妊娠腹内儿哭或钟鸣者,因腹中脐带上疙瘩儿含口中,妊妇或登高举臂脱出儿口,以此作声。令妊妇曲
腰就地如拾物状,或合作男子拜揖状,或令扫地,其疙瘩仍入儿口即止。亦有胎热不安而啼者,以黄
连浓煎汁,妊妇时时呷之即止。
妊妇有按月行经而胎日长者.名曰盛胎,其妇血气充盛,养胎之外,血有余故也。有数月之胎而血大下,
谓之漏胎,因事触胎,动其任脉,故血下而不伤子宫也。然孕中失血,胎虽不坠,气血亦亏,多致逾月不产。
曾见有十二、三月,或十七、八月,或二十余月而生者,俱是血气不足,胚胎难长故耳。凡十月之后未产
者,当大补气血之药以倍养之,庶无分娩之患。所以胎气本乎血气而长,其胎不长者,亦惟气血之不足。故
有受胎之后而漏血不止,则血不归胎者;有妇人中年血气衰败,泉源日涸者;有因脾胃病,仓廪薄,化源
亏,而冲任穷者;有多郁怒,肝气逆,血不调而胎失所养者;有血气寒而不长,阳气衰,生气少者;有血
热而不长,火邪甚,真阴损者。种种不一。凡治此病,则宜补、宜固、宜温、宜清,因其病而随机应之。
胎气渐充,自无不长。然又有妊母气血自旺而胎不长者,此必父气孱弱,又当大剂保元,专补其气,不得杂
一味血药助母,则子气方得受益。总之,胎之能长而旺者,全赖母之脾土输气于子。凡长养万物莫不由土,
故胎之生发虽主乎肾肝,而长养实
关乎脾土。所以治胎气不长,必用八珍、十全、归脾、补中之类,助其母气以长胎,免致多延日月。试观
瘠薄之土,虽 不获,得沃泽灌溉便能成实,义可见矣。其过期不产,有属气虚者,当补其气。有血虚气
滞者,用补血行滞汤,服之即产。复有胎气因母举动失调,或所禀怯弱不能自固,致儿内失荣养,不能长发,
仍不陨坠者,此与果实干萎在枝无异,名曰枯胎,惟宜急早资母血气,则胎自长。若失于早为滋养,以致
萎燥既成,无能为矣。曾有孕妇十七月不产,自五月以后胎则不动,用丹参一味,日服七钱,两旬余,胎
下已死而枯。又一妇十三月不产,脉来微结,用十全大补汤二十余剂,而下胎枯色白。如过期不产而脉沉细,
但当脐下悸动,此为瘀积化水,当作鬼胎治之。
保元汤 治营卫不足。
黄 (三钱至六钱,蜜酒炙) 人参(三钱至一两) 炙草(一钱)
水煎服。
十全大补汤 治营卫俱虚。
人参 黄 (蜜炙) 白术(土炒) 茯苓 熟地 当归(各一钱) 川芎 白芍(炒。各八分)
肉桂 炙草(各五分)
姜枣引,水煎服。
补血行滞汤(又名催生汤。) 治过月不产,又能催生。
当归(酒浸) 川芎 白芍(炒) 熟地 香附(制。各一钱) 桃仁(去皮尖) 枳壳(麸炒)
砂仁(碎) 紫苏(各七分)
姜一片,枣二枚,水煎服。
归脾汤(见本卷胎漏小产门。) 八珍汤 补中益气汤(俱见本卷诸痛门)
妊娠期间,胎儿在腹中啼哭或发出类似钟鸣的声音,是因为脐带上的疙瘩被含在口中,孕妇如果登高并举起手臂,导致疙瘩脱出胎儿口腔,从而发出声音。让孕妇弯腰贴近地面,做出拾物的姿势,或者配合做男子拜揖的动作,或者令其扫地,那个疙瘩重新进入胎儿口中,声音就会停止。也有因胎热不安而啼哭的,用黄连浓煎汁,让孕妇不时小口饮用即可停止。
孕妇有每月来月经但胎儿依然每日生长的,称为“盛胎”,这是因为孕妇气血充盛,在滋养胎儿之外,血液还有盈余的缘故。有怀胎数月却大量出血的,称为“漏胎”,是因为受到外界刺激触动胎儿,扰动任脉,所以血液下行但不损伤子宫。然而孕期失血,虽然胎儿不坠落,但气血也会亏损,多导致超过月份不能分娩。曾见过十二、三个月,或十七、八个月,甚至二十几个月才生产的,都是因为气血不足,胚胎难以生长所致。凡是怀孕十个月后未生产的,应当使用大补气血的药物加倍滋养,这样才不会有分娩时的祸患。所以胎气依靠血气而生长,胎儿不长,也是因为气血不足。