巢元方曰∶妊娠恶阻者,心中愦闷,头眩,四肢懈惰,恶闻食气,欲啖咸酸果实,多睡少起,世言恶食,
又云恶阻是也。三四月以上,不自胜举。此由妇人本元虚羸,血气不足,肾气又弱,兼当风饮冷,心下有痰水
挟之。娠后经血闭塞,水渍于脏,脏气不宣,故心烦愦闷,气逆呕吐。血脉不通,经络痞涩,则四肢沉重。挟
风则头目眩,又不知患之所在。脉理和平,即是有胎也。
《圣济总录》曰∶妇人所食谷味,化为血气,下为月水。凡妊娠之初,月水乍聚,一月为 ,二月为胚,
三月为胎,成则男女上食于母,口如鸟。在 胚之时,血气未用,五味不化,中气壅实,所以脾胃不思谷味,
闻见于物,即恶心有阻也。
朱丹溪曰∶凡孕二三月间,呕逆不食,或心烦闷。此乃气血积聚,以养胎元,精血内郁,秽腐之气上攻于
胃,是以呕逆不能纳食。血既养胎,心失所荣,是以心虚烦闷。法当调血散郁,用参、术、甘草补中气,橘红、
紫苏、木香、生姜,散郁气,茯苓、麦冬、黄芩、竹茹,清热解烦,名参橘饮。
陈良甫曰∶妊娠恶阻病,《产宝》谓之子病,巢氏《病源》谓之恶阻。由胃气怯弱,中脘停痰,脉息和顺,
但肢体沉重,头眩,择食,唯嗜酸咸。甚者寒热呕吐,胸膈烦闷,半夏茯苓丸主之。
巢元方说:妊娠恶阻(妊娠早期出现的恶心、呕吐等反应),表现为心中烦乱闷塞,头晕目眩,四肢倦怠无力,厌恶食物的气味,想吃咸酸口味的果实,嗜睡而少起身,世人所说的“恶食”,又叫做“恶阻”。到了怀孕三四个月以上时,身体沉重得难以自持。这是由于妇人原本元气虚弱瘦弱,气血不足,肾气也虚弱,加上感受风邪、饮用冷物,导致心下有痰饮和水湿停留并夹杂其中。怀孕后经血闭止不行,水湿浸渍于脏腑,脏腑之气不得宣通,所以心烦意乱闷塞,气机上逆而呕吐。血脉运行不通畅,经络阻滞涩滞,则四肢沉重。若兼夹风邪,则头目眩晕,又不知病痛的具体所在。脉象平和均匀,就是怀孕的征象。
《圣济总录》说:妇女所吃的谷物味道,转化为血气,下行成为月经。凡是怀孕初期,月经突然停止凝聚,第一个月称为“始”,第二个月称为“胚”,第三个月称为“胎”,成形后男女胎儿在母体内摄取营养,口部如同鸟喙一般。在“始”和“胚”的阶段,血气尚未充分运用,五味不能正常运化,中焦之气壅滞充实,所以脾胃不想进食谷物,闻到或看到食物,就会感到恶心且有阻碍感。
朱丹溪说:凡是怀孕二三个月期间,出现呕吐逆气、不能进食,或者心烦闷乱。这是因为气血积聚以滋养胎元,精血在内郁结,秽浊腐败之气上攻于胃,因此呕吐逆气不能纳食。血液既然用来养胎,心脏失去濡养,所以心虚而烦闷。治疗法则应当调和血液、疏散郁结,用人参、白术、甘草补益中气,橘红、紫苏、木香、生姜,疏散郁结之气,茯苓、麦冬、黄芩、竹茹,清热解除烦闷,名为参橘饮。
陈良甫说:妊娠恶阻病,《产宝》称之为子病,巢氏《诸病源候论》称之为恶阻。这是由于胃气怯弱,中脘部位停聚痰饮,脉息和顺,只是肢体沉重,头晕目眩,挑食,唯独嗜好酸咸口味。严重的出现寒热交替、呕吐,胸膈烦闷,用半夏茯苓丸主治。
Chao Yuanfang stated: Pregnancy malaise (nausea and vomiting occurring in early pregnancy) is characterized by a feeling of mental confusion and oppression, dizziness, lassitude and weakness of the four limbs, aversion to the smell of food, a craving for salty and sour fruits, excessive sleepiness with little rising from bed. What the world calls "aversion to food" is also known as "malaise." By the third or fourth month, the body becomes so heavy that one cannot lift it voluntarily. This arises because the woman originally has deficient yuan qi and emaciation, insufficient blood and qi, and weak kidney qi, compounded by exposure to wind and consumption of cold drinks, leading to phlegm-fluid retention under the heart. After conception, menstrual blood ceases; fluid moisture infiltrates the zang-fu organs, causing their qi to fail to circulate freely. Thus, there is mental restlessness and oppression, rebellious qi leading to vomiting. When blood vessels are unobstructed and meridians are blocked and stagnant, the four limbs feel heavy. If complicated by wind, dizziness of the head and eyes occurs, and the exact location of the ailment is unknown. A pulse that is peaceful and uniform indicates pregnancy.
The *Shengji Zonglu* states: The flavors of grains consumed by women transform into blood and qi, which flow downward to become menstruation. At the beginning of pregnancy, menstruation suddenly stops and gathers. In the first month, it is called "shi" (beginning); in the second month, "pei" (embryo); in the third month, "tai" (fetus). Once formed, the male or female fetus nourishes itself from the mother, with the mouth resembling a bird's beak. During the "shi" and "pei" stages, blood and qi are not yet fully utilized, and the five flavors are not properly transformed. The middle qi becomes congested and solid, so the spleen and stomach lose their desire for grain food. Upon smelling or seeing objects/food, nausea and obstruction occur.
Zhu Danxi said: During the second and third months of pregnancy, symptoms such as retching, inability to eat, or mental irritability and oppression may appear. This is due to the accumulation of blood and qi to nourish the fetal origin. Essence and blood stagnate internally, and foul, corrupting qi attacks the stomach upward, resulting in retching and an inability to accept food. Since blood is used to nourish the fetus, the heart loses its nourishment, leading to heart deficiency, irritability, and oppression. The treatment method should regulate blood and dissipate stagnation. Use Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), and Gancao (Licorice Root) to tonify middle qi; Juhong (Tangerine Peel), Zisu (Perilla Leaf), Muxiang (Aucklandiae Radix), and Shengjiang (Fresh Ginger Rhizome) to dissipate stagnant qi; Fuling (Poria), Maidong (Ophiopogonis Radix), Huangqin (Scutellariae Radix), and Zhuru (Bambusae Caulis in Taenia) to clear heat and relieve irritability. This formula is named Shenju Yin (Ginseng and Tangerine Peel Decoction).
Chen Liangfu stated: Regarding the disease of pregnancy malaise, the *Chanbao* refers to it as "zi bing" (fetal disease), while Chao Shi's *Bingyuan* calls it "e zu" (malaise). It is caused by weak stomach qi and phlegm retention in the zhongwan region. The pulse is harmonious, but the limbs feel heavy, there is dizziness, selective eating, and a preference for sour and salty tastes. In severe cases, alternating chills and fever, vomiting, and chest and diaphragm oppression occur. Banxia Fuling Wan (Pinellia and Poria Pill) is the primary treatment.