(即子烦,附口干)
大全云∶妊娠苦烦闷者,以四月受少阴君火气以养精,六月受少阳相火气以养气,若母
心惊胆寒,多有烦闷,名曰子烦也。《产宝》云∶
夫妊娠而子烦者,是肺脏虚而热乘于心,(肺虚乘热于心,于理似背,当在虚字上看)则令
心烦也,停痰积饮,在心胸之间,或冲于心,亦令烦也。若热而烦者,但热而已,若有痰饮而
烦者,呕吐涎沫,恶闻食气,烦躁不安也。大凡妊娠之人,既停痰积饮,又寒热相搏,气郁不
舒,或烦躁,或呕吐涎沫,剧则胎动不安,均为子烦也。
薛氏曰∶前证若因内热,用竹叶汤;气滞,用紫苏饮;痰滞,用二陈、白术、黄芩、枳壳;气
郁,用分气饮加川芎;脾胃虚弱,用六君、紫苏、山栀。
大全云∶妊娠烦躁口干者(烦躁口干,属心脾与子烦大同小异),足太阴脾经,其气通
于口,手少阴心经,其气通于舌,若脏腑气虚,荣卫不理,致阴阳隔绝,热乘于心脾,津液枯
少,故令心烦而口干也。与子烦大同小异,宜用知母丸。
薛氏曰∶前证若胃经实火,用竹叶石膏汤;若胃经虚热,用人参黄 散;若胃经气虚,
用补中益气汤;若肺经虚热,用紫苏饮;若肝经火动,用加味逍遥散;若脾气郁结,用加味
归脾汤;若肾经火动,加味地黄丸。
竹叶汤 治妊娠心惊胆怯,终日烦闷,名曰子烦。
白茯苓(三钱) 麦门冬(去心) 防风 黄芩(各二钱)
上作一服,加竹叶十片,水煎服,无时。一方有知母,无黄芩。一方有人参,无黄芩。
知母饮 治妊娠心脾壅热,咽膈渴苦,烦闷多惊。
知母 麦门冬(去心) 赤茯苓(各一钱半) 黄芩 黄 (各二钱)(壅热用黄 ,要知是虚非实)
甘草(一钱)
上作一服,水二盅,入桑白皮半钱,煎至一盅,再入竹沥些少,同煎一二沸服,无时。
犀角散 治子烦。
犀角尖(磨水时入) 地骨皮 条芩 麦门
冬(去心) 甘草(五分) 赤茯苓(各二钱)
上切,作一服,水二盅,煎八分,入竹沥一合,温服。
当归饮 治子烦。
当归(二钱,酒洗) 川芎 阿胶珠 豆豉 桑寄生(各一钱) 葱白(七茎)
上锉,水煎温服。(用葱、豉、川芎散热,又是一法)
人参散 治妊娠热乘心脾,津液枯少,烦躁干渴。
人参 麦门冬(去心) 赤茯苓 地骨皮 干葛 黄芩(炒) 犀角(镑,各七钱五分) 甘草(半两)
上锉,每服三钱,水煎服。
竹茹汤 疗妊娠烦躁,或胎不安。(清心凉肝妙剂)
用淡青竹刮茹一两,以水一大升煮取四合,徐徐服尽为度。
治妊娠心烦热不止
葱白(一握) 豉(二合)
上以水二大盏,煎至一盏半,去滓,温分三服。
一母丸 治妊娠因服药致胎气不安,有似虚烦不得眠。巢氏谓之子烦也,医者不知,
作虚烦治之,损动胎气宜矣。
知母(洗焙,二两)
为细末,枣肉丸,如弹子大,每服一丸,煎人参汤下。
《妇人大全良方》说:妊娠期间感到苦闷烦躁的,是因为在怀孕第四个月时受到少阴君火之气以滋养胎儿的精气,第六个月时受到少阳相火之气以滋养胎儿的气血。如果孕妇内心惊恐、胆气寒怯,往往会出现烦闷的症状,这叫做“子烦”。
《产宝》说:妊娠出现子烦的,是由于肺脏虚弱而热邪乘袭于心。(肺虚受热传心,从常理看似乎违背,应当从“虚”字上去理解),从而导致心烦。此外,痰饮停滞积聚在心胸之间,或者上冲于心,也会引起烦闷。如果是因热邪引起的烦闷,仅仅表现为发热而已;如果是因痰饮引起的烦闷,则伴有呕吐涎沫、厌恶食物气味、烦躁不安等症状。大凡妊娠妇女,如果体内既有停痰积饮,又有寒热邪气相互搏结,导致气机郁滞不舒,就会出现烦躁或呕吐涎沫的症状,严重时会导致胎动不安,这些都属于“子烦”的范畴。
薛己说:上述证候如果是由于内热引起,使用竹叶汤;如果是气机阻滞,使用紫苏饮;如果是痰湿阻滞,使用二陈汤加白术、黄芩、枳壳;如果是气机郁结,使用分气饮加川芎;如果是脾胃虚弱,使用六君子汤加紫苏、山栀。
