夫胎痛者,皆妊妇禁忌不知,或由生冷或触风寒,邪正相击,随气上下,冲于心则心痛,攻于肠胎,则肠胎痛。
【主意】
胎痛分明胎气伤,致令妊妇痛长声。脉来细紧寒食气,缩砂
四气最为良。脉涩血虚宜四物,紫苏香附服安详。尺数热痛连炒入,诊脉须分阴与阳。
四七汤
苏叶 浓朴(姜) 白茯苓(各一钱) 半夏(一钱五分,姜制)
加姜、枣,水煎服。
皆妇人禀受怯弱,或有风气,或有痰饮,凡妊便是有病,其妇颜色如故,脉息和顺,但觉体肢沉重,
头目昏眩,择食,恶闻气味,好食酸咸,甚者作寒热,呕吐痰水。轻者不必服药,重者以半夏汤,茯苓丸可也。
【主意】
血夺胃气呕咽干,一云痰火自相搏,饮食下咽随口出,致令恶阻食难吞。半夏茯苓汤要药,
二陈藿术亦为尊。脉分热冷并虚实,顺气和脾胎自安。
半夏汤
半夏(姜制) 缩砂(各二两) 茯苓 白术(炒) 杏仁(去皮尖) 芍药(各五
两) 竹叶(三十片) 大枣(五枚) 陈皮(五两)
水煎服
半夏甘而益脾,辛而散滞。姜所以制半夏之毒也。脾喜燥而畏湿,故用白术燥脾,茯苓渗湿。
脾喜通而恶塞,故用杏仁利气,陈皮泄气,竹叶清气,能去水中之火,芍药味酸,能泻土中之水,
大枣取其甘而益脾耳。
茯苓丸
赤茯 人参 桂心 干姜(炙) 半夏(制) 陈皮(各一两) 白术(炒) 干葛 枳壳 甘草(炙)
共为末蜜丸,梧桐子大,每服五十丸,一日三服
半夏茯苓汤
半夏(制) 茯苓(八分) 砂仁(炒) 陈皮 甘草(各四分)
加枣、姜、乌梅,水煎服二三剂,再服茯苓丸。此方健脾化
痰滞要药,或加白术为好。若食滞加枳壳,气恼加柴胡。
回春散
白茯苓(一钱) 半夏(制,一钱) 陈皮(五分) 苍术 浓朴(各一钱、姜汁炒)
砂仁(五分) 藿香(八分) 干姜(二分) 乌梅(一个) 甘草(三分)
加姜三片,水煎服。
胎痛,都是由于孕妇不知道禁忌,或者因为吃了生冷食物,或者受到风寒侵袭,邪气与正气相互搏击,随着气机上下运行。如果邪气冲犯心脏,就会引起心痛;如果攻袭肠道和胞胎,就会引起肠部和胞胎疼痛。
【主治歌诀】
胎痛明确是因为胎气受损,导致孕妇长时间疼痛并伴有呻吟声。脉象细紧,提示有寒邪或饮食停滞之气,此时用缩砂仁配合四气药最为良效。脉象涩滞,提示血虚,适宜服用四物汤,配合紫苏、香附服用则安稳。尺部脉数且热痛明显者,可将药物炒制后入药,诊脉时必须区分阴证与阳证。
四七汤
紫苏叶、厚朴(姜汁制)、白茯苓(各一钱),半夏(一钱五分,姜汁制)。
加入生姜、大枣,用水煎服。
这些情况都是由于妇人先天禀赋怯弱,或者有风气(风邪),或者有痰饮。凡是怀孕就带有病态的妇女,其面色如常,脉息和顺,只是觉得肢体沉重,头目昏眩,挑食,厌恶闻气味,喜欢吃酸咸食物,严重的出现寒热往来,呕吐痰水。轻症不必服药,重症可以用半夏汤、茯苓丸治疗。
【主治歌诀】
气血亏损,胃气上逆导致咽喉干燥,另一种说法是痰火相互搏结,饮食咽下随即吐出,导致恶阻症状,食物难以吞咽。半夏茯苓汤是主要药物,二陈汤加藿香、白术也是尊贵的方剂。脉象要分辨热冷以及虚实,使气机顺畅、脾胃调和,胎儿自然安宁。
半夏汤
半夏(姜汁制)、缩砂仁(各二两),茯苓、白术(炒)、杏仁(去皮尖)、芍药(各五两),竹叶(三十片),大枣(五枚),陈皮(五两)。
用水煎服。
半夏味甘能补益脾胃,味辛能消散积滞。用生姜是为了制约半夏的毒性。脾脏喜欢干燥而畏惧湿气,所以用白术燥湿健脾,茯苓渗利湿气。脾脏喜欢通畅而厌恶壅塞,所以用杏仁利气,陈皮泄气,竹叶清气,能去除水中的火热之邪;芍药味酸,能泻土中的水湿;大枣取其甘味以补益脾胃。
茯苓丸
赤茯苓、人参、桂心、干姜(炙)、半夏(制)、陈皮(各一两),白术(炒)、干葛、枳壳、甘草(炙)。
共研为末,用蜂蜜制成梧桐子大小的丸药,每次服用五十丸,一日三次。
半夏茯苓汤
半夏(制)、茯苓(八分)、砂仁(炒)、陈皮、甘草(各四分)。
加入枣、姜、乌梅,用水煎服二三剂,然后再服用茯苓丸。此方是健脾化痰滞的要药,或者加入白术更好。如果有食滞,加入枳壳;如果有气恼郁结,加入柴胡。
回春散
白茯苓(一钱)、半夏(制,一钱)、陈皮(五分)、苍术、厚朴(各一钱,姜汁炒),砂仁(五分)、藿香(八分)、干姜(二分)、乌梅(一个)、甘草(三分)。
加入生姜三片,用水煎服。
Tongue pain during pregnancy is caused by the pregnant woman's failure to observe taboos, either by consuming raw and cold foods or by exposure to wind-cold pathogens. The pathogenic factors clash with the healthy qi, moving up and down with the Qi mechanism. If the pathogen rushes to the Heart, it causes heart pain; if it attacks the intestines and the fetus, it causes pain in the intestines and the fetal region.
[Main Therapeutic Verse]
