龚子才治刘尚书外家，有孕患恶阻，呕吐不止，饮食不下，心中烦躁，头目眩晕。咸以二陈汤、藿香正气散、
保生汤之类，遍投不效。诊之，左脉微数，气口数，此血虚气盛有火也。若不养血，则火不降，火不降则呕不
止。以茯苓补心汤加姜汁炒黄连、竹茹，二服全愈。
卢不远治史氏妇，呕吐之声，远闻百步。脉之，左关鼓指，不连于寸，两尺滑搏，于左独加，水饮不入唇
七日矣。与透肝之剂，断其必男。药进而呕定，月足果产男。是证初寒热大作，呕吐不食，人皆以为伤寒。卢
以尺中脉搏，知其为妊；其关不连寸者，盖肝郁善怒而不能发也。顺其性而伸之调之，肝舒气平，恶自无阻，
而呕自定耳。
冯楚瞻治一妇，妊娠三月而大吐，两月有余，药食俱不能受，六脉沉微已极，竟根据脉立方，以人参五钱，
炙甘草一钱，炮姜、制附各一钱五分，数剂而愈，胎亦安然。经曰∶有故无殒，亦无殒也。
柴屿青治翁氏家人沈泰女，怀娠三月，患恶阻。医以感冒治之，方中用半夏二钱，连投二剂，腹痛异常，
身热盗汗，历有二旬。求诊，柴谓半夏乃孕妇所禁，如何可用二钱？无怪乎腹痛之甚也，其胎不堕幸矣。遂与
养阴之剂，半月而瘥。并令其八月后服达生散十余剂，至临产生理甚顺而速，得举一子。
张路玉治钱氏妇，去秋疟久大虚，饮食大减，经水不调，季冬略行一度，今春时发寒热，腹满不食，服宽
肠利水药不应，拟进破血通经之剂。张诊之，其脉左手厥厥动摇，右关与两尺虽微弦，而重按久按却滑实流利，
惟右寸左关虚濡而数，寻之涩涩少力，此阴中伏阳之象，洵为胎脉无疑。良由中气虚乏，不能转运其胎，故作
胀耳。前医曰∶自结缡至今，距十二载，从未受孕，病后元气大虚，安有怀子之理？张曰∶向之不孕，必有
其故。今病后余热留于血室，因而得孕，亦恒有之理。细推病机，每粥食到口，辄欲作呕，惟向晚寒热之际，
得热饮入胃，其寒热顿减，岂非胃气虚寒，水精不能四布，留为涎液，汪洋心下乎？俗名恶阻是也。其腹满便
难之虚实，尤当明辨。《金匮》云∶跗阳脉微弦，法当腹满，不满必便难，乃虚寒从下上也，当以温柔药服之。
况大便之后，每加胀急，以里气下通，浊阴乘之上扰，与得下临时宽快回殊。其治虽当以安胎为主，但浊阴之
气，非藉辛温，不能开导其结。遂疏六君子汤，益入归、芍以收荣血之散，稍借肉桂为浊阴之向导，使母气得
温中健运之力，胎息无浊阴侵犯之虞。桂不伤胎，庞安常先有明试，余尝屡验之矣。服后寒热渐止，腹胀渐宽，
饮食渐进，胎息亦渐形着。至仲夏，因起居不慎，而胎漏下血，前医犹认石瘕，欲进破积。喻以左寸动滑，断
属干象，与扶脾药得安，后产一子。
陈三农治恶阻，诸药不纳，以苏梗三钱，砂仁一钱煎服。或乌药为君，沉香次之，人参、甘草又次之，为
细末，以姜切片粘药末咬嚼，咽津液送至丹田，过一时，又如此嚼，即愈。
一孕妇呕吐酸水，胸满不食，此脾土虚，为肝木所侮。用六君子加白芍而愈，又用四君子加枳、桔而安。
万密斋治徽商吴俨妻，年三十余，少子二岁尚食乳，月水未行，因反目激怒，得呕逆病，食入随吐。凡所
食物，鼻中即作其臭，医俱作反胃治不效。其脉左三部沉实搏手，右三部平和，曰∶此有孕也，当生二男。
汪曰∶前生三子，皆三岁而后孕，今儿方二岁，经水未动，宜非孕也。曰∶身自有孕，且不知之，况医人乎？
宜其治之不效。盖怒伤肝，肝传心，诸臭皆属于心。心传脾，故随所食物，即作其气而出也。呕逆食臭，皆肝、
心二脏之火炎上也。以黄芩一两，黄连、白术、陈皮、香附、茯苓各五钱，炒砂仁二钱，为末，神曲糊丸绿豆
大。每服五十丸，白汤下，未五日而安，后生双男。
龚子才治疗刘尚书的外家亲属，该女子怀孕后患有恶阻（妊娠呕吐），呕吐不止，无法进食，心中烦躁，头晕目眩。众人均使用二陈汤、藿香正气散、保生汤等方剂，遍投无效。龚子才诊察其脉象，左手脉微数，气口脉数，判断此为血虚而气盛有火。若不养血，则火势不降；火势不降，则呕吐不止。于是使用茯苓补心汤，加入姜汁炒黄连和竹茹，服用两剂后痊愈。
卢不远治疗史氏妇人，其呕吐声远达百步之外。诊脉发现，左关脉鼓指有力，但不延伸至寸部，两尺脉滑而搏指，左侧尤为明显，患者已七日水饮不入唇舌。卢不远给予疏肝透邪的药剂，断言必生男孩。服药后呕吐停止，足月果然产下男婴。此证初起时寒热大作，呕吐不食，人们都以为是伤寒。卢不远通过尺脉搏动有力，知道是妊娠；左关脉不连于寸部，是因为肝气郁结且易怒而不能发泄。顺应肝性加以舒展调理，肝气舒畅，气机平和，恶心自然消除，呕吐也就停止了。
冯楚瞻治疗一位妇女，妊娠三个月出现剧烈呕吐，两个多月来，药物和食物都无法接受，六脉沉微到了极点。冯楚瞻完全依据脉象处方，用人参五钱，炙甘草一钱，炮姜、制附子各一钱五分，服用数剂后痊愈，胎儿也安然无恙。《内经》说：有病则病受之，不会伤害母体，也不会伤害胎儿。
柴屿青治疗翁氏家人沈泰的女儿，怀孕三个月，患恶阻。医生按感冒治疗，方中用了半夏二钱，连续服用两剂后，腹痛异常剧烈，身体发热并盗汗，病程长达二十天。求诊时，柴屿青认为半夏是孕妇禁用的药物，怎能用二钱？难怪腹痛如此严重，胎儿未流产已是万幸。于是给予养阴的药剂，半个月后病愈。并嘱咐其在八月后服用达生散十余剂，直到临产时生理过程非常顺利迅速，得享一子。
