〔大〕夫妊娠不长者,因有宿疾,或因失调,以致脏腑衰损,气血虚弱而胎不长也。
当治其疾疚,益其气血,则胎自长矣。
〔薛〕前证更当察其经络,审其所因而治之。一妊妇胎六月,体倦懒食,面黄晡
热而胎不长,因劳欲坠。此脾气不足也,用八珍汤倍加参、术、茯苓,三十余剂,脾胃
渐健,胎安而长矣。一妊妇因怒寒热往来,内热晡热,胁痛呕吐,胎至八月而不长。此
因肝脾郁怒所致,用六君加柴胡、山栀、枳壳、紫苏、桔梗,病愈而胎亦长矣。
安胎白术散 治妊娠宿有冷,胎痿不长,或失于将理,伤胎多堕。此药补荣卫,养胎
气。
白术 川芎(各一两) 吴茱萸(汤泡,半两) 甘草(炙,一两半)
为细末,每服二钱,食前温酒调下,忌生冷果实。
白术散(见前胎动不安。)
黄 散 主妊娠胎不长。安胎和气思食,利四肢。
黄 白术 陈皮 麦门冬 白茯苓 前胡 人参(各七钱半) 川芎 甘草(各半两)
上 咀,每服三钱,水一盏,姜三片,枣一枚,煎至七分,去滓温服。
人参丸 主妊娠胎不长宜服,养胎。
人参 白茯苓 当归 柴胡 刺苏 浓朴 桑寄生(各一两) 枳壳(七钱半)
甘草(半两)
上为细末,炼蜜为丸,如梧子大。每服二十丸,食前温水吞下。
《集验》治妇人怀胎不长方。
鲤鱼(长一尺者,去肠肚鳞)
以水渍没,纳盐及枣煮熟,取汁稍稍饮之,当胎所腹上当汗出如牛鼻状,虽有所见,
胎虽不安者,十余日辄一作此,令胎长大,甚平安。
〔附〕枳实槟榔丸 安养胎气,调和经候, 瘕癖块有似孕妇,可以久服,血气通和。
枳实(生用) 槟榔 黄连 黄柏 黄芩 当归 木香 阿胶(灰炒、研。各半两)
上为细末。水和丸如小豆大。每服三十丸,不拘时,用温米饮送下。
【大】妊娠期间胎儿发育迟缓,是因为患者原本就有旧疾,或者因为调养不当,导致脏腑功能衰退受损,气血虚弱,从而使胎儿不能正常生长。
应当治疗其原有的疾病,补益气血,那么胎儿自然就会生长发育了。
【薛】上述症状更应当观察经络情况,审察病因所在然后进行治疗。有一位孕妇怀孕六个月,身体疲倦、食欲不振,面色萎黄,傍晚发热且胎儿发育迟缓,这是因为劳累和房事过度导致胎气下坠。这是脾气不足的表现,使用八珍汤并加倍人参、白术、茯苓的用量,服用三十多剂后,脾胃功能逐渐强健,胎气安定并正常生长了。还有一位孕妇因为愤怒导致寒热往来,体内发热、傍晚发热,胁肋疼痛、呕吐,怀孕到八个月时胎儿仍不发育。这是因为肝脾郁结愤怒所致,使用六君子汤加入柴胡、山栀、枳壳、紫苏、桔梗,病愈后胎儿也正常生长了。
安胎白术散 治疗妊娠期间素有寒气,胎儿萎缩不长,或者因为疏于调理,损伤胎气导致多次流产。此药能补养营卫,滋养胎气。
白术、川芎(各一两)、吴茱萸(用热水浸泡,半两)、甘草(炙过,一两半)
研成细末,每次服用二钱,饭前用温酒调服,忌食生冷瓜果。
黄芪散 主治妊娠胎儿发育迟缓。能安胎、调和气机、增进食欲、通畅四肢。
黄芪、白术、陈皮、麦门冬、白茯苓、前胡、人参(各七钱半)、川芎、甘草(各半两)
切碎,每次服用三钱,用水一盏,生姜三片,大枣一枚,煎煮至七分满,去渣后温服。
人参丸 主治妊娠胎儿发育迟缓适宜服用,能滋养胎儿。
人参、白茯苓、当归、柴胡、紫苏、厚朴、桑寄生(各一两)、枳壳(七钱半)、甘草(半两)
研成细末,用炼蜜制成梧桐子大小的丸药。每次服用二十丸,饭前用温水送服。
《集验方》治疗妇女怀胎发育迟缓的方子。
鲤鱼(身长一尺的,去掉肠肚鳞片)
用水浸没,加入盐和枣煮熟,取汤汁少量多次饮用,应当在胎儿所在的腹部位置出汗像牛鼻子那样,即使出现异常迹象,或者胎气不安的情况,每隔十余天做一次这样的处理,能使胎儿长大,非常平安。
【附】枳实槟榔丸 安养胎气,调和月经周期,对于类似孕妇的瘕癖积聚块状物,可以长期服用,使血气通畅调和。
枳实(生用)、槟榔、黄连、黄柏、黄芩、当归、木香、阿胶(用灰炒、研碎,各半两)
研成细末。用水泛丸如小豆大小。每次服用三十丸,不限时间,用温米汤送服。
[Da] If the fetus fails to grow during pregnancy, it is due to pre-existing chronic diseases or improper regulation, resulting in the decline and damage of Zang-Fu organs, and deficiency of Qi and Blood, thereby hindering fetal growth.
