霍乱者,因甘肥过度,腐积成痰,七情郁结,气盛为火,停蓄胃中,乍因寒热之感,邪正交争,阴阳相
混,故令心腹绞痛,吐、利并作,挥霍变乱。如邪在上胃脘,则当心痛而吐多;邪在下胃脘,则当脐痛而
利多;邪在中脘,则腹中痛,吐、利俱多。吐多则伤气,利多则伤血,血气受伤不能护养其胎,邪气鼓击胎
元,子母未有不殒者,此危症不可不亟治也,宜香苏散加藿香,先服后探吐之。
妊娠泄泻,不外脾肾二脏,虚者居多。夫血统于脾,血拥胎元,则脾阴虚而食不运化。脾主健运,下
焦壅滞而清气难舒,于是水谷难消而作泻。且胎系于肾,胎窃其气以拥护,而肾气既弱,命门火衰,不能上蒸脾
土,此妊娠泄泻之由也。虽其间不无风寒暑湿之外感,饮食生冷之内伤,然属于脾肾有亏者乃其本也。
妊娠伤食,多由脾胃中气虚弱,不能运化,若中气壮实,无是病也。然胎以脾胃为主,脾胃强则胎系如悬
钟而不坠,若伤食不化则脾困而胎不能固。故凡即消食导滞,皆先以补脾健胃为主,而推扬谷气,则饮食自化。
若徒事消克,不但胎元易坠,且脾虚而愈虚之,化源之机竭矣。
凡七情内伤,六淫外感,皆足致失血之患。而妊娠吐血一主火热者,以气血壅养胎元,或有所感则
气逆而火上乘心,心烦满闷,血随而溢也。但火略有虚实之分,实火当清热以养血;虚火
当滋阴以补水,则血可安而胎可固。若泛用行血、消血之剂,胎必堕而祸不旋踵矣。
霍乱,是由于过食甘甜肥腻之物,导致食物腐败积滞而成痰,加上七情郁结,气机旺盛化为火邪,停蓄在胃中。忽然感受寒热之邪,邪气与正气交争,阴阳之气混乱,因此导致心腹剧烈绞痛,呕吐和腹泻同时发作,病情变化迅速且混乱。如果邪气位于上脘(胃的上部),则会出现心痛且呕吐较多;如果邪气位于下脘(胃的下部),则会出现肚脐周围疼痛且腹泻较多;如果邪气位于中脘(胃的中部),则会出现腹部疼痛,呕吐和腹泻都很多。呕吐过多会损伤气,腹泻过多会损伤血,气血受损后无法护养胎儿,邪气鼓动冲击胎元,母子没有不死亡的,这是危急重症,不可不紧急治疗,适宜用香苏散加藿香,先服用后再探吐以排出病邪。
妊娠期间发生泄泻,不外乎脾、肾两脏的问题,其中虚证居多。血液由脾所统摄,血液供养胎元,会导致脾阴不足而饮食难以运化。脾主健运,若下焦壅滞导致清气难以舒展,于是水谷难以消化而发生泄泻。而且胎儿系于肾,胎儿窃取肾气来拥护自身,导致肾气虚弱,命门之火衰微,不能向上蒸腾温煦脾土,这就是妊娠泄泻的原因。虽然其间也不排除有风寒暑湿等外感,或饮食生冷等内伤,但属于脾肾亏虚才是其根本原因。
妊娠伤食,多由脾胃中气虚弱,不能运化所致,如果中气壮实,就不会得这种病。然而胎儿以脾胃为主,脾胃强健则胎儿像悬挂的钟一样稳固不坠,如果伤食不化则脾受困顿而胎儿不能固摄。所以凡是治疗消食导滞,都应当先以补脾健胃为主,推扬谷气,那么饮食自然能够消化。如果只是单纯使用消食克伐的药物,不但容易导致胎元坠落,而且会使脾虚更加严重,导致化生之源枯竭。
凡是七情内伤,六淫外感,都足以导致失血的祸患。而妊娠吐血主要归属于火热证,因为气血壅盛以供养胎元,一旦有所感触则气机上逆,火邪上乘于心,导致心烦意乱、胸中满闷,血液随之溢出。但是火邪略有虚实之分,实火应当清热以养血;虚火应当滋阴以补水,这样血液可以安宁而胎儿可以稳固。如果滥用行血、破血的药剂,胎儿必定流产,灾祸随即而至。
Huo Luan (Acute Gastroenteritis with Vomiting and Diarrhea) arises from excessive consumption of sweet and fatty foods, leading to food stagnation transforming into phlegm. Combined with emotional depression causing Qi stagnation and transformation into fire, these pathogenic factors accumulate in the Stomach. Upon sudden exposure to cold or heat pathogens, the pathogenic factor and healthy Qi contend, causing a confusion of Yin and Yang. This results in severe cramping pain in the heart and abdomen, with simultaneous vomiting and diarrhea, characterized by rapid and chaotic changes. If the pathogen is located in the Upper Jiao/Stomach region, there will be heart pain with predominant vomiting; if in the Lower Jiao/Stomach region, there will be periumbilical pain with predominant diarrhea; if in the Middle Jiao/Stomach region, there will be abdominal pain with both vomiting and diarrhea being profuse. Excessive vomiting damages Qi, while excessive diarrhea damages Blood. When Qi and Blood are injured, they cannot nourish and protect the Fetus. The pathogenic factor agitates and strikes the Tai Yuan (Fetal Origin), endangering both mother and child, which constitutes a critical condition requiring urgent treatment. It is appropriate to administer Xiang Su San (Aromatic Perilla Powder) added with Huo Xiang (Patchouli Herb), followed by inducing vomiting to expel the pathogen.
