〔痰逆不食〕
恶阻谓呕吐恶心,头眩恶食择食是也。
〔千金〕凡妇人虚羸,血气不足,肾气又弱,或当风饮冷太过,心下有痰水者,欲
有胎而喜病阻,所谓欲有胎者,其人月水尚来,颜色肌肤如常,但苦沉重愦闷,不欲食
饮,又不知其患所在,脉理顺时平和,则是欲有娠也。如此经二月日后,便觉不通,则
结胎也。阻病者,患心中愦愦,头重眼眩,四肢沉重,懈惰不欲执作,恶闻食气,欲啖咸
酸果实,多卧少起,世谓恶食,其至三四月日以上,皆大剧吐逆,不能自胜举也。此由
经血既闭,水渍于脏,脏气不宣通,故心烦愦闷,气逆而呕吐也。血脉不通,经络痞涩,
则四肢沉重,挟风则头目眩也。觉如此候者,便宜服半夏茯苓汤数剂,后将茯苓丸痰水消
除,便欲食也。既得食力,体强气壮,力足养胎,母便健矣。
〔大全〕妊娠禀受怯弱,便有阻病,其状颜色如故,脉息和顺,但觉肢体沉重,头
目昏眩,择食,恶闻食气,好食咸酸,甚者或作寒热,心中愦闷,呕吐痰水,恍惚不能
支持,巢氏谓之恶阻,但证有轻重耳。轻者不服药亦不妨,重者须以药疗之《千金方》以
半夏茯苓汤、茯苓丸专治阻病,然此二药比来少有服者,以半夏有动胎之性,盖胎初结,
虑其易散,此不可不谨也。张仲景《伤寒论》有用黄龙汤者,小柴胡汤中去半夏是也。
此盖为妊娠而设焉。王子亨则有白术散,《局方》则人参丁香散,杨振则有人参橘皮汤,齐
士明则有醒脾饮,皆不用半夏,用之多效。李茂翁云∶若左脉弱而呕,服诸药不止者,当
服理血归原药则愈,经云∶无阴则呕是也。
〔薛〕前证若中脘停痰,用二陈汤加枳壳。若饮食停滞,用六君子加枳壳。
若脾胃虚弱,用异功散。若胃气不足,用人参橘皮汤,兼气恼加枳壳,胸胁痞闷,再加苏梗,胁
痛再加柴胡。若饮食少思,用六君子加紫苏、枳壳。头晕体倦,用六君子汤。若脾胃虚弱,
呕吐不食,用半夏茯苓汤。盖半夏乃健脾气化痰滞之主药也。脾胃虚弱而呕吐,或痰涎
壅滞,饮食少思,胎不安,必用茯苓半夏汤倍加白术。然半夏、白术。茯苓、陈皮、砂
仁,善能安胎气健脾胃,予尝用之验矣。痰逆不食证,因食停滞,用半夏茯苓汤加枳壳,
兼气恼更加柴胡。因痰壅滞,用半夏茯苓汤加白术。因风寒外伤,用参苏饮。饮食腹胀,
用香砂六君子汤,寒热呕吐,人参养胃汤。一妊娠呕吐恶食,体倦嗜卧,此胃气虚而恶
阻也,用人参橘皮汤,二剂渐愈;又用六君加紫苏,二剂而安。一妊娠吞酸恶心,时
欲作呕,此因脾胃虚而饮食停滞,用六君加枳壳、香附,治之而愈。一妊妇停食腹满,
呕吐吞酸,作泻不食,余以为饮食停滞,兼肝木伤脾土,用六君子汤以健脾胃,加苍术、
浓朴以消饮食,吴茱萸所制黄连以清肝火,诸证悉愈。又以六君加砂仁调理,而脾土乃安。
一妊妇呕吐胁胀,或寒热往来,面色青黄,此木旺而克脾土,用六君子加柴胡、桔梗、枳
壳而安。一妊妇呕吐酸水,胸满不食,此脾土虚而肝木所侮,用六君子加芍药而愈。
一妊妇胸腹膨胀,吐痰不食,此脾胃虚而饮食为痰,用半夏茯苓汤渐愈,又用六君子加
枳壳、苏梗、桔梗而饮食如常。后因恚怒,胁胀不食,吐痰恶心,用半夏茯苓汤加柴胡、山
栀而愈。
汪石山治一妇形质瘦小,面色近紫,产后年余,经水不通,首夏忽病呕吐,手指麻
痹,拳不能伸展,声音哑小,哕不出声,医皆视为风病危之。汪诊脉皆细微近滑、曰∶此
妊娠恶阻病也。众谓经水不通,安有妊理?汪曰∶天下之事,有常有变,此乃事之变也。脉
虽细微,似近于滑,又尺按不绝,乃妊娠也。遂以四君子加二陈治之,诸证俱减,尚畏粥
汤,惟食干糕香燥之物,而有生意。
给事游让溪夫人,病新愈月余,经事不行,呕哕眩晕,饮食艰进,医以为二阳之病
发心脾,女子不月,法在不治,江 诊之,尺脉虽小,按之滑而不绝,此妊而恶阻,非
凶候也。六君加砂仁,数服而安,后产一女。
〔金匮〕妇人得平脉,阴脉小弱,其人渴不能食,无寒热,名妊娠,桂枝汤主之。于
法六十日当有此证,设有医治逆者,却一月加吐下者,则绝之。娄全善曰∶绝之者,谓
绝止医治,候其自安也。予尝治一二妇阻病吐,愈治愈逆,因思仲景绝之之旨,遂停药
月余自安。真大哉!圣贤之言也。
《万全方》云∶凡妊娠恶食者,以所思食任意食之必愈。
仲景云∶妊娠呕吐不止,干姜人参半夏丸主之。
干姜人参半夏丸
干姜 人参(各一两) 半夏(汤洗去滑,二两)
上三味末之,以生姜汁糊为丸,如梧子大,饮服十丸,日三服。
半夏茯苓汤 治妊娠恶阻,呕吐心烦,头目眩晕,恶闻食气,好食酸咸,多卧少起,百
节烦疼,羸瘦有痰,胎孕不牢。
半夏(洗,一两二钱半) 赤茯苓 熟地黄(各七钱半) 橘红 旋复花(《千金方》无旋复,有细
辛、紫苏) 人参 芍药 川芎 桔梗 甘草(各半两)
上 咀,每服五钱,姜七片,水煎空心服,兼服茯苓丸。若有客热,烦渴口疮,去
橘红、细辛,加前胡、知母七钱半。若腹冷下痢,去地黄加炒桂心半两。若胃中虚热,大
便秘,小便赤涩,加大黄七钱半,去地黄,加黄芩二钱五分。
茯苓丸 治妊娠阻病,心中烦闷,吐痰眩晕,先服半夏茯苓汤两剂,后服此药。
赤茯苓 人参 桂心 干姜 半夏(汤泡七次,炒黄) 橘皮(各一两) 白术 葛根
甘草 枳壳(各二两)
上为细末,炼蜜丸如桐子大,每服五十丸,米饮下,日三服。一方加麦门冬。《肘
后》加五味子。
疗妊娠心胸支满,痰逆不思饮食。
赤茯苓 前胡 白术 紫苏叶(各一两) 半夏 麦门冬 人参 大腹皮(各半两)
上为粗末,每服四钱,水一盏,姜五片,煎至七分,去滓温服。一方无腹皮、人参、有
大腹子槟榔。
疗妊娠心膈气滞,呕吐不下,饮水,心神虚烦,四肢少力。
枇杷叶 半夏 麦门冬 人参 甘草(半两) 诃子肉 藿香(各一两) 赤茯苓 枳壳 陈皮(各七钱半)
上 咀,每服三钱,水一盏,姜三片,枣一枚,煎至七分,去滓温服。一方无诃子及枣。
《集验》疗妇人妊娠恶阻,呕吐不下食。
青竹茹 橘皮(各三两) 生姜 茯苓(各四两) 半夏(五两)
上细切,以水六升,煮取二升半,去滓分三服,不瘥频服。忌羊肉、饧、 等物。
旋复半夏汤 治妊娠恶阻,吐逆酸水,恶闻食气,多卧少起。
旋复花(去枝萼) 川芎 细辛(去土) 人参 甘草(炙,各七分) 当归(去芦)
半夏(汤泡) 赤茯苓(去皮) 干生姜 陈皮(去白,各一钱五分)
上作一服,水二盅,姜五片,煎至一盅,不拘时服。
旋复花汤 治妊娠六七个月,胎不安,呕吐。
旋复花(五分) 浓朴 白术 枳壳 黄芩 茯苓(各一钱五分) 半夏 芍药 生姜(各一钱)
上作一服,水二盅,煎至一盅,食前服。
上诸方并用半夏,盖取其辛以散结气,泻逆气,故呕恶自止,非专为痰设也。 娄全
善曰∶《大全》方论半夏动胎而不用,仲景方乃用之。予治妊娠阻病累用半夏,未尝动胎
