肺主卫,卫为气,得热则泄,得寒则涩,寒气客于肠外,与卫气相搏,气不得荣,因有所系,结瘕而内着,恶气乃
起,息肉乃生,渐而至大,如怀子状,气病而血未病,故月事不断,应时而下,木香通气散。(散二十二。)
寒气客于子门,气不通,而月事不下,结硬如石,非大辛热之剂不能消,见 丸。(攻四。)
倘有孕,用香附子(醋炒)、桃仁、海粉(醋煮)、白术,为末,面糊丸,服之颇稳。
生产为天地化育之道,本无所难,其有难产者,皆产家张皇自致之耳。能静以待之,儿得转身,自然产下。治法以
顺气和血为主,切勿肆用催生药。
心怀恐惧而气结不行,恐则气下,惧则气怯,怯则上焦闭,闭则气还,还则下焦胀,气乃不行。宜服紫苏饮。(散三)
胞破浆水下而儿不下,速当补气养血,如鱼得水而自顺矣。宜保产万全汤。(和二十二,)再用浓煎葱汤,洗其产户,
令上下之气宣通。
胞中败血壅滞,儿枕破,血裹儿身,致转身不利,急服胜金散。(攻五)
暑月热气蒸人,有郁冒冲晕之患,生化汤。(和二十四。)加益元散。(寒三十)
冬月寒气逼人,经血凝聚而难下,宜生化汤加肉桂、乳香。(和二十四)
交骨不开,阴气虚也。加味芎归汤。(补三十六。)开骨膏。(和二十三)
子趋谷道,焦盐熨之。
横生逆产,此因儿未转身,母即用力逼之,遂致横逆也。或先露手,或先露足,以小针刺儿手足心,用盐擦之,儿
痛即缩入,并以盐摩产妇腹。若眼闭心闷欲绝,取顶上发如两指大,用力挽之,眼即开。或以米醋 之,车前子为末,
酒下亦可。又,儿先露手,速令产母仰卧,看生之妇,将儿手推上,徐徐正之,候其身正。煎催生药服之,使儿生下。
又三退散可下。(攻六)
盘肠产,子未下而肠先下,此因产母气血虚弱,因而下脱。当大补气血,兼以升提。参、 、芎、归,加升麻少许,
连服之,自收。若肠干不收,以磨刀水少许温润之。或浓煎黄 汤,贮漆器内,候弗冷弗热,将肠浸之,令温暖之气
上熏则肠自上。或以蓖麻子四十九粒,研烂涂母头顶,待肠收上急洗去;又五倍子、白矾汤浸亦好。子肠与子宫脱下者,
同一治法。
胎死腹中,察产母腹胀口青,或舌黑,腹中阴冷重坠,呕恶不宁,秽气上冲,皆子死之证。速当下之,当归、浓朴、
陈皮,酒、水各一碗,煎半,入朴硝三五钱,再煎十余沸,服。如在疑似之间,只服芎归汤为稳。
肺主司卫气,卫气属于气的一种,受热则外泄,受寒则凝涩。寒气侵袭于肠外,与卫气相互搏结,导致气机不能正常濡养,因而有所羁绊,形成积块并附着在内,恶浊之气由此产生,息肉随之生成,逐渐增大,状如怀孕。此时仅是气分病变而血分未病,所以月经按时来潮且不断绝,可用木香通气散治疗。(见方剂卷二十二。)
寒气侵袭子门(子宫口),导致气机不通,月经因此无法下行,结块坚硬如石,非用大辛大热之药不能消散,可见相关丸剂。(见攻邪卷四。)
如果已有身孕,可使用醋炒的香附子、桃仁、醋煮的海粉、白术,研为细末,用面糊制成丸剂服用,颇为稳妥。
分娩是天地化育生命的自然之道,本无困难,那些难产的情况,都是产妇因惊慌失措而自找的。若能镇定等待,胎儿得以转身,自然就能顺产。治疗方法以顺气和血为主,切勿滥用催生药物。
若心中恐惧导致气机郁结而不行,恐则气陷,惧则气怯,气怯则上焦闭塞,闭塞则气还返,气还则下焦胀满,气机因此停滞不行。适宜服用紫苏饮。(见方剂卷三。)
若胞衣破裂、羊水流出而胎儿不下,应当迅速补气养血,如同鱼得水般自然顺畅。宜用保产万全汤。(见和法卷二十二。)再用浓煎的葱汤清洗产道,使上下气机宣通。
若胞中败血壅滞,导致儿枕(产后瘀血块)破裂,血液包裹胎儿身体,致使胎儿转身不利,应紧急服用胜金散。(见攻邪卷五。)
夏季暑热蒸腾,有出现郁冒冲晕的危险,可用生化汤。(见和法卷二十四。)加入益元散。(见寒证卷三十。)
冬季寒气逼人,经血凝聚难以下行,宜用生化汤加肉桂、乳香。(见和法卷二十四。)
交骨(耻骨联合)不开,是由于阴气虚弱所致。可用加味芎归汤。(见补法卷三十六。)配合开骨膏外用。(见和法卷二十三。)
横生逆产,这是因为胎儿尚未转身,母亲就用力逼迫,从而导致胎位横逆。或先露出手,或先露出脚,用小针刺入胎儿手足心,用盐擦拭,胎儿因疼痛即缩回,并用盐按摩产妇腹部。若产妇眼闭心闷欲绝,取头顶发际处约两指宽范围的头发,用力向上牵引,眼睛即可睁开。或用米醋熏鼻,或将车前子研为细末,酒送服也可。另外,若胎儿先露出手,速令产妇仰卧,请接生妇人将胎儿的手推上去,徐徐矫正,待其身体端正后,再煎服催生药,使胎儿娩出。此外,三退散也可服用。(见攻邪卷六。)
