治怀胎三月、四月至九个月,曰恶阻。病者心中愦闷,头重目眩,四肢沉重,懈怠不欲;
热作,恶闻食气,欲啖咸酸,多睡少起,呕逆不食。或胎动不安,非时转动,腰腹疼痛;或
时下血及妊娠一切疾病,并皆治之。
甘草 茯苓 当归 熟地黄 川芎 白术 黄 白芍药 半夏(泡洗七分,切、
炒) 阿胶(切,粉炒) 地榆(各等分)
上 咀,每服三钱,水盏半,生姜四片,煎至八分,去滓温服无时候。一方无半夏、
地榆,有人参、桑寄生。一方无白术、黄 、半夏、地榆;有艾叶。只是胶艾汤加白茯苓。
夫水饮停积,结聚为痰,人皆有之。少者不能为害,多则成病,妨害饮食,乃至呕逆。
妊娠之病,若呕逆甚者,伤胎也。原疾之由,皆胃气不调或风冷乘之,冷搏于胃,故成斯病
也。亦恶阻之一端。
治妊娠恶阻,心中愦闷,虚烦吐逆,头目昏眩,四肢怠堕,百节烦疼,痰逆呕吐,嫌闻
食气,好啖咸酸,恶寒汗出,羸极黄瘦,多卧多起,不进饮食。妊妇有痰,必生阻病。《千
金》以半夏茯苓汤以对之,此思邈处方之妙也。若孕妇羸弱,胎孕不牢,则动必成咎。全在
医者相人强弱以投之,又何虑焉?
半夏(一两,泡十次,别切,炒令黄) 生姜(五两) 茯苓 熟地黄(各三两) 橘
红北细辛 人参 芍药 紫苏 川芎(各一两) 苦梗 甘草(各半两)
上 咀,每服四大钱。水二盏,姜七片,煎至七分,去滓,空心温服。兼服茯苓丸。《
局方》与崔氏无紫苏、细辛;有旋复花一两。有客热烦渴,口疮,去橘皮、细辛,加前胡、
知母各三两。腹冷下痢者,去地黄加炒桂心二两。胃中虚热,大便秘,小便赤涩,加大
黄三两,去地黄加黄芩一两。然半夏虽能动胎,若炒过则无妨。
治疗怀孕三个月、四个月至九个月期间,称为恶阻。患者心中烦乱闷塞,头部沉重,眼睛昏花眩晕,四肢沉重乏力,精神懈怠不想活动;发热发作时,厌恶闻到食物的气味,想要吃咸酸的食物,嗜睡而少起,呕吐逆气不能进食。或者胎动不安,非正常时间胎动,腰部腹部疼痛;或者时下出血以及妊娠期间的各种疾病,都予以治疗。
甘草、茯苓、当归、熟地黄、川芎、白术、黄(此处疑为黄芪或黄芩之误,原文如此)、白芍药、半夏(炮制清洗七次,切片,炒制)、阿胶(切片,用米粉炒制)、地榆(各等分)。
以上药物捣碎成粗末,每次服用三钱,用水一盏半,生姜四片,煎煮至八分满,滤去药渣,温服,不限固定时间。另一版本没有半夏、地榆,有人参、桑寄生。另一版本没有白术、黄、半夏、地榆,有艾叶。这只是在胶艾汤的基础上加上了白茯苓。
水饮停滞积聚,凝结成为痰,人人都有这种情况。量少时不会造成危害,量多则形成疾病,妨害饮食,甚至导致呕吐逆气。妊娠期间的疾病,如果呕吐逆气严重,会损伤胎儿。疾病的根源,都是胃气不调或者风冷邪气侵袭,寒气搏击于胃,所以形成这种病。这也是恶阻的一种情况。
治疗妊娠恶阻,心中烦乱闷塞,虚热烦躁呕吐逆气,头目昏花眩晕,四肢懈怠下垂,全身关节烦痛,痰逆呕吐,厌恶闻到食物气味,喜好食用咸酸食物,怕冷出汗,身体极度消瘦面色萎黄,多卧少起,不进饮食。孕妇体内有痰,必然产生阻滞性疾病。《千金方》用半夏茯苓汤来应对它,这是孙思邈处方的精妙之处。如果孕妇身体羸弱,胎孕不牢固,那么胎动必定会造成过失。全在于医生根据人的强弱体质来投药,又有什么可忧虑的呢?
