产宝方 治小儿在腹中哭,及孕妇腹内钟鸣。
用空房下鼠穴中土一块,令孕妇噙之即止。或为末,入麝香少许,酒调下二钱立愈。然
麝香开窍,当酌量用之。
补遗方 治孕妇腹中儿哭。
用黄连浓煎汁,母常呷之,即止。
一法 小儿腹哭者,盖脐带上疙瘩儿含口中,因娠妇登高举臂,脱出儿口,以此作声,
令妊妇曲腰就地如拾物,仍入儿口,即止。(有令孕妇以笤帚扫地即止者,亦此意)
黄帝问曰∶妇人重身,毒之何如?岐伯曰∶有故无殒。帝曰∶愿闻其故。歧伯曰∶大积大
聚,其可犯也,衰其大半而止,过者死。
丹溪方 治血块如盘,有孕难服峻剂,此方主之。
香附子(醋煮,四两) 桃仁(去皮尖,一两) 海粉(醋煮,二两)白术(一两)
上为末,面糊丸服。
大全曰∶经云∶饮食自倍,肠胃乃伤。又云∶阴之所生,本在五味,阴之五宫,伤在五
味。若妊子饮食不节,生冷毒物,恣性食啖,致伤脾胃,故娠伤食,最难得药,惟木香丸、白术
散,二方最稳捷。
薛氏曰∶东垣先生云∶脾胃之气壮,则过时而不饥,多食而不伤。盖胃主司纳,脾主消
化,五脏之本也。然食倍而伤者,乃脾气虚而不化也,若投以峻剂,则脾胃复伤,而胎亦损
矣,当审其所因,而调治之。若饮食停滞,或肚腹作痛,用平胃散,腹满泄泻,用六君子汤;若
脾气下陷,用补中益气汤。凡嗳觉药气,且戒药饵,节饮食。经云∶损其脾者,调其饮食,适
其寒温。大凡脾胃虚弱,饮食难化,以白术、陈皮为末等分,陈曲糊丸,常服最善。枳术丸但
可暂用,枳实峻厉,能耗真气,治者慎之。
一妊妇因伤食服枳术丸,胸腹不利,饮食益少,更服消导宽胸之剂,其胎下坠。余谓此
脾气虚而不能承载也,用补中益气,及六君子汤,中气渐健,其胎渐安。又用八珍汤加柴胡、
升麻,调理而痊。
平胃散 治妊娠饮食停滞,或肚腹作痛。
苍术(米泔浸,炒) 浓朴(姜制) 陈皮(各一钱) 甘草(炙,五分)
上锉,加生姜三片,枣一枚,水煎服。
呕吐恶心,加枳壳、砂仁。吞酸嗳腐,加黄连三分,吴茱萸二分。
六君子汤 治脾胃虚弱,饮食难化,或腹
满泄泻。
人参 白术 茯苓 甘草(炙) 半夏 陈皮(各一钱)
上锉,加生姜三片,枣一枚,水煎服。
停滞肉食,加山楂。停滞面食,倍加麦 。停滞糯米食,用白酒曲一味。停滞
米饮,倍加谷 。 鱼腥所伤,倍加陈皮。伤辛热之物,加黄连。伤生冷之物,加砂仁、
木香;如不应,更加肉豆蔻、补骨脂,再不应,用四神丸。
木香丸 治妊娠脾胃虚弱,饮食不消,肚腹膨胀,或呕吐泄泻。
木香(二钱) 三棱(三棱犯胎忌,与人参并用或无妨,亦须看人强弱) 人参 白茯苓(各三钱)
上为末,面糊丸,如绿豆大,每服三四十丸,熟水下。
白术散 治妊娠脾胃虚弱,气不调和,饮食易伤。
白术(炒)(佐紫苏、白芷,调和胃气妙) 紫苏(各一两) 人参 白芷(炒,各七钱半) 川芎 诃
子皮 青皮(各半两) 甘草(炒,二钱半)
上每服二钱,加生姜三片,水煎服。
【产宝方】治疗胎儿在母腹中啼哭,以及孕妇腹部发出如钟鸣般的声响。
取空房屋下老鼠洞中的泥土一块,让孕妇含在口中即可停止。或者将其研成粉末,加入少许麝香,用酒调服二钱,立刻痊愈。然而麝香具有开窍通闭的功效,应当酌情用量。
【补遗方】治疗孕妇腹中胎儿啼哭。
用黄连浓煎取汁,让孕妇经常饮用,啼哭即止。
另一种方法:小儿在腹中啼哭,是因为脐带上的疙瘩被婴儿含在口中,因孕妇登高举臂,导致疙瘩脱出婴儿口腔,从而发出声音。令孕妇弯腰贴近地面,如同拾取物品的姿势,使疙瘩重新进入婴儿口中,啼哭即止。(也有让孕妇用扫帚扫地来止啼的方法,也是同样的道理)
