妇人怀妊之后，恶心呕吐，思酸解渴，见食则憎，困倦欲卧，人以为妊娠之恶阻也，
谁知肝血之太燥乎。夫肾一受精，则肾水生胎，不能分润于他脏，肝为肾之子，日食肾母
之气，一旦无津液之养，则肝气燥而益急，火动而气乃逆也，于是恶心呕吐之症生。虽呕吐
不至太甚，而伤气则一也。气伤则肝血愈耗，世人以四物治产前诸症，正以其能生肝血也。
然补肝以生血，未为不佳，但恐生血不能生气，则脾胃衰微，不胜频呕。吾恐气虚血不易生
也，故治法平肝补血之中宜用健脾开胃之药，以生阳气，则气能生血，尤益胎气耳。然虽气逆
而用补气之药，气旺不益助其逆耶。不知怀妊恶阻，其逆不甚，且逆亦因虚而逆，非因邪而
逆也。因邪而逆者，助其气而逆增；因虚而逆者，补其气而逆转。况补气于补血之中，则阴
足以制阳，何患于逆乎。方用顺肝益气汤∶
白芍（三钱） 当归（一钱） 白术（三钱） 人参（一钱） 茯苓（二钱） 熟地（五
钱） 苏子（一钱） 麦冬（三钱） 砂仁（一粒） 神曲（一钱） 陈皮（三分）水煎服。
一剂恶阻轻，再剂而平，三剂全愈。
此方肝、肾、脾、胃、肺五经同调之法，其意专主于肝肾，肝平则气不逆，肾旺则血
易生。凡胎不动而少带恶阻者，俱以此方投之，无不安静如故，有益于孕妇不浅，实胜于四物
之汤也。盖四物汤专治肝，此方不止治肝，所以奏功尤神耳。
用润肝安娠汤亦佳。
人参 茯苓 扁豆 山药（各三钱） 半夏 熟地 白术（各五钱） 川芎 麦冬 丹
皮苏子 神曲（各二钱） 白豆蔻（一粒） 陈皮（三分）水煎服。连服四剂，而恶阻止矣。
妊娠每至五月，肢体倦怠，饮食无味，先两足肿，渐至遍身，后及头面俱肿，人以为犯
湿而然也，谁知是脾肺之气虚乎。夫妊娠虽有按月养胎之分，其实不可拘于月数，总以健脾
补肺为主。盖脾统血而肺通气也，胎非血不荫，儿非气不生，脾健则血旺而荫胎，肺清则气壮
而生子。苟肺衰则气馁，即不能运气于皮肤矣。脾虚则血少，即不能运化于肢体矣。气血两衰，
脾肺失令，饮食难消，精微不化，势必气血下陷，不能升举。而湿邪即乘其所虚之处，聚湿
而浮肿矣。治法当补其脾肺之虚，不必以去湿为事。方用补中益气汤加减治之。
人参（五钱） 白术（五钱） 当归（三钱） 黄 （三钱） 陈皮（三分） 甘草（一
分） 柴胡（一钱） 升麻（三分） 茯苓（一两）水煎服。一剂少胀，二剂即宽，三剂渐消，四剂即愈。十剂不再犯
也。
补中益气汤原是升提脾肺之药，似益气而不益血也。不知血非气不生，况湿气相犯，未
便补血，故补气而助之利湿之味，则气升而水尤易散耳。然则少用利水之味可也，何重用茯
苓至一两，不几以利水为君乎。夫重用茯苓于补气之中，虽是利水，仍是健脾清肺。凡利水之
药，多耗气血，茯苓与白术补多于利，所以重用以分湿邪，即所以补气血耳。
用土金双培汤亦效甚。
人参 苏子 茯苓 谷芽 巴戟天 菟丝子 白芍（各三钱） 白术 薏仁（各五钱）
山药（五钱） 神曲（二钱） 砂仁（一粒） 甘草（二分） 柴胡（五分）水煎服。四剂全
消。
妇人怀孕之后，出现恶心呕吐、想吃酸味食物以解渴、见到食物就厌恶、疲倦想睡觉的症状，人们认为这是妊娠恶阻（妊娠期因气机逆乱导致的恶心呕吐等症），
谁知道这是因为肝血过于干燥呢。肾一旦接受了精液，就会生成肾水来滋养胎儿，不能分润滋养其他脏腑，肝是肾的儿子，每天消耗肾母体的气，一旦没有津液的滋养，肝气就会干燥且更加急躁，火动而气机上逆，于是产生了恶心呕吐的症状。虽然呕吐不至于太严重，但损伤正气是一样的。正气受损则肝血更加耗损，世人用四物汤治疗产前各种病症，正是因为它能生养肝血。
然而补肝以生血，并非不好，只是担心生血不能生气，导致脾胃衰微，承受不住频繁的呕吐。我担心气虚则血不易生成，所以治疗方法在平抑肝气、补充血液的同时，应该使用健脾开胃的药物，以生发阳气，这样气能生血，尤其对胎气有益。虽然气机上逆却使用补气药，气旺盛不是更助长气逆吗？不知道怀孕期间的恶阻，其气逆并不严重，而且气逆是因为虚所致，不是因为邪气所致。因为邪气导致的气逆，助长气分会使气逆加重；因为虚导致的气逆，补益气分反而能使气逆逆转。况且在补血之中加入补气药，阴足以制约阳，何必担心气逆呢。方剂用顺肝益气汤：
白芍（三钱） 当归（一钱） 白术（三钱） 人参（一钱） 茯苓（二钱） 熟地黄（五钱） 苏子（一钱） 麦冬（三钱） 砂仁（一粒） 神曲（一钱） 陈皮（三分） 水煎服。
服用一剂恶阻症状减轻，两剂后平稳，三剂后完全痊愈。
此方是调和肝、肾、脾、胃、肺五脏经络的方法，其意图主要侧重于肝肾，肝气平和则气不逆，肾气旺盛则血易生。凡是胎动不明显且轻微伴有恶阻的，都用此方投药，无不恢复安静如常，对孕妇益处不小，确实胜过四物汤。因为四物汤专门治疗肝，此方不止治肝，所以见效特别神奇。
使用润肝安娠汤也很好。
人参 茯苓 扁豆 山药（各三钱） 半夏 熟地黄 白术（各五钱） 川芎 麦冬 牡丹皮 苏子 神曲（各二钱） 白豆蔻（一粒） 陈皮（三分） 水煎服。连续服用四剂，恶阻就停止了。