张路玉治疗钱氏妇人，去年秋季因疟疾日久导致极度虚弱，饮食大幅减少，月经不调，季冬时节仅行经一次，今春时常发寒热，腹部胀满不能进食，服用宽肠利水的药物无效，拟进破血通经的药剂。张路玉诊察其脉象，左手脉厥厥动摇，右关与两尺虽微弦，但重按久按却滑实流利，只有右寸和左关虚濡而数，寻之涩涩少力，这是阴中伏阳的现象，确实是胎脉无疑。这主要是由于中气虚乏，不能转运胞胎，所以产生胀感。前医说：自结婚至今，相隔十二年，从未受孕，病后元气大虚，怎么会有怀孕的道理？张路玉说：之前不孕，必有原因。如今病后余热留在血室，因而怀孕，也是常理。仔细推敲病机，每遇粥食到口，就想作呕，只有在傍晚寒热发作之际，喝热饮入胃，寒热顿时减轻，这难道不是胃气虚寒，水液精微不能四布，停留成为涎液，充斥心下吗？这就是俗称的恶阻。其腹满和大便难的虚实，尤其应当明辨。《金匮要略》说：趺阳脉微弦，法当腹满，若不满则大便难，这是虚寒从下上逆，应当用温柔的药物服用。况且大便之后，往往加重胀急，因为里气下通，浊阴乘机上扰，这与排便后的暂时宽快截然不同。治疗虽然应以安胎为主，但浊阴之气，非借辛温之药，不能开导其结滞。于是开具六君子汤，加入当归、白芍以收敛荣血的耗散，稍加肉桂作为引导浊阴外出的向导，使母气获得温中健运之力，胎儿气息没有受到浊阴侵犯的忧虑。肉桂不伤胎，庞安常已有明确验证，我曾多次验证实效。服用后寒热逐渐停止，腹胀逐渐缓解，饮食逐渐增加，胎儿气息也逐渐显现。到了仲夏，因起居不慎，导致胎漏下血，前医仍认为是石瘕，想要进用破积药物。张路玉指出左寸脉动滑，断定为干血（或阴虚内热）之象，给予扶脾药物得以安宁，后来产下一子。
陈三农治疗恶阻，各种药物都无法纳受，使用苏梗三钱，砂仁一钱煎服。或者以乌药为君药，沉香次之，人参、甘草又次之，研为细末，用生姜切片粘附药末咬嚼，咽下津液送至丹田，过一个时辰，再这样咀嚼，即可痊愈。
一位孕妇呕吐酸水，胸满不能进食，这是脾土虚弱，被肝木所克制（相侮）。使用六君子汤加白芍而痊愈，后又用四君子汤加枳壳、桔梗而安定。
万密斋治疗徽商吴俨的妻子，三十多岁，小儿子两岁还在吃奶，月经未行，因反目激怒，得了呕逆病，食物入口随即吐出。凡是所吃的食物，鼻子闻到即觉得臭秽，医生都按反胃病治疗无效。其脉象左三部沉实搏手，右三部平和，万密斋说：这是怀孕，将生双男。汪氏（患者或其家属）说：之前生了三个孩子，都是三岁后才再次怀孕，现在小儿才两岁，月经未动，应该不是怀孕吧。万密斋说：身体自有孕，尚且不知道，何况医生呢？所以治疗无效。这是因为怒伤肝，肝传于心，各种气味皆归属于心。心传于脾，所以食物入口即散发气味而出。呕逆和食臭，都是肝、心两脏之火炎上的表现。使用黄芩一两，黄连、白术、陈皮、香附、茯苓各五钱，炒砂仁二钱，研为末，神曲糊丸如绿豆大。每次服用五十丸，白开水送下，不到五天就安宁了，后来生下双胞胎男孩。
Gong Zicai treated the relative of Vice Minister Liu, a woman who suffered from *Ezu* (pregnancy nausea and vomiting) after conception. She experienced incessant vomiting, inability to take food or drink, mental restlessness, dizziness, and vertigo. Various physicians administered formulas such as Erchen Tang (Two-Cured Decoction), Huoxiang Zhengqi San (Patchouli Powder for Rectifying the Qi), and Baosheng Tang (Preserve Life Decoction), but none were effective. Gong’s pulse diagnosis revealed a slightly rapid pulse on the left side and a rapid pulse at the Qi Kou position. He diagnosed this as blood deficiency with excess Qi and internal heat. He reasoned that without nourishing the blood, the fire would not descend; if the fire does not descend, the vomiting would not cease. He prescribed Fuling Buxin Tang (Poria Decoction for Nourishing the Heart), adding ginger-processed Huanglian (Coptis Rhizome) and Zhuru (Bamboo Shavings). After two doses, she was completely cured.
