答曰。怀则以身根据也。娠则以时动也。若腹中不时撞动者。谓之胎动也。多因劳役气力。触
冒冷热。饮食不适。居处失宜。轻者止转动不安。重者便致损坠。若母有疾。以疾动胎者。
治母则胎安。若胎不固。动致母病者。治胎则母瘥。若胎不牢固。其胎必致损也。
保安散。治妊娠胎气不安。心腹疼痛胎动。安胎。
当归(一两半) 人参(一两) 阿胶(半两蛤粉炒成珠) 甘草(半两炙)
上 咀。每服三钱。水盏半。葱白一茎拍破。煎八分。去滓温服。食前。未定再服。
安胎饮。治妊娠偶因所触。或从高堕下。致胎动不安。腰中疼痛。服此药后。觉胎动处热。
即胎已安。
缩砂(不拘多少慢火炒令热透后去皮取仁用)
上为细末每服三钱。热酒调下。不饮酒者煎盐艾汤调下。食前。严氏第一问。妊娠两三月。
胎动不安者何也。曰。男女阴阳会通。血气调匀。乃成其孕。设若下血腹痛。盖繇子宫久虚
。致令胎堕。其危甚于正产。若妊娠曾受此苦。可预服杜仲丸。
杜仲(去皮锉姜汁浸炒去丝) 川续断(酒浸各三两)
上为细末。枣肉丸。桐子大。每服七十丸。空心米饮下。一日三服。
答曰。妊娠之人。经血拥闭以养其胎。或掩水气。血水相搏以致体肿。皆繇脾胃虚弱。脏腑
之间宿有停水之所掩也。谓之子满。若水停不去。浸渍于胎。则令胎坏。诊其脉浮。腹满兼
喘者。其胎必坠也。
泽泻散。治妊娠气壅。身体腹胁浮肿。喘息促急。大小便秘涩。
泽泻 桑白皮 枳壳(麸炒黄) 槟榔 赤茯苓 木通(各一两)
上 咀。每服四钱。水盏半。姜五片。煎八分。去滓温服。食前。稍利为度效。
木通散。治妊娠身体浮肿。心腹胀满。小水不通。
木通(一两) 诃梨勒皮 木香(各三分) 香 (一两一本茹) 枳壳(半两面炒) 槟榔(半两)
桑根皮(一两用白) 赤茯苓(三分) 鸡苏(茎叶一两)
上 咀。每服四钱。水盏半。姜五片煎六分。去滓温服。食前。
商陆赤小豆汤
赤小豆 干商陆(各等分)
上 咀。每服一两。水一盏。煎七分。去滓温服。
严氏第五问。论胎冷腹胀虚痛。两胁虚鸣。脐下冷痛欲泄。小便频数。大便虚滑者。何也。
曰。胎气既全。子形成质。或食瓜果甘甜。饮冷不时之物。当风取凉。受不时之气则令胎冷
。子身不能安处。皮毛疼痛。筋骨拘急。手足挛拳。致使母有危证。急宜服安胎和气散。
诃子(煨) 白术(各一两) 陈皮 良姜(炒) 木香(煨) 白芍药 陈米(炒) 甘草(炙各半
两)
上 咀。每四钱。水盏半。姜五片。煎七分。去滓温服。不拘时。忌生冷。
答:怀孕是以母体为根本依托。妊娠则表现为胎儿按时胎动。如果腹中不时出现撞击跳动,这叫做“胎动”。多因过度劳累、气力耗损,或受冷受热刺激,饮食不当,居住起居不适宜所致。轻者仅表现为胎动不安,重者会导致流产坠胎。如果母亲患病,因病邪扰动导致胎动,治疗母亲的疾病则胎儿自然安定。如果胎儿不稳固,胎动引发母亲生病,治疗安胎则母亲病愈。如果胎元不牢固,胎儿必然受损。
保安散:治疗妊娠期胎气不安,心腹疼痛,胎动,具有安胎功效。
药材:当归(一两半)、人参(一两)、阿胶(半两,用蛤粉炒至成珠状)、甘草(半两,炙)。
制法与用法:将药物切碎。每次服用三钱,加水一盏半,葱白一根拍破,煎煮至八分满,去渣温服。饭前服用。若症状未定,可再次服用。
安胎饮:治疗妊娠期间偶然受到撞击,或从高处置坠落,导致胎动不安,腰部疼痛。服用此药后,感觉胎动部位发热,即表示胎儿已安定。
药材:缩砂(不限多少,慢火炒至热透后去皮取仁使用)。
制法与用法:研为细末。每次服用三钱,用热酒调服。不饮酒者,用盐艾汤调服。饭前服用。(出自严氏第一问)
关于妊娠两三个月时胎动不安的原因:男女阴阳交合,血气调和,才能形成妊娠。如果出现下血腹痛,这是由于子宫长期虚弱,导致胎堕。其危险性甚至超过正常分娩。如果妊娠期间曾遭受这种痛苦,可以预先服用杜仲丸进行预防。
药材:杜仲(去皮锉碎,用姜汁浸泡后炒去丝)、川续断(酒浸,各三两)。
制法与用法:研为细末,用枣肉制成丸剂,大小如梧桐子。每次服用七十丸,空腹时用米汤送服。每日三次。
答:妊娠妇女,经血闭止以滋养胎儿。或者水气停滞,血与水相互搏结,导致身体浮肿。这都是由于脾胃虚弱,脏腑之间素有停水之处被掩盖所致。这叫做“子满”(妊娠水肿)。如果水湿停留不去,浸渍于胎儿,则会导致胎儿坏死。诊察其脉象浮,腹部胀满兼有气喘的,胎儿必然坠落。
泽泻散:治疗妊娠气机壅滞,身体及腹胁浮肿,喘息急促,大小便便秘涩滞。
药材:泽泻、桑白皮、枳壳(麸炒黄)、槟榔、赤茯苓、木通(各一两)。
制法与用法:将药物切碎。每次服用四钱,加水一盏半,生姜五片,煎煮至八分满,去渣温服。饭前服用。稍微通利即为有效。
木通散:治疗妊娠身体浮肿,心腹胀满,小便不通。
药材:木通(一两)、诃梨勒皮、木香(各三分)、香附(一两,另一版本作茹)、枳壳(半两,面炒)、槟榔(半两)、桑根皮(一两,用白色者)、赤茯苓(三分)、鸡苏(茎叶一两)。
制法与用法:将药物切碎。每次服用四钱,加水一盏半,生姜五片,煎煮至六分满,去渣温服。饭前服用。
商陆赤小豆汤:
药材:赤小豆、干商陆(各等分)。
制法与用法:将药物切碎。每次服用一两,加水一盏,煎煮至七分满,去渣温服。
