〔仲〕妇人怀胎,腹中 痛,当归芍药散主之。(见前。)
〔洁〕地黄当归汤 治妇人有孕胎痛。
当归(一两) 熟地黄(二两)
上为末,作一服,水三升,煎至一升半,去滓顿服。
〔仲〕妇人腹中痛,小建中汤主之。(方见伤寒腹痛。)
〔云〕芎归汤 治妊娠先患冷气,忽心腹痛如刀刺。(见前心腹痛。)
〔丹〕孙院君因近丧冒恶气伤胎,肚痛手不可近,发热,口中不思食,须安胎,散
滞气。
青皮(三钱) 黄芩 芍药(各二钱) 归尾(一钱半) 川芎(一钱) 木香(五分)
甘草(炙,少许)
分二帖,水三盏,先煮苎根两大片至二盏,去苎根,入前药同煎至一盏,热服。
治妊娠腹痛,用生地黄三斤,捣取汁,酒一升合煎减半,顿服愈。
〔脉〕师曰∶妇人有胎腹痛,其人不安,若胎病不动,欲知生死,令人摸之,如覆杯
者则男,如肘颈参差起者女也。冷在何面,冷者为死,温者为生。
〔大〕妊娠小腹痛者,由胞络虚,风寒相搏,痛甚亦令胎动也。
〔薛〕前证若风寒所搏,用紫苏饮加生姜。气血虚,用八珍汤。脾气虚,用六君子
汤。中气虚,用补中益气汤。若腹胀痛,用安胎饮加升麻、白术;不应,兼补中益气汤。
一妊妇小腹作痛,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,小便小利,水道重坠,胎仍不安,此亦肝木炽盛所
致,用龙胆泻肝汤一剂,诸证顿愈。乃以四君子加柴胡、升麻,以培脾土而安。
疗妊娠被惊恼,胎向下不安,小腹痛连腰,下血。
当归 川芎(各八分) 阿胶(炙) 人参 艾叶(各四分) 大枣(二十个) 茯苓(十分)
上细切,以水四升,煮取二升,温分三服。
《补遗》治妊妇小腹痛,胎动不安。
川芎为细末,酒调下。
又方 川芎 当归(各等分) 水煎温服。
〔张仲景〕妇女怀孕后,腹中疼痛,用当归芍药散主治。(方剂见前文。)
〔李东垣〕地黄当归汤治疗孕妇胎痛。
当归(一两) 熟地黄(二两)
以上药物研为细末,作为一次服用的剂量,加水三升,煎煮至一升半,滤去药渣,一次性服用。
〔张仲景〕妇女腹中疼痛,用小建中汤主治。(方剂见伤寒腹痛章节。)
〔朱丹溪注引云〕芎归汤治疗妊娠期间先患有冷气,突然心腹部疼痛如刀刺一般。(见前文心腹痛章节。)
〔朱丹溪〕孙院君因为临近丧事冒犯恶气而伤胎,肚痛得手不能触碰,发热,口中不想进食,需要安胎,并疏散滞气。
青皮(三钱) 黄芩 芍药(各二钱) 归尾(一钱半) 川芎(一钱) 木香(五分)
甘草(炙,少许)
分为两帖,加水三盏,先煮苎麻根两大片至两盏,去掉苎麻根,加入前面的药物同煎至一盏,热服。
治疗妊娠腹痛,用生地黄三斤,捣取汁液,加酒一升合煎减半,一次性服用可愈。
〔脉诀〕老师说:妇女有胎腹痛,其人不安,如果胎病不动,想知道胎儿生死,让人触摸腹部,形状像倒扣的杯子则是男孩,像肘颈参差不齐突起则是女孩。冷处为死胎,温处为生胎。
〔陈自明〕妊娠小腹痛,是由于胞络虚,风寒相互搏结,痛甚也会导致胎动。
〔薛己〕上述证候如果是风寒所搏结,用紫苏饮加生姜。气血虚,用八珍汤。脾气虚,用六君子汤。中气虚,用补中益气汤。如果腹胀痛,用安胎饮加升麻、白术;无效,兼用补中益气汤。
一位孕妇小腹作痛,其胎不安,气攻左右,有时逆上,小便不利,用小柴胡汤加青皮、山栀,清肝火而痊愈,后来因发怒小腹胀满,小便不利,水道重坠感,胎仍不安,这也是肝木炽盛所致,用龙胆泻肝汤一剂,诸证顿时痊愈。于是用四君子汤加柴胡、升麻,以培补脾土而安胎。
治疗妊娠被惊扰恼怒,胎向下不安,小腹痛连腰部,下血。
当归 川芎(各八分) 阿胶(炙) 人参 艾叶(各四分) 大枣(二十个) 茯苓(十分)
以上细切,用水四升,煮取二升,温时分三次服用。
《补遗》治疗妊妇小腹痛,胎动不安。
川芎研为细末,用酒调服。
又一方 川芎 当归(各等分) 水煎温服。
[Zhongjing] When a woman is pregnant and experiences abdominal pain, Danggui Shaoyao San (Angelica and Peony Powder) is the primary treatment. (See previous section.)
