治妊娠洞泄寒中。
干姜 浓朴(去粗皮,细锉)
上等分,先杵令烂,水拌,同炒令干再为末,水煮面糊为丸如梧桐子大,每服五十丸
,食前,米饮下。
治妊娠脏气本虚,宿挟风冷,脾胃久弱,脏腑虚滑,脐腹 痛,日夜无度。
浓朴(去粗皮,姜汁浸,炒黄,二两) 肉豆蔻(一个,面煨) 草豆蔻(一个,煨)
上 咀,每服三钱。水一盏,姜三片,煎至七分,去滓热服。
三黄熟艾汤、(方见第八卷第十论。)理中丸、理中汤、五苓散、黄连阿胶丸、戊己丸、
感应丸。以上并见《和剂局方》。
论曰∶夫妊娠之人,胞血既闭,脏气不理,脾胃易伤;或恣食腥肥生冷,脾胃停滞,不
能克化。冷热相搏,致令心腹搅刺疼痛,脓血赤白杂下,古书所谓滞下是也。原疾之由,皆
因冷热不调,大肠虚冷,热气客于肠间。热气乘之则赤,冷气乘之则白。冷热相交,则赤白
相杂,而运滞水止,名为滞痢也。其状白脓如涕而有血杂,亦有血少者。如白脓涕而有赤脉
如鱼脑,此名鱼脑痢。又有血痢者,热乘血入于大肠,为血痢也。血之随气,外行经络,内
通脏腑,常无滞积。若触冒劳动生热,热乘血散,渗入大肠,肠虚相化,故成血痢也。
疗妊娠患痢脓血,状如鱼脑髓,小腹绞痛难忍,地榆散。
阿胶(炙,二两) 地榆 酸石榴皮(三两) 薤白(切,一升) 黄连(一方是黄柏
皮。各三两,并细切)
上用水七升,煎取二升,温分三服。忌生冷、肥腻。
治疗妊娠期间发生的洞泄(指腹泻严重,大便如水直下)且伴有寒邪内侵的病症。
干姜、浓朴(去除粗皮,切成细丝)
以上两味药等量,先将药物捣烂,用水拌湿,共同炒至干燥,再研磨成粉末,用水煮面糊作为粘合剂,制成如梧桐子大小的丸剂,每次服用五十丸,饭前用米汤送服。
治疗妊娠期间脏腑之气本虚,素来夹杂风冷之邪,脾胃长期虚弱,脏腑虚滑不固,导致脐腹部疼痛,日夜无度地腹泻。
浓朴(去除粗皮,用姜汁浸泡,炒至黄色,二两)、肉豆蔻(一个,用面粉煨熟)、草豆蔻(一个,煨熟)
以上药物切碎,每次服用三钱。加水一盏,生姜三片,煎煮至七分水量,去渣后热服。
三黄熟艾汤(方剂见第八卷第十论)、理中丸、理中汤、五苓散、黄连阿胶丸、戊己丸、感应丸。以上方剂均见于《和剂局方》。
论述说:妊娠妇女,由于胞宫血液闭藏以养胎,导致脏腑气机运行不畅,脾胃容易受损;或者恣意食用腥膻肥腻及生冷食物,导致脾胃停滞,无法运化消化。寒热之气相互搏结,致使心腹搅动刺痛,脓血与赤白杂下,古书中称之为“滞下”。这种疾病的起因,都是由于冷热不调,大肠虚冷,热气客居在肠间。热气侵袭则便血色红,冷气侵袭则便色白。寒热交互作用,则赤白相杂,而运化停滞、水液止泻,称为“滞痢”。其症状表现为白色脓液像鼻涕一样并夹杂血液,也有血量较少的情况。如果白色脓涕中夹杂红色脉络如同鱼脑,这叫做“鱼脑痢”。又有血痢的情况,是热气侵入血液进入大肠,形成血痢。血液随气运行,外行于经络,内通于脏腑,通常没有停滞积聚。如果触犯劳倦产生热邪,热气使血液散乱,渗入大肠,因肠道虚弱而被转化,所以形成血痢。
治疗妊娠患痢疾,排出脓血,状如鱼脑髓,小腹绞痛难以忍受,使用地榆散。
阿胶(炙烤,二两)、地榆、酸石榴皮(三两)、薤白(切碎,一升)、黄连(一方使用黄柏皮代替。各三两,都切碎)
以上药物用水七升,煎取二升药液,分三次温服。忌食生冷、肥腻食物。
Treats dysentery with profuse watery diarrhea (Dongxie, referring to severe diarrhea where stool flows down like water) and internal invasion of cold pathogen during pregnancy.
