《良方》安胎寄生汤(见《妇人规古方》)治妊娠下血,或胎不安,或腰腹作痛。
桑寄生 白术 茯苓(各五分) 甘草(一钱)
上,水煎服。
当归芍药汤(见《妇人规古方》)治妊娠心腹急痛,或去血过多而晕眩。
当归 白芍药(炒) 白术(炒) 茯苓 泽泻(各一钱) 川芎(二钱)
上,水煎服。
妊娠忽然下血,其证有四∶或因火热,迫血则妄行;或因郁怒,气逆则动血;或因损触胎气,胞宫受伤
而下血;或因脾肾气陷,命门不固而脱血。凡此皆动血之最者也。不速为调理,则必致堕胎矣。然治此者,
必先察其血去之多少,及于血去之后,尤当察其邪之微甚,如火犹未清,仍当清火,气犹未顺,仍当顺气。
若因邪而动血,血去而营虚,则速当专顾元气,以防脱陷。此中或当治标,或当救本,或当兼标本而调理
之。倘不知先后缓急,将恐治标未已而救本无暇也,当详察之。
若火盛迫血妄行者,当察其火之微甚。火之微者,凉胎饮;稍甚者,徙薪饮;再甚者,保阴煎、子芩散。
若肝经有风热而血下者,宜防风黄芩丸。若怒气伤肝,气逆血动而暴至者,宜保阴煎;若气有未顺而胀满者,
四七汤、二陈汤,或加芎、归之类;若兼肝火者,宜化肝煎。
凉胎饮(见安胎)
徙薪饮(见崩淋经漏不止)
保阴煎(见血热经早)
子芩散(见血热论外方)
防风黄芩丸(见崩漏论外方)
四七汤(见安胎)
二陈汤(见安胎)
化肝煎(见崩淋经漏不止)
若触损胎气,胞宫受伤而血下者,宜安胎散、胶艾汤;去血多者,倍加人参。若从高堕下,伤动胎气而下
血者,宜益母地黄汤、安胎散;若因惊,气虚而陷者,仍加人参。
安胎散(见胎漏)
胶艾汤(良方胶艾汤,见安胎)
益母地黄汤(见安胎论外方)
若脾胃素弱,或偶因伤脾下血者,宜寿脾煎、归脾汤;或中气下陷者,补中益气汤。若血虚微热,漏血、
尿血者,续断汤。
寿脾煎(见血虚经乱)
归脾汤(见经不调)
补中益气汤(见经不调)
续断汤(见血热论外方)
以上诸动血证,若去血未多,血无所积,胎未至伤而不止者,宜凉则凉,宜补则补,惟以安之、固之为主
治。若血已离位,蓄积胞宫,为胀为痛,而余血未出者,欲与留之有不可得,欲去其血而不伤营气,则惟四
物汤大加当归为最宜也。若察其胎气已动,势有难留,则五物煎、决津煎皆切要之药。
四物汤(见经不调)
五物煎(见血寒论外方)
决津煎(见经期腹痛)
一方∶治顿仆胎动。用川芎末二钱,酒下二三钱。胎生即安胎,死即下。
又方∶治同前。用砂仁和皮炒为末,每服二钱,米饮下,腹热即安。
《良方》中的安胎寄生汤(见《妇人规古方》)用于治疗妊娠期间阴道出血,或胎动不安,或腰腹部疼痛。
桑寄生、白术、茯苓(各五分),甘草(一钱)。
以上药材,加水煎煮后服用。
当归芍药汤(见《妇人规古方》)用于治疗妊娠期心腹急剧疼痛,或因失血过多导致的眩晕。
当归、炒白芍药、炒白术、茯苓、泽泻(各一钱),川芎(二钱)。
以上药材,加水煎煮后服用。
妊娠期间突然阴道出血,其证候有四种:一是因火热之邪,逼迫血液妄行;二是因郁怒,导致气机逆乱而动血;三是因外力损伤胎气,胞宫受伤而下血;四是因脾肾之气下陷,命门不固而脱血。凡是这些情况,都是导致动血最严重的因素。如果不迅速进行调理,必然会导致堕胎。然而治疗此类病症,必须先观察出血量的多少,以及在出血之后,更要观察病邪的轻重程度。如果火热之邪尚未清除,仍应当清热泻火;如果气机尚未顺畅,仍应当顺气理气。如果是因邪气扰动而致出血,在血液流失后营血亏虚,则应当迅速专注于顾护元气,以防正气脱陷。这其中,有的应当治标,有的应当救本,有的应当标本兼治。倘若不懂得治疗的先后缓急,恐怕在治标的措施还未完成时,已无暇顾及救本了,因此必须详细审察。
如果是火热炽盛逼迫血液妄行,应当观察火势的轻重。火势轻微者,用凉胎饮;稍重者,用徙薪饮;更重者,用保阴煎、子芩散。如果是肝经有风热而导致下血,宜用防风黄芩丸。如果是怒气伤肝,气逆血动且突然发作的,宜用保阴煎;如果气机尚不顺遂并伴有胀满的,用四七汤、二陈汤,或者加入川芎、当归之类的药物;如果兼有肝火的,宜用化肝煎。
凉胎饮(见安胎章节)
徙薪饮(见崩淋经漏不止章节)
保阴煎(见血热经早章节)
子芩散(见血热论外方章节)
防风黄芩丸(见崩漏论外方章节)
四七汤(见安胎章节)
二陈汤(见安胎章节)
化肝煎(见崩淋经漏不止章节)
如果是因触碰损伤胎气,胞宫受伤而下血的,宜用安胎散、胶艾汤;如果失血较多,加倍使用人参。如果是从高处坠落,伤动胎气而下血的,宜用益母地黄汤、安胎散;如果是因受惊,导致气虚下陷的,仍然要加入人参。
安胎散(见胎漏章节)
胶艾汤(良方胶艾汤,见安胎章节)
益母地黄汤(见安胎论外方章节)
如果脾胃素来虚弱,或者偶尔因伤脾而下血的,宜用寿脾煎、归脾汤;如果是中气下陷的,用补中益气汤。如果是血虚伴有微热,出现漏血、尿血的,用续断汤。
寿脾煎(见血虚经乱章节)
归脾汤(见经不调章节)
补中益气汤(见经不调章节)
续断汤(见血热论外方章节)
以上各种动血证候,如果出血量不多,血液没有积聚,胎元未至受损但出血不止的,该清热的就清热,该补益的就补益,唯独以安胎、固摄为主要治法。如果血液已经离经妄行,蓄积在胞宫,导致胀满疼痛,而余血未尽排出的,想要保留它已不可能,想要去除瘀血而不损伤营气,那么只有四物汤大量增加当归用量最为适宜。如果审察发现胎气已动,形势难以挽留,那么五物煎、决津煎都是关键重要的药物。
四物汤(见经不调章节)
五物煎(见血寒论外方章节)
决津煎(见经期腹痛章节)
一方:治疗因跌倒震动导致的胎动。用川芎末二钱,酒送服二三钱。胎儿活着则安胎,胎儿死亡则排出。
又一方:治疗同上。用砂仁与皮一起炒成粉末,每次服用二钱,米汤送服,腹部感到发热即安胎。