半夏(一两,炮制十次,另切,炒至黄色)、生姜(五两)、茯苓、熟地黄(各三两)、橘红、北细辛、人参、芍药、紫苏、川芎(各一两)、苦梗、甘草(各半两)。
以上药物捣碎成粗末,每次服用四大钱。用水二盏,生姜七片,煎煮至七分满,滤去药渣,空腹温服。兼服茯苓丸。《局方》与崔氏的版本没有紫苏、细辛,有一两旋复花。如果有客热烦躁口渴、口疮,去掉橘皮、细辛,加入前胡、知母各三两。腹部寒冷下痢的,去掉地黄,加入炒桂心二两。胃中虚热,大便秘结,小便赤涩,加入大黄三两,去掉地黄,加入黄芩一两。然而半夏虽然可能动胎,但如果经过炒制就没有妨碍了。
Treatment for the period from three to nine months of pregnancy is called Ezu (Morning Sickness / Pregnancy Nausea). The patient experiences mental restlessness and oppression, heaviness of the head, dizziness and blurred vision, heaviness and weakness in the four limbs, lethargy and lack of desire to move; when heat arises, there is aversion to the smell of food, a craving for salty and sour flavors, excessive sleep with little rising, vomiting and inability to eat. Or there may be restless fetus, abnormal fetal movement, pain in the waist and abdomen; or vaginal bleeding at inappropriate times, as well as all diseases during pregnancy, are all treated by this prescription.
Gancao (Licorice Root), Fuling (Poria), Danggui (Angelica Sinensis), Shudihuang (Prepared Rehmannia Root), Chuanxiong (Sichuan Lovage Rhizome), Baizhu (Atractylodes Macrocephala Rhizome), Huang [Note: Text implies Huangqi or Huangqin, kept as original], Shaoyao (White Peony Root), Banxia (Pinellia Tuber - processed, washed seven times, sliced, stir-fried), Ejiao (Donkey-hide Gelatin - sliced, stir-fried with rice flour), Diyü (Sanguisorba Root) (all in equal proportions).
Crush the above herbs into coarse powder. Take 3 qian per dose, add 1.5 cups of water and 4 slices of fresh ginger, decoct until reduced to 0.8 cup, strain, and take warm at any time. Another version excludes Banxia and Diyü, but includes Renshen (Ginseng) and Sangjisheng (Taxillus Branches). Another version excludes Baizhu, Huang, Banxia, and Diyü, but adds Aye (Mugwort Leaf). This is essentially Jiao'ai Tang (Gelatin and Mugwort Decoction) added with Fuling (Poria).
Water and fluids stagnate and accumulate, condensing into Phlegm (Tan), which everyone possesses. When scant, it causes no harm; when abundant, it becomes pathological, obstructing digestion and leading to vomiting and reflux. In pregnancy, if vomiting and reflux are severe, it damages the fetus. The origin of these ailments lies in disharmony of Stomach Qi or invasion by Wind-Cold. Cold combats within the Stomach, thus forming this disease. This is also one aspect of Ezu.
For treating pregnancy Ezu, characterized by mental restlessness and oppression, deficiency-heat irritability and vomiting, dizziness and blurred vision, lethargy and drooping of the four limbs, general joint pain, phlegm-induced vomiting, aversion to food smells, preference for salty and sour foods, aversion to cold with sweating, extreme emaciation and sallow complexion, excessive lying down with little rising, and refusal to eat: If a pregnant woman has Phlegm, it inevitably causes obstruction diseases. *Qianjin Fang* uses Banxia Fuling Tang (Pinellia and Poria Decoction) to address this, demonstrating the brilliance of Sun Simiao's prescriptions. If the pregnant woman is weak and the fetus is unstable, fetal movement will certainly lead to adverse outcomes. It entirely depends on the physician to assess the patient's strength and weakness before prescribing, so what is there to worry about?
Banxia (Pinellia Tuber - 1 liang, processed ten times, separately sliced, stir-fried until yellow), Shengjiang (Fresh Ginger - 5 liang), Fuling (Poria), Shudihuang (Prepared Rehmannia Root) (each 3 liang), Juhong (Citrus Reticulata Pericarpium), Beixixin (Asari Radix et Rhizoma), Renshen (Ginseng), Shaoyao (Peony Root), Zisu (Perilla Leaf), Chuanxiong (Ligusticum Chuanxiong Rhizome) (each 1 liang), Kugen (Platycodon Root), Gancao (Licorice Root) (each 0.5 liang).
Crush the above herbs into coarse powder. Take 4 qian per dose, add 2 cups of water and 7 slices of ginger, decoct until reduced to 0.7 cup, strain, and take warm on an empty stomach. Also take Fuling Wan (Poria Pill). The *Ju Fang* and Cui Shi's versions exclude Zisu and Xixin, but include Xuanfuhua (Inula Flower, 1 liang). If there is exogenous heat causing irritability and thirst, or mouth ulcers, remove Juhong and Xixin, and add Qianhu (Peucedanum Root) and Zhimu (Anemarrhena Rhizome), each 3 liang. For cold abdomen with diarrhea, remove Shudihuang and add Chao Guixin (Stir-fried Cinnamon Twig), 2 liang. For deficiency-heat in the Stomach with constipation and dark, scanty urine, add Dahuang (Rhubarb Root), 3 liang, remove Shudihuang, and add Huangqin (Scutellaria Root), 1 liang. Although Banxia may disturb the fetus, if stir-fried properly, it poses no harm.