胎实而不安者,惟其素本不虚,而或多郁滞者有之,治宜开之、导之。若呕吐不止者,参橘汤。食滞胀满
者,小中和饮。肝气滞逆肿满者,解肝煎。怒动肝火者,化肝煎。脾肺气滞上攻作痛者,紫苏饮。气滞兼痰者,
四七汤。气滞兼火者,枳壳汤。
参橘汤
人参 陈皮 麦冬(去心) 白术(蜜炙,一钱) 浓朴
(姜制) 茯苓(各五分) 炙甘草(三分)
上加淡竹茹弹子大一丸,姜三片,水煎,温服。
若中脘停痰加枳壳(麸炒)、半夏(姜制、炒黄)各一钱。
小中和饮
陈皮 茯苓 浓朴(姜制,各一钱半) 山楂 扁豆(炒,各二钱) 甘草(五分) 姜(五片)
水煎服。
呕吐加半夏(姜制、炒黄)一钱,胀满加砂仁七分,火郁加栀子炒黑一钱,气逆血滞加紫苏梗、香附(制)
各一钱,寒滞加干姜一钱、肉桂五分。
解肝煎
陈皮 半夏(姜制、炒黄) 浓朴(姜制) 茯苓(各一钱五分) 苏叶 白芍(各一钱) 砂仁(七分)
姜(三片)
水煎服。
如胁腹胀痛加白芥子一钱,胸膈气滞加枳壳(麸炒)、香附(制)各一钱。
化肝煎
青皮 陈皮(各二钱) 白芍 丹皮 栀子(炒焦) 泽泻(各一钱五分) 贝母(三钱)
水煎,食远温服。
大便下血加地榆,小便下血加通草(各一钱五分,去泽泻加甘草)。兼寒热加柴胡一钱,火盛加黄芩一钱。
胁腹胀痛加白芥子一钱。胀满勿用白芍。
紫苏饮
小腹皮 芎川 白芍 陈皮 苏叶 当归(各一钱) 人参
甘草(各五分) 姜(三片) 葱白(一茎)
水煎服。
四七汤
半夏(姜制,一钱五分) 茯苓(一钱二分) 苏叶(六分) 浓朴(姜制,九分) 姜(七片) 枣(二枚)
水煎服。或加当归一钱更妙。
枳壳汤
枳壳(麸炒) 黄芩(酒炒,一钱) 白术(蜜炙,二钱)
水煎,食远服。气滞加陈皮一钱,茯苓八分。
胎气充实但出现不安症状的,是因为孕妇原本体质不虚,但体内多有气机郁滞所致,治疗应当采用疏通、导滞的方法。如果呕吐不止的,使用参橘汤。饮食停滞导致胀满的,使用小中和饮。肝气郁结逆乱导致胁腹胀满的,使用解肝煎。因愤怒引动肝火导致的,使用化肝煎。脾肺气机郁滞上冲引起疼痛的,使用紫苏饮。气滞兼有痰湿的,使用四七汤。气滞兼有火热的,使用枳壳汤。
参橘汤
人参、陈皮、麦冬(去除心)、白术(用蜂蜜炙烤,一钱)、厚朴(用姜汁炮制)、茯苓(各五分)、炙甘草(三分)。
上方加入淡竹茹如弹子大小的一丸,生姜三片,加水煎煮,温服。
如果中脘部停聚痰湿,加枳壳(用麸皮炒)、半夏(用姜汁炮制、炒至微黄)各一钱。
小中和饮
陈皮、茯苓、厚朴(用姜汁炮制,各一钱半)、山楂、扁豆(炒,各二钱)、甘草(五分)、生姜(五片)。
加水煎煮后服用。
呕吐加重加半夏(用姜汁炮制、炒至微黄)一钱,胀满加重加砂仁七分,火热郁结加栀子炒黑一钱,气逆血滞加紫苏梗、香附(炮制)各一钱,寒邪停滞加干姜一钱、肉桂五分。
解肝煎
陈皮、半夏(用姜汁炮制、炒至微黄)、厚朴(用姜汁炮制)、茯苓(各一钱五分)、苏叶、白芍(各一钱)、砂仁(七分)、生姜(三片)。
加水煎煮后服用。
如果胁肋腹部胀痛,加白芥子一钱;胸膈气机郁滞加枳壳(用麸皮炒)、香附(炮制)各一钱。
化肝煎
青皮、陈皮(各二钱)、白芍、丹皮、栀子(炒焦)、泽泻(各一钱五分)、贝母(三钱)。
加水煎煮,饭后稍远时温服。
大便下血加地榆,小便下血加通草(各一钱五分,去掉泽泻,加上甘草)。兼有寒热症状加柴胡一钱,火势旺盛加黄芩一钱。
胁肋腹部胀痛加白芥子一钱。若以胀满为主则不要用白芍。
紫苏饮
小腹皮、川芎、白芍、陈皮、苏叶、当归(各一钱)、人参、甘草(各五分)、生姜(三片)、葱白(一根)。
加水煎煮后服用。
四七汤
半夏(用姜汁炮制,一钱五分)、茯苓(一钱二分)、苏叶(六分)、厚朴(用姜汁炮制,九分)、生姜(七片)、大枣(两枚)。
加水煎煮后服用。或者加入当归一钱效果更好。
枳壳汤
枳壳(用麸皮炒)、黄芩(用酒炒,一钱)、白术(用蜂蜜炙烤,二钱)。
加水煎煮,饭后稍远时服用。气滞加重加陈皮一钱、茯苓八分。
When the fetus is solid but unstable, it is due to the mother's original constitution not being deficient, but rather having much qi stagnation. The treatment should involve opening and guiding (resolving stagnation). If vomiting persists, use Shenju Tang (Ginseng and Tangerine Peel Decoction). If food stagnation causes distension and fullness, use Xiao Zhonghe Yin (Minor Harmonizing Decoction). If liver qi stagnation and rebellion cause swelling and fullness, use Jiegan Jian (Liver-Resolving Decoction). If anger stirs up liver fire, use Huagan Jian (Transforming Fire Decoction). If spleen and lung qi stagnation attacks upward causing pain, use Zisu Yin (Perilla Leaf Decoction). If qi stagnation is accompanied by phlegm, use Siqi Tang (Four-Seven Decoction). If qi stagnation is accompanied by fire, use Zhike Tang (Immature Bitter Orange Decoction).