Diarrhea during pregnancy primarily involves the Spleen and Kidney organs, with deficiency patterns being most common. Blood is governed by the Spleen; when blood nourishes the Fetus, it may lead to Spleen Yin deficiency and impaired digestion. The Spleen governs transportation and transformation; if the Lower Jiao is obstructed preventing the clear Qi from ascending smoothly, water and grain fail to digest, resulting in diarrhea. Furthermore, the fetus is rooted in the Kidney; the fetus draws upon Kidney Qi for support, weakening the Kidney Qi. When the Fire of the Ming Men (Gate of Life) declines, it fails to steam and warm the Earth of the Spleen, which is the etiology of diarrhea during pregnancy. Although external invasions of Wind-Cold, Summer-Heat, and Dampness, or internal injuries from raw and cold food, may occur, the root cause lies in the deficiency of the Spleen and Kidney.
Food stagnation during pregnancy is mostly due to the weakness of Middle Qi in the Spleen and Stomach, impairing transportation and transformation. If Middle Qi were robust, this disease would not occur. However, the fetus relies on the Spleen and Stomach as its foundation; strong Spleen and Stomach ensure the fetus remains secure like a suspended bell, whereas food stagnation confuses the Spleen and fails to secure the fetus. Therefore, in treating food stagnation, the primary approach must be tonifying the Spleen and strengthening the Stomach first. By promoting the generation of Gu Qi (Grain Qi), food digestion occurs naturally. If one merely employs digestive and purgative methods without tonification, not only does it risk fetal expulsion, but it also exacerbates Spleen deficiency, exhausting the source of transformation and production.
Internal injury from the Seven Emotions and external invasion by the Six Evils can all lead to hemorrhage. Hematemesis (vomiting blood) during pregnancy is primarily attributed to Heat-Fire. Because Qi and Blood are congested to nourish the Fetus, any disturbance causes Qi to rebel upward, with Fire attacking the Heart. This leads to mental restlessness, chest fullness, and oppression, causing blood to overflow. However, Fire has slight distinctions between Excess and Deficiency. Excess Fire should be cleared to nourish Blood; Deficient Fire should be treated by nourishing Yin to replenish Water. In this way, Blood can be stabilized and the Fetus secured. If hemostatic or blood-invigorating formulas are used indiscriminately, the Fetus will inevitably abort, and disaster will follow immediately.