小产之证,有轻重、有远近、有禀赋、有人事。由禀赋者,多以虚弱;由人事者,多以损伤。凡正产者,
出于熟落之自然;小产者,由于损折之勉强,此小产之所以不可忽也。若其年力已衰,产育已多,欲其再振,
且固自所难能。凡见此者,但得保其母气,则为善矣。若少年不慎,以致小产,此则最宜调理,否则下次临期
仍然复坠,以至二次三次,终难子嗣,系不小矣。凡此安之之法,见前“数堕胎”条中。既产调理之法,亦与
大产相似,详后“产后”条中,俱当按而用之。
凡妇人年及中衰,胎元无力,则常有胎不能长及多小产、昏晕之患。此气血衰败而然。血气既衰,则凡于
小产之后,多有胎既落而复又下坠,如更有一胎欲产者,此非胎也,乃因气虚而胞宫随胎下陷也。产母不知,
必至惊慌,此无足虑,但以寿脾煎,或八珍、十全大补汤
之类主之,则自安矣。
寿脾煎(见血虚经乱)
八珍汤(见经不调)
十全大补汤(见调经论外备用方)
又凡小产有远近,其在二月三月为之近,五月六月为之远。新受而产者,其势轻,怀久而产者,其势重。
此皆人之所知也。至若犹有近者,则随孕随产矣。凡今艰嗣之家,犯此者十居五六,其为故也,总由纵欲而
然。第自来人所不知,亦所不信,兹谨以笔代灯,用指迷者,倘济后人,实深愿也。请详言之。盖胎元始肇,
一月如珠露,二月如桃花,三月四月而后血脉形体具,五月六月而后筋骨毛发生。方其初受,亦不过一滴之玄
津耳。此其橐 正无根据根, 尚无地,
巩之则固,决之则流。故凡受胎之后,极宜节欲,以防泛滥。而少年纵情,罔知忌惮,虽胎固欲轻者,保全亦
多,其有兼人之勇者,或恃强而不败,或既败而复战,当此时也,主方欲静,客不肯休,无奈狂徒敲门撞户,
顾彼水性热肠,有不启扉而从,随流而逝者乎?斯时也,落花与粉蝶齐飞,火枣共交梨并逸,合污同流,已莫
知其昨日孕而今日产矣,朔日孕而望日产矣。随孕随产,本无形迹,盖明产者胎已成形,小产必觉;暗产者
胎仍似水,直溜何知?故凡今之HT HT 家,多无大产,以小产之多也。娶娼妓者,多少子息,以其子
宫滑而惯于小产也。今尝见艰嗣求方者,问其阳事,则曰能战,问其功夫,则曰尽通,问其意况,则怨叹曰∶
人皆有子,我独无!亦岂知人之明产,而尔之暗产耶?此外如受胎三月五月而每有堕者,虽衰薄之妇常有之,
然必由纵欲不节,致伤母气而堕者,为尤多也。故凡恃强过勇者,多无子,以强弱自相残也。纵肆不节者,
多不育,以盗损胎元之气也。岂悉由妇人之罪哉?欲求我方者,当以此篇先读之,则传方之思已过半矣。
小产的病症,有轻重的区别,有发生时间的早晚(妊娠月份),有先天禀赋的原因,也有后天人事的原因。由先天禀赋导致的,多表现为身体虚弱;由后天人事(如房事不节、劳倦等)导致的,多表现为身体损伤。凡是足月顺产,是瓜熟蒂落的自然过程;而小产,则是由于外力或内伤强行折损所致,这就是小产不可轻视的原因。如果产妇年岁已高且体力衰退,生育次数过多,想要再次恢复元气并成功受孕,这本身就很困难。凡遇到这种情况,只要能够保全母亲的气血元气,就是很好的了。如果是年轻人不慎导致小产,这就最需要调理,否则下次怀孕时仍然会流产,以至于经历两次、三次,最终难以拥有子嗣,后果相当严重。以上安胎的方法,参见前文“数堕胎”条中所述。小产后的调理方法,也与足月产后相似,详见后文“产后”条中,都应当参照使用。
凡是妇人年龄到了中年衰退期,胎元无力,就常有胎儿不能正常发育以及多次小产、昏晕的隐患。这是气血衰败造成的。既然气血已经衰弱,那么在小产之后,多有胎盘虽已脱落但子宫仍感下坠,好像还有第二个胎儿要生出来一样。这并不是真的又有胎儿,而是因为气虚导致胞宫随着之前的胎物一起下陷。产妇不知道这一点,必定会惊慌失措,这其实不必忧虑,只需使用寿脾煎,或者八珍汤、十全大补汤之类的方剂来主治,身体自然会安宁。
寿脾煎(见血虚经乱章节)
八珍汤(见经不调章节)
十全大补汤(见调经论外备用方章节)
另外,小产的发生时间有远近之分,在妊娠第二、三个月发生的称为“近”,第五、六个月发生的称为“远”。刚受孕不久就流产的,病情较轻;怀孕很久才流产的,病情较重。这些都是人们所知道的。至于还有更近的,那就是随受孕随流产(暗产)。如今那些难以生育的家庭,犯此病的占十之五六,其根本原因,总归是由于纵欲过度所致。但这向来是人们所不知晓、也不相信的,现在我谨以笔代灯,用来指引迷途者,倘若能救济后人,实为深愿。请允许我详细论述。大概胎元刚开始形成时,一个月时像露珠,两个月时像桃花,第三、四个月以后血脉形体才具备,第五、六个月以后筋骨毛发才生长。在其刚刚受胎时,也不过是一滴珍贵的津液罢了。此时胎元正没有根基,还没有立足之地,加固它则稳固,决堤它则流失。