[Jie] Dihuang Danggui Tang (Rehmannia and Angelica Decoction) treats fetal pain in pregnant women.
Danggui (1 liang), Shudihuang (2 liang).
Grind the above into powder, take as one dose, add 3 sheng of water, decoct to 1.5 sheng, remove dregs, and take in one go.
[Zhongjing] When a woman has abdominal pain, Xiao Jianzhong Tang (Minor Construct the Middle Decoction) is the primary treatment. (Formula see Shaoyin Abdominal Pain.)
[Yun] Xionggui Tang (Ligusticum and Angelica Decoction) treats pregnancy complicated by pre-existing cold qi, suddenly causing heart and abdominal pain like knife stabbing. (See previous Heart and Abdominal Pain section.)
[Danyuan] Sun Yuanjun injured her fetus due to exposure to foul air near a funeral, resulting in abdominal pain so severe that it could not be touched, fever, and loss of appetite. The treatment requires calming the fetus and dispersing stagnant qi.
Qingpi (3 qian), Huangqin, Shaoyao (each 2 qian), Guiwei (1.5 qian), Chuanxiong (1 qian), Muxiang (5 fen), Gancao (roasted, a small amount).
Divide into two doses, add 3 zhan of water, first decoct two large slices of Zhugen (Ramie Root) until reduced to 2 zhan, remove Zhugen, add the aforementioned herbs, decoct to 1 zhan, and take hot.
To treat abdominal pain during pregnancy, use 3 jin of Shengdihuang (Fresh Rehmannia Root), crush to extract juice, mix with 1 sheng of wine, decoct until halved, and take in one go for cure.
[Maijue] The Master said: If a pregnant woman has fetal abdominal pain and feels uneasy, if the fetus is not moving, to determine life or death, have someone palpate the abdomen. If it feels like an inverted cup, it is a male; if it feels uneven like elbows or necks, it is a female. Cold areas indicate a dead fetus, warm areas indicate a living fetus.
[Dazhong] Small abdominal pain during pregnancy is caused by deficiency of the uterine collaterals, where wind and cold fight each other; severe pain can also cause fetal movement.
[Xue] For the above conditions, if caused by wind-cold fighting, use Zisu Yin (Perilla Drink) with added Shengjiang (Fresh Ginger). For Qi and Blood deficiency, use Bazhen Tang (Eight Treasures Decoction). For Spleen Qi deficiency, use Liujunzi Tang (Six Gentlemen Decoction). for Middle Qi deficiency, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). If accompanied by abdominal distension and pain, use Antai Yin (Fetal Calming Drink) with Shengma (Cimicifuga Rhizome) and Baizhu (Atractylodes Macrocephala Rhizome); if ineffective, combine with Buzhong Yiqi Tang.
A pregnant woman suffered from lower abdominal pain with fetal instability, Qi attacking left and right, sometimes rising upward, and dysuria. She was treated with Xiaochaihu Tang (Minor Bupleurum Decoction) plus Qingpi (Green Tangerine Peel) and Shanzhi (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 continued fetal instability. This was also caused by excessive Liver Wood fire. One dose of Longdan Xiegan Tang (Gentiana Liver-Draining Decoction) cured all symptoms immediately. Subsequently, Sijunzi Tang (Four Gentlemen Decoction) with Chaihu (Bupleuri Radix) and Shengma was used to nourish Spleen Earth and calm the fetus.
To treat pregnancy disturbed by fright and annoyance, with downward fetal instability, lower abdominal pain radiating to the waist, and bleeding:
Danggui, Chuanxiong (each 8 fen), Ejiao (roasted), Renshen, Aye (each 4 fen), Dazao (20 pieces), Fuling (10 fen).
Finely chop, add 4 sheng of water, decoct to obtain 2 sheng, take warm in three divided doses.
[Buyi] To treat lower abdominal pain in pregnant women with fetal instability:
Chuanxiong ground into fine powder, taken with wine.
Another formula: Chuanxiong, Danggui (equal parts), decoct in water and take warm.