夫至精才化,一气方凝,始受胞胎,渐成形质,子在腹中,随母听闻。自妊娠之后,则
须行坐端严,性情和悦,常处静室,多听美言,令人讲读诗书、陈礼说乐,耳不闻非言,目
不观恶事,如此则生男女福寿敦浓,忠孝贤明。不然则男女既生,则多鄙贱不寿而愚,此所
谓因外象而内感也。昔太壬娠文王目不视恶色,耳不听恶声,口不谈恶言,世传胎教之道,
是谓此也。前论亦略叙之矣。然则妇人有终身无子者,何也?按《巢氏病源》云∶妇人无子
者,盖有三焉∶一者坟墓不嗣;二者夫妇年命相克;三者夫疹妇病,皆令无子。若夫疹妇病
,可以服药,而后能有子,余皆不可致也。今观是说,亦未尽善。有人以妇人无子,问西京
常器之者,乃曰∶妇人自少多病,服燥药无节,使天癸耗动且早,故终身无子。又有问襄阳
宋大亨者,亦然。然则妇人妊娠有两胎者,何也?按古今方书并无论及此者,惟巢氏论云∶
阳施阴化,精气有余,故生二胎。且谓成一胎之理,其精有几耶?今观妇人有两胎者,其精
神气宇略无小异。至于数有两胎,或间成两胎者,有俱男俱女者,有一男一女者。《道藏经
》云有求子法,云妇人月信初止后,一日、三日、五日,值男女旺相日,阳日阳时交合,
有子多男。若男女禀受皆壮,则多子。一有怯弱,则少子。以此推之,理可概见焉。又妇人
妊娠,男女之别何也?按《颅囟经》云∶阳盛发阴,当孕成男,六脉诸经,皆举其阳;阴盛
发阳,当孕成女,六脉诸经,皆举其阴。《巢氏病源》云∶三阳所会则生男,三阴所会则生
女。葛洪《肘后方》云∶男从父气,女从母气。《圣济经》云∶天之德,地之气,阴阳之至
和,相为流薄于一体,因气而左动则属阳,阳资之则成男;因气而右动则属阴,阴资而成女
。《易》称干道成男,坤道成女。此男女之别也。凡妊娠有疾,投以汤药,有伤胎破血者之
忌,何也?《内经》云∶妇人重身,毒之奈何?岐伯答曰∶有故无殒,衰其大半而已也。盖
妊妇有疾不可不投药也,必在医者审度疾势轻重,量度药性高下,处以中庸,不必多品。视
其疾势已衰,药宜便止,则病去母安,子亦无损,复何惧于攻治哉!
当最精微的生命物质刚刚形成,元气开始凝聚,胚胎初具雏形时,胎儿在母体腹中,能够随着母亲而感知外界的声音。自怀孕之后,孕妇必须举止端庄严肃,保持性情平和愉悦,常处于安静的居室之中,多听美好的言语,让人诵读诗书、阐述礼仪和音乐的道理,耳朵不听非议之语,眼睛不看丑恶之事,像这样所生的子女便会福气深厚、寿命绵长,且忠诚孝顺、贤良明智。如果不这样做,那么生下的子女大多卑贱短命而且愚笨,这就是所说的“因外象而内感”(通过外部形象影响内在感应)。从前太壬怀文王时,眼睛不看恶色,耳朵不听恶声,嘴巴不谈恶言,世间流传的胎教之道,说的就是这种情况。前面的论述中也大致叙述过这一点。
然而,有些妇女终身没有子女,这是为什么呢?根据《巢氏病源》记载:妇女不能生育的原因大概有三点:一是祖坟风水问题导致无后;二是夫妻双方的生辰八字相克;三是丈夫或妻子患有疾病,这些都会导致无法生育。如果是丈夫或妻子的疾病所致,可以通过服药治疗,之后便能拥有子女,其余两种情况则无法通过人为努力解决。现在看这种说法,也不尽完善。有人向西京的常器之询问妇女无子的原因,常器之说:妇女从小多病,无节制地服用燥热药物,导致天癸(指月经及生殖机能)耗损且提前枯竭,所以终身无子。又有向襄阳的宋大亨询问,得到的回答也是如此。
那么,妇女怀孕时有双胞胎的情况是怎么回事呢?查阅古今方书都没有提及此事,只有《巢氏病源》论述说:阳气施放,阴气化育,精气有余,所以生下二胎。并且问构成一个胎儿的原理,其精子有多少呢?现在观察有双胞胎的妇女,她们的精神气质并没有丝毫差异。至于多次怀双胞胎,或者间隔怀双胞胎的,有全是男孩或全是女孩的,也有有一男一女的。《道藏经》中有求子的方法,说妇女月经刚停止后的第一天、第三天、第五天,正值男女旺盛的日子,在阳日的阳时进行交合,容易生男孩。如果男女禀受的气血都强壮,就会多子。一旦怯弱,就会少子。以此类推,道理可以概见。
另外,妇女怀孕时,如何区分男女?根据《颅囟经》记载:阳气盛而激发阴气,应当孕育成男,六脉各经都显现出阳的特征;阴气盛而激发阳气,应当孕育成女,六脉各经都显现出阴的特征。《巢氏病源》说:三阳经气交会则生男,三阴经气交会则生女。葛洪《肘后方》说:男从父气,女从母气。《圣济经》说:天的德性,地的气机,阴阳的最高和谐,相互流动融合于身体之中,因气向左动则属于阳,阳气滋养则成男;因气向右动则属于阴,阴气滋养则成女。《易经》称乾道成男,坤道成女。这就是男女的区别。
凡是妊娠期间患病,使用汤药治疗,有哪些伤胎破血的禁忌呢?《内经》说:妇人怀孕,能用毒药吗?岐伯回答说:有病邪存在就不会伤害母体,只要削弱病势到一半以上就可以了。大概是因为孕妇有病不可不投药,必须在医生审慎判断病情轻重,衡量药性高低,处以中庸之法,不必用多种药物。看到病情已经衰退,用药就应停止,这样病去母安,胎儿也无损伤,还怕什么攻治呢!