The An Tai Ji Sheng Tang (Cuscuta and Taxillus Decoction for Calming the Fetus, see "Ancient Formulas of Fu Ren Gui" in Liang Fang) is used to treat vaginal bleeding during pregnancy, or fetal restlessness, or pain in the lower back and abdomen.
Sang Ji Sheng (Taxilli Caulis), Bai Zhu (Atractylodis Rhizoma), Fu Ling (Poria) (each 5 fen), Gan Cao (Glycyrrhizae Radix et Rhizoma) (1 qian).
Take the above herbs, decoct with water, and take orally.
Dang Gui Shao Yao Tang (Angelica Sinensis and Paeonia Decoction, see "Ancient Formulas of Fu Ren Gui") is used to treat acute pain in the heart and abdomen during pregnancy, or dizziness caused by excessive blood loss.
Dang Gui (Angelicae Sinensis Radix), Chao Bai Shao Yao (Fried Paeoniae Radix Alba), Chao Bai Zhu (Fried Atractylodis Rhizoma), Fu Ling (Poria), Ze Xie (Alismatis Rhizoma) (each 1 qian), Chuan Xiong (Ligustici Chuanxiong Rhizoma) (2 qian).
Take the above herbs, decoct with water, and take orally.
Sudden vaginal bleeding during pregnancy has four types of syndromes: one is due to fire-heat forcing blood to move recklessly; another is due to depression and anger causing qi rebellion and disturbing blood; a third is due to physical trauma damaging the fetal qi and injuring the uterus, leading to bleeding; and the fourth is due to sinking of spleen and kidney qi, with failure of the Gate of Vitality (Ming Men) to consolidate, resulting in hemorrhage. All these are the most severe causes of disturbing blood. If not regulated promptly, abortion will inevitably occur. However, when treating this condition, one must first observe the amount of blood lost, and especially after the bleeding, observe the severity of the pathogenic factors. If fire-heat has not been cleared, it should still be cleared; if qi is not yet smooth, it should still be regulated. If bleeding was caused by pathogens, and after blood loss the nutritive qi (Ying Qi) is deficient, one must quickly focus on protecting the original qi (Yuan Qi) to prevent collapse. In this context, some cases require treating the branch (symptoms), some require saving the root (constitution), and some require addressing both simultaneously. If the sequence and urgency of treatment are not understood, there is a fear that while treating the branch, there will be no time left to save the root; therefore, careful observation is essential.
