《大全》曰∶娠妇心痛，乃风邪痰饮交结。若伤心经，为真心痛，旦发夕死，夕发旦死
。若伤心支络，则乍安乍发。若伤于子脏，则胎动而血下。
按薛氏曰∶前症若饮食所伤，用平胃散加枳壳、山楂。若因错杂诸邪，当审其因而治之
。
(附子痛、小腹痛)
《大全》云∶娠妊心腹痛者，或由宿有冷疼，或新触风寒，皆由脏虚而致动也。邪正相
击而
并于气，随气上下，上冲于心则心痛，下攻于腹则腹痛，故令心腹痛也。娠妊而痛者，邪正
二气交攻于内也。若不时差者，其痛冲击胞络，必致动胎，甚则伤堕也。又云∶娠妊心腹疼
痛，多是风寒湿冷痰饮与脏气相击，故令腹痛，攻冲不已，则致胎动也。
按薛氏曰；前症若风寒痰饮，用金沸草散，杂病咳嗽，胎气郁结，加香附、川芎。若饮
食停
滞，用六君子加紫苏、枳壳。若怒动肝火，前药更加柴、栀。若郁结伤脾，用归脾汤加枳壳
、山栀。
仲景云∶妇人怀胎，腹中诸疾痛，当归芍药散主之。《脉经》曰∶妇人有胎腹痛，其人
不安
。若胎动痛，不动欲知生死，令人摸之，如覆杯者生，如肘颈参差起者死。又冷者死，温者
生。
薛氏曰∶若腹中不时作痛，或小腹重坠，名曰胎痛。用地黄当归汤。未应，加参、术、
陈皮。或因脾气虚，用四君子加归、地。中气虚，补中益气汤(真虚者可用)。
《大全》云∶娠妊小腹痛者，由络虚风寒相搏，痛亦令胎动也。宜紫苏饮加生姜。若腹
胀痛，用安胎饮加升麻、白术，不应，兼用补中益气汤。
《大全》说：孕妇心痛，是由于风邪与痰饮相互纠结。如果损伤了心经，就会形成“真心痛”，早上发作晚上死亡，晚上发作早上死亡。如果损伤的是心的支络，则疼痛时好时发。如果伤及子宫（子脏），就会导致胎动不安并伴有阴道出血。
按薛己的观点说：上述症状如果是饮食所伤，使用平胃散加枳壳、山楂。如果是因各种杂邪交错引起，应当审察病因进行治疗。
《大全》说：妊娠期间出现心腹疼痛，可能是因为原本就有冷痛宿疾，或者是新近触犯了风寒，这都是因为脏腑虚弱而导致病情发作。邪气与正气相互搏击，并随气机上下运行，向上冲逆到心则导致心痛，向下攻冲到腹部则导致腹痛，所以会出现心腹疼痛。妊娠期间的疼痛，是邪气与正气在体内相互交攻所致。如果不时缓解，这种疼痛冲击胞络，必然会导致胎动，严重时甚至会造成流产或堕胎。又说：妊娠期间心腹疼痛，多是风寒湿冷、痰饮与脏腑之气相互搏击，从而导致腹痛，如果攻冲不止，就会导致胎动。
按薛己的观点说：上述症状如果是风寒痰饮引起，使用金沸草散；如果是杂病咳嗽且胎气郁结，加入香附、川芎。如果是饮食停滞，使用六君子汤加紫苏、枳壳。如果是愤怒引动肝火，在前药基础上再加柴胡、栀子。如果是郁结损伤脾气，使用归脾汤加枳壳、山栀。
张仲景说：妇女怀孕后，腹中各种疼痛，用当归芍药散主治。《脉经》说：妇女有胎腹痛的，其人身体不安稳。如果是胎动引起的疼痛，若胎儿未动但想知道其生死，让人用手触摸腹部，感觉像倒扣的杯子那样平滑隆起的为活胎，感觉像肘颈那样参差错落的为死胎。另外，腹部发冷的为死胎，温热的为活胎。
薛己说：如果腹中不时作痛，或小腹有重坠感，称为“胎痛”。用地黄当归汤治疗。如果无效，加入人参、白术、陈皮。如果是由于脾气虚弱，使用四君子汤加当归、地黄。如果是中气虚弱，使用补中益气汤（真正虚损者可用）。
《大全》说：妊娠期间小腹痛，是由于络脉虚弱，风寒相互搏结，疼痛也会导致胎动。宜用紫苏饮加生姜。如果是腹部胀痛，使用安胎饮加升麻、白术，如果无效，兼用补中益气汤。
*Daquan* states: Heart pain in pregnant women is caused by the entanglement of wind pathogen and phlegm-fluid. If the Heart Meridian (Heart Channel) is damaged, it becomes "True Heart Pain" (Zhen Xin Tong), where onset in the morning leads to death in the evening, and onset in the evening leads to death in the morning. If the collateral branches of the Heart are damaged, the pain comes and goes intermittently. If the Zi Zang (uterus) is injured, it causes fetal movement accompanied by vaginal bleeding.
