大全云∶妊娠不长者,因而宿疾,或因失调,以致脏腑衰损,气血虚弱,而胎不长也。当治其疾疚,益其气
血,则胎自长矣。
薛氏曰∶前证更当察其经络,审其所因而治之。
一妊妇胎六月,体倦懒食,面黄晡热,而胎不长,因劳欲坠,此脾气不足也,用八珍汤,倍加参、术、茯苓三十余
剂,脾胃渐健,胎安而长矣。
一妊妇因怒,寒热往长,内热晡热,胁痛
呕吐,胎至八月而不长,此因肝脾郁怒所致,用六君加柴胡、山栀、枳壳、紫苏、桔梗病愈,
而胎亦长矣。
安胎白术散 治妊娠宿有冷,胎痿不长,或失于将理,伤胎多堕,引药补荣卫,养胎气。
白术 川芎(各一两) 吴茱萸(汤泡,半两) 甘草(炙,一两半)
上为细末,每服二钱,食前温酒调下,忌生冷果实。(天地以大,气春生夏长,人身以心
肝应之,若有宿冷者,春气不温也,以吴茱萸温之;胎痿不长者,夏气不大也,以川芎大之;
白术、甘草,乃培土以补其母也。以此为法,思过半矣)
黄 汤 治妊娠胎不长,安胎和气,思食,利四肢。
黄 (炒) 白术(炒) 白茯苓 前胡 人参(各七分半) 川芎 甘草(炒,各五分)
上 咀,加生姜三片,枣二枚,水煎,食前服。(此方悉以补气为主,而前胡散结气,川芎
行结血,皆所助其生长也。观其主治,乃得其妙)
长胎白术丸 治孕妇宿有风冷,胎痿不长,或将理失宜,伤动胎气,多致损堕,常服益
血保胎,调补冲任。
白术 川芎 阿胶 生地(各六分) 当归(一两) 牡蛎(二分) 川椒(三分)
上为末,炼蜜丸,如桐子大,每服三十丸,米饮下。(此方以风冷而用川椒、川芎,以伤动
而用白术、牡蛎、阿胶、生地。凉血固胎,不多用者,畏其凉也。当归一两,其血中之主药欤,
故以为君。分两奇)
人参丸 治妊娠胎不长,宜服养胎。(此方助生气,宽中育胎,又是一法)
人参 白茯苓 当归 柴胡 刺蓟 浓朴 桑寄生(各一两) 枳壳(七钱半) 甘草(半两)
上为细末,炼蜜丸,桐子大,每服二十丸,食前温水下。
《女科百问》中说:妊娠期间胎儿发育迟缓,是因为原有的旧疾,或者因为调养不当,导致脏腑功能衰退受损,气血虚弱,从而使胎儿不能正常生长。应当治疗其原有的疾病,补益其气血,那么胎儿自然就会生长了。
薛己说:上述病症更应当观察经络情况,审察致病原因进行治疗。
有一位孕妇怀孕六个月,身体疲倦、食欲不振,面色萎黄且傍晚发热,胎儿发育迟缓,因劳累和房事有流产迹象,这是脾气不足的表现,使用八珍汤,加倍加入人参、白术、茯苓,服用三十多剂后,脾胃功能逐渐强健,胎儿安定并正常生长了。
另一位孕妇因愤怒导致寒热往来,体内发热且傍晚加重,胁肋疼痛、呕吐,胎儿长到八个月仍发育迟缓,这是因为肝脾郁结愤怒所致,使用六君子汤加入柴胡、山栀、枳壳、紫苏、桔梗,病愈后,胎儿也正常生长了。
安胎白术散:治疗妊娠期间原有寒气,胎儿萎缩发育迟缓,或者由于调理失当,损伤胎气导致多次流产,此方通过药物补养营卫之气,滋养胎气。
药材组成:白术、川芎(各一两)、吴茱萸(用热水浸泡,半两)、甘草(炙烤,一两半)。
制法用法:将上述药材研成细末,每次服用二钱,饭前用温酒调服,忌食生冷瓜果。
(按语:天地广阔,气候春季生发、夏季生长,人体以心、肝与之相应,如果有宿寒,则春气不温暖,用吴茱萸来温煦;胎儿萎缩不长,则夏气不盛大,用川芎来助长;白术、甘草,是培补脾胃以补益母体。以此为法则,思虑便过半了。)
黄芪汤:治疗妊娠胎儿发育迟缓,安胎和气,增进食欲,通畅四肢。
药材组成:黄芪(炒)、白术(炒)、白茯苓、前胡、人参(各七分半)、川芎、甘草(炒,各五分)。
制法用法:将药材切碎,加生姜三片、大枣二枚,水煎煮,饭前服用。
(按语:此方完全以补气为主,而前胡疏散结聚之气,川芎运行结滞之血,都是帮助胎儿生长的因素。看它的主治功效,就得到了其中的奥妙。)
长胎白术丸:治疗孕妇原有风冷,胎儿萎缩发育迟缓,或者调理失宜,伤动胎气,多导致损伤流产,常服可益血保胎,调补冲脉和任脉。
药材组成:白术、川芎、阿胶、生地(各六分)、当归(一两)、牡蛎(二分)、川椒(三分)。
制法用法:将药材研成粉末,用炼蜜制成丸子,如梧桐子大小,每次服用三十丸,米汤送下。
(按语:此方因风冷而用川椒、川芎,因伤动胎气而用白术、牡蛎、阿胶、生地。凉血固胎,但用量不多,是担心过于寒凉。当归一两,是补血中的主药,所以作为君药。剂量搭配奇特精妙。)
人参丸:治疗妊娠胎儿发育迟缓,适宜服用以养胎。(此方辅助生气,宽中育胎,是另一种方法。)
药材组成:人参、白茯苓、当归、柴胡、刺蓟、浓朴、桑寄生(各一两)、枳壳(七钱半)、甘草(半两)。
制法用法:将药材研成细末,用炼蜜制成丸子,如梧桐子大小,每次服用二十丸,饭前温水送下。
