(方未见。) 治妇人怀娠六七月。脉弦发热。其胎愈胀。腹痛恶寒。少腹如扇。所以
然者。子脏开故也。以此汤温其脏。
男元犀按。太阳主表。少阴主里。脉弦发热者。寒伤太阳之表也。腹痛恶寒者。寒侵少
阴之里也。夫胎居脐下。与太少相连。寒侵太少。气并胞宫。迫动其胎。故胎愈胀也。腹痛
恶寒少腹如扇者。阴邪盛于内。寒气彻于外。故现出阵阵如扇之状也。然胎得暖则安。寒则
动。寒气内胜。必致坠胎。故曰。所以然者子脏开故也。附子汤温其脏。使子脏温而胎固。
自无陨坠之虞矣。附子汤方未见。疑是伤寒附子汤。(附子、茯苓、人参、白术、芍药。)
治妇人有漏下者。有半产后因续下血。都不绝者。有妊娠下血者。假令妊娠腹中痛
胞阻。以此汤主之。
干地黄(六两。) 川芎 阿胶 甘草(各二两。) 艾叶 当归(各三两。) 芍药
(四两。)
上七味。以水五升。清酒三升。合煮取三升。去滓。内胶令消尽。温服一升。日三服。
不差
歌曰 妊娠腹满阻胎胞。(名曰胞阻。以胞中气血虚寒而阻其化育也。)二两芎 草与胶。
归
男元犀按。芎 、芍、地。补血之药也。然血不自生。生于阳明水谷。故以甘草补之。
阿胶
冲任
治妇人怀妊。腹中 痛。此散主之。
当归 川芎(各三两。) 芍药(一斤。) 茯苓 白术(各四两。) 泽泻(半斤。)
上六味。杵为散。取方寸匕。酒和。日三服。
歌曰 妊娠 痛势绵绵。(不若寒疝之绞痛。血气之刺痛也。)三两归芎润且芍药一
斤泽减半。术苓四两妙盘旋。
男元犀按。怀妊腹痛。多属血虚。而血生于中气。中者土也。土过燥不生物。故以归、
芎、芍药滋之。土过湿亦不生物。故以苓、术、泽泻渗之。燥湿得宜。则中气治而血自生。
其痛自止。
(附子汤的方剂组成在此未列出。)治疗妇女怀孕六七个月时,出现脉象弦、发热,胎儿胀感加重,腹痛且怕冷,小腹部感觉像被扇子扇风一样的凉意。之所以这样,是因为子宫口张开的原因。用这个汤剂来温暖子宫。
陈元犀按语:太阳经主表,少阴经主里。脉弦且发热,是寒邪损伤了太阳经的体表;腹痛且怕冷,是寒邪侵入了少阴经的体内。胎儿位于脐下,与太阳、少阴两经相连。寒邪侵袭太阳和少阴,气机并聚于胞宫,逼迫扰动胎儿,所以胎儿胀感加重。腹痛、怕冷、小腹如扇风状,是因为阴寒邪气盛于内,寒气透达于外,所以呈现出阵阵如被风吹扇的感觉。然而,胎儿得温暖则安,受寒则动。寒气在内占优势,必然导致流产。所以说,之所以这样,是因为子宫口张开的原因。附子汤温暖子宫,使子宫温暖而胎元稳固,自然就没有堕胎的忧虑了。附子汤的方剂在此未列出,怀疑是《伤寒论》中的附子汤。(组成:附子、茯苓、人参、白术、芍药。)
治疗妇女有漏下(非经期阴道持续少量出血)症状的,有半产后因继续下血不止的,有妊娠期间下血的,假如妊娠期腹中疼痛称为“胞阻”(胞宫阻滞),用这个汤剂主治。
干地黄(六两),川芎,阿胶,甘草(各二两),艾叶,当归(各三两),芍药(四两)。
以上七味药,用水五升,清酒三升,混合煎煮取三升药液,去渣滓,加入阿胶使其完全溶化。每次温服一升,每日服用三次。若病不愈……
歌诀曰:妊娠腹满阻胎胞。(名为胞阻,是因为胞宫中气血虚寒而阻碍了孕育功能。)川芎、甘草和阿胶各二两,当归……
陈元犀按语:川芎、芍药、地黄,都是补血药物。然而血液不能自行生成,它生于阳明胃腑的水谷精微,所以用甘草来补益脾胃。阿胶能调理冲任二脉。
治疗妇女怀孕,腹中绵绵作痛,用这个散剂主治。
当归,川芎(各三两),芍药(一斤),茯苓,白术(各四两),泽泻(半斤)。
以上六味药,捣碎成散剂。每次取一方寸匕的药量,用酒调和送服,每日服用三次。
歌诀曰:妊娠腹痛势绵绵。(不像寒疝那样的绞痛,也不像血气瘀滞那样的刺痛。)当归、川芎各三两以滋润,芍药一斤,泽泻减半,白术、茯苓各四两妙用盘旋。
陈元犀按语:怀孕期间腹痛,多属于血虚,而血生于中焦之气,中焦属土。土气过燥则不生万物,所以用当归、川芎、芍药来滋润它。土气过湿也不能生万物,所以用茯苓、白术、泽泻来渗利湿气。燥湿得到适宜调节,则中焦之气调和而血液自然生成,腹痛自然停止。
(The formula for Fuzi Tang is not listed here.) It treats women who are six or seven months pregnant, presenting with a wiry pulse and fever, increased fetal distension, abdominal pain, aversion to cold, and a sensation of cold in the lower abdomen as if being fanned by a wind. The reason for this is that the Zi Zang (uterus) is open. This decoction is used to warm the Zi Zang.