黄帝问道:妇女怀孕时,使用有毒性的药物会怎样?岐伯回答说:有病则病受之,不会伤害胎儿(有故无殒)。黄帝说:我想听听其中的缘故。岐伯说:对于大的积聚病证,可以使用攻伐之法,但病情消退大半时就应停止,如果过度攻伐会导致死亡。
【丹溪方】治疗血块大如盘子,因有孕在身难以服用峻猛药剂,此方主治。
香附子(醋煮,四两)、桃仁(去皮尖,一两)、海粉(醋煮,二两)、白术(一两)。
以上药材研为细末,用面糊制成丸药服用。
《大全》说:医经云:“饮食过量一倍,肠胃就会受伤。”又说:“阴精的生成,根本在于五味;五脏的功能活动,也易受五味损伤。”如果怀孕期间饮食不节制,生冷毒物,放纵食欲,导致脾胃受损,所以妊娠伤食,最难用药,只有木香丸、白术散这两个方子最为稳妥快捷。
薛氏说:东垣先生曾说:“脾胃之气强壮,就不会过时感到饥饿,多吃也不会受伤。”胃主受纳,脾主消化,这是五脏的根本。然而饮食过量而受伤,是脾气虚弱不能运化的结果,如果投以峻猛药剂,则会再次损伤脾胃,也会损害胎气,应当审察病因,进行调理治疗。如果是饮食停滞,或肚腹疼痛,用平胃散;如果是腹满泄泻,用六君子汤;如果是脾气下陷,用补中益气汤。凡是闻到药味就反感的,暂时戒断药物,节制饮食。医经云:“损伤了脾脏,要调节其饮食,适应寒温变化。”大凡脾胃虚弱,饮食难消化,将白术、陈皮研为细末,等分混合,用陈年曲糊制成丸药,常服效果最好。枳术丸只能暂时使用,因为枳实药性峻厉,会耗损真气,医者需谨慎。
有一位孕妇因伤食服用枳术丸后,胸腹不适,饮食更少,又服用消导宽胸的药物,导致胎气下坠。我认为这是脾气虚弱不能承载胎元所致,于是使用补中益气汤及六君子汤,中气逐渐强健,胎气逐渐安定。后又用八珍汤加柴胡、升麻,调理后痊愈。
【平胃散】治疗妊娠期间饮食停滞,或肚腹作痛。
苍术(米泔水浸泡,炒制)、厚朴(姜制)、陈皮(各一钱)、甘草(炙,五分)。
以上切碎,加生姜三片,大枣一枚,水煎服。
若呕吐恶心,加枳壳、砂仁。若有吞酸嗳腐症状,加黄连三分,吴茱萸二分。
【六君子汤】治疗脾胃虚弱,饮食难消化,或腹满泄泻。
人参、白术、茯苓、甘草(炙)、半夏、陈皮(各一钱)。
以上切碎,加生姜三片,大枣一枚,水煎服。
若停滞肉食,加山楂。若停滞面食,加倍加大麦蘖。若停滞糯米食物,单用白酒曲一味。若停滞米饮,加倍加大麦芽。若因鱼腥所伤,加倍加大陈皮。若伤于辛热之物,加黄连。若伤于生冷之物,加砂仁、木香;如果无效,再加肉豆蔻、补骨脂;再无效,用四神丸。
【木香丸】治疗妊娠脾胃虚弱,饮食不消化,肚腹膨胀,或呕吐泄泻。
木香(二钱)、三棱(三棱犯胎禁忌,但若与人参同用或许无妨,也需视患者体质强弱而定)、人参、白茯苓(各三钱)。
以上研为细末,用面糊制成丸药,如绿豆大小,每次服用三四十丸,熟水送下。
【白术散】治疗妊娠脾胃虚弱,气机不调和,饮食易受伤。
白术(炒)(配合紫苏、白芷,调和胃气效果妙)、紫苏(各一两)、人参、白芷(炒,各七钱半)、川芎、诃子皮、青皮(各半两)、甘草(炒,二钱半)。
以上每次服用二钱,加生姜三片,水煎服。
[Chanbao Fang] Treats fetal crying in the womb and bell-like ringing sounds in the pregnant woman's abdomen.
