凡妇人受孕之后,思酸选食,头晕作呕,甚至食物既吐,此系胞宫气阻血滞,盖人以食为本,胞以胃为
根,根蒂受伤,则枝叶萎黄,此自然之理也。凡虚弱之妇人,因此坠胎者,不可胜计。
其病根实由恶阻之甚者,使然耳。
怀孕三月恶心,而阻隔饮食是也。
眉批∶妊娠禀受怯弱,便有阻病。如颜色如常脉息和顺,但觉肢体沉重,头目
昏眩,择食恶食爱酸者,当以所思之食,任意食之。轻则勿药可愈,此症右脉必弦数,
左脉必微弱。
亦有六七月,尚病呕者,治同然。肥人责之痰,瘦人责其火,俱宜二陈汤加白术,黄芩或加香附,砂仁,
姜汁、竹茹与吐家同。
二陈汤
制半夏 陈皮 茯苓(各一钱五分) 炙草(八分) 加生姜(二片) 枣(五枚)
日久津液损,胃燥干哕,不纳汤水,用二陈汤和四物汤加竹沥,姜汁润以降之,昧者,谓半夏犯胎,地
黄泥膈,乃知常而不达变也。如吐多脉弱,体倦不纳谷,用六君子汤加麦冬,黄柏、生姜,如左脉弦急,心下
胀闷,恶心不止者,挟肝气上冲也。宜煎茯苓汤下抑青丸平之。胁胀或寒热往来,面色青黄,此木克土也。
宜六君子汤加柴胡,桔梗、枳壳。兼腰痛者,防胎欲坠,宜二陈汤合四物汤加白术、黄 、黄芩、阿胶。如
胀闷加缩砂仁。吐而心烦用竹茹、麦冬、前胡、橘红、芦根煎汤徐服。
因食冷物及凉药,吐不止者,以丁香、泡姜加二陈汤煎服温之。恶阻渐退、则徐服后方补之。
抑青丸
黄连(一钱为末)
丸如绿豆大。每服二十丸,眉批∶若吐虽定,而每食粥饭则口酸此肝
火盛,宜用川芎、陈皮、黑山栀、茯苓、生姜 煎汤下抑青丸。
归苓参附汤
当归(三钱五分) 川芎(一钱七分) 茯苓 党参 生地 香附(各二钱) 白术 麦冬(一钱五分) 黄芩(七
分)
姜枣饮
单氏参橘饮
治恶阻。
人参(一钱) 当归 白术(各二钱) 橘红 藿香 甘草(各四分) 半夏(八分) 砂仁(三分) 竹茹(四
分) 如肥人加竹沥半匙。
凡是妇女怀孕之后,想吃酸味食物、挑食,出现头晕想吐的症状,甚至吃完食物后呕吐出来,这是因为胞宫(子宫)气机阻滞、血液运行不畅所致。大概因为人以饮食为根本,而胞宫以胃气为根基,根基受到损伤,那么枝叶就会枯萎发黄,这是自然的道理。凡是体质虚弱的妇女,因此导致流产堕胎的,数量多得数不过来。这种病的根源实际上是由严重的恶阻(妊娠呕吐)引起的。
怀孕三个月时感到恶心,并且阻碍饮食摄入,就是这种情况。
眉批:妊娠期间如果禀赋怯弱,就会出现阻滞性疾病。如果面色如常,脉息和顺,只是觉得肢体沉重,头目昏眩,挑食、厌恶某些食物或喜爱酸味食物的,应当随意食用其想吃的食物。病情轻的不用药也可以痊愈,此症右脉必定弦数,左脉必定微弱。
也有在怀孕六七月时仍然患病呕吐的,治疗方法相同。不过对于肥胖的人要责之于痰湿,瘦弱的人要责之于内火,都适宜使用二陈汤加白术、黄芩,或者加香附、砂仁、姜汁、竹茹,与治呕吐的方法相同。
二陈汤
制半夏 陈皮 茯苓(各一钱五分) 炙甘草(八分) 加生姜(两片) 大枣(五枚)
病程日久损伤津液,导致胃燥干呕,不能进食汤水,用二陈汤合四物汤加竹沥、姜汁润降治疗。庸俗的医生认为半夏犯胎,地黄碍膈,这是只知道常规而不通变通。如果呕吐多且脉弱,身体疲倦不能进食谷物,用六君子汤加麦冬、黄柏、生姜;如果左脉弦急,心下胀闷,恶心不止的,是挟带肝气上冲所致。适宜用煎好的茯苓汤送服抑青丸来平抑它。胁肋胀满或寒热往来,面色青黄,这是木克土(肝木乘脾土)。适宜用六君子汤加柴胡、桔梗、枳壳。兼有腰痛者,防止胎儿欲坠,适宜用二陈汤合四物汤加白术、黄芩、黄柏、阿胶。如果胀闷加重加缩砂仁。呕吐伴心烦的用竹茹、麦冬、前胡、橘红、芦根煎汤慢慢服用。
因为吃生冷食物及凉性药物,呕吐不止的,用丁香、炮姜加二陈汤煎服以温中散寒。恶阻症状逐渐减退后,再慢慢服用后面的方剂进行补益。
抑青丸
黄连(一钱研末)
制成如绿豆大小的丸药。每次服用二十丸,眉批:如果呕吐虽然停止,但每吃粥饭则口酸,这是肝火旺盛,适宜用川芎、陈皮、黑山栀、茯苓、生姜煎汤送服抑青丸。
归苓参附汤
当归(三钱五分) 川芎(一钱七分) 茯苓 党参 生地 香附(各二钱) 白术 麦冬(一钱五分) 黄芩(七分)
姜枣饮
单氏参橘饮
治疗恶阻。
人参(一钱) 当归 白术(各二钱) 橘红 藿香 甘草(各四分) 半夏(八分) 砂仁(三分) 竹茹(四分) 如果是肥胖的人加半匙竹沥。
Translation of the original text into modern vernacular Chinese, then into academic English based on WHO standards.
