妊娠经水涩少不断,饮食精神如故,此血盛有余谓之胎漏,胎长必自愈。如冲任经虚不能约束经血,或劳役
房室致损血脉,均能今孕妇漏胎,必常觉淋漓不断。
血盛脉滑动数胎漏,血虚脉涩胎漏动伤损,劳役伤中脉必软数,胎或触损紧涩无疑。
清热养胎以澄其源,固经涩血以洁其流,损者养之,劳者益之,羸弱者滋培之,触动者调护之,清阳若陷,
急当升举胎气,或逆清降必需。
主以安胎饮,气虚加人参,血虚培熟地,血热换生地,气郁加香附,气陷加柴胡,气逆加连灰,邪伤血室加
荆芥灰,血窍滑脱加赤石脂,劳役伤脾补中益气汤,若伤营气补阴益气,煮最捷。
漏胎安胎饮
治漏胎脉软数者。
熟地(五钱) 黄 (三钱,蜜炙) 当归(三钱,醋炒) 川芎(一钱) 白芍(一钱半,醋炒) 艾叶
(八分,醋炒黑) 阿胶(三钱,血佘灰炒) 地榆(三钱,炒炭) 甘草(五分) 荷叶
水煮去渣温服。
妊娠血气两亏,冲任不能操蓄泄之权而血得漏泄于外,故漏胎下血不已焉。熟地补血以滋养其胎,黄 补气
以固摄其血,当归养血荣冲任,白芍敛阴止漏血,川芎行血海以升阳,阿胶补阴血以安胎,艾叶振冲任之阳,阳
密则漏血自止,荷叶举阳明之阳,阳举则陷下可回,甘草缓中和胃,地榆涩血止漏也,水煎温服,俾血气内充则
冲任完固而胎得所养,何漏胎之足患哉。
如圣汤
治漏胎腹痛脉虚微涩者。
鲤鱼皮(三钱,炒灰) 熟地(五钱) 当归(三钱) 白芍(一钱半,酒炒) 川芎(一钱) 阿胶(三钱,
蒲黄炒) 续断(三钱,炒灰) 甘草(五分)
水煎去渣温服。
妊娠经血有亏,不能滋养其胎,故胎动腹痛漏血不止焉。熟地补血滋荣冲任以养胎,当归养血荣养血脉以
安胎,川芎行血中之气而腹痛可除,续断续经脉之伤而漏血自止,阿胶补血以滋冲任之阴,白芍敛阴以止漏胎之
血,生甘草缓中和胃,鲤鱼皮利水厘清也。水煎温服,俾经血内充则经气调和而胎得所养腹痛自退,胎动漏血无
不并止矣。
妊娠期间经血量少且淋漓不断,但饮食和精神状态正常,这是血气旺盛有余所致,称为胎漏,胎儿生长到一定程度自然会痊愈。如果是冲脉和任脉虚弱,不能约束经血,或者因劳累、房事过度导致血脉受损,都会引起孕妇漏胎,必然经常感觉血液淋漓不断。
血气旺盛导致的胎漏,脉象表现为滑、动、数;血虚导致的胎漏伴有胎动不安或损伤,脉象涩滞;因劳累内伤导致的胎漏,脉象必定软弱而数;若因外力触碰损伤,脉象紧涩无疑。
治疗上应清热养胎以澄清水源,固经止血以清洁水流,亏损者予以调养,劳伤者予以补益,体弱消瘦者予以滋养培补,受触动者予以调理保护。如果清阳之气下陷,应当紧急提升举升胎气,或者需要降逆清气。
主要使用安胎饮。气虚加人参,血虚加熟地黄,血热换用生地黄,气郁加香附,气陷加柴胡,气逆加连翘灰(注:原文“连灰”疑为连翘炭或类似药物,此处保留原意),邪气损伤血室加荆芥炭,血窍滑脱不禁加赤石脂,劳累损伤脾胃用补中益气汤,若损伤营气则用补阴益气汤,煮服最为快捷。
漏胎安胎饮
治疗漏胎且脉象软弱数的患者。
熟地黄(五钱) 黄芪(三钱,蜜炙) 当归(三钱,醋炒) 川芎(一钱) 白芍(一钱半,醋炒) 艾叶(八分,醋炒黑) 阿胶(三钱,用血余炭炒) 地榆(三钱,炒炭) 甘草(五分) 荷叶
用水煎煮,去渣后温服。
妊娠期间血气两亏,冲脉和任脉不能掌握蓄积和排泄的权力,导致血液从体外漏泄,所以漏胎下血不止。熟地黄补血以滋养胎儿,黄芪补气以固摄血液,当归养血使冲任二脉荣润,白芍收敛阴液以止漏血,川芎运行血海之气以提升阳气,阿胶补益阴血以安胎,艾叶振奋冲任之阳气,阳气致密则漏血自止,荷叶升举阳明之阳气,阳气升举则下陷之气可回,甘草缓和药性并调和胃气,地榆涩血以止漏。水煎温服,使血气在内充盈,则冲任二脉完固,胎儿得到滋养,还担心什么漏胎呢?
