丁酉夏，予寓雉城顾乡宦宅。其门下竹匠妇，怀妊五月而患心痛。究其所由起，谓由失
足坠楼也。始教饮韭菜汁一盏，而痛随止。其夫又从他医赎药二帖归，令煎服。服既，心复痛，
吐鲜血盈盆，胸间忡忡上抵，疼不可言，危在顷刻。竹匠告急予仆孙安，安怜之，恳予延医
。六脉皆洪大，汗出如雨，喘息不相续。其妇楼居低小，予令亟移居楼下，随与益元散五钱
，令用紫苏汤调服。又嘱之曰∶今夜若睡，听其自醒，切勿惊动，汗止即苏也。服后果睡至
晓，汗敛而胸膈不痛，喘息亦定。再与固胎饮一帖，煎服而安全矣。先是邻医诊其脉，谓吐
血之脉宜沉细，今反洪大，而汗出喘息不休，危在今夜。及病起来，询余曰∶妊妇不得汗、
不得下、不得利小便，是谓三禁。昨日之剂悉犯之，而反获效，何哉？予曰∶医贵审证，盖
妇之患，非由病汗，以楼居低小，当酷暑而热逼故也。汗血去而胎失养，故忡忡上抵，喘息
不续。移楼下以避暑气，益元散为解暑之圣药，而紫苏又安胎下气之妙品，气下则血归原而
病痊矣。此对症之药，法出王海藏《医垒元戎》中四血饮是也。特诸君检阅不遍，即检阅亦
不知为胎产之治。余何能，不过融会前人之法，用之不胶焉耳。邻医俯首，唯唯而退。
丁酉年夏天，我居住在雉城顾乡绅的宅邸中。他府上的一位竹匠妻子，怀孕五个月时患上了心痛病。探究其发病原因，说是因为失足从楼上摔下来导致的。起初我教她喝一盏韭菜汁，疼痛随即停止。她的丈夫又从其他医生那里买回两帖药，让她煎服。服药后，心痛复发，吐出鲜血盈满盆子，胸部悸动不安向上顶撞，疼痛难以言表，情况危急，命在旦夕。竹匠急忙告知我的仆人孙安，孙安怜悯她，恳请我去诊治。诊察发现六脉皆洪大，出汗如雨，喘息断续不接。由于她住在低矮狭小的楼屋中，我命令立即将她移至楼下居住，随即给予益元散（滑石、甘草、朱砂组成的解暑方剂）五钱，嘱咐用紫苏汤调服。我又叮嘱道：今晚如果睡着了，就让她自然醒来，千万不要惊动她，汗止住了人就会苏醒。服药后果然睡到天亮，汗收敛了，胸膈不再疼痛，喘息也平复了。再给予固胎饮一帖，煎服后母子便平安了。在此之前，邻居医生诊察她的脉象，说吐血之脉应当沉细，现在反而洪大，加上出汗不止、喘息不停，危险就在当晚。等到病人康复后，邻居医生来询问我说：孕妇不得发汗、不得攻下、不得利小便，这被称为“三禁”。昨天的药剂全都违反了这些禁忌，却反而获得了疗效，这是为什么呢？我回答说：医术贵在审察证候。这位妇女患病，并非因为疾病本身导致出汗，而是因为住在低矮狭小的楼屋中，正值酷暑，热气逼迫所致。汗和血流失导致胎元失去滋养，所以出现心悸上顶、喘息断续的症状。移到楼下以躲避暑热之气，益元散是解除暑热的圣药，而紫苏又是安胎下气的妙品，气机下行则血液归经，病也就痊愈了。这是对症的药物，法度出自王海藏《医垒元戎》中的四血饮。只是各位医生检阅不够全面，即使检阅了也不知道这是治疗胎产的方子。我有什么能耐呢，不过是融会贯通前人的方法，运用时不拘泥罢了。邻医低头认错，恭敬地退下了。
In the summer of Dingyou, I resided in the mansion of a gentry named Gu in Zhicheng. A bamboo craftsman's wife in his household, who was five months pregnant, suffered from heart pain. Investigating the cause, it was attributed to falling from a staircase due to a misstep. Initially, I instructed her to drink one cup of Chinese chive juice, after which the pain ceased. Her husband then purchased two doses of medicine from another physician for her to decoct and take. After ingestion, the heart pain recurred, accompanied by vomiting blood that filled a basin, palpitations rising up to the chest, and unbearable pain; the situation was critical, with life hanging in the balance. The craftsman urgently informed my servant, Sun An, who, out of pity, pleaded with me to attend to her. Examination revealed all six pulses were surging and large (Hong Da), profuse sweating like rain, and intermittent panting. Since she lived in a low, small upper-story room, I ordered her to be moved downstairs immediately, followed by administering five qian of Yiyuan San (Cooling Powder) mixed with Perilla Decoction (Zisu Tang). I further instructed: "If she falls asleep tonight, let her wake naturally; do not disturb her. Once the sweating stops, she will recover." Indeed, she slept until dawn, the sweating subsided, chest oppression and pain resolved, and breathing stabilized. Another dose of Gutai Yin (Fetus-Securing Decoction) was given, decocted and taken, resulting in the safety of both mother and fetus. Previously, a neighboring physician had examined her pulse and stated that the pulse for hematemesis should be deep and fine (Chen Xi); however, hers was surging and large, combined with incessant sweating and panting, indicating imminent danger that night. Upon her recovery, the neighbor asked me: "For pregnant women, diaphoresis (sweating), purgation, and promoting urination are prohibited, known as the 'Three Prohibitions.' Yesterday's prescription violated all three, yet achieved efficacy. Why?" I replied: "Medicine values accurate syndrome differentiation. This woman's condition was not caused by disease-induced sweating, but by heat forcing perspiration due to residing in a cramped, hot upper-story room during intense summer heat. The loss of sweat and blood deprived the fetus of nourishment, causing palpitations and interrupted breathing. Moving her downstairs avoided the summer heat; Yiyuan San is a supreme remedy for clearing summer-heat, and Perilla is an excellent herb for calming the fetus and directing qi downward. With qi descending, blood returns to its vessels, and the illness resolves. This corresponds to the Four Blood Decoction (Sixue Yin) from Wang Haizang's *Yilei Yuanrong*. It is merely that you gentlemen have not reviewed texts thoroughly enough, or even if you have, you did not recognize it as a treatment for pregnancy and childbirth. What ability do I possess? I merely integrated previous methods without being rigid in their application." The neighbor bowed in submission and withdrew respectfully.