盘肠产,是指胎儿未生下而肠子先脱出,这是因为产妇气血虚弱,导致内脏下脱。应当大补气血,兼以升提。用人参、[缺字]、川芎、当归,加少许升麻,连续服用,肠子自然收回。若肠子干燥无法收回,用少量磨刀水湿润它。或用浓煎的黄芪汤,贮存在漆器内,待温度不冷不热时,将肠子浸泡其中,利用温暖的蒸汽上行熏蒸,肠子即可自行收回。或用蓖麻子四十九粒,研烂涂在产妇头顶,待肠子收回后立即洗去;或者用五倍子、白矾汤浸泡也有效。子宫下垂与肠子脱出的治法相同。
胎死腹中,观察产妇腹胀、口唇发青,或舌色发黑,腹中感觉阴冷沉重坠胀,恶心呕吐不安,秽浊之气上冲,这些都是胎儿死亡的征象。应当迅速使用下胎之法:用当归、厚朴、陈皮,各取一碗酒和水,煎至半量,加入朴硝三五钱,再煮沸十余次,服用。如果在疑似之间,只服用芎归汤较为稳妥。
The Lung governs Wei Qi (Defensive Qi), which is a type of Qi. When exposed to heat, it dissipates; when exposed to cold, it becomes stagnant. If Cold pathogen lodges outside the intestines and contends with Wei Qi, the Qi fails to nourish properly, becoming bound and forming a mass that adheres internally. Evil Qi arises, and polyps grow, gradually enlarging until resembling pregnancy. At this stage, only Qi is diseased while Blood remains unaffected; thus, menstruation continues regularly without interruption. Muxiang Tongqi San (Wood Fragrance Qi-Regulating Powder) should be used. (See Formula Vol. 22.)
If Cold lodges in the Zi Men (uterine orifice), Qi flow is obstructed, preventing menstruation from descending. The resulting mass is hard as stone and cannot be dissolved except by strongly acrid and hot agents. Refer to the relevant pill formula. (See Attack Vol. 4.)
If pregnancy exists, use Vinegar-fried Cyperi Rhizoma (Xiangfu), Peach Kernel (Taoren), Vinegar-boiled Hai Fen (Sea Starch/Calcium Carbonate), and Atractylodis Macrocephalae Rhizoma (Baizhu). Grind into powder, form pills with wheat paste, and administer orally for stability.
Childbirth is the natural way of Heaven and Earth’s nurturing process and inherently poses no difficulty. Cases of dystocia arise solely from the mother's panic and self-induced distress. By remaining calm and waiting, the fetus can turn, leading to natural delivery. Treatment focuses on regulating Qi and harmonizing Blood; never recklessly employ parturition-inducing drugs.
