〔薛〕前证肝脾湿热,用升阳除湿汤。(血崩。)肝脾风热,用加味逍遥散。肝脾郁怒,
用加味归脾汤。脾胃气虚,用钱氏白术散。若脾气下陷,用补中益气汤,肝经风热,用防
风黄芩丸。风入肠胃,用胃风汤。一妊娠因怒胸膈不利,饮食少思,服消导顺气之剂,
脾胃愈弱,饮食愈少,大便不实且无度,久而便黄水或带白,视其面色黄中隐白。余曰∶
黄色脾虚也,白色肺虚也。朝以补中益气汤升补胃气,夕以六君子培补脾气而愈。
《大全方》治妊娠忽然下黄汁如胶,或如豆汁,胎动腹痛。
粳米(五合) 黄 (六两)
上以水七升,煎取二升,分为四服。
银苎酒(见前胎动不安。)
又方 用生艾汁二盏 阿胶 白蜜(各一两)
煎至七分,温服。如无生艾,煎干艾浓汁亦可。一方加竹茹。一方用酒不用蜜。
《脉经》云∶妇人怀躯六月、七月,暴下斗余水,其胎必倚而堕,此非时孤浆预下故
也。(胎漏徐徐下水,今暴下而多,故知堕胎也。)
〔大〕妊娠惊胎者,乃怀妊将满,胎神已具,坠仆伤胎,甚至下血不醒。若欲验其
子母安否,当参第四论治之。
〔薛〕愚按前证若因怒跌仆,或手足抽搐,用钓藤汤。(见前。)若因气滞,用紫苏饮。
(胎上逼心。)若因脾胃气虚,用六君子加苏梗。若郁结伤脾,用归脾汤。若郁怒伤肝脾,用四
七汤(杂病气。)加芎、归。若去血过多,用佛手散。如不应,胶艾汤。气血虚,八珍汤加胶、艾。
催生神妙佛手散 治妇人妊娠五七月,因事筑磕着胎,或子死腹中,恶露下,疼痛
不已,口噤欲绝,用此药探之。若不损则痛止,子母俱安。若胎损,立便逐下。本出徐
文仲神验胎动方,云治血上冲心腹满闷者,如汤沃雪。又治产前、产后体热败血腹痛。(又名芎 汤。)
当归(六两) 川芎(四两,张氏方等分)
上为粗末,每服三钱,水一大盏,煎令泣泣欲干,投酒一大盏,止煎一沸,去滓温
服,口噤灌之。如人行五里再服,不过三五服便生。一方云∶此药治伤胎去血多,崩中
去血多,金疮去血多,拔牙去血多,昏晕欲倒者,以水煎服。或先以漏血,腹内疼痛,加
芍药、官桂减半,随手效。(余详胎产大法)
治妊娠忽因倒地,或擎重作劳促损,腹中疼痛肿重,及子死腹中不出,三服立下。
川芎(一两)
上为细末,以热酒调服方寸匕,日三、四服。
按∶川芎上窜散气,有服之暴亡者。若诊其脉举之有,按之无者,忌服。
治妊娠从高坠下,腹痛下血烦闷。
生地黄 益母草(各一两) 当归 黄 (各半两)
上 咀,每服四钱,水一盏,姜四片,煎至六分,去滓无时候。
《集验》疗妊娠二三月,上至七八月,顿仆失跌,胎动不安、伤损,腰腹痛欲死,若
有所见,及胎奔上抢心短气,下血不止方。
干地黄 当归 艾叶(各二两) 阿胶 川芎(各三两)
上以水七升,煮取二升半,分作三服。腹痛甚,加杜仲、五加皮(各三两) 一方无地黄,
有甘草。一方无地黄,却用生姜自然汁一匙,地黄汁半合,马通半合,煎成药去滓,入
此再煎三沸,温服。一方有人参、白茯苓,水煎。
〔丹〕妇人因闪挫伤胎,肚疼血崩。
归尾 陈皮 白术 人参 茯苓 白芍药 川芎(各三钱) 甘草(炙,五分)
上 咀,分四帖,水三盏,煎取一盏,下缩砂末一钱五分,炒黑五灵胎一钱。
竹茹酒 治妊娠误有失坠损血,胎损疼痛。
青竹茹(二合) 好酒(一升)
上煮三五沸,分作三服,即安。
秦艽汤 疗妊娠或因僵仆,胎动不安,脐腹 痛。(方见胎动不安。)
治妊娠偶有所伤,胎动不安,疼痛不可忍。兼治崩血,又兼治子冒,又名子痫。
缩砂(不以多少,)和皮炒令黑色。一方用仁,熨斗内略炒为细末,热酒调下二钱,不饮酒
者以米饮调下皆可。觉腹中热,则胎已安矣。此方神效,予常用之有验。
补遗安胎散 治卒然腰痛,下血不已。
熟地黄 艾叶 白芍药 川芎 黄 阿胶(炒) 当归 甘草 地榆(各等分)
上 咀,每四钱,姜五片,枣一枚,煎温服。
〔薛〕若因毒药,用甘草、黑豆、淡竹叶。若因顿仆,用阿胶散,未应,煎送知母
丸。若因顿仆下血腹痛,用佛手散,未应,用八珍送知母丸。血出过多,用八珍汤斤许,益
母草四两,水煎徐徐与服。若胎死,以朴硝或平胃散下之。
快捷方式方 治用毒药攻胎,药毒冲心,外证牙关紧急,口不能言,两手强直,握拳头
低,自汗身微热。外证与中风相似,但其脉浮而软,十死一生,医多不识,若作中风治
之,必死无疑。用白扁豆二两,生,去皮为末,新汲水调下即效。
阿胶散 治妊娠不问月数深浅,或因顿仆,或因毒药,胎动不安,腰痛腹满,或有
所下,或胎上抢心,短气乏力。(方见前胎动不安。)