The *Daquan* (Compendium) states: When the fetus fails to grow during pregnancy, it is due to pre-existing chronic diseases or improper regulation, leading to the decline and damage of the Zang-Fu organs, and deficiency of Qi and Blood, thereby preventing normal fetal growth. One should treat the underlying disease and tonify Qi and Blood, then the fetus will naturally grow.
Xue Ji stated: For the aforementioned conditions, one must further examine the meridians and investigate the etiology to guide treatment.
In one case, a pregnant woman at six months gestation presented with fatigue, poor appetite, sallow complexion, and afternoon fever, with the fetus failing to grow; she also had a tendency to miscarry due to overwork and sexual indulgence. This was attributed to Spleen Qi deficiency. She was prescribed Bazhen Tang (Eight Treasure Decoction), with increased doses of Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Rhizoma), and Fuling (Poria), administered for more than thirty doses. Her Spleen and Stomach function gradually strengthened, the fetus became stable, and growth resumed.
In another case, a pregnant woman experienced alternating chills and fever, internal heat worsening in the afternoon, hypochondriac pain, and vomiting after becoming angry. The fetus failed to grow by the eighth month. This was caused by Liver and Spleen Qi stagnation due to anger. She was treated with Liujun Zi Tang (Six Gentlemen Decoction) modified with Chaihu (Bupleuri Radix), Zhizi (Gardeniae Fructus), Zhike (Aurantii Fructus), Zisu (Perillae Folium), and Jiegeng (Platycodonis Radix). After the illness resolved, the fetus grew normally.
Antepartum Atractylodes Powder (Antai Baizhu San): Treats pre-existing cold in pregnancy, fetal atrophy and failure to grow, or miscarriages resulting from improper care. It nourishes Ying and Wei (Nutritive and Defensive Qi) and supports fetal Qi.