If flourishing fire forces blood to move recklessly, one must observe the severity of the fire. For mild fire, use Liang Tai Yin (Cool the Fetus Decoction); for slightly more severe cases, use Xi Xin Yin (Remove Firewood Decoction); for even more severe cases, use Bao Yin Jian (Preserve Yin Decoction) or Zi Qin San (Zi Qin Powder). If wind-heat in the Liver channel causes bleeding, use Fang Feng Huang Qin Wan (Saposhnikovia and Scutellaria Pills). If anger injures the Liver, causing qi rebellion and sudden blood disturbance, use Bao Yin Jian (Preserve Yin Decoction); if qi is not yet smooth and accompanied by distension, use Si Qi Tang (Four Seven Decoction) or Er Chen Tang (Two Aged Herbs Decoction), possibly adding Chuan Xiong (Ligustici Chuanxiong Rhizoma) and Dang Gui (Angelicae Sinensis Radix); if accompanied by Liver fire, use Hua Gan Jian (Transform Liver Decoction).
Liang Tai Yin (see Calming the Fetus chapter)
Xi Xin Yin (see Hemorrhage, Leukorrhea, and Continuous Dripping chapter)
Bao Yin Jian (see Early Menstruation due to Blood Heat chapter)
Zi Qin San (see Extra Formulas for Blood Heat discussion chapter)
Fang Feng Huang Qin Wan (see Extra Formulas for Metrorrhagia and Metrostaxis chapter)
Si Qi Tang (see Calming the Fetus chapter)
Er Chen Tang (see Calming the Fetus chapter)
Hua Gan Jian (see Hemorrhage, Leukorrhea, and Continuous Dripping chapter)
If touching or trauma damages the fetal qi and injures the uterus causing bleeding, use An Tai San (Calming the Fetus Powder) or Jiao Ai Tang (Colla Corii Asini and Artemisia Decoction); if blood loss is significant, double the dosage of Ren Shen (Ginseng Radix et Rhizoma). If falling from a height damages the fetal qi and causes bleeding, use Yi Mu Di Huang Tang (Motherwort and Rehmannia Decoction) or An Tai San (Calming the Fetus Powder); if caused by fright leading to qi deficiency and sinking, add Ren Shen (Ginseng Radix et Rhizoma).
An Tai San (see Fetal Leakage chapter)
Jiao Ai Tang (Liang Fang Jiao Ai Tang, see Calming the Fetus chapter)
Yi Mu Di Huang Tang (see Extra Formulas for Calming the Fetus discussion chapter)
If the Spleen and Stomach have always been weak, or if bleeding occurs occasionally due to Spleen injury, use Shou Pi Jian (Nourish Spleen Decoction) or Gui Pi Tang (Restore the Spleen Decoction); if Middle Qi is sinking, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). If blood deficiency with slight heat causes dripping blood or hematuria, use Xu Duan Tang (Dipsacus Decoction).
Shou Pi Jian (see Blood Deficiency and Menstrual Disorder chapter)
Gui Pi Tang (see Irregular Menstruation chapter)
Bu Zhong Yi Qi Tang (see Irregular Menstruation chapter)
Xu Duan Tang (see Extra Formulas for Blood Heat discussion chapter)
For the above various conditions of disturbing blood, if the blood loss is not heavy, there is no accumulation of blood, the fetus is not yet damaged but bleeding persists, clear if necessary, tonify if necessary, but primarily focus on calming and consolidating the fetus. If blood has already left its vessels, accumulated in the uterus, causing distension and pain, and residual blood remains unexpelled, retaining it is impossible, and expelling it without damaging Ying Qi (Nutritive Qi) is difficult; thus, using Si Wu Tang (Four Substances Decoction) with a significantly increased dose of Dang Gui (Angelicae Sinensis Radix) is most appropriate. If observation shows that fetal qi is disturbed and retention is difficult, then Wu Wu Jian (Five Items Decoction) and Jue Jin Jian (Cross River Decoction) are crucial medicines.
Si Wu Tang (see Irregular Menstruation chapter)
Wu Wu Jian (see Extra Formulas for Blood Cold discussion chapter)
Jue Jin Jian (see Abdominal Pain during Menstruation chapter)
Another formula: Treats fetal movement caused by sudden falls. Use 2 qian of Chuan Xiong (Ligustici Chuanxiong Rhizoma) powder, taken with wine. If the fetus is alive, it calms the fetus; if dead, it expels it.
Another formula: Treats the same condition. Use Sha Ren (Amomi Fructus) fried with peel into powder, take 2 qian each time, administered with rice water. The abdomen feeling warm indicates the fetus is calmed.