薛立斋治鸿胪张淑人,痢疾后胎动,心神不安,肢体殊倦,用八珍散二十余剂渐愈。因劳加烦热头痛,以
大剂补中益气汤加蔓荆子治之,热痛顿止。仍用前散,又五十余剂而安,其后生产甚易。
一妊妇八月,胎欲坠如产,卧久稍安,日晡益甚,此气血虚弱。用补中益气汤加茯苓、半夏随愈。更以八
珍汤调理而安。
一妊妇小便作痛,其胎不安,气攻左右,或时逆上,小便不利,用小柴胡汤加青皮、山栀,清肝火而愈。
后因怒,小腹胀满,小便不利,水道重坠,胎仍不安,此亦肝木炽盛所致。用龙胆泻肝汤一剂,诸症顿愈。乃
以四君子加柴胡、升麻,以培脾土而安。
孙文垣治张溪亭子室,娠已七月,梦见亡过祖母挥拳在背打一下,即觉胎动不安,血已下,大小便皆急,
腰与小腹胀痛者五日。诊之,两寸俱短弱,此上焦元气大虚,当骤补之。人参、阿胶、黄 、白术各二钱,当
归、白芍、条芩、杜仲各一钱,砂仁、香附各五分,苎根嫩皮三钱,葱白六钱,一剂而血止,再剂诸症悉除。
四剂后减去葱白、苎根,调理旬日,足月产一女。
吴孚先治孙氏妊妇,六月作泻欲小产。诊之曰∶此水胎也。四君子加炮姜、制附,十余剂而安。
陈三农治一孕妇,腰痛甚,如欲小产,用杜仲一两,姜汁拌炒续断一两,二味为丸,白汤送下遂安。
薛立斋治一妇人,胎下坠,或动,身体倦,饮食少思,此脾气虚弱。用补中益气汤,倍白术加苏梗,三十
余剂而安。产后眩晕,胸满咳嗽,用四物加茯苓、半夏、桔梗而愈。
一妊妇内热晡热,或兼寒热,食饮少思,其胎或下坠,或上攻,此肝经血虚而火动耳。先用加味逍遥散数
剂,次用六君子加柴胡、枳壳,各数剂而愈。
一妇人每受胎,三四月作痛欲坠,此为胎痛。用当归二钱、熟地黄三钱而愈。
张飞畴曰∶古人用条芩安胎,惟形瘦血热,荣行过疾,胎常上逼者相宜。若形盛气衰,胎常下坠,非人参
举之不安;形实气盛,胎常不运者,非香、砂耗之不安;血虚火旺,腹常急痛者,非归、芍养之不安;体肥痰
盛,呕逆眩运者,非二陈豁之不安。此皆治母气之偏盛也。若有外邪,仍宜表散伏邪。时气尤宜急下,惟忌芒
硝,切不可犯。
雄按∶条芩但宜于血热之人。若血虚有火者,余以竹茹、桑叶、丝瓜络为君,而辅以他药极有效。盖三物
皆养血清热而息内风也。物之坚强莫如竹,皮肉之紧贴亦莫如竹,实为诸血证之要药,观其塞舟不漏可知
矣。桑叶蚕食之以成丝,丝瓜络筋膜联系,质韧子坚,具包罗维系之形,且皆色青入肝,肝虚而胎系不牢
者,胜于四物、阿胶多矣。
薛立斋治疗鸿胪寺官员张淑人,他在患痢疾后出现胎动不安、心神不宁、肢体极度疲倦的症状,使用八珍散(由人参、白术、茯苓、甘草、当归、川芎、白芍、熟地黄组成)二十多剂后逐渐痊愈。后来因劳累导致烦热头痛加重,薛立斋用大剂量的补中益气汤(由黄芪、人参、白术、甘草、当归、陈皮、升麻、柴胡组成)加入蔓荆子进行治疗,热痛立刻停止。之后继续服用之前的八珍散,又服五十多剂后病情安定,其后生产非常顺利。
一位怀孕八个月的孕妇,感觉胎儿欲坠落如临产状,卧床休息后稍安,但到了傍晚时分症状加重,这是气血虚弱的表现。薛立斋使用补中益气汤加入茯苓、半夏,随症治愈。随后再用八珍汤进行调理而安定。
另一位孕妇小便疼痛,胎气不安,气机攻冲左右两侧,有时逆上,小便不通利,薛立斋使用小柴胡汤(由柴胡、黄芩、人参、半夏、甘草、生姜、大枣组成)加入青皮、山栀,清泻肝火而痊愈。后来因为发怒,导致小腹胀满,小便不利,尿道有重坠感,胎气仍不安定,这也是肝木火气炽盛所致。薛立斋使用龙胆泻肝汤一剂,所有症状立刻痊愈。随后用四君子汤(由人参、白术、茯苓、甘草组成)加入柴胡、升麻,以培补脾土而使胎气安定。
孙文垣治疗张溪亭的妻子,她已怀孕七个月,梦见去世的祖母挥拳在背上打了一下,随即感到胎动不安,阴道出血,大小便都急迫,腰部和小腹胀痛持续了五天。诊脉发现两寸脉短弱,这是上焦元气大虚,应当紧急进补。处方用人参、阿胶、黄芩、白术各二钱,当归、白芍、条芩、杜仲各一钱,砂仁、香附各五分,苎麻根嫩皮三钱,葱白六钱,服用一剂后血止,再服两剂后所有症状消除。四剂后减去葱白、苎根,调理十天后,足月产下一名女婴。
