丹溪治一妇。孕两月。呕吐头眩。医以参、术、川芎、陈皮、茯苓服之。愈重。脉弦。
左为甚。而且弱。此恶阻病。必怒气所激。问之果然。肝气既逆。又挟胎气。参、术之补。
大非所宜。以茯苓汤下抑青丸二十四粒。五服稍安。脉略数。口干苦。食则口酸。意其膈间
滞气未尽行。以川芎、陈皮、山栀、生姜、茯苓煎汤。下抑青丸十五粒而愈。但口酸易饥。
此肝热未平。以热汤下抑青丸二十粒。至二十日而愈。后两手脉平和。而右甚弱。其胎必堕
此时肝气既平。可用参、术。遂以初方参、术等补之。预防堕胎以后之虚。服一月而胎自
堕。却得平安矣。
震按右脉弱而胎必堕。虽投参、术无功。此必丹溪试验数次。故确信不疑。
一妇孕三月吐痰水并饮食。每日寅卯作。作时觉小腹有气冲上。然后膈满而吐。面赤
微躁。头眩。卧不能起。肢疼微渴。盖肝火挟冲脉之火冲上也。一日甚。二日轻。脉和。右
手寸高。药不效者将二月余。偶用沉香磨水。化抱龙丸。一服膈宽。气不上冲。二三服。吐
止眩减。食进而安。
震按抱龙丸乃香窜辛散之药。似非孕妇所宜。竟获大效者。此妇必多郁。或多思。故气
结而右寸脉高。诸香药能破郁开结。则效也。
汪石山治一妇。形质瘦小。面色近紫。产后年余。经水不通。首夏忽病呕吐。手指麻痹
挛拳。不能伸展。声音哑小。哕不出声。医皆视为风病。危之。汪诊脉皆细微近滑。曰。此
妊娠恶阻病也。众谓经水不通。安有妊理。汪曰。天下之事。有常有变。此乃事之变也。脉
虽细微。似近于滑。又尺脉不绝。乃妊娠也。遂以四君子加二陈治之。诸证俱减。尚畏粥汤
惟食干糕香燥之物而有生意。
给事游让溪夫人。病新愈。月余经事不行。呕哕眩晕。饮食难进。医以为二阳之病发心
脾。女子不月。法在不治。江篁南诊之。尺脉虽小。按之滑而不绝。此妊而恶阻。非凶候也
六君子加砂仁。数服而安。后产一女。
震按前条系产后经犹未通。此条系病后月事不行。殊难指其为孕。汪公谓事之变。近来
却常有之。尺按不绝。最宜留心。至如恶阻乃常病。千金半夏茯苓汤最佳。二陈加生地、芍
芎、复花、桔梗、细辛、人参、生姜也。有寒者千金茯苓丸可用。六君加枳实、桂心、干
姜、葛根也。橘皮竹茹汤治胃热。抑青丸治肝火。法亦备矣。诸法不应则停药。金匮所谓加
吐下者则绝之也。过八十日。自愈。
朱丹溪治疗一位妇女。怀孕两个月，出现呕吐、头晕的症状。医生给她服用人参、白术、川芎、陈皮、茯苓，结果病情加重。脉象弦，左侧更为明显且虚弱。这是恶阻病（妊娠早期出现的恶心呕吐等症），必定是由怒气激发所致。询问后证实确实如此。肝气已经上逆，又夹杂胎气，人参、白术的补益作用，非常不适宜。于是用茯苓汤送服抑青丸二十四粒，服用五剂后稍微安定。脉象略微变快，口干口苦，进食时口中发酸。推测是膈间的滞气尚未完全行散，于是用川芎、陈皮、山栀、生姜、茯苓煎汤，送服抑青丸十五粒而痊愈。只是口中发酸且容易饥饿，这是肝热尚未平息，于是用热汤送服抑青丸二十粒，到第二十日痊愈。后来两手脉象平和，但右侧特别弱，胎儿此时必然流产。这时肝气已经平复，可以使用人参、白术。于是用最初的人参、白术等方药进行补益，预防流产后的虚损。服药一个月后胎儿自然流产，却得以平安无事。
俞震按语：右脉弱而胎儿必然流产，虽然投用人参、白术也无功效，这必定是丹溪经过多次试验验证，所以确信不疑。
另一位妇女怀孕三个月，呕吐痰水和饮食，每天在寅时和卯时发作。发作时感觉小腹有气向上冲，然后胸膈胀满而呕吐，面色发红，轻微烦躁，头晕，卧床不能起身，肢体疼痛，轻微口渴。这是肝火挟带冲脉之火上冲所致。一天比一天严重，第二天减轻，脉象平和，右手寸部脉高。用药无效将近两个多月。偶然使用沉香磨水，化开抱龙丸服用，一服后胸膈宽舒，气不再上冲，二三服后呕吐停止，眩晕减轻，食欲恢复而安宁。
俞震按语：抱龙丸是香窜辛散的藥物，似乎不适合孕妇服用，竟然获得大效，这位妇女必定多郁结或多思虑，所以气机郁结导致右寸脉高。各种香药能破除郁结、开通闭塞，所以有效。
汪石山治疗一位妇女，形体瘦小，面色接近紫色，产后一年多，月经不通。初夏忽然患病呕吐，手指麻痹、挛缩成拳，不能伸展，声音嘶哑细小，呃逆不出声。医生们都视为风病，认为情况危急。汪石山诊察脉象都细微近滑，说：“这是妊娠恶阻病。”众人说月经不通，哪里有怀孕的道理？汪石山说：“天下的事，有常理也有变局，这是事之变也。脉象虽然细微，似近于滑，而且尺脉不绝，乃是妊娠。”于是用四君子汤加二陈汤治疗，各种症状都减轻，仍然畏惧喝粥汤，只吃干糕香燥之物而有生机。
给事游让溪夫人，大病初愈，一个多月月经不行，呕吐呃逆眩晕，饮食难进。医生认为是二阳之病发于心脾，女子闭经，法度上属于不治之症。江篁南诊察她的脉象，尺脉虽然小，但按之滑而不绝，这是怀孕而患恶阻，不是凶险的征候。用六君子汤加砂仁，服用几剂后安宁。后来产下一女婴。