妊娠每到五月，肢体倦怠，饮食无味，先双脚肿胀，逐渐发展到全身，后来头脸都肿，人们认为是受湿邪影响所致，谁知道这是脾肺之气虚弱呢。妊娠虽然有按月养胎的说法，其实不可拘泥于月数，总要以健脾补肺为主。因为脾统摄血液而肺运行气机，胎儿非血不能荫蔽，婴儿非气不能生长，脾健则血旺而荫蔽胎儿，肺清则气壮而孕育婴儿。如果肺衰弱则气馁，就不能将气运送到皮肤了。脾虚则血少，就不能将营养运送到肢体了。气血两衰，脾肺功能失调，饮食难以消化，精微物质不能转化，势必气血下陷，不能升举。而湿邪就趁其虚弱之处，聚集湿气而形成浮肿。治疗方法应当补益脾肺的虚弱，不必以祛湿为事务。方剂用补中益气汤加减治疗。
人参（五钱） 白术（五钱） 当归（三钱） 黄芪（三钱） 陈皮（三分） 甘草（一分） 柴胡（一钱） 升麻（三分） 茯苓（一两） 水煎服。一剂后腹胀稍减，两剂后舒畅，三剂后逐渐消退，四剂后痊愈。十剂后不再复发。
补中益气汤原本是提升脾肺之气的药物，似乎只益气而不益血。不知道血非气不生，况且有湿邪侵犯，不便补血，所以补气并辅助利湿的药物，则气上升而水湿更容易消散。那么少用利水的药物就可以了，为什么重用茯苓至一两，岂不是以利水为主要目的吗？在补气之中重用茯苓，虽然是利水，仍然是健脾清肺。凡是利水的药物，大多耗伤气血，茯苓与白术补益多于利泄，所以重用它们来分消湿邪，也就是补益气血了。
使用土金双培汤也很有效。
人参 苏子 茯苓 谷芽 巴戟天 菟丝子 白芍（各三钱） 白术 薏苡仁（各五钱） 山药（五钱） 神曲（二钱） 砂仁（一粒） 甘草（二分） 柴胡（五分） 水煎服。四剂后完全消退。
After a woman becomes pregnant, she experiences nausea and vomiting, a craving for sour foods to quench thirst, aversion to food, fatigue, and a desire to lie down. People consider this to be *Ezu* (morning sickness/nausea of pregnancy),
but who would know that it is due to excessive dryness of Liver Blood? Once the Kidney receives the essence, it generates Kidney Water to nourish the fetus, leaving no fluid to moisten other organs. The Liver is the "son" of the Kidney; it consumes Qi from its "mother," the Kidney, daily. Once deprived of the nourishment of body fluids, the Liver Qi becomes dry and increasingly irritable, Fire stirs, and Qi rebels upward, thereby generating symptoms of nausea and vomiting. Although the vomiting may not be severe, the damage to Qi is the same. When Qi is damaged, Liver Blood is further depleted. The world uses *Siwu Tang* (Four Substances Decoction) to treat various conditions during pregnancy precisely because it can generate Liver Blood.
However, tonifying the Liver to generate blood is not bad, but one must fear that generating blood without generating Qi will lead to the decline of the Spleen and Stomach, which cannot withstand frequent vomiting. I fear that if Qi is deficient, Blood will not easily be generated. Therefore, in the treatment