妊娠受胎，七日一变，今妇人堕胎，必在三月、五月、七月者多；在二月、四月、六月者少。盖诸经养胎，
脏阴而腑
阳，三月属心，五月属脾，七月属肺，皆在五脏之脉，阴常易亏，故多堕耳。如在三月曾堕，后孕至期，必乘其所虚而
三月亦堕，以心脉受伤故也，须预于二月先调其心。五月、七月亦然，必多服健脾益气养荣之药，一有胎后，日不可间
乃佳。唯一月堕胎，人所不知，一月属肝，怒则多堕，洗下体则窍开亦堕，一次既堕，肝脉受伤，下次亦堕，今之无子
者，大半一月堕胎，非尽不受孕也。故凡初交后，最宜将息，勿复交接以扰子宫，勿令劳怒，勿举重，勿洗浴，又多服
养肝平气药，则无一再之坠而胎固矣。若连堕数次，胎元损甚者，服药须多，盖久则胎元可复。其药以养荣、调气、补
肾、益脾，如四物汤去川芎、生地，换熟地，加人参、白术、陈皮、条芩、阿胶、续断、杜仲之类。如有跌扑所伤，须
逐污生新为主，佛手散最妙；腹痛加益母草，服下痛止，则子母俱安。如胎已损，则污物并下，再加童便、制香附、益
母草、陈皮，煎浓汁饮之。如从高坠下，腹痛下血、烦闷，加生地、黄 ，补以安之，如因使内腹痛下血，加参、术、
陈皮、茯苓、炙甘草、砂仁末，以保之；如胎下而去血过多，昏闷欲绝，脉大无力，用浓浓独参汤冲童便服之。小产本
由气血大虚，今当产后，益虚其虚矣，故较正产尤宜调补。
巢氏论诸经脉养胎，各三十日，而十二经中，独心与小肠不养胎，何也？心为牡脏，小肠为腑，主生血而合脉。《经》
曰∶脏直通于心，心藏血，脉之气也。有孕则经脉不通，所谓闭经以养胎也。是知胎以血为本，始终皆在于心，
自不当以输养分次第矣。三月之时，心包络养胎，《灵枢》云∶心包主脉。若分气及胎，脉必虚代。《经》云∶心合脉，
盖心与包，虽分二经，其实原属一脏也。若至期当养之经，虚实不调，则胎必不安，甚则下血而胎堕矣。
夫阳施阴化，胎孕乃成，胎寒则痛，胎热多惊。若血气虚损，不足以荣养其胎，则自堕矣。譬之枝枯则果落，藤萎
则花坠。有因七情太过，五火内发，火能消物而堕者；有因劳力闪挫，伤动其胎而堕者；有因怒动肝火，疏泄用事
而堕者；有因过于房事，盗泄胎元而堕者；正如风撼其树，而根本为动摇也。然小产重于大产，盖胎脏损伤，胞系腐
烂。治宜大补荣卫，生肌肉养脏气，略佐消瘀。若素有堕胎之患者，宜按症预为早治，临期补之无及也。
妊娠半产，非七情六淫，劳役房室，则无是患，故用药与正产无殊，总不外丹溪大补气血为主。如三四月前，胎未
成形而下者，名曰堕胎。至五六月后，胎已成形而下者，名曰半产。总属妊妇气血虚弱，冲任经虚，以致胎元不固，
愈迟者，而气血愈虚也，故千金保胎元不固，愈迟者，而气血愈虚也，故千金保胎丸一方最妙，而赵养葵以六味饮
加杜续、五味、阿胶尤佳，诚为安胎之圣药也。
小产不可轻视，视养十倍于正产。大产如栗熟自脱，小产如生采之。破其皮壳断其根蒂也。忽略成病者不少，因
而致死者恒多，然此症始因敛血以成胎，继因精血以长养，终因精血不足而萎堕，故瘀血甚少。倘有腹痛成块有形，
多属血虚气逆，惟加大为温补，则新者生，而瘀者去。若加消瘀破滞，则逆气愈攻而愈升，多致不救，戒之哉！况有
血虚而腹痛者，更有真阴亏损，不能纳气，以致疝瘕为患者，更有真阴亏损，不能纳气，以致疝瘕为患者，更有真阴亏
损，不能纳气，以致疝瘕为患者，更有真阴亏损，不能纳气，以致疝瘕为患者，（张）常以八味丸加牛膝、五味子者，
早晚吞服而安。
驴马有孕，牡者，近则蹄之，名为护胎所以绝无小产。人之胎系胞中，有气血以养之，静则神藏，欲火一动，则精
神走泄，火扰于中，则胎自堕矣。种玉者，可知欲而不知忌乎。
丹溪曰∶有妇经住三月后，尺脉或涩或微弱，其妇却无病，知是子宫真气不全，故阳不施，阴不化精，血虽凝，
终不成形，至产血块，或产血胞也。惟脉洪盛者，胎可不堕耳。
半产者，此气血不续而不能长养胎元也。然气血不足之中，尚有性禀偏阴偏阳，或寒或热之异，自当凭脉调
治。如阴虚内热者，而用艾、附、白术、砂仁温暖之剂，则阴道愈消，如草木之无雨露，自然枯萎也。如阳虚内寒者，
而用芩、芍凉血之剂，则脾胃虚寒，
气血益弱，犹果品春夏易生，秋冬少结也。故辨症合宜，虽大寒大热，俱可益人，《经》所谓∶应犯而犯，似乎无犯也。
妊娠受孕后，每七天发生一次变化。现在妇女发生堕胎，大多发生在怀孕第三个月、第五个月和第七个月；发生在第二个月、第四个月和第六个月的较少。这是因为各经脉滋养胎儿，脏属阴而腑属阳。第三个月由心经养胎，第五个月由脾经养胎，第七个月由肺经养胎，这些都属于五脏的脉象。阴气容易亏损，所以容易发生堕胎。如果在第三个月曾经堕胎，之后再次怀孕到了这个时期，必定会乘其虚弱而再次在第三个月堕胎，因为心脉已经受伤，所以必须在第二个月预先调理心脏。第五个月和第七个月也是如此，必须多服用健脾益气养血（荣）的药物，一旦受孕，每天都不能间断，这样才好。唯独第一个月堕胎，人们不了解。第一个月属于肝经，发怒容易导致堕胎，清洗下身导致窍孔开放也会导致堕胎。一旦有一次堕胎，肝脉受伤，下次也会堕胎。