也。经云∶有故无殒是也。
白术散 治恶阻吐清水,甚者害十余日水浆不入。
白术(一两) 人参(半两) 丁香(二钱半) 甘草(一钱)
上为细末,每服二钱,水一盏,姜五片,煎至七分,温服。
人参丁香散 (二方。)治妊娠恶阻,胃寒呕逆,翻胃吐食,及心腹刺痛。
人参 丁香 藿香叶(各二钱半)
上为散,每服三钱,水一盏,煎七分,去滓温服,无时。
又方
人参 丁香 柿蒂(各二两) 甘草 良姜(各半两)
上为细末,每服二钱,热汤点下,无时。
醒脾饮子 治妊妇阻病,呕逆不食,甚者中满,口中无味,或作寒热。(此出王氏《博济方》。)
草豆蔻(以湿纸裹,灰火中煨令纸干,取出去皮用) 浓朴(姜制,各半两) 干姜(一两)
甘草(一两二钱半)
上为细末,每服二大钱,水一大盏,枣二枚,生姜三片,煎至八分,去滓呷服。
病轻者只一两服,便能食。旧有橘红二两,治寒热疟痢不食,后人去橘皮以干生姜代。干
姜治老人气虚,大便秘,少津液引饮有奇效。产科医官齐士明依旧用干姜去橘皮,亦名醒
脾饮子,治阻病极神验。
上诸方与前茯苓丸并用,丁香、干姜,惟中寒脉迟者宜之。
人参橘皮汤 治阻病呕吐痰水。
人参 橘皮 白术 麦门冬(去心,各一两) 甘草(三钱) 浓朴(制) 白茯苓(各五钱)
为粗末,每四钱加淡竹茹弹子大,姜三片,水同煎。
治妊娠呕吐不食,兼吐痰水。
生芦根(七分) 橘红(四分) 生姜(六分) 槟榔(二分) 枇杷叶(三分)
上切,水二盏,煎七分,空心热服。
治妊娠恶食,心中烦愦,热闷呕吐。
青竹茹 麦门冬(各三两) 前胡(二两) 橘皮(一两) 芦根(一握,如体热,四肢烦热者,
加地骨皮一握。)
上切细,以水一大升,煮半升,去渣,分两服,食前。
上诸方内用门冬、竹茹、芦根,皆气凉而性和,有热无寒者通用之平剂也。
治妊娠恶食《古今录验方》
人参(四两) 浓朴 生姜 枳壳 甘草(各二两)
水六升,煮取三升,分三服。
归原散 治妊娠恶阻,呕吐不止,头痛,全不入食,服诸药无效者,用此药理血归原
则愈。
人参 甘草 川芎 当归 芍药 丁香(各半两) 白茯苓 白术 陈皮(各一两五钱)
桔梗(炒) 枳壳(去瓤炒,各二钱半) 半夏(汤洗七次,切、炒黄、一两)
上 咀,每服三钱,生姜五片,枣一枚,水同煎。
安胎饮 治怀胎三月、四月至九个月,日呕吐痰水,心中愦闷,头重目眩,恶闻食气,
或胎动不安,腰腹疼痛,或时下血,及妊娠一切疾病,并皆治之。
甘草 茯苓 当归 熟地黄 川芎 白术 黄 白芍药 半夏(汤泡七次,切,炒)
阿胶(切,粉炒) 地榆(各等分)
上 咀,每服三钱,生姜四片,水煎温服,无时候。一方无半夏,地榆,有人参、桑
寄生,一方无 、术、半夏、地榆,有艾叶,只是胶艾汤加白茯苓。
小地黄丸 治妊娠恶心,呕吐清水,腹疼不食。
人参(去芦) 干姜(炮,各等分)
上为细末,以生地黄汁和为丸,如桐子大。每服五十丸,食前米饮送下。
上方并理血之剂。李茂翁所谓左脉弱而呕,服诸药不止者,服理血归原药则愈,即
此类是也。
保生汤 治妇人经候不行,身无病而似病,脉滑大而六脉俱匀,乃是孕妇之脉也。精
神如故,恶闻食臭,或但嗜一物,或大吐,或时吐清水,此名恶阻。切勿作寒病治之,宜
服此药。如觉恶心呕吐,加丁香、生姜煎服。(温隐居方)
人参 甘草(各二钱半) 白术 香附子 乌药 橘红(各半两)
上 咀,每服三大钱,水一盏半,姜五片,煎至七分,去滓温服,无时。或作末子
调服。
白术散 治妊娠胎气不和,饮食少进。
白术(炒) 紫苏(各一钱) 人参(二钱) 青皮(去白) 诃子肉 川芎(各八分) 甘草(炙,半钱)
上作一服,水二盅,姜三片,煎至一盅,不拘时服。
二香散 治妊娠胎动不安,气不升降,饮食不美,呕吐酸水,起坐觉重。
香附子(一两) 藿香叶 甘草(各三钱)
上为细末,每服二钱,不拘时,沸汤调下。
《补遗》予尝给妊妇恶阻,呕吐不食,头晕不敢行步,以苦柚皮浓煎汤,饮数盏而愈、
吐甚者,加姜汁。
又方 缩砂仁末,每二钱,姜汤调下,或米饮调。
上方并理气之剂。气虚者首二方为宜;气不顺者,第三方为宜。
〔娄〕一妇人孕三月,吐痰水并饮食,每日寅卯时作,作时觉少腹有气冲上,然后
膈满而吐,面赤微躁,头眩卧不起床,四肢疼,微渴,此肝火挟冲脉之火冲上也。一日
甚,一日轻,脉和右寸洪大,百药不效,将二月。予男病,偶用沉香磨水,化抱龙丸一
服,膈宽气不上冲,二三服吐止,眩减,食进而安。又应氏妇嘈杂吐食,脉壅,心下
满塞,气攻背,两肘皆痛,要人不住手以热物摩熨,得吐稍疏,脉洪大,处此方。
黄连(一钱) 黄芩(二钱半,各炒) 白术 半夏(各一钱) 甘草(炙) 缩砂(各五分)
陈皮 当归 山栀 枳壳(炒) 香附 人参 苍术(各一钱) 茯苓(一钱半) 生姜(七片)
服二帖后,嘈杂、吐止,心满塞退,但于夜间背肘痛,用摩熨,遂与抱龙丸化服,其
疾如失。
〔丹〕一妇人年近三十,怀孕两月,病呕吐头眩,自觉不可禁持。以人参、白术、川
芎、陈皮、茯苓等药,服五七日,愈觉沉重。召予脉之,两手弦,左为甚,而且弱。予曰∶
【痰气上逆导致不能进食】
恶阻是指妊娠期间出现的呕吐恶心、头晕目眩、厌恶食物或偏食等症状。
〔《千金方》〕凡是身体虚弱消瘦、气血不足、肾气又弱的妇女,如果感受风邪、过饮冷水,或者心下有痰饮停聚,想要怀孕时容易患上恶阻病。所谓“想要怀孕”,是指该女子月经尚且正常来潮,面色和肌肤状态如常,只是感到身体沉重烦闷,不想饮食,又不知道病因在哪里,脉象在平常时候平和,这就是将要受孕的表现。像这样经过两个月后,如果感觉月经停止不通,那就是已经结胎了。患恶阻病的患者,心中烦闷不舒,头重眼眩,四肢沉重,懈怠懒惰不想劳作,厌恶闻见食物的气味,想吃咸酸的水果,喜欢多卧少起,世人称之为“恶食”。到了三四月以上,往往出现严重的呕吐逆气,身体虚弱到无法支撑举起。这是由于经血闭止后,水湿浸渍于脏腑,脏气不能宣通,所以心烦意乱、胸闷气逆而呕吐。血脉不通,经络阻滞涩滞,所以四肢沉重;兼夹风邪则头目眩晕。感觉到这些症状的,应当立即服用半夏茯苓汤几剂,随后服用茯苓丸以消除痰饮水湿,就能产生食欲了。一旦获得饮食的营养,身体强壮、气息充沛,精力足以滋养胎儿,母亲也就健康了。
