苓枳壳 柴胡（各八分） 炮姜（四分） 红花（二分） 甘草（五分）
上除生地，水煎去渣，入地黄，再煎数沸，加陈酒服之。不应，加穿山甲五分。
又不应，加附子三分。有实热难用附子者，须与大黄钱许同用。
小建中汤（见下卷脱汗亡阳门。） 四物汤 紫苏饮 安胎饮 千金保孕丸（俱见本卷安
胎门）。 归脾汤（见本卷胞漏小产门。） 香桂散（见本卷子死腹中门。）
妊娠胎逆上逼，重则胀满疼痛，谓之子悬，紫苏饮为必用之药。盖因紫苏饮为治妊娠胎气不和，
浊气举胎上凑，胎热气逆，心胃胀满之证。且此证挟气者居多，宜疏气舒郁，非紫苏、腹皮、川芎、陈
皮无以流气，非归、芍无以养血，气血既利而胎自降。然邪之所凑，其正必虚，故以人参、甘草补之。
如饮食不甘，加四君子。有热加芩、栀、归、芍。内热晡热，或四君兼逍遥散。若常常多怒，时觉
胀满，服顺气药不应，宜用和气安胎饮，或加味逍遥散。胎上攻而作痛，宜紫苏饮，或顺气安胎散。
若脾虚停滞胀满，安胎饮力薄，宜用加参平胃散。有因郁滞者，亦宜紫苏饮，或加味归脾汤。有因痰
结聚者，紫苏饮加芩、连、贝母。有因暴怒者，左关必弦洪，肝火内动，用小柴胡加茯苓、枳壳、山
栀。大抵胎气上逆，皆属火旺，急用芩、术、香附之类，不可服大寒之药，反致他变。予每治孕妇心
胃胀满，用尊生和
气饮甚效。子悬证，有两尺脉绝，余脉平和，不可错认死胎，且死胎有面青舌青可辨，宜紫苏饮治之，
则胎归原位，胀消脉起矣。如临月胎上逼心，呕哕欲死，急用童便灌之即下，或乌梅肉十枚研烂，入生姜三
片，煎汤灌之亦下。取酸以降敛之，兼辛以散火气之逆也。又有因坐草太早，心怀恐惧，气结不行，紫
苏饮一服便产。后附针灸一方备用。
四君子汤 治胃气虚弱，饮食不思，倦怠少食。
人参（一钱至三钱） 白术（一钱至二钱，土炒黄） 茯苓（一钱至钱半） 炙草（六分至一钱）
水煎服。
逍遥散（附八味逍遥散，又名加味逍遥散。） 治血虚肝燥，骨蒸劳热，往来寒热，咳嗽潮热，月
经不调，口干便涩。
柴胡 当归（酒拌） 白芍（酒炒） 白术（土炒） 茯苓（各一钱） 炙草（五分）
加煨姜、薄荷引，水煎服。一方无茯苓、薄荷，有茯神，生姜为引。治肝脾血虚，郁怒伤肝，血少
目暗，发热胁痛等证。加丹皮、栀子各七分，名八味逍遥散，又名加味逍遥散，治小便带血，或过劳
及多食炒炙，宜清膀胱之火，柴胡、当归
加倍，白术加五分。
和气安胎饮 治孕妇多怒，胸中胀满，若用乌药、香附、砂仁顺气等药，反加满闷，宜服此饮。
人参 白术（土炒） 当归（酒洗。各二钱） 川芎 条芩（各八分） 陈皮 紫苏 炙草（各四
分） 木香（二分，磨汁冲服）
姜引，煎服。一方无木香，有砂仁四分，名顺气安胎散，治孕妇胎气上攻，心
腹胀满作痛，子悬之证。有因气恼者，加木香二分，磨冲服。
加参平胃散 治孕妇脾气虚弱，饮食停滞，以致腹胀呕吐，安胎饮力缓，宜用此散。
人参 白术（土炒。各一钱） 苍术（米泔浸制） 浓朴（姜制，七分） 陈皮 炙草（各四分）
姜一片，水煎服。
尊生和气饮 治孕妇心胃胀满。
人参 苏粳 白芍（酒炒） 川芎（各六分） 当归（一钱或六分，酒洗） 腹皮（五分，制净） 木
香（二分，磨冲药服） 炙草（三分）
水煎服。
附针灸方 妊娠六七个月，饮食绝然不进，胸膈胀，水与药皆不能下，诊脉平和，又非病脉，此
乃膈气不通，药不能治，惟针灸可通，宜灸内关穴，即能进饮食矣。
其穴在手掌大纹后二寸两筋间。此穴可针，亦可灸，男左女右，重则双手同灸，轻者七壮，重加十数壮，
艾如黍大，或如麦大。寸取本人同身寸，以男左女右，手中指屈回，用草较所屈中指中节内纹两头尽