所以凡是受孕之后,极宜节制性欲,以防精气泛滥。然而少年人放纵情感,不知忌惮,虽然有些体质较弱的人,保全胎儿的也很多,那些兼有强力、或者恃强好胜、或者失败后又继续行房的人,在这个时候,主方(母体/胎儿)想要静止,客方(情欲/外邪)不肯停止,无奈狂徒敲门撞户,凭着那水性杨花、热情冲动的心态,有不打开门扉而跟随流逝的吗?这个时候,落花与粉蝶齐飞,火枣与交梨并逸(比喻精液与卵子结合及随后的流失),同流合污,已经不知道昨天受孕今天流产了,初一受孕十五就流产了。随孕随产,本来没有明显的痕迹,因为明产(显性流产)时胎儿已成形,小产必然会有感觉;暗产(隐性流产)时胎儿仍像水一样,直接溜走怎么知道呢?所以如今难以生育的家庭,大多没有足月生产,是因为小产太多的缘故。娶妓女为妻妾的,往往很少子女,因为他们的子宫滑利且习惯于小产。我曾经见过那些难以生育来求方的人,问他们的性功能,回答说还能战斗;问他们是否泄尽精气,回答说全部通达;问他们的心情,却抱怨叹息说:“别人都有孩子,唯独我没有!”又哪里知道别人的是明产,而你的却是暗产呢?此外,如在妊娠第三、五个月经常堕胎的,虽然是身体衰弱的妇女常有之事,但必定是由于纵欲不节制,导致损伤母气而堕胎的情况更为多见。所以凡是恃强好胜、过度纵欲的人,大多没有子嗣,因为强弱相互残害。放纵不节制的人,大多不育,因为盗损了胎元的元气。这难道全都是妇人的罪过吗?想要寻求我方的人,应当先读这一篇,那么理解传方的思路就已经过半了。
The syndrome of spontaneous abortion (Xiao Chan) varies in severity, timing (gestational age), congenital constitution, and acquired factors. Those caused by congenital constitution often manifest as physical weakness; those caused by acquired factors (such as sexual indiscretion or overexertion) often manifest as physical injury. Normal term delivery is a natural process akin to fruit ripening and falling; spontaneous abortion results from forced disruption due to damage, which is why it must not be neglected. If the woman's vitality has declined with age and she has had many births, expecting her to recover strength and conceive again is inherently difficult. In such cases, preserving the mother's Qi and Blood is the best approach. If a young person suffers spontaneous abortion due to carelessness, regulation and treatment are most crucial; otherwise, subsequent pregnancies may also end in miscarriage, leading to repeated losses and ultimately infertility, which is a significant issue. The methods for stabilizing pregnancy mentioned above can be found in the section on "Recurrent Miscarriage" (Shu Duo Tai). Post-abortion regulation is similar to that after term delivery; see the section on "Postpartum" (Chan Hou) for details, which should be applied accordingly.