〔《妇人大全良方》〕妊娠期间禀赋怯弱的人,就会发生恶阻病,其症状表现为面色如故,脉息和顺,只觉得肢体沉重,头目昏眩,偏食,厌恶闻见食物气味,喜好咸酸口味,严重的甚至出现寒热交替,心中烦闷,呕吐痰水,精神恍惚难以支持。巢元方称之为恶阻,只是证候有轻重之分。轻者不服药也无妨,重者必须用药治疗。《千金方》用半夏茯苓汤、茯苓丸专门治疗恶阻病,然而近来很少有人服用这两种药,因为半夏有动胎气的性质,大概是因为胎气初结,担心它容易消散,这是不可不谨慎的。张仲景《伤寒论》中有使用黄龙汤(注:此处原文可能有误,通常指小柴胡汤类方,但依原文翻译)的记载,即在小柴胡汤中去掉半夏。这大概是专门为妊娠而设立的。王子亨则有白术散,《太平惠民和剂局方》有人参丁香散,杨振有人参橘皮汤,齐士明有醒脾饮,都不用半夏,用了半夏大多有效。李茂翁说:如果左脉弱且呕吐,服用各种药物无效,应当服用理血归原的药物才能痊愈,经书说:“无阴则呕”就是这个意思。
〔薛己〕前面的证候如果是中脘停痰,用二陈汤加枳壳。如果是饮食停滞,用六君子汤加枳壳。如果是脾胃虚弱,用异功散。如果是胃气不足,用人参橘皮汤,兼有气恼加枳壳,胸胁痞闷再加苏梗,胁痛再加柴胡。如果是饮食减少思虑,用六君子汤加紫苏、枳壳。头晕体倦,用六君子汤。如果是脾胃虚弱,呕吐不食,用半夏茯苓汤。因为半夏是健脾气、化痰滞的主要药物。脾胃虚弱而呕吐,或者痰涎壅滞,饮食少思,胎不安,必须用茯苓半夏汤倍加白术。然而半夏、白术、茯苓、陈皮、砂仁,善于安定胎气、健运脾胃,我曾经使用过并验证有效。痰气上逆不食的证候,因饮食停滞,用半夏茯苓汤加枳壳,兼有气恼更加柴胡。因痰浊壅滞,用半夏茯苓汤加白术。因风寒外感,用参苏饮。饮食腹胀,用香砂六君子汤,寒热呕吐,用人参养胃汤。有一个孕妇呕吐恶食,体倦嗜卧,这是胃气虚导致的恶阻,用人参橘皮汤,两剂后逐渐痊愈;又用六君子汤加紫苏,两剂后安宁。有一个孕妇吞酸恶心,时常想呕吐,这是因为脾胃虚而饮食停滞,用六君子汤加枳壳、香附,治疗后痊愈。有一个孕妇停食腹满,呕吐吞酸,腹泻不食,我认为是饮食停滞,兼肝木损伤脾土,用六君子汤以健运脾胃,加苍术、厚朴以消导饮食,吴茱萸制的黄连以清肝火,各种症状全部痊愈。又以六君子汤加砂仁调理,脾土才安宁。有一个孕妇呕吐胁胀,有时寒热往来,面色青黄,这是肝木旺盛克制脾土,用六君子汤加柴胡、桔梗、枳壳而安宁。有一个孕妇呕吐酸水,胸满不食,这是脾土虚而受肝木侮逆,用六君子汤加芍药而痊愈。有一个孕妇胸腹膨胀,吐痰不食,这是脾胃虚而饮食化为痰,用半夏茯苓汤逐渐痊愈,又用六君子汤加枳壳、苏梗、桔梗而饮食恢复正常。后来因为愤怒,胁胀不食,吐痰恶心,用半夏茯苓汤加柴胡、山栀而痊愈。
汪石山治疗一个妇人形体瘦小,面色近紫,产后一年多,月经不通,初夏忽然患病呕吐,手指麻木麻痹,拳头不能伸展,声音哑小,呃逆不出声,医生都视为风病认为危险。汪石山诊脉皆细微近滑,说:“这是妊娠恶阻病。”众人说月经不通,哪有怀孕的道理?汪石山说:“天下的事,有常有变,这是事之变也。脉虽然细微,似乎接近滑脉,而且尺部按之不绝,这是妊娠。”于是用四君子汤加二陈汤治疗,各种症状都减轻,还害怕喝粥汤,只吃干糕香燥的食物,而有生机。
给事游让溪夫人,生病新愈月余,月经不行,呕哕眩晕,饮食难进,医生认为是二阳之病发于心脾,女子不月经,法度上属于不治之症,江应宿诊察她,尺脉虽小,按之滑而不绝,这是妊娠而恶阻,不是凶险的征候。用六君子汤加砂仁,服几剂后安宁,后来生了一个女儿。
〔《金匮要略》〕妇人得到平脉,阴脉小弱,其人口渴不能食,无寒热,名为妊娠,用桂枝汤主治。按照法度六十日应当有此证,如果有医治不当反而加重,过一个月出现呕吐下利的,就停止治疗。娄全善说:“绝之者,是说停止医治,等待其自我安宁。”我曾经治疗一两个妇女恶阻呕吐,越治越逆,因此想到仲景“绝之”的宗旨,于是停药月余自己安宁。真是伟大啊!圣贤的话。
《万全方》说:“凡是妊娠恶食的,以所想的吃的任意吃它,必定痊愈。”
干姜人参半夏丸
干姜 人参(各一两) 半夏(汤洗去滑,二两)
将这三味药研成末,用生姜汁糊制成丸,如梧桐子大,温水送服十丸,每日三次。
半夏茯苓汤 治疗妊娠恶阻,呕吐心烦,头目眩晕,厌恶闻见食物气味,喜好酸咸,多卧少起,全身关节烦疼,消瘦有痰,胎孕不牢。
半夏(洗,一两二钱半) 赤茯苓 熟地黄(各七钱半) 橘红 旋复花(《千金方》无旋复花,有细辛、紫苏) 人参 芍药 川芎 桔梗 甘草(各半两)
切碎,每服五钱,生姜七片,水煎空腹服,同时服用茯苓丸。如果有客热,烦渴口疮,去掉橘红、细辛,加前胡、知母七钱半。如果腹冷下痢,去掉地黄加炒桂心半两。如果胃中虚热,大便秘结,小便赤涩,加大黄七钱半,去掉地黄,加黄芩二钱五分。
茯苓丸 治疗妊娠恶阻病,心中烦闷,吐痰眩晕,先服半夏茯苓汤两剂,后服此药。
赤茯苓 人参 桂心 干姜 半夏(汤泡七次,炒黄) 橘皮(各一两) 白术 葛根 甘草 枳壳(各二两)
研为细末,炼蜜制成丸如桐子大,每服五十丸,米饮送下,每日三次。一方加麦门冬。《肘后备急方》加五味子。
治疗妊娠心胸支满,痰气上逆不思饮食。
赤茯苓 前胡 白术 紫苏叶(各一两) 半夏 麦门冬 人参 大腹皮(各半两)
研为粗末,每服四钱,水一盏,生姜五片,煎至七分,去渣温服。一方无腹皮、人参,有大腹子槟榔。
治疗妊娠心膈气滞,呕吐不下,饮水,心神虚烦,四肢少力。
枇杷叶 半夏 麦门冬 人参 甘草(半两) 诃子肉 藿香(各一两) 赤茯苓 枳壳 陈皮(各七钱半)
切碎,每服三钱,水一盏,生姜三片,枣一枚,煎至七分,去渣温服。一方无诃子及枣。
《集验方》治疗妇人妊娠恶阻,呕吐不下食。
青竹茹 橘皮(各三两) 生姜 茯苓(各四两) 半夏(五两)
细切,用水六升,煮取二升半,去渣分三次服,不好再频服。忌羊肉、饴糖等物。
旋复半夏汤 治疗妊娠恶阻,吐逆酸水,厌恶闻见食物气味,多卧少起。
旋复花(去枝萼) 川芎 细辛(去土) 人参 甘草(炙,各七分) 当归(去芦) 半夏(汤泡) 赤茯苓(去皮) 干生姜 陈皮(去白,各一钱五分)
作一服,水二盅,生姜五片,煎至一盅,不拘时候服。
旋复花汤 治疗妊娠六七个月,胎不安,呕吐。
旋复花(五分) 厚朴 白术 枳壳 黄芩 茯苓(各一钱五分) 半夏 芍药 生姜(各一钱)
作一服,水二盅,煎至一盅,食前服。
上述各方都用半夏,大概是取其辛味以散结气,泻逆气,所以呕恶自然停止,并非专为痰设。娄全善说:“《大全》方论半夏动胎而不用,仲景方乃用之。我治疗妊娠恶阻病多次用半夏,未曾动胎。经书说:‘有故无殒’就是这个意思。”
白术散 治疗恶阻吐清水,严重的害病十余日水浆不入。
白术(一两) 人参(半两) 丁香(二钱半) 甘草(一钱)
研为细末,每服二钱,水一盏,生姜五片,煎至七分,温服。
人参丁香散 (二方。)治疗妊娠恶阻,胃寒呕逆,翻胃吐食,及心腹刺痛。
人参 丁香 藿香叶(各二钱半)
研为散,每服三钱,水一盏,煎七分,去渣温服,不拘时候。
