缪仲淳治于润父夫人,妊九月,患伤寒阳明症,头痛壮热,渴甚,舌上黑苔有刺,势甚危。缪投竹叶石膏
汤,索白药子(医马病者。)不得,即以井底泥涂脐上,干则易之。一日夜尽石膏十五两五钱。病瘳产一女,母子毋恙。
治妊娠伤寒,护胎为要,否则堕胎多死。以白药子为细末,鸡子清调摊绵纸上如碗大,自脐贴至脐下胎
存生处,干即以湿水润之,临产者慎勿忘此。
冯楚瞻治一孕妇,劳役受寒,忽四肢厥冷,喘急大作,额汗如雨,六脉沉细欲绝。令以人参五钱,桂、附
共三钱煎服。病家曰∶已孕三四月,服桂、附保勿堕乎?曰∶此时重母不重子,未有母亡而子活者。服下少顷,
即吐出清水,药入肠胃,其声 直达而下,作嗳数声,喘减汗收,脉渐起。乃平和调理,以渐而安,十月足,
生一子。
张路玉治一妇人,素禀气虚多痰,怀妊三月,因腊月举丧受寒,遂恶寒呕逆清血,(血字疑水字之误。)腹痛下坠。
脉得弦细如丝,按之欲绝。与生料干姜人参半夏丸,二服不应。更与附子理中加苓、半、肉桂,调理而康。大
抵怀孕母气多火,得连则安,多寒得桂、附则安,多痰得苓、半则安,务在调其偏胜,适其寒温。未有母气逆
而胎得安,亦未有母气安而胎反堕者。(较冯说自然。)所以《金匮》有怀妊六七月,胎胀,腹痛恶寒,少腹如扇,
用附子汤温其脏者。然认症不果,不得妄行是法。一有差误,祸不旋踵,非比芩、连之误,犹可引延时日也。
缪仲淳治疗于润父的夫人,当时她怀孕九个月,患伤寒阳明症,表现为头痛、高热,极度口渴,舌苔黑且有芒刺,病情非常危急。缪仲淳给予竹叶石膏汤,并索要白药子(一种用于治疗马病的药物)未果,于是用井底泥涂抹在肚脐上,干了就更换。一天一夜内服用了十五两五钱的石膏。病愈后生下一个女儿,母子平安无事。
治疗妊娠期间的伤寒,保护胎儿是首要任务,否则容易导致流产甚至死亡。将白药子研成细末,用蛋清调和后摊在绵纸上,大小如碗口,从肚脐贴至胎儿着床处下方,干了就用湿水润泽,临近分娩时切记不要忽略此法。
冯楚瞻治疗一位孕妇,因劳累受寒,突然四肢厥冷,气喘急促严重,额头出汗如雨,六脉沉细几乎摸不到。他让人取人参五钱,桂枝、附子共三钱煎服。家属说:“已经怀孕三四个月了,服用桂枝和附子难道不怕导致流产吗?”冯楚瞻说:“此时应以保全母亲为重而非胎儿,没有母亲去世而胎儿存活的道理。”服药片刻后,患者吐出清水,药液进入肠胃,声音直达下行,打了几个嗝,气喘减轻,汗止,脉搏逐渐恢复。随后进行平和调理,渐渐安稳,十月期满,生下一子。
张路玉治疗一位妇人,平时体质气虚且多痰,怀孕三个月,因腊月举办丧事受寒,出现怕冷、呕吐清血(“血”字疑为“水”字之误)、腹痛下坠感。脉象弦细如丝,重按几乎消失。给予生料干姜人参半夏丸,服两剂无效。改为附子理中汤加茯苓、半夏、肉桂,调理后康复。大抵怀孕期间母体多火,得黄连则安;多寒,得桂枝、附子则安;多痰,得茯苓、半夏则安,关键在于调节偏胜之气,使其寒温适宜。没有母体气机逆乱而胎儿能安定的,也没有母体气机安定而胎儿反而流产的。(这比冯氏的说法更为自然。)所以《金匮要略》中提到怀孕六七个月,胎胀,腹痛怕冷,少腹像被扇子扇风一样冷,应用附子汤温暖脏腑。然而如果辨证不确切,不可妄用此法。一旦有差错,灾祸立刻降临,不像黄芩、黄连用错了,还可以拖延时日。
Miao Zhongchun treated the wife of Yu Runfu, who was nine months pregnant and suffering from Yangming syndrome (a stage in Shanghan Lun where heat is abundant) due to cold damage. She presented with headache, high fever, extreme thirst, and a black tongue coating with prickles, indicating a critical condition. Miao administered Zhuyeshigu Tang (Bamboo Leaf and Gypsum Decoction). He requested Baiyaizi (Aristolochia debilis root, used for treating horse diseases), but it was unavailable, so he applied mud from the bottom of a well to her umbilicus, replacing it when dry. Within one day and night, she consumed fifteen taels and five qian of gypsum. The illness resolved, and she delivered a healthy daughter; both mother and child were safe.