现在没有子女的人，大半是因为第一个月堕胎，并非完全没有受孕。所以凡是初次同房后，最适宜静养休息，不要再次同房以扰动子宫，不要劳累发怒，不要举重物，不要洗浴，并多服用养肝平气的药物，就不会有反复堕胎的情况，胎儿就能稳固了。如果连续堕胎数次，胎元损伤严重的，服药需要较多，因为时间久了胎元可以恢复。药物以养血、调气、补肾、益脾为主，如四物汤去掉川芎、生地黄，换成熟地黄，加入人参、白术、陈皮、黄芩、阿胶、续断、杜仲之类的药物。如果有跌打损伤，必须以祛除瘀血、生成新血为主，佛手散最为巧妙；腹痛加用益母草，服下后疼痛停止，则母子都平安。如果胎儿已经受损，那么瘀血污物一并排出，再加童便、制香附、益母草、陈皮，煎煮浓汁饮用。如果从高处置坠落，腹痛下血、烦闷，加生地黄、黄柏，补益以安定胎儿；如果是因房事导致腹痛下血，加人参、白术、陈皮、茯苓、炙甘草、砂仁末，以保固胎儿；如果胎儿已下且失血过多，昏闷欲绝，脉象大而无力的，用浓浓的独参汤冲服童便。小产本来是由气血大虚引起的，现在处于产后状态，更是虚上加虚，所以比正常生产更应当调补。
巢元方论述各经脉养胎，各三十天，而在十二经脉中，唯独心和小肠不养胎，为什么呢？心为牡脏（阳脏），小肠为腑，主生血并与脉相合。《内经》说：脏直通于心，心藏血，脉是气的表现。怀孕后经脉不通，所谓闭经是为了养胎。由此可知胎儿以血为本，始终都与心有关，自然不应当按输养分次的顺序来论。第三个月的时候，心包络养胎，《灵枢》说：心包主脉。如果分气及胎，脉必出现虚代现象。《内经》说：心合脉。大概心和心包，虽然分为两条经脉，其实原本属于同一个脏。如果到了该养的时期，当养的经脉虚实不调，那么胎儿必然不安，甚至下血而堕胎。
阳气施放，阴气化育，胎孕才能形成。胎寒则痛，胎热多惊。如果气血虚损，不足以营养胎儿，就会自然堕胎。好比树枝枯死果实就会掉落，藤蔓枯萎花朵就会坠落。有的因为七情太过，五火内生，火能消物而导致堕胎；有的因为劳力闪挫，伤动胎儿而导致堕胎；有的因为发怒触动肝火，疏泄功能过盛而导致堕胎；有的因为房事过度，盗泄胎元而导致堕胎。正如风吹撼树木，根本动摇一样。然而小产重于大产，因为胎脏损伤，胞系腐烂。治疗应当大补营卫，生肌肉养脏气，略微辅助消除瘀血。如果素来有堕胎病史的患者，应当根据症状预先及早治疗，临期再补就来不及了。
妊娠半产，如果不是七情六淫、劳役房室所致，就没有这种祸患，所以用药与正常生产没有不同，总不外乎丹溪主张的大补气血为主。如在三四个月前，胎儿未成形而下落的，名叫堕胎。到了五六个月后，胎儿已成形而下落的，名叫半产。总属于孕妇气血虚弱，冲任二脉虚弱，以致胎元不稳固，时间越久，气血越虚弱。所以千金保胎丸这一方子最好，而赵养葵用六味地黄丸加杜仲、续断、五味子、阿胶尤其好，确实是安胎的圣药。
小产不可轻视，调养程度十倍于正常生产。大产像栗子成熟自然脱落，小产像生采下来，破开皮壳切断根蒂。忽略此症而成病的人不少，因此致死的也很多。然而这个病症开始是因为收敛血液以成胎，接着因为精血来长养，最终因为精血不足而萎堕，所以瘀血很少。如果有腹痛成块有形，多属于血虚气逆，只有加大温补力度，那么新的血液生成，瘀血去除。如果加用消瘀破滞的药物，那么逆气会更加攻伐而上升，多导致无法救治，要警惕啊！况且有血虚而腹痛的，更有真阴亏损，不能纳气，以致疝瘕为患者，常用八味丸加牛膝、五味子，早晚吞服而安定的。
驴马有孕，公马靠近时踢它的蹄子，名叫护胎，所以绝无小产。人的胎儿系在胞宫中，有气血来滋养它，安静则神志内藏，欲望之火一动，则精神走泄，火扰于中，则胎儿自然堕落了。种玉（指求子）的人，可知只知追求欲望而不知道禁忌吗？
朱丹溪说：有妇女月经停住三个月后，尺脉或涩或微弱，这位妇女却没有病，知道是子宫真气不全，所以阳气不施放，阴气不化精，血液虽凝结，终究不成形，到生产时流出血块，或者流出血胞。只有脉象洪盛的，胎儿才不会堕落。
半产，这是气血不接续而不能长养胎元。然而气血不足之中，还有禀性偏阴偏阳，或寒或热的差异，自然应当凭脉象调治。如阴虚内热的，如果用艾叶、附子、白术、砂仁等温暖剂，则阴道更加消耗，如同草木没有雨露，自然枯萎。如阳虚内寒的，如果用黄芩、芍药等凉血剂，则脾胃虚寒，气血更加虚弱，如同果品春夏容易生长，秋冬结果少。所以辨证合适，即使是大寒大热，都可以有益于人，《内经》所谓：应该犯的错误犯了，似乎没有犯错误一样。