Lu Buanyuan treated Mrs. Shi, whose vomiting sound could be heard from a hundred paces away. Pulse diagnosis showed a surging and forceful pulse at the Left Guan position, which did not extend to the Cun position. The pulses at both Chi positions were slippery and forceful, particularly on the left. The patient had been unable to take even water into her mouth for seven days. Lu prescribed a formula to penetrate and soothe the Liver, predicting she would bear a son. After taking the medicine, the vomiting ceased, and at full term, she indeed gave birth to a male infant. Initially, the condition presented with severe alternating chills and fever, vomiting, and anorexia, leading others to diagnose it as Shanghan (Cold Damage). However, Lu recognized pregnancy due to the forceful Chi pulse. The discontinuation of the Guan pulse from the Cun position indicated Liver Qi stagnation accompanied by irritability that could not be expressed. By soothing the Liver and regulating its nature, the Qi became calm, the aversion to nausea disappeared naturally, and the vomiting stopped.
Feng Chuzhan treated a woman who suffered severe vomiting in the third month of pregnancy. For over two months, she could not tolerate any medicine or food. Her six pulses were extremely deep and faint. Relying solely on the pulse diagnosis, Feng prescribed Ren Shen (Ginseng Root) 5 qian, Zhi Gancao (Honey-fried Licorice Root) 1 qian, Pao Jiang (Roasted Ginger) and Zhi Fuzi (Prepared Aconite Root) each 1.5 qian. After several doses, she recovered, and the fetus remained safe. As stated in the classics: "If there is a pathogen, there will be no harm [to the healthy Qi], nor will there be harm to the fetus."
Chai Yuqing treated Shen Tai’s daughter, a member of the Weng family, who suffered from *Ezu* in the third month of pregnancy. A physician treated her for a common cold, prescribing Banxia (Pinellia Tuber) 2 qian. After two doses, she experienced severe abdominal pain, fever, and night sweats, lasting for twenty days. Upon consultation, Chai pointed out that Banxia is contraindicated in pregnancy; using 2 qian was inappropriate. It was no wonder the abdominal pain was so severe, and it was fortunate the fetus had not miscarried. He then prescribed a Yin-nourishing formula, and she recovered in half a month. He also advised her to take Dasheng San (Deliver Life Powder) for more than ten doses after the eighth month, ensuring a smooth and rapid delivery, resulting in the birth of a son.
