【子肿危殆歌】子肿伤肝唇定黑,缺盆平也必心伤;背平伤肺脾脐凸,脚背平时肾病深。
妊娠浮肿,其说有二。盖胎前患水肿者少,而患胎气者多,乃气病也,名曰子肿。紫苏饮主
之。若小便不利腹胀者,水肿也。紫苏饮加泽泻、车前、白术治之。三焦无病者,加山栀、
黄芩利小便甚捷。如孕妇浮肿,上半身者宜发汗,下半身者宜利小便,上下俱肿,汗利兼施
,服药肿退而脱身者,不必再药。
凡妇人怀孕,宜别室安睡,常使身心清净,不得再犯房事。夜睡须左右转换,使小儿左舒右
安,肢体活动,临产自然快便,生子亦聪明少疾。背有一医宿店,值店妇生产,数日不下,
下体甚冷,急以椒、橘、茱萸、干姜、良姜等煎浓汤熏洗脐腹产门等处,气温血行而遂产。
【胎漏歌】血下如同月水来,漏干胞血必伤胎。胎伤妊娠须忧虑,急赐灵丹救得回。只缘欲
火房劳损,非是寻常虚漏胎。
盖胎之漏者,必有因而来,或误吞动胎物,被热毒所侵,或房劳而伤损,损轻则漏亦轻,损
重则漏亦重,血尽而胎死。或因母病而胎动者,病治而胎自安。或胎不坚固而母病者,胎安
而母自愈矣。又有值经期而见血,每月一至,名曰漏胎,宜服安胎饮,或紫苏饮加黄芩、白
术、阿胶、砂仁,自然无事。亦有伤胎气而下血不止,宜夺命丹。胎未损者,服之可安,已
损者,服之即下。
【子肿危殆歌】子肿(妊娠期浮肿)若损伤肝脏,嘴唇发黑则预后不良;缺盆穴(锁骨上窝)平坦则提示心脏受损;背部平坦、脾脏受累且肚脐突出,脚背浮肿则表明肾脏病变深重。
妊娠期的浮肿,其病因主要有两种说法。一般来说,怀孕前患水肿病的较少,而患胎气病(因胎气阻滞导致的气机失调)的较多,这属于气病,称为“子肿”。治疗以紫苏饮为主方。如果伴有小便不利和腹胀,则是真正的水肿病。可在紫苏饮中加入泽泻、车前子、白术进行治疗。若三焦功能正常,加入山栀、黄芩以利小便,效果非常迅速。如孕妇出现浮肿,上半身肿胀适宜采用发汗法,下半身肿胀适宜采用利小便法,上下半身均肿胀则发汗与利小便兼用。服药后浮肿消退,身体恢复正常的,不必再服药。
凡是妇人怀孕,应当居住在单独的居室安静睡眠,经常保持身心清净,不得再次进行房事。夜间睡觉需要左右交替变换姿势,使胎儿左侧舒展、右侧安稳,肢体活动自如,临产时自然顺利分娩,生下的孩子也聪明少病。曾有一位医生在旅途中投宿于一家旅店,恰逢店主妇生产,数日胎儿未娩出,产妇下身极冷,医生急忙用花椒、橘皮、吴茱萸、干姜、高良姜等煎煮浓汤,熏洗产妇的脐部、腹部及产门等处,药气温通血脉运行,于是顺利分娩。
【胎漏歌】阴道出血如同月经来潮,若血液流尽胞宫之血必伤及胎儿。胎儿受损,妊娠期间必须忧虑,需紧急赐予灵丹妙药方可挽救。只因欲望之火导致房事劳损,并非寻常的虚证漏胎。
大凡胎漏(妊娠期阴道少量出血),必定有其原因引起,或是误吞动胎之物,或被热毒所侵袭,或因房事劳损而受伤,损伤轻则出血少,损伤重则出血多,若血液流尽则胎儿死亡。或者是由于母亲患病而导致胎动不安,母亲疾病治愈则胎儿自然安固。或者是胎儿本身不坚固而母亲患病,胎儿安固则母亲自愈。又有正值经期而见血,每月一次,称为“漏胎”,适宜服用安胎饮,或紫苏饮加入黄芩、白术、阿胶、砂仁,自然无事。也有因损伤胎气而下血不止的,适宜服用夺命丹。胎儿未受损者,服用后可安胎;已受损者,服用后胎儿即排出。
[Song on the Danger of Zi Zhong (Edema during Pregnancy)] If Zi Zhong (edema during pregnancy) injures the Liver, blackening of the lips indicates a poor prognosis; flattening of the Quepen (Keyuan, LI 15) acupoint suggests injury to the Heart; flattening of the back with Spleen involvement and protrusion of the umbilicus indicate Lung injury; edema of the dorsum of the feet implies deep Kidney pathology.
