小产非正产之证,不可作产前治。盖小产,气血大伤,胎动而下,必损带脉,急宜大补气血,则带脉损处可
以复生。他日受妊,庶无再损之患,宜大补地黄汤。
大补地黄汤
人参 白术(蜜炙) 当归(各五钱) 茯苓(三钱) 熟地黄
一两) 杜仲(盐水炒,二钱) 炮姜(五分)
水煎服。
妊娠三月(未成形而胎下)者为堕胎,五月而堕者为小产,七月而堕者为半产,此皆重于大产。但人视为
轻,忽而殒,命者有之。治宜补血养气,生新去瘀。若未足月,痛而欲产,下血不止,宜芎归补血汤,倍加知
母止之。产而下血不止,宜人参黄 汤。产而血瘀心腹疼痛,手按愈甚,宜当归川芎汤。胎气弱而小产,宜八
珍汤(方见前胎虚不安条中)。血出过多而发热,宜圣愈汤。汗出不止,宜独参汤。发热烦躁,大渴面赤,脉
洪而虚,宜当归补血汤。身热面赤,脉沉而细,宜姜附四君汤。
芎归补血汤
黄 (蜜炙) 当归 白术(蜜炙) 杜仲(盐水炒) 白芍(各一钱) 干姜 阿胶(炒珠) 川芎
五味子 木香(不见火) 人参 甘草(炙,各五分)
上加知母二钱,水煎服(一方无木香)。
人参黄 汤
人参 黄 (蜜炙) 当归 白术(蜜炙) 白芍 艾叶(各一钱) 阿胶(炒珠,二钱)
水煎服。
当归川芎汤
当归 熟地黄 白芍(炒) 玄胡索(炒) 川芎 桃仁(去皮尖、捣) 红花 香附(制) 青皮(炒)
泽兰叶 牡丹皮
水煎,入童便、酒各小半,冲服。
圣愈汤
人参 川芎 当归 熟地黄(酒蒸) 生地黄(酒洗) 黄 (蜜炙,各一钱)
水煎服。
独身汤
人参(二两)
水一钟半,煎七分,温服。
当归补血汤
黄 (蜜炙,一两) 当归(三钱)
水一钟半,煎八分,食远服。
姜附四君汤
人参 白术(蜜炙) 茯苓 炙甘草(各一钱) 干姜(炮) 附子(制熟,各五分)
水煎服。
小产不是正常分娩的证候,不能按照产前病来治疗。因为小产会导致气血严重受损,胎动下坠,必然损伤带脉,急需大补气血,这样带脉受损处才能恢复。日后再次怀孕,才不会有再次损伤的祸患,适宜使用大补地黄汤。
大补地黄汤
人参、白术(用蜜炙)、当归(各五钱)、茯苓(三钱)、熟地黄(一两)、杜仲(用盐水炒,二钱)、炮姜(五分)
加水煎煮后服用。
妊娠三个月(胎儿尚未成形而坠落)称为堕胎,五个月而坠落称为小产,七个月而坠落称为半产,这些情况都比足月生产更为严重。但人们往往轻视它,导致突然流产丧命的情况也有发生。治疗应当补血养气,促进新血生成并去除瘀血。如果未满月,腹痛欲产,出血不止,适宜使用芎归补血汤,加倍加入知母以止血。产后出血不止,适宜使用人参黄芪汤。产后因血瘀导致心腹疼痛,用手按压疼痛加剧,适宜使用当归川芎汤。胎气虚弱而导致小产,适宜使用八珍汤(方剂见前文“胎虚不安”条中)。出血过多而出现发热,适宜使用圣愈汤。汗出不止,适宜使用独参汤。发热烦躁,极度口渴,面色发红,脉搏洪大但按之空虚,适宜使用当归补血汤。身体发热,面色发红,脉搏沉细,适宜使用姜附四君汤。
芎归补血汤
黄芪(用蜜炙)、当归、白术(用蜜炙)、杜仲(用盐水炒)、白芍(各一钱)、干姜、阿胶(炒成珠状)、川芎、五味子、木香(不经过火烤)、人参、甘草(炙,各五分)
上方加入知母二钱,加水煎煮后服用(另一版本方中无木香)。
人参黄芪汤
人参、黄芪(用蜜炙)、当归、白术(用蜜炙)、白芍、艾叶(各一钱)、阿胶(炒成珠状,二钱)
加水煎煮后服用。
当归川芎汤
当归、熟地黄、白芍(炒)、玄胡索(炒)、川芎、桃仁(去皮尖、捣碎)、红花、香附(制过)、青皮(炒)、泽兰叶、牡丹皮
加水煎煮,加入童便和酒各一小半,冲服。
圣愈汤
人参、川芎、当归、熟地黄(用酒蒸)、生地黄(用酒洗)、黄芪(用蜜炙,各一钱)
加水煎煮后服用。
Miscarriage is not a condition of normal delivery and should not be treated as antenatal disease. Since miscarriage causes severe depletion of Qi and Blood, with fetal movement leading to expulsion, the Dai Mai (Belt Vessel) must inevitably be damaged. It is urgent to greatly tonify Qi and Blood so that the damaged Dai Mai may regenerate. In future pregnancies, there will be no risk of further damage; Da Bu Di Huang Tang (Greatly Tonifying Rehmannia Decoction) is indicated.