According to Xue Ji: For the aforementioned symptoms caused by dietary injury, use Pingwei San (Calm the Stomach Powder) with added Zhike (Aurantii Fructus Immaturus) and Shanzha (Crataegi Fructus). If caused by a mixture of various pathogens, one should investigate the cause and treat accordingly.
(Attached: Heart pain, Lower abdominal pain)
*Daquan* states: Heart and abdominal pain during pregnancy may arise from pre-existing cold pain or recent exposure to wind-cold. Both result from deficiency in the Zang organs leading to disease activation. When pathogenic and healthy Qi clash and move together with the Qi mechanism, rising to attack the Heart causes heart pain, while descending to attack the abdomen causes abdominal pain, thus resulting in heart and abdominal pain. Pain during pregnancy is due to the mutual attacking of pathogenic and healthy Qi internally. If not relieved promptly, this pain impacts the Bao Luo (uterine collaterals), inevitably causing fetal movement, and in severe cases, miscarriage or abortion. It also states: Heart and abdominal pain during pregnancy is mostly caused by wind-cold-dampness, cold, phlegm-fluid clashing with Zang Qi, leading to abdominal pain. If the attacking sensation continues without relief, it causes fetal movement.
According to Xue Ji: For the aforementioned symptoms caused by wind-cold and phlegm-fluid, use Jinfei Cao San (Boiling Down Herb Powder); for miscellaneous diseases with cough and constrained fetal Qi, add Xiangfu (Cyperi Rhizoma) and Chuanxiong (Ligustici Chuanxiong Rhizoma). For food stagnation, use Liujunzi Tang (Six Gentlemen Decoction) with added Zisu (Perillae Folium) and Zhike. For anger stirring Liver Fire, add Chaihu (Bupleuri Radix) and Zhizi (Gardeniae Fructus) to the previous prescriptions. For constraint injuring Spleen Qi, use Guipi Tang (Restore the Spleen Decoction) with added Zhike and Shanzhi (Gardeniae Fructus).
Zhang Zhongjing states: For women who are pregnant and suffer from various pains in the abdomen, Danggui Shaoyao San (Angelica Sinensis and Peony Powder) is the primary treatment. *Mai Jing* (Pulse Classic) states: Women with fetal abdominal pain feel uneasy. If there is pain due to fetal movement, but the fetus has not yet moved and one wishes to know if it is alive or dead, let someone palpate the abdomen. If it feels like an inverted cup (smooth and rounded), the fetus is alive; if it feels uneven like elbows and necks protruding irregularly, the fetus is dead. Furthermore, if the abdomen is cold, the fetus is dead; if warm, the fetus is alive.
Xue Ji states: If there is intermittent pain in the abdomen or a heavy dragging sensation in the lower abdomen, it is called "Tai Tong" (Fetal Pain). Use Dihuang Danggui Tang (Rehmannia and Angelica Decoction). If ineffective, add Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), and Chenpi (Citri Reticulatae Pericarpium). If due to Spleen Qi deficiency, use Sijunzi Tang (Four Gentlemen Decoction) with added Danggui (Angelicae Sinensis Radix) and Dihuang (Rehmanniae Radix). If due to Middle Qi deficiency, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (can be used for true deficiency).
*Daquan* states: Lower abdominal pain during pregnancy is caused by deficiency in the collaterals and the clashing of wind-cold. The pain can also cause fetal movement. One should use Zisu Yin (Perilla Infusion) with added Shengjiang (Zingiberis Rhizoma Recens). If there is abdominal distension and pain, use Antai Yin (Stabilize the Fetus Infusion) with added Shengma (Cimicifugae Rhizoma) and Baizhu. If ineffective, combine with Buzhong Yiqi Tang.