妊娠误服诸药毒,致胎动不安治之方。
甘草 黑豆 淡竹叶(等分) 浓煎汁饮之。
夺命丸 治妇人小产,下血至多,子死腹中,其人憎寒,手指、唇口、爪甲青白,面
色黄黑,胎上抢心则闷绝欲死,冷汗自出,喘满不食。或食毒物,或误服草药,伤动胎气,
下血不止,胎尚未损,服之可安,已死服之可下。若胎腐烂腹中危甚者,立可取出。此
方的系异人传授,至妙。(此即仲景茯苓桂枝丸,但用淡醋汤嚼下不同耳。方即牡丹皮、茯苓、桂枝、
桃仁、赤芍药等分是也。丹溪亦称妙。)
【薛己】前述证候若属肝脾湿热,使用升阳除湿汤。(针对血崩。)若属肝脾风热,使用加味逍遥散。若属肝脾郁怒,使用加味归脾汤。若属脾胃气虚,使用钱氏白术散。若脾气下陷,使用补中益气汤;若属肝经风热,使用防风黄芩丸。若风邪侵入肠胃,使用胃风汤。曾有一孕妇因发怒导致胸膈不畅,饮食减少,服用消食导滞、顺气的药物后,脾胃更加虚弱,饮食更少,大便稀溏且无节制,日久排出黄色水样便或带有白色物质,观察其面色黄中隐现白色。我说:黄色代表脾虚,白色代表肺虚。早晨服用补中益气汤以升提补益胃气,傍晚服用六君子汤以培补脾气,从而痊愈。
《大全方》治疗妊娠突然流出黄色汁液如胶状,或如豆汁状,胎动不安伴腹痛。
粳米(五合) 黄芩(六两)
以上药材用水七升,煎煮取二升药液,分四次服用。
银苎酒(见前文“胎动不安”章节)。
又一方:用生艾叶汁两盏,阿胶一两,白蜜一两。
煎至七分满,温服。若无生艾叶,煎煮干艾叶的浓汁也可以。另一配方加入竹茹。另一配方用酒而不用蜜。
《脉经》说:妇女怀孕六个月、七个月时,突然大量流出斗余清水,胎儿必然倾斜坠落,这是因为非正常时间的孤浆预先流出所致。(胎漏是缓慢流水,现在是突然大量流出,所以知道是堕胎。)
【大论】妊娠惊胎,是指怀孕将满,胎神已具,因坠跌仆倒损伤胎儿,甚至出现下血不省人事。若要验证母子是否平安,应当参考第四篇论述进行治疗。
【薛己】我按:前述证候若因愤怒、跌仆,或手足抽搐,使用钓藤汤。(见前文。)若因气滞,使用紫苏饮。(针对胎上逼心。)若因脾胃气虚,使用六君子汤加紫苏梗。若因郁结伤脾,使用归脾汤。若因郁怒伤肝脾,使用四七汤(杂病气滞方)加川芎、当归。若失血过多,使用佛手散。如果无效,使用胶艾汤。若气血虚弱,使用八珍汤加阿胶、艾叶。
催生神妙佛手散:治疗妇女妊娠五七月,因事情撞击伤胎,或胎儿死于腹中,恶露下行,疼痛不止,牙关紧闭欲绝,使用此药试探。若胎儿未受损则疼痛停止,母子俱安。若胎儿已损,立即排出。本方出自徐文仲神验胎动方,称治疗血气上冲心腹满闷者,如汤泼雪般迅速见效。又治疗产前、产后体热败血腹痛。(又名芎劳汤。)
当归(六两) 川芎(四两,张氏方为等分)
以上研为粗末,每次服用三钱,加水一大盏,煎至几乎干涸,投入酒一大盏,再煮沸一次,去渣温服,若牙关紧闭则灌服。如人行走五里路后再服,不超过三五次即可分娩。另一说法称:此药治疗伤胎失血多,崩中失血多,金疮失血多,拔牙失血多,昏晕欲倒者,用水煎服。或先有漏血,腹内疼痛,加芍药、官桂减半,随手见效。(详见胎产大法)
治疗妊娠忽然因倒地,或举重劳作损伤,腹中疼痛肿重,及胎儿死于腹中不出,服用三剂即可立下。
川芎(一两)
以上研为细末,用热酒调服方寸匕,每日三四次。
按:川芎上行散气,有服用后暴亡的案例。若诊察其脉象举之有力、按之无力者,忌服。
治疗妊娠从高坠落,腹痛下血烦闷。
生地黄 益母草(各一两) 当归 黄芩(各半两)
以上切碎,每次服用四钱,加水一盏,生姜四片,煎至六分,去渣不拘时候服用。
《集验方》治疗妊娠二三个月,直至七八个月,突然跌倒失足,胎动不安、损伤,腰腹痛欲死,如有幻觉,以及胎气奔上抢心短气,下血不止的方子。
干地黄 当归 艾叶(各二两) 阿胶 川芎(各三两)
以上用水七升,煮取二升半,分作三次服用。腹痛严重,加杜仲、五加皮(各三两)。另一方无地黄,有甘草。另一方无地黄,改用生姜自然汁一匙,地黄汁半合,马通汁半合,煎成药去渣,加入这些再煎三沸,温服。另一方有人参、白茯苓,用水煎。
【丹溪】妇人因闪挫伤胎,肚疼血崩。
归尾 陈皮 白术 人参 茯苓 白芍药 川芎(各三钱) 甘草(炙,五分)
以上切碎,分四帖,水三盏,煎取一盏,加入缩砂仁末一钱五分,炒黑五灵脂一钱。
竹茹酒:治疗妊娠误有失坠损伤出血,胎损疼痛。
青竹茹(二合) 好酒(一升)
以上煮三五沸,分作三次服用,即安。
