甘麦大枣汤
30.脏燥无故自悲伤, 象若神灵大枣汤, 甘草小麦与大枣, 方出金匮
效非常.
【注】孕妇无故, 时时伤悲哀痛, 象若神灵凭根据者, 名曰脏燥, 宜用
金匮甘麦大枣汤服之. 其方即甘草, 小麦, 大枣三味, 煎服, 其效非
常也.
31.邪思情感鬼胎生, 腹大如同怀子形, 岂缘鬼神能交接, 自身血气
结而成.
【注】鬼胎者, 因其人思想不遂, 情志相感, 自身气血凝结而成, 其
腹渐大如怀子形状. 古云实有鬼神交接, 其说似属无据. 妇人石瘕,
肠覃二证, 亦俱如怀孕之状, 由气血凝结而成, 则可知其必无是理矣
!
香棱丸
32.肠覃石瘕气血分, 寒客肠外客子门, 二证俱如怀子状, 辨在经行
经不行. 石瘕吴萸汤最效, 肠覃香棱丸若神, 丁木茴香川楝子, 青皮
广茂与三棱.
【注】经云: 寒气客于肠外, 与卫气相搏, 气不得荣, 因有所系, 瘕
而内着, 恶气乃起, 瘜肉乃生, 始如鸡卵, 稍以益大如怀子状, 按之
则坚, 推之则移, 月事以时下. 石瘕生于胞中, 寒气客于子门, 子门
闭塞, 气不得通, 恶血当下不下, 衄以留止, 日以益大, 状如怀子,
月事不以时下, 皆生于女子, 可导而下. 由经文观之, 二证虽皆如怀
子状, 肠覃气病而血不病, 故月事以时下; 石瘕先气病而后血病, 故
月事不来也, 石瘕宜吴萸汤. 肠覃宜香棱丸, 即木香, 丁香, 茴香,
川楝子, 青皮, 广茂, 三棱, 醋煮面糊为丸也.
吴茱萸汤 方见首卷
30. 脏燥证患者无缘无故地悲伤哭泣,神情恍惚如同神灵附体。此病宜用《金匮要略》中的甘麦大枣汤治疗,该方由甘草、小麦和大枣三味药组成,疗效非凡。
【注】孕妇若无缘无故地时常感到悲伤哀痛,神情恍惚如同神灵凭依一般,这种病症称为“脏燥”,适宜服用《金匮要略》中的甘麦大枣汤。该方仅由甘草、小麦、大枣三味药组成,煎煮后服用,其疗效非常显著。
31. 因邪思妄念或情感郁结导致“鬼胎”生成,腹部增大如同怀孕之状。这难道是因为鬼神能与人体交接吗?其实是由自身气血凝结而成的。
【注】所谓“鬼胎”,是因为患者思想不得舒展,情志相互感应,导致自身气血凝结而成,腹部逐渐增大,形状如同怀孕。古人说确实有鬼神与人交接,这种说法似乎缺乏依据。妇女的“石瘕”和“肠覃”两种证候,也都呈现类似怀孕的状态,都是由气血凝结而成,由此可知必然没有鬼神交接的道理。
32. “肠覃”与“石瘕”在气血病机上有所区分,寒气客居在肠外及子宫口(子门)。这两种证候都表现为腹部增大如同怀孕,辨别的关键在于月经是否按时来潮。“石瘕”用吴茱萸汤疗效最佳,“肠覃”用香棱丸效果神妙。香棱丸由丁香、木香、茴香、川楝子、青皮、广茂(莪术)和三棱组成。
【注】医经记载:寒气客居于肠外,与卫气相搏结,气机不能正常荣养,因而有所羁绊,形成积块并内着于体内,恶气于是产生,息肉(此处指赘生物或肿块)随之生长,起初像鸡蛋大小,随后逐渐增大,状如怀孕,按压时感觉坚硬,推动时可以移动,但月经仍能按时来潮。“石瘕”生于胞宫之中,寒气客居于子宫口,子宫口闭塞,气机不能通畅,败血应当下行却未能下行,瘀血留滞体内,日渐增大,形状如同怀孕,但月经不能按时来潮。这两种病都发生于女子身上,可以用导下法治疗。从经文来看,这两种证候虽然都表现为腹部增大如同怀孕,但“肠覃”是气分有病而血分无病,所以月经能按时来潮;“石瘕”先是气分有病而后波及血分,所以月经不来潮。“石瘕”适宜用吴茱萸汤,“肠覃”适宜用香棱丸。香棱丸即由木香、丁香、茴香、川楝子、青皮、广茂、三棱组成,用醋煮面糊制作成丸剂。
吴茱萸汤 方剂见本书首卷
Ganmai Dazao Decoction (Licorice, Wheat, and Jujube Decoction)
30. Patients with Zang Dryness (a syndrome characterized by emotional instability and dryness of the internal organs) weep and feel sorrowful for no apparent reason, appearing as if possessed by spirits. This condition is treated with Ganmai Dazao Decoction from *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet), which consists of Licorice Root (*Gancao*), Wheat (*Xiaomai*), and Jujube Fruit (*Dazao*). Its efficacy is extraordinary.