又方
人参 丁香 柿蒂(各二两) 甘草 良姜(各半两)
研为细末,每服二钱,热汤点下,不拘时候。
醒脾饮子 治疗妊妇恶阻病,呕逆不食,严重的中满,口中无味,或作寒热。(此出王氏《博济方》。)
草豆蔻(以湿纸裹,灰火中煨令纸干,取出去皮用) 厚朴(姜制,各半两) 干姜(一两) 甘草(一两二钱半)
研为细末,每服两大钱,水一大盏,枣二枚,生姜三片,煎至八分,去渣呷服。
病轻者只一两服,便能食。旧方有橘红二两,治疗寒热疟痢不食,后人去掉橘皮以干生姜代替。干姜治疗老人气虚,大便秘结,少津液引饮有奇效。产科医官齐士明依旧用干姜去掉橘皮,也叫醒脾饮子,治疗恶阻病极神验。
上述各方与前茯苓丸并用,丁香、干姜,只有中寒脉迟者适宜用之。
人参橘皮汤 治疗恶阻病呕吐痰水。
人参 橘皮 白术 麦门冬(去心,各一两) 甘草(三钱) 厚朴(制) 白茯苓(各五钱)
为粗末,每四钱加淡竹茹弹子大,生姜三片,水同煎。
治疗妊娠呕吐不食,兼吐痰水。
生芦根(七分) 橘红(四分) 生姜(六分) 槟榔(二分) 枇杷叶(三分)
切碎,水二盏,煎七分,空腹热服。
治疗妊娠恶食,心中烦愦,热闷呕吐。
青竹茹 麦门冬(各三两) 前胡(二两) 橘皮(一两) 芦根(一握,如体热,四肢烦热者,加地骨皮一握。)
切碎细,用水一大升,煮半升,去渣,分两次服,食前。
上述各方内用门冬、竹茹、芦根,都是气凉而性平和,有热无寒者通用的平剂。
治疗妊娠恶食《古今录验方》
人参(四两) 厚朴 生姜 枳壳 甘草(各二两)
水六升,煮取三升,分三次服。
归原散 治疗妊娠恶阻,呕吐不止,头痛,完全不能进食,服用各种药物无效者,用此药理血归原则痊愈。
人参 甘草 川芎 当归 芍药 丁香(各半两) 白茯苓 白术 陈皮(各一两五钱) 桔梗(炒) 枳壳(去瓤炒,各二钱半) 半夏(汤洗七次,切、炒黄、一两)
切碎,每服三钱,生姜五片,枣一枚,水同煎。
安胎饮 治疗怀胎三月、四月至九个月,每日呕吐痰水,心中烦闷,头重目眩,厌恶闻见食物气味,或胎动不安,腰腹疼痛,或时下血,以及妊娠一切疾病,都治疗。
甘草 茯苓 当归 熟地黄 川芎 白术 黄芪 白芍药 半夏(汤泡七次,切,炒) 阿胶(切,粉炒) 地榆(各等分)
切碎,每服三钱,生姜四片,水煎温服,不拘时候。一方无半夏,地榆,有人参、桑寄生,一方无黄芪、白术、半夏、地榆,有艾叶,只是胶艾汤加白茯苓。
小地黄丸 治疗妊娠恶心,呕吐清水,腹痛不食。
人参(去芦) 干姜(炮,各等分)
研为细末,以生地黄汁和为丸,如桐子大。每服五十丸,食前米饮送下。
上方都是理血的药剂。李茂翁所谓左脉弱而呕,服用各种药物无效者,服用理血归原药则痊愈,就是这一类的。
保生汤 治疗妇人月经不行,身无病而似病,脉滑大而六脉俱匀,乃是孕妇之脉也。精神如故,厌恶闻见食物臭味,或但嗜一物,或大吐,或时吐清水,此名恶阻。切勿当作寒病治疗,宜服此药。如觉恶心呕吐,加丁香、生姜煎服。(温隐居方)
人参 甘草(各二钱半) 白术 香附子 乌药 橘红(各半两)
切碎,每服三大钱,水一盏半,生姜五片,煎至七分,去渣温服,不拘时候。或作末子调服。
白术散 治疗妊娠胎气不和,饮食少进。
白术(炒) 紫苏(各一钱) 人参(二钱) 青皮(去白) 诃子肉 川芎(各八分) 甘草(炙,半钱)
作一服,水二盅,生姜三片,煎至一盅,不拘时候服。
二香散 治疗妊娠胎动不安,气不升降,饮食不美,呕吐酸水,起坐觉重。
香附子(一两) 藿香叶 甘草(各三钱)
研为细末,每服二钱,不拘时候,沸汤调下。
《补遗》我曾经治疗妊妇恶阻,呕吐不食,头晕不敢行步,用苦柚皮浓煎汤,饮数盏而痊愈、吐甚重的,加姜汁。
又方 缩砂仁末,每二钱,姜汤调下,或米饮调。
上方都是理气的药剂。气虚者首二方为宜;气不顺者,第三方为宜。
〔娄全善〕一个妇人怀孕三个月,吐痰水并饮食,每日寅卯时发作,发作时觉得少腹有气冲上,然后膈满而吐,面赤微躁,头眩卧不起床,四肢疼,微渴,这是肝火挟冲脉之火冲上也。一日重,一日轻,脉和右寸洪大,百药不效,将近两个月。我儿子生病,偶然用沉香磨水,化抱龙丸一服,膈宽气不上冲,二三服吐止,眩减,食进而安宁。又应氏妇嘈杂吐食,脉壅,心下满塞,气攻背,两肘皆痛,要人不住手以热物摩熨,得吐稍疏,脉洪大,开此方。
黄连(一钱) 黄芩(二钱半,各炒) 白术 半夏(各一钱) 甘草(炙) 缩砂(各五分) 陈皮 当归 山栀 枳壳(炒) 香附 人参 苍术(各一钱) 茯苓(一钱半) 生姜(七片)
服二帖后,嘈杂、吐止,心满塞退,但于夜间背肘痛,用摩熨,遂与抱龙丸化服,其疾如失。
〔朱丹溪〕一个妇人年近三十,怀孕两月,病呕吐头眩,自觉不可禁持。以人参、白术、川芎、陈皮、茯苓等药,服五七日,愈觉沉重。召予脉之,两手弦,左为甚,而且弱。我说:
[Phlegm-Rebellion and Inability to Eat]
Ezu (Morning Sickness) refers to vomiting, nausea, dizziness, aversion to food, or selective eating during pregnancy.
[From *Qianjin Fang*] Whenever a woman is physically weak and emaciated, deficient in Qi and Blood, and has weak Kidney Qi, or if she is exposed to wind and drinks too much cold liquid, causing phlegm-fluid retention under the Heart, she is prone to Ezu when conceiving. The phrase "prone to conceiving" means that although her menstruation still comes regularly, and her complexion and skin appear normal, she suffers from heaviness and mental restlessness, lacks appetite, and does not know the cause of her ailment. Her pulse is smooth and peaceful, indicating