秦艽汤:治疗妊娠或因僵仆,胎动不安,脐腹疼痛。(方见“胎动不安”章节。)
治疗妊娠偶有所伤,胎动不安,疼痛不可忍。兼治崩血,又兼治子冒,又名子痫。
缩砂(不限多少),带皮炒至黑色。另一方用仁,在熨斗内略炒为细末,热酒调下二钱,不饮酒者以米饮调下皆可。感觉腹中热,则胎已安。此方神效,我常用之有效。
补遗安胎散:治疗卒然腰痛,下血不已。
熟地黄 艾叶 白芍药 川芎 黄芩 阿胶(炒) 当归 甘草 地榆(各等分)
以上切碎,每次四钱,生姜五片,大枣一枚,煎温服。
【薛己】若因毒药,使用甘草、黑豆、淡竹叶。若因顿仆,使用阿胶散,无效,煎送知母丸。若因顿仆下血腹痛,使用佛手散,无效,用八珍汤送服知母丸。血出过多,用八珍汤斤许,益母草四两,水煎徐徐与服。若胎死,以朴硝或平胃散下之。
快捷方式方:治疗用毒药攻胎,药毒冲心,外证牙关紧急,口不能言,两手强直,握拳低头,自汗身微热。外证与中风相似,但其脉浮而软,十死一生,医生多不识,若作中风治之,必死无疑。用白扁豆二两,生,去皮为末,新汲水调下即效。
阿胶散:治疗妊娠不问月数深浅,或因顿仆,或因毒药,胎动不安,腰痛腹满,或有下血,或胎上抢心,短气乏力。(方见前文“胎动不安”章节。)
妊娠误服诸药毒,致胎动不安治之方。
甘草 黑豆 淡竹叶(等分) 浓煎汁饮之。
夺命丸:治疗妇人小产,下血至多,子死腹中,其人憎寒,手指、唇口、爪甲青白,面色黄黑,胎上抢心则闷绝欲死,冷汗自出,喘满不食。或食毒物,或误服草药,伤动胎气,下血不止,胎尚未损,服之可安,已死服之可下。若胎腐烂腹中危甚者,立可取出。此方确系异人传授,至妙。(此即仲景茯苓桂枝丸,但用淡醋汤嚼下不同耳。方即牡丹皮、茯苓、桂枝、桃仁、赤芍药等分是也。丹溪亦称妙。)
[Xue] If the aforementioned syndrome is due to damp-heat in the Liver and Spleen, use Shengyang Chushi Tang (Ascending Yang and Expelling Dampness Decoction). (For metrorrhagia.) If it is due to wind-heat in the Liver and Spleen, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). If it is due to depression and anger in the Liver and Spleen, use Jiawei Guipi Tang (Modified Restore the Spleen Decoction). If it is due to Qi deficiency of the Stomach and Spleen, use Qianshi Baizhu San (Qian’s Atractylodes Macrocephala Powder). If Spleen Qi sinks, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction); if it is due to wind-heat in the Liver channel, use Fangfeng Huangqin Wan (Saposhnikovia and Scutellaria Pill). If wind pathogen invades the intestines and stomach, use Weifeng Tang (Stomach Wind Decoction). There was a pregnant woman who, due to anger, experienced chest and diaphragm discomfort and reduced appetite. After taking herbs for digestion promotion and Qi regulation, her Spleen and Stomach became weaker, her appetite decreased further, and she suffered from loose stools