处，截断，为准一寸也。
紫苏饮（见本卷安胎门。） 小柴胡汤（见本卷诸痛门。） 加味归脾汤（见本卷小
产门，附归脾汤下。）
茯苓、枳壳、柴胡（各八分），炮姜（四分），红花（二分），甘草（五分）。
以上药物除生地外，加水煎煮后去渣，加入地黄，再煮沸数分钟，加陈年老酒送服。若无效，加穿山甲五分。
如果仍无效，加附子三分。对于有实热难以使用附子的患者，必须与大黄约一钱同用。
小建中汤（见下卷脱汗亡阳门）、四物汤、紫苏饮、安胎饮、千金保孕丸（均见本卷安胎门）。归脾汤（见本卷胞漏小产门）。香桂散（见本卷子死腹中门）。
妊娠期间胎气上逆逼迫，重则出现胀满疼痛，称为“子悬”，紫苏饮是必用的方药。因为紫苏饮是治疗妊娠胎气不和，浊气举胎上冲，胎热气逆，导致心胃胀满的证候。而且此证多兼夹气滞，适宜疏理气机、舒展郁结，不用紫苏、腹皮、川芎、陈皮就无法流通气机，不用当归、白芍就无法养血，气血通畅后胎儿自然下降。然而邪气聚集之处，正气必然虚弱，所以用人参、甘草来补益。如饮食无味，加四君子汤。有热象加黄芩、栀子、当归、白芍。内热或午后潮热，可用四君子汤兼逍遥散。如果常常发怒，时常觉得胀满，服用顺气药无效，宜用和气安胎饮，或加味逍遥散。胎气上攻而作痛，宜用紫苏饮，或顺气安胎散。若是脾虚停滞导致的胀满，安胎饮力量薄弱，宜用加参平胃散。有因气郁阻滞的，也宜用紫苏饮，或加味归脾汤。有因痰凝结聚的，紫苏饮加黄芩、黄连、贝母。有因暴怒引起的，左关脉必呈弦洪之象，肝火内动，用小柴胡汤加茯苓、枳壳、山栀。大抵胎气上逆，都属于火旺，急用黄芩、白术、香附之类，不可服用大寒的药物，否则反而导致其他病变。我每次治疗孕妇心胃胀满，用尊生和气饮非常有效。子悬证，如果出现两尺脉绝，其余脉象平和，不可误认为死胎，且死胎有面色青、舌色青可以辨别，宜用紫苏饮治疗，则胎儿回归原位，胀消脉起。如在临产前胎气上逼心胸，呕吐呃逆欲死，急用童便灌服即可缓解，或用乌梅肉十枚研烂，加入生姜三片，煎汤灌服也能缓解。取酸味以收敛降逆，兼辛味以发散逆乱之火气。又有因坐草太早，心怀恐惧，气结不行，紫苏饮一服便能分娩。后附针灸一方备用。
四君子汤 治疗胃气虚弱，不想饮食，倦怠少食。
人参（一钱至三钱），白术（一钱至二钱，土炒至黄），茯苓（一钱至钱半），炙甘草（六分至一钱）。
加水煎服。
逍遥散（附八味逍遥散，又名加味逍遥散。） 治疗血虚肝燥，骨蒸劳热，往来寒热，咳嗽潮热，月经不调，口干便涩。
柴胡，当归（酒拌），白芍（酒炒），白术（土炒），茯苓（各一钱），炙甘草（五分）。
加煨姜、薄荷为引，加水煎服。另一配方无茯苓、薄荷，有茯神，生姜为引。治疗肝脾血虚，郁怒伤肝，血少目暗，发热胁痛等证。加丹皮、栀子各七分，名为八味逍遥散，又名加味逍遥散，治疗小便带血，或因过劳及多食炒炙食物，宜清膀胱之火，柴胡、当归加倍，白术加五分。
和气安胎饮 治疗孕妇易怒，胸中胀满，如果用乌药、香附、砂仁等顺气药，反而加重满闷，宜服此饮。
人参，白术（土炒），当归（酒洗，各二钱），川芎，条芩（各八分），陈皮，紫苏，炙甘草（各四分），木香（二分，磨汁冲服）。
生姜为引，煎服。另一配方无木香，有砂仁四分，名为顺气安胎散，治疗孕妇胎气上攻，心腹胀满作痛，子悬之证。有因气恼引起的，加木香二分，磨汁冲服。
加参平胃散 治疗孕妇脾气虚弱，饮食停滞，以致腹胀呕吐，安胎饮力量缓慢，宜用此散。
人参，白术（土炒，各一钱），苍术（米泔水浸制），浓朴（姜制，七分），陈皮，炙甘草（各四分）。
