子悬乃胎气上逼,紧塞于胸次之间,胀满疼痛是也。有寒火之分,有肝气,有停饮,有火盛。心闷绝而死者,
方用紫苏饮连进以救之。
紫苏饮
紫苏梗 归身(各一钱) 白芍 炙草(各五分) 川芎(三分) 人参(六分) 大腹皮(八分,黑豆水洗)
砂仁(三分,去壳)
以上各味外加姜(一片),葱白(一寸),煎服。
子眩,为气逆晕厥,并用紫苏饮。然有脾虚夹痰,用六君子汤加天麻五分。若脾不甚虚,独顽痰闭塞者,
用二陈汤加竹沥、姜汁。虚实之间,宜察辨之。如不合法,即防胎落。大约肝经气逆者多,予常用紫苏饮加枳壳、钩藤
而安。
紫苏饮(见前)
六君子汤(见前恶阻)
二陈汤(见前恶阻)
(又曰子冒)
孕妇血虚,风邪入肝,忽然昏冒不知,须臾则醒,过时复发,久则变痉。痉即口噤搐搦,背腰反张,如儿
童发惊之状,方用羚羊角散定之。若怒动肝火,佐以逍遥散加人参五分。若引动胎气逆上,佐以紫苏饮。兼脾
虚夹痰者,佐以六君子汤。或因中寒而发者,宜理中汤加防风、钩藤。此症宜速治,若频发无休,不但胎孕骤
下,抑或血随涣散,母命难保。如胎下,急大温补气血为要,方可得保母命,迟恐难以挽回。
羚羊角散
羚羊角 独活 当归(各一钱) 川芎(三分) 人参(八分) 茯神(一钱五分) 桑寄生(二钱)
钩藤(三钱) 防风(七分) 甘草(五分)
加姜或竹沥,煎服。
理中汤
白术(二钱) 炙草(五分) 干姜(一两)
水煎服,或加人参更妙。
逍遥散 紫苏饮 六君子汤(俱见前)
子悬是指胎气上冲,紧塞于胸膈之间,表现为胀满疼痛。此证有寒证与火证之分,病因涉及肝气郁结、痰饮停滞或火热亢盛。若出现心胸憋闷窒息甚至死亡的情况,应连续服用紫苏饮以急救。
紫苏饮
紫苏梗、当归身(各一钱),白芍、炙甘草(各五分),川芎(三分),人参(六分),大腹皮(八分,用黑豆水洗过),砂仁(三分,去壳)。
以上药物外加生姜一片、葱白一寸,煎汤服用。
子眩,表现为气逆导致的晕厥,也使用紫苏饮治疗。但若属于脾虚夹带痰湿者,使用六君子汤加天麻五分。如果脾虚不严重,仅是顽痰闭塞者,使用二陈汤加竹沥、姜汁。对于虚实夹杂的情况,应当仔细辨别。如果用药不当,就要防止流产。大致而言,多因肝经气逆所致,我常用紫苏饮加枳壳、钩藤来安胎。
紫苏饮(见前文)
六君子汤(见前文恶阻章节)
二陈汤(见前文恶阻章节)
(又称子冒)
孕妇血虚,风邪侵入肝脏,突然昏蒙不知人事,片刻后苏醒,过后又复发,日久则转变为痉病。痉病即牙关紧闭、肢体抽搐、腰背反张,如同儿童发惊风的样子,方用羚羊角散来平息。若是因愤怒引动肝火,辅助使用逍遥散加人参五分。若是引动胎气上逆,辅助使用紫苏饮。兼有脾虚夹痰者,辅助使用六君子汤。若是因中寒而发作的,适宜使用理中汤加防风、钩藤。此症宜速治,若频繁发作不止,不仅会导致胎孕骤降(流产),或者导致血液涣散流失,母亲的生命难保。如果胎儿已下,急需大补气血为要,才能保全母亲生命,拖延恐怕难以挽回。
羚羊角散
羚羊角、独活、当归(各一钱),川芎(三分),人参(八分),茯神(一钱五分),桑寄生(二钱),钩藤(三钱),防风(七分),甘草(五分)。
加生姜或竹沥,煎汤服用。
Zixuan (Fetal Distension) refers to fetal qi rushing upward, tightly obstructing the chest and diaphragm, manifesting as distension and pain. This condition is differentiated into cold and fire patterns, with etiologies involving Liver qi stagnation, retained fluid retention, or excessive fire. In cases where chest oppression leads to syncope or death, Zisu Yin (Perilla Stem Decoction) should be administered continuously for emergency rescue.
