妇人怀妊有口渴汗出,大饮冷水,而烦躁发狂,腰腹疼痛,以致胎欲堕者,人莫不谓火盛之极也,抑知是何经
之火盛乎?此乃胃火炎炽,熬煎胞胎之水,以致胞胎之水
涸,胎失所养,故动而不安耳。夫胃为水谷之海,多气多
血之经,所以养五脏六腑者,盖万物皆生于土,土气浓而
物始生,土气薄而物必死。然土气之所以能浓者,全赖火气之来生也;胃之能化水谷者,亦赖火气之能化也。今胃
中有火,宜乎生土,何以火盛而反致害乎?不知无火难以生土,而火多又能铄水。虽土中有火土不死,然亦必有水
方不燥;使胃火太旺,必致铄干肾水,土中无水,则自润不足,又何以分润胞胎;土铄之极,火势炎蒸,犯心越
神,儿胎受逼,安得不下坠乎!经所谓“二阳之病发心脾”者,正此义也。治法必须泄火滋水,使水气得旺,则
火气自平,火平则汗、狂、躁、渴自除矣。
方用息焚安胎汤。
生地(一两,酒炒) 青蒿(五钱) 白术(五钱,土炒) 茯苓(三钱) 人参(三钱) 知母(二钱) 花
粉(二钱)
水煎服。一剂而狂少平,二剂而狂大定,三剂而火尽解,胎亦安矣。此方药料颇重,恐人虑不胜,而不敢全
用,又不得不再为嘱之。怀胎而火胜若此,非大剂何以能蠲,火不息则狂不止,而胎能安耶!况药料虽多,均是滋
水之味,益而无损,勿过虑也。
眉批∶原方不可加减。
妊娠躁狂,每误有别症,不曰痰甚,即云时疾传经,而置妊娠于不问,误服多药,数月不愈。甚有打去胎而以顾大
人性命为名者,更属糊涂之极。
歌括∶妊娠腰腹痛难当,烦躁发狂欲饮凉。
胃火太盛灼肾水,胎无水润堕须防。
息焚安胎用人参,青蒿白术天花粉。
生地知母白茯苓,火尽胎安定心神。
妇女怀孕后出现口渴、出汗,大量饮用冷水,进而烦躁发狂,腰腹疼痛,导致胎儿欲堕的情况,人们无不认为是火气极盛所致。然而,谁知道是哪一经的火气极盛呢?这其实是胃火炎炽,煎熬胞胎中的津液,导致胞胎津液枯竭,胎儿失去滋养,所以胎动不安。
胃是水谷汇聚的海,是多气多血的经脉,用来滋养五脏六腑。大概万物都生于土,土气浓厚则万物始生,土气薄弱则万物必死。然而土气之所以能浓厚,全赖火气的滋生;胃之所以能消化水谷,也依赖火气的运化。现在胃中有火,按理说应该助长土气,为什么火气过盛反而导致危害呢?不知道没有火难以生土,但火过多又能熔化水。虽然土中有火土不会死,但也必须有水才不会干燥;如果胃火太旺,必然导致肾水被熔化干枯,土中没有水,自然滋润不足,又怎能分润滋养胞胎呢?土被熔化到了极点,火势炎蒸,侵犯心神,使神志越出常态,胎儿受到逼迫,怎么能不向下坠落呢!《内经》所说的“二阳之病发心脾”,正是这个意思。治疗方法必须泄火滋水,使水气旺盛,则火气自然平息,火气平息则汗出、发狂、烦躁、口渴自然消除。
方用息焚安胎汤。
生地(一两,酒炒) 青蒿(五钱) 白术(五钱,土炒) 茯苓(三钱) 人参(三钱) 知母(二钱) 花粉(二钱)
水煎服。一剂后狂躁稍平,二剂后狂躁大定,三剂后火气尽解,胎儿也就安稳了。此方药量颇重,恐怕人担心身体承受不住,而不敢全用,因此不得不再次嘱咐。怀孕而火气胜到这种地步,不用大剂量怎么能清除病邪,火气不息止则狂躁不止,胎儿怎么能安稳呢!况且药料虽多,都是滋水的药物,只有益处没有损害,不要过分担忧。
眉批:原方不可加减。
妊娠期的躁狂,常常被误诊为其他病症,不是说痰湿很重,就是说是时疫疾病传经,从而置妊娠于不顾,误服多种药物,数月不愈。甚至有以顾全大人性命为名打掉胎儿的,更是糊涂到了极点。
歌括:
妊娠腰腹痛难当,烦躁发狂欲饮凉。
胃火太盛灼肾水,胎无水润堕须防。
息焚安胎用人参,青蒿白术天花粉。
生地知母白茯苓,火尽胎安定心神。
When a pregnant woman experiences thirst, sweating, excessive drinking of cold water, followed by irritability and madness, along with lower back and abdominal pain leading to threatened abortion, people invariably attribute it to extreme excess heat. However, which meridian's heat is excessively abundant? This is actually due to blazing Stomach Fire (Wei Huo Yan Chi), which boils and consumes the fluids of the Chong-Ren vessels (Bao Tai), causing the fluids of the Chong-Ren vessels to dry up. Consequently, the fetus loses nourishment, resulting in fetal movement and instability.
