赵养葵曰∶恶阻多在三个月之时，相火化胎之候，壮火食气，上冲胃口，食入即呕吐，少阴肾水既养胎，
少阴之火益炽，须用清肝滋肾汤，即六味饮加柴胡、白芍。先用
逍遥散止呕，再用调经滋肾汤加杜、续。呕甚者，加川连、吴茱妙。
陈良甫曰∶《千金方》有半夏茯苓汤、茯苓丸，专治恶阻。此二方，比来少有服者，以半夏能动胎，胎初
结，虑其辛燥易散故也。须姜汁炒，以制毒。凡恶阻，非半夏不能止，是有故无殒也。
娄全善曰∶《大全方》谓半夏动胎不用，今观仲景用人参半夏干姜丸，罗谦甫用半夏茯苓汤，朱丹溪用二
陈加减，并治胎前恶阻，痰逆呕吐，心烦，头眩，恶食，俱效，独不知此乎？予治恶阻，用之未尝动胎。正经
云有故无殒是也。
薛立斋曰∶半夏乃健脾气，化痰滞主药。脾胃虚弱呕吐，或痰涎壅滞，饮食少，胎不安，必用半夏茯苓汤，
倍加白术，安胎健脾，予尝用验也。
薛立斋曰∶妊娠若饮食不甘，或欲呕吐，用六君子加紫苏、枳壳。若恶阻，呕吐，头眩，体倦，用参橘饮，
未应，用六君子汤。若恶阻，呕吐不食，亦用参橘散。或饮食停滞，腹胀呕吐，此是脾胃虚弱，不能消化，用
六君子汤不应，用平胃散加参、苓。
慎斋按∶以上一十三条，序胎前有恶阻呕吐之证也。凡妇人妊孕，其始证先见于恶阻。而恶阻，自《金匮》
有绝之法而下，病机盖非一端。巢元方以下，主于气凝血聚。陈良甫以下，主于停痰积饮。若仲景《金匮》以
寒治，太无、养葵作火论，于恶阻病机，可谓详悉。但胎前无寒，产后无热，此常法也。故恶阻呕吐，大抵寒者
少，热者多。总属血壅胎元，脏气不能宣通，停痰积饮，郁热壅滞，变而为火，有热无寒，致生诸证。故丹溪、
立斋论治，每以枳壳、紫苏、苏梗、木香、砂仁，为降气顺气之法，所谓胎前须顺
气者此也。
赵养葵说：恶阻（妊娠早期因胎气上逆引起的恶心呕吐）多发生在怀孕三个月左右，这是相火（寄居于肝肾、维持生命活动的阳气）化生胎元的时期。壮火（亢盛的病理之火）会消耗正气，导致气机上冲胃口，食物吃下去就会呕吐。此时少阴肾水既要滋养胎元，少阴之火也会更加炽盛。应当使用清肝滋肾汤，即六味地黄丸加入柴胡、白芍。先用逍遥散止呕，再用调经滋肾汤加杜仲、续断。呕吐严重的，加黄连、吴茱萸。
陈良甫说：《千金方》中有半夏茯苓汤、茯苓丸，专门治疗恶阻。这两个方子，近来很少有人服用，因为认为半夏会动胎气，胎儿刚形成，担心其辛燥之性容易使胎元散失。必须用姜汁炒制，以制约其毒性。凡是恶阻，非半夏不能止住呕吐，这就是“有故无殒”（有病则病受之，不会伤害母体）的道理。
娄全善说：《大全方》称半夏动胎气而不用，如今看张仲景用人参半夏干姜丸，罗谦甫用半夏茯苓汤，朱丹溪用二陈汤加减，都治疗胎前恶阻、痰逆呕吐、心烦、头晕、厌食，都很有效，难道不知道这些吗？我治疗恶阻，使用半夏从未动过胎气。经典经文说“有故无殒”是正确的。
薛立斋说：半夏是健脾气、化痰滞的主药。脾胃虚弱呕吐，或者痰涎壅滞，饮食减少，胎元不安，必须用半夏茯苓汤，加倍加入白术，安胎健脾，我曾经验证过很有效。
薛立斋说：妊娠如果饮食无味，或者想要呕吐，用六君子汤加紫苏、枳壳。如果是恶阻，呕吐，头晕，身体疲倦，用参橘饮，没有效果，再用六君子汤。如果是恶阻，呕吐不进食，也用参橘散。或者是饮食停滞，腹胀呕吐，这是脾胃虚弱，不能消化，用六君子汤无效，用平胃散加人参、茯苓。
慎斋按语：以上十三条，叙述了胎前有恶阻呕吐的证候。凡是妇人怀孕，最初的证候先表现为恶阻。而恶阻的病机，自从《金匮要略》提出绝嗣之法以后，病因并非只有一种。巢元方以下，主张是气凝血聚。陈良甫以下，主张是停痰积饮。像张仲景《金匮》用寒凉法治，太无、养葵作火热论，对于恶阻的病机，可以说非常详细。但是胎前无寒，产后无热，这是常法。所以恶阻呕吐，大抵寒证少，热证多。总归属于血壅塞胎元，脏气不能宣通，停痰积饮，郁热壅滞，变而为火，只有热没有寒，从而导致各种证候。所以丹溪、立斋论述治疗，常用枳壳、紫苏、苏梗、木香、砂仁，作为降气顺气的方法，所谓“胎前须顺气”就是这个道理。
Zhao Yangkui stated: Ezu (nausea and vomiting in early pregnancy due to rebellious fetal qi) mostly occurs around the third month of pregnancy, which is the period when ministerial fire (the physiological yang qi residing in the liver and kidney that sustains life) transforms into the fetus. Vigorous fire (pathological hyperactive fire) consumes healthy qi, causing qi to rush upward to the stomach gate, resulting in immediate vomiting after eating. At this time, Shaoyin Kidney Water must nourish the fetus, while Shaoyin Fire becomes even more intense. One should use Qinggan Zishen Tang (Liver-Clearing and Kidney-Nourishing Decoction), which is Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) added with Chaihu (Bupleuri Radix) and Baishao (Paeoniae Radix Alba). First use Xiaoyao San (Free and Easy Wanderer Powder) to stop vomiting, then use Tiaojing Zishen Tang (Menstruation-Regularizing and Kidney-Nourishing Decoction) added with Duzhong (Eucommiae Cortex) and Xuxian (Drynariae Rhizoma). For severe vomiting, add Huanglian (Coptidis Rhizoma) and Wuzhuyu (Evodiae Fructus).