生姜一片，加水煎服。
尊生和气饮 治疗孕妇心胃胀满。
人参，苏粳，白芍（酒炒），川芎（各六分），当归（一钱或六分，酒洗），腹皮（五分，制净），木香（二分，磨汁冲药服），炙甘草（三分）。
加水煎服。
附针灸方 妊娠六七个月，饮食完全不能进食，胸膈胀满，水和药都不能下咽，诊脉平和，又不是病脉，这是膈气不通，药物不能治疗，只有针灸可以疏通，宜灸内关穴，就能进饮食了。
该穴位在手掌大纹后二寸两筋之间。此穴可针也可灸，男左女右，重则双手同灸，轻者七壮，重者加十余壮，艾绒如黍米大，或如麦粒大。寸取本人同身寸，以男左女右为例，手中指屈回，用草量所屈中指中节内纹两头尽头处，截断，作为一寸的标准。
Fuling (Poria), Zhike (Immature Bitter Orange), Chaihu (Bupleurum Root) (each 8 fen), Paojiang (Prepared Ginger) (4 fen), Honghua (Safflower) (2 fen), Gancao (Licorice Root) (5 fen).
For the above herbs, excluding Shengdi (Rehmannia Root), add water, decoct, remove dregs, add Dihuang (Prepared Rehmannia Root), boil for a few more minutes, and take with aged wine. If ineffective, add Chanshanjia (Pangolin Scales) 5 fen.
If still ineffective, add Fuzi (Prepared Aconite Root) 3 fen. For those with excess heat where Fuzi is difficult to use, it must be used together with Dahuang (Rhubarb Root) approximately 1 qian.
Xiao Jianzhong Tang (Minor Construct the Middle Decoction) (see Menstrual Sweating and Yang Collapse section in the lower volume), Siwu Tang (Four Substances Decoction), Zisu Yin (Perilla Infusion), Antai Yin (Fetus-Securing Infusion), Qianjin Baoyun Wan (Thousand Golden Pregnancy-Preserving Pill) (all see Fetus-Securing section in this volume). Guipi Tang (Restore the Spleen Decoction) (see Uterine Bleeding and Miscarriage section in this volume). Xianggui San (Cinnamon and Costus Powder) (see Dead Fetus in Womb section in this volume).
