阿胶(二两) 鸡子(一个)
上以水二大盏,煮甘草一盏,三分,去滓下鸡子、胶,候胶烊,搅匀分三服。
龙骨散 疗因损娠,下恶血不止。
龙骨 当归 地黄(各二两) 艾叶(一两,炒) 地榆 阿胶 芍药 干姜(各一两半)
蒲黄(一两二钱半) 牛角 (炙焦,二两半。共为细末)
上食前用米饮调下二钱。
《千金》疗落胎下血不止方。
上以生地黄汁一小盏,调代赭石末一钱,日三服。
治妊娠下血不止疼痛方。亦治小便不禁。
家鸡翎(烧灰) 细研,以温酒调下二钱,如人行五里再服,以效为度。
《千金》疗妊娠胎堕下血不止方。
以丹参(十二两) 细切,酒五升,煮取三升,分三服。
《补遗》催生如神散,妙。
又方 香附子为末,米饮调下。
当归酒 治妊娠堕胎后血不出。
当归(炙,令香) 芍药(炒,各二两)
咀,每服三钱匕,无灰酒一盏,入生地黄汁一合,银器内慢火煎至七分,去滓温
服,以恶血下为度。
乌金散 治妊娠堕胎后恶血不下,兼治诸疾血病。
好墨(二两,折、二寸挺子,烧通赤,用好醋一升,蘸七遍,又再烧通赤,放冷,别研
为末) 没药(研) 麒麟竭(各二钱半) 麝香(一钱)
上为细末,每服温酒调下一钱匕。如血迷心,用童便加酒,调下二钱匕。
治妊娠堕胎后血不出,少腹满痛。
用羚羊角烧灰,细研如面,每服三钱,不拘时,以豆淋酒调下。
治妊娠堕胎下血不尽,苦烦满欲极,时发寒热狂闷。
鹿角屑(一两,熬)
上用水一大盏,煎豉一合,取汁六分,分三服,调鹿角屑二钱服,日三,须臾血下。
红蓝花散 治堕胎后血不出奔心,闷绝不识人。
红蓝(微熬过) 男子发(烧存性) 京墨(烧红) 血竭(研) 蒲黄(隔纸炒,各等分)
上为细末,以童便小半盏,调二钱服之,立效。
白蜜汤 治堕胎后恶血不出。
白蜜(二两) 生地黄(取汁,一盏) 酒(半盏)
上汁与酒,共入铜器中煎五七沸,入蜜搅匀,分两服,服三剂,百病可愈。
猪膏饮 治堕胎血不出上抢心,疼痛烦愦。
猪膏(七合) 白蜜(三合) 生地黄(切,二两)
上先将猪膏、地黄相和,煎令赤色,去地黄,纳蜜搅匀,分温二服,相次再服。
当归汤 治妊娠堕胎,胞衣不出。
当归(切,炒) 牛膝(酒浸,切、焙。各一两半) 木通(锉) 滑石(研,各二两)
冬葵子(炒,二合) 瞿麦穗(一两)
上 咀,每服三钱,水一盏半,煎至七分,去滓温服。未下再服,以下为度。
地黄汤
蒲黄(炒) 生姜(切,炒。各二钱半) 生地黄(半两,以铜、竹刀切,炒)
上以无灰酒三盏,于银器内同煎至二盏,去滓分三服,未下再作服。
泽兰汤
泽兰叶(切,研) 滑石末(各半两) 生麻油(少许)
上以水三盏,先煎泽兰至一盏半,去滓,入滑石末并油,更煎三沸,顿服之,未下更服。
蒲黄酒(作丸名槐子丸。)
蒲黄(炒,一合) 槐子(十四枚,为末)
上以酒三盏,煎至二盏,去滓分温二服,未下更作服。又治妊娠不足月,欲产腹痛,为
末,蜜丸酒下。
【朱丹溪论述】阳施阴化,胎孕乃成。若血气虚损,不足以滋养胎儿,胎元便会自然堕落。或因劳累、愤怒导致情志受伤,内火随之而动,也能导致堕胎。推究其根本原因,都在于热,因为火能消蚀万物,这是造化的自然规律。《诸病源候论》却说是风冷损伤子宫而导致堕胎,这并没有掌握病情的实质。我曾诊治贾氏的妇人,每次怀孕到三个月左右必定堕胎,诊察她的脉象,左手脉大而无力,重按时则涩,知道她是血少。因为她正值妙龄,我只补益中气,使血液自然充盈荣养。当时正值初夏,教导她用浓煎的白术汤送服一钱黄芩末,服用三四十帖后,便得以保全胎儿。由此思考,因内热兼虚而导致的堕胎,在情理上占多数。所谓热与虚,应当区分轻重。大概怀孕到三个月,正属于相火(寄居于肝肾之火)旺盛之时,所以容易堕胎,否则为什么黄芩、熟艾叶、阿胶等是安胎的妙药呢?希望行医之人不要轻视此理。
又有一位三十多岁的妇人,有时月经停止,有时胎儿成形但未发育完全,胎必堕落。观察她性情急躁易怒,面色黑而气实,这是相火太盛,不能生化气血以养胎,反而消耗气、损伤精的缘故。因此让她在停经的第二个月开始用药,使用黄芩、白术、当归、甘草,服至第三个月结束停药,后来生下一个儿子。
又有一位妇人停经三个月后,尺脉或涩或微弱,但她本人并无其他病症,我知道这是子宫真气不全,所以阳气不施,阴气不化,虽然精血凝结,最终也不能成形。结果要么产出血块,要么产出血胞。
又有一位妇人腹部逐渐增大像怀孕一样,到了十个月时求取催生药物。观察她的神色非常困难痛苦,给她服药后,没过几天生出了半桶白色的虫子。这是因为妇人的元气太虚弱,虽然精血凝结,但不能成胎而化为秽浊腐败之物,蕴积日久,湿气化为热,湿热生虫,这是理所当然的。但也必须经过满十个月的周期,发动而产出,终究不是好兆头。这位妇人不到一个月就死了。湿热生虫,就像沟渠污浊,积聚久了不流动,就会在其中生出各种虫子。
汪石山治疗一位身材瘦长、面色黄白的妇人,性格急躁,三十多岁,经常发生堕胎,已经发生过七八次了。诊察她的脉象,都柔软无力,两尺脉虽然浮但弱,不耐寻按。他说:这是因为堕胎太多,气血耗损严重,胎儿缺乏滋养,所以频繁堕胎,就像水干涸禾苗枯死,土壤削薄树木倒下一样。况且三月、五月,正是少阳相火发动的时候,加上她性格急躁容易引发火势,所以堕胎多发生在三、五、七月。适宜用大补阴汤去掉桂枝,加入黄柏、黄芩煎服,仍然制成研末蜜丸服用,才可以保胎生子,服用半年后胎气稳固并生了两个儿子。
钱仲阳治疗一位孕妇患病,医生说胎儿快要堕落了。钱仲阳说:妊娠期间五脏传递营养养育胎儿,每六十天更替一次,等待月份偏补即可,何必担心堕胎。后来母子都平安无事。
陈斗岩治疗一位妇人怀孕四个月堕下,过了十天腹部肿胀发热,气喘,脉象洪盛,面赤,口鼻舌呈现青黑色。陈斗岩诊察后说:脉象洪盛的,说明胎还没有堕。面赤,是心火盛而血液干枯。舌青口鼻黑,是肝气已绝而胎儿死亡了。内外的人都认为胎已堕很久。再次诊察神色脉象如前,用蛇蜕煎汤送服平胃散加芒硝、加倍的归尾服用。一会儿,腹鸣如雷,腰腹阵痛,随即排出一个死胎,病也好了。
程仁甫治疗一位妇人,年纪近四十,体质素来虚弱,自行堕胎,五天内渐渐腹胀如鼓,胀气上冲至心前,呕吐不能进食,用补药无效。诊察六脉微弱,只叫喊胀得想死,这是损伤脾气导致的胀满,然而急则治其标,如果拘泥于丹溪的法度恐怕来不及救治了。于是用桃仁承气汤加枳实、厚朴,加倍芒硝、大黄,煎服四分之一剂,吐掉了一半,第二天早上仍然不通,情况紧急,又服用琥珀丸三钱,到申时大便大通,胀减,但身体疲倦四肢无力,口不知味,发热,再用人参、黄芪、当归、白芍、山楂、白术、陈皮八剂而安定。
江应宿治疗汪镐的妻子,三十五岁,厌恶生产误服打胎药,下血如崩漏持续十多天,腹痛一阵即止,有时流鼻血,各种药物无效。诊得六脉数而微弦,这是厥阳之火泛逆,投用四物汤换为生地黄,加入阿胶、炒黑山栀、蒲黄,一剂痊愈。
薛氏说:大致治疗方法,必须审察某月属于哪一经育养而用药。
济生芎劳补中汤:治疗怀孕血气虚弱,不能卫护滋养,以致数月而堕,名叫半产。(常见妇人怀孕不满十月而损伤堕落,得到服用此方遂能安全。)