Pregnancy conception undergoes a change every seven days. Currently, women who experience spontaneous abortion (miscarriage) mostly do so in the third, fifth, and seventh months of pregnancy; those in the second, fourth, and sixth months are fewer. This is because the meridians nourish the fetus, with Zang organs being Yin and Fu organs being Yang. The third month is governed by the Heart meridian, the fifth by the Spleen meridian, and the seventh by the Lung meridian, all belonging to the pulse patterns of the Five Zang organs. Yin is prone to deficiency, hence miscarriages are common. If a miscarriage occurred in the third month previously, upon subsequent pregnancies reaching that period, it will likely miscarry again in the third month due to the weakness, as the Heart pulse has been injured; thus, one must pre-adjust the Heart in the second month. The same applies to the fifth and seventh months; one must frequently take herbs that invigorate the Spleen, benefit Qi, and nourish Blood (Ying). Once pregnant, daily administration without interruption is ideal. Only the first-month miscarriage is unknown to people. The first month belongs to the Liver meridian; anger often causes miscarriage, and washing the lower body opens the orifices leading to miscarriage. After one miscarriage, the Liver pulse is injured, causing subsequent miscarriages. Most childless individuals today suffer from first-month miscarriages, not from infertility. Therefore, after initial intercourse, rest is most appropriate; avoid further intercourse to disturb the Uterus, avoid labor and anger, avoid lifting heavy objects, avoid bathing, and take more herbs to nourish the Liver and calm Qi, ensuring no repeated miscarriages and stabilizing the fetus. If multiple consecutive miscarriages occur with severe damage to the Fetal Origin, more medication is needed, as long-term use can restore the Fetal Origin. Herbs should focus on nourishing Blood, regulating Qi, tonifying Kidney, and benefiting Spleen, such as Siwu Tang removing Chuanxiong and Raw Rehmannia Root, replacing with Prepared Rehmannia Root, adding Ginseng, Atractylodes Macrocephala Rhizome, Tangerine Peel, Scutellaria Baicalensis Root, Donkey-hide Gelatin, Dipsacus Root, and Eucommia Bark. For traumatic injury, the main treatment should be expelling stasis and generating new