沈尧封曰∶钱彬安室人,内热咳呛涎痰,夜不能卧,脉细且数,呼吸七至,邀余诊视。问及经事,答
言向来不准,今过期不至。余因邻近,素知伊芳禀怯弱,不敢用药。就诊吴门叶氏,云此百日劳,不治。延本
邑浦书亭治疗,投逍遥散,不应;更蒌蕤汤,亦不应。曰∶病本无药可治,但不药必骇病者,可与六味汤,聊
复尔尔!因取六味丸料二十分之一煎服,一剂咳减,二剂热退,四剂霍然。惟腹中觉有块,日大一日,弥月
生一女,母女俱安。越十余年,女嫁母故。后以此法治怀妊咳呛涎疾,或内热或不内热,或脉数或脉不数,
五月以内者俱效,五月以外者,有效有不效。
王孟英按∶亦有劳损似娠者,盖凡事皆有两面也。
丹溪曰∶因火动胎,逆上作喘急者,用条芩、香附为末,水调服。
吕沧洲曰∶有妇胎死腹中,病喘不得卧,医以风药治肺。诊其脉∶气口盛人迎一倍,左关弦劲而疾,两
尺俱短而离经。因曰∶病盖得之毒药动血,以致胎死不下,奔迫而上冲,非外感也。大剂芎归汤,加催生
药服之,下死胎。其夫曰∶病外家有娠,室人见嫉,故药去之,众所不知也。
沈尧封曰∶外感作喘,仍照男子治。故不录。他病仿此。
王海藏《医垒元戌》曰∶胎前病唯当顺气。若外感四气,内伤七情,以成他病,治法与男子同,当于
各证类中求之,惟动胎之药,切不可犯。
沈尧封说:钱彬安的妻子,体内发热、咳嗽气喘并伴有痰涎,夜间无法躺卧,脉象细而快,呼吸频率达到每分钟七次,邀请我诊治。询问月经情况,回答说向来不准时,如今过期未来。我因为与她家邻近,素知她体质虚弱怯弱,不敢轻易用药。于是就诊于吴门叶氏医生,叶氏说是“百日劳”(妊娠早期因气血变化导致的虚损病证),认为无法治愈。后来延请本邑浦书亭治疗,投用逍遥散,没有见效;改用蒌蕤汤,也没有见效。浦书亭说:这病本来无药可治,但如果不给药必会让病人惊恐,可以给予六味地黄汤,姑且安抚一下病情!于是取六味丸药料的二十分之一煎服,一剂后咳嗽减轻,两剂后热退,四剂后病愈。只是腹中感觉有块状物,一天比一天大,满一个月后生下一个女儿,母女都平安。过了十多年,女儿出嫁,母亲去世。后来用这种方法治疗怀孕期间的咳嗽气喘痰疾,有的内热有的不内热,有的脉快有的脉不快,在怀孕五个月以内的都有效,五个月以外的,有的有效有的无效。
朱丹溪说:因火邪扰动胎气,气逆上冲导致喘急的,用条芩(黄芩)、香附研为末,用水调服。
吕沧洲说:有一位妇女胎死腹中,患喘证不能躺卧,医生用治风药来治肺。诊察她的脉象:气口脉搏比人迎脉搏强一倍,左关脉弦劲而快速,两尺脉都短促且符合离经之脉的特征。因此说:这病大概是因毒药动血,导致胎死不下,气血奔迫而上冲,并非外感所致。用大剂量的芎归汤,加入催生药物服用,排出死胎。患者的丈夫说:病人的娘家姐姐怀孕,妻子嫉妒,所以用药害掉了胎儿,这是众人不知道的事。
沈尧封说:因外感引起的喘证,仍然按照男子的方法治疗。所以不收录。其他疾病仿照此例。
王海藏《医垒元戌》说:产前疾病只应当顺气。如果因外感风寒暑湿四气,或内伤喜怒忧思悲恐惊七情,从而形成其他疾病,治疗方法与男子相同,应当在各证候类别中寻找,唯独动胎的药物,切不可触犯。
Shen Yaofeng said: The wife of Qian Bin'an suffered from internal heat, coughing, wheezing, and expectoration of phlegm-saliva, unable to lie down at night. Her pulse was fine and rapid, with a respiratory rate of seven breaths per cycle (note: context implies rapid breathing/pulse, traditionally "qi zhi" refers to pulse beats or breaths; here likely referring to rapid pulse/breath indicative of severe condition). She invited me for consultation. Upon asking about her menstruation, she replied that it had always been irregular, and now it was overdue and absent. Because I lived nearby and knew her constitution was inherently weak and delicate, I dared not prescribe medication immediately. She consulted Dr. Ye in Wumen, who diagnosed this as "Hundred-Day Labor" (a type of consumptive disease occurring early in pregnancy due to blood and qi changes), stating it was incurable. Later, Pu Shuting from the same county was invited. He prescribed Xiaoyao San (Free and Easy Wanderer Powder), which was ineffective; he then switched to Lou Rui Tang (Trichosanthes and Adenophora Decoction), which was also ineffective. Pu stated: "This illness has no specific cure, but withholding treatment would frighten the patient. One may administer Liuwei Tang (Six-Ingredient Decoction) merely to appease the symptoms." Thus, one-twentieth of the ingredients of Liuwei Wan (Six-Ingredient Pill) was decocted and taken. After one dose, the cough subsided; after two doses, the fever receded; after