薛立斋治一妊娠下血,服凉血之药,下血益甚,食少体倦。此脾气虚而不能摄血,用补中益气汤而愈。后
因怒而寒热,其血仍下。此肝火旺而血沸腾,用加味逍遥散血止,用补中益气汤而安。
一妊妇下血,发热作渴,食少体倦,属脾气虚而肝火所侮,用四君子加柴胡、山栀血止。因怒复作,用六
君子加柴胡、山栀、升麻而安。
一妊妇六月,每怒血下,甚至寒热头痛,胁胀腹痛,作呕少食。薛谓寒热头痛,乃肝火上冲;(此语无人解通。)
胁胀腹痛,乃肝气不行;作呕少食,乃肝火侮胃;小便下血,乃肝火血热。用小柴胡加白芍、炒山栀、茯苓、
白术而愈。
一妊妇胎及六月,形体倦怠,饮食少进,劳役下血,胎动不安,用六君加当归、熟地、升麻、柴胡而愈。
张子和治一妇,娠半年,因伤损下血。张诊之,以三和汤,一名玉烛散,承气汤、四物汤对停,加朴硝煎
之,下数行,痛如手拈,下血亦止。此法可与智识高明者言,膏粱之家,慎勿举似,非徒骇之,抑又谤之。呜
乎!正道难行,正法难用,古今皆然。
孙文垣治侄孙妇,三孕而三小产,六脉滑数,乃气虚血热也。因血频下,甚恐怖,终日偃卧,稍起血即大
下,与生地、白芍、白术、地榆、桑皮、寄生、续断、甘草、升麻、椿根白皮、黄柏、条芩服之,血三日不
来,惟白带绵绵下。因起身稍劳,血复行,谓血滑已久,若不涩,必不能止。又血海甚热,亦肝风所致,防风
子芩丸,正与病对,宜制与之。又制白芍六两,侧柏叶、条芩各三两,防风、椿根白皮各二两,蜜丸服之,遂
血止胎定,足月产子,此后绝无胎漏之患。后遇此证,第用此法皆验。
张路玉治郑墨林夫人,素有便红证,妊七月,正肺气养胎时,患冬温咳嗽,咽痛如刺,下血如崩,脉较平时
反觉小弱而数,此热伤手太阴血分也。与黄连阿胶汤,二剂血止。后去黄连,加葳蕤、桔梗、人中黄,四剂而安。
柴屿青治其外家母,怀孕五月,与女伴争竞致伤,腹痛见红,稳婆验云∶昨夜子已在产门,定死腹中。诊其
六脉如常,验其舌红活,断以决无此理。用安胎养血药,二剂而起。至十月满足,产一子。
叶杏林曰∶一妇人妊娠,月信不断,而胎不损。产科熊宗古曰∶妇人血盛气衰,其体必肥,是以月信来而
胎不损。若作漏胎,则胎必堕。若不作漏胎,则胎未必堕也。
立斋治一妊妇尿血,内热作渴,寒热往来,胸乳作胀,饮食少思,肝肺弦弱,此肝经血虚而有热也。用加
味逍遥、六味兼服渐愈。又用八珍汤加柴、栀、丹皮而全愈矣。
魏玉横曰∶许竹溪室人,妊娠七月,偶以举重跌磕,遂胎动下血甚多,与熟地一两,杞子五钱,白芍三钱,
甘草五分,枣仁三钱,数剂全愈。
胡田室人先尝妊娠,以胎漏诸治罔效。延至二十四月而产。近有孕,仍漏血下,因胃痛,求治。脉之,两
关弦数,与生地、杞子、沙参、麦冬、川楝,胃痛愈,而胎亦不漏矣。
薛立斋治疗一位妊娠期下血的孕妇,服用凉血药物后,下血症状反而加重,伴有食欲减退、身体疲倦。这是脾气虚弱不能统摄血液所致,使用补中益气汤治愈。后来因为发怒出现寒热往来,出血仍未停止。这是肝火旺盛导致血液沸腾,使用加味逍遥散使血止,再用补中益气汤调理而安。
另一位孕妇下血,伴有发热、口渴、食欲减退、身体疲倦,属于脾气虚弱且受肝火克制(木侮土),使用四君子汤加入柴胡、山栀,血止。后因发怒复发,使用六君子汤加入柴胡、山栀、升麻而安定。
还有一位怀孕六个月的孕妇,每次发怒就出血,甚至出现寒热、头痛、胁肋胀满、腹痛、呕吐、食欲不振。薛立斋认为寒热头痛是肝火上冲;(这句话无人能解释通。)胁肋胀满腹痛是肝气郁滞不通;呕吐食欲不振是肝火侵犯胃腑;小便下血是肝火血热。使用小柴胡汤加入白芍、炒山栀、茯苓、白术而治愈。
又一位怀孕六个月的孕妇,形体倦怠,饮食减少,因劳累而下血,胎动不安,使用六君子汤加入当归、熟地、升麻、柴胡而治愈。
