(音因)
凡妊娠三五个月,忽失音不语者,胞络脉绝也,名曰子喑。盖胞系于肾,肾脉贯舌,故失音。此非药可治,
分娩即自出声。
汤建中云∶前症俱由妊娠脾土不运而生湿,湿生痰,痰生热,热生风。如∶子肿,湿也;恶阻,痰也;子烦、
子淋,热也;子痫,风也;子悬,气也;转脬,虚也。治法虽有清热、消痰、渗湿、顺气、疏风、补之不同,要
不外去邪保胎四字为总诀也。
凡妊娠外感风寒,浑身壮热,眼花头眩,此因风寒客于肌表,
侵人脾胃,伤损营卫,是以憎寒发热,头疼眼痛,甚至心腹烦闷。不可妄投峻剂,只宜芎苏散表其寒邪。
按∶妇人天癸未行属少阴,天癸已行属厥阴,天癸已绝属太阴。胎产之病,治厥阴者,溯化之源也。故《机
要》曰∶胎产病当从厥阴经论,毋犯胃气及上二焦。谓之三禁∶不可汗,不可下,不可利小便是也。汗则痞满,
下则伤脾,利小便则内亡津液,中州枯燥。故受孕三五个月时,不可用一毫辛散滑利之品。惟七八个月后,倘有闭
结,乃敢稍施以滑利之剂。故上云∶不可妄投峻剂。
加味芎苏散
紫苏 羌活 陈皮 麦冬(各一钱) 川芎 白芍(各八分) 干姜 生甘草(各五分)
加生姜二片,水煎服。胎前宜清凉,干姜还须忌用。
(音因)
凡是怀孕三到五个月时,突然失音不能说话的情况,是因为胞络的脉气暂时断绝所致,这种病症称为“子喑”(妊娠失音)。因为胞宫系属于肾,肾经的脉络贯穿舌根,所以会导致失音。这种情况不需要用药治疗,分娩后自然就能发声。
汤建中说:上述症状都是由妊娠期脾土运化功能失常产生湿气,湿气生痰,痰生热,热极生风引起的。例如:子肿(妊娠肿胀),是湿邪所致;恶阻(妊娠呕吐),是痰邪所致;子烦(妊娠心烦)、子淋(妊娠小便淋痛),是热邪所致;子痫(妊娠抽搐),是风邪所致;子悬(妊娠胸胁胀满),是气滞所致;转脬(妊娠尿潴留),是虚证所致。治疗方法虽然有清热、消痰、渗湿、顺气、疏风、补益等不同,但总原则不外乎“去邪保胎”这六个字。
凡是孕妇外感风寒,出现全身高热、眼花头晕的症状,这是因为风寒之邪侵袭肌表,进而侵入脾胃,损伤了营卫之气,因此出现怕冷发热、头痛眼痛,甚至心腹烦闷。此时不可随意投用猛烈的药物,只适宜使用芎苏散来发散寒邪。
按语:妇女在天癸(月经)未行之前,体质属少阴;天癸已行之后,体质属厥阴;天癸绝经之后,体质属太阴。对于胎产疾病,从厥阴经论治,是追溯化生的本源。所以《机要》说:胎产疾病应当从厥阴经进行论述,不要损伤胃气及上、中二焦。这被称为“三禁”:不可发汗,不可攻下,不可通利小便。发汗会导致痞满,攻下会损伤脾脏,通利小便会耗伤体内津液,导致中焦干燥。因此在受孕三到五个月时,不可使用任何辛散或滑利的药物。只有到了七八个月后,如果有便秘情况,才敢稍微使用一些滑利的药物。所以上面说:不可随意投用猛烈的药物。
加味芎苏散
紫苏、羌活、陈皮、麦冬(各一钱),川芎、白芍(各八分),干姜、生甘草(各五分)。
加入生姜两片,水煎服。孕期宜用清凉药,干姜仍需忌用。
(Yin Yin)
When a woman is three to five months pregnant and suddenly loses her voice, it is because the meridians of the Bao (uterus) are temporarily obstructed. This condition is called "Zi Yin" (pregnancy-related aphonia). Since the uterus is connected to the Kidney, and the Kidney meridian passes through the root of the tongue, this leads to loss of voice. This condition does not require medical treatment; speech will return naturally after delivery.
Tang Jianzhong stated: The aforementioned symptoms arise from the failure of Spleen Earth to transport and transform during pregnancy, leading to dampness, which generates phlegm, then heat, and finally wind. For example: Zi Zhong (pregnancy edema) is caused by dampness; E Zu (pregnancy nausea/vomiting) is caused by phlegm; Zi Fan (pregnancy restlessness) and Zi Lin (pregnancy dysuria) are caused by heat; Zi Xian (pregnancy eclampsia/seizures) is caused by wind; Zi Xuan (pregnancy chest/hypochondriac distension) is caused by Qi stagnation; Zhuan Pao (pregnancy urinary retention) is due to deficiency. Although treatment methods vary—such as clearing heat, resolving phlegm, leaching out dampness, regulating Qi, dispelling wind, or tonifying—the general principle is always "expel pathogenic factors and protect the fetus."
When a pregnant woman contracts external Wind-Cold, presenting with high fever, visual disturbances, and dizziness, it is because Wind-Cold pathogens invade the muscle layer, penetrate into the Spleen and Stomach, and damage Ying (Nutritive) and Wei (Defensive) Qi. Consequently, there is aversion to cold and fever, headache, eye pain, and even mental restlessness and abdominal discomfort. One must not recklessly administer harsh medications; instead, Xiong Su San should be used to release the exterior and disperse Cold pathogens.
Note: Before the onset of Tian Gui (menstruation), a woman's constitution belongs to Shao Yin; after menstruation begins, it belongs to Jue Yin; after menopause, it belongs to Tai Yin. For diseases related to pregnancy and childbirth, treating via the Jue Yin meridian traces the source of transformation and generation. Therefore, *Ji Yao* states: Diseases of pregnancy and childbirth should be discussed according to the Jue Yin meridian, without damaging Stomach Qi and the Upper and Middle Jiao. This is known as the "Three Prohibitions": do not induce sweating, do not purge downward, and do not promote urination. Inducing sweating leads to fullness and obstruction; purging damages the Spleen; promoting urination depletes internal body fluids, causing dryness in the Central Jiao. Therefore, during the first three to five months of pregnancy, no acrid-dispersing or slippery-lubricating substances should be used. Only after seven to eight months, if constipation occurs, may one cautiously use slightly lubricating agents. Hence, it was previously stated: do not recklessly administer harsh medications.
Modified Xiong Su San
Perillae Folium (Zisu), Notopterygii Rhizoma et Radix (Qianghuo), Exocarpium Citri Reticulatae (Chenpi), Ophiopogonis Radix (Maidong) (each 1 qian); Chuanxiong Rhizome (Chuanxiong), Paeoniae Radix Alba (Baishao) (each 8 fen); Zingiberis Rhizoma Recens (Ganjiang), Glycyrrhizae Radix et Rhizoma Preparatum (Sheng Gancao) (each 5 fen).
Add two slices of fresh ginger, decoct in water, and take orally. During pregnancy, cooling herbs are preferred; Ganjiang (Dried Ginger) should still be avoided.