impending pregnancy. After two months, if menstruation ceases, conception is confirmed. Patients with Ezu suffer from mental restlessness, heavy head and dizzy eyes, heavy limbs, lethargy and unwillingness to work, aversion to the smell of food, craving for salty and sour fruits, preferring to lie down more than get up. This is commonly called "aversion to food." By the third or fourth month, severe vomiting and rebellion of Qi may occur, making it unbearable. This is caused by the closure of menstrual blood, where water-dampness infiltrates the Zang organs, preventing their Qi from circulating freely, resulting in mental restlessness and vomiting due to rebellious Qi. When blood vessels are blocked and meridians are stagnant, limbs become heavy; if accompanied by Wind, the head and eyes become dizzy. Upon noticing these signs, one should promptly take Banxia Fuling Tang (Pinellia and Poria Decoction) for several doses, followed by Fuling Wan (Poria Pills) to eliminate phlegm-fluid, which will restore appetite. Once nourished by food, the body becomes strong, Qi robust, and energy sufficient to nourish the fetus, ensuring the mother's health.
[From *Daquan Yifang*] Women with weak constitutions during pregnancy are prone to Ezu. Their appearance remains unchanged, and their pulse is smooth, but they feel heavy limbs, dizzy head and eyes, selective eating, aversion to food smells, and preference for salty and sour tastes. Severe cases may experience alternating chills and fever, mental restlessness, vomiting of phlegm-fluid, and mental confusion making them unable to endure. Chao Yuanfang calls this Ezu, noting variations in severity. Mild cases may not require medication, but severe cases must be treated. *Qianjin Fang* uses Banxia Fuling Tang and Fuling Wan specifically for Ezu. However, these are rarely used recently because Banxia (Pinellia Rhizome) is believed to disturb the fetus. Since the fetus is newly formed, there is concern about miscarriage, so caution is advised. Zhang Zhongjing's *Shanghan Lun* mentions using Huanglong Tang (Yellow Dragon Decoction), specifically Xiaochaihu Tang without Banxia, presumably designed for pregnancy. Wang Ziheng proposed Baizhu San (Atractylodes Powder), *Jufang* offers Ren Shen Dingxiang San (Ginseng and Clove Powder), Yang Zhen offers Ren Shen Jupi Tang (Ginseng and Tangerina Peel Decoction), and Qi Shiming offers Xingpi Yin (Spleen-Awakening Drink). None use Banxia, yet all are effective. Li Maoweng stated: If the Left Pulse is weak with vomiting unresponsive to other medicines, one should take Lixue Guiyuan Yao (Blood-Regulating and Origin-Returning Medicine) to cure it, as the classic states: "Without Yin, there is vomiting."
