芎藭 阿胶 甘草各二两 艾叶 当归各三两 芍药四两 干地黄
右七味,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,不差更作。
@@@
妇人怀妊,腹中□痛,当归芍药散主之。
【按】
妊娠腹中急痛用此方,未详其义,必是脱简,不释。
当归三两 芍药一斤 茯苓四两 白术四两 泽泻半筋 芎藭半筋
右六味,杵为散,取方寸匕,酒和,日三服。
@@@
妊娠,呕吐不止,干姜人参半夏丸主之。
【注】
妊娠呕吐谓之恶阻。恶阻者,谓胃中素有寒饮,恶阻其胎而妨饮食也。主之以干姜去
寒,半夏止呕,恶阻之人,日日呕吐,必伤胃气,故又佐人参也。
【集注】
程林曰:寒在胃脘,则令呕吐不止,故用干姜散寒,半夏、生姜止呕,人参和胃。半
夏、干姜能下胎。娄全善云:余治娠阻病,累用半夏,未尝动胎,亦有故无殒之义,
临病之工,何必拘泥。
尤怡曰:此益虚温胃之法,为妊娠中虚而有寒者设也。夫阳明之脉,顺而下行者也。
有寒则逆,有热亦逆,逆则饮必从之,而妊娠之体,精凝血聚,每多蕴而成热者矣。
按『外台』方:青竹茹、橘皮、半夏各五两,生姜、茯苓各四两,麦冬、人参各三两
,为治胃热气逆呕吐之法,可补仲景之未备也。
川芎、阿胶、甘草各二两,艾叶、当归各三两,芍药四两,干地黄。
以上七味药,用水五升、清酒三升,共同煎煮至剩余三升,滤去药渣,加入阿胶,使其完全溶化,每次温服一升,每日服用三次,若病未愈,可继续制作服用。
@@@
妇女怀孕后,腹部疼痛,用当归芍药散主治。
【按语】
妊娠期间出现腹部急痛使用此方,其具体原理不详,原文必有脱漏,故不解释。
当归三两,芍药一斤,茯苓四两,白术四两,泽泻半筋(注:此处“筋”应为“斤”之误或通假,依古制折算),川芎半筋。
以上六味药,捣碎成散剂,每次取一方寸匕的量,用酒调和,每日服用三次。
@@@
妊娠期呕吐不止,用干姜人参半夏丸主治。
【注解】
妊娠期的呕吐称为恶阻(妊娠反应)。所谓恶阻,是指胃中素有寒饮,阻碍胎气并妨碍饮食。方中以干姜去除寒气,半夏停止呕吐,因恶阻患者日日呕吐,必然损伤胃气,所以又佐以人参来补益。
【集注】
程林说:寒邪在胃脘,会导致呕吐不止,因此使用干姜散寒,半夏、生姜止呕,人参调和胃气。半夏、干姜能导致流产。娄全善说:我治疗妊娠恶阻病,多次使用半夏,从未动胎,这符合“有故无殒”(有病则病受之,不伤正气)的道理,临证治疗的医生,何必拘泥于常规禁忌。
尤怡说:这是补益虚损、温养胃气的治法,专为妊娠期间中焦虚弱而有寒邪者设立。阳明经脉是顺行下行的。有寒邪则气机上逆,有热邪也会上逆,气机上逆则水饮随之而上,而妊娠的体质,精血凝聚,往往多蕴结而成热。参考《外台秘要》中的方子:青竹茹、橘皮、半夏各五两,生姜、茯苓各四两,麦冬、人参各三两,这是治疗胃热气逆所致呕吐的方法,可以补充张仲景方剂的不足。
Rhizoma Chuanxiong (Xiong), Colla Corii Asini (Ejiao), Radix Glycyrrhizae (Gancao) each 2 liang; Folium Artemisiae Argyi (Aiye), Radix Angelicae Sinensis (Danggui) each 3 liang; Radix Paeoniae Alba (Shaoyao) 4 liang; Radix Rehmanniae Preparata (Shengdihuang).
The above seven herbs are decocted together with 5 sheng of water and 3 sheng of clear wine until reduced to 3 sheng. The dregs are removed, Colla Corii Asini (Ejiao) is added and melted completely. Take one sheng warm, three times a day. If not cured, prepare again.
@@@
For women during pregnancy experiencing abdominal pain, Danggui Shaoyao San (Angelica and Peony Powder) is the primary treatment.
[Commentary]
Using this formula for acute abdominal pain during pregnancy is unclear in its rationale; there must be missing text in the original manuscript, so it is not explained.
Radix Angelicae Sinensis (Danggui) 3 liang; Radix Paeoniae Alba (Shaoyao) 1 jin; Poria (Fuling); Rhizoma Atractylodis Macrocephalae (Baizhu) each 4 liang; Alisma Rhizoma (Zexie) half jin; Rhizoma Chuanxiong (Xiong) half jin.
The above six herbs are pounded into a powder. Each dose is one fangcun bi (a square-inch scoop), mixed with wine, taken three times a day.
@@@
For persistent vomiting during pregnancy, Ganjiang Renshen Banxia Wan (Dry Ginger, Ginseng, and Pinellia Pill) is the primary treatment.
[Annotation]
Vomiting during pregnancy is called Ezu (morning sickness/nausea of pregnancy). "Ezu" refers to cold-fluid retention in the stomach that obstructs the fetus and hinders food intake. Ganjiang (Rhizoma Zingiberis) is used to dispel cold, Banxia (Rhizoma Pinelliae) to stop vomiting. Since patients with Ezu vomit daily, damaging Stomach Qi, Renshen (Radix Ginseng) is added as an assistant to tonify.
[Collected Notes]
Cheng Lin stated: Cold in the epigastrium causes persistent vomiting; thus, Ganjiang (Rhizoma Zingiberis) disperses cold, Banxia (Rhizoma Pinelliae) and Shengjiang (Rhizoma Zingiberis Recens) stop vomiting, and Renshen (Radix Ginseng) harmonizes the Stomach. Banxia (Rhizoma Pinelliae) and Ganjiang (Rhizoma Zingiberis) can induce abortion. Lou Quanshan said: In my treatment of pregnancy obstruction, I have repeatedly used Banxia (Rhizoma Pinelliae) without disturbing the fetus. This aligns with the principle of "having the pathogen allows for no injury" (treating the disease does not harm the healthy qi). Physicians treating clinical cases need not be rigidly bound by conventions.
You Yi stated: This is a method of tonifying deficiency and warming the Stomach, designed for those with middle-jiao deficiency and cold during pregnancy. The Yangming meridian flows downward. Cold causes rebellion (upward flow), and heat also causes rebellion. When rebellious, fluids follow the path, and the pregnant constitution, with condensed essence and blood, often harbors heat. Referencing the prescription from "Waitai Mi Yao": Qingzhuru (Bambusae Caulis in Taeniam), Chupi (Citri Reticulatae Pericarpium), and Banxia (Rhizoma Pinelliae) each 5 liang; Shengjiang (Rhizoma Zingiberis Recens) and Fuling (Poria) each 4 liang; Maidong (Radix Ophiopogonis) and Renshen (Radix Ginseng) each 3 liang. This is a method for treating vomiting due to Stomach heat and rebellious Qi, which supplements the incompleteness of Zhang Zhongjing's prescriptions.