《妇人大全良方》说:妊娠期间出现烦躁且口干的(烦躁口干,与子烦大同小异),足太阴脾经的气脉通达于口,手少阴心经的气脉通达于舌。如果脏腑之气虚弱,营卫之气运行紊乱,导致阴阳隔绝,热邪乘袭心脾,致使津液枯少,所以出现心烦和口干的症状。这与子烦大同小异,适宜使用知母丸。
薛己说:上述证候如果是胃经实火,使用竹叶石膏汤;如果是胃经虚热,使用人参黄芪散;如果是胃经气虚,使用补中益气汤;如果是肺经虚热,使用紫苏饮;如果是肝经火动,使用加味逍遥散;如果是脾气郁结,使用加味归脾汤;如果是肾经火动,使用加味地黄丸。
竹叶汤:治疗妊娠期间心惊胆怯,终日烦闷,名为子烦。
药材:白茯苓(三钱)、麦门冬(去心)、防风、黄芩(各二钱)。
用法:以上药物为一服量,加入竹叶十片,加水煎煮服用,不拘时间。另一版本含有知母,不含黄芩。另一版本含有人参,不含黄芩。
知母饮:治疗妊娠期间心脾壅滞有热,咽喉膈部渴痛难受,烦闷多惊悸。
药材:知母、麦门冬(去心)、赤茯苓(各一钱半)、黄芩、黄芪(各二钱)(注:此处用黄芪是因为是虚热而非实热,需知辨别)、甘草(一钱)。
用法:以上药物为一服量,用水两盅,加入桑白皮半钱,煎至一盅,再加入少许竹沥,同煎一二沸后服用,不拘时间。
犀角散:治疗子烦。
药材:犀角尖(磨水时加入)、地骨皮、条芩、麦门冬(去心)、甘草(五分)、赤茯苓(各二钱)。
用法:以上药物切碎,为一服量,用水两盅,煎至八分,加入竹沥一合,温服。
当归饮:治疗子烦。
药材:当归(二钱,酒洗)、川芎、阿胶珠、豆豉、桑寄生(各一钱)、葱白(七茎)。
用法:以上药物切碎,加水煎煮后温服。(使用葱、豉、川芎来散热,这是另一种治法)。
人参散:治疗妊娠期间热邪乘袭心脾,津液枯少,烦躁干渴。
药材:人参、麦门冬(去心)、赤茯苓、地骨皮、干葛、黄芩(炒)、犀角(镑片,各七钱五分)、甘草(半两)。
用法:以上药物切碎,每次服用三钱,加水煎煮服用。
竹茹汤:治疗妊娠烦躁,或胎动不安。(清心凉肝的妙剂)
用法:取淡青竹刮下的竹茹一两,用水一大升煮取四合,慢慢服完为止。
治疗妊娠心烦热不止
药材:葱白(一握)、豆豉(二合)。
用法:以上药物用水两大盏,煎至一盏半,滤去药渣,分三次温服。
一母丸:治疗妊娠期间因服药导致胎气不安,症状类似虚烦不得眠。巢元方称之为子烦,但医生不知此病,当作虚烦治疗,从而损伤了胎气。
药材:知母(洗净焙干,二两)。
用法:研为细末,用枣肉制成丸药,如弹子大小,每次服用一丸,用人参汤送下。
(Also known as Zi Fan [Fetal Restlessness], with attached Dry Mouth)
*Da Quan* states: When a pregnant woman suffers from vexation and oppression, it is because in the fourth month of pregnancy, she receives the Qi of Shaoyin Junhuo (Ministerial Fire) to nourish the fetus's essence, and in the sixth month, she receives the Qi of Shaoyang Xianghuo (Assistant Fire) to nourish the fetus's Qi. If the mother experiences heart fright and gallbladder coldness, she often feels vexed and oppressed, which is called "Zi Fan" [Fetal Restlessness].