The treatment should focus on curing the underlying disease and tonifying Qi and Blood, after which the fetus will naturally grow.
[Xue] In addition to the aforementioned symptoms, one must also examine the meridians and investigate the etiology before treating. A pregnant woman at six months gestation presented with fatigue, poor appetite, sallow complexion, afternoon fever, and fetal growth retardation, caused by overexertion and sexual indulgence leading to a sinking sensation of the fetus. This indicates Spleen Qi deficiency; she was treated with Bazhen Tang (Eight-Tonics Decoction) with increased doses of Renshen (Ginseng), Baizhu (Atractylodes Macrocephala Rhizome), and Fuling (Poria), administered for over thirty doses. Her Spleen and Stomach function gradually strengthened, the fetus became stable, and growth resumed. Another pregnant woman experienced alternating chills and fever, internal heat, afternoon fever, hypochondriac pain, and vomiting due to anger, with no fetal growth by the eighth month. This was caused by Liver and Spleen Qi stagnation due to anger; she was treated with Liujunzi Tang (Six-Gentlemen Decoction) modified with Chaihu (Bupleuri Radix), Zhizi (Gardeniae Fructus), Zhike (Aurantii Fructus), Zisu (Perillae Folium), and Jiegeng (Platycodonis Radix). Upon recovery from the illness, the fetus also grew normally.
Antepartum Bai Zhu San (White Atractylodes Powder for Calming the Fetus) treats cold accumulation during pregnancy causing fetal atrophy and failure to grow, or frequent miscarriages due to neglect of self-care. This formula nourishes Ying and Wei (Nutritive and Defensive levels), and sustains fetal Qi.
Baizhu (Atractylodis Macrocephalae Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma) (each 1 liang); Wuzhuyu (Evodiae Fructus) (soaked in hot water, 0.5 liang); Gancao (Glycyrrhizae Radix et Rhizoma) (honey-fried, 1.5 liang).
Grind into fine powder. Take 2 qian per dose, mixed with warm wine before meals. Avoid raw/cold foods and fruits.
Bai Zhu San (See "Restless Fetus" section above.)
Huangqi San (Astragalus Powder) primarily treats fetal growth retardation during pregnancy. It calms the fetus, harmonizes Qi, stimulates appetite, and benefits the four limbs.
Huangqi (Astragali Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Maimendong (Ophiopogonis Radix), Baifuling (Poria cum Ramis et Ligno), Qianhu (Peucedani Radix), Renshen (Ginseng Radix et Rhizoma) (each 7.5 qian); Chuanxiong (Ligustici Chuanxiong Rhizoma), Gancao (Glycyrrhizae Radix et Rhizoma) (each 0.5 liang).
Coarsely crush. Take 3 qian per dose with one cup of water, three slices of Shengjiang (Zingiberis Rhizoma Recens), and one Dazao (Jujubae Fructus). Decoct until reduced to 70%, strain, and take warm.
Renshen Wan (Ginseng Pill) is indicated for fetal growth retardation during pregnancy to nourish the fetus.
Renshen (Ginseng Radix et Rhizoma), Baifuling (Poria cum Ramis et Ligno), Danggui (Angelicae Sinensis Radix), Chaihu (Bupleuri Radix), Zisu (Perillae Folium), Houpo (Magnoliae Officinalis Cortex), Sangjisheng (Taxilli Herba) (each 1 liang); Zhike (Aurantii Fructus) (7.5 qian); Gancao (Glycyrrhizae Radix et Rhizoma) (0.5 liang).
Grind into fine powder, mix with refined honey to form pills the size of wutong seeds. Take 20 pills per dose, swallowed with warm water before meals.
Jiyan Fang (Collected Proven Prescriptions) treats fetal growth retardation in women.
Li Yu (Common Carp) (one chi long, cleaned of intestines and scales).
Soak in water until submerged, add salt and jujubes, and boil until cooked. Strain the broth and drink it slowly in small amounts. Sweat resembling that of an ox's nose should appear on the abdomen where the fetus is located. Even if there are abnormal signs or fetal instability, repeating this every ten days will promote fetal growth and ensure safety.
[Appendix] Zhishi Binglang Wan (Immature Bitter Orange and Areca Seed Pill) nourishes fetal Qi and regulates menstruation. It can be taken long-term for masses resembling pregnancy (zhijia and piku accumulations), promoting smooth flow of Qi and Blood.
Zhishi (Aurantii Fructus Immaturus) (raw), Binglang (Arecae Semen), Huanglian (Coptidis Rhizoma), Huangbai (Phellodendri Cortex), Huangqin (Scutellariae Radix), Danggui (Angelicae Sinensis Radix), Muxiang (Aucklandiae Radix), Ejiao (Asini Corii Colla) (fried with ash and ground, each 0.5 liang).
Grind into fine powder. Form pills using water, sized like small beans. Take 30 pills per dose at any time, washed down with warm rice gruel.