Fear causes Qi to knot and stagnate. Terror causes Qi to sink, and timidity causes Qi to weaken. Weakness leads to closure of the Upper Jiao (Upper Burner); closure causes Qi to return; returning Qi causes distension in the Lower Jiao (Lower Burner), halting Qi movement. Zisu Yin (Perilla Decoction) is suitable. (See Formula Vol. 3.)
If the amniotic sac ruptures and fluid flows but the fetus does not descend, rapidly tonify Qi and nourish Blood. Like a fish entering water, delivery will proceed naturally. Baichan Wanquan Tang (Ten Thousand Complete Postpartum Preservation Decoction) is indicated. (See Harmonize Vol. 22.) Additionally, wash the vulva with strong decoction of Scallion (Cong Bai) to promote the free flow of Qi above and below.
If foul blood stagnates in the uterus, causing the "child pillow" (postpartum blood stasis mass) to rupture and blood to wrap around the fetus, hindering turning, urgently administer Shengjin San (Winning Gold Powder). (See Attack Vol. 5.)
In summer months, steaming heat may cause depression, fainting, or dizziness. Use Huasheng Tang (Life Generation Decoction). (See Harmonize Vol. 24.) Add Yiyuan San (Benefit Origin Powder). (See Cold Vol. 30.)
In winter, biting cold causes menstrual blood to coagulate and become difficult to pass. Use Huasheng Tang added with Cinnamon Twig (Rougui) and Frankincense (Ruxiang). (See Harmonize Vol. 24.)
Failure of the Jiao Gu (pubic symphysis) to open is due to deficiency of Yin Qi. Use Jiawei Xiong Gui Tang (Modified Angelica and Ligusticum Decoction). (See Tonify Vol. 36.) Apply Kaigu Gao (Bone-Opening Ointment). (See Harmonize Vol. 23.)
If the fetal head directs towards the anus, apply scorched salt as a warm compress.
Transverse lie or malpresentation occurs because the fetus has not turned, yet the mother exerts force prematurely, causing transverse deviation. Hands or feet may present first. Prick the soles of the hands and feet with a small needle, rub with salt; pain causes retraction. Rub the maternal abdomen with salt. If the mother closes her eyes and feels heart oppression nearing death, pull firmly a tuft of hair about two fingers wide from the vertex; the eyes will open. Alternatively, fumigate with rice vinegar, or take Cheqianzi (Plantago Seed) powder with wine. Furthermore, if the hand presents, have the mother lie supine. The midwife should push the hand back up, gently correcting until the body is aligned. Then decoct and administer parturition-inducing medicine to deliver the fetus. Santsui San (Three Retreats Powder) may also be administered. (See Attack Vol. 6.)
Prolapsed intestine during childbirth (Pan Chang Chan) occurs when the intestine protrudes before the fetus due to severe Qi and Blood deficiency causing organ prolapse. Greatly tonify Qi and Blood and raise sinking Qi. Use Ginseng (Renshen), [missing character], Chuanxiong (Ligusticum), and Danggui (Angelica), with a small amount of Bupleurum (Shengma). Continuous administration allows natural retraction. If the intestine is dry and does not retract, moisten with a little grinding water. Or, steep the intestine in thick decoction of Astragalus (Huangqi) stored in a lacquerware vessel at lukewarm temperature, allowing warm steam to rise and assist retraction. Alternatively, grind 49 Castor Seeds (Bimazi) and apply to the vertex; wash off immediately after retraction. Soaking in Alum (Baifan) and Chinese Gallnut (Wubeizi) solution is also effective. Uterine prolaxis shares the same treatment.
Fetal demise in utero is evidenced by maternal abdominal distension, cyanosis of the lips, black tongue, sensation of cold heaviness in the abdomen, persistent nausea/vomiting, and rising foul odor. These indicate fetal death. Rapid expulsion is required: Decoct Radix Angelicae Sinensis (Danggui), Magnolia Bark (Houpo), and Exocarpium Citri Reticulatae (Chenpi) in one bowl each of wine and water until half remains. Add Natrii Sulfas (Piaoxiao) 3-5 qian, boil ten times more, and administer. If diagnosis is uncertain, simply administering Xiong Gui Tang (Ligusticum and Angelica Decoction) is safer.