胎前产后,症亦繁多。大法胎前以安胎为第一义,产后以行血为第一义。然安胎之药,
不专
恃芩术也。形盛气实,胎常不运者,非香砂耗之不安,血虚火旺,腹常急痛者,非芎归养之
不安。体肥痰盛,呕逆眩运者,非芩半豁之不安。或因风寒外伤,而胎不安者,桂枝汤香苏
饮皆宜。此安胎之要诀。若兼目疾,治法亦不外此,惟气虚不运者,发在右目,翳障羞明,
宜补气和中,如四君子加香砂之类是也。血虚不能滋养肝木,化火生风者,发在左目,星翳
肉,宜补血清热,如四物汤加黄芩之类是也。若风寒外感,发为目病,而兼妊娠,宜解散
之中
兼和血调气,如苏梗枳壳芎归之类,皆可参用也。产后有三冲三急三禁。三冲者,瘀血之冲
肺冲心冲胃也。三急者,新产之呕吐泄泻多汗也。三禁者,禁佛手散,以川芎能发汗也;禁
四物汤,以地黄能作泻也;禁小柴胡汤,以黄芩能阻恶露也。若兼目疾,因气血大亏,不能
裹精而为瞳神散大,宜急补气血,固敛精膏。或因去血过多,木失所养,而为翳雾羞明,宜
养血平肝。有哭泣悲伤,而为拳毛倒睫者。有邪乘空窍而为沿烂流泪者,皆气血不足所致,
治宜护肝养血。盖产后肝胆发生之气甚弱,而血液衰少,必须调护培养,务在早治,莫待病
根深入,为终身之患也。
妊娠期间和产后,病症种类繁多。治疗的大法是:妊娠期以安胎为首要原则,产后以活血行血为首要原则。然而,安胎的药物,并不专门依赖黄芩和白术。形体壮实、气机壅盛,导致胎动不安的,非用香附、砂仁等理气药耗散其滞不能安定;血虚火旺,腹部经常急痛的,非用川芎、当归养血润燥不能安定。身体肥胖、痰湿盛重,出现呕吐逆气、头晕目眩的,非用黄芩、半夏化痰清热不能安定。或者因为风寒外邪侵袭,导致胎动不安的,桂枝汤或香苏饮都适宜。这是安胎的要诀。如果兼有眼疾,治疗方法也不超出这个范围,只是气虚运行无力导致的,病发在右眼,出现翳障、畏光羞明,宜补气和中,如四君子汤加香附、砂仁之类就是适用的。血虚不能滋养肝木,化火生风的,病发在左眼,出现星形翳膜、肉(注:原文“肉”后似缺字,依语境推测可能指胬肉或类似病变,此处直译),宜补血清热,如四物汤加黄芩之类就是适用的。如果因风寒外感,引发眼病,且兼有妊娠,宜在解散表邪的同时兼顾和血调气,如紫苏梗、枳壳、川芎、当归之类,都可以参考使用。
产后有三冲、三急、三禁。所谓三冲,是指瘀血上冲肺、冲心、冲胃。所谓三急,是指新产之后出现的呕吐、泄泻、多汗。所谓三禁,是禁止使用佛手散,因为川芎能发汗;禁止使用四物汤,因为地黄会导致腹泻;禁止使用小柴胡汤,因为黄芩会阻碍恶露排出。如果兼有眼疾,是因为气血大亏,不能固摄精气而导致瞳神散大,宜紧急补益气血,固敛精膏。或者因为失血过多,肝木失去滋养,导致翳雾、畏光羞明,宜养血平肝。有因哭泣悲伤,导致拳毛倒睫的。有因邪气乘虚侵入空窍,导致眼睑溃烂流泪的,这些都是气血不足所致,治疗宜护肝养血。因为产后肝胆发生之气非常微弱,而血液衰少,必须调理养护培养,务必尽早治疗,不要等到病根深入,成为终身的隐患。
During pregnancy and postpartum, symptoms are numerous. The general principle is that during pregnancy, the primary goal is to calm the fetus (An Tai), while after childbirth, the primary goal is to promote blood circulation (Xing Xue). However, herbs for calming the fetus do not rely solely on Huangqin (Scutellariae Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma). In cases where the constitution is robust and qi is excessive, causing fetal restlessness, it cannot be stabilized without using aromatic and acrid herbs like Xiangfu (Cyperi Rhizoma) and Sharen (Amomi Fructus) to dissipate stagnation. In cases of blood deficiency with hyperactive fire, causing frequent abdominal cramping, it cannot be stabilized without nourishing blood with Chuanxiong (Ligustici Chuanxiong Rhizoma) and Danggui (Angelicae Sinensis Radix). In cases of obesity with abundant phlegm, causing vomiting, retching, dizziness, and vertigo, it cannot be stabilized without resolving phlegm with Huangqin (Scutellariae Radix) and Banxia (Pinelliae Rhizoma). If fetal restlessness is caused by external wind-cold invasion, Guizhi Tang (Cinnamon Twig Decoction) or Xiangsu Yin (Perilla Leaf Infusion) are both suitable. These are the essential principles for calming the fetus.
If accompanied by eye diseases, the treatment methods do not deviate from these principles. For cases due to qi deficiency failing to move properly, manifesting in the right eye with nebulae, photophobia, and aversion to light, one should tonify qi and harmonize the middle jiao, such as using Sijunzi Tang (Four Gentlemen Decoction) plus Xiangfu and Sharen. For cases of blood deficiency failing to nourish the liver wood, transforming into fire and generating wind, manifesting in the left eye with stellate nebulae and fleshy growths, one should nourish blood and clear heat, such as using Siwu Tang (Four Substances Decoction) plus Huangqin. If an eye disease is triggered by external wind-cold in a pregnant woman, one should resolve the exterior while simultaneously harmonizing blood and regulating qi; herbs such as Suzhugeng (Perillae Caulis), Zhike (Aurantii Fructus Immaturus), Chuanxiong, and Danggui can all be considered.
Postpartum involves three rushes (San Chong), three urgencies (San Ji), and three prohibitions (San Jin). The three rushes refer to blood stasis rushing upward to the lungs, heart, and stomach. The three urgencies refer to vomiting, diarrhea, and profuse sweating occurring immediately after childbirth. The three prohibitions are: prohibiting Foshou San (Buddha's Hand Powder) because Chuanxiong can induce sweating; prohibiting Siwu Tang because Dihuang (Rehmanniae Radix) can cause diarrhea; and prohibiting Xiaochaihu Tang (Minor Bupleurum Decoction) because Huangqin can obstruct the discharge of lochia.
If eye diseases accompany the postpartum state due to severe deficiency of qi and blood, failing to contain essence and resulting in dilation of the pupil, urgent tonification of qi and blood to consolidate and astringe essence is required. Or, if excessive blood loss leads to liver wood losing its nourishment, resulting in misty nebulae and photophobia, nourishing blood and pacifying the liver is indicated. Cases may arise from crying and sorrow leading to trichiasis (Quanmao Daojie). Cases may also arise from pathogenic factors invading empty orifices, leading to eyelid ulceration and tearing. All these are caused by insufficiency of qi and blood; treatment should focus on protecting the liver and nourishing blood. Since the generation qi of the liver and gallbladder is very weak postpartum, and blood is depleted, careful regulation, nursing, and cultivation are necessary. Early treatment is crucial; do not wait for the root of the disease to penetrate deeply, becoming a lifelong affliction.