Zhang Luyu treated Mrs. Qian. Last autumn, prolonged malaria had caused extreme debility, significantly reducing her appetite. Her menstruation was irregular, occurring only once in late winter. In spring, she frequently experienced alternating chills and fever, abdominal distension, and anorexia. Previous treatments with intestinal-widening and diuretic herbs failed. The previous physician intended to prescribe blood-breaking and menstruation-promoting agents. Zhang’s pulse diagnosis revealed a throbbing pulse at the Left Hand, while the Right Guan and both Chi positions were slightly wiry but slippery, solid, and fluent upon heavy and prolonged pressing. Only the Right Cun and Left Guan were deficient, soggy, rapid, and felt weak and choppy upon light palpation. This indicated Yang hidden within Yin, undoubtedly a fetal pulse. The cause was deficiency of Middle Qi, failing to transport the fetus, leading to distension. The previous physician argued that having been married for twelve years without conceiving, and being severely depleted post-illness, pregnancy was impossible. Zhang countered that prior infertility must have had a cause. Now, residual heat remaining in the Blood Chamber (Uterus) likely facilitated conception. Analyzing the pathology further: whenever porridge approached her mouth, she felt nauseous; however, during the evening chills and fever, hot drinks reduced these symptoms. This suggested Stomach Qi deficiency and cold, where fluids and essences failed to distribute, accumulating as saliva and phlegm in the epigastrium—known as *Ezu*. The distinction between excess and deficiency regarding abdominal distension and difficult defecation was crucial. The *Jinkui Yaolue* states: "A superficially wiry pulse indicates abdominal distension; if there is no distension, there is difficulty in defecation, caused by deficiency-cold rising from below; treat with gentle/warm medicines." Moreover, distension worsened after defecation because lower Qi unblocking allowed turbid Yin to rise and disturb. This differed from the temporary relief felt during defecation. Although the treatment should focus on calming the fetus, turbid Yin requires acrid-warm herbs to resolve stagnation. Thus, he prescribed Liujunzi Tang (Six-Gentlemen Decoction), adding Danggui (Angelica Sinensis Root) and Shaoyao (Peony Root) to consolidate Ying Blood, and a small amount of Rougui (Cinnamon Bark) to guide turbid Yin outward. This warmed the Mother’s Qi, promoting middle-jiao transportation, protecting the fetus from turbid Yin invasion. Rougui does not harm the fetus, as demonstrated by Pang Anchang and verified by Zhang. After administration, chills and fever subsided, abdominal distension eased, appetite improved, and fetal signs became apparent. In mid-summer, careless daily living led to threatened abortion with bleeding. The previous physician suspected Stone Mass (Lei Ji) and wanted to use mass-resolving drugs. Zhang identified the moving and slippery pulse at the Left Cun as indicating Dry Blood (Yin deficiency with heat), prescribing Spleen-supporting herbs, leading to stability and the birth of a son.
Chen Sansan treated *Ezu* where all medicines were rejected. He used Su Geng (Perilla Stem) 3 qian and Sharen (Amomum Fruit) 1 qian decocted and taken orally. Alternatively, he used Wuyao (Lindera Root) as the chief herb, Chenxiang (Aquilaria Wood) as secondary, followed by Ren Shen and Gancao. These were ground into fine powder. The patient chewed slices of fresh ginger coated with the powder, swallowing the saliva down to the Dantian. After one hour, this process was repeated until recovery.
Another pregnant woman vomited sour fluid, had chest fullness, and anorexia. This was attributed to Spleen Earth deficiency being oppressed by Liver Wood. She was cured using Liujunzi Tang plus Baishao (White Peony Root) and stabilized with Sijunzi Tang (Four-Gentlemen Decoction) plus Zhike (Aurantium Fruit) and Jiegie (Platycodon Root).
Wan Mizhai treated the wife of Merchant Wu Hui, aged thirty-something. Her youngest child was two years old and still breastfeeding, and her menstruation had not resumed. Due to anger and conflict, she developed vomiting and regurgitation, expelling food immediately after ingestion. Any food smelled foul to her nose. Physicians treated her as Fanwei (Regurgitation/Reverse Flow) without success. Her pulse was deep, solid, and forceful at the three positions of the Left Hand, while the Right Hand positions were peaceful. Wan diagnosed pregnancy, predicting twin boys. The husband/family doubted this, noting previous pregnancies occurred only after three years, and with the current child only two years old and no menses, pregnancy seemed unlikely. Wan replied: "The body carries pregnancy, yet you do not know it, let alone the physicians. Hence, previous treatments failed." Anger injured the Liver, which transmitted to the Heart; all odors are associated with the Heart. The Heart transmitted to the Spleen, causing food to emit odor upon entry. Vomiting and food odor were due to Fire flaring up from the Liver and Heart. He prescribed Huangqin (Scutellaria Root) 1 liang, Huanglian (Coptis Rhizome), Baizhu (Atractylodes Macrocephala Rhizome), Chenpi (Tangerine Peel), Xiangfu (Cyperus Rhizome), and Fuling (Poria) each 5 qian, plus fried Sharen 2 qian. Ground into powder, formed into pills with Shenqu (Medicated Leaven) paste, sized like mung beans. Fifty pills per dose, taken with warm water. Within five days, she was stable, and later delivered twin boys.