俞震按语：前一条是产后月经仍未通，这一条是大病后月经不行，很难断定其为怀孕。汪公说是事之变，近来却常有这种情况。尺脉按之不绝，最应留心。至于恶阻乃是常见病，千金半夏茯苓汤最佳，即二陈汤加生地、芍药、川芎、复花、桔梗、细辛、人参、生姜组成。有寒者可用千金茯苓丸，即六君子汤加枳实、桂心、干姜、葛根组成。橘皮竹茹汤治疗胃热，抑青丸治疗肝火，方法也已经完备了。诸法不应则停药，正如《金匮要略》所说“加吐下者则绝之也”。过八十日，自愈。
Zhu Danxi treated a woman who was two months pregnant, presenting with vomiting and dizziness. The physician administered Ren Shen (Ginseng Root), Bai Zhu (Atractylodes Rhizome), Chuan Xiong (Ligusticum Rhizome), Chen Pi (Citrus Reticulata Peel), and Fu Ling (Poria) to her, but the condition worsened. The pulse was wiry (Xian Mai), more pronounced on the left side and weak. This is E Zu (morning sickness), likely provoked by anger. Upon inquiry, this was confirmed. Since the Liver Qi had rebelled upward and was mixed with fetal Qi, the tonifying effects of Ren Shen and Bai Zhu were highly inappropriate. He prescribed Yi Qing Wan (Suppressing Blue Pill) taken with Fu Ling Decoction, 24 pills per dose. After five doses, she felt slightly relieved. The pulse became slightly rapid, accompanied by dry mouth and bitter taste, and sour taste in the mouth after eating. It was surmised that stagnant Qi in the diaphragm had not yet fully dispersed. Therefore, a decoction of Chuan Xiong, Chen Pi, Shan Zhi (Gardenia Fruit), Sheng Jiang (Fresh Ginger), and Fu Ling was used to administer 15 Yi Qing Wan pills, resulting in recovery. However, she still experienced a sour taste and increased appetite, indicating that Liver Heat had not yet subsided. She was then given 20 Yi Qing Wan pills with hot water, recovering completely by the twentieth day. Subsequently, both wrists' pulses were harmonious, but the right side was particularly weak, suggesting the fetus would likely abort at this time. With the Liver Qi now pacified, Ren Shen and Bai Zhu could be used. Thus, the initial formula containing Ren Shen and Bai Zhu was employed to tonify, preventing deficiency after the abortion. After one month of medication, the fetus aborted naturally, yet she remained safe.
