（孟英按∶即子痫证）
沈尧封曰∶妊妇病源有三大纲∶一曰阴亏。人身
精血有限，聚以养胎，阴分必亏。二曰气滞。腹中增一障碍，则升降之气必滞。三曰痰饮。人身脏腑接壤，
腹中遽增一物，脏腑之机栝，为之不灵，津液聚为痰饮。知此三者，庶不为邪说所惑。妊妇卒倒不语，或
口眼歪斜，或手足螈 ，皆名中风；或腰背反张，时昏时醒。名为痉，又名子痫。古来皆作风治，不知卒
倒不语，病名为厥，阴虚失纳，孤阳逆上之谓。口眼歪斜，手足螈 ，或因痰滞经络；或因阴亏不吸，肝
阳内风暴动。至若腰背反张一证，临危必见戴眼，其故何欤？盖足太阳膀胱之经脉，起于目内 ，上额交
巅，循肩膊内，夹脊抵腰中；足太阳主津液，虚则经脉时缩，脉缩，故腰背反张。经云∶瞳子高者，太阳
不足。谓太阳之津液不足也，脉缩急则瞳子高，甚则戴眼。治此当用地黄、麦冬等药，滋养津液为主。胎
前病，阳虚者绝少，慎勿用小续命汤。
王孟英按∶阴虚、气滞二者，昔人曾已言之。痰饮一端，则发前人之未发，因而悟及产后谵妄等证，诚
沈氏独得之秘。反复申明，有裨后学，不亦多乎！
沈尧封曰∶钱鹄云正室，饮食起居无恙。一夜连
厥数十次，发则目上窜，形如尸，次日又厥数十次，至晚一厥不醒。以火炭投醋中，近鼻熏之，不觉。切其
脉，三部俱应，不数不迟，并无怪象。诊毕，伊芳父倪福增曰∶可治否？余曰∶可用青铅一斤化烊，倾盆内，捞
起，再烊再倾，三次。取水煎生地一两、天冬二钱、细石斛三钱、甘草一钱、石菖蒲一钱服。倪留余就寝书
室。晨起见倪复治药，云昨夜服药后，至今止厥六次，厥亦甚轻。故照前方再煎与服，服后厥遂不发。后生
一子。计其时，乃受胎初月也。移治中年非受胎者，亦屡效。
吴门叶氏，治一反张，发时如跳虫，离席数寸，发过即如平人。用白芍、甘草、紫石英、炒小麦、南枣，
煎服而愈。《快捷方式方》载一毒药攻胎，药毒冲上，外证牙关紧急，口不能言，两手强直握拳，自汗，身有微热，
与中风相似，但脉浮而软，十死一生，医多不识，若作中风治必死。用白扁豆二两，生去皮为末，新汲水调
下，即效。
沈尧封曰∶痰滞经络，宜二陈加胆星、竹沥、姜汁。
沈尧封说：孕妇疾病的根源主要有三个大纲：一是阴液亏虚。人体的精血是有限的，汇聚起来用来滋养胎儿，阴分必然亏损。二是气机阻滞。腹中增加了一个障碍（胎儿），那么升降的气机必然阻滞。三是痰饮内停。人体脏腑相互连接，腹中突然增加一个物体，脏腑的机能活动变得不灵活，津液凝聚成为痰饮。明白了这三点，才不至于被错误的说法所迷惑。孕妇突然昏倒不能说话，或者口眼歪斜，或者手足抽搐，都称为中风；或者腰背向后反张，时而昏迷时而清醒。这称为痉病，又名子痫。自古以来都用治疗中风的方法，却不知道突然昏倒不能说话，病名叫做厥证，这是阴虚不能摄纳，孤阳逆上所致。口眼歪斜、手足抽搐，可能是因为痰浊阻滞经络；也可能是因为阴液亏虚不能制约，肝阳内动引发内风。至于腰背反张这一症状，临危时必定出现眼球上翻（戴眼），这是什么缘故呢？足太阳膀胱经的经脉，起于目内眦，上行至额部交会于巅顶，沿肩膊内侧，夹脊柱到达腰部；足太阳经主管津液，虚损时经脉就会时常收缩，经脉收缩，所以导致腰背反张。医经说：瞳孔上视，是太阳经不足的表现。说的是太阳经的津液不足，经脉收缩紧急则瞳孔上视，严重时出现戴眼。治疗此症应当用地黄、麦冬等药物，以滋养津液为主。妊娠期间的疾病，阳虚的情况极少，千万不要使用小续命汤。
王孟英按语：阴虚和气滞这两点，前人已经论述过了。关于痰饮这一点，则是阐发了前人未曾发现的问题，由此领悟到产后谵妄等病症，确实是沈氏独到的心得。反复申明这些道理，对后学大有裨益，难道不是很有价值吗！
沈尧封说：钱鹄的妻子正室，饮食起居都没有异常。一天夜里连续发作厥证几十次，发作时眼睛向上窜，身体像尸体一样僵硬，第二天又发作几十次，到了晚上有一次厥证没有醒来。用烧红的火炭投入醋中，让蒸汽熏鼻子，她没有知觉。切她的脉，寸关尺三部脉搏都有反应，不快不慢，并没有奇怪的征象。诊脉完毕，她的父亲倪福增问：能治好吗？我说：可以用青铅一斤熔化，倒入盆中，捞起，再熔化再倒入，重复三次。取这种水煎煮生地一两、天冬二钱、细石斛三钱、甘草一钱、石菖蒲一钱服用。倪先生留我在书房住宿。早晨见到倪先生再次诊治药物，他说昨晚服药后，到今天只发作了六次厥证，而且程度很轻。所以照前面的方子再煎服，服后厥证就不再发作。后来生下一个儿子。计算时间，正是受孕的第一个月。移治中年非怀孕的患者，也屡次见效。
吴门叶姓医生，治疗一例角弓反张患者，发作时像跳虫一样，离开座位几寸远，发作过后就像正常人一样。用白芍、甘草、紫石英、炒小麦、南枣，煎服而痊愈。《快捷方式方》记载一例毒药攻胎的案例，药毒冲逆向上，外证表现为牙关紧闭，不能说话，两手强直握拳，自汗，身体有微热，与中风相似，但脉象浮而软，十死一生，医生大多不认识，如果当作中风治疗必死无疑。用白扁豆二两，生用去皮研为粉末，新汲水调服，立即见效。
(Wang Mengying's commentary: This is the syndrome of eclampsia.)