严氏第五问:论述胎冷引起的腹胀虚痛,两胁虚鸣,脐下冷痛欲泄泻,小便频数,大便虚滑的情况,原因是什么?
答:胎气既已完备,子形已成质。如果食用瓜果甘甜之物,不时饮用冷饮,当风取凉,感受非时之气,则会导致胎冷。胎儿身体无法安宁,皮毛疼痛,筋骨拘急挛缩,手足蜷曲,致使母亲出现危重证候。急需服用安胎和气散。
药材:诃子(煨)、白术(各一两)、陈皮、良姜(炒)、木香(煨)、白芍药、陈米(炒)、甘草(炙,各半两)。
制法与用法:将药物切碎。每次四钱,加水一盏半,生姜五片,煎煮至七分满,去渣温服。不拘时间服用。忌食生冷食物。
Answer: Pregnancy relies on the mother's body as its foundation. Gestation is characterized by fetal movement at specific times. If there is intermittent striking or throbbing in the abdomen, it is called "Fetal Movement" (Tai Dong). This is often caused by excessive physical labor and depletion of Qi, exposure to cold or heat, improper diet, or inappropriate living conditions. In mild cases, it manifests only as restlessness of the fetus; in severe cases, it leads to miscarriage. If the mother is ill and the pathology disturbs the fetus, treating the mother's illness will stabilize the fetus. If the fetus is unstable and its movement causes illness in the mother, treating and stabilizing the fetus will cure the mother. If the fetal root is not firm, the fetus will inevitably be damaged.
Bao'an San (Security Decoction): Treats restless fetal Qi during pregnancy, epigastric and abdominal pain, and fetal movement; has the effect of calming the fetus.
Ingredients: Danggui Radix Angelicae Sinensis (1.5 liang), Renshen Radix Ginseng (1 liang), Ejiao Colla Corii Asini (0.5 liang, stir-fried with powder of concha Meretricis et Cyclinae until pearl-like), Gancao Radix Glycyrrhizae Preparata (0.5 liang, honey-fried).
Preparation and Administration: Coarsely crush the herbs. Take 3 qian per dose, add 1.5 cups of water and one stem of Congbai Bulbus Allii Fistulosi (crushed), decoct until 0.8 cup remains, strain, and take warm before meals. If symptoms persist, repeat the dose.
Antai Yin (Calming Fetus Decoction): Treats fetal movement and restlessness due to accidental trauma or falling from a height during pregnancy, accompanied by lower back pain. After taking this medicine, if heat is felt at the site of fetal movement, it indicates the fetus has stabilized.
Ingredients: Suosha Fructus Amomi Rotundus (appropriate amount, slow-fire fried until thoroughly hot, then peeled and the kernel used).