药材:川芎、五味子、阿胶(蛤粉炒)、干姜(炮,各一钱)、黄芪(去芦,蜜炙)、当归(酒浸)、白芍药、白术(各一钱半)、杜仲(去粗皮,炒去丝)、人参、木香(不见火)、甘草(各五分,炙)。
用法:以上作一服,水二盅,煎至一盅,不拘时候服用。
阿胶汤:治疗妊娠多次堕胎,小腹疼痛不可忍受。
药材:阿胶(炙燥)、熟干地黄(焙)、艾叶(微炒)、川芎、当归(切,焙)、杜仲(去粗皮,炙,锉)、白术(各一两)。
用法:以上切碎,每服四钱,水一盏半,枣三枚,掰破,同煎至八分,去渣食前温服。
杜仲丸:治疗妊娠三两个月,胎动不安,防止欲堕,宜预先服用。
药材:杜仲(姜制,炒去丝)、续断(酒浸,各二两)。
用法:为细末,煮枣肉捣丸如梧子大。每服七十丸,米饮送下。
四制艾附丸:治疗妇人数次堕胎,由气不升降,所以胎气不固,尤其适宜服用此方。
药材:香附(杵去毛,净一斤,分四分,一分酒浸,一分醋浸,一分童便浸,一分盐水浸,各浸七日,取出焙干)。
用法:为细末,醋煮糊和丸如梧子大,每服七十丸,空心温酒送下。肥人只根据本方,瘦人加泽兰叶、赤茯苓各二两。
一方:用香附子(一斤)、艾叶(四两)、当归(二两。俱用醋煮)。
《删繁方》:治疗妊娠怀胎数次滑落而不结实,或冷或热,百病之源。(《经心录》相同。)
药材:甘草、黄芪、人参、川芎、白术、地黄、吴茱萸(各等分)。(一方有当归、干姜。)
用法:以上为末,空心温酒调二钱。忌菘菜、桃、李、雀肉、醋物。
【娄全善按语】:丹溪的论述全是虚热而没有寒证,现在姑且保存这个一方,以期待在千百人中适用其一的人。醋附丸:治疗数堕胎。(方见血崩篇。)
《千金方》:治疗妊娠三个月,胎欲堕方。灸膝下一寸,七壮。妊子不成,时时受胎后漏下五色,疼痛。灸胞门。(关门左边二寸,名胞门,右边二寸,名子户。)
【胎堕后为半产】
妊娠日月未足,胎气未全而产者,称为半产。大概由于妊妇冲任气虚,不能滋养胎儿,胎气不固,或因跌扑闪坠,导致气血损伤动荡,或因热病温疟之类,都导致半产。张仲景说寒虚相搏,这名为革脉,妇人则表现为半产漏下。又说:半产俗呼小产,或三四月,或五六月,都称为半产,因为男女已成形。或因忧恐悲哀暴怒,或因劳力打扑损伤,或触冒暑热,忌用黑神散,恐怕犯热药转生他疾。宜用玉烛散、和经汤之类。《便产须知》说:小产不可轻视,调养十倍于正常生产即可。又说:半产即肌肉腐烂,补其虚损,生其肌肉,益其气血,去其风邪,养其脏气,调养过于正产十倍,没有不平复的,应当审慎对待。
【薛己论述】:小产重于大产,大概大产如栗子成熟自然脱落,小产如生采破其皮壳,断其根蒂。只是人们轻忽导致死亡的很多。治疗方法宜补形气,生新血,去瘀血。若未满月,痛而欲产,芎归补中汤倍加知母以制止。若产后血不止,用人参黄芪汤补之。若产后心腹痛,用当归川芎汤主治。胎气弱而小产者,用八珍汤固摄。若出血过多而发热,用圣愈汤。汗不止,急用独参汤。发热烦躁,肌肉跳动筋惕,用八珍汤。大渴面赤,脉洪而虚,用当归补血汤。身热面赤,脉沉而微,用四君子汤加姜、附。东垣说:昼发热而夜安静,是阳气自旺于阳分;昼安静而夜发热,是阳气下陷于阴中;如昼夜俱发热者,是重阳无阴。当峻补其阴。王太仆说:如大寒而甚,热之不热,是无火也。热来复去,昼见夜伏,夜发昼止,时节而动,是无火也。如大热而甚,寒之不寒,是无水也。热动复止,倏忽往来,时动时止,是无水也。若阳气自旺者,用补中益气汤;阳气陷于阴者,用四物二连汤;重阳无阴者,用四物汤;无火者,用八味丸;无水者,用六味丸。
一妊妇五月服剪红丸堕胎,腹中胀痛,服破血药益甚,手按之愈痛。我说:这是峻药重伤,脾胃受患,用八珍汤倍加人参、黄芪、半夏、乳香、没药,二剂痛止,数剂全愈。
史仲子的妻子,年仅二十,疫疠之气致胎堕,时常咳嗽,服清肺解表药,喘急不寐,请我诊治。我说:脾土虚不能生肺金,药重损之,给予补中益气汤加茯苓、半夏、五味子、炮姜,四剂渐愈;再去视诊,又给予八珍汤加五味子及十全大补汤而全愈。
陈氏妇张,素怯弱,生女亲自哺乳,因病疥疮年余,遂致羸困,又因执丧礼劳顿,多次想要眩晕仆倒。一日感气,忽然患心脾高肿作疼,手不可按,呕吐不止,六脉微细之极。陈翁自以为脉虽虚而病形则实,误以为诸痛不可补气,乃用青皮、香附、吴茱萸等药而愈。继而又患疟疾且堕胎,又自己投用理气行血之药,病去元气转脱,再投人参、黄芪补剂不应了。六脉如丝欲绝,思非附子不能起,于是急忙请薛己诊治,说:这是由于理气损真之误。连投人参、黄芪、当归、白术、附子、姜、桂六剂,间用八味丸五日,眠食渐甘,六脉全复。薛己告诫他说:假使心脾疼时即服此药,疟疾也不会发作了。
一妊妇堕胎,昏愦不省,自汗发搐,时吐痰,自用养血化痰之剂,昏愦不省,痰涎涌出,彼以为中风,欲用祛风化痰。我说:这属于脾气虚寒所致,遂用十全大补汤加炮姜二十余剂,不久痊愈。
生地黄汤:治疗妊娠胎气损动,气血不调,或因跌扑闪坠,以致胎堕,堕后恶滞不尽,腹中痛。
药材:生干地黄(焙,一两)、大黄(暴,煨)、芍药、白茯苓(去黑皮)、当归(切炒)、细辛(去苗)、甘草(炙)、黄芩(去黑皮)、桂(去粗皮。各半两)。
用法:以上切碎,每服五钱匕,水一盏半,入生姜、大枣拍碎,同煎至一盏,去渣不拘时候温服。
人参汤:治疗半产后血下过多,心惊体颤,头目运转,或寒或热,脐腹虚胀疼痛。
药材:人参、麦门冬(去心,焙)、生干地黄(焙)、当归(洗,焙)、芍药、黄芪、白茯苓(去皮)、甘草(炙。各一两)。
用法:切碎,每服三钱,水一盏,煎至七分,去渣食前温服。
【张大春论述】:堕胎后复损经脉,而下血不止,甚则烦闷至死,都以调补胃气为主。
【薛己论述】:前证若肝经血热,用四物汤、人参、白术、山栀。肝经风热,用防风、黄芩丸。肝经怒火,用加味逍遥散。脾经气虚,用四君子汤、当归、地黄。脾经郁滞,用加味归脾汤。气滞不和,用紫苏饮。骨气下陷,用补中益气汤。
人参黄芪汤:治疗小产气虚,血下不止。
药材:人参、黄芪(炒)、当归、白术(炒)、白芍药(炒)、艾叶(各一钱)、阿胶(炒,二钱)。
用法:以上作一剂,水煎服。
治妊娠损动,下血不止,腹痛,宜服此方。
药材:阿胶(一两,炒)、艾叶(半两)。
用法:水一大盏,煎六分,去渣空心服。
治妊娠损动下血不止方。
药材:甘草(一两,炙)、阿胶(二两)、鸡子(一个)。
用法:以上以水二大盏,煮甘草至一盏三分,去渣下鸡子、胶,候胶烊化,搅匀分三服。
龙骨散:疗因损娠,下恶血不止。
药材:龙骨、当归、地黄(各二两)、艾叶(一两,炒)、地榆、阿胶、芍药、干姜(各一两半)、蒲黄(一两二钱半)、牛角鳔(炙焦,二两半。共为细末)。
用法:以上食前用米饮调下二钱。
《千金方》:疗落胎下血不止方。
用法:以上以生地黄汁一小盏,调代赭石末一钱,日三服。
治妊娠下血不止疼痛方。亦治小便不禁。
药材:家鸡翎(烧灰)。
用法:细研,以温酒调下二钱,如人行五里再服,以效为度。
《千金方》:疗妊娠胎堕下血不止方。
药材:丹参(十二两)。