Shenju Tang (Ginseng and Tangerine Peel Decoction)
Renshen (Ginseng Root), Chenpi (Aged Tangerine Peel), Maidong (Ophiopogon Tuber, heart removed), Baizhu (Atractylodes Rhizome, honey-fried, 1 qian), Houpo (Magnolia Bark, ginger-processed), Fuling (Poria, each 0.5 qian), Zhigancao (Honey-fried Licorice Root, 0.3 qian).
Add a pill-sized piece of Danshuzhu Ru (Bamboo Shavings from Dendrocalamus latiflorus), three slices of Shengjiang (Fresh Ginger), decoct in water, and take warm.
If phlegm stops in the Zhongwan area (CV12), add Zhike (Immature Bitter Orange, bran-fried) and Banxia (Pinellia Tuber, ginger-processed, fried yellow), each 1 qian.
Xiao Zhonghe Yin (Minor Harmonizing Decoction)
Chenpi (Aged Tangerine Peel), Fuling (Poria), Houpo (Magnolia Bark, ginger-processed, each 1.5 qian), Shanzha (Hawthorn Fruit), Biandou (Lablab Bean, fried, each 2 qian), Gancao (Licorice Root, 0.5 qian), Shengjiang (Fresh Ginger, five slices).
Decoct in water and take.
For increased vomiting, add Banxia (Pinellia Tuber, ginger-processed, fried yellow) 1 qian; for increased distension, add Sharen (Amomum Fruit) 0.7 fen; for constrained fire, add Zhizi (Gardenia Fruit, fried black) 1 qian; for rebellious qi and stagnant blood, add Zisugeng (Perilla Stem) and Xiangfu (Cyperus Rhizome, processed), each 1 qian; for cold stagnation, add Ganjiang (Dried Ginger) 1 qian and Rougui (Cinnamon Bark) 0.5 qian.
Jiegan Jian (Liver-Resolving Decoction)
Chenpi (Aged Tangerine Peel), Banxia (Pinellia Tuber, ginger-processed, fried yellow), Houpo (Magnolia Bark, ginger-processed), Fuling (Poria, each 1.5 qian), Ziye (Perilla Leaf), Baishao (White Peony Root, each 1 qian), Sharen (Amomum Fruit, 0.7 fen), Shengjiang (Fresh Ginger, three slices).
Decoct in water and take.
For hypochondriac and abdominal distending pain, add Baijiezi (White Mustard Seed) 1 qian; for chest and diaphragm qi stagnation, add Zhike (Immature Bitter Orange, bran-fried) and Xiangfu (Cyperus Rhizome, processed), each 1 qian.
Huagan Jian (Transforming Fire Decoction)
Qingpi (Green Tangerine Peel), Chenpi (Aged Tangerine Peel, each 2 qian), Baishao (White Peony Root), Danpi (Moutan Cortex), Zhizi (Gardenia Fruit, fried scorched), Zexie (Alisma Rhizome, each 1.5 qian), Beimu (Fritillaria Bulb, 3 qian).
Decoct in water, take warm long after meals.
For blood in stool, add Diyü (Sanguisorba Root); for blood in urine, add Tongcao (Tetrapanax Pith), each 1.5 qian (remove Zexie, add Gancao/Licorice Root). For concomitant chills and fever, add Chaihu (Bupleurum Root) 1 qian; for excessive fire, add Huangqin (Scutellaria Root) 1 qian.
For hypochondriac and abdominal distending pain, add Baijiezi (White Mustard Seed) 1 qian. Do not use Baishao if distension/fullness is predominant.
Zisu Yin (Perilla Leaf Decoction)
Xiaofupi (Pericarpium Citri Reticulatae Viride - specifically referring to immature fruit peel here, often interpreted as Qingpi or similar citrus peel variants in some contexts, but literally "Little Belly Skin"), Chuanxiong (Ligusticum Rhizome), Baishao (White Peony Root), Chenpi (Aged Tangerine Peel), Ziye (Perilla Leaf), Danggui (Angelica Sinensis Root), each 1 qian; Renshen (Ginseng Root), Gancao (Licorice Root), each 0.5 qian; Shengjiang (Fresh Ginger, three slices), Congbai (Scallion White, one stalk).
Decoct in water and take.
Siqi Tang (Four-Seven Decoction)
Banxia (Pinellia Tuber, ginger-processed, 1.5 qian), Fuling (Poria, 1.2 qian), Ziye (Perilla Leaf, 0.6 fen), Houpo (Magnolia Bark, ginger-processed, 0.9 fen), Shengjiang (Fresh Ginger, seven slices), Zao (Jujube, two pieces).
Decoct in water and take. Adding Danggui (Angelica Sinensis Root) 1 qian is even better.
Zhike Tang (Immature Bitter Orange Decoction)
Zhike (Immature Bitter Orange, bran-fried), Huangqin (Scutellaria Root, wine-fried, 1 qian), Baizhu (Atractylodes Rhizome, honey-fried, 2 qian).
Decoct in water, take warm long after meals. For aggravated qi stagnation, add Chenpi (Aged Tangerine Peel) 1 qian and Fuling (Poria) 0.8 fen.