吴孚先治疗孙姓孕妇,怀孕六个月时腹泻,有流产迹象。诊脉后说:这是水胎(指胎元不稳或伴有水湿)。使用四君子汤加入炮姜、制附子,十余剂后病情安定。
陈三农治疗一位孕妇,腰痛剧烈,似要流产,使用杜仲一两,姜汁拌炒续断一两,将这两味药制成丸剂,用温开水送服,随即安定。
薛立斋治疗一位妇人,胎儿下坠,胎动不安,身体疲倦,饮食少思,这是脾气虚弱所致。使用补中益气汤,加倍白术并加入苏梗,三十多剂后病情安定。产后出现眩晕、胸满咳嗽,使用四物汤(由当归、川芎、白芍、熟地黄组成)加入茯苓、半夏、桔梗而痊愈。
一位孕妇体内发热,傍晚发热,有时兼有寒热往来,饮食少思,胎儿有时下坠,有时上攻,这是肝经血虚而虚火内动所致。先用加味逍遥散(即丹栀逍遥散)数剂,后用六君子汤(即四君子汤加陈皮、半夏)加入柴胡、枳壳,各服数剂而痊愈。
一位妇人每次受孕,在三四个月时腹痛欲坠,这称为“胎痛”。使用当归二钱、熟地黄三钱而痊愈。
张飞畴说:古人使用条芩(黄芩的一种)安胎,只适用于形体瘦弱、血热、营血运行过速、胎气常向上逼迫的患者适宜。如果形体壮盛但气衰,胎气常下坠的,非用人参提升就不能安定;形体结实、气盛,胎气常不运转的,非用香附、砂仁耗散其滞就不能安定;血虚火旺,腹部常急痛的,非用当归、白芍滋养就不能安定;体胖痰盛,呕吐眩晕的,非用二陈汤豁痰就不能安定。这些都是治疗母体之气偏盛的方法。如果有外邪,仍宜用解表法疏散伏邪。如果是时行疫病,尤其应当急下,只是忌讳芒硝,切不可触犯。
雄按(徐灵胎按语):条芩只适宜于血热的患者。如果是血虚有火的,我用竹茹、桑叶、丝瓜络作为主药,辅以其他药物,极有效验。因为这三味药都能养血清热而平息内风。物体中没有比竹子更坚硬的,皮肉紧贴竹子也没有比竹子更紧密的,它确实是各种血证的重要药物,看它能塞住船不漏可知其坚固之理。桑叶被蚕食用后能结成丝,丝瓜络像筋膜一样联系,质地坚韧种子坚硬,具有包罗维系的外形,且它们的颜色都青入肝经,对于肝虚而导致胎系不牢固的情况,效果胜过四物汤和阿胶很多。
Xue Lizhai treated Zhang Shuren, a Grand Master of Ceremonies, who experienced fetal restlessness, mental uneasiness, and extreme fatigue of the limbs after suffering from dysentery. He prescribed Bazhen San (Eight Treasures Powder) for more than twenty doses, leading to gradual recovery. Later, due to overexertion, he developed irritability, fever, and headache. Xue Lizhai treated him with a large dose of Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Jingjie (Bupleuri Radix) and Manjingzi (Viticis Fructus), which instantly stopped the fever and pain. He continued using the previous Bazhen San for another fifty-plus doses, after which the condition stabilized, and subsequent delivery was very smooth.