Zisu Yin (Perilla Stem Decoction)
Zisugeng (Stem of Perilla Frutescens), Dangguishen (Radix Angelicae Sinensis, root portion) (each 1 qian); Baishao (Radix Paeoniae Alba), Zhigancao (Radix Glycyrrhizae Preparata) (each 0.5 qian); Chuanxiong (Rhizoma Chuanxiong) (0.3 qian); Renshen (Radix Ginseng) (0.6 qian); Dafupi (Pericarpium Citri Grandis) (0.8 qian, washed with black soybean water); Sharen (Fructus Amomi Rotundus) (0.3 qian, husk removed).
Add one slice of Shengjiang (Rhizoma Zingiberis Recens) and one cun of Congbai (Bulbus Allii Cepae) to the above herbs, decoct in water, and take orally.
Zixuan (Fetal Vertigo/Syncope) manifests as syncope due to rebellious qi, also treated with Zisu Yin (Perilla Stem Decoction). However, if it involves Spleen deficiency with phlegm accumulation, Liujunzi Tang (Six Gentlemen Decoction) plus Tianma (Rhizoma Gastrodiae, 0.5 qian) is used. If Spleen deficiency is not severe, but merely stubborn phlegm obstruction exists, Erchen Tang (Two Aged Herbs Decoction) plus Zhuli (Nodus Bambusae in Taenia) and Jiangzhi (Succus Zingiberis Recens) is employed. One must carefully distinguish between excess and deficiency. Improper treatment may lead to miscarriage. Generally, this is mostly caused by rebellious qi in the Liver channel; I commonly use Zisu Yin (Perilla Stem Decoction) plus Zhike (Fructus Aurantii) and Gouteng (Ramulus Uncariae cum Uncis) to calm the fetus.
Zisu Yin (Perilla Stem Decoction) (see previous section)
Liujunzi Tang (Six Gentlemen Decoction) (see previous section on Ezu)
Erchen Tang (Two Aged Herbs Decoction) (see previous section on Ezu)
(Also known as Zimao)
When a pregnant woman has Blood deficiency and Wind pathogen invades the Liver, she suddenly becomes unconscious and disoriented, awakens after a moment, and relapses later. Prolonged occurrence transforms into Jing disease (Spasm). Jing disease presents with locked jaws, convulsions, and opisthotonos, resembling infantile convulsions. Lingyangjiao San (Antelope Horn Powder) is used to settle the spasms. If anger stirs up Liver fire, Xiaoyao San (Free and Easy Wanderer Powder) plus Renshen (Radix Ginseng, 0.5 qian) is added as an adjunct. If fetal qi is stirred and rebels upward, Zisu Yin (Perilla Stem Decoction) is added as an adjunct. For cases with concurrent Spleen deficiency and phlegm, Liujunzi Tang (Six Gentlemen Decoction) is added as an adjunct. If caused by Cold invading the Middle Jiao, Lizhong Tang (Regulate the Middle Decoction) plus Fangfeng (Radix Saposhnikoviae) and Gouteng (Ramulus Uncariae cum Uncis) is appropriate. This condition requires rapid treatment. Frequent, unceasing attacks not only cause sudden miscarriage but may also lead to dispersion of Blood, endangering the mother's life. If the fetus is expelled, urgent and substantial tonification of Qi and Blood is essential to save the mother; delay may make recovery impossible.
Lingyangjiao San (Antelope Horn Powder)
Lingyangjiao (Cornu Saigae Tataricae), Duhuo (Radix Angelicae Pubescentis), Danggui (Radix Angelicae Sinensis) (each 1 qian); Chuanxiong (Rhizoma Chuanxiong) (0.3 qian); Renshen (Radix Ginseng) (0.8 qian); Fushen (Poria cum Radix Pinelliae) (1.5 qian); Sangjisheng (Cacumen Taxilli) (2 qian); Gouteng (Ramulus Uncariae cum Uncis) (3 qian); Fangfeng (Radix Saposhnikoviae) (0.7 qian); Gancao (Radix Glycyrrhizae) (0.5 qian).
Add Shengjiang (Rhizoma Zingiberis Recens) or Zhuli (Nodus Bambusae in Taenia), decoct in water, and take orally.
Lizhong Tang (Regulate the Middle Decoction)
Baizhu (Rhizoma Atractylodis Macrocephalae) (2 qian); Zhigancao (Radix Glycyrrhizae Preparata) (0.5 qian); Ganjiang (Rhizoma Zingiberis Secatum) (1 liang).
Decoct in water and take orally; adding Renshen (Radix Ginseng) is even better.
Xiaoyao San (Free and Easy Wanderer Powder), Zisu Yin (Perilla Stem Decoction), Liujunzi Tang (Six Gentlemen Decoction) (all see previous sections)