without control. Over time, she passed yellow watery stool or stool containing white matter. Observing her complexion, which was yellow with hidden white tones, I said: Yellow indicates Spleen deficiency, and white indicates Lung deficiency. In the morning, administer Buzhong Yiqi Tang to raise and tonify Stomach Qi; in the evening, administer Liujunzi Tang (Six Gentlemen Decoction) to cultivate and tonify Spleen Qi, leading to recovery.
Daquan Fang treats sudden discharge of yellow fluid like glue or like bean curd dregs during pregnancy, accompanied by fetal movement and abdominal pain.
Japonica Rice (5 he) Scutellaria Root (6 liang)
Boil these in seven sheng of water until two sheng remain, divide into four doses.
Yinzhu Jiu (Silver Ramie Wine) (See previous section on "Fetal Movement Instability").
Another prescription: Use two zhan of fresh Mugwort Juice, one liang of Donkey-hide Gelatin, and one liang of White Honey.
Decoct until three-tenths remain, take warm. If fresh mugwort is unavailable, decocting concentrated juice from dried mugwort is also acceptable. Another formula adds Bamboo Shavings. Another formula uses wine instead of honey.
Mai Jing states: When a woman is six or seven months pregnant, if she suddenly discharges more than a dou of clear water, the fetus will inevitably tilt and fall; this is because the isolated amniotic fluid is discharged prematurely out of season. (Fetal leakage involves slow water discharge; since here it is sudden and abundant, we know it is abortion.)
[Da Lun] Fetal shock in pregnancy refers to the condition when pregnancy is nearly full, the fetal spirit is established, but injury occurs due to falling or stumbling, even leading to bleeding and unconsciousness. To verify whether mother and child are safe, refer to the treatment discussed in Chapter Four.