During pregnancy, if fetal qi rebels upward causing pressure, severe cases present with distension and pain, termed "Zixuan" (Fetal Distension). Zisu Yin is an essential prescription. This is because Zisu Yin treats pregnancy conditions of disharmonious fetal qi, where turbid qi lifts the fetus upward, causing fetal heat and rebellious qi, leading to fullness and distension in the heart and stomach. Moreover, this condition often involves qi stagnation; it is suitable to soothe qi and relieve depression. Without Zisu (Perilla Leaf), Fupi (Mandarin Orange Peel), Chuanxiong (Ligusticum Rhizome), and Chenpi (Aged Tangerine Peel), qi cannot flow; without Danggui (Angelica Sinensis) and Shaoyao (White Peony Root), blood cannot be nourished. Once qi and blood are unobstructed, the fetus naturally descends. However, where pathogenic factors gather, healthy qi must be deficient; therefore, Renshen (Ginseng Root) and Gancao (Licorice Root) are used to tonify. If appetite is poor, add Sijunzi Tang (Four Gentlemen Decoction). If there is heat, add Huangqin (Scutellaria Root), Zhizi (Gardenia Fruit), Danggui (Angelica Sinensis), and Shaoyao (White Peony Root). For internal heat or afternoon tidal fever, use Sijunzi Tang combined with Xiaoyao San (Free and Easy Wanderer Powder). If one frequently gets angry and feels distended, and qi-regulating medicines are ineffective, use Heqi Antai Yin (Harmonizing Qi and Fetus-Securing Infusion) or Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). If fetal qi attacks upward causing pain, use Zisu Yin (Perilla Infusion) or Shunqi Antai San (Regulating Qi and Fetus-Securing Powder). If distension is due to spleen deficiency and stagnation, Antai Yin (Fetus-Securing Infusion) is too weak; use Jiaren Pingwei San (Ginseng-Added Stomach-Pinguing Powder). For cases due to qi depression and stagnation, Zisu Yin (Perilla Infusion) or Jiawei Guipi Tang (Modified Restore the Spleen Decoction) are also suitable. For cases due to phlegm accumulation, add Huangqin (Scutellaria Root), Lian (Coptis Rhizome), and Beimu (Fritillaria Bulb) to Zisu Yin (Perilla Infusion). For cases caused by sudden anger, the left Guan pulse will likely be wiry and surging, indicating internal stirring of liver fire; use Xiao Chaihu Tang (Minor Bupleurum Decoction) plus Fuling (Poria), Zhike (Immature Bitter Orange), and Shanzhi (Gardenia Fruit). Generally, rebellious fetal qi belongs to excessive fire; urgently use Huangqin (Scutellaria Root), Baizhu (Atractylodes Rhizome), Xiangfu (Cyperus Rhizome) and similar herbs. Do not administer major cold medicines, as this may cause other complications. I often treat pregnant women with heart and stomach distension using Zunsheng Heqi Yin (Respect Life Harmonizing Qi Infusion) with great effect. In Zixuan syndrome, if the two Chi pulses are absent while other pulses are peaceful, do not mistake it for a dead fetus. A dead fetus can be distinguished by a blue-green complexion and tongue. Use Zisu Yin (Perilla Infusion) to treat it; then the fetus returns to its original position, distension subsides, and pulses rise. If near term, fetal qi presses on the heart, causing vomiting and retching to the point of death, urgently灌 (administer) Tongbian (Child's Urine) which brings relief, or grind ten Wu Mei (Mume Fruit) into a paste, add three slices of Shengjiang (Fresh Ginger), decoct in water, and administer; this also brings relief. The sour flavor is taken to descend and astringe, combined with pungent flavors to dissipate rebellious fire qi. There are also cases due to lying in bed too early, fear and anxiety causing qi knotting and stagnation; one dose of Zisu Yin (Perilla Infusion) can induce delivery. An acupuncture formula is attached below for reference.
Sijunzi Tang (Four Gentlemen Decoction) Treats weak stomach qi, lack of desire for food, fatigue, and reduced intake.
Renshen (Ginseng Root) (1 qian to 3 qian), Baizhu (Atractylodes Rhizome) (1 qian to 2 qian, stir-fried with earth until yellow), Fuling (Poria) (1 qian to 1.5 qian), Zhigancao (Honey-fried Licorice Root) (6 fen to 1 qian).
Decoct in water and take.
Xiaoyao San (Free and Easy Wanderer Powder) (Attached: Bawei Xiaoyao San, also known as Jiawei Xiaoyao San.) Treats blood deficiency with dry liver, bone-steaming tidal fever, alternating chills and fever, cough with tidal fever, irregular menstruation, dry mouth, and difficult urination/defecation.
Chaihu (Bupleurum Root), Danggui (Angelica Sinensis) (soaked in wine), Shaoyao (White Peony Root) (stir-fried with wine), Baizhu (Atractylodes Rhizome) (stir-fried with earth), Fuling (Poria) (each 1 qian), Zhigancao (Honey-fried Licorice Root) (5 fen).
Add Wei Jiang (Baked Ginger) and Bohe (Mint) as guides, decoct in water and take. Another formula has no Fuling (Poria) or Bohe (Mint), but includes Fushen (Poria with Hostwood), with Shengjiang (Fresh Ginger) as guide. Treats liver-spleen blood deficiency, liver injury from depression and anger, dim vision due to blood deficiency, fever, and hypochondriac pain. Add Danpi (Moutan Bark) and Zhizi (Gardenia Fruit) each 7 fen, named Bawei Xiaoyao San (Eight-Ingredient Free and Easy Wanderer Powder), also known as Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder), treating hematuria, or when caused by overwork and excessive consumption of fried/roasted foods, to clear bladder fire; double Chaihu (Bupleurum Root) and Danggui (Angelica Sinensis), add 5 fen to Baizhu (Atractylodes Rhizome).