A pregnant woman at eight months gestation felt as if the fetus were falling out, resembling labor. She felt slightly relieved when lying down, but symptoms worsened in the late afternoon. This indicated deficiency of Qi and Blood. Xue Lizhai used Buzhong Yiqi Tang added with Fuling (Poria) and Banxia (Pinelliae Rhizoma), which cured her. She was then regulated with Bazhen Tang (Eight Treasures Decoction) to stabilize the pregnancy.
Another pregnant woman suffered from painful urination and fetal unrest, with Qi attacking both sides of the abdomen and sometimes rushing upward, accompanied by difficult urination. Xue Lizhai prescribed Xiaochaihu Tang (Minor Bupleurum Decoction) added with Qingpi (Citri Reticulatae Pericarpium Viride) and Zhizi (Gardeniae Fructus) to clear Liver Fire, resulting in recovery. Later, due to anger, she experienced lower abdominal distension and fullness, difficult urination, a heavy sensation in the urinary tract, and persistent fetal unrest. This was also caused by excessive Liver Wood fire. One dose of Longdan Xiegan Tang (Gentian Liver-Draining Decoction) instantly resolved all symptoms. Subsequently, Sijunzi Tang (Four Gentlemen Decoction) was used with Chaihu (Bupleuri Radix) and Shengma (Cimicifugae Rhizoma) to nourish Spleen Earth and stabilize the fetus.
Sun Wen Yuan treated the wife of Zhang Xiting, who was seven months pregnant. After dreaming that her deceased grandmother punched her on the back, she immediately felt fetal restlessness, vaginal bleeding, urgency in both bowel and bladder movements, and lower back and lower abdominal pain lasting for five days. Pulse diagnosis revealed short and weak pulses at both Cun (inch) positions, indicating severe deficiency of Yuan Qi (Original Qi) in the Upper Jiao. Immediate tonification was required. The prescription included Renshen (Ginseng Radix), Ejiao (Asini Corii Colla), Huangqin (Scutellariae Radix), Baizhu (Atractylodis Macrocephalae Rhizoma) each 2 qian; Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Tiao Qin (Scutellariae Radix), Duzhong (Eucommiae Cortex) each 1 qian; Sharen (Amomi Fructus), Xiangfu (Cyperi Rhizoma) each 5 fen; Zhumagen neping (Radix Boehmeriae Niveae Tender Bark) 3 qian; Congbai (Allii Fistulosi Bulbus) 6 qian. After one dose, bleeding stopped; after two doses, all symptoms disappeared. After four doses, Congbai and Zhumagen were removed, and she was regulated for ten days, delivering a healthy female infant at term.
Wu Fuxian treated a pregnant surnamed Sun who had diarrhea at six months gestation, threatening miscarriage. Upon pulse diagnosis, he said: "This is a water fetus" (referring to unstable fetal origin or dampness). He prescribed Sijunzi Tang (Four Gentlemen Decoction) added with Paojiang (Zingiberis Rhizoma Preparatum) and Zhi Fu (Aconiti Lateralis Radix Preparata). After more than ten doses, the condition stabilized.