用法:细切,酒五升,煮取三升,分三服。
《补遗》:催生如神散,妙。
又方:香附子为末,米饮调下。
当归酒:治疗妊娠堕胎后血不出。
药材:当归(炙,令香)、芍药(炒,各二两)。
用法:切碎,每服三钱匕,无灰酒一盏,入生地黄汁一合,银器内慢火煎至七分,去渣温服,以恶血下为度。
乌金散:治疗妊娠堕胎后恶血不下,兼治诸疾血病。
药材:好墨(二两,折、二寸挺子,烧通赤,用好醋一升,蘸七遍,又再烧通赤,放冷,别研为末)、没药(研)、麒麟竭(各二钱半)、麝香(一钱)。
用法:以上为细末,每服温酒调下一钱匕。如血迷心,用童便加酒,调下二钱匕。
治妊娠堕胎后血不出,少腹满痛。
用法:用羚羊角烧灰,细研如面,每服三钱,不拘时,以豆淋酒调下。
治妊娠堕胎下血不尽,苦烦满欲极,时发寒热狂闷。
药材:鹿角屑(一两,熬)。
用法:以上用水一大盏,煎豉一合,取汁六分,分三服,调鹿角屑二钱服,日三,须臾血下。
红蓝花散:治疗堕胎后血不出奔心,闷绝不识人。
药材:红蓝花(微熬过)、男子发(烧存性)、京墨(烧红)、血竭(研)、蒲黄(隔纸炒,各等分)。
用法:以上为细末,以童便小半盏,调二钱服之,立效。
白蜜汤:治疗堕胎后恶血不出。
药材:白蜜(二两)、生地黄(取汁,一盏)、酒(半盏)。
用法:以上汁与酒,共入铜器中煎五七沸,入蜜搅匀,分两服,服三剂,百病可愈。
猪膏饮:治疗堕胎血不出上抢心,疼痛烦愦。
药材:猪膏(七合)、白蜜(三合)、生地黄(切,二两)。
用法:以上先将猪膏、地黄相和,煎令赤色,去地黄,纳蜜搅匀,分温二服,相次再服。
当归汤:治疗妊娠堕胎,胞衣不出。
药材:当归(切,炒)、牛膝(酒浸,切、焙。各一两半)、木通(锉)、滑石(研,各二两)、冬葵子(炒,二合)、瞿麦穗(一两)。
用法:以上切碎,每服三钱,水一盏半,煎至七分,去渣温服。未下再服,以下为度。
地黄汤
药材:蒲黄(炒)、生姜(切,炒。各二钱半)、生地黄(半两,以铜、竹刀切,炒)。
用法:以上以无灰酒三盏,于银器内同煎至二盏,去渣分三服,未下再作服。
泽兰汤
药材:泽兰叶(切,研)、滑石末(各半两)、生麻油(少许)。
用法:以上以水三盏,先煎泽兰至一盏半,去渣,入滑石末并油,更煎三沸,顿服之,未下更服。
蒲黄酒(作丸名槐子丸。)
药材:蒲黄(炒,一合)、槐子(十四枚,为末)。
用法:以上以酒三盏,煎至二盏,去渣分温二服,未下更作服。又治妊娠不足月,欲产腹痛,为末,蜜丸酒下。
[Discussion by Zhu Danxi] When Yang acts and Yin transforms, conception is achieved. If Qi and Blood are deficient and damaged, failing to nourish the fetus, the fetus will naturally abort. It may also be caused by fatigue or anger injuring the emotions, causing internal fire to move, which can also lead to abortion. Investigating the root cause, it all stems from Heat, as Fire can consume things; this is the natural law of creation. *The Source of Diseases* (Bing Yuan) claims that Wind-Cold damaging the Zi Zang (uterus) causes abortion; this fails to grasp the essence of the pathology. I once treated a woman surnamed Jia who invariably aborted around three months of pregnancy. Her pulse was large and powerless on the left hand, and choppy upon heavy pressure, indicating Blood deficiency. As she was in her prime years, I only tonified Middle Qi so that Blood would naturally flourish and nourish. At that time, it was early summer, and I instructed her to take one qian of Huang Qin (Scutellariae Radix, 黄芩) powder with thickly decocted Bai Zhu Tang (Atractylodis Macrocephalae Decoction). After taking thirty to forty doses, she successfully preserved the pregnancy. Reflecting on this, abortions due to internal Heat combined with deficiency are common. One must distinguish the severity of Heat and deficiency. Generally, at three months of pregnancy, the Xiang Huo (Ministerial Fire, 相火) is flourishing, making abortion prone; otherwise, why are Huang Qin (Scutellariae Radix), Shu Ai Ye (Artemisiae Argyi Folium Preparatum), and E Jiao (Colla Corii Asini, 阿胶) considered excellent herbs for stabilizing the fetus? Practitioners should not underestimate this principle.