*Chanbao* states: The reason for Zi Fan during pregnancy is that the Lung organ is deficient, allowing Heat to invade the Heart. (Although Lung deficiency transmitting Heat to the Heart seems contrary to logic, one should understand this through the concept of "deficiency"). This causes mental restlessness. Additionally, retained phlegm and accumulated fluids stagnate between the chest and heart, or surge upward to affect the Heart, also causing vexation. If the vexation is caused by Heat, there is merely fever; if caused by phlegm-fluids, there are symptoms such as vomiting saliva and foam, aversion to food odors, and restless agitation. Generally, pregnant women who have retained phlegm and accumulated fluids, combined with the struggle between Cold and Heat pathogens, leading to stagnant and uncomfortable Qi mechanism, may experience vexation or vomiting of saliva and foam. In severe cases, this leads to fetal movement insecurity. All these conditions belong to Zi Fan.
Xue Ji stated: For the aforementioned syndromes, if caused by internal Heat, use Zhuye Tang (Bamboo Leaf Decoction); if caused by Qi stagnation, use Zisu Yin (Perilla Infusion); if caused by Phlegm stagnation, use Erchen Tang (Two-Cured Decoction) added with Baizhu (Atractylodis Rhizoma), Huangqin (Scutellariae Radix), and Zhike (Aurantii Fructus); if caused by Qi depression, use Fenqi Yin (Qi-Separating Infusion) added with Chuanxiong (Ligustici Chuanxiong Rhizoma); if caused by Spleen-Stomach deficiency, use Liujunzi Tang (Six-Gentlemen Decoction) added with Zisu (Perillae Folium) and Shanzhi (Gardeniae Fructus).
*Da Quan* states: Pregnant women suffering from vexation and dry mouth (Vexation and dry mouth are largely similar but slightly different from Zi Fan): The Qi of the Foot-Taiyin Splein Meridian connects to the mouth, and the Qi of the Hand-Shaoyin Heart Meridian connects to the tongue. If the Zang-Fu organs are deficient in Qi, and Ying-Wei (Nutritive and Defensive) Qi fails to regulate properly, leading to an interruption of Yin-Yang communication, Heat invades the Heart and Spleen. This causes the body fluids to become scanty, resulting in mental vexation and dry mouth. This condition is largely similar to Zi Fan, and Zhimu Wan (Anemarrhenae Pill) is appropriate.
Xue Ji stated: For the aforementioned syndromes, if caused by Excess Fire in the Stomach Meridian, use Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction); if caused by Deficient Heat in the Stomach Meridian, use Renshen Huangqi San (Ginseng and Astragalus Powder); if caused by Qi deficiency in the Stomach Meridian, use Buzhong Yiqi Tang (Middle-Boosting Qi-Supplementing Decoction); if caused by Deficient Heat in the Lung Meridian, use Zisu Yin (Perilla Infusion); if caused by Fire stirring in the Liver Meridian, use Jiawei Xiaoyao San (Modified Free Wanderer Powder); if caused by Spleen Qi depression, use Jiaweigui Pi Tang (Modified Restore the Spleen Decoction); if caused by Fire stirring in the Kidney Meridian, use Jiawei Dihuang Wan (Modified Rehmannia Pill).
**Zhuye Tang (Bamboo Leaf Decoction)**: Treats fetal restlessness characterized by heart fright, gallbladder timidity, and all-day vexation.
Ingredients: Baifuren (Poria) (3 qian), Maimendong (Ophiopogonis Radix, de-centered), Fangfeng (Saposhnikoviae Radix), Huangqin (Scutellariae Radix) (each 2 qian).