The Stomach is the sea of water and grain, a meridian rich in Qi and Blood, responsible for nourishing the Zang-Fu organs. Generally, all things are born from Earth; when Earth Qi is robust, life begins, and when it is thin, life perishes. The reason Earth Qi can be robust lies entirely in the generation by Fire Qi; similarly, the Stomach's ability to digest food and drink relies on the transformative power of Fire Qi. Now that there is fire in the Stomach, one might expect it to generate Earth, yet why does excessive fire cause harm? It is unknown that without fire, it is difficult to generate Earth, but too much fire can melt Water. Although Earth containing fire does not die, it must have water to avoid dryness; if Stomach Fire is too strong, it will inevitably melt and dry up Kidney Water (Shen Shui). Without water in the Earth, natural moistening is insufficient, and how can it distribute moisture to nourish the Chong-Ren vessels? When Earth is scorched to the extreme, the fire flares up, invading the Heart Spirit (Xin Shen) and causing spiritual deviation. The fetus, being pressured, cannot help but descend. As stated in the *Classic*, "Diseases of the Two Yangs originate in the Heart and Spleen," this precisely illustrates this principle. The treatment method must involve purging fire and nourishing water. Once Water Qi becomes robust, Fire Qi will naturally subside; once the fire subsides, sweating, madness, irritability, and thirst will naturally disappear.
Prescribe Xi Fen An Tai Tang (Incense-Extinguishing Fetus-Calming Decoction).
Sheng Di Huang (Rehmanniae Radix Praeparata, 1 liang, stir-fried with wine) Qing Hao (Artemisiae Annuae Herba, 5 qian) Bai Zhu (Atractylodis Macrocephalae Rhizoma, 5 qian, stir-fried with soil) Fu Ling (Poria, 3 qian) Ren Shen (Ginseng Radix et Rhizoma, 3 qian) Zhi Mu (Anemarrhenae Rhizoma, 2 qian) Hua Fen (Trichosanthis Radix, 2 qian)
Decoct in water and take orally. After one dose, the madness slightly calms; after two doses, the madness largely stabilizes; after three doses, the fire is completely resolved, and the fetus becomes secure. The dosage in this prescription is quite heavy; some may fear their constitution cannot withstand it and dare not use the full amount. Therefore, I must reiterate: when pregnancy is accompanied by such overwhelming heat, only large doses can eliminate the pathogen. If the fire is not extinguished, the madness will not cease, and how can the fetus remain secure? Moreover, although there are many ingredients, they are all substances that nourish water, providing benefit without harm. Do not worry excessively.
Marginal Note: The original formula should not be modified.
Madness and irritability during pregnancy are often misdiagnosed as other conditions; either phlegm is blamed, or it is claimed that an epidemic disease has transmitted through the meridians, ignoring the pregnancy itself. Many drugs are mistakenly taken, failing to cure for months. Even worse, some advocate aborting the fetus under the guise of saving the mother's life, which is extremely foolish.
Verse:
During pregnancy, lower back and abdominal pain are unbearable;
Irritability and madness arise, craving cool drinks.
Stomach fire is too strong, scorching Kidney water;
Without water to moisten the fetus, abortion must be guarded against.
Xi Fen An Tai Tang uses Ren Shen,
Qing Hao, Bai Zhu, and Tian Hua Fen.
Sheng Di, Zhi Mu, and Bai Fu Ling,
Once fire is gone, the fetus settles, calming the spirit.