Another woman, over thirty years old, sometimes had amenorrhea, sometimes conceived but failed to develop fully, resulting in inevitable abortion. Observing her irritable nature, dark complexion, and robust Qi, this indicated excessive Ministerial Fire, which failed to generate Qi and Blood to nourish the fetus, instead consuming Qi and damaging Essence. Therefore, starting from the second month after missed menses, I prescribed Huang Qin (Scutellariae Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Dang Gui (Angelicae Sinensis Radix), and Gan Cao (Glycyrrhizae Radix et Rhizoma). She stopped medication at the end of the third month and subsequently gave birth to a son.
Another woman, three months post-missed menses, had a Chi (Cun-Guan-Chi pulse position corresponding to Kidney/Bladder/Lower Jiao) pulse that was either choppy or faint and weak, yet she had no other symptoms. I knew this was incomplete True Qi of the Zi Gong (uterus), so Yang did not act and Yin did not transform. Although Jing and Blood condensed, they ultimately failed to form a fetus. The result was either the expulsion of blood clots or a bloody sac.
Another woman’s abdomen gradually enlarged like pregnancy. At ten months, she sought parturition-inducing medicine. Her expression and demeanor were extremely distressed. After administering medicine, within a few days, half a bucket of white worms were expelled. This was because the woman’s Yuan Qi (Original Qi) was too deficient; although Jing and Blood condensed, they could not form a fetus but turned into turbid, putrid matter. Accumulated over a long time, Dampness transformed into Heat, and Damp-Heat generated worms—this is logical. However, it still required the full ten-month cycle to activate and expel, which was ultimately an ominous sign. The woman died within a month. Damp-Heat generating worms is like a ditch becoming filthy; if stagnant for too long without flow, various worms will breed within it.
Wang Shishan treated a slender woman with a yellowish-white complexion, aged over thirty, who suffered frequent abortions, having experienced it seven or eight times. Her pulses were soft and powerless throughout; the two Chi positions were floating but weak, unable to withstand deep palpation. He said: "This is due to excessive abortions depleting Qi and Blood severely, leaving the fetus without nourishment, hence frequent abortions. It is like water drying up causing crops to wither, or soil eroding causing trees to fall. Moreover, the third and fifth months are when Shaoyang Fire moves; combined with her irritable temperament which exacerbates the fire, abortions often occur in the third, fifth, and seventh months. She should use Da Bu Yin Tang (Great Tonification of Yin Decoction) removing Gui Zhi (Cinnamomi Ramulus), adding Huang Bo (Phellodendri Cortex) and Huang Qin (Scutellariae Radix) for decoction, and also take it as powder pills with honey. This way, the fetus can be protected and children born. After half a year of treatment, the fetus stabilized, and she bore two sons."
