丹溪论血不足以荣养其胎而堕胎者,犹枝枯而果落,藤萎而花堕也;其劳怒动火而堕者
,犹
风撼其木,人折其枝也。二论极是,然未详晰论辨,无惑乎妊妇之不慎戒也。夫妇人冲脉主
血海,血旺始成胎;任脉主胞胎,静养则胎安。若怒伤肝,劳伤肾,致二脏失,相火耗血动
气,未有能保孕之不漏不堕,娩后尚多崩热之症也。如衰弱人有妊,及曾堕者,必须恪遵胎
教,通达事情,如古太任兢兢爱护,坐卧不偏,视听无邪,毋溺专宠,阃事悉委于婢外家,罔
怀妒忌,忿 不留于胸臆。至如食物药饵,一律禁戒无犯。斯火不动而血旺荫孕,形不劳而
气完胎固,且生子禀全易养,形端体正。况屡堕损血倍于正产,怒劳致堕,由已自招。禀弱
之人,惟知有子自足,毋以小嫌害大,而自取无后之忧也。
补母固胎饮(忌食小鲤鱼、苋菜)
白术(二钱) 当归(二钱) 熟地(二钱) 陈皮(三分) 紫苏(三分) 砂仁(三分) 甘草
(三分) 人参(一钱) 条芩(八分) 智草(五分) 大枣(二枚)
妊妇误食苋菜,诸药书此以晓弱妇,欲子寿,必须信方月服。凡妊至四、五、六月内,
误食
苋菜,或少服苓、术等药,多吃炙爆煎炒动火热物,必堕胎产。如见有别症,凡大黄、芒硝
一切金石下气之药,皆宜禁用。万不得已,亦宜斟酌。不用中病即止,勿误人命。不特半夏
、牛膝等药宜慎,即茯苓性降亦须慎用。时医不知,故特表而出之。总之,孕妇杂症,必以
安胎为主,杂症为佐使矣。
朱丹溪论述因血液不足以滋养胎儿而导致流产的情况,就像树枝干枯果实掉落、藤蔓枯萎花朵坠落一样;那些因劳累和愤怒引发内火而导致流产的,就像风吹撼树木、人折断树枝一样。这两种理论都非常正确,但是未能详细清晰地辨析,难怪孕妇们不能谨慎戒忌。
妇女的冲脉主管血海,血液旺盛才能形成胎元;任脉主管胞胎,安静休养则胎元安稳。如果发怒损伤肝脏,劳累损伤肾脏,导致这两脏功能失调,相火消耗血液并扰动气机,没有能够保住妊娠不出现漏下或流产的,分娩后还多有崩漏、发热等症状。
如果是身体虚弱的人怀孕,以及曾经有过流产史的,必须严格遵循胎教,通晓事理,像古代的太任那样兢兢业业地爱护自己,坐卧姿势端正,视听行为无邪僻,不要沉溺于专宠之中,家务琐事全部委托给婢女和外家亲属,心中不要怀有嫉妒,愤怒的情绪不要留在胸中。至于食物和药物,一律禁止触犯。这样火势不动而血液旺盛荫护孕育,形体不劳累而元气完好胎元稳固,而且孩子禀赋健全容易抚养,身形端正体态正直。况且多次流产损耗的血倍于正常生产,因愤怒和劳累导致流产,是由自己招致的。禀赋薄弱的人,只知道有子嗣就满足了,不要因为小的嫌隙损害大局,从而自取无后的忧患。
补母固胎饮(忌食小鲤鱼、苋菜)
白术(二钱) 当归(二钱) 熟地黄(二钱) 陈皮(三分) 紫苏(三分) 砂仁(三分) 甘草(三分) 人参(一钱) 黄芩(八分) 炙甘草(五分) 大枣(两枚)
孕妇误食苋菜,各种药书都记载这一点来告知虚弱的妇人,想要子女长寿,必须相信方剂每月服用。凡是怀孕到四、五、六月期间,误食苋菜,或者少服茯苓、白术等药物,多吃烤、炸、煎、炒等动火生热的食物,必然会导致流产或早产。如果见到有其他病症,凡是使用大黄、芒硝等一切金石类降气攻下的药物,都应该禁用。万不得已的情况下,也应该仔细斟酌。不用药时中病即止,不要误人性命。不仅半夏、牛膝等药物应该谨慎,就连茯苓性味沉降也必须慎用。当时的医生不知道这些,所以特意表明出来。总之,孕妇的各种杂症,必须以安胎为主,治疗杂症为辅佐了。
Zhu Danxi discussed that miscarriage caused by insufficient blood to nourish the fetus is like a fruit falling from a withered branch or a flower dropping from a shriveling vine; those caused by labor and anger stirring up internal fire are like wind shaking trees or people breaking branches. These two theories are extremely correct, yet they fail to discuss and differentiate in detail, which explains why pregnant women do not take precautions seriously.