Yu Zhen commented: A weak right pulse indicates inevitable fetal abortion; even administering Ren Shen and Bai Zhu yields no effect. This must be based on Danxi's repeated experimental verification, hence his firm conviction without doubt.
Another woman, three months pregnant, vomited phlegm-fluids and food daily, specifically during the Yin and Mao hours (3 AM - 7 AM). During attacks, she felt Qi rushing up from the lower abdomen, followed by chest fullness and vomiting, flushed face, slight irritability, dizziness, inability to rise from bed, limb pain, and slight thirst. This was due to Liver Fire carrying Chong Mai (Penetrating Vessel) fire upward. Symptoms worsened on the first day and improved on the second. The pulse was harmonious, but the Cun position (inch position) on the right hand was high. Medication was ineffective for nearly two months. Accidentally, Chen Xiang (Aquilaria Wood) was ground into water to dissolve Bao Long Wan (Embrace Dragon Pill). One dose widened the chest and stopped Qi rebellion; two to three doses stopped vomiting and reduced dizziness, restoring appetite and peace.
Yu Zhen commented: Bao Long Wan consists of aromatic, penetrating, acrid, and dispersing herbs, seemingly unsuitable for pregnant women. That it achieved great efficacy suggests this woman suffered from much depression or overthinking, causing Qi stagnation and a high Cun pulse. Various aromatic herbs can break depression and open knots, thus producing efficacy.
Wang Shishan treated a woman who was physically small and thin, with a complexion approaching purple. More than a year postpartum, her menstruation had ceased. In early summer, she suddenly developed vomiting, numbness and spasms of the fingers curling into fists unable to extend, hoarse and quiet voice, and hiccups without sound. Physicians regarded this as Wind disease and considered it critical. Wang diagnosed the pulses as all fine, minute, and near slippery. He stated, "This is pregnancy-related E Zu." The crowd argued that since menstruation had ceased, how could she be pregnant? Wang replied, "Worldly affairs have norms and variations; this is a variation. Although the pulse is fine and minute, resembling slippery, and the Chi position (cubit position) pulse is unceasing, it is indeed pregnancy." He treated her with Si Jun Zi Tang (Four Gentlemen Decoction) combined with Er Chen Tang (Two Cured Agents Decoction). All symptoms decreased. She still feared congee and soup, finding vitality only in eating dry cakes and aromatic-dry foods.
Madam You Rangxi, wife of the Censor, had just recovered from illness. Her menstruation had not occurred for over a month. She suffered from vomiting, hiccups, and dizziness, making it difficult to ingest food. Physicians believed this was an illness of the Yangming channels originating in the Heart and Spleen, and amenorrhea in women falls under untreatable conditions. Jiang Huangnan diagnosed her pulse: although the Chi pulse was small, pressing revealed it to be slippery and unceasing. This was pregnancy with E Zu, not a ominous sign. He prescribed Liu Jun Zi Tang (Six Gentlemen Decoction) with Sha Ren (Amomum Fruit). After several doses, she stabilized. Later, she delivered a daughter.
Yu Zhen commented: The previous case involved postpartum amenorrhea; this case involves amenorrhea following illness, making it difficult to identify as pregnancy. Master Wang called it a variation, which is common nowadays. One must pay close attention to the Chi pulse being unceasing upon pressure. As for E Zu, it is a common condition. Qian Jin Ban Xia Fu Ling Tang is best, composed of Er Chen Tang plus Sheng Di Huang (Rehmannia Root), Bai Shao (White Peony Root), Chuan Xiong, Fu Pen Zi (Rubus Fruit), Jie Geng (Platycodon Root), Xi Xin (Asarum), Ren Shen, and Sheng Jiang. For cold patterns, Qian Jin Fu Ling Wan can be used, composed of Liu Jun Zi Tang plus Zhi Shi (Immature Bitter Orange), Gui Xin (Cinnamon Twig Center), Gan Jiang (Dried Ginger), and Ge Gen (Kudzu Root). Ju Pi Zhu Ru Tang treats Stomach Heat; Yi Qing Wan treats Liver Fire. Methods are comprehensive. If these methods fail, stop medication, as stated in the *Jin Gui Yao Lue*: "If vomiting and purging are added, cease treatment." After eighty days, it resolves spontaneously.