blood; Foshou San is best; for abdominal pain, add Motherwort Herb; once pain stops after ingestion, both mother and child are safe. If the fetus is already damaged, bloody discharge will occur together; add Child's Urine, Processed Cyperus Rhizome, Motherwort Herb, and Tangerine Peel, decoct into thick juice and drink. If falling from height causes abdominal pain, bleeding, and irritability, add Raw Rehmannia Root and Phellodendron Bark to tonify and stabilize; if caused by sexual activity leading to abdominal pain and bleeding, add Ginseng, Atractylodes Macrocephala Rhizome, Tangerine Peel, Poria, Roasted Licorice Root, and Amomum Fruit powder to preserve; if the fetus is expelled with excessive bleeding, faintness, and a large but weak pulse, use strong Ginseng Decoction mixed with Child's Urine. Minor miscarriage originates from severe Qi and Blood deficiency; post-miscarriage, deficiency increases, requiring more adjustment and tonification than normal delivery.
Chao Yuanfang discussed that each meridian nourishes the fetus for thirty days, yet among the Twelve Meridians, only the Heart and Small Intestine do not nourish the fetus. Why? The Heart is a Yang organ, the Small Intestine is a Fu organ, both governing blood generation and connecting to the vessels. The Classics state: Zang organs connect directly to the Heart; the Heart stores Blood, and vessels represent Qi. During pregnancy, menstrual flow stops to nourish the fetus. Thus, the fetus relies on Blood as its root, always involving the Heart, and should not be analyzed by sequential meridian nourishment. In the third month, the Pericardium meridian nourishes the fetus. The Ling Shu states: The Pericardium governs the vessels. If Qi and fetus are separated, the pulse may show deficiency or intermission. The Classics say: The Heart combines with the vessels. Although Heart and Pericardium are two meridians, they essentially belong to one Zang. If the relevant meridian is imbalanced at the appropriate time, the fetus becomes unstable, potentially leading to bleeding and miscarriage.