Take a piece of earth from a rat hole under an empty house, let the pregnant woman hold it in her mouth to stop the sound. Alternatively, grind it into powder, add a small amount of Moschus (She Xiang), mix with wine, and take two qian for immediate cure. However, since Moschus opens orifices, use it with discretion.
[Buyi Fang] Treats fetal crying in the pregnant woman's abdomen.
Decoct Coptidis Rhizoma (Huang Lian) thickly to extract the juice, and let the pregnant woman sip it frequently; the crying will stop.
Another method: Fetal crying is caused by a knot on the umbilical cord being held in the infant's mouth. When the pregnant woman climbs high and raises her arms, the knot slips out of the infant's mouth, causing noise. Instruct the pregnant woman to bend her waist to the ground as if picking up an object, allowing the knot to re-enter the infant's mouth, which stops the crying. (Some suggest having the pregnant woman sweep the floor with a broom to achieve the same effect.)
The Yellow Emperor asked: How should toxic medicines be used during pregnancy? Qibo replied: If there is a disease, the medicine targets the disease without harming the fetus (Yougu wu yun). The Emperor said: I wish to hear the reason. Qibo said: For large accumulations and masses, attacking methods may be used, but one must stop when more than half of the condition has subsided; exceeding this limit leads to death.
[Danjia Fang] Treats blood masses as large as a plate. Since strong purgatives are difficult to administer during pregnancy, this formula is indicated.
Cyperi Rhizoma (Xiang Fu Zi) boiled in vinegar (4 liang), Persicam Semen Tao Ren (Tao Ren) peeled and de-pitted (1 liang), Tapioca Starch (Hai Fen) boiled in vinegar (2 liang), Atractylodis Macrocephalae Rhizoma (Bai Zhu) (1 liang).
Grind all ingredients into fine powder, form pills using wheat paste, and take orally.
*Daquan* states: The classics say, "If food intake doubles, the intestines and stomach are injured." It also says, "Yin essence is generated from the five flavors; the five zang organs are damaged by the five flavors." If dietary habits are unregulated during pregnancy, consuming raw, cold, or toxic substances excessively, leading to spleen and stomach injury, treating food stagnation in pregnancy is difficult. Only Muxiang Wan and Baizhu San are considered the safest and most effective formulas.
Xue Ji stated: Master Dongyuan said, "When spleen and stomach qi are robust, one does not feel hungry past meal times, and excessive eating does not cause injury." The stomach governs reception, and the spleen governs digestion; these are the roots of the five zang organs. However, injury from overeating results from spleen qi deficiency failing to transform food. Administering harsh medicines would further injure the spleen and stomach and damage the fetus. One must examine the cause and regulate treatment. For food stagnation or abdominal pain, use Pingwei San; for abdominal fullness and diarrhea, use Liujunzi Tang; for sinking of spleen qi, use Buzhong Yiqi Tang. If the patient dislikes the smell of medicine, temporarily discontinue medication and regulate diet. The classics state, "For spleen injury, regulate diet and adjust to temperature changes." Generally, for spleen and stomach weakness and difficulty digesting food, equal parts of Atractylodis Macrocephalae Rhizoma (Bai Zhu) and Citri Reticulatae Pericarpium (Chen Pi) ground into powder, formed into pills with aged yeast paste, taken regularly yields the best results. Zhizhu Wan should only be used temporarily; Zhi Shi is harsh and can deplete true qi, so physicians must exercise caution.