Preparation and Administration: Grind into fine powder. Take 3 qian per dose, mixed with warm wine. For those who do not drink alcohol, mix with salt and Artemisia argyi soup. Take before meals. (From Yan Shi, Question 1)
Regarding fetal movement and restlessness in the second or third month of pregnancy: When male and female Yin and Yang unite and blood and Qi are harmonious, pregnancy is formed. If there is vaginal bleeding and abdominal pain, it is due to long-term deficiency of the Uterus, leading to fetal abortion. The danger is greater than normal childbirth. If a woman has suffered this distress during pregnancy, she can preemptively take Duzhong Wan for prevention.
Ingredients: Duzhong Cortex Eucommiae Preparated (peeled, cut, soaked in ginger juice, fried to remove silk fibers), Chuanxuduan Radix Dipsaci (soaked in wine, each 3 liang).
Preparation and Administration: Grind into fine powder, make pills with date paste, size of Sophora japonica seeds. Take 70 pills per dose, swallow with rice water on an empty stomach. Three times a day.
Answer: During pregnancy, menstrual blood is retained to nourish the fetus. Alternatively, fluid retention may occur, where blood and water contend, causing generalized edema. This is all due to Spleen-Stomach weakness, with pre-existing stagnant water hidden within the Zang-Fu organs. This condition is called "Zi Man" (Pregnancy Edema/Fullness). If water stagnates and does not resolve, soaking the fetus, it will cause fetal death. Palpating the pulse, if it is floating, accompanied by abdominal fullness and wheezing, the fetus will likely be aborted.
Zexie San (Alisma Powder): Treats Qi stagnation during pregnancy, edema of the body and hypochondrium, rapid breathing, and constipation of both urine and stool.
Ingredients: Zexie Rhizoma Alismatis, Sangbaipi Cortex Mori Radicis, Zhike Fructus Aurantii Immaturus (bran-fried yellow), Binglang Semen Arecae, Chi Fuling Poria Cocos cum Ligno Rubra (each 1 liang), Mutong Herba Akebiae (1 liang).
Preparation and Administration: Coarsely crush the herbs. Take 4 qian per dose, add 1.5 cups of water and 5 slices of Shengjiang Rhizoma Zingiberis Recens, decoct until 0.8 cup remains, strain, and take warm before meals. Slight relief of urination/stool indicates efficacy.
Mutong San (Akebia Powder): Treats generalized edema during pregnancy, epigastric and abdominal fullness, and urinary obstruction.
Ingredients: Mutong Herba Akebiae (1 liang), Helilepi Pericarpium Terminaliae Chebulae, Muxiang Radix Aucklandiae (each 3 fen), Xiangfu Rhizoma Cyperi Rotundi (1 liang, alternative text says Ru), Zhike Fructus Aurantii Immaturus (0.5 liang, flour-fried), Binglang Semen Arecae (0.5 liang), Sanggenpi Cortex Mori Radicis (1 liang, white bark), Chi Fulving Poria Cocos cum Ligno Rubra (3 fen), Jisu Herba Elsholtziae (stems and leaves, 1 liang).
Preparation and Administration: Coarsely crush the herbs. Take 4 qian per dose, add 1.5 cups of water and 5 slices of Shengjiang Rhizoma Zingiberis Recens, decoct until 0.6 cup remains, strain, and take warm before meals.
Shanglu Chi Xiao Dou Tang (Phytolacca and Adzuki Bean Decoction):
Ingredients: Chi Xiaodou Semen Phaseoli Angularis, Gan Shanglue Radix Phytolaccae (equal parts).
Preparation and Administration: Coarsely crush the herbs. Take 1 liang per dose, add 1 cup of water, decoct until 0.7 cup remains, strain, and take warm.
Yan Shi, Question 5: Discusses the causes of abdominal distension and deficiency-pain due to Cold Womb, empty ringing in the two hypochondria, cold pain below the umbilicus with urge to defecate, frequent urination, and loose stools.
Answer: Once the fetal Qi is complete and the fetal form is established, eating sweet fruits and melons, drinking cold beverages irregularly, exposing oneself to wind while cooling down, or contracting non-seasonal pathogens can cause Cold Womb. The fetus cannot remain comfortable, leading to pain in skin and hair, stiffness and spasm of sinews and bones, and curling of hands and feet, causing critical conditions in the mother. It is urgent to take Antai Heqi San.
Ingredients: Hezi Fructus Chebulae Roasted (1 liang), Baizhu Rhizoma Atractylodis Macrocephalae (1 liang), Chenpi Pericarpium Citri Reticulatae, Liangjiang Rhizoma Zingiberis Officinalis Preparated (fried), Muxiang Radix Aucklandiae Roasted, Baishaoyao Radix Paeoniae Alba, Chenmi Oryza Sativa Preparated (fried), Gancao Radix Glycyrrhizae Preparata (honey-fried, each 0.5 liang).
Preparation and Administration: Coarsely crush the herbs. Take 4 qian per dose, add 1.5 cups of water and 5 slices of Shengjiang Rhizoma Zingiberis Recens, decoct until 0.7 cup remains, strain, and take warm. Take at any time. Avoid raw and cold foods.