因此有的受孕后漏血不止,导致血不归附于胎;有的妇人中年气血衰败,源泉日益枯竭;有的因脾胃病,仓廪薄弱,化源亏虚,导致冲任二脉穷竭;有的多郁怒,肝气上逆,血液不调而胎儿失去滋养;有的血气寒而不长,阳气衰微,生气少;有的血热而不长,火邪严重,真阴受损。情况种种不一。凡治疗此病,适宜补益、固摄、温养、清热,根据病情随机应变。胎气逐渐充盈,自然没有不长的。然而又有母亲气血旺盛而胎儿不长的,这必定是父亲精气孱弱,又当用大剂量的保元汤,专门补气,不得夹杂一味补血药助母,这样子的精气才能受益。总之,胎儿能生长旺盛,全赖母亲的脾土将气输送给胎儿。凡长养万物没有不由土的,所以胎儿的生发虽主要取决于肾和肝,但长养实际上关乎脾土。所以治疗胎气不长,必须使用八珍汤、十全大补汤、归脾汤、补中益气汤之类,帮助母气以滋养胎儿,避免拖延时日。试看贫瘠的土地,虽然不收获,得到肥沃灌溉便能结实,道理可见一斑。那些过期不产的,有属于气虚的,应当补气。有血虚气滞的,用补血行滞汤,服用后即生产。又有因母亲举动失调,或禀赋怯弱不能自固,导致胎儿在内失去荣养,不能长发,仍然不坠落的,这与果实干枯萎缩在树枝上没有区别,称为“枯胎”,只宜尽早资助母体血气,则胎儿自然生长。如果失于早期滋养,以致干枯燥结已成,就无能为力了。曾有孕妇十七个月不产,从五个月以后胎儿就不动,只用丹参一味药,每天服用七钱,二十多天后,胎儿生下已死且干枯。又一妇女十三个月不产,脉象微结,用十全大补汤二十多剂,生下干枯白色的胎儿。如果过期不产而脉象沉细,只是感到脐下悸动,这是瘀积化为水湿,当作鬼胎治疗。
保元汤 治疗营卫不足。
黄芪(三钱至六钱,蜜酒炙) 人参(三钱至一两) 炙甘草(一钱)
水煎服。
十全大补汤 治疗营卫俱虚。
人参 黄芪(蜜炙) 白术(土炒) 茯苓 熟地黄 当归(各一钱) 川芎 白芍(炒。各八分)
肉桂 炙甘草(各五分)
生姜、大枣为引,水煎服。
补血行滞汤(又名催生汤。) 治疗过月不产,又能催生。
当归(酒浸) 川芎 白芍(炒) 熟地黄 香附(制。各一钱) 桃仁(去皮尖) 枳壳(麸炒)
砂仁(碎) 紫苏(各七分)
生姜一片,大枣二枚,水煎服。
During pregnancy, if the fetus cries inside the abdomen or makes a sound like a bell tolling, it is because a nodule on the umbilical cord has been held in the mouth. If the pregnant woman climbs high and raises her arms, the nodule may be dislodged from the fetal mouth, causing this sound. Instruct the pregnant woman to bend her waist and lower herself to the ground as if picking up an object, or to perform a bowing gesture like a man, or to sweep the floor; once the nodule re-enters the fetal mouth, the sound will cease. There are also cases where the fetus cries due to fetal heat and restlessness; administering concentrated decoction of Huanglian (Coptidis Rhizoma) for the pregnant woman to sip occasionally will stop the crying.