Yang exerts influence, Yin transforms, forming pregnancy. Cold fetus causes pain; heat fetus causes fright. If Qi and Blood are deficient and cannot nourish the fetus, it miscarries naturally. Like dry branches dropping fruit or withered vines losing flowers. Some miscarry due to excessive Seven Emotions triggering internal Fire, which consumes substances; some due to physical strain causing trauma; some due to anger stirring Liver Fire causing excessive dispersion; some due to excessive sexual activity leaking Fetal Origin. It is like wind shaking a tree, disturbing its roots. However, minor miscarriage is more severe than major delivery because the fetal viscera are damaged and the placental connections rot. Treatment requires greatly tonifying Ying and Wei, generating flesh, nourishing visceral Qi, and slightly assisting in eliminating stasis. Those with a history of recurrent miscarriage should be treated early based on symptoms; treating at the time of miscarriage is too late.
Premature birth, unless caused by Seven Emotions, Six Evils, labor, or sexual excess, does not occur. Medication is similar to normal delivery, primarily following Zhu Danxi's principle of greatly tonifying Qi and Blood. Miscarriage before the third or fourth month when the fetus is unformed is called "Spontaneous Abortion." Miscarriage after the fifth or sixth month when the fetus is formed is called "Premature Birth." Both result from maternal Qi and Blood deficiency and Xu Ren meridian weakness, failing to secure the Fetal Origin; the longer the duration, the greater the deficiency. Hence, Qianjin Bao Tai Wan is excellent; Zhao Yangkui's modification of Liuwei Dihuang Pill with Eucommia Bark, Dipsacus Root, Schisandra Berry, and Donkey-hide Gelatin is even better, truly a sacred medicine for securing pregnancy.
Minor miscarriage must not be underestimated; care required is tenfold that of normal delivery. Major delivery is like a ripe chestnut falling naturally; minor miscarriage is like picking it raw, breaking the shell and cutting the stem. Neglect leads to disease and often death. This condition begins with collecting blood to form the fetus, continues with Jing and Blood nourishing it, and ends with insufficient Jing and Blood causing withering and miscarriage, resulting in little stasis. If abdominal pain presents with palpable masses, it is mostly Blood deficiency with rebellious Qi; increasing warming tonification generates new blood and removes stasis. Using stasis-resolving and stagnation-breaking herbs would aggravate rebellious Qi, often leading to untreatable conditions; beware! Furthermore, Blood deficiency causing abdominal pain, or True Yin deficiency failing to grasp Qi leading to hernias and masses, can be stabilized by taking Bawei Wan added with Achyranthes Root and Schisandra Berry morning and night.
Donkeys and horses protect their fetuses; stallions kick the mare's hooves when she is pregnant, named "protecting the fetus," hence no minor miscarriage occurs. Human fetuses reside in the Bao Zhong (uterus), nourished by Qi and Blood. Stillness keeps the Spirit contained; movement of desire causes Spirit leakage, fire disturbs internally, and the fetus miscarries. Those seeking conception know desire but ignore taboos.
Zhu Danxi said: Women whose menstruation stops for three months, with Chi pulse being choppy or weak, yet otherwise healthy, have incomplete Zhen Qi in the Uterus. Thus, Yang does not exert, Yin does not transform essence; although blood coagulates, it never forms properly, resulting in blood clots or membranes during delivery. Only with a surging pulse can the fetus be secured.
Premature birth results from discontinuous Qi and Blood failing to nourish the Fetal Origin. Within Qi and Blood insufficiency, there are variations in constitution (Yin/Yang bias) and temperature (cold/heat), requiring pulse-based regulation. For Yin deficiency with internal heat, using warming agents like Mugwort, Aconite, Atractylodes, and Amomum consumes Yin further, like plants without rain wilting. For Yang deficiency with internal cold, using cooling agents like Scutellaria and Peony damages Spleen-Stomach Yang, weakening Qi and Blood further, like fruits failing to set in autumn/winter. Thus, proper syndrome differentiation allows even extreme cold or heat to benefit the patient, as the Classics state: committing an error appropriately seems like no error.