[Xue Ji] For the above symptoms, if Phlegm stagnates in the Middle Jiao, use Erchen Tang (Two-Cured Decoction) with Zhike (Immature Bitter Orange). If Food Stagnation exists, use Liu Junzi Tang (Six-Gentlemen Decoction) with Zhike. If Spleen-Stomach deficiency is present, use Yigong San (Extraordinary Aid Powder). If Stomach Qi is insufficient, use Ren Shen Jupi Tang; add Zhike for emotional distress, Su Geng (Perilla Stem) for chest/hypochondriac fullness, and Chaihu (Bupleurum Root) for hypochondriac pain. If appetite is poor, use Liu Junzi Tang with Zi Su (Perilla Leaf) and Zhike. For dizziness and fatigue, use Liu Junzi Tang. For Spleen-Stomach weakness with vomiting and anorexia, use Banxia Fuling Tang, as Banxia is the primary herb for strengthening Spleen Qi and resolving Phlegm. For Spleen-Stomach weakness with vomiting, Phlegm-Damp obstruction, poor appetite, and fetal unrest, Banxia Fuling Tang with increased Baizhu (Atractylodes Macrocephala Rhizome) is essential. Banxia, Baizhu, Fuling (Poria), Chenpi (Tangerine Peel), and Sharen (Amomum Fruit) effectively calm the fetus and strengthen the Spleen-Stomach; I have verified their efficacy. For Phlegm-Rebellion and Anorexia due to Food Stagnation, use Banxia Fuling Tang with Zhike; add Chaihu for emotional distress. For Phlegm Obstruction, use Banxia Fuling Tang with Baizhu. For External Wind-Cold, use Rensu Yin (Ginseng and Perilla Drink). For Food Bloating, use Xiangsha Liu Junzi Tang. For Chills/Fever and Vomiting, use Rensongyangwei Tang (Ginseng Stomach-Nourishing Decoction).
Case 1: A pregnant woman with vomiting, anorexia, fatigue, and somnolence had Stomach Qi deficiency Ezu. Treated with Ren Shen Jupi Tang for two doses with gradual improvement, then Liu Junzi Tang with Zi Su for two doses for stability.
Case 2: A pregnant woman with acid regurgitation, nausea, and frequent retching had Spleen-Stomach deficiency with Food Stagnation. Treated with Liu Junzi Tang plus Zhike and Xiangfu (Cyperus Rhizome) for cure.
Case 3: A pregnant woman with food retention, abdominal fullness, vomiting, acid regurgitation, diarrhea, and anorexia was diagnosed with Food Stagnation and Liver Wood overacting on Spleen Earth. Treated with Liu Junzi Tang to strengthen Spleen, Cangzhu (Atractylodes Lancea Rhizome) and Houpo (Magnolia Bark) to resolve food, and Coptis prepared with Evodia to clear Liver Fire. All symptoms resolved. Regulated with Liu Junzi Tang plus Sharen to settle Spleen Earth.
Case 4: A pregnant woman with vomiting, hypochondriac distension, alternating chills/fever, and green-yellow complexion had Exuberant Liver Wood attacking Spleen Earth. Treated with Liu Junzi Tang plus Chaihu, Jiegeng (Platycodon Root), and Zhike for stability.
Case 5: A pregnant woman with vomiting acid water, chest fullness, and anorexia had Deficient Spleen Earth insulted by Liver Wood. Treated with Liu Junzi Tang plus Shaoyao (Peony Root) for cure.
Case 6: A pregnant woman with chest/abdominal distension, vomiting phlegm, and anorexia had Spleen-Stomach deficiency transforming food into Phlegm. Treated with Banxia Fuling Tang for gradual improvement, then Liu Junzi Tang plus Zhike, Su Geng, and Jiegeng to normalize diet. Later, due to anger, she developed hypochondriac distension, anorexia, phlegm vomiting, and nausea. Treated with Banxia Fuling Tang plus Chaihu and Zhizi (Gardenia Fruit) for cure.
Wang Shishan treated a thin woman with purplish complexion who, one year postpartum with amenorrhea, suddenly developed vomiting, finger numbness/inability to extend fists, hoarse voice, and silent hiccups in early summer. Physicians considered it critical Wind disease. Wang palpated fine, slightly slippery pulses and diagnosed Pregnancy Ezu. Others questioned pregnancy given amenorrhea. Wang replied: "There are constants and variables in nature; this is a variable. Though fine, the pulse is slightly slippery, and the Chi position at the wrist is uninterrupted, confirming pregnancy." He treated with Sijunzi Tang (Four-Gentlemen Decoction) plus Erchen Tang. Symptoms subsided. She feared congee but ate dry, aromatic foods, showing vitality.
Madam You Rangxi, wife of a Censor, recovered from illness a month prior, with amenorrhea, hiccups, dizziness, and difficulty eating. Physicians diagnosed "Duo-Yang disease affecting Heart/Spleen," deeming amenorrhea incurable. Jiang Huangnan palpated a small Chi pulse that was slippery and uninterrupted upon pressure, diagnosing Pregnancy Ezu, not a ominous sign. Treated with Liu Junzi Tang plus Sharen; stabilized after several doses, later delivering a daughter.
[From *Jin Gui Yao Lue*] If a woman has a normal pulse, but the Yin pulse (Chi position) is small and weak, and she experiences thirst and inability to eat without chills or fever, it is named Pregnancy. Guizhi Tang (Cinnamon Twig Decoction) is indicated. According to method, this symptom appears around sixty days. If improper treatment causes vomiting or purging after one month, stop treatment ("Jue Zhi"). Lou Quanshan explained: "Jue Zhi" means stopping medical intervention and waiting for self-healing. I once treated women with Ezu vomiting who worsened with treatment. Recalling Zhongjing's principle, I stopped medication for over a month, and they healed naturally. How profound are the words of sages!
*Wan Quan Fang* states: "For pregnant women with food aversion, allowing them to eat whatever they crave will cure them."
Zhongjing stated: "For persistent vomiting in pregnancy, Ganjiang Renshen Banxia Wan (Dried Ginger, Ginseng, and Pinellia Pill) is indicated."
**Ganjiang Renshen Banxia Wan**
Ganjiang (Dried Ginger) and Renshen (Ginseng Root) (1 liang each); Banxia (Pinellia Rhizome, washed in hot water to remove slipperiness) (2 liang).
Grind the three ingredients into powder, mix with fresh ginger juice to form pills the size of wutong seeds. Take 10 pills with warm water, three times daily.
**Banxia Fuling Tang**
Indicated for Pregnancy Ezu, vomiting, mental restlessness, dizziness, aversion to food smells, craving for sour/salty tastes, preference for lying down, joint pain, emaciation with phlegm, and unstable pregnancy.
Banxia (washed) (1.25 qian); Chifuling (Red Poria), Shudihuang (Prepared Rehmannia Root) (0.75 qian each); Juhong (Red Tangerina Peel), Xuanfuhua (Inula Flower - note: *Qianjin Fang* omits Xuanfuhua, adds Xixin and Zisu); Renshen, Shaoyao, Chuanxiong, Jiegeng, Gancao (Licorice Root) (0.5 liang each).
Chop ingredients. Take 5 qian per dose with 7 slices of ginger, decoct in water, take on an empty stomach. Also take Fuling Wan.