张子和治疗一位妇女,妊娠半年,因跌打损伤而下血。张子和诊察后,给予三和汤,又名玉烛散,由承气汤与四物汤等量混合,加入朴硝煎煮,服药后大便下行数次,疼痛如被手揉捏般缓解,下血也停止了。这种方法只能与见识高明的人谈论,对于富贵人家,千万不要提及,不仅会吓到他们,还会遭到诽谤。唉!正道难以推行,正法难以使用,古今都是如此。
孙文垣治疗侄孙媳妇,三次怀孕三次小产,六脉滑数,这是气虚血热的表现。因为频繁出血,非常恐惧,整天卧床不起,稍微起身血就大量流出。给予生地、白芍、白术、地榆、桑皮、寄生、续断、甘草、升麻、椿根白皮、黄柏、条芩服用,三天后血不再来,只有白带绵绵流出。因为起身稍加劳累,血又流出,孙文垣说血滑已久,如果不收敛固涩,必定不能止血。另外血海甚热,也是肝风所致,防风子芩丸正好对症,应当制作给她服用。又制作白芍六两,侧柏叶、条芩各三两,防风、椿根白皮各二两,蜜丸服用,于是血止胎安,足月生产儿子,此后再也没有胎漏的隐患。后来遇到此类证候,只用此法都有效。
张路玉治疗郑墨林夫人,素来有便红(大便带血)的病症,妊娠七月,正值肺气养胎之时,患冬温咳嗽,咽喉疼痛如刺,下血如崩,脉象比平时反而觉得细小弱而数,这是热邪伤害手太阴肺经血分。给予黄连阿胶汤,两剂后血止。后来去掉黄连,加入葳蕤、桔梗、人中黄,四剂后病情安定。
柴屿青治疗其岳母,怀孕五月,与女伴争吵致伤,腹痛见红,稳婆检查说:昨夜胎儿已在产门,定死腹中。诊察其六脉如常,观察其舌红活,断定绝无此事。使用安胎养血药,两剂后好转。至十月满足,产下一子。
叶杏林说:一位妇人妊娠期间,月经不断,但胎儿未损。产科医生熊宗古说:妇人血盛气衰,身体必然肥胖,所以月经来潮而胎儿不损。如果当作漏胎,则胎儿必堕。如果不当作漏胎,则胎儿未必会堕。
薛立斋治疗一位孕妇尿血,内热口渴,寒热往来,胸乳胀满,饮食少思,肝肺脉弦弱,这是肝经血虚而有热。使用加味逍遥散、六味地黄丸兼服逐渐痊愈。后又用八珍汤加入柴胡、山栀、丹皮而完全痊愈。
魏玉横说:许竹溪的妻子,妊娠七月,偶然因举重跌倒磕碰,随即胎动下血很多,给予熟地一两,枸杞五钱,白芍三钱,甘草五分,枣仁三钱,数剂后完全痊愈。
胡田的妻子先前曾怀孕,因胎漏各种治疗无效。拖延至二十四个月才生产。最近再次怀孕,仍然漏血,因胃痛求治。诊脉,两关脉弦数,给予生地、枸杞、沙参、麦冬、川楝子,胃痛痊愈,胎儿也不再漏血了。
Dr. Xue Lizhai treated a pregnant woman with vaginal bleeding during pregnancy. After taking blood-cooling herbs, the bleeding worsened, accompanied by poor appetite and physical fatigue. This was due to Spleen Qi deficiency failing to control the blood. She was cured using Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). Later, due to anger, she experienced alternating chills and fever, and the bleeding persisted. This was caused by hyperactive Liver Fire boiling the blood. Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) stopped the bleeding, and Buzhong Yiqi Tang stabilized her condition.