Shen Yaofeng said: The root causes of diseases in pregnant women can be summarized into three main categories: First, deficiency of Yin fluids. The essence and blood of the human body are limited; they gather to nourish the fetus, so the Yin aspect inevitably becomes deficient. Second, stagnation of Qi. With an obstacle (the fetus) added to the abdomen, the ascending and descending movement of Qi must become stagnant. Third, retention of phlegm and fluid. The organs and viscera of the human body are adjacent; with a sudden addition of an object in the abdomen, the functional mechanisms of the organs become inflexible, causing body fluids to condense into phlegm and fluid. Understanding these three points prevents one from being confused by erroneous theories. When a pregnant woman suddenly faints and cannot speak, or has deviation of the mouth and eyes, or convulsions of the limbs, it is all termed stroke (Zhong Feng); or when there is opisthotonos (backward arching of the back), alternating between coma and consciousness, it is termed spasm (Jing), also known as eclampsia (Zi Xian). Historically, it has always been treated as stroke, but one does not realize that sudden fainting and inability to speak is a disease named Jue (syncope/collapse), which refers to Yin deficiency failing to anchor the solitary Yang leading to upward rebellion. Deviation of the mouth and eyes and limb convulsions may be due to phlegm obstructing the meridians; or due to Yin deficiency failing to absorb/anchor, causing Liver Yang to move internally and generate internal wind. As for the symptom of opisthotonos, at the critical stage, upward staring of the eyes (Dai Yan) must appear. What is the reason? The meridian of Foot-Taiyang Bladder originates from the inner canthus, ascends to the forehead and intersects at the vertex, runs along the medial side of the shoulder blades, flanks the spine, and reaches the middle of the waist; the Foot-Taiyang governs body fluids. When deficient, the meridians contract intermittently; due to contraction, opisthotonos occurs. The Classics state: "High pupils indicate Taiyang insufficiency." This means insufficiency of the fluids of the Taiyang meridian. When the meridians contract and tighten, the pupils look upward; severely, Dai Yan occurs. Treatment should employ herbs such as Sheng Di Huang (Rehmanniae Radix) and Mai Dong (Ophiopogonis Tuber) to primarily nourish body fluids. In pregnancy-related diseases, Yang deficiency is extremely rare; one must strictly avoid using Xiao Xuming Tang (Minor Cinnamon Twig Decoction).