Ganjiang (Dried Ginger), Houpo (Magnolia Bark, remove coarse bark, finely sliced).
Equal parts of the above two herbs. First pound them until soft, mix with water, stir-fry together until dry, then grind into powder. Use wheat paste made by boiling flour in water as a binder to form pills the size of Sophora seeds. Take 50 pills per dose, before meals, washed down with rice water.
Treats conditions where the visceral qi is inherently deficient during pregnancy, with a history of wind-cold accumulation, long-term weakness of the spleen and stomach, and deficiency-induced laxity of the viscera, resulting in pain around the umbilicus and abdomen, and unceasing diarrhea day and night.
Houpo (Magnolia Bark, remove coarse bark, soak in ginger juice, stir-fry until yellow, 2 liang), Roudoukou (Nutmeg, one piece, baked in flour), Caodoukou (Cardamom, one piece, baked).
Chop the above herbs. Take 3 qian per dose. Add one盏 (approx. 200ml) of water and three slices of ginger, decoct until the volume reduces to 70%, strain, and take hot.
Sanhuang Shuai Ai Tang (Three-Yellow Prepared Mugwort Decoction; see Volume 8, Treatise 10 for formula), Lizhong Wan (Regulate the Middle Pill), Lizhong Tang (Regulate the Middle Decoction), Wuling San (Five-Ling Powder), Huanglian Ejiao Wan (Coptis and Donkey-Hide Gelatin Pill), Wuji Wan (Wu-Ji Pill), Yinggan Wan (Responsive Pill). All the above formulas are found in *Heji Jufang* (Formulary of the Bureau of Preserving Health).
Discussion states: In pregnant women, since the blood in the uterus is retained to nourish the fetus, the qi mechanism of the viscera becomes disordered, making the spleen and stomach prone to injury; or due to excessive consumption of fishy, greasy, and raw/cold foods, causing stagnation in the spleen and stomach and inability to transform and transport. Cold and heat pathogens contend with each other, causing churning and stabbing pain in the heart and abdomen, with pus, blood, red, and white matter mixed in the stool. Ancient texts refer to this as "Zhixia" (Stagnant Downward Flow). The origin of this disease lies in the imbalance of cold and heat, deficiency-cold of the large intestine, and heat pathogen lodging in the intestines. When heat pathogen attacks, the stool appears red; when cold pathogen attacks, it appears white. When cold and heat interact, red and white mix, and transportation stagnates while fluid discharge stops, named "Zhi Li" (Stagnant Dysentery). Its presentation involves white pus resembling mucus mixed with blood, sometimes with less blood. If the white pus contains red streaks resembling fish brain, it is called "Yunao Li" (Fish Brain Dysentery). There is also bloody dysentery, caused by heat invading the blood and entering the large intestine, forming bloody dysentery. Blood follows qi, circulating externally through meridians and internally connecting to viscera, usually without stagnation. If exposed to labor or movement generating heat, the heat causes blood to scatter and seep into the large intestine. Due to intestinal deficiency, transformation occurs, thus forming bloody dysentery.
To treat dysentery with pus and blood resembling fish brain marrow during pregnancy, accompanied by unbearable cramping pain in the lower abdomen, use Diyue San (Sanguisorba Powder).
Ejiao (Donkey-Hide Gelatin, roasted, 2 liang), Diyue (Sanguisorba Root), Suan Shiliu Pi (Acid Pomegranate Peel, 3 liang), Xiebai (Allium Macrostemon Bulb, cut, 1 sheng), Huanglian (Coptis Rhizome; in some prescriptions, Huangbo Pi [Phellodendron Bark] is used instead. Each 3 liang, all finely cut).
Add seven sheng (approx. 1400ml) of water, decoct to obtain two sheng (approx. 400ml) of liquid. Divide into three doses and take warm. Avoid raw/cold and greasy foods.