Another pregnant woman presented with vaginal bleeding, fever, thirst, poor appetite, and fatigue. This belonged to Spleen Qi deficiency with suppression by Liver Fire (Wood insulting Earth). Si Jun Zi Tang (Four Gentlemen Decoction) added with Chai Hu (Bupleuri Radix) and Shan Zhi (Gardeniae Fructus) stopped the bleeding. It recurred after anger, and Liu Jun Zi Tang (Six Gentlemen Decoction) added with Chai Hu, Shan Zhi, and Sheng Ma (Cimicifugae Rhizoma) stabilized her.
A third pregnant woman at six months gestation bled upon every episode of anger, even experiencing chills, fever, headache, distension in the hypochondrium, abdominal pain, vomiting, and poor appetite. Dr. Xue stated that chills, fever, and headache were due to Liver Fire rushing upward; (this statement is difficult to interpret.) Distension in the hypochondrium and abdominal pain were due to stagnant Liver Qi; vomiting and poor appetite were due to Liver Fire insulting the Stomach; hematuria was due to Liver Fire and blood heat. Xiao Chai Hu Tang (Minor Bupleurum Decoction) added with Bai Shao (Paeoniae Radix Alba), fried Shan Zhi, Fu Ling (Poria), and Bai Zhu (Atractylodis Macrocephalae Rhizoma) cured her.
Another pregnant woman at six months gestation presented with physical fatigue, reduced food intake, vaginal bleeding due to overexertion, and restless fetus. Liu Jun Zi Tang added with Dang Gui (Angelicae Sinensis Radix), Shu Di Huang (Rehmanniae Radix Praeparata), Sheng Ma, and Chai Hu cured her.
Zhang Zihe treated a woman who, at half a year of pregnancy, suffered vaginal bleeding due to trauma. Zhang diagnosed this and prescribed San He Tang (Three Harmonies Decoction), also known as Yu Zhu San (Jade Candle Powder), which combined Cheng Qi Tang (Order the Qi Decoction) and Si Wu Tang (Four Substance Decoction) in equal parts, adding Po Xiao (Natrii Sulfas), decocted and administered. After several bowel movements, the pain subsided as if kneaded by hand, and the bleeding stopped. This method can only be discussed with those of high insight; one must be cautious not to mention it to wealthy families, for it will not only frighten them but also invite slander. Alas! The correct path is hard to follow, and correct methods are hard to use; this has been true since ancient times.
