20.气血充实胎自安, 冲任虚弱损胎原, 暴怒房劳伤肝肾, 疾病相干
跌扑颠. 五月成形名小产, 未成形像堕胎言, 无故至期数小产, 须慎
胎为欲火煎.
【注】孕妇气血充足, 形体壮实, 则胎气安固. 若冲, 任二经虚损,
则胎不成实. 或因暴怒伤肝, 房劳伤肾, 则胎气不固, 易致不安; 或
受孕之后, 患生他疾, 干犯胎气, 致胎不安者亦有之; 或因跌扑筑磕
,从高坠下, 以致伤胎, 堕胎者亦有之. 然小产, 堕胎, 亦自有别:
五,七月已成形像者, 名为小产, 三月未成形像者, 谓之堕胎. 以上
小产, 堕胎皆出有因, 若怀胎三, 五, 七月, 无故而胎自堕, 至下次
受孕亦复如是, 数数堕胎, 则谓之滑胎. 多因房劳太过, 欲火煎熬,
其胎因而不安, 不可不慎者也.
加味圣愈汤 加味佛手散 十圣散 加味芎藭汤 益母丸
21.胎伤腹痛血未下, 圣愈汤加杜续砂, 下血腹痛佛手散, 胶艾杜续
术芩加. 十全续缩减苓桂, 因病伤胎十圣夸, 跌扑芎藭调益母, 怒劳
逍遥地黄佳.
【注】妊娠胎伤, 若腹痛不下血者, 宜用圣愈汤加杜仲, 续断, 砂仁
安之. 若下血腹痛者, 宜用佛手散加阿胶, 蕲艾, 杜仲, 续断, 白术
,条芩安之. 若因母病, 以致伤胎欲堕者, 宜十圣散, 即十全大补汤
减茯苓, 肉桂, 加续断, 砂仁. 若因跌扑筑磕, 伤胎欲堕者, 宜芎藭
汤调益母丸服之. 芎藭汤即川芎, 当归也. 若暴怒, 房劳伤肝肾, 以
致胎动不安者, 宜逍遥散, 地黄汤治之.
圣愈汤 佛手散 逍遥散 地黄汤 方俱见首卷
20. 气血充盛，胎元自然安固；冲任二脉虚弱，则损伤胎元之根本。暴怒或房事过度会损伤肝肾，疾病干扰或跌打撞击也会造成危害。怀孕五个月胎儿成形称为小产，未成形则称为堕胎。若无明显原因在预产期前多次发生小产，必须谨慎对待，因为多因欲火煎熬所致。
【注】孕妇若气血充足、形体壮实，则胎气安固。如果冲脉和任脉虚损，则胎元不能结实稳固。或者因暴怒伤肝、房劳伤肾，导致胎气不固，容易引发胎动不安；或者受孕之后，患上其他疾病，干扰胎气，也会导致胎不安宁；或者因跌打碰撞、从高处坠落，以致伤胎，导致堕胎的情况也存在。然而，小产与堕胎自有区别：怀孕五至七月，胎儿已具形像的，称为小产；怀孕三月，尚未成形的，称为堕胎。以上所说的小产、堕胎都是有原因的。如果怀孕三、五、七月，无故而胎自堕，下次受孕也是如此，屡次堕胎，则称为滑胎。这多因房劳太过，欲火煎熬，致使胎元不安，不可不慎。
21. 胎伤腹痛但血未下者，用圣愈汤加杜仲、续断、砂仁；若见下血且腹痛，用佛手散加阿胶、艾叶、杜仲、续断、白术、黄芩。因母体疾病伤胎欲堕者，用十全大补汤减去茯苓、肉桂（即十圣散）以夸耀其效；因跌打损伤致胎欲堕者，用芎藭汤调服益母丸；因暴怒或劳倦伤及肝肾致胎动不安者，用逍遥散合地黄汤治疗为佳。
【注】妊娠期间胎元受损，若出现腹痛但未下血，适宜使用圣愈汤加入杜仲、续断、砂仁来安胎。若出现下血且腹痛，适宜使用佛手散加入阿胶、蕲艾、杜仲、续断、白术、条芩来安胎。若因母亲患病，以致伤胎欲堕，适宜使用十圣散，即由十全大补汤减去茯苓、肉桂，加入续断、砂仁组成。若因跌打碰撞，伤胎欲堕，适宜服用芎藭汤调和益母丸。芎藭汤即由川芎、当归组成。若因暴怒、房劳损伤肝肾，以致胎动不安，适宜用逍遥散、地黄汤治疗。
20. When Qi and Blood are abundant, the fetus is naturally secure; when the Chong and Ren meridians are deficient, the root of the fetus is damaged. Sudden anger or excessive sexual activity damages the Liver and Kidney; diseases interfering with pregnancy or physical trauma also cause harm. Fetal expulsion at five months, when the fetus has formed, is called spontaneous abortion (Xiao Chan); before formation, it is called miscarriage (Duo Tai). If spontaneous abortions occur repeatedly at term without obvious cause, one must be cautious, as this is often due to the simmering of desire fire.