Preparation: Combine as one dose, add ten leaves of Zhuye (Bamboo Leaves), decoct in water, and take at any time. Another version contains Zhimu (Anemarrhenae Rhizoma) without Huangqin. Another version contains Renshen (Ginseng) without Huangqin.
**Zhimu Yin (Anemarrhenae Infusion)**: Treats fetal restlessness caused by heat accumulation in the Heart and Spleen, bitter thirst in the throat and diaphragm, vexation, and frequent palpitations/fright.
Ingredients: Zhimu (Anemarrhenae Rhizoma), Maimendong (Ophiopogonis Radix, de-centered), Chi Fuling (Red Poria) (each 1.5 qian), Huangqin (Scutellariae Radix), Huangqi (Astragali Radix) (each 2 qian) (Note: Use Huangqi here because it is deficient heat, not excess heat, so discernment is required), Gancao (Licorice Root) (1 qian).
Preparation: Combine as one dose, add two zhong of water and half a qian of Sangbaipi (Morus Cortex), decoct until one zhong remains, then add a small amount of Zhuli (Bamboo Sap), boil for one or two boils, and take at any time.
**Xijiao San (Rhinoceros Horn Powder)**: Treats fetal restlessness.
Ingredients: Xijiao Jian (Tip of Rhinoceros Horn, ground into water when preparing), Digupi (Lycii Cortex), Tiao Qin (Scutellariae Radix), Maimendong (Ophiopogonis Radix, de-centered), Gancao (Licorice Root) (5 fen), Chi Fuling (Red Poria) (each 2 qian).
Preparation: Cut the herbs, combine as one dose, add two zhong of water, decoct until eight fen remain, add one he of Zhuli (Bamboo Sap), and take warm.
**Danggui Yin (Angelica Infusion)**: Treats fetal restlessness.
Ingredients: Danggui (Angelicae Sinensis Radix, washed with wine) (2 qian), Chuanxiong (Ligustici Chuanxiong Rhizoma), Ejiao Zhu (Colla Corii Asini beads), Douchi (Fermented Soybean), Sangjisheng (Taxilli Caulis) (each 1 qian), Congbai (Allii Fistulosi Bulbus) (7 stalks).
Preparation: Chop the herbs, decoct in water, and take warm. (Using Congbai, Douchi, and Chuanxiong to dissipate heat is another method.)
**Renshen San (Ginseng Powder)**: Treats fetal restlessness caused by Heat invading the Heart and Spleen, scanty body fluids, vexation, and dry thirst.
Ingredients: Renshen (Ginseng), Maimendong (Ophiopogonis Radix, de-centered), Chi Fuling (Red Poria), Digupi (Lycii Cortex), Gange (Puerariae Radix), Huangqin (Scutellariae Radix, stir-fried), Xijiao (Rhinoceros Horn, sliced) (each 7.5 qian), Gancao (Licorice Root) (0.5 liang).
Preparation: Chop the herbs, take three qian per dose, decoct in water, and take.
**Zhuru Tang (Bamboo Sheath Decoction)**: Cures fetal restlessness or fetal insecurity. (An excellent formula for clearing Heart heat and cooling Liver fire.)
Usage: Take one liang of Zhuru (Bamboo Sheath) scraped from light green bamboo, boil in one sheng of water to obtain four he, and drink slowly until finished.
**Treatment for Unceasing Mental Vexation and Heat During Pregnancy**
Ingredients: Congbai (Allii Fistulosi Bulbus) (one handful), Douchi (Fermented Soybean) (two he).
Preparation: Add two large zhan of water, decoct until one and a half zhan remain, strain the dregs, and divide into three warm doses.
**Yimu Wan (One-Mother Pill)**: Treats fetal insecurity caused by medication during pregnancy, presenting with symptoms similar to deficiency-vexation and insomnia. Chao Yuanfang referred to this as Zi Fan. However, physicians did not recognize it and treated it as deficiency-vexation, thereby damaging the fetal Qi.
Ingredients: Zhimu (Anemarrhenae Rhizoma, washed and dried) (2 liang).
Preparation: Grind into fine powder, form pills using jujube flesh, size of a bullet. Take one pill per dose, swallowed with Ginseng decoction.