Dr. Sun Wenyuan treated his nephew’s wife, who had three consecutive miscarriages. Her six pulses were slippery and rapid, indicating Qi deficiency and blood heat. Due to frequent bleeding, she was terrified, lying flat all day; any slight movement caused heavy bleeding. He prescribed Sheng Di Huang (Rehmanniae Radix), Bai Shao, Bai Zhu, Di Yu (Sanguisorbae Radix), Sang Bai Pi (Mori Cortex), Du Zhong (Eucommiae Cortex), Xu Duan (Dipsaci Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Sheng Ma, Chun Gen Bai Pi (Toosendanii Cortex), Huang Bo (Phellodendri Cortex), and Tiao Qin (Scutellariae Radix). After three doses, bleeding ceased, leaving only continuous leukorrhea. Upon slight exertion while rising, bleeding resumed. Dr. Sun said, "The blood slipperiness has lasted long; without astringency, it cannot stop." Furthermore, the Blood Sea is very hot, caused by Liver Wind. Fang Feng Zi Qin Wan (Wind-Dispersing Fetus-Securing Pill) was precisely indicated and should be prepared for her. He also prepared pills made of 6 liang of Bai Shao, 3 liang each of Ce Bai Ye (Biota Top Leaf) and Tiao Qin, 2 liang each of Fang Feng (Saposhnikoviae Radix) and Chun Gen Bai Pi, sweetened with honey. She took them, bleeding stopped, the fetus settled, and she delivered a healthy baby at term. Thereafter, she never suffered from fetal leakage again. In subsequent cases of this syndrome, using this method proved effective.
Dr. Zhang Luyu treated Madam Zheng Molin, who had a history of hematochezia (blood in stool). At seven months of pregnancy, during the period when Lung Qi nourishes the fetus, she contracted Winter-Warmth disease with cough, sore throat like stabbing, and vaginal bleeding like a gush. Her pulse felt smaller, weaker, and more rapid than usual, indicating Heat injuring the Blood aspect of the Hand-Taiyin Lung Meridian. Huang Lian E Jiao Tang (Coptis and Donkey-Hide Gelatin Decoction) was given for two doses, stopping the bleeding. Later, Huang Lian was removed, and Rui Zhu (Polygonati Rhizoma), Jie Geng (Platycodonis Radix), and Ren Zhong Huang (Human Midsection Ash) were added. Four doses stabilized her.
Chai Yuqing treated his mother-in-law, who at five months of pregnancy was injured by an argument with a female companion, resulting in abdominal pain and spotting. The midwife examined her and claimed: "Last night the fetus was already at the birth canal, surely dead in the womb." Palpating her six pulses as normal and observing her tongue as red and lively, he ruled out this possibility. Anxi Yangxue Yao (Fetus-Calming and Blood-Nourishing Medicine) was used, and she improved after two doses. At ten months, she delivered a son.
Ye Xinglin said: A woman had continuous menstruation during pregnancy without fetal damage. Obstetrician Xiong Zonggu said: When a woman has abundant blood and deficient Qi, her body is necessarily fat; thus, menstruation occurs without fetal damage. If treated as fetal leakage, the fetus will abort. If not treated as fetal leakage, the fetus may not abort.
Dr. Lizhai treated a pregnant woman with hematuria, internal heat, thirst, alternating chills and fever, chest and breast distension, and poor appetite. Her Liver and Lung pulses were wiry and weak, indicating Liver Meridian Blood deficiency with Heat. Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) and Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) were taken concurrently, leading to gradual recovery. Later, Bazhen Tang (Eight Treasures Decoction) added with Chai Hu, Shan Zhi, and Dan Pi (Moutan Cortex) completely cured her.
Dr. Wei Yuheng said: Mrs. Xu Zhuxi, at seven months of pregnancy, accidentally fell while lifting heavy objects, causing significant fetal restlessness and bleeding. Shu Di Huang, Gou Qi Zi (Lycii Fructus), Bai Shao, Gan Cao, and Suan Zao Ren (Ziziphi Spinosae Semen) were given for several doses, resulting in full recovery.
Mrs. Hu Tiantian had previously experienced pregnancy complicated by fetal leakage, unresponsive to various treatments, delivering at twenty-four months. Recently pregnant again, she still had leakage and sought treatment for stomach pain. Her pulse was wiry and rapid at both Guan positions. Sheng Di Huang, Gou Qi Zi, Sha Shen (Glehniae Radix or Adenophorae Radix), Mai Dong (Ophiopogonis Tuber), and Chuan Lian Zi (Meliosmae Fructus) were prescribed. The stomach pain resolved, and the fetal leakage stopped.