Da Bu Di Huang Tang (Greatly Tonifying Rehmannia Decoction)
Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Rhizoma, honey-fried), Dang Gui (Angelicae Sinensis Radix) (each 5 qian), Fu Ling (Poria), Shu Di Huang (Rehmanniae Radix Praeparata) (1 liang), Du Zhong (Eucommiae Cortex, salt-water fried), Pao Jiang (Zingiberis Rhizoma Preparatum) (5 fen).
Decoct in water and take orally.
Expulsion of the fetus before three months of gestation (while the fetus is not yet formed) is called Tuotai (Fetus Falling); expulsion at five months is called Xiaochan (Minor Miscarriage); expulsion at seven months is called Banchan (Half-term Miscarriage). All these are more severe than full-term delivery. However, people often underestimate them, leading to sudden abortion and even death. Treatment should focus on nourishing Blood and tonifying Qi, generating new tissue, and removing blood stasis. If the pregnancy is not yet full-term, accompanied by abdominal pain, desire for delivery, and continuous bleeding, Xiong Gui Bu Xue Tang (Ligusticum and Angelica Blood-Tonifying Decoction) is indicated, with added Zhi Mu (Anemarrhenae Rhizoma) doubled to stop bleeding. For continuous bleeding after delivery, Ren Shen Huang Qi Tang (Ginseng and Astragalus Decoction) is indicated. For postpartum heart and abdominal pain due to blood stasis, which worsens upon palpation, Dang Gui Chuan Xiong Tang (Angelica and Ligusticum Decoction) is indicated. For minor miscarriage due to weak fetal Qi, Ba Zhen Tang (Eight Treasure Decoction) is indicated (formula see previous section "Fetal Deficiency and Instability"). For fever resulting from excessive blood loss, Sheng Yu Tang (Sage Saving Decoction) is indicated. For incessant sweating, Du Shen Tang (Single Ginseng Decoction) is indicated. For fever, irritability, extreme thirst, red face, and a洪 (Surging) pulse that is empty upon pressure, Dang Gui Bu Xue Tang (Angelica Blood-Tonifying Decoction) is indicated. For body heat, red face, and a deep, thin pulse, Jiang Fu Si Jun Tang (Ginger and Aconite Four Gentlemen Decoction) is indicated.
Xiong Gui Bu Xue Tang (Ligusticum and Angelica Blood-Tonifying Decoction)
Huang Qi (Astragali Radix, honey-fried), Dang Gui (Angelicae Sinensis Radix), Bai Zhu (Atractylodis Rhizoma, honey-fried), Du Zhong (Eucommiae Cortex, salt-water fried), Bai Shao (Paeoniae Radix Alba) (each 1 qian), Gan Jiang (Zingiberis Rhizoma), E Jiao (Asini Corii Colla, fried into pearls), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Wu Wei Zi (Schisandrae Fructus), Mu Xiang (Aucklandiae Radix, not exposed to fire), Ren Shen (Ginseng Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted) (each 5 fen).
Add Zhi Mu (Anemarrhenae Rhizoma) 2 qian to the above, decoct in water, and take orally (another version excludes Mu Xiang).
Ren Shen Huang Qi Tang (Ginseng and Astragalus Decoction)
Ren Shen (Ginseng Radix), Huang Qi (Astragali Radix, honey-fried), Dang Gui (Angelicae Sinensis Radix), Bai Zhu (Atractylodis Rhizoma, honey-fried), Bai Shao (Paeoniae Radix Alba), Ai Ye (Artemisiae Argyi Folium) (each 1 qian), E Jiao (Asini Corii Colla, fried into pearls, 2 qian).
Decoct in water and take orally.
Dang Gui Chuan Xiong Tang (Angelica and Ligusticum Decoction)
Dang Gui (Angelicae Sinensis Radix), Shu Di Huang (Rehmanniae Radix Praeparata), Bai Shao (Paeoniae Radix Alba, fried), Yan Hu Suo (Corydalis Rhizoma, fried), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Tao Ren (Persicae Semen, skin and tip removed, pounded), Hong Hua (Carthami Flos), Xiang Fu (Cyperi Rhizoma, processed), Qing Pi (Citri Reticulatae Pericarpium Viride, fried), Ze Lan Ye (Lycopus Herba), Mu Dan Pi (Moutan Cortex).
Decoct in water, add Tong Bian (Child's Urine) and Jiu (Alcohol) each in small amounts, mix well, and take orally.
Sheng Yu Tang (Sage Saving Decoction)
Ren Shen (Ginseng Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix), Shu Di Huang (Rehmanniae Radix Praeparata, steamed with wine), Sheng Di Huang (Rehmanniae Radix, washed with wine), Huang Qi (Astragali Radix, honey-fried) (each 1 qian).
Decoct in water and take orally.
Du Shen Tang (Single Ginseng Decoction)
Ren Shen (Ginseng Radix) (2 liang).
Decoct in 1.5 zhong of water until 0.7 zhong remains, warm, and take orally.
Dang Gui Bu Xue Tang (Angelica Blood-Tonifying Decoction)
Huang Qi (Astragali Radix, honey-fried, 1 liang), Dang Gui (Angelicae Sinensis Radix) (3 qian).
Decoct in 1.5 zhong of water until 0.8 zhong remains, take long after meals.
Jiang Fu Si Jun Tang (Ginger and Aconite Four Gentlemen Decoction)
Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Rhizoma, honey-fried), Fu Ling (Poria), Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted) (each 1 qian), Gan Jiang (Zingiberis Rhizoma, prepared), Fu Zi (Aconiti Lateralis Radix Praeparata, cooked and processed) (each 5 fen).
Decoct in water and take orally.