Qian Zhongyang treated a pregnant woman who fell ill; the physician said the fetus was about to abort. Qian said: "During pregnancy, the five Zang organs transmit nourishment to the fetus, renewing every sixty days. Wait for the month to shift and supplement accordingly; why worry about abortion?" Later, both mother and child were safe.
Chen Douyan treated a woman who aborted at four months. Ten days later, her abdomen swelled, she had fever, asthma, a洪盛 (surging and abundant) pulse, red face, and blue-black tongue and nose. Chen diagnosed: "A surging pulse indicates the fetus has not yet aborted. Red face shows Heart Fire excess and dry Blood. Blue tongue and black nose indicate Liver Qi exhaustion and fetal death." Everyone inside and outside believed the fetus had aborted long ago. Re-examining the complexion and pulse as before, he used She Tui (Mantis Egg Case) decoction to administer Ping Wei San (Peaceful Stomach Powder) plus Mang Xiao (Natrii Sulfas) and double the amount of Gui Wei (Angelicae Sinensis Radix Tip). Shortly after, borborygmus sounded like thunder, intermittent pain in waist and abdomen occurred, and a dead fetus was expelled; the illness resolved.
Cheng Renfu treated a woman near forty, constitutionally weak, who self-induced abortion. Within five days, her abdomen gradually bloated like a drum, rising to the epigastrium, causing vomiting and inability to eat. Tonics were ineffective. Her six pulses were faint; she cried out about dying from bloating. This was Spleen Qi damage causing bloating. However, in emergencies, treat the branch first; adhering strictly to Danxi’s methods might be too slow. He used Tao Ren Cheng Qi Tang (Peach Kernel Magnolia Bark Decoction) added with Zhi Shi (Aurantii Fructus) and Hou Po (Magnoliae Officinalis Cortex), doubling Mang Xiao and Da Huang (Rhei Radix et Rhizoma). She took one-quarter dose, vomited half, but remained constipated the next morning. Urgent situation, so she took three qian of Hu Po Wan (Amber Pill). By Shen hour, she had a massive bowel movement, bloating reduced, but she felt fatigued, limbs weak, lost taste sensation, and had fever. Then, using Ren Shen (Ginseng Radix), Huang Qi (Astragali Radix), Dang Gui, Bai Shao (Paeoniae Radix Alba), Shan Zha (Crataegi Fructus), Bai Zhu, and Chen Pi (Citri Reticulatae Pericarpium) for eight doses, she stabilized.
Jiang Yingsu treated Wang Hao’s wife, thirty-five, who accidentally took abortifacient drugs due to fear of childbirth. She had bleeding like a gush for over ten days, abdominal pain lasting only briefly, occasional epistaxis, and other medicines failed. Her six pulses were rapid and slightly wiry, indicating Jue Yang Fire rebelling upward. He administered Si Wu Tang (Four Substances Decoction) replacing Shu Di Huang (Rehmanniae Radix Preparata) with Sheng Di Huang (Rehmanniae Radix), adding E Jiao (Colla Corii Asini), Chao Hei Shan Zhi (Stir-fried Gardenia Fruit), and Pu Huang (Typhae Pollen). One dose cured her.
Xue Ji stated: Generally, treatment requires examining which meridian nourishes the fetus in a specific month and medicating accordingly.
Jisheng Xiong Gui Bu Zhong Tang (Ephedra and Cinnamon Twig Decoction for Supplementing the Middle): Treats pregnancy with Qi and Blood deficiency, failing to protect and nourish, leading to abortion after several months, termed Ban Chan (Half-birth/Miscarriage). (Commonly seen in women whose pregnancies do not reach ten months and are damaged/aborted; taking this formula ensures safety.)
Ingredients: Xiong Gui (Ligustici Chuanxiong Rhizoma), Wu Wei Zi (Schisandrae Chinensis Fructus), E Jiao (Colla Corii Asini, stir-fried with clam powder), Gan Jiang (Zingiberis Rhizoma, processed, each 1 qian), Huang Qi (Astragali Radix, de-rhizome, honey-roasted), Dang Gui (Angelicae Sinensis Radix, wine-soaked), Bai Shao (Paeoniae Radix Alba), Bai Zhu (Atractylodis Macrocephalae Rhizoma, each 1.5 qian), Du Zhong (Eucommiae Cortex, de-bark, stir-fried to remove silk fibers), Ren Shen (Ginseng Radix), Mu Xiang (Aucklandiae Radix, avoid direct fire), Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted, each 0.5 qian).
Usage: Make one dose, add two zhong of water, decoct to one zhong, take anytime.
E Jiao Tang (Donkey-Hide Gelatin Decoction): Treats pregnancy with frequent abortions and unbearable lower abdominal pain.
Ingredients: E Jiao (roasted dry), Shu Gan Di Huang (Prepared Rehmanniae Radix, baked), Ai Ye (Artemisiae Argyi Folium, lightly stir-fried), Xiong Gui, Dang Gui (cut, baked), Du Zhong (de-bark, roasted, chopped), Bai Zhu (each 1 liang).
Usage: Cut into pieces, take 4 qian per dose, add 1.5 zhong of water and 3 jujubes (broken), decoct to 0.8 zhong, remove dregs, take warm before meals.
Du Zhong Wan (Eucommia Pill): Treats pregnancy at 2-3 months with restless fetus, preventing impending abortion; suitable for preventive use.
Ingredients: Du Zhong (processed with ginger, stir-fried to remove silk fibers), Xu Duan (Dipsaci Radix, wine-soaked, each 2 liang).
Usage: Grind to powder, mix with date paste to make pills the size of wu zi (loquat seeds). Take 70 pills per dose with rice drink.
Si Zhi Ai Fu Wan (Four-Processed Mugwort and Cyperus Pill): Treats women with frequent abortions due to failure of Qi ascending and descending, leading to unstable fetal Qi; especially suitable for this formula.