[Note] If a pregnant woman has sufficient Qi and Blood and a robust physique, the fetal Qi will be stable. If the Chong and Ren meridians are deficient, the fetus cannot become solid. Alternatively, sudden anger may damage the Liver, and sexual fatigue may damage the Kidney, leading to unstable fetal Qi and predisposing to fetal restlessness. Or, after conception, contracting other illnesses may interfere with fetal Qi, causing fetal instability. Or, physical trauma such as bumps, falls from heights, etc., may injure the fetus, leading to miscarriage. However, there is a distinction between Xiao Chan (spontaneous abortion) and Duo Tai (miscarriage): those occurring in the fifth or seventh month, where the fetus has taken shape, are called Xiao Chan; those occurring in the third month, where the fetus has not yet taken shape, are called Duo Tai. The aforementioned cases of Xiao Chan and Duo Tai all have specific causes. If a woman miscaries spontaneously in the third, fifth, or seventh month without reason, and this recurs upon subsequent pregnancies, repeatedly losing the fetus, it is termed Slippery Fetus (Hua Tai). This is mostly due to excessive sexual activity and the simmering of desire fire, which makes the fetus insecure; thus, caution is essential.
Jiawei Shengyu Decoction, Jiawei Foshou Powder, Shisheng San, Jiawei Xiongqiong Tang, Yimu Wan.
21. For fetal injury with abdominal pain but no bleeding, use Shengyu Decoction plus Du Zhong, Xu Duan, and Sha Ren. For bleeding with abdominal pain, use Foshou Powder plus E Jiao, Ai Ye, Du Zhong, Xu Duan, Bai Zhu, and Huang Qin. For fetal threat due to maternal illness, use Shisheng San (Ten Holy Powder), derived from Shiquan Dabu Decoction by removing Fu Ling and Rou Gui, praised for its efficacy. For fetal threat due to physical trauma, use Xiongqiong Tang mixed with Yimu Wan. For fetal restlessness due to sudden anger or fatigue damaging the Liver and Kidney, Xiaoyao San combined with Dihuang Tang is excellent.
[Note] In pregnancy, if the fetus is injured and there is abdominal pain without bleeding, it is appropriate to use Shengyu Decoction added with Du Zhong, Xu Duan, and Sha Ren to calm the fetus. If there is bleeding accompanied by abdominal pain, it is appropriate to use Foshou Powder added with E Jiao, Qi Ai, Du Zhong, Xu Duan, Bai Zhu, and Tiao Qin to calm the fetus. If the fetus is threatened due to maternal illness, it is appropriate to use Shisheng San, which is Shiquan Dabu Decoction minus Fu Ling and Rou Gui, plus Xu Duan and Sha Ren. If the fetus is threatened due to physical trauma, it is appropriate to take Xiongqiong Tang harmonized with Yimu Wan. Xiongqiong Tang consists of Chuan Xiong and Dang Gui. If fetal restlessness is caused by sudden anger or sexual fatigue damaging the Liver and Kidney, it is appropriate to treat with Xiaoyao San and Dihuang Tang.
The formulas for Shengyu Decoction, Foshou Powder, Xiaoyao San, and Dihuang Tang are all found in the first volume of this book.