Wang Mengying's commentary: The aspects of Yin deficiency and Qi stagnation have been discussed by predecessors. The aspect of phlegm and fluid, however, elucidates issues previously unmentioned by predecessors, thereby leading to insights into conditions such as postpartum delirium. This is indeed Shen's unique insight. Repeatedly clarifying these principles benefits future students greatly, is it not valuable!
Shen Yaofeng said: Qian Hu's principal wife had normal diet and起居 (daily activities). One night, she experienced syncope dozens of times in succession. During attacks, her eyes rolled upward, and her body was rigid like a corpse. The next day, she had dozens more episodes. By evening, one episode did not resolve. Red-hot charcoal was thrown into vinegar, and the vapor was wafted near her nose, but she showed no awareness. Her pulse at the Cun, Guan, and Chi positions on both hands responded normally, neither rapid nor slow, showing no abnormal signs. After diagnosis, her father, Ni Fuzeng, asked: Can this be cured? I said: Use one jin (approx. 500g) of Qing Qian (Lead) to melt it, pour it into a basin, scoop it up, melt again, and pour again, repeating this three times. Take this water to decoct Sheng Di Huang (Rehmanniae Radix) 1 liang, Tian Dong (Asparagi Radix) 2 qian, Xi Shi Hu (Dendrobii Caulis) 3 qian, Gan Cao (Glycyrrhizae Radix et Rhizoma) 1 qian, and Shi Chang Pu (Acori Tatarinowii Rhizoma) 1 qian for administration. Mr. Ni invited me to stay overnight in his study. In the morning, seeing Mr. Ni reviewing the prescription, he said that after taking the medicine last night, she only had six episodes of syncope until now, and they were very mild. Therefore, the previous prescription was decocted and administered again. After taking it, syncope ceased. She later gave birth to a son. Calculating the time, this was during the first month of conception. Transferring this treatment to middle-aged non-pregnant patients also yielded frequent success.
Dr. Ye from Wu Men treated a case of opisthotonos. During attacks, the patient jumped like a worm, moving several inches away from the seat; after the attack, she returned to normal. Using Bai Shao (Paeoniae Radix Alba), Gan Cao (Glycyrrhizae Radix et Rhizoma), Zi Shi Ying (Hematitum), Chao Xiao Mai (Fritillariae Thunbergii Bulbus - stir-fried wheat), and Nan Zao (Jujubae Fructus), decocted and taken orally, she recovered. *Kuaijie Fang* (Quick Method Formulas) records a case of toxic drugs attacking the fetus. The drug toxicity rushed upward. External symptoms included locked jaw, inability to speak, rigid clenched fists, spontaneous sweating, and slight fever, resembling stroke. However, the pulse was floating and soft. The prognosis was ten deaths to one survival. Most physicians failed to recognize it; treating it as stroke would certainly lead to death. Use Bai Bian Dou (Dolichos Lablab Seed) 2 liang, raw, peeled, and powdered. Mix with fresh well water and administer. Immediate effect ensued.
Shen Yaofeng said: For phlegm obstructing the meridians, Er Chen Tang (Two-Cured Decoction) added with Dan Xing (Arisaematis Cum Bile) Zhu Li (Bambusae Succus) and Jiang Zhi (Zingiberis Recensis Juice) is appropriate.