Ingredients: Xiang Fu (Cyperi Rhizoma, pounded to remove hairs, net weight 1 jin, divided into four parts: one part soaked in wine, one in vinegar, one in child’s urine, one in salt water, each soaked for 7 days, then taken out and dried).
Usage: Grind to fine powder, mix with vinegar paste to make pills the size of wu zi. Take 70 pills per dose on an empty stomach with warm wine. For obese people, follow the base formula; for thin people, add Ze Lan Ye (Leonuri Herba) and Chi Fu Ling (Poria with Red Core, each 2 liang).
Another Prescription: Use Xiang Fu Zi (1 jin), Ai Ye (4 liang), Dang Gui (2 liang). All boiled with vinegar.
*Shan Fan Fang*: Treats pregnancy with repeated spontaneous abortions that are not firm, or cold/heat conditions, the source of hundred diseases. (*Jing Xin Lu* agrees.)
Ingredients: Gan Cao, Huang Qi, Ren Shen, Chuan Xiong, Bai Zhu, Di Huang, Wu Zhu Yu (Evodiae Fructus, equal parts). (One prescription includes Dang Gui and Gan Jiang.)
Usage: Grind to powder, take 2 qian with warm wine on an empty stomach. Avoid brassica vegetables, peach, plum, sparrow meat, and vinegar items.
[Lou Quanshan’s Note]: Danxi’s discussions focus entirely on deficiency-Heat without Cold. I preserve this one prescription here, hoping it applies to one in a thousand cases. Cu Fu Wan (Vinegar-Processed Aconite Pill): Treats frequent abortions. (Formula see under Metrorrhagia.)
*Qian Jin Fang*: Treatment for pregnancy at three months with threatened abortion. Moxibustion at one cun below the knee, seven moxa cones. If conception fails, frequent leakage of five-colored discharge after conception with pain. Moxibustion on Bao Men (2 cun left of Guanmen, named Bao Men; 2 cun right, named Zi Hu).
[After Abortion: Ban Chan]
When gestation is incomplete and fetal Qi is not fully formed at birth, it is called Ban Chan (Half-birth/Miscarriage). This is generally due to deficiency of Chong and Ren meridians in the pregnant woman, failing to nourish the fetus, leading to unstable fetal Qi. Or due to falls/blows causing Qi and Blood damage and disturbance, or due to febrile diseases/warm malaria, all leading to Ban Chan. Zhang Zhongjing said: Cold and Deficiency combining creates Ge Pulse (Leather Pulse); in women, this manifests as Ban Chan and leakage. He also said: Ban Chan is commonly called Xiao Chan (Small Birth/Miscarriage); whether at 3-4 months or 5-6 months, it is Ban Chan because the male/female form is established. Or due to sorrow/fear/sudden anger, or labor/blows causing damage, or exposure to summer heat. Avoid Hei Shen San (Black Divine Powder), fearing hot herbs may cause other diseases. Use Yu Zhu San (Jade Candle Powder) or He Jing Tang (Harmonizing Meridian Decoction). *Bian Chan Xu Zhi* says: Do not underestimate Xiao Chan; care should be ten times that of normal delivery. It also says: Ban Chan involves muscle rot; tonify deficiency, regenerate muscle, benefit Qi and Blood, dispel Wind-Evil, nourish Zang Qi. Care exceeding normal delivery by ten times leads to recovery without exception; examine carefully.
[Xue Ji’s Discussion]: Xiao Chan is more severe than Da Chan (Normal Delivery). Da Chan is like a ripe chestnut falling naturally; Xiao Chan is like picking unripe fruit, breaking the shell, and cutting the stem. Many die due to negligence. Treatment should tonify Form/Qi, generate new Blood, and remove stasis. If pre-term with pain and urge to deliver, use Xiong Gui Bu Zhong Tang doubled with Zhi Mu (Anemarrhenae Rhizoma) to stop it. If bleeding continues post-delivery, use Ren Shen Huang Qi Tang (Ginseng and Astragalus Decoction) to tonify. If heart/abdominal pain post-delivery, use Dang Gui Chuan Xiong Tang (Angelica and Ligusticum Decoction). If fetal Qi is weak leading to miscarriage, use Ba Zhen Tang (Eight Treasures Decoction) to secure it. If excessive bleeding with fever, use Sheng Yu Tang (Sage Salvation Decoction). If sweating continues, urgently use Du Shen Tang (Single Ginseng Decoction). If fever with irritability, muscle twitching/tremors, use Ba Zhen Tang. If extreme thirst, red face, surging but empty pulse, use Dang Gui Bu Xue Tang (Angelica Tonifying Qi Decoction). If body heat, red face, deep and faint pulse, use Si Jun Zi Tang (Four Gentlemen Decoction) plus Ginger and Aconite. Dong Yuan said: Fever by day, quiet by night, indicates Yang Qi flourishing in Yang divisions; quiet by day, fever by night, indicates Yang Qi sinking into Yin; fever day and night indicates Double-Yang without Yin. Severe tonification of Yin is needed. Wang Taipu said: Extreme cold, heating does not warm, indicates No-Fire. Heat comes and goes, visible by day, hidden by night, erupts by night, stops by day, moves with seasons, indicates No-Fire. Extreme heat, cooling does not cool, indicates No-Water. Heat moves and stops, suddenly comes and goes, moves and stops intermittently, indicates No-Water. If Yang Qi flourishes naturally, use Bu Zhong Yi Qi Tang (Supplement the Middle and Augment the Qi Decoction); if Yang Qi sinks into Yin, use Si Wu Er Lian Tang (Four Substances and Two Lianas Decoction); if Double-Yang without Yin, use Si Wu Tang; if No-Fire, use Ba Wei Wan (Eight-Ingredient Pill); if No-Water, use Liu Wei Wan (Six-Ingredient Pill).
A pregnant woman took Jian Hong Wan (Cut Red Pill) at five months, causing abortion, abdominal distension/pain worsened by blood-breaking herbs, tenderness on palpation. I said: This is severe drug injury damaging Spleen/Stomach. Use Ba Zhen Tang doubled with Ren Shen, Huang Qi, Ban Xia (Pinelliae Rhizoma), Ru Xiang (Olibanum), and Mo Yao (Myrrha). Two doses stopped pain, several doses cured completely.