Ingredients: Baizhu (Atractylodis Rhizoma) and Chuanxiong (Ligustici Chuanxiong Rhizoma) (1 liang each); Wuzhuyu (Evodiae Fructus) (soaked in hot water, 0.5 liang); Gancao (Glycyrrhizae Radix et Rhizoma) (roasted, 1.5 liang).
Preparation and Administration: Grind into fine powder. Take 2 qian per dose, mixed with warm wine before meals. Avoid raw/cold foods and fruits.
(Commentary: Heaven and Earth are vast; spring promotes growth and summer promotes flourishing, corresponding to the Heart and Liver in the human body. If there is pre-existing cold, the spring Qi is not warm; Wuzhuyu warms it. If the fetus is atrophic and fails to grow, the summer Qi is not vigorous; Chuanxiong enhances it. Baizhu and Gancao cultivate Earth to tonify the Mother. Understanding this principle covers half the understanding.)
Huangqi Decoction (Huangqi Tang): Treats fetal failure to grow in pregnancy, calms the fetus, harmonizes Qi, stimulates appetite, and benefits the limbs.
Ingredients: Huangqi (Astragali Radix) (stir-fried), Baizhu (Atractylodis Rhizoma) (stir-fried), Fuling (Poria), Qianhu (Peucedani Radix), Renshen (Ginseng Radix et Rhizoma) (0.75 fen each); Chuanxiong (Ligustici Chuanxiong Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma) (stir-fried, 0.5 fen each).
Preparation and Administration: Coarsely crush the herbs. Add three slices of Shengjiang (Zingiberis Rhizoma Recens) and two dates (Jujubae Fructus). Decoct in water and take before meals.
(Commentary: This formula focuses primarily on tonifying Qi. Qianhu disperses stagnant Qi, and Chuanxiong moves stagnant Blood, both assisting growth. Observing its indications reveals its efficacy.)
Fetal-Growth Atractylodes Pill (Changtai Baizhu Wan): Treats pre-existing wind-cold in pregnant women, fetal atrophy and failure to grow, or miscarriages due to improper care that disturbs fetal Qi. Regular use nourishes Blood, protects the fetus, and regulates the Chong and Ren vessels.
Ingredients: Baizhu (Atractylodis Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma), Ejiao (Asini Corii Colla), Shengdi (Rehmanniae Radix) (0.6 fen each); Danggui (Angelicae Sinensis Radix) (1 liang); Muli (Ostreae Concha) (0.2 fen); Chuanjiao (Sichuan Pepper/ Zanthoxyli Pericarpium) (0.3 fen).
Preparation and Administration: Grind into powder. Form pills with refined honey, size of Sophora seeds. Take 30 pills per dose with rice drink.
(Commentary: Chuanjiao and Chuanxiong are used for wind-cold; Baizhu, Muli, Ejiao, and Shengdi are used for disturbed fetal Qi. They cool Blood and secure the fetus but are used sparingly to avoid excessive cooling. Danggui (1 liang) is the primary herb for nourishing Blood, hence it serves as the Sovereign herb. The dosage ratios are unique.)
Renshen Pill (Renshen Wan): Treats fetal failure to grow in pregnancy; suitable for nourishing the fetus. (This method assists the generation of Qi, relaxes the Middle Jiao, and nurtures the fetus.)
Ingredients: Renshen (Ginseng Radix et Rhizoma), Fuling (Poria), Danggui (Angelicae Sinensis Radix), Chaihu (Bupleuri Radix), Ciji (Cirsii Japonici Herba), Houpo (Magnoliae Officinalis Cortex), Sangjisheng (Taxilli Herba) (1 liang each); Zhike (Aurantii Fructus) (7.5 qian); Gancao (Glycyrrhizae Radix et Rhizoma) (0.5 liang).
Preparation and Administration: Grind into fine powder. Form pills with refined honey, size of Sophora seeds. Take 20 pills per dose with warm water before meals.