Chen San Nong treated a pregnant woman with severe lower back pain, threatening miscarriage. He used Duzhong (Eucommiae Cortex) 1 liang and Xuduan (Dioscoreae Hypoglaucae Rhizoma) stir-fried with ginger juice 1 liang. These two herbs were made into pills and taken with warm water, resulting in immediate stabilization.
Xue Lizhai treated a woman whose fetus felt like it was falling or moving restlessly, accompanied by body fatigue and poor appetite. This was attributed to Spleen Qi deficiency. He prescribed Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with doubled Baizhu (Atractylodis Macrocephalae Rhizoma) and added Rugeng (Perillae Caulis). After thirty-plus doses, the condition stabilized. Postpartum, she suffered from dizziness, chest fullness, and cough. She was cured with Siwu Tang (Four Substances Decoction) added with Fuling (Poria), Banxia (Pinelliae Rhizoma), and Jiegeng (Platycodonis Radix).
A pregnant woman experienced internal heat and afternoon fever, sometimes alternating with chills, poor appetite, and fetal sensations of either sinking or rising. This was due to Liver Blood deficiency with stirring of deficient fire. Initially, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) was given for several doses, followed by Liujunzi Tang (Six Gentlemen Decoction) added with Chaihu (Bupleuri Radix) and Zhike (Aurantii Fructus) for several doses, resulting in recovery.
A woman experienced abdominal pain and a feeling of impending miscarriage every time she conceived, specifically around the third or fourth month. This is called "Tai Tong" (Fetal Pain). She was cured using Danggui (Angelicae Sinensis Radix) 2 qian and Shudi Huang (Rehmanniae Radix Preparata) 3 qian.
Zhang Feichou stated: Ancients used Tiao Qin (a type of Huangqin/Scutellariae Radix) to calm the fetus, which is suitable only for patients who are thin, have blood heat, rapid Ying (Nutrient) circulation, and frequent upward pressure of the fetus. If the patient is physically robust but has Qi deficiency, with the fetus frequently sinking, Ren Shen (Ginseng Radix) is needed to lift it to stabilize; if the patient is solid with abundant Qi, and the fetus fails to move properly, Xiangfu (Cyperi Rhizoma) and Sharen (Amomi Fructus) are needed to dissipate stagnation to stabilize; if there is Blood deficiency with vigorous fire and frequent acute abdominal pain, Danggui (Angelicae Sinensis Radix) and Baishao (Paeoniae Radix Alba) are needed to nourish to stabilize; if the patient is obese with phlegm abundance, vomiting, and dizziness, Erchen Tang (Two Aged Things Decoction) is needed to resolve phlegm to stabilize. These methods treat the excess of the mother's Qi. If external pathogens are present, they should still be dispersed via sweating. In cases of seasonal epidemics, purgation is urgently needed, but Mangxiao (Natrii Sulfas) must be avoided strictly.
Xiong [Xu Lingtai] commented: Tiao Qin is only suitable for those with blood heat. For those with Blood deficiency and fire, I use Zhuru (Bambusae Caulis in Taenia), Sangye (Mori Folium), and Sigualuo (Luffae Fructus Retinervus) as chief herbs, assisted by others, yielding excellent results. These three herbs nourish Blood, clear heat, and extinguish internal wind. Nothing is harder than bamboo; nothing adheres tighter to skin and flesh than bamboo. It is indeed a crucial herb for various blood disorders, as evidenced by its ability to plug leaks in boats. Mulberry leaves are eaten by silkworms to produce silk; luffa loofah resembles fascia connections. Their texture is tough and seeds hard, possessing forms of encompassing and connecting. Moreover, their green color enters the Liver channel. For Liver deficiency causing insecure fetal attachment, they surpass Siwu Tang (Four Substances Decoction) and Ejiao (Asini Corii Colla).