Commentary by Chen Yuanxi: The Taiyang channel governs the exterior, while the Shaoyin channel governs the interior. A wiry pulse with fever indicates that cold pathogen has injured the exterior of the Taiyang channel. Abdominal pain with aversion to cold indicates that cold pathogen has invaded the interior of the Shaoyin channel. The fetus resides below the umbilicus, connected to both the Taiyang and Shaoyin channels. When cold pathogen invades these two channels, Qi converges in the Bao Gong (uterus), disturbing and agitating the fetus, thus causing increased fetal distension. The symptoms of abdominal pain, aversion to cold, and the lower abdomen feeling like it is being fanned occur because Yin-cold pathogen is abundant internally, and cold qi penetrates externally, resulting in paroxysmal sensations resembling wind blowing. However, the fetus remains stable when warm and moves when cold. If cold qi prevails internally, it will inevitably lead to miscarriage. Therefore, it is said that the reason for this condition is that the Zi Zang (uterus) is open. Fuzi Tang warms the Zi Zang, making the uterus warm and the fetal root secure, thereby eliminating the risk of miscarriage. The formula for Fuzi Tang is not listed here; it is suspected to be the Fuzi Tang from Shanghan Lun (Treatise on Cold Damage). (Ingredients: Fuzi [Prepared Aconite Root], Fuling [Poria], Renshen [Ginseng Root], Baizhu [Atractylodes Macrocephala Rhizome], Shaoyao [White Peony Root].)
It treats women suffering from Lou Xia (persistent slight vaginal bleeding outside of menstruation), those whose bleeding continues after a spontaneous abortion (partial delivery), and those experiencing bleeding during pregnancy. In cases where abdominal pain occurs during pregnancy, termed Bao Zu (obstruction of the uterus), this decoction is the primary treatment.
Sheng Dihuang (Raw Rehmannia Root, 6 liang), Chuanxiong (Szechwan Lovage Rhizome), Ejiao (Donkey-hide Gelatin), Gancao (Licorice Root, 2 liang each), Aiye (Mugwort Leaf), Danggui (Angelica Sinensis Root, 3 liang each), Shaoyao (White Peony Root, 4 liang).
The above seven ingredients are boiled with five sheng of water and three sheng of clear wine until three sheng of liquid remain. Strain the dregs, add Ejiao (Donkey-hide Gelatin) and stir until completely dissolved. Take one sheng warm, three times daily. If the condition does not improve...
Song says: Pregnancy abdominal fullness obstructs the fetal womb. (This is named Bao Zu, because deficiency-cold of Qi and blood in the Bao Gong [uterus] obstructs gestation.) Two liang of Chuanxiong, Gancao [Licorice Root], and Ejiao [Donkey-hide Gelatin], Danggui [Angelica Sinensis Root]...
Commentary by Chen Yuanxi: Chuanxiong [Szechwan Lovage Rhizome], Shaoyao [White Peony Root], and Dihuang [Rehmannia Root] are herbs that nourish blood. However, blood does not generate itself; it is generated from the grain and water essence of the Yangming Stomach. Therefore, Gancao [Licorice Root] is used to tonify the middle. Ejiao [Donkey-hide Gelatin] regulates the Chong and Ren vessels.
It treats women who are pregnant and suffer from continuous dull pain in the abdomen. This powder is the primary treatment.
Danggui [Angelica Sinensis Root], Chuanxiong [Szechwan Lovage Rhizome] (3 liang each), Shaoyao [White Peony Root] (1 jin), Fuling [Poria], Baizhu [Atractylodes Macrocephala Rhizome] (4 liang each), Zexie [Alisma Rhizome] (0.5 jin).
The above six ingredients are pounded into a powder. Take one cun bi (a square-inch measure) per dose, mixed with wine. Take three times daily.
Song says: Pregnancy abdominal pain is continuous and mild. (Unlike the cramping pain of Han Han [cold colic] or the stabbing pain of blood stasis.) Three liang each of Danggui [Angelica Sinensis Root] and Chuanxiong [Szechwan Lovage Rhizome] moisten and nourish; one jin of Shaoyao [White Peony Root]; half amount of Zexie [Alisma Rhizome]; four liang each of Baizhu [Atractylodes Macrocephala Rhizome] and Fuling [Poria] work wonders in harmonizing.
Commentary by Chen Yuanxi: Abdominal pain during pregnancy often belongs to blood deficiency. Blood is generated from the Qi of the Middle Jiao (Middle Burner), which corresponds to Earth. If Earth is too dry, it cannot generate things; therefore, Danggui [Angelica Sinensis Root], Chuanxiong [Szechwan Lovage Rhizome], and Shaoyao [White Peony Root] are used to moisten it. If Earth is too damp, it also cannot generate things; therefore, Fuling [Poria], Baizhu [Atractylodes Macrocephala Rhizome], and Zexie [Alisma Rhizome] are used to leach out dampness. When dryness and dampness are properly balanced, the Qi of the Middle Jiao is regulated, blood is naturally generated, and the pain ceases.