Regarding edema during pregnancy, there are two main theories. Generally, few women suffer from true edema before or during pregnancy, while many suffer from Tai Qi Bing (disorders of fetal qi), which is a Qi disorder known as "Zi Zhong" (fetal edema). The primary formula is Zisu Yin (Perilla Decoction). If accompanied by difficulty in urination and abdominal distension, it is true edema. It should be treated with Zisu Yin added with Ze Xie (Alisma Rhizome), Che Qian (Plantago Seed), and Bai Zhu (Atractylodes Macrocephala Rhizome). If the San Jiao (Triple Burner) is not diseased, adding Shan Zhi (Gardenia Fruit) and Huang Qin (Scutellaria Root) to promote diuresis yields very rapid results. For pregnant women with edema, swelling in the upper body is suitable for sweating therapy, swelling in the lower body is suitable for promoting urination, and swelling in both upper and lower bodies requires combined sweating and diuretic therapies. After taking medicine, if the edema subsides and the body returns to normal, no further medication is necessary.
Whenever a woman is pregnant, she should sleep in a separate room to ensure tranquility, keeping her mind and body pure, and must abstain from sexual intercourse. During night sleep, one should alternate positions between left and right, allowing the fetus to stretch comfortably on the left and rest securely on the right, ensuring free movement of limbs. This facilitates smooth delivery at term, resulting in a smart and healthy child. Once, a physician stayed at an inn where the owner's wife was giving birth but had not delivered after several days. Her lower body was extremely cold. The physician urgently prepared a strong decoction of Jiao Hua (Sichuan Pepper), Ju Pi (Tangerine Peel), Wu Zhu Yu (Evodia Fruit), Gan Jiang (Dried Ginger), and Liang Jiang (Galangal Rhizome) to fumigate and wash the navel, abdomen, and vulva. The warming nature of the herbs promoted blood circulation, leading to successful delivery.
[Song on Tai Lou (Fetal Leakage)] Vaginal bleeding resembling menstruation occurs; if the uterine blood is exhausted, the fetus will inevitably be injured. When the fetus is injured, one must worry about the pregnancy; urgent administration of spiritual pills can save it. This is due to damage from sexual desire and excessive intercourse, not ordinary deficiency-type leakage.
Generally, Tai Lou (fetal leakage) always has a cause: either accidental ingestion of substances that disturb the fetus, invasion by heat toxins, or injury from sexual exhaustion. Mild injury leads to mild leakage, severe injury leads to severe leakage, and if blood is completely exhausted, the fetus dies. Alternatively, if the mother's illness causes fetal agitation, curing the mother's illness naturally stabilizes the fetus. Or, if the fetus is inherently unstable and the mother falls ill, stabilizing the fetus allows the mother to heal herself. There is also a condition where bleeding occurs during the expected menstrual period, happening once a month, called "Lou Tai" (leaking fetus); An Tai Yin (Stabilize Fetus Decoction) is appropriate, or Zisu Yin added with Huang Qin (Scutellaria Root), Bai Zhu (Atractylodes Macrocephala Rhizome), E Jiao (Donkey-hide Gelatin), and Sha Ren (Amomum Fruit), which resolves the issue naturally. In cases where fetal qi is damaged causing continuous bleeding, Ming Dan (Life-Saving Pill) is indicated. If the fetus is undamaged, taking it stabilizes the pregnancy; if already damaged, it induces expulsion.