A pregnant woman took Zhizhu Wan for food stagnation, resulting in chest and abdominal discomfort and reduced appetite. After taking additional digestive and chest-opening agents, the fetus descended. I reasoned that this was due to spleen qi deficiency failing to support the fetus. I prescribed Buzhong Yiqi Tang and Liujunzi Tang. As middle qi gradually strengthened, the fetus stabilized. Subsequently, Shenzhen Tang was added with Chai Hu and Sheng Ma for regulation, leading to recovery.
[Pingwei San] Treats food stagnation during pregnancy or abdominal pain.
Atractylodis Rhizoma (Cang Zhu) soaked in rice water and stir-fried, Magnoliae Officinalis Cortex (Nan Piao Mu Xiang - note: text says Nong Bo, likely Hou Po), Citri Reticulatae Pericarpium (Chen Pi) (each 1 qian), Glycyrrhizae Radix et Rhizoma (Gan Cao) roasted (0.5 qian).
Cut into pieces, add three slices of Zingiberis Rhizoma Recens (Sheng Jiang) and one Jujubae Fructus (Zao), decoct in water and take orally.
For vomiting and nausea, add Aurantii Fructus (Zhi Ke) and Amomi Fructus Rotundus (Sha Ren). For acid regurgitation and belching of rotten food, add Coptidis Rhizoma (Huang Lian) (0.3 qian) and Evodiae Fructus (Wu Zhu Yu) (0.2 qian).
[Liujunzi Tang] Treats spleen and stomach weakness, difficulty digesting food, abdominal fullness, or diarrhea.
Ginseng Radix et Rhizoma (Ren Shen), Atractylodis Macrocephalae Rhizoma (Bai Zhu), Poria (Fu Ling), Glycyrrhizae Radix et Rhizoma (Gan Cao) roasted, Pinelliae Rhizoma (Ban Xia), Citri Reticulatae Pericarpium (Chen Pi) (each 1 qian).
Cut into pieces, add three slices of Zingiberis Rhizoma Recens (Sheng Jiang) and one Jujubae Fructus (Zao), decoct in water and take orally.
For meat stagnation, add Crataegi Fructus (Shan Zha). For flour stagnation, double the amount of Hordeum Fructus Germinatus (Mai Ya). For glutinous rice stagnation, use Saccharomyces (Jiu Qu) alone. For rice drink stagnation, double the amount of Coicis Semen (Yi Yi Ren - note: text implies Mai Ya/Yi Yi Ren contextually, usually Mai Ya for grains). For fish odor injury, double Citri Reticulatae Pericarpium (Chen Pi). For injury from pungent and hot foods, add Coptidis Rhizoma (Huang Lian). For injury from raw and cold foods, add Amomi Fructus Rotundus (Sha Ren) and Aucklandiae Radix (Mu Xiang); if ineffective, add Myristicae Semen (Rou Dou Kou) and Psoraleae Fructus (Bu Gu Zhi); if still ineffective, use Sishen Wan.
[Muxiang Wan] Treats spleen and stomach weakness during pregnancy, indigestion, abdominal distension, vomiting, or diarrhea.
Aucklandiae Radix (Mu Xiang) (2 qian), Sparganii Rhizoma (San Leng) [Note: San Leng is contraindicated in pregnancy, but may be safe when combined with Ren Shen, depending on constitution], Ginseng Radix et Rhizoma (Ren Shen), Poria (Bai Fu Ling) (each 3 qian).
Grind into powder, form pills with wheat paste, size of mung beans. Take 30-40 pills per dose with warm water.
[Baizhu San] Treats spleen and stomach weakness during pregnancy, qi disharmony, and susceptibility to food injury.
Atractylodis Macrocephalae Rhizoma (Bai Zhu) roasted (combined with Perillae Folium and Angelicae Dahuricae Radix to harmonize stomach qi), Perillae Folium (Zi Su) (each 1 liang), Ginseng Radix et Rhizoma (Ren Shen), Angelicae Dahuricae Radix (Bai Zhi) roasted (each 7.5 qian), Chuanxiong Rhizoma (Chuan Xiong), Terminalia Chebulae Fructus (He Zi Pi), Citri Reticulatae Pericarpium Viride (Qing Pi) (each 0.5 liang), Glycyrrhizae Radix et Rhizoma (Gan Cao) roasted (2.5 qian).
Take 2 qian per dose, add three slices of Zingiberis Rhizoma Recens (Sheng Jiang), decoct in water and take orally.