four doses, she recovered completely. However, she felt a mass in her abdomen, growing larger day by day. At full term, she delivered a daughter, and both mother and child were safe. Over ten years later, the daughter married, and the mother passed away. Subsequently, this method was used to treat coughing, wheezing, and phlegm disorders during pregnancy, whether accompanied by internal heat or not, and whether the pulse was rapid or not. Cases within five months of gestation were all effective; cases beyond five months showed variable efficacy.
Wang Mengying added a note: There are also cases where consumptive diseases mimic pregnancy, as everything has two sides.
Zhu Danxi said: For wheezing and urgency caused by fire disturbing the fetus and causing rebellious upward movement of Qi, use Tiao Qin (Scutellariae Radix, specifically the strip-cut variety) and Xiang Fu (Cyperi Rhizoma) ground into powder, mixed with water and taken orally.
Lu Cangzhou said: A woman had a dead fetus retained in the womb, suffering from wheezing and inability to lie down. The physician treated the lungs with wind-dispelling herbs. Upon palpating her pulse: the Qi Kou (radial artery at the wrist, representing the Zang organs) was twice as strong as the Ying Kou (carotid artery, representing the Fu organs); the Left Guan position was wiry, firm, and rapid; both Chi positions (representing the Kidneys and lower jiao) were short and indicated Li Jing Mai (pulse changing significantly during pregnancy or indicating abnormal conditions). He stated: "The illness likely resulted from toxic drugs disturbing the blood, leading to a retained dead fetus. The Qi and Blood rushed upward violently; this is not an external contraction." He prescribed a large dose of Xiong Gui Tang (Ligusticum and Angelica Decoction) combined with labor-inducing herbs, which expelled the dead fetus. The husband revealed: "The patient's sister-in-law (wife's elder sister) was pregnant, and my wife was jealous, so she administered drugs to abort the fetus. This was unknown to others."
Shen Yaofeng said: Wheezing caused by external contractions should still be treated according to the methods for men. Therefore, it is not recorded here. Other illnesses follow this principle.
Wang Haicang in *Yi Lei Yuan Xu* (Fortress of Medical Crystals) stated: Diseases during pregnancy should primarily focus on regulating Qi. If other diseases arise from external contraction of the Four Qi (Wind, Cold, Summerheat, Dampness) or internal injury from the Seven Emotions (Joy, Anger, Worry, Thought, Sorrow, Fear, Fright), the treatment methods are the same as those for men and should be sought in the respective syndrome categories. However, herbs that disturb the fetus must strictly be avoided.