Chen Liangfu stated: The *Qianjin Fang* contains Banxia Fuling Tang (Pinellia and Poria Decoction) and Fuling Wan (Poria Pill), specifically treating Ezu. These two formulas are rarely used nowadays because it is believed that Banxia (Pinelliae Tuber) can disturb the fetus. Since the fetus has just formed, there is concern that its acrid and dry nature might easily disperse the fetal essence. It must be stir-fried with ginger juice to mitigate its toxicity. For all cases of Ezu, only Banxia can stop the vomiting; this illustrates the principle of "Yougu Wu Yun" (When there is a specific pathology, treatment will not harm the body).
Lou Quanshan stated: The *Daquan Fang* claims that Banxia disturbs the fetus and should not be used. However, observing Zhang Zhongjing using Renshen Banxia Jianggan Wan (Ginseng, Pinellia, and Dried Ginger Pill), Luo Qianfu using Banxia Fuling Tang, and Zhu Danxi using Erchen Tang modifications, all treat pre-pregnancy Ezu, phlegm-rebellious vomiting, mental restlessness, dizziness, and anorexia with efficacy. How could one ignore this? In my treatment of Ezu, I have used Banxia without ever disturbing the fetus. The classic text states that "Yougu Wu Yun" is correct.
Xue Lizhai stated: Banxia is the principal herb for strengthening spleen qi and resolving phlegm stagnation. For vomiting due to spleen and stomach deficiency, or phlegm-fluid retention causing reduced appetite and fetal instability, Banxia Fuling Tang must be used, with doubled Baizhu (Atractylodis Macrocephalae Rhizoma) to calm the fetus and strengthen the spleen. I have verified its efficacy.
Xue Lizhai stated: If a pregnant woman lacks appetite or desires to vomit, use Liujunzi Tang (Six-Gentlemen Decoction) added with Zisu (Perillae Folium) and Zhike (Aurantii Fructus). If suffering from Ezu, vomiting, dizziness, and fatigue, use Shenju Yin (Ginseng and Tangerine Peel Drink); if ineffective, use Liujunzi Tang. If suffering from Ezu, vomiting, and inability to eat, also use Shenju San (Ginseng and Tangerine Peel Powder). If food stagnation causes abdominal distension and vomiting, this indicates spleen and stomach deficiency failing to digest; if Liujunzi Tang is ineffective, use Pingwei San (Stomach-Pacifying Powder) added with Renshen (Ginseng Radix et Rhizoma) and Fuling (Poria).
Shenzhai commented: The above thirteen items describe the syndrome of Ezu and vomiting during pregnancy. In all pregnant women, the initial manifestation appears as Ezu. Regarding the pathogenesis of Ezu, since the *Jinkui Yaolue* mentioned methods leading to sterility, the mechanisms have been diverse. From Chao Yuanfang onwards, the focus was on qi stagnation and blood coagulation. From Chen Liangfu onwards, the focus was on retained phlegm and accumulated fluids. Zhang Zhongjing’s *Jinkui* used cold-natured treatments, while Taiwu and Yangkui analyzed it as a fire syndrome, providing detailed insights into the pathogenesis of Ezu. However, generally, there is no cold in pregnancy and no heat in postpartum; this is the standard rule. Therefore, in Ezu and vomiting, cold syndromes are rare, while heat syndromes are common. Ultimately, it belongs to blood congestion obstructing the fetal source, preventing the free flow of zang-organs' qi, leading to retained phlegm and fluids, stagnant heat accumulation, transformation into fire, resulting in heat without cold, thus generating various symptoms. Hence, Danxi and Lizhai, in their discussions on treatment, frequently use Zhike (Aurantii Fructus), Zisu (Perillae Folium), Sugeng (Perillae Caulis), Muxiang (Aucklandiae Radix), and Sharen (Amomi Fructus Rotundus) as methods to descend and smooth qi. This is what is meant by "pregnancy requires smoothing the qi."