When treating cold damage during pregnancy, protecting the fetus is paramount; otherwise, miscarriage and death are common. Pulverize Baiyaizi, mix with egg white, spread on cotton paper to the size of a bowl, and apply from the umbilicus down to the area below where the fetus is implanted. If it dries, moisten it with water. Do not forget this method near delivery.
Feng Chuzhan treated a pregnant woman who, after overwork and exposure to cold, suddenly developed cold limbs, severe asthma and urgency, profuse sweating on the forehead like rain, and deep, fine pulses nearly imperceptible. He prescribed Ren Shen (Ginseng Root) 5 qian, combined with Gui Zhi (Cinnamon Twig) and Fu Zi (Aconite Lateralis Preparata) totaling 3 qian, decocted and administered. The family asked, "She is three or four months pregnant; will taking Cinnamon Twig and Aconite cause a miscarriage?" Feng replied, "At this time, saving the mother takes precedence over the fetus; there is no case where the mother dies and the fetus survives." After a short while, she vomited clear fluid, the medicine entered the stomach and intestines, sound traveled downward, she belched several times, her breathing eased, sweating stopped, and her pulse gradually recovered. Subsequent mild regulation led to gradual stability. She carried to term and gave birth to a son.
Zhang Luyu treated a woman constitutionally deficient in Qi and prone to phlegm. At three months pregnant, she caught cold while attending a funeral in the twelfth lunar month, resulting in aversion to cold, vomiting of clear fluid (the character 'blood' is likely an error for 'water'), abdominal pain, and a sensation of bearing down. Her pulse was wiry and fine as a thread, barely perceptible upon pressure. He administered Shengliao Ganjiang Renshen Banxia Wan (Raw Material Dried Ginger, Ginseng, and Pinellia Pill). After two doses, there was no response. He then switched to Fuzi Lizhong Jia Ling Ban Rougui Tang (Aconite and Poria Decoction with Added Poria, Pinellia, and Cinnamon Bark), which cured her through regulation. Generally, if the maternal constitution tends toward heat, Huang Lian (Coptis Rhizome) brings peace; if toward cold, Gui Zhi and Fu Zi bring peace; if toward phlegm, Fu Ling (Poria) and Ban Xia (Pinellia Tuber) bring peace. The key is to adjust the excess and ensure appropriate warmth or cooling. There is no instance where fetal safety exists amidst maternal Qi rebellion, nor is there any case where maternal Qi is stable yet the fetus miscarries. (This view is more natural than Feng's.) Therefore, *Jingui Yaolue* states that in the sixth or seventh month of pregnancy, if there is fetal distension, abdominal pain, aversion to cold, and a sensation of cold in the lower abdomen as if fanned by a wind, Fuzi Tang (Aconite Decoction) should be used to warm the viscera. However, if the syndrome differentiation is not accurate, this method must not be used recklessly. Any error leads to immediate disaster, unlike errors with Huang Qin (Scutellaria Root) or Huang Lian, which might only delay the outcome.