《大全》云∶妊娠吐血者，皆由脏腑所伤，凡忧思惊怒，皆伤脏腑。气逆于上，血随而
溢，心闷胸满，久而不已。心闷甚，死，妊娠病此，多堕胎也。
立斋云∶前症若肝经怒火，先用小柴胡加山栀、生地，次用前药合四物，后用加味逍
遥散。
肝经风热，防风子芩丸。心经有热，朱砂安神丸。心气不足，补心汤。思虑伤心，妙香散。
胃经有火，犀角地黄汤。膏粱积热，加味清胃散。郁结伤脾，加味归脾汤。肺经有火，黄芩
清肺饮。
《大全》云∶娠妊羸瘦，或挟疾病，脏腑虚损，气血枯竭，不能养胎，致胎动而不坚固
。若终不安者，则可下之，免害娠妇也。
薛氏曰∶前症宜用腰腹背痛门方论主治，其胎果不能安者方可议下，慎之慎之。
丹溪云∶阳施阴化，胎孕乃成，血气虚损不荣养，其胎自堕。或劳怒伤情，内火便动，
亦能
自堕。推原其本，皆因热火消物，造化自然，《病源》乃谓风冷伤于子脏而堕，此未得病情
者也。昔者一妇但有孕至三月左右必堕，诊其左手大而无力，重取则涩，知其血少也。以其
少年，只补中气，使血自荣，时正初夏，教以浓煎白术汤下黄芩末一钱，服三四十帖遂得保
全其生(单用白术补中，以荣出中焦，土生万物也)。因而思之，堕因内热，而虚者为多，曰
热曰虚，当分轻重。盖孕至三月，正属相火，所以易堕，不然何以黄芩、熟艾(熟艾性温，
亦助相火，若果有热，或恐不宜)、阿胶等为安胎圣药耶(好生之工，幸毋轻视)?
《妇人大全良方》说：妊娠期间吐血，都是由于脏腑受到损伤。凡是忧愁、思虑、惊恐、愤怒等情绪，都会伤害脏腑。气机逆乱向上，血液随之溢出，导致心中烦闷、胸部胀满，如果长期不愈，病情加重，会导致死亡。孕妇患此病，大多会发生流产。
薛己（立斋）说：上述症状如果是肝经怒火所致，先用小柴胡汤加山栀、生地，再用前面的药合四物汤，最后用加味逍遥散。
如果是肝经风热，用防风子芩丸。心经有热，用朱砂安神丸。心气不足，用补心汤。思虑过度伤心，用妙香散。胃经有火，用犀角地黄汤。饮食厚味积热，用加味清胃散。郁结伤脾，用加味归脾汤。肺经有火，用黄芩清肺饮。
《妇人大全良方》说：孕妇身体消瘦，或者兼夹疾病，导致脏腑虚损，气血枯竭，不能滋养胎儿，致使胎动不安且不坚固。如果始终无法安胎，则可以下胎，以免危害孕妇生命。
薛氏说：上述症状适宜用“腰腹背痛门”中的方论主治，只有当胎儿确实无法保住时，才可以讨论下胎，务必谨慎再谨慎。
朱丹溪说：阳气施放，阴气化生，胎孕才能形成。如果血气虚损，不能荣养胎儿，胎儿就会自然堕落。或者是劳累、愤怒导致情志受伤，内火便发动，也能导致自然堕落。推究其根本原因，都是因为热火消耗物质，这是造化自然的规律，《诸病源候论》却说是风冷伤害子宫而导致堕胎，这是没有掌握病情本质的说法。过去有一位妇女，每次怀孕到三个月左右必然流产，诊察她的左手脉象大而无力，重按则涩，知道她是血少。因为她年轻，只补中气，使血液自然充盈荣养，当时正是初夏，教她用浓煎的白术汤送服一钱黄芩末，服用三四十帖后，终于保全了胎儿的生命（单用白术补益中气，以荣养出自中焦，土能生万物）。由此思考，流产因为内热的情况较多，而虚证的情况也多，关于热和虚，应当区分轻重。大概怀孕到三个月，正值相火旺盛之时，所以容易流产，否则为什么黄芩、熟艾（熟艾性温，也会助长相火，如果确实有热，或许不宜使用）、阿胶等是安胎的圣药呢？（爱护生命的医生，希望不要轻视这些道理）。
The *Da Quan* states: Hematemesis during pregnancy is caused by injury to the zang-fu organs. All emotions such as worry, overthinking, fright, and anger injure the zang-fu organs. Qi rebels upward, and blood follows it to overflow, causing mental oppression and chest fullness. If prolonged and unhealed, severe mental oppression leads to death. Pregnant women suffering from this condition often miscarry.