When the most refined vital essence first transforms and the single qi begins to condense, the embryo is initially conceived and gradually takes form. The fetus in the womb perceives sounds along with the mother. After pregnancy commences, the woman must maintain dignified posture in walking and sitting, keep her temperament harmonious and joyful, reside often in quiet rooms, listen frequently to beautiful words, and have others recite poetry and books, expound rituals, and discuss music. Her ears should not hear improper speech, nor her eyes behold ugly things. By doing so, the children born will possess abundant fortune and longevity, and be loyal, filial, wise, and virtuous. If not done thus, the children born will likely be of low status, short-lived, and foolish. This is what is called "internal perception due to external images" (Yin Wai Xiang Er Nei Gan). In ancient times, Tai Ren, while pregnant with King Wen, did not look at evil colors, did not listen to evil sounds, and did not speak evil words. The way of prenatal education (Tai Jiao) passed down in the world refers to this. The previous discussion has also briefly narrated this.
However, why do some women remain childless throughout their lives? According to *Chao Shi Bing Yuan* (Source of Diseases by Chao Yuanfang), there are generally three reasons for a woman's infertility: First, ancestral graves fail to continue the lineage; Second, the husband and wife's birth years and fates clash; Third, either the husband or wife suffers from illness, all of which lead to infertility. If it is due to the husband's or wife's illness, medicine can be taken to subsequently conceive children; the other two cases cannot be achieved through human effort. Observing this view now, it is not entirely sound. Someone asked Chang Qizhi of Xijing about the cause of female infertility. He replied that women often suffer from illnesses since childhood and take drying/hot medicines without restraint, causing Tian Gui (menstruation and reproductive function) to deplete and decline prematurely, resulting in lifelong infertility. Another inquiry to Song Daren of Xiangyang yielded the same answer.
Then, why do some women carry twins during pregnancy? Ancient and modern medical texts rarely mention this, except for *Chao Shi Bing Yuan*, which states: When Yang exerts and Yin transforms, and the essence and qi are abundant, twins are born. It further asks regarding the principle of forming one fetus, how much sperm is involved? Now observing women who bear twins, their spirit and demeanor show no slight difference. As for those who have multiple sets of twins or spaced twin pregnancies, they may have all males, all females, or one male and one female. The *Dao Zang Jing* (Daoist Canon) contains methods for seeking offspring, stating that after a woman's menstruation stops, on the first, third, or fifth day, when it is a prosperous day for men or women, intercourse during the yang hour of a yang day tends to produce sons. If both male and female endowments are robust, there will be many children. If weak, there will be few. Inferring from this, the principle can be broadly understood.
Furthermore, how to distinguish between male and female fetuses during pregnancy? According to *Lu Xin Jing* (Classic of Cranial Fontanelle): When Yang is abundant and stimulates Yin, a male fetus is formed; the six pulses and various meridians all exhibit yang characteristics. When Yin is abundant and stimulates Yang, a female fetus is formed; the six pulses and various meridians all exhibit yin characteristics. *Chao Shi Bing Yuan* states: Convergence of the Three Yang meridians produces a boy; convergence of the Three Yin meridians produces a girl. Ge Hong's *Zhou Hou Bei Fang* (Handbook of Prescriptions for Emergencies) states: Males derive from the father's qi, females from the mother's qi. *Sheng Ji Jing* states: The virtue of Heaven and the qi of Earth, the ultimate harmony of Yin and Yang, flow and blend into one body. Movement of qi to the left belongs to Yang; nourished by Yang, it forms a male. Movement of qi to the right belongs to Yin; nourished by Yin, it forms a female. The *I Ching* (Book of Changes) states: The Way of Qian forms the male, the Way of Kun forms the female. This is the distinction between males and females.
Regarding any diseases during pregnancy and the administration of decoctions, what are the taboos concerning damage to the fetus or breaking blood? The *Nei Jing* (Inner Canon) asks: How should toxic substances be used for a pregnant woman? Qibo answers: If there is an existing pathology, there will be no injury to the mother; simply reduce the pathogenic factor by more than half. Generally, because a pregnant woman with illness cannot avoid medication, the physician must carefully assess the severity of the disease and weigh the potency of the drugs, prescribing moderate measures without using too many ingredients. Once the disease trend has subsided, medication should cease. Thus, the illness is removed, the mother remains safe, and the fetus is undamaged. Why fear such treatment!