张子和云∶戴人过谯都营中饮,会有一卒说出妻事。戴人问其故,答曰∶吾妇为室女时
,心下有冷积如覆杯,按之如水声,以热手熨之如冰。娶来已十五年矣,恐断吾嗣,是以去
之。戴人曰∶公勿黜也,如用吾药,病可除,孕可得。卒从之。戴人诊其脉,寸脉沉而迟,
尺脉洪大有力,非无子之候也,可不逾年而孕。其良人笑曰∶试之。先以三圣散,吐涎一斗,
心下平软;次服白术调中汤、五苓散,后以四物汤和之, 不再月,气血合度,数月而娠一
子。戴人常曰∶用吾此法,无不子之妇。此言不诬。一妇人年三十四岁,梦与鬼神交,惊怕
异常,及见神堂阴司,舟楫桥梁。如此一十五年,竟无妊娠。巫祈觋祷,无所不至,钻肌炙
肉,孔穴万千,黄瘦发热,引饮中满,足肿,委命于天。一日苦请戴人,戴人曰,阳火盛于
上,阴水盛于下,见鬼神者,阴之灵,神堂者,阴之所,舟楫桥梁,水之用,两手寸脉皆沉
而伏,知胸中有实痰也。凡三涌三泄三汗,不旬日而无梦,一月而有娠。(此二案,非子和先生不能)
丹溪秦桂丸论曰∶无子之因,多起于妇人,医者不求其因起于何处,遍阅古方,惟秦桂
丸,其辞确,其意专,用温热药近乎人情,欣然受之,锐然服之,甘受燔灼之祸,犹懵然不
悔。何者?阳精之施,阴血能摄之,精成其子,血成其胞,胎孕乃成。今妇人之无子者,率
由血少不足以摄精也。血之少也,固非一端,然欲得子者,必须调补阴血,使无亏欠,乃可
推其有余,以成胎孕。何乃轻用热剂,煎熬脏腑,血气沸腾,祸不旋踵矣。或曰,春气温和(妙在温和二字,盖大寒大
热,皆不能生物故也)
,则万物发生,冬气寒凛,则万物消陨,非秦桂丸之温热,何以得子脏温暖而成胎耶?予曰
,诗曰∶妇人和平,则乐有子。和则血气均,平则阴阳不争,今得此药,经血必转紫黑,渐
成衰少,或先或后,始则饮食骤进,久则口苦而干,阴阳不平,血气不和,疾病蜂起,焉能
成胎。纵然成胎,生子亦多病而不寿,以秦桂丸耗损天真之阴也。戒之慎之。(按秦桂丸
施于肥人而少其丸数,兼服调理补药亦无妨,但忌施于瘦人火多者也)(此注最当)
张子和说:戴人经过谯都军营时饮酒,遇到一名士兵讲述他休妻的事。戴人询问原因,士兵回答说:“我的妻子在还是未出嫁的女子时,心下(胃脘部)有冷积,形状像倒扣的杯子,按压时有水声,用热手抚摸它感觉像冰一样冰冷。娶她回家已经十五年了,担心断绝我的后代,所以休了她。”戴人说:“您不要休弃她,如果服用我的药,病可以去除,怀孕是可以得到的。”士兵听从了他。戴人诊察她的脉象,寸脉沉而迟,尺脉洪大有力,这不是不能怀孕的征候,不用超过一年就能怀孕。她的丈夫笑着说:“试试看。”先用三圣散,吐出涎液一斗,心下变得平坦柔软;接着服用白术调中汤、五苓散,最后用四物汤调和身体,不到一个月,气血调和适度,几个月后怀上了一子。戴人常说:“使用我的这种方法,没有不能怀孕的妇女。”这话是不虚假的。
有一位妇人三十四岁,梦见与鬼神交合,惊恐害怕异常,以及见到神堂阴司、舟楫桥梁等景象。这样持续了十五年,始终没有怀孕。求巫祈祷,无所不至,钻肌炙肉(针灸穴位成千上万),身体黄瘦发热,口渴多饮且胸中胀满,足部肿胀,只能听天由命。一天苦苦请求戴人诊治,戴人说:“阳火盛于上焦,阴水盛于下焦,看见鬼神,是阴之灵的表现;神堂,是阴之所居;舟楫桥梁,是水的用途。两手寸脉都沉而伏,知道胸中有实痰。经过三次涌吐、三次泻下、三次发汗,不到十天就没有了梦魇,一个月后就怀孕了。(这两个医案,非张子和先生不能做到)”
朱丹溪论秦桂丸说:不能怀孕的原因,大多起于妇人。医生不探究病因起于何处,遍阅古方,只有秦桂丸,言辞确切,用意专一,使用温热药物近乎人之常情,欣然接受,急切服用,甘愿承受焚烧灼热的祸害,仍然懵懂不后悔。为什么呢?阳精施予,阴血能摄受它,精形成胎儿,血形成胞宫,胎孕才形成。现在妇人不能怀孕的,大都因为血少不足以摄受精液。血少的原因,固然不止一端,然而想要得到孩子的,必须调补阴血,使其没有亏欠,然后才可以推究其有余的部分,来形成胎孕。怎么可以轻易使用热剂,煎熬脏腑,导致血气沸腾,灾祸随即而至呢?有人说:“春天气候温和(妙在‘温和’二字,因为大寒大热都不能孕育生命),万物发生;冬天气候寒冷凛冽,万物消陨。如果不是秦桂丸的温热,怎么能使子宫温暖而成胎呢?”我说:“《诗经》说:‘妇人和平,则乐有子。’和则血气均匀,平则阴阳不争。现在得到这种药,经血必定转为紫黑色,逐渐衰少,或提前或错后。开始时饮食突然增加,久了则口苦口干,阴阳不平,血气不和,疾病蜂拥而起,怎么能成胎呢?即使成胎,生下的孩子也多病且不长寿,因为秦桂丸耗损了天真之阴。告诫人们要谨慎啊。(按语:秦桂丸施用于肥胖之人并减少丸数,兼服调理补药也无妨,但忌讳施用于瘦人多火的人。)(此注最为恰当)”
Zi He said: When Dai Ren passed through the military camp in Qiao Du and drank, he met a soldier who told him about his divorce. Dai Ren asked for the reason, and the soldier replied, "When my wife was still an unmarried maiden, she had a cold accumulation under her heart (epigastric region), shaped like an inverted cup. When pressed, it made a water sound, and when touched with a hot hand, it felt as cold as ice. I have been married to her for fifteen years, fearing that our lineage would end, so I divorced her." Dai Ren said, "Do not dismiss her. If you use my medicine, the illness can be cured, and pregnancy can be achieved." The soldier followed his advice. Dai Ren examined her pulse: the Cun (inch) position was deep and slow, while the Chi (cubit) position was surging, large, and forceful. This is not a sign of infertility; she will conceive within a year. Her husband laughed and said, "Let's try it." First, San Sheng San (Three Holy Powders) was administered, resulting in the vomiting of one dou of saliva, after which the area under the heart became flat and soft. Next, Baizhu Tiaozhong Tang (Atractylodes Macrocephala Decoction for Regulating the Middle) and Wuling San (Five-Ingredient Powder with Poria) were taken, followed by Siwu Tang (Four Substances Decoction) to harmonize the body. Within less than a month, Qi and Blood were balanced and moderate. Several months later, she conceived a son. Dai Ren often said, "Using this method of mine, there are no women who cannot conceive." This statement is not false.