Whenever a woman becomes pregnant and experiences cravings for sour foods, picky eating, dizziness, and nausea, or even vomiting after eating, this is due to qi stagnation and blood stasis in the Baogong (uterus). Generally speaking, humans rely on food as their foundation, and the uterus relies on the Stomach Qi as its root. If the root is damaged, the branches and leaves will wither and turn yellow; this is a natural principle. For women with weak constitutions, the number of spontaneous abortions caused by this condition is countless. The root cause of this disease actually lies in severe Ezu (pregnancy toxemia/vomiting).
Nausea occurring three months into pregnancy, accompanied by an obstruction to dietary intake, is precisely this condition.
Marginal note: If a pregnant woman has a weak constitution from conception, she may develop obstructive diseases. If her complexion is normal and pulse rhythm is harmonious, but she feels heavy limbs, dizzy head and eyes, picks at food, dislikes certain foods, or loves sour tastes, she should be allowed to eat whatever she desires. Mild cases can heal without medication. In such cases, the right pulse must be wiry and rapid, while the left pulse must be weak and thready.
There are also cases where vomiting persists until the sixth or seventh month of pregnancy; the treatment is the same. However, for obese individuals, the cause is attributed to Phlegm; for thin individuals, it is attributed to Fire. All should use Erchen Tang (Two-Aged Decoction) added with Baizhu (Atractylodis Rhizoma), Huangqin (Scutellariae Radix), or alternatively Xiangfu (Cyperi Rhizoma), Sharen (Amomi Fructus), Jiangzhi (Zingiberis Rhizoma Juice), and Zhuru (Bambusae Caulis in Taenia). This aligns with treatments for general vomiting patients.