如圣汤
治疗漏胎伴有腹痛且脉象虚微涩滞的患者。
鲤鱼皮(三钱,炒成炭灰) 熟地黄(五钱) 当归(三钱) 白芍(一钱半,酒炒) 川芎(一钱) 阿胶(三钱,用蒲黄炒) 续断(三钱,炒成炭灰) 甘草(五分)
用水煎煮,去渣后温服。
妊娠期间经血亏虚,不能滋养胎儿,所以胎动不安、腹痛且漏血不止。熟地黄补血滋荣冲任以养胎,当归养血荣养血脉以安胎,川芎运行血中之气从而使腹痛消除,续断接续经脉之损伤从而使漏血自止,阿胶补血以滋充冲任之阴,白芍收敛阴液以止漏胎之血,生甘草缓和药性并调和胃气,鲤鱼皮利水澄清。水煎温服,使经血在内充盈,则经气调和,胎儿得到滋养,腹痛自然消退,胎动漏血无不一起停止。
During pregnancy, menstrual flow is scanty and continuous without stopping, while diet and spirit remain normal. This condition of excessive blood abundance is called "Tai Lou" (Fetal Leakage), where the fetus will naturally heal as it grows. If the Chong and Ren meridians are deficient and unable to constrain menstrual blood, or if labor and excessive sexual activity damage the blood vessels, both can cause fetal leakage in pregnant women, characterized by a constant feeling of dripping blood.
For fetal leakage due to abundant blood, the pulse is slippery, active, and rapid. For fetal leakage with fetal movement disturbance or injury due to blood deficiency, the pulse is choppy. For fetal leakage caused by internal injury from labor, the pulse must be soft and rapid. If caused by physical trauma, the pulse is tight and choppy without doubt.
Treatment involves clearing heat and nourishing the fetus to clarify the source, securing the menses and astringing blood to purify the flow. Those who are depleted should be nourished; those injured by labor should be supplemented; the emaciated should be enriched and cultivated; those affected by trauma should be regulated and protected. If clear yang qi sinks, it is urgent to raise and lift the fetal qi, or descending and clearing may be necessary.
The primary formula is Antaeal Decoction (Antai Yin). Add Ginseng Root (Renshen) for Qi deficiency; add Prepared Rehmannia Root (Shudihuang) for Blood deficiency; replace with Raw Rehmannia Root (Shengdihuang) for Blood heat; add Cyperus Rhizome (Xiangfu) for Qi stagnation; add Bupleurum Root (Chaihu) for Qi sinking; add Charred Forsythia Fruit (Lianhui) for rebellious Qi; add Charred Schizonepeta Spike (Jingjiehui) if pathogenic factors injure the Blood Chamber; add Red Kaolin (Chishizhi) for slipping blood pores; use Tonifying the Middle and Augmenting Qi Decoction (Buzhong Yiqi Tang) for spleen injury from labor; if Ying (Nutritive) Qi is injured, use Nourishing Yin and Augmenting Qi Decoction (Buyin Yiqi Tang), which is boiled for the fastest effect.
**Antaeal Decoction (Antai Yin)**
Treats fetal leakage with a soft and rapid pulse.
Prepared Rehmannia Root (Shudihuang) [5 qian], Astragalus Membranaceus Root (Huangqi) [3 qian, honey-fried], Angelica Sinensis Root (Danggui) [3 qian, vinegar-fried], Szechuan Lovage Rhizome (Chuanxiong) [1 qian], White Peony Root (Baishao) [1.5 qian, vinegar-fried], Mugwort Leaf (Aiye) [0.8 fen, vinegar-fried until black], Donkey-hide Gelatin (Ejiao) [3 qian, fried with Human Excrement Ash (Xuyehui)], Sanguisorba Root (Diyu) [3 qian, charred], Licorice Root (Gancao) [0.5 fen], Lotus Leaf (Heye).
Boil in water, remove dregs, and take warm.
In pregnancy, dual deficiency of Blood and Qi causes the Chong and Ren meridians to lose control over storage and discharge, leading to external bleeding and persistent fetal leakage. Prepared Rehmannia nourishes Blood to sustain the fetus; Astragalus tonifies Qi to secure Blood; Angelica nourishes Blood to enrich the Chong and Ren meridians; White Peony astringes Yin to stop leakage; Szechuan Lovage moves Qi in the Blood Sea to raise Yang; Donkey-hide Gelatin supplements Yin-Blood to calm the fetus; Mugwort stimulates Yang of the Chong and Ren meridians, so when Yang is dense, leakage stops; Lotus Leaf raises Yang of the Yangming meridian, so when Yang rises, sunken Qi returns; Licorice moderates and harmonizes the Stomach; Sanguisorba astringes blood to stop leakage. Boil in water and take warm. When Blood and Qi fill internally, the Chong and Ren meridians become solid, and the fetus is nourished, eliminating worry about fetal leakage.
**Rusheng Decoction (Rusheng Tang)**
Treats fetal leakage with abdominal pain and a weak, minute, and choppy pulse.
Carp Skin (Liyupi) [3 qian, charred], Prepared Rehmannia Root (Shudihuang) [5 qian], Angelica Sinensis Root (Danggui) [3 qian], White Peony Root (Baishao) [1.5 qian, wine-fried], Szechuan Lovage Rhizome (Chuanxiong) [1 qian], Donkey-hide Gelatin (Ejiao) [3 qian, fried with Pollen Typhae (Puhuang)], Drynaria Rhizome (Xuduan) [3 qian, charred], Licorice Root (Gancao) [0.5 fen].
Boil in water, remove dregs, and take warm.
Deficiency of menstrual blood during pregnancy fails to nourish the fetus, causing fetal movement, abdominal pain, and persistent bleeding. Prepared Rehmannia nourishes Blood and enriches the Chong and Ren meridians to sustain the fetus; Angelica nourishes Blood and benefits blood vessels to calm the fetus; Szechuan Lovage moves Qi within the Blood to relieve abdominal pain; Drynaria repairs meridian injuries to stop leakage; Donkey-hide Gelatin supplements Blood to nourish Yin of the Chong and Ren; White Peony astringes Yin to stop fetal leakage blood; Raw Licorice moderates and harmonizes the Stomach; Carp skin promotes urination and clears turbidity. Boil in water and take warm. When menstrual blood fills internally, meridian Qi harmonizes, the fetus is nourished, abdominal pain recedes, and fetal movement and leakage cease simultaneously.