Shi Zhongzi’s wife, twenty years old, contracted epidemic qi causing abortion, coughing frequently. Took Lung-clearing/exterior-releasing drugs, developed wheezing/insomnia. I examined her. I said: Spleen Earth deficiency fails to generate Lung Metal; heavy drugs damaged it further. Prescribed Bu Zhong Yi Qi Tang plus Fu Ling (Poria), Ban Xia, Wu Wei Zi, Pao Jiang (Prepared Ginger). Four doses improved. On re-examination, prescribed Ba Zhen Tang plus Wu Wei Zi and Shi Quan Da Bu Tang (Ten Complete Great Tonification Decoction) for complete recovery.
Chen’s wife Zhang, constitutionally timid/weak, breastfed daughter, suffered from scabies for over a year, becoming emaciated/exhausted. Further exhausted by mourning rituals. Frequently felt dizzy/near syncope. One day caught wind, suddenly developed high swelling/pain in Heart/Spleen region, intolerable to touch, continuous vomiting. Six pulses extremely faint/thin. Chen’s father thought pulse was deficient but disease form was excess, mistakenly believing pain cannot be treated with Qi tonification. Used Qing Pi (Tangerine Peel, Unripe), Xiang Fu, Wu Zhu Yu, etc., and recovered. Later contracted malaria and aborted fetus again. Self-administered Qi-regulating/Blood-moving drugs. Disease gone but Yuan Qi collapsed. Further administration of Ren Shen/Huang Qi tonics failed. Six pulses thread-like, near extinction. Thought only Fu Zi (Aconiti Lateralis Radix Preparata) could revive her. Urgently requested Xue Ji. He said: This is error from regulating Qi damaging True Qi. Continuously administered Ren Shen, Huang Qi, Dang Gui, Bai Zhu, Fu Zi, Ginger, Gui Zhi for six doses, interspersed with Ba Wei Wan for five days. Sleep/appetite improved, six pulses fully restored. Xue Ji advised: Had you taken these drugs when Heart/Spleen pain started, malaria would not have occurred.
A pregnant woman aborted, became unconscious/comatose, spontaneous sweating, convulsions, occasional phlegm vomiting. Self-used Blood-nourishing/Phlegm-resolving agents. Coma persisted, phlegm surged. Believed it was Stroke, wanted Wind-dispelling/Phlegm-resolving drugs. I said: This is due to Spleen Qi deficiency and Cold. Used Shi Quan Da Bu Tang plus Pao Jiang for over twenty doses, soon recovered.
Sheng Di Huang Tang (Rehmannia Decoction): Treats pregnancy with fetal Qi damage, Qi/Blood imbalance, or falls/blows leading to abortion, post-abortion retention of lochia/stasis, abdominal pain.
Ingredients: Sheng Gan Di Huang (Baked, 1 liang), Da Huang (Rhei Radix et Rhizoma, sun-dried, baked), Shao Yao, Bai Fu Ling (Poria, de-black skin), Dang Gui (cut, stir-fried), Xi Xin (Asari Radix et Rhizoma, de-tips), Gan Cao (roasted), Huang Qin (Scutellariae Radix, de-black skin), Gui (Cinnamomi Cortex, de-bark. Each 0.5 liang).
Usage: Cut into pieces, take 5 qian bi per dose, add 1.5 zhong water, crushed Ginger and Jujube, decoct to 1 zhong, remove dregs, take warm anytime.
Ren Shen Tang (Ginseng Decoction): Treats post-miscarriage excessive bleeding, heart fright/body tremors, spinning head/eyes, alternating chills/fever, vacuous bloating/pain in umbilical/abdominal region.
Ingredients: Ren Shen, Mai Men Dong (Ophiopogonis Radix, de-heart, baked), Sheng Gan Di Huang (Baked), Dang Gui (washed, baked), Shao Yao, Huang Qi, Bai Fu Ling (de-skin), Gan Cao (roasted. Each 1 liang).
Usage: Cut, take 3 qian per dose, add 1 zhong water, decoct to 0.7 zhong, remove dregs, take warm before meals.
[Zhang Dachun’s Discussion]: Post-abortion re-injury of meridians, continuous bleeding, even to the point of distress/death, primarily focus on regulating and tonifying Stomach Qi.
[Xue Ji’s Discussion]: For the above syndromes: If Liver Meridian Blood-Heat, use Si Wu Tang, Ren Shen, Bai Zhu, Shan Zhi (Gardeniae Fructus). If Liver Meridian Wind-Heat, use Fang Feng (Saposhnikoviae Radix), Huang Qin Wan. If Liver Meridian Anger-Fire, use Jia Wei Xiao Yao San (Modified Free Wanderer Powder). If Spleen Meridian Qi Deficiency, use Si Jun Zi Tang, Dang Gui, Di Huang. If Spleen Meridian Stagnation, use Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction). If Qi Stagnation/Disharmony, use Zi Su Yin (Perilla Infusion). If Bone Qi Sinking, use Bu Zhong Yi Qi Tang.
Ren Shen Huang Qi Tang (Ginseng and Astragalus Decoction): Treats post-miscarriage Qi deficiency, continuous bleeding.
Ingredients: Ren Shen, Huang Qi (stir-fried), Dang Gui, Bai Zhu (stir-fried), Bai Shao (stir-fried), Ai Ye (each 1 qian), E Jiao (stir-fried, 2 qian).
Usage: Make one dose, decoct in water and take.
Treats pregnancy damage, continuous bleeding, abdominal pain. Suitable for this.
Ingredients: E Jiao (1 liang, stir-fried), Ai Ye (0.5 liang).
Usage: Add 1 zhong water, decoct to 0.6 zhong, remove dregs, take on empty stomach.
Treats pregnancy damage, continuous bleeding.
Ingredients: Gan Cao (1 liang, roasted), E Jiao (2 liang), Ji Zi (Chicken Egg, 1).
Usage: Add 2 large zhong water, boil Gan Cao to 1.3 zhong, remove dregs, add egg and gelatin, wait for gelatin to melt, stir well, divide into three doses.
Long Gu San (Dragon Bone Powder): Treats pregnancy damage, continuous expulsion of evil blood.
Ingredients: Long Gu (Fossilized Bones), Dang Gui, Di Huang (each 2 liang), Ai Ye (1 liang, stir-fried), Di Yu (Sanguisorbae Radix), E Jiao, Shao Yao, Gan Jiang (each 1.5 liang), Pu Huang (1.25 liang), Niu Jiao Jiao (Ovis/Capra Cornu Colla, roasted until charred, 2.5 liang. Grind together to fine powder).