The Chong Mai (Penetrating Vessel) governs the Sea of Blood; only when blood is abundant can the fetus be formed. The Ren Mai (Conception Vessel) governs the Bao Tai (Uterus); quiet rest ensures fetal stability. If anger injures the Liver and labor injures the Kidney, causing dysfunction of these two viscera, the Ministerial Fire consumes blood and disturbs Qi. In such cases, it is impossible to maintain pregnancy without leakage or miscarriage, and postpartum complications such as metrorrhagia and fever often occur.
For individuals with weak constitutions who become pregnant, or those with a history of miscarriage, one must strictly adhere to prenatal education, understand principles of conduct, and emulate the ancient Tai Ren by being diligent and protective. One should maintain upright sitting and lying postures, avoid improper sights and sounds, not indulge in exclusive favor, delegate household matters to maids and maternal relatives, harbor no jealousy, and keep anger from the heart. Regarding food and medicine, all prohibitions must be observed without violation. Thus, fire remains dormant, blood is abundant to nurture conception, the body is not overworked, Qi is complete, and the fetus is secure. Moreover, the child will have a sound constitution, be easy to raise, and possess a dignified posture. Furthermore, repeated miscarriages cause blood loss far exceeding that of normal childbirth. Miscarriage due to anger and labor is self-inflicted. Those with weak constitutions should consider having offspring sufficient for their needs and not let minor grievances harm major interests, thereby avoiding the worry of having no descendants.
Bu Mu Gu Tai Yin (Mother-Nourishing Fetus-Securing Decoction) (Avoid eating small carp and Amaranth)
Bai Zhu (Atractylodis Rhizoma, 2 qian) Dang Gui (Angelicae Sinensis Radix, 2 qian) Shu Di Huang (Rehmanniae Radix Praeparata, 2 qian) Chen Pi (Citri Reticulatae Pericarpium, 3 fen) Zi Su (Perillae Folium, 3 fen) Sha Ren (Amomi Fructus Rotundus, 3 fen) Gan Cao (Glycyrrhizae Radix et Rhizoma, 3 fen) Ren Shen (Ginseng Radix, 1 qian) Tiao Qin (Scutellariae Radix, 8 fen) Zhi Cao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle, 5 fen) Da Zao (Jujubae Fructus, 2 pieces)
Pregnant women accidentally consuming Amaranth: various medical texts record this to inform weak women. To ensure the longevity of the child, one must believe in the prescription and take it monthly. From the fourth to sixth month of pregnancy, accidental consumption of Amaranth, or taking insufficient doses of herbs like Scutellariae Radix and Atractylodis Rhizoma, or consuming excessive amounts of roasted, fried, pan-fried, or stir-fried foods that generate heat and fire, will inevitably lead to miscarriage or premature delivery. If other symptoms appear, all drugs such as Rhubarb (Rhei Radix et Rhizoma), Mirabilite (Natrii Sulfas), and other mineral-based descending purgatives should be strictly contraindicated. In extreme necessity, careful consideration is required. Stop medication once the disease is cured; do not endanger lives. Not only Ban Xia (Pinelliae Rhizoma) and Niu Xi (Achyranthis Bidentatae Radix) require caution, but also Fu Ling (Poria) due to its descending nature, which must be used carefully. Contemporary physicians are unaware of this, so it is specifically highlighted. In summary, for miscellaneous diseases in pregnant women, securing the fetus must be the primary principle, while treating miscellaneous diseases serves as an adjuvant.