[Xue] I observe: If the aforementioned syndrome is caused by anger, falling, or convulsions of hands and feet, use Gouteng Tang (Uncaria Decoction). (See previous.) If caused by Qi stagnation, use Zisu Yin (Perilla Drink). (For fetal pressure on the heart.) If caused by Spleen and Stomach Qi deficiency, use Liujunzi Tang added with Perilla Stem. If caused by depression injuring the Spleen, use Guipi Tang. If caused by depression and anger injuring the Liver and Spleen, use Siqi Tang (Qi disorder formula) added with Chuanxiong and Danggui. If blood loss is excessive, use Foshou San. If ineffective, use Jiaoai Tang. If Qi and Blood are deficient, use Bazhen Tang added with Donkey-hide Gelatin and Mugwort.
Cishen Shenmiao Foshou San (Miraculous Foshou San for Childbirth): Treats women in their fifth or seventh month of pregnancy who suffer fetal injury due to impact, or fetal death in the uterus, with lochia discharge, unceasing pain, locked jaw, and near collapse. Use this medicine to probe. If the fetus is undamaged, pain stops, and both mother and child are safe. If the fetus is damaged, it will be expelled immediately. This formula originates from Xu Wenzhong's Miraculous Formula for Fetal Movement Instability, stating it treats blood rushing up to the heart and abdomen causing fullness, effective as quickly as pouring hot water on snow. It also treats pre- and post-natal body heat, blood stasis, and abdominal pain. (Also known as Xionglao Tang.)
Danggui (6 liang) Chuanxiong Rhizome (4 liang, Zhang's formula uses equal parts)
Grind into coarse powder. Take 3 qian per dose, add one large zhan of water, decoct until almost dry, add one large zhan of wine, boil once more, strain, and take warm. If the jaw is locked, force-feed. Re-administer after walking for five li. Delivery usually occurs within three to five doses. Another account says: This medicine treats excessive blood loss due to fetal injury, metrorrhagia, traumatic wounds, tooth extraction, fainting, and impending collapse; decoct in water and take. Or if there is initial spotting with abdominal pain, add Peony and Cinnamon Bark, reducing dosage by half, with immediate effect. (See detailed discussion in Principles of Pregnancy and Childbirth).
Treats sudden falling during pregnancy, or injury from lifting heavy objects or overexertion, causing abdominal pain, swelling, heaviness, and fetal death in the uterus not being expelled. Three doses will cause expulsion.
Chuanxiong Rhizome (1 liang)
Grind into fine powder. Mix with hot wine and take one fangcun bi (square inch spoonful), three to four times daily.
Note: Chuanxiong ascends and disperses Qi; there are cases of sudden death after ingestion. If the pulse is strong upon light pressure but weak upon deep pressure, it is contraindicated.
Treats high falls during pregnancy, causing abdominal pain, bleeding, and irritability.
Rehmannia Root (Fresh) (1 liang) Motherwort Herb (1 liang) Angelica Sinensis (0.5 liang) Scutellaria Root (0.5 liang)
Cut into pieces. Take 4 qian per dose, add one zhan of water and four slices of ginger, decoct until six-tenths remain, strain, and take at any time.
Jiyan Treats pregnancy from two to three months up to seven to eight months, sudden falls or slips, causing fetal movement instability, injury, severe lower back and abdominal pain, hallucinations, fetal Qi rushing up to the heart causing shortness of breath, and continuous bleeding.
Prepared Rehmannia Root (2 liang) Angelica Sinensis (2 liang) Mugwort Leaf (2 liang) Donkey-hide Gelatin (3 liang) Chuanxiong Rhizome (3 liang)
Decoct in seven sheng of water until two and a half sheng remain, divide into three doses. For severe abdominal pain, add Eucommia Bark and Acanthopanax Bark (3 liang each). Another formula omits Rehmannia and includes Licorice. Another formula omits Rehmannia and uses one spoonful of fresh Ginger Juice, half he of Rehmannia Juice, and half he of Horse Manure Juice; decoct the medicine, strain, add these juices, boil three times, and take warm. Another formula includes Ginseng and Poria, decocted in water.
[Danxi] Women suffering fetal injury due to sprains or twists, with abdominal pain and metrorrhagia.