Usage: Take 2 qian mixed with rice drink before meals.
*Qian Jin Fang*: Treats post-abortion continuous bleeding.
Usage: Mix 1 small zhong fresh Di Huang juice with 1 qian Dai Zhe Shi (Hematitum) powder, take three times daily.
Treats pregnancy continuous bleeding/pain. Also treats urinary incontinence.
Ingredients: Jia Ji Ling (Chicken Feather, burnt to ash).
Usage: Grind finely, mix with warm wine, take 2 qian. Repeat after walking five li, continue until effective.
*Qian Jin Fang*: Treats pregnancy abortion, continuous bleeding.
Ingredients: Dan Shen (Salviae Miltiorrhizae Radix, 12 liang).
Usage: Finely cut, boil in 5 sheng wine to obtain 3 sheng, divide into three doses.
*Bu Yi*: Cui Sheng Ru Shen San (Divine Speed Parturition Powder), excellent.
Another Method: Xiang Fu Zi powder, mix with rice drink and take.
Dang Gui Jiu (Angelica Wine): Treats post-abortion failure of blood to exit.
Ingredients: Dang Gui (roasted until fragrant), Shao Yao (stir-fried, each 2 liang).
Usage: Cut, take 3 qian bi, add 1 zhong non-cloudy wine, 1 he fresh Di Huang juice, slowly simmer in silver vessel to 0.7 zhong, remove dregs, take warm, stop when evil blood exits.
Wu Jin San (Black Gold Powder): Treats post-abortion failure of evil blood to exit, also treats various blood disorders.
Ingredients: Hao Mo (Good Ink Stick, 2 liang, broken into 2-cun sticks, burned red-hot, dipped 7 times in 1 sheng good vinegar, burned red-hot again, cooled, separately ground to powder), Mo Yao (Myrrha, ground), Qi Lin Jie (Dragon’s Blood, each 2.5 qian), She Xiang (Moschus, 1 qian).
Usage: Grind to fine powder. Take 1 qian bi mixed with warm wine. If blood confuses the heart, use child’s urine plus wine, take 2 qian bi.
Treats post-abortion failure of blood to exit, lower abdominal fullness/pain.
Usage: Burn Ling Yang Jiao (Capricornis Cornu, Antelope Horn) to ash, grind finely like flour. Take 3 qian per dose anytime, mix with Dou Lin Jiu (Bean-Dripping Wine).
Treats post-abortion incomplete bleeding, severe distress/fullness, intermittent chills/fever/manic confusion.
Ingredients: Lu Jiao Xie (Deer Horn Scraps, 1 liang, roasted).
Usage: Add 1 zhong water, decoct 1 he fermented soybean (Chi) to obtain 0.6 zhong juice. Divide into three doses, mix with 2 qian Lu Jiao Xie powder, take three times daily. Blood will descend shortly.
Hong Lan Hua San (Red Blue Flower Powder): Treats post-abortion blood failing to exit, rushing to heart, suffocation/unconsciousness.
Ingredients: Hong Lan Hua (Carthami Flos, lightly roasted), Nan Zi Fa (Male Hair, burned retaining nature), Jing Mo (Beijing Ink, burned red), Xue Jie (Dragon’s Blood, ground), Pu Huang (stir-fried through paper, equal parts).
Usage: Grind to fine powder. Mix with half a small zhong of child’s urine, take 2 qian. Immediate effect.
Bai Mi Tang (White Honey Decoction): Treats post-abortion failure of evil blood to exit.
Ingredients: Bai Mi (White Honey, 2 liang), Sheng Di Huang (fresh juice, 1 zhong), Jiu (Wine, 0.5 zhong).
Usage: Mix juice and wine, boil in copper vessel for 5-7 boils, add honey, stir well. Divide into two doses. Take three courses, hundred diseases can be cured.
Zhu Gao Yin (Pork Fat Drink): Treats post-abortion blood failing to exit, rushing to heart, pain/distress.
Ingredients: Zhu Gao (Pork Fat, 7 he), Bai Mi (White Honey, 3 he), Sheng Di Huang (cut, 2 liang).
Usage: First mix pork fat and Di Huang, boil until red color, remove Di Huang, add honey, stir well. Divide into two warm doses, take sequentially.
Dang Gui Tang (Angelica Decoction): Treats pregnancy abortion, failure of placenta to exit.
Ingredients: Dang Gui (cut, stir-fried), Niu Xi (Achyranthis Bidentatae Radix, wine-soaked, cut, baked. Each 1.5 liang), Mu Tong (Akebiae Caulis), Hua Shi (Talcum, ground. Each 2 liang), Dong Kui Zi (Malvae Semen, stir-fried, 2 he), Qu Mai (Polygoni Avicularis Herba, 1 liang).
Usage: Cut into pieces, take 3 qian per dose, add 1.5 zhong water, decoct to 0.7 zhong, remove dregs, take warm. If not expelled, take again. Stop when expelled.
Di Huang Tang (Rehmannia Decoction)
Ingredients: Pu Huang (stir-fried), Sheng Jiang (Fresh Ginger, cut, stir-fried. Each 2.5 qian), Sheng Di Huang (0.5 liang, cut with copper/bamboo knife, stir-fried).
Usage: Add 3 zhong non-cloudy wine, decoct in silver vessel to 2 zhong, remove dregs, divide into three doses. If not expelled, prepare again.
Ze Lan Tang (Leonurus Decoction)
Ingredients: Ze Lan Ye (Leonuri Herba, cut, ground), Hua Shi Mo (Talcum Powder, each 0.5 liang), Sheng Ma You (Raw Sesame Oil, a little).
Usage: Add 3 zhong water, first decoct Ze Lan to 1.5 zhong, remove dregs, add Talcum powder and oil, boil three more times, take in one dose. If not expelled, take again.
Pu Huang Jiu (Typha Wine) (Made into pill named Huai Zi Wan)
Ingredients: Pu Huang (stir-fried, 1 he), Huai Zi (Sophorae Japonicae Fructus, 14 pieces, ground to powder).
Usage: Add 3 zhong wine, decoct to 2 zhong, remove dregs, divide into two warm doses. If not expelled, prepare again. Also treats pre-term pregnancy with labor pain. Grind to powder, make honey pills, take with wine.