Heqi Antai Yin (Harmonizing Qi and Fetus-Securing Infusion) Treats pregnant women who are prone to anger and have chest distension. If using Wuyao (Lindera Root), Xiangfu (Cyperus Rhizome), Sharen (Amomum Fruit) and other qi-regulating medicines worsens the fullness, this infusion should be taken.
Renshen (Ginseng Root), Baizhu (Atractylodes Rhizome) (stir-fried with earth), Danggui (Angelica Sinensis) (washed with wine, each 2 qian), Chuanxiong (Ligusticum Rhizome), Tiaoqin (Scutellaria Root) (each 8 fen), Chenpi (Aged Tangerine Peel), Zisu (Perilla Leaf), Zhigancao (Honey-fried Licorice Root) (each 4 fen), Muxiang (Aucklandia Root) (2 fen, ground into juice and mixed).
Use Shengjiang (Fresh Ginger) as guide, decoct and take. Another formula has no Muxiang (Aucklandia Root) but has 4 fen of Sharen (Amomum Fruit), named Shunqi Antai San (Regulating Qi and Fetus-Securing Powder), treating pregnant women with fetal qi attacking upward, causing heart and abdominal distension and pain, the Zixuan (Fetal Distension) syndrome. For cases due to anger, add 2 fen of Muxiang (Aucklandia Root), ground into juice and mixed.
Jiaren Pingwei San (Ginseng-Added Stomach-Pinguing Powder) Treats pregnant women with weak spleen qi, food stagnation, leading to abdominal distension and vomiting. Antai Yin (Fetus-Securing Infusion) is too slow; use this powder instead.
Renshen (Ginseng Root), Baizhu (Atractylodes Rhizome) (stir-fried with earth, each 1 qian), Cangzhu (Atractylodes Lancea Rhizome) (soaked in rice wash water), Houpo (Magnolia Bark) (prepared with ginger, 7 fen), Chenpi (Aged Tangerine Peel), Zhigancao (Honey-fried Licorice Root) (each 4 fen).
One slice of Shengjiang (Fresh Ginger), decoct in water and take.
Zunsheng Heqi Yin (Respect Life Harmonizing Qi Infusion) Treats pregnant women with heart and stomach distension.
Renshen (Ginseng Root), Sujing (Perilla Seed/Rice?), Shaoyao (White Peony Root) (stir-fried with wine), Chuanxiong (Ligusticum Rhizome) (each 6 fen), Danggui (Angelica Sinensis) (1 qian or 6 fen, washed with wine), Fupi (Mandarin Orange Peel) (5 fen, processed clean), Muxiang (Aucklandia Root) (2 fen, ground into juice and mixed with medicine), Zhigancao (Honey-fried Licorice Root) (3 fen).
Decoct in water and take.
Attached Acupuncture Formula: During the sixth or seventh month of pregnancy, if food intake is completely stopped, chest and diaphragm are distended, and neither water nor medicine can be swallowed, and the pulse is peaceful and not pathological, this is due to obstruction of diaphragmatic qi. Medicines cannot treat it; only acupuncture and moxibustion can unblock it. It is suitable to moxa the Neiguan (Pericardium 6) acupoint, after which food intake will resume.
The acupoint is located two cun behind the large crease of the palm, between the two tendons. This acupoint can be needled or moxa-ed. For men, use the left side; for women, the right side. In severe cases, moxa both hands simultaneously. For mild cases, seven moxa cones; for severe cases, add ten or more cones. The moxa cone should be the size of a millet seed or a wheat grain. One cun is measured using the patient's own body measurement. Taking the man's left hand as an example, flex the middle finger. Measure the distance between the two ends of the transverse crease at the middle joint of the flexed middle finger using grass, cut it off, and this length serves as the standard for one cun.
Zisu Yin (Perilla Infusion) (see Fetus-Securing section in this volume). Xiao Chaihu Tang (Minor Bupleurum Decoction) (see Pain Syndromes section in this volume). Jiawei Guipi Tang (Modified Restore the Spleen Decoction) (see Miscarriage section in this volume, attached under Guipi Tang).