Some pregnant women experience monthly menstruation while the fetus continues to grow daily; this is called "Sheng Tai" (Abundant Fetus). This occurs because the woman's Qi and Blood are abundant, and after nourishing the fetus, there is still surplus blood. In cases where heavy bleeding occurs several months into pregnancy, it is called "Lou Tai" (Leaking Fetus). This happens when external stimuli disturb the fetus and agitate the Ren Mai (Conception Vessel), causing blood to flow downward without damaging the uterus. However, blood loss during pregnancy, although the fetus does not abort, depletes Qi and Blood, often leading to post-term delivery. Cases have been seen where delivery occurred at twelve or thirteen months, seventeen or eighteen months, or even over twenty months; these are all due to insufficient Qi and Blood, making it difficult for the embryo to grow. For those who have passed ten months of gestation without delivering, potent Qi and Blood tonifying medicines should be used generously to nourish them, thereby avoiding complications during childbirth. Thus, fetal growth depends on Qi and Blood; failure of the fetus to grow is solely due to deficiency in Qi and Blood. Therefore, some suffer from continuous bleeding after conception, causing blood to fail to return to the fetus; some women in middle age experience decline and exhaustion of Qi and Blood, with their source drying up day by day; some suffer from Spleen and Stomach disorders, where the granary is thin, the source of transformation is deficient, leading to exhaustion of the Chong and Ren vessels; some suffer from excessive anger and depression, causing Liver Qi to rebel, blood to be unregulated, and the fetus to lose nourishment; some have cold Qi and Blood that fail to promote growth, with declining Yang Qi and little vital energy; some have hot blood that fails to promote growth, with severe fire pathogens damaging true Yin. These situations are numerous. Treatment for this condition should involve tonification, consolidation, warming, or clearing, adapted to the specific pathology. As fetal Qi gradually fills, growth will naturally occur. However, there are cases where the mother's Qi and Blood are robust but the fetus does not grow; this is likely due to weak paternal essence. In such cases, large doses of Baoyuan Tang (Preserve the Origin Decoction) should be used to specifically tonify Qi, without adding any blood-nourishing herbs to assist the mother, so that the child's Qi may benefit. In summary, the ability of the fetus to grow and flourish relies entirely on the mother's Spleen Earth transmitting Qi to the child. All things that grow depend on Earth; thus, although fetal development is primarily governed by the Kidney and Liver, its nourishment actually concerns the Spleen Earth. Therefore, treating poor fetal growth requires formulas such as Bazhen Tang (Eight Treasure Decoction), Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction), Guipi Tang (Restore the Spleen Decoction), and Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) to assist maternal Qi in nourishing the fetus, preventing prolonged delay. Consider barren soil: though it yields nothing, irrigation with fertile water allows fruits to mature; the principle is evident. Regarding post-term delivery, some cases are due to Qi deficiency and require Qi tonification. Some are due to Blood deficiency with Qi stagnation; using Buchu Xingzhi Tang (Nourish Blood and Move Stagnation Decoction) will induce labor immediately. Other cases arise from improper movement by the mother or inherent weakness failing to secure the fetus, causing internal lack of nourishment and failure to develop, yet the fetus does not fall; this is akin to a fruit withering on the branch, known as "Ku Tai" (Withered Fetus). It is imperative to promptly tonify maternal Qi and Blood, so the fetus grows naturally. If early nourishment is neglected, resulting in established withering and dryness, no action can be taken. A case was recorded of a pregnant woman who did not deliver for seventeen months; after five months, the fetus ceased moving. Using only Danshen (Salviae Miltiorrhizae Radix et Rhizoma), seven qian daily, for over twenty days, the fetus was delivered dead and withered. Another woman did not deliver for thirteen months; her pulse was slightly knotted. After taking Shiquan Dabu Tang for over twenty doses, she delivered a withered, white fetus. If post-term delivery presents with a deep, fine pulse and only palpitations below the navel, this indicates stasis transforming into fluid; it should be treated as a "Ghost Fetus."
Baoyuan Tang (Preserve the Origin Decoction): Treats insufficiency of Ying and Wei Qi.
Huangqi (Astragali Radix) (3 to 6 qian, honey-wine stir-fried) Renshen (Ginseng Radix) (3 qian to 1 liang) Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) (1 qian)
Decoct in water and take orally.
Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction): Treats deficiency of both Ying and Wei Qi.
Renshen (Ginseng Radix) Huangqi (Astragali Radix) (honey-fried) Baizhu (Atractylodis Macrocephalae Rhizoma) (soil-stir-fried) Fuling (Poria) Shudi (Rehmanniae Radix Preparata) Danggui (Angelicae Sinensis Radix) (each 1 qian) Chuanxiong (Ligustici Chuanxiong Rhizoma) Baishao (Paeoniae Radix Alba) (stir-fried, each 8 fen) Rougui (Cinnamomi Cortex) Zhigancao (Prepared Glycyrrhizae Radix et Rhizoma) (each 5 fen)
Use Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus) as guides, decoct in water and take orally.
Buchu Xingzhi Tang (Nourish Blood and Move Stagnation Decoction), also known as Cuisheng Tang (Induce Labor Decoction): Treats post-term non-delivery and induces labor.
Danggui (Angelicae Sinensis Radix) (wine-soaked) Chuanxiong (Ligustici Chuanxiong Rhizoma) Baishao (Paeoniae Radix Alba) (stir-fried) Shudi (Rehmanniae Radix Preparata) Xiangfu (Cyperi Rhizoma) (processed, each 1 qian) Taoren (Persicae Semen) (skin and tip removed) Zhike (Aurantii Fructus) (bran-stir-fried) Sharen (Amomi Fructus Rotundus) (crushed) Zisu (Perillae Folium) (each 7 fen)
One slice of Shengjiang (Zingiberis Rhizoma Recens), two Dazao (Jujubae Fructus), decoct in water and take orally.
Guipi Tang (Restore the Spleen Decoction) (see Section on Lou Tai and Xiao Chan in this volume). Bazhen Tang (Eight Treasure Decoction). Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (both see Section on Various Pains in this volume).