method, while soothing the Liver and nourishing Blood, one should use herbs that strengthen the Spleen and open the appetite to generate Yang Qi. In this way, Qi can generate Blood, which is especially beneficial to the fetal Qi. Although Qi rebels, using Qi-tonifying herbs might seem to exacerbate the rebellion. However, one does not realize that in pregnancy-related *Ezu*, the rebellion is not severe, and the rebellion is due to deficiency rather than pathogenic factors. When rebellion is caused by pathogens, boosting Qi increases the rebellion; when rebellion is caused by deficiency, tonifying Qi reverses the rebellion. Moreover, adding Qi-tonifying herbs among Blood-nourishing herbs ensures that Yin sufficiently controls Yang, so why worry about rebellion? The prescription used is *Shun Gan Yi Qi Tang* (Liver-Soothing and Qi-Boosting Decoction):
*Bai Shao* (White Peony Root, 3 qian) *Dang Gui* (Chinese Angelica Root, 1 qian) *Bai Zhu* (Atractylodes Macrocephala Rhizome, 3 qian) *Ren Shen* (Ginseng Root, 1 qian) *Fu Ling* (Poria, 2 qian) *Shu Di Huang* (Prepared Rehmannia Root, 5 qian) *Su Zi* (Perilla Fruit, 1 qian) *Mai Dong* (Ophiopogon Tuber, 3 qian) *Sha Ren* (Amomum Fruit, 1 grain) *Shen Qu* (Medicated Leaven, 1 qian) *Chen Pi* (Citrus Reticulata Peel, 3 fen) Decoct in water and take orally.
After one dose, *Ezu* symptoms lighten; after two doses, it stabilizes; after three doses, it is completely cured.
This formula harmonizes the meridians of the Liver, Kidney, Spleen, Stomach, and Lung, with its intent primarily focusing on the Liver and Kidney. When the Liver is peaceful, Qi does not rebel; when the Kidney is robust, Blood is easily generated. For any case where the fetus is stable with mild *Ezu*, administering this formula invariably restores calmness as before, benefiting the pregnant woman significantly, truly surpassing *Siwu Tang*. This is because *Siwu Tang* specifically treats the Liver, whereas this formula treats more than just the Liver, hence its miraculous efficacy.