There was a thirty-four-year-old woman who dreamed of copulating with ghosts and spirits, experiencing extreme fear and panic, and seeing divine halls, underworld offices, boats, and bridges. This persisted for fifteen years, yet she never conceived. She consulted shamans and priests without limit, underwent acupuncture and moxibustion at thousands of acupoints, became emaciated and yellowish with fever, suffered from thirst, excessive drinking, epigastric fullness, and swollen feet, resigning herself to fate. One day, she bitterly requested Dai Ren's treatment. Dai Ren said, "Yang Fire is abundant in the upper Jiao, and Yin Water is abundant in the lower Jiao. Seeing ghosts and spirits is a manifestation of Yin spirits; divine halls are dwellings of Yin; boats and bridges relate to the function of water. Both Cun positions on the hands are deep and hidden, indicating substantial Phlegm in the chest. After three rounds of emesis, purgation, and diaphoresis, the nightmares ceased within ten days, and she conceived within a month. (These two cases could only be handled by Master Zi He.)"
Zhu Danxi discussed Qin Gui Wan (Qin Cinnamon Pill): The cause of infertility often lies with the woman. Physicians do not investigate where the cause originates but instead browse ancient prescriptions. Only Qin Gui Wan has precise wording and focused intent. Using warming and hot medicines aligns with human nature, so patients accept them gladly and take them eagerly, willingly suffering the disaster of burning and scorching, yet remaining ignorant and unrepentant. Why? Yang Essence is applied, and Yin Blood receives it. The essence forms the fetus, and the blood forms the uterine sac, thus pregnancy is established. Now, women who cannot conceive mostly suffer from insufficient Yin Blood to receive the essence. The causes of insufficient blood are manifold, but those desiring children must regulate and tonify Yin Blood to prevent deficiency, thereby allowing surplus to form pregnancy. How can one lightly use hot agents to fry the Zang-Fu organs, causing Qi and Blood to boil, leading to immediate disaster? Some say, "Spring weather is mild (the subtlety lies in 'mild,' as neither extreme cold nor extreme heat can generate life); thus all things sprout. Winter air is biting cold, so all things wither. Without the warmth of Qin Gui Wan, how can the uterus become warm enough to conceive?" I say, "The Book of Songs states: 'If a woman is harmonious and peaceful, she will joyfully have children.' Harmony means Qi and Blood are even; peace means Yin and Yang do not contend. With this medicine, menstrual blood will turn purple-black, gradually becoming scanty, irregular in timing. Initially, appetite increases suddenly, but later, the mouth becomes bitter and dry. Yin and Yang become imbalanced, Qi and Blood disharmonious, and diseases arise in swarms. How can pregnancy be formed? Even if pregnancy occurs, the child will likely be sickly and short-lived, because Qin Gui Wan depletes the innate Yin. Beware and be cautious. (Note: Qin Gui Wan may be used for obese individuals with reduced dosage, combined with regulating tonics, but it is contraindicated for thin individuals with excess fire.) (This note is most appropriate.)"