Li Zhai (Xue Ji) stated: For the aforementioned symptoms due to fire from liver channel stagnation, first use Xiao Chai Hu Tang (Minor Bupleurum Decoction) with Shanzhi (Gardeniae Fructus) and Shengdi (Rehmanniae Radix), then combine the previous prescription with Si Wu Tang (Four Substances Decoction), and finally use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder).
For wind-heat in the liver channel, use Fang Feng Zi Qin Wan (Saposhnikoviae and Scutellariae Pill). For heat in the heart channel, use Zhu Sha An Shen Wan (Cinnabar Calming the Spirit Pill). For deficiency of heart qi, use Bu Xin Tang (Tonify Heart Decoction). For overthinking injuring the heart, use Miao Xiang San (Miraculous Fragrance Powder). For fire in the stomach channel, use Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction). For accumulation of heat from rich food, use Jia Wei Qing Wei San (Modified Stomach-Clearing Powder). For constraint injuring the spleen, use Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction). For fire in the lung channel, use Huang Qin Qing Fei Yin (Scutellaria Lung-Clearing Infusion).
The *Da Quan* states: When a pregnant woman is emaciated or complicated by disease, leading to deficiency and damage of the zang-fu organs, depletion of qi and blood, she cannot nourish the fetus, resulting in fetal movement that is not firm. If the fetus remains unstable, abortion may be induced to avoid harming the mother.
Mr. Xue stated: The aforementioned symptoms should be treated according to the formulas and discussions in the section on "Lower Abdominal and Back Pain." Only when the fetus is truly untenable should one consider inducing abortion; exercise utmost caution.
Danxi stated: Yang exerts its influence and yin transforms it, thus conception occurs. If qi and blood are deficient and fail to nourish, the fetus will naturally abort. Alternatively, labor or anger may injure the emotions, stirring internal fire, which can also cause spontaneous abortion. Tracing to the root, all cases involve hot fire consuming substances, following the natural course of creation. The *Bing Yuan* attributes miscarriage to wind-cold injuring the uterus, which fails to grasp the true nature of the pathology. In the past, a woman would invariably miscarry around the third month of pregnancy. Her left hand pulse was large but weak, and rough upon heavy pressure, indicating blood deficiency. Being young, only middle qi was tonified to allow blood to naturally flourish. It was early summer, so she was instructed to take one qian of Huang Qin (Scutellariae Radix) powder with thickly decocted Bai Zhu (Atractodylae Rhizoma) decoction. After taking 30-40 doses, she successfully preserved the pregnancy (Using Bai Zhu alone to tonify middle qi, allowing nourishment to arise from the middle jiao, as earth generates all things). Reflecting on this, miscarriage due to internal heat is common, as is deficiency. One must distinguish the severity of heat versus deficiency. Generally, at three months of pregnancy, the ministerial fire is dominant, making miscarriage more likely. Otherwise, why are Huang Qin (Scutellariae Radix), Shu Ai Ye (Artemisiae Argyi Folium Preparatum), and E Jiao (Colla Corii Asini) considered sacred herbs for calming the fetus? (Physicians who cherish life should not underestimate these principles).