Using *Run Gan An Zhen Tang* (Liver-Moistening and Fetus-Calming Decoction) is also excellent.
*Ren Shen* *Fu Ling* *Bian Dou* *Shan Yao* (each 3 qian) *Ban Xia* *Shu Di Huang* *Bai Zhu* (each 5 qian) *Chuan Xiong* *Mai Dong* *Dan Pi* *Su Zi* *Shen Qu* (each 2 qian) *Bai Dou Kou* (1 grain) *Chen Pi* (3 fen) Decoct in water and take orally. After four consecutive doses, *Ezu* ceases.
During the fifth month of pregnancy, limbs become fatigued, food lacks flavor, swelling starts in both feet, gradually spreading to the whole body, and eventually involving the head and face. People assume this is due to dampness, but who knows it is actually deficiency of Spleen and Lung Qi? Although pregnancy involves monthly fetal nourishment, one should not rigidly adhere to months; the main principle is always strengthening the Spleen and tonifying the Lung. The Spleen governs Blood, and the Lung governs Qi. The fetus is not nourished without Blood, and the child is not born without Qi. If the Spleen is healthy, Blood is abundant and nourishes the fetus; if the Lung is clear, Qi is strong and sustains the child. If the Lung declines, Qi fails, and it cannot transport Qi to the skin. If the Spleen is deficient, Blood is scarce, and it cannot transport nutrients to the limbs. With dual deficiency of Qi and Blood, and dysfunction of the Spleen and Lung, food is difficult to digest, and essences fail to transform. Consequently, Qi and Blood sink and cannot ascend. Dampness then takes advantage of these deficient areas, accumulating moisture and causing edema. The treatment method should tonify the deficiency of the Spleen and Lung, rather than focusing on dispelling dampness. The prescription is *Bu Zhong Yi Qi Tang* (Tonify the Middle and Augment the Qi Decoction) with modifications:
*Ren Shen* (5 qian) *Bai Zhu* (5 qian) *Dang Gui* (3 qian) *Huang Qi* (Astragalus Root, 3 qian) *Chen Pi* (3 fen) *Gan Cao* (Licorice Root, 1 fen) *Chai Hu* (Bupleurum Root, 1 qian) *Sheng Ma* (Cimicifuga Rhizome, 3 fen) *Fu Ling* (1 liang) Decoct in water and take orally. After one dose, bloating decreases slightly; after two doses, comfort returns; after three doses, swelling gradually subsides; after four doses, recovery occurs. After ten doses, recurrence is prevented.
*Bu Zhong Yi Qi Tang* originally lifts Spleen and Lung Qi, seemingly tonifying Qi but not Blood. One does not realize that Blood is not generated without Qi. Moreover, with dampness invading, it is inappropriate to tonify Blood directly. Thus, tonifying Qi and assisting with damp-dispelling herbs allows Qi to ascend and water to disperse more easily. Then, why use only small amounts of diuretics? Why heavily use *Fu Ling* up to 1 liang, making it the chief herb for draining water? Using heavy *Fu Ling* within a Qi-tonifying context, although it drains water, still strengthens the Spleen and clears the Lung. Most water-draining herbs consume Qi and Blood, but *Fu Ling* and *Bai Zhu* have more tonifying than draining effects. Therefore, using them heavily to share the burden of dampness is essentially tonifying Qi and Blood.
Using *Tu Jin Shuang Pei Tang* (Earth and Metal Dual-Nourishing Decoction) is also very effective.
*Ren Shen* *Su Zi* *Fu Ling* *Gu Ya* *Ba Ji Tian* *Tu Si Zi* *Bai Shao* (each 3 qian) *Bai Zhu* *Yi Yi Ren* (each 5 qian) *Shan Yao* (5 qian) *Shen Qu* (2 qian) *Sha Ren* (1 grain) *Gan Cao* (2 fen) *Chai Hu* (5 fen) Decoct in water and take orally. After four doses, swelling completely disappears.