Angelica Sinensis Tail (3 qian) Tangerine Peel (3 qian) Atractylodes Macrocephala Rhizome (3 qian) Ginseng (3 qian) Poria (3 qian) White Peony Root (3 qian) Chuanxiong Rhizome (3 qian) Licorice Root (Roasted, 5 fen)
Cut into pieces. Divide into four doses. Add three zhan of water, decoct to one zhan, add one qian 5 fen of Amomum Fruit Powder, and one qian of roasted black Trogopterus Dung.
Zhuru Jiu (Bamboo Shavings Wine): Treats accidental falls during pregnancy causing blood loss and fetal injury pain.
Green Bamboo Shavings (2 he) Good Wine (1 sheng)
Boil for three to five boils, divide into three doses, and relief follows.
Qinjiao Tang (Gentian Decoction): Treats fetal movement instability due to stiff falls, with umbilical and abdominal pain. (Formula see "Fetal Movement Instability".)
Treats accidental injury during pregnancy causing fetal movement instability and unbearable pain. Also treats metrorrhagia, and Zi Mao (also known as Zi Xian/Eclampsia).
Amomum Fruit (Any amount), stir-fry with skin until black. Another formula uses the kernel, lightly stir-fried in an ironing board until fine powder, take 2 qian mixed with hot wine. Non-drinkers can mix with rice water. Feeling warmth in the abdomen indicates the fetus is stabilized. This formula is miraculous; I often use it with verified results.
Supplemental Anticonvulsive Powder: Treats sudden lower back pain and continuous bleeding.
Prepared Rehmannia Root Mugwort Leaf White Peony Root Chuanxiong Rhizome Scutellaria Root Donkey-hide Gelatin (Roasted) Angelica Sinensis Licorice Root Sanguisorba Root (Equal parts)
Cut into pieces. Take 4 qian per dose with five slices of ginger and one jujube, decoct and take warm.
[Xue] If caused by toxic substances, use Licorice Root, Black Soybean, and Bambusa Vulgaris Var. Viridisculis Sheath. If caused by falling, use Ejiao San; if ineffective, administer Zhimu Wan with decoction. If caused by falling with bleeding and abdominal pain, use Foshou San; if ineffective, administer Zhimu Wan with Bazhen Tang. If blood loss is excessive, use approximately one jin of Bazhen Tang with four liang of Motherwort Herb, decocted in water and taken slowly. If the fetus is dead, expel it using Mirabilite or Pingwei San.
Quick Method Formula: Treats toxic substances used to abort, where poison rushes to the heart. External signs include locked jaw, inability to speak, rigid arms, clenched fists, head lowered, spontaneous sweating, and slight fever. The external presentation resembles Stroke, but the pulse is floating and soft. It has a ten-to-one mortality rate, and many physicians do not recognize it; treating it as Stroke will surely lead to death. Use two liang of raw Coix Seed, remove skin, grind to powder, mix with fresh well water, and take for immediate effect.
Ejiao San (Donkey-hide Gelatin Powder): Treats pregnancy regardless of gestational age, whether due to falling or toxic substances, causing fetal movement instability, lower back pain, abdominal fullness, bleeding, fetal Qi rushing to the heart, shortness of breath, and fatigue. (Formula see previous "Fetal Movement Instability" section.)
Formula for treating fetal movement instability caused by accidental ingestion of various medicinal poisons during pregnancy.
Licorice Root Black Soybean Bambusa Vulgaris Var. Viridisculis Sheath (Equal parts) Decoct thickly and drink.
Duoming Wan (Life-Restoring Pill): Treats women with miscarriage, excessive bleeding, fetal death in the uterus, aversion to cold, cyanosis of fingers, lips, and nails, sallow-black complexion. If fetal Qi rushes to the heart, it causes suffocation and near-death state, cold sweat, panting, fullness, and anorexia. Or if poisonous food is eaten, or herbal medicine is mistakenly ingested, damaging fetal Qi, causing continuous bleeding. If the fetus is not yet damaged, taking this can stabilize it; if already dead, it can expel it. If the fetus is rotting in the uterus and the condition is critical, it can be extracted immediately. This formula was indeed transmitted by a strange person and is extremely efficacious. (This is essentially Zhang Zhongjing's Fuling Guizhi Wan, but differs in that it is chewed down with light vinegar soup. The formula consists of equal parts Moutan Cortex, Poria, Cinnamon Twig, Peach Kernel, and Red Peony Root. Danxi also praised it as miraculous.)