Erchen Tang (Two-Aged Decoction):
Zhi Banxia (Prepared Pinelliae Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Fuling (Poria) (each 1.5 qian); Zhi Cao (Honey-fried Glycyrrhizae Radix et Rhizoma) (0.8 qian); add Shengjiang (Fresh Zingiberis Rhizoma) (2 slices) and Dazao (Jujubae Fructus) (5 pieces).
If the disease lingers for a long time, damaging body fluids and causing dry stomach heat with dry heaving, unable to retain soups or water, use Erchen Tang combined with Siwu Tang (Four Substance Decoction) added with Zhuli (Bambusae Caulis in Taenia Juice) and Jiangzhi to moisten and descend. Ignorant physicians claim that Banxia harms the fetus and Dihuang (Rehmanniae Radix) clogs the chest; this shows they know the routine but fail to adapt to changes. If vomiting is frequent with a weak pulse, fatigue, and inability to eat grains, use Liujunzi Tang (Six Gentlemen Decoction) added with Maidong (Ophiopogonis Radix), Huangbai (Phellodendri Cortex), and Shengjiang. If the left pulse is wiry and urgent, with subcostal fullness and incessant nausea, this indicates Liver Qi rushing upward. It is appropriate to administer Yiqing Wan (Suppressing Blue Pill) with decocted Fuling Tang. If there is hypochondriac distension or alternating chills and fever, with a bluish-yellow complexion, this represents Wood overacting on Earth (Liver attacking Spleen/Stomach). Use Liujunzi Tang added with Chaihu (Bupleuri Radix), Jiegeng (Platycodonis Radix), and Zhike (Aurantii Fructus Immaturus). If accompanied by lower back pain, fearing impending miscarriage, use Erchen Tang combined with Siwu Tang added with Baizhu, Huangqin, Huangbo, and Ejiao (Asini Corii Colla). If distension worsens, add Suosharen (Amomi Fructus). For vomiting with mental restlessness, use Zhuru, Maidong, Qianhu (Peucedani Radix), Juhong (Citri Reticulatae Pericarpium Rubrum), and Lugen (Phragmitis Rhizoma) decocted and taken slowly.
For those who vomit incessantly due to consuming cold foods or cooling medicines, use Dingxiang (Eugeniae Caryophyllati Flos) and Paoshengjiang (Prepared Fresh Zingiberis Rhizoma) added to Erchen Tang, decocted and taken warm to dispel cold. As Ezu symptoms gradually recede, slowly take the subsequent formulas for tonification.
Yiqing Wan (Suppressing Blue Pill):
Huanglian (Coptidis Rhizoma) (1 qian, ground into powder).
Form pills the size of mung beans. Take 20 pills per dose. Marginal note: If vomiting has ceased but eating porridge or rice causes sour taste in the mouth, this indicates excessive Liver Fire. Use Chuanxiong (Ligustici Chuanxiong Rhizoma), Chenpi, Heishanzhi (Gardeniae Fructus carbonized), Fuling, and Shengjiang decocted to take with Yiqing Wan.
Guiling Shenfu Tang (Angelica, Poria, Ginseng, and Aconite Decoction):
Danggui (Angelicae Sinensis Radix) (3.5 qian), Chuanxiong (1.7 qian), Fuling, Dangshen (Codonopsis Radix), Shengdi (Rehmanniae Radix), Xiangfu (each 2 qian), Baizhu, Maidong (1.5 qian), Huangqin (0.7 qian).
Jiangzao Yin (Ginger and Jujube Drink).
Shanshi Shenju Yin (Dr. Shan's Ginseng and Tangerine Peel Drink):
Treats Ezu.
Renshen (Panax Ginseng Radix et Rhizoma) (1 qian), Danggui, Baizhu (each 2 qian), Juhong, Huoxiang (Agastaches Herba), Gancao (Licorice Root) (each 0.4 qian), Banxia (0.8 qian), Sharen (0.3 qian), Zhuru (0.4 qian). If the patient is obese, add half spoonful of Zhuli.