Women approaching middle age with declining vitality often suffer from inability to carry the fetus to term, recurrent spontaneous abortions, and fainting spells. This is due to the decline of Qi and Blood. Once Qi and Blood are weakened, after a spontaneous abortion, there is often a sensation of further descent even after the fetus has passed, as if another fetus were about to be delivered. This is not another fetus but rather the uterus sinking along with the expelled tissue due to Qi deficiency. Unaware of this, the mother may panic, but there is no need for worry. Treatment with Shou Pi Jian (Spleen-Nourishing Decoction), Ba Zhen Tang (Eight Treasures Decoction), or Shi Quan Da Bu Tang (Ten Complete Great Tonifying Decoction) will restore peace.
Shou Pi Jian (See Section on Blood Deficiency and Menstrual Irregularity)
Ba Zhen Tang (See Section on Menstrual Irregularity)
Shi Quan Da Bu Tang (See Supplementary Formulas in Section on Regulating Menstruation)
Furthermore, spontaneous abortion occurs at different stages: occurring in the second or third month is considered "early" (Jin), while occurring in the fifth or sixth month is considered "late" (Yuan). Abortion shortly after conception is mild in nature, whereas abortion after prolonged gestation is severe. These are common knowledge. However, there is an even earlier stage: immediate loss upon conception. In families struggling with infertility, five or six out of ten cases fall into this category. The root cause is invariably excessive sexual indulgence. Although this is unknown and often disbelieved by people, I write this to illuminate the path for those lost in confusion, hoping to benefit future generations. Let me explain in detail. When the fetal origin begins, at one month it resembles dewdrops, at two months like peach blossoms. By the third and fourth months, blood vessels and form are established; by the fifth and sixth months, bones, sinews, hair, and teeth grow. Initially, conception is merely a drop of precious essence. At this stage, the fetal foundation is unestablished and lacks a firm base; if consolidated, it remains secure; if breached, it flows away. Therefore, after conception, one must strictly abstain from sex to prevent the leakage of essence. Yet, youths indulge their passions without fear. Even among those with weaker constitutions who manage to preserve the fetus, those who are vigorous or insist on continuing sexual activity after initial signs of instability face danger. At this time, the maternal body desires rest, but desire does not cease. Like a madman banging on doors, driven by watery fluidity and fiery passion, how can one avoid opening the door and letting the essence flow away? At this moment, falling flowers fly with butterflies, and fire dates escape with pear fruits (metaphors for the union and subsequent loss of essence). Muddied together, one may not realize that conception occurred yesterday and abortion today, or on the first day of the lunar month and abortion on the fifteenth. Immediate loss upon conception leaves no obvious traces because explicit abortion (Ming Chan) involves a formed fetus and is felt; implicit abortion (An Chan) involves a fetus resembling water, slipping away unnoticed. Thus, many infertile families have no term deliveries because they suffer from frequent implicit abortions. Those who marry prostitutes often have few children because their uterine environment is slippery and accustomed to implicit abortion. I have seen men seeking prescriptions for infertility; when asked about their sexual function, they say they are capable; when asked if they ejaculate completely, they say yes; yet they complain, "Everyone else has children, why not me?" They do not realize that while others experience explicit abortion, they suffer from implicit abortion. Additionally, women who miscarry frequently in the third or fifth months, though common among frail women, mostly do so due to unchecked sexual indulgence damaging the mother's Qi. Therefore, those who rely on physical prowess and excess often remain childless due to mutual destruction between strength and weakness. Those who indulge without restraint often fail to rear children because they steal and damage the fetal Qi. Is this entirely the fault of women? Those seeking my formulas should read this chapter first, as understanding the rationale will constitute half the prescription.