Tongue pain is clearly due to injury of the fetal Qi, causing the pregnant woman to suffer from prolonged pain and groaning. A fine and tight pulse indicates cold or food stagnation; Su Sha Ren (Amomi Fructus Rotundus) combined with Si Qi medicines is most effective. A choppy pulse indicates blood deficiency, suitable for Si Wu Tang (Four Substances Decoction), taken with Zi Su Ye (Perillae Folium) and Xiang Fu (Cyperus Rhizoma) for stability. If the Chi position pulse is rapid and heat pain is prominent, herbs should be stir-fried before use. Pulse diagnosis must distinguish between Yin and Yang patterns.
Si Qi Tang (Four Seven Decoction)
Zi Su Ye (Perillae Folium), Hou Po (Magnoliae Officinalis Cortex) [processed with Ginger Juice], Bai Fu Ling (Poria) (each 1 qian), Ban Xia (Pinelliae Rhizoma) (1.5 qian, processed with Ginger Juice).
Add Sheng Jiang (Zingiberis Rhizoma Recens) and Da Zao (Jujubae Fructus), decoct in water and take orally.
These conditions arise because women have a weak congenital constitution, or possess Wind pathogens, or have Phlegm-Fluid retention. In such cases, pregnancy itself acts as a pathological state. The woman's complexion remains normal, and the pulse is harmonious and smooth, but she feels heaviness in the limbs, dizziness of the head and eyes, selective appetite, aversion to odors, a craving for sour and salty flavors, and in severe cases, alternating chills and fever, vomiting of phlegm-fluids. Mild cases do not require medication; severe cases can be treated with Ban Xia Tang (Pinellia Decoction) or Fu Ling Wan (Poria Pill).
[Main Therapeutic Verse]
Loss of Blood and rebellious Stomach Qi cause dryness in the throat. Another view suggests that Phlegm-Fire clashing together causes food to be vomited immediately after swallowing, leading to E Zu (Morning Sickness/Hyperemesis Gravidarum) where food is difficult to swallow. Ban Xia Fu Ling Tang (Pinellia and Poria Decoction) is the primary remedy; Er Chen Tang (Two-Cured Decoction) added with Huo Xiang (Agastaches Herba) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) is also highly esteemed. The pulse must differentiate between Heat/Cold and Deficiency/Excess. Harmonizing Qi and strengthening the Spleen ensures the safety of the fetus.