[Annotation] When a pregnant woman feels frequent sadness and grief without cause, appearing as if possessed by spirits, this condition is named Zang Dryness. It is appropriate to administer Ganmai Dazao Decoction from *Jingui Yaolue*. The formula consists of only three ingredients: Licorice Root (*Gancao*), Wheat (*Xiaomai*), and Jujube Fruit (*Dazao*). Decocted and taken orally, its therapeutic effect is remarkable.
31. Ghost Pregnancy (*Guotai*) arises from evil thoughts or emotional constraints; the abdomen enlarges resembling pregnancy. Is it due to sexual intercourse with ghosts and deities? No, it is formed by the coagulation of one's own Qi and Blood.
[Annotation] "Ghost Pregnancy" occurs because the patient's thoughts are unfulfilled and emotions are disturbed, leading to the coagulation of Qi and Blood within the body. Consequently, the abdomen gradually enlarges, taking on the shape of pregnancy. Ancient texts claim that actual sexual intercourse with ghosts and deities causes this; such claims appear to lack evidence. Women suffering from Shi Jia (Stone Mass) and Chang Qun (Intestinal Polyp/Mass) also present with appearances similar to pregnancy, both resulting from the coagulation of Qi and Blood. Thus, it can be deduced that the notion of ghostly intercourse is unfounded.
Xiang Leng Wan (Fragrant Triangle Pill)
32. Chang Qun and Shi Jia differ in their involvement of Qi and Blood. Cold pathogens lodge outside the intestines and at the Zi Men (Os Uteri/Cervical Orifice). Both conditions manifest as abdominal enlargement resembling pregnancy; the distinction lies in whether menstruation occurs regularly. For Shi Jia, Wuzhuyu Tang (Evodia Decoction) is most effective; for Chang Qun, Xiang Leng Wan is miraculous. Xiang Leng Wan comprises Clove (*Dingxiang*), Costus Root (*Muxiang*), Fennel Seed (*Huixiang*), Sichuan Chinaberry Fruit (*Chuanlianzi*), Green Tangerine Peel (*Qingpi*), Ezhu (*Guangmao*), and Burreed Tuber (*Sanleng*).
[Annotation] The medical classics state: When cold pathogens lodge outside the intestines and contend with Wei Qi (Defensive Qi), Qi fails to nourish properly, becoming bound and forming a mass that adheres internally. Evil Qi arises, and polyps (masses) grow. Initially the size of a chicken egg, they gradually enlarge to resemble pregnancy. They are firm upon palpation but movable upon pushing. Menstruation proceeds at its regular time. Shi Jia originates in the Bao Zhong (Uterus); cold pathogens lodge at the Zi Men, causing closure and blocking Qi flow. Bad blood should descend but does not, remaining stagnant and enlarging daily, resembling pregnancy, yet menstruation does not occur at its regular time. Both conditions occur in women and can be treated with methods to guide out stagnation. From the classic text, although both conditions resemble pregnancy, Chang Qun involves Qi pathology without Blood pathology, hence menstruation occurs regularly. Shi Jia involves Qi pathology first, followed by Blood pathology, hence menstruation ceases. Shi Jia is suitable for Wuzhuyu Tang; Chang Qun is suitable for Xiang Leng Wan. Xiang Leng Wan is made from Costus Root (*Muxiang*), Clove (*Dingxiang*), Fennel Seed (*Huixiang*), Sichuan Chinaberry Fruit (*Chuanlianzi*), Green Tangerine Peel (*Qingpi*), Ezhu (*Guangmao*), and Burreed Tuber (*Sanleng*), processed into pills using vinegar-boiled wheat paste.
Wuzhuyu Tang (Evodia Decoction) Formula is found in the first volume.