Modifications: For external heat, irritability, thirst, mouth ulcers: remove Juhong and Xixin, add Qianhu (Peucedanum Root) and Zhimu (Anemarrhena Rhizome) (0.75 qian). For cold abdomen and diarrhea: remove Dihu, add fried Guixin (Cinnamon Bark) (0.5 liang). For deficiency heat in stomach, constipation, dark/scanty urine: add Dahuang (Rhubarb Root) (0.75 qian), remove Dihu, add Huangqin (Scutellaria Root) (0.25 liang).
**Fuling Wan**
Indicated for Pregnancy Ezu, mental restlessness, vomiting phlegm, dizziness. Take Banxia Fuling Tang for two doses first, then this medicine.
Chifuling, Renshen, Guixin, Ganjiang, Banxia (soaked in hot water seven times, stir-fried yellow), Jupi (Tangerine Peel) (1 liang each); Baizhu, Gegen (Kudzu Root), Gancao, Zhike (2 liang each).
Grind into fine powder, make pills with honey the size of tung seeds. Take 50 pills with rice drink, three times daily. One formula adds Maidong (Ophiopogon Tuber); *Zhouhou Fang* adds Wuweizi (Schisandra Berry).
**Formula for Chest/Diaphragm Fullness and Phlegm-Rebellion in Pregnancy**
Chifuling, Qianhu, Baizhu, Zisuye (Perilla Leaf) (1 liang each); Banxia, Maidong, Renshen, Dafupi (Areca Peel) (0.5 liang each).
Grind into coarse powder. Take 4 qian per dose with 1 cup of water, 5 slices of ginger, decoct to 70%, strain, and take warm. One formula omits Dafupi and Renshen, adding Dafuzi (Areca Seed/Betel Nut).
**Formula for Qi Stagnation in Chest/Diaphragm, Vomiting, Mental Restlessness, and Limb Weakness**
Pipaye (Loquat Leaf), Banxia, Maidong, Renshen, Gancao (0.5 liang); Hézirou (Persimmon Calyx Flesh), Huoxiang (Patchouli Leaf) (1 liang each); Chifuling, Zhike, Chenpi (0.75 qian each).
Chop ingredients. Take 3 qian per dose with 1 cup of water, 3 slices of ginger, 1 jujube, decoct to 70%, strain, and take warm. One formula omits Hézirou and jujube.
*[Jiyan Fang]* For Pregnancy Ezu, vomiting, inability to eat.
Qingzhuru (Green Bamboo Shavings), Jupi (Tangerine Peel) (3 liang each); Shengjiang (Fresh Ginger), Fuling (Poria) (4 liang each); Banxia (5 liang).
Cut finely. Boil in 6 sheng of water until 2.5 sheng remains. Strain and divide into three doses. Repeat if ineffective. Avoid mutton, malt sugar, etc.
**Xuanfu Banxia Tang**
Indicated for Pregnancy Ezu, vomiting acid water, aversion to food smells, preference for lying down.
Xuanfuhua (debranned), Chuanxiong, Xixin (cleaned), Renshen, Gancao (roasted) (0.7 fen each); Danggui (deheaded), Banxia (hot-water soaked), Chifuling (peeled), Ganjiang Shengjiang (Dried Fresh Ginger), Chenpi (de-white) (0.15 qian each).
One dose. Boil in 2 zhong of water with 5 slices of ginger until 1 zhong remains. Take anytime.
**Xuanfu Hua Tang**
Indicated for Pregnancy (6-7 months), fetal unrest, vomiting.
Xuanfuhua (0.5 fen); Nongpu (Magnolia Bark), Baizhu, Zhike, Huangqin, Fuling (0.15 qian each); Banxia, Shaoyao, Shengjiang (0.1 qian each).
One dose. Boil in 2 zhong of water until 1 zhong remains. Take before meals.
All the above formulas use Banxia, likely for its acridity to disperse knotting Qi and descend rebellious Qi, thus stopping vomiting, not solely for Phlegm. Lou Quanshan noted: *Daquan* avoids Banxia due to fears of disturbing the fetus, while Zhongjing uses it. I have used Banxia frequently for Ezu without disturbing the fetus. The Classic states: "If there is a pathogen, there is no injury [to the healthy Qi]."
**Baizhu San**
Indicated for Ezu vomiting clear fluid, severe cases unable to keep fluids down for over ten days.
Baizhu (1 liang), Renshen (0.5 liang), Dingxiang (Cloves) (0.25 qian), Gancao (Licorice Root) (0.1 qian).
Grind into fine powder. Take 2 qian per dose with 1 cup of water, 5 slices of ginger, decoct to 70%, take warm.
**Ren Shen Ding Xiang San** (Two Formulas)
Indicated for Pregnancy Ezu, Cold-Stomach vomiting/reversal, food regurgitation, and stabbing heart/abdominal pain.
Ren Shen, Ding Xiang, Huoxiangye (Patchouli Leaf) (0.25 qian each).
Grind into powder. Take 3 qian per dose with 1 cup of water, decoct to 70%, strain, take warm, anytime.
**Another Formula**
Ren Shen, Ding Xiang, Shidi (Persimmon Calyx) (2 liang each); Gancao, Liangjiang (Galangal Root) (0.5 liang each).
Grind into fine powder. Take 2 qian per dose with hot water, anytime.
**Xingpi Yinzi**
Indicated for Pregnancy Ezu, vomiting/anorexia, severe epigastric fullness, tastelessness, or alternating chills/fever. (From Wang Shi's *Boji Fang*).
Caodoukou (Cardamom Seed, baked in wet paper/ashes until dry, peeled), Nongpu (processed with ginger) (0.5 liang each); Ganjiang (Dried Ginger) (1 liang); Gancao (1.25 qian).
Grind into fine powder. Take 2 large qian per dose with 1 large cup of water, 2 jujubes, 3 slices of ginger, decoct to 80%, strain, and sip.
Mild cases heal after 1-2 doses. Old versions included 2 liang of Juhong for chills/fever/malaria/dysentery with anorexia; later practitioners removed Chenpi and substituted Ganjiang. Ganjiang is highly effective for elderly Qi deficiency, constipation, and dry mouth/thirst. Obstetrician Qi Shiming retained Ganjiang and removed Chenpi, also naming it Xingpi Yinzi, which is extremely effective for Ezu.
The above formulas, combined with Fuling Wan, contain Dingxiang and Ganjiang, suitable only for Cold-Ethos with slow pulse.
**Ren Shen Jupi Tang**
Indicated for Ezu vomiting phlegm-fluid.
Ren Shen, Jupi, Baizhu, Maidong (dehearted) (1 liang each); Gancao (0.3 qian); Nongpu (processed), Baifuling (White Poria) (0.5 liang each).
Grind into coarse powder. Take 4 qian per dose with a piece of Danzhuru (Light Bamboo Shavings) the size of a bullet and 3 slices of ginger, decoct together in water.
**For Pregnancy Vomiting/Anorexia with Phlegm-Fluid Vomiting**
Shenglugen (Fresh Reed Rhizome) (0.7 fen), Juhong (0.4 fen), Shengjiang (0.6 fen), Binglang (Betel Nut) (0.2 fen), Pipaye (0.3 fen).
Cut ingredients. Boil in 2 cups of water until 0.7 cups remain. Take hot on an empty stomach.
