Whether pregnant women can use Ligusticum chuanxiong (Chuanxiong, 川芎) was rarely a matter of debate in ancient times. Zhang Zhongjing included generous amounts of Chuanxiong in many of his prescriptions for pregnant women, and no classical materia medica ever recorded it as contraindicated during pregnancy. Yet in the modern era, people have become inexplicably cautious — banishing Chuanxiong to the cold palace on the basis of no evidence whatsoever.
When I prescribe for pregnancy support, I mostly reach for Taishan Panshi Powder (泰山磐石散) in the first trimester — and it contains Chuanxiong. If patients fill their prescriptions elsewhere, they often come back telling me the pharmacy refused to dispense it because it contains blood-activating herbs. At that point I stake my professional reputation on telling them: find a way to get it filled — not a single herb can be omitted.
In treating pregnancy nausea and vomiting (恶阻), I also routinely use Pinellia (Banxia, 半夏) alongside Chuanxiong. Banxia is indicated because the Essentials from the Golden Cabinet explicitly prescribes Dried Ginger, Pinellia, and Ginseng Pill for pregnancy-related vomiting. Chuanxiong, on the other hand, is inspired by Sun Simiao’s Thousand Golden Essential Prescriptions — the King of Medicine included Chuanxiong in most of his formulas for nausea of pregnancy. Clearly, when a pregnant woman needs to harmonize qi and blood, regulate the spleen and stomach, and clear deficient heat, Chuanxiong is an indispensable medicine.
However, due to the prolonged neglect of traditional Chinese medicine in China since 1949, the caliber of TCM practitioners has suffered — and the shortage of qualified Chinese materia medica professionals is even more severe. Most dispensers hired by pharmacies today do not hold bachelor’s degrees; those with genuine pharmaceutical knowledge are exceedingly rare. Few pharmacies can afford to keep an experienced senior herbalist on staff. Compounding this is today’s adversarial doctor-patient relationship. Since Chuanxiong is classified as a blood-activating herb, the knee-jerk conclusion is that it must not be given to pregnant women — even though the Chinese Pharmacopoeia contains no contraindication warning for use during pregnancy.
When all is said and done, the reason TCM as a whole has deteriorated so severely comes down to one thing: inadequate scholarship.
Heartbreaking.
中文原文 / Chinese Original
孕妇能不能用川芎这个问题，古代很少有争论，医生张仲景的许多给孕妇的处方中都使用了大量的川芎，历代本草从未出现孕妇忌用川芎的记载，反而到了新世纪，人们倒束手束脚起来，在毫无根据的情况下把川芎打入了冷宫。
我给孕妇保胎，早期大多选用泰山磐石散，里面就含有川芎，如果患者不在我这里拿药，一般都会反馈我说外面不给她抓，因为里面有活血药。这时候我就要拼上身家性命告诉她，必须想办法抓，一味都不能少。
我治疗妊娠恶阻，一般也会用到半夏和川芎，用半夏是因为金匮要略明确记载妊娠呕吐要用干姜半夏人参丸，用川芎是收到孙思邈千金方的启迪，药王在恶阻病的处方中多数都含有川芎，可见孕妇需要和气血、理脾胃、清虚热，川芎是不可或缺的良药。
然而，由于新中国成立后我国对中医药长期的不重视，中医人才的水平就不说了，中药人才其实更加短缺，现在的药店里聘用的调剂员大多数没有本科学历，具有中药常识的少之又少。很少有药店能常年请的动有经验的老药工坐镇。加之当前医患关系之恶劣，川芎既然作为活血药，当然是不能给孕妇使用的，即使中国药典中并无孕妇禁忌的相关警示。
说来说去，现在中医的水平之所以整体下降这么严重，还是学业不精的问题。
痛心疾首！
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