Ban Xia Tang (Pinellia Decoction)
Ban Xia (Pinelliae Rhizoma) [processed with Ginger Juice], Su Sha Ren (Amomi Fructus Rotundus) (each 2 liang), Fu Ling (Poria), Bai Zhu (Atractylodis Macrocephalae Rhizoma) [stir-fried], Xing Ren (Armeniacae Semen Amarum) [skin and tip removed], Shao Yao (Paeoniae Radix Alba) (each 5 liang), Zhu Ye (Bambusae Folium) (30 leaves), Da Zao (Jujubae Fructus) (5 pieces), Chen Pi (Citri Reticulatae Pericarpium) (5 liang).
Decoct in water and take orally.
Ban Xia is sweet to benefit the Spleen and pungent to dissipate stagnation. Ginger is used to neutralize the toxicity of Ban Xia. The Spleen prefers dryness and fears dampness; thus, Bai Zhu is used to dry the Spleen, and Fu Ling to leach out dampness. The Spleen prefers free flow and dislikes obstruction; thus, Xing Ren is used to promote Qi movement, Chen Pi to vent Qi, and Zhu Ye to clear Heat, removing fire from within the water. Shao Yao is sour and can drain water from the Earth element. Da Zao is used for its sweetness to benefit the Spleen.
Fu Ling Wan (Poria Pill)
Chi Fu Ling (Poria with Red Hosta Root), Ren Shen (Ginseng Radix et Rhizoma), Gui Xin (Cinnamomi Ramulus), Gan Jiang (Zingiberis Rhizoma) [roasted], Ban Xia (Pinelliae Rhizoma) [processed], Chen Pi (Citri Reticulatae Pericarpium) (each 1 liang), Bai Zhu (Atractylodis Macrocephalae Rhizoma) [stir-fried], Gan Ge (Puerariae Lobatae Radix], Zhi Qiao (Aurantii Fructus Immaturus), Gan Cao (Glycyrrhizae Radix et Rhizoma) [roasted].
Grind into powder, make pills with honey the size of paulownia seeds. Take 50 pills per dose, three times a day.
Ban Xia Fu Ling Tang (Pinellia and Poria Decoction)
Ban Xia (Pinelliae Rhizoma) [processed], Fu Ling (Poria) (8 fen), Sha Ren (Amomi Fructus) [stir-fried], Chen Pi (Citri Reticulatae Pericarpium), Gan Cao (Glycyrrhizae Radix et Rhizoma) (each 4 fen).
Add Da Zao (Jujubae Fructus), Sheng Jiang (Zingiberis Rhizoma Recens), and Wu Mei (Mume Fructus), decoct in water. Take 2-3 doses, then follow with Fu Ling Wan (Poria Pill). This formula is a key medicine for strengthening the Spleen and resolving Phlegm stagnation; adding Bai Zhu (Atractylodis Macrocephalae Rhizoma) is beneficial. If there is Food Stagnation, add Zhi Qiao (Aurantii Fructus Immaturus); if there is emotional distress/Qi constraint, add Chai Hu (Bupleuri Radix).
Hui Chun San (Revitalization Powder)
Bai Fu Ling (Poria) (1 qian), Ban Xia (Pinelliae Rhizoma) [processed, 1 qian], Chen Pi (Citri Reticulatae Pericarpium) (5 fen), Cang Zhu (Atractylodis Rhizoma), Hou Po (Magnoliae Officinalis Cortex) (each 1 qian, stir-fried with Ginger Juice), Sha Ren (Amomi Fructus) (5 fen), Huo Xiang (Agastaches Herba) (8 fen), Gan Jiang (Zingiberis Rhizoma) (2 fen), Wu Mei (Mume Fructus) (1 piece), Gan Cao (Glycyrrhizae Radix et Rhizoma) (3 fen).
Add 3 slices of Sheng Jiang (Zingiberis Rhizoma Recens), decoct in water and take orally.