**For Pregnancy Food Aversion, Mental Restlessness, Heat/Stuffiness, and Vomiting**
Qingzhuru, Maidong (3 liang each); Qianhu (2 liang); Jupi (1 liang); Lugen (Reed Rhizome, a handful; if body heat/four-limb irritability exists, add Gudupi (Lycium Bark) a handful).
Cut finely. Boil in 1 sheng of water until 0.5 sheng remains. Strain and divide into two doses before meals.
Among the above formulas, Maidong, Zhuru, and Lugen are cool in nature and neutral in property, serving as balanced remedies for heat patterns without cold.
**For Pregnancy Food Aversion [Gujin Luyan Fang]**
Ren Shen (4 liang); Nongpu, Shengjiang, Zhike, Gancao (2 liang each).
Boil in 6 sheng of water until 3 sheng remains. Divide into three doses.
**Guiyuan San**
Indicated for Pregnancy Ezu, persistent vomiting, headache, total anorexia, unresponsive to other medicines. Use this Blood-Regulating and Origin-Returning formula for cure.
Ren Shen, Gancao, Chuanxiong, Danggui, Shaoyao, Dingxiang (0.5 liang each); Baifuling, Baizhu, Chenpi (1.5 liang each); Jiegeng (roasted), Zhike (de-seeded, roasted) (0.25 qian each); Banxia (washed seven times, cut, stir-fried yellow) (1 liang).
Chop ingredients. Take 3 qian per dose with 5 slices of ginger and 1 jujube, decoct together in water.
**Anteating Drink (Antai Yin)**
Indicated for Pregnancy (3rd to 9th month) with daily vomiting of phlegm-fluid, mental restlessness, heavy head/dizzy eyes, aversion to food smells, fetal unrest, lower back/abdominal pain, occasional bleeding, and all pregnancy diseases.
Gancao, Fuling, Danggui, Shudihuang, Chuanxiong, Baizhu, Huangqi (Astragalus Root), Shaoyao, Banxia (hot-water soaked seven times, cut, stir-fried), Ejiao (Donkey-hide Gelatin, cut, stir-fried with powder), Diyü (Sanguisorba Root) (equal parts).
Chop ingredients. Take 3 qian per dose with 4 slices of ginger, decoct in water, take warm, anytime.
Variations: One omits Banxia/Diyü, adds Renshen/Sangjisheng (Mulberry Mistletoe Stem). Another omits Huangqi/Baizhu/Banxia/Diyü, adds Aiye (Mugwort Leaf); this is essentially Jiao'ai Tang (Gelatin and Mugwort Decoction) plus Baifuling.
**Xiao Dihuang Wan**
Indicated for Pregnancy nausea, vomiting clear fluid, abdominal pain, anorexia.
Ren Shen (deheaded), Ganjiang (prepared) (equal parts).
Grind into fine powder, mix with raw Dihuang (Rehmannia) juice to form pills the size of tung seeds. Take 50 pills with rice drink before meals.
The above formulas regulate Blood. Li Maoweng's statement regarding weak Left Pulse and vomiting unresponsive to other medicines being cured by Blood-Regulating Origin-Returning medicines refers to such categories.
**Baosheng Tang**
Indicated for women with absent menstruation, appearing ill but healthy, with slippery/large and uniform six-pulse positions (pregnancy pulse). Spirit is normal, but aversion to food odors, craving specific foods, severe vomiting, or occasional clear fluid vomiting indicates Ezu. Do not treat as Cold disease. Take this medicine. If nausea/vomiting occurs, add Dingxiang and Shengjiang. (Wu Yinju's Formula)
Ren Shen, Gancao (0.25 qian each); Baizhu, Xiangfuzi (Cyperus Rhizome), Wuyao (Lindera Root), Juhong (0.5 liang each).
Chop ingredients. Take 3 large qian per dose with 1.5 cups of water, 5 slices of ginger, decoct to 70%, strain, take warm, anytime. Or grind into powder and mix with water.
**Baizhu San**
Indicated for Pregnancy Disharmony of Fetal Qi, poor appetite.
Baizhu (stir-fried), Zisu (Perilla Leaf) (0.1 qian each); Renshen (0.2 qian); Qingpi (Green Tangerina Peel, de-white), Hézirou, Chuanxiong (0.08 qian each); Gancao (roasted, 0.05 qian).
One dose. Boil in 2 zhong of water with 3 slices of ginger until 1 zhong remains. Take anytime.
**Erxiang San**
Indicated for Pregnancy Fetal Unrest, Qi non-ascent/descent, poor appetite, vomiting acid water, heaviness upon rising/sitting.
Xiangfuzi (1 liang); Huoxiangye, Gancao (0.3 qian each).
Grind into fine powder. Take 2 qian per dose, anytime, mixed with boiling water.
*[Supplement]* I once treated a pregnant woman with Ezu, vomiting/anorexia, dizziness, and fear of walking. She was cured by drinking several cups of concentrated bitter pomelo peel decoction. For severe vomiting, add ginger juice.
**Another Formula**
Sha ren (Amomum Fruit) powder, 2 qian per dose, mixed with ginger water or rice drink.
The above formulas regulate Qi. For Qi Deficiency, the first two are suitable; for Qi Disregulation, the third is suitable.
[Lou Quanshan] A woman at 3 months pregnancy vomited phlegm-fluid and food at Yin/Mao hours (5-7 AM). She felt Qi rushing up from the lower abdomen, causing diaphragmatic fullness and vomiting, red face, slight agitation, dizziness unable to rise from bed, limb pain, and slight thirst. This was Liver Fire carrying Chong Mai (Penetrating Vessel) Fire upward. Severity alternated daily. Pulse was harmonous but Right Cun was surging. Hundred medicines failed for nearly two months. My son fell ill; I accidentally used Chenxiang (Agarwood) ground in water to dissolve Baolong Wan (Embrace Dragon Pill) for him. His diaphragm relaxed, Qi stopped rushing up. After 2-3 doses, vomiting stopped, dizziness decreased, appetite returned, and he stabilized.
Another case: Mrs. Ying had burning sensation, vomiting food, congested pulse, epigastric fullness/blockage, Qi attacking the back, bilateral elbow pain requiring constant hot rubbing. Vomiting provided slight relief. Pulse was surging. Prescribed:
Huanglian (Coptis Rhizome) (1 qian), Huangqin (Scutellaria Root, stir-fried) (2.5 qian), Baizhu, Banxia (1 qian each), Gancao (roasted), Suosha (Amomum Fruit) (0.5 fen each); Chenpi, Danggui, Shanzhi (Gardenia Fruit), Zhike (roasted), Xiangfu, Renshen, Cangzhu (1 qian each), Fuling (1.5 qian), Shengjiang (7 slices).
After two prescriptions, burning/vomiting stopped, epigastric blockage receded. Nighttime back/elbow pain persisted, managed with hot rubbing. Then administered Baolong Wan dissolved in water; the disease vanished instantly.
[Zhu Danxi] A woman near thirty, two months pregnant, suffered vomiting and dizziness, feeling unbearable. She took Renshen, Baizhu, Chuanxiong, Chenpi, Fuling, etc., for 5-7 days, feeling heavier. I palpated her pulses: both were wiry, Left more so, and weak. I said: