【歌】心痛多端仔细占，风寒痰热总相兼，火龙散共砂仁散，痛甚延胡及手拈。
【论】大全曰∶妊娠心痛乃气邪痰饮交结，若伤心正经为真心痛，则爪甲青，旦发夕死，夕发旦死。若伤支
络，则乍安乍作，名厥心痛。若伤于子脏，则胎动而下血。妊娠心痛，非止一端，当审脉症而治之。
【方】
火龙散
川楝子 茴香（各三钱） 艾叶（一钱五分，盐水炒）
水煎服。
手拈散
延胡索 五灵脂 草果 乳香 没药
末服一钱。
【歌】上下攻冲胸腹疼，阴阳邪正互相争，当归芍药原方治，香附砂仁亦有能。
【论】胸腹痛者，或宿有冷痛，或新触风寒，皆由脏虚而致也。邪正相搏而并于气，随气上下，上冲于胸则
胸痛，下攻于腹则腹痛也。
张仲景曰∶妇人怀娠腹中疼痛，当归芍药散。
【方】
当归芍药散
当归（三两） 白芍（一斤） 茯苓（四两） 白术（四两） 泽泻（八两） 川芎（三两）
末服一钱。
缩砂饮
砂仁（炒）
为末酒调二钱，觉腹中热胎即安。
【歌】妊妇胞胎系肾经，一毫触犯不安宁，青蛾通气调肝肾，还恐胎元不久停。
【论】何松庵曰∶腰痛脉大而痛不已者，肾虚也，青蛾丸。脉涩而日轻夜重者，气血凝滞也，缩砂饮。脉浮
者，为风邪所乘，大豆紫汤。脉实者，闪挫也，通气散，总以安胎为主。
【方】
通气散
补骨脂
炒为末，嚼胡桃以酒服三钱。
青娥不老丸
杜仲（一斤，姜炒） 补骨脂（四两，盐酒炒） 桃肉（十枚）
蜜丸服。
鹿角散
鹿角长六寸，烧赤淬酒中，又烧又淬，取酒服。
【歌诀】心痛的症状多种多样，需要仔细辨别，通常由风寒、痰饮和热邪相互兼夹引起。治疗可用火龙散或砂仁散，如果疼痛剧烈，可使用延胡索及手拈散。
【论述】《大全》指出：妊娠期间的心痛是由于气邪与痰饮交结所致。如果损伤了心脏的正经，称为“真心痛”，症状表现为指甲发青，早晨发病傍晚死亡，傍晚发病早晨死亡。如果损伤的是分支络脉，则疼痛时好时坏，间歇发作，称为“厥心痛”。如果损伤了子宫（子脏），则会导致胎动不安并伴有阴道出血。妊娠期心痛的原因不止一种，应当审察脉象和症状来进行治疗。
【方剂】
火龙散
川楝子、茴香（各三钱）、艾叶（一钱五分，用盐水炒制）
用水煎煮后服用。
手拈散
延胡索、五灵脂、草果、乳香、没药
研成细末，每次服用一钱。
【歌诀】疼痛上下攻冲于胸腹部，是阴阳邪正相互争斗的表现。治疗可用当归芍药散的原方，香附和砂仁也有疗效。
【论述】胸腹痛的原因，有的是素有冷痛旧疾，有的是新近触犯风寒，这都是由于脏腑虚弱所导致的。邪气与正气相搏结并汇聚于气分，随着气的运行上下流动，向上冲击胸部则导致胸痛，向下攻冲腹部则导致腹痛。
张仲景说：妇女怀孕后腹中疼痛，适用当归芍药散。
【方剂】
当归芍药散
当归（三两）、白芍（一斤）、茯苓（四两）、白术（四两）、泽泻（八两）、川芎（三两）
研成细末，每次服用一钱。
缩砂饮
砂仁（炒制）
研成细末，用酒调服二钱，感觉腹中有热气且胎儿安稳即可。
【歌诀】孕妇的胞胎系属于肾经，稍有触动就会不得安宁。使用青娥丸配合通气散来调理肝肾，但仍担心胎元不能长久维持。
【论述】何松庵说：腰痛且脉象大而疼痛不止的，是肾虚所致，用青娥丸。脉象涩且白天轻晚上重的，是气血凝滞所致，用缩砂饮。脉象浮的，是被风邪侵袭所致，用大豆紫汤。脉象实的，是闪挫损伤所致，用通气散。总体原则都以安胎为主。
【方剂】
通气散
补骨脂
炒熟后研成细末，咀嚼胡桃肉并用酒送服三钱。
[Song] Heart pain has many manifestations and requires careful differentiation; it is generally caused by the combination of wind-cold, phlegm, and heat. Huolong San (Fire Dragon Powder) or Sharen San (Amomum Powder) may be used. If the pain is severe, Yanhusuo (Corydalis Rhizome) and Shounian San (Hand-Picking Powder) can be employed.
[Discussion] *Daquan* states: Heart pain during pregnancy is caused by the entanglement of qi pathogenic factors and phlegm-fluids. If the main meridian of the heart is injured, it is called "Zhenxintong" (True Heart Pain), characterized by cyanosis of the fingernails; if onset occurs in the morning, death follows in the evening, and vice versa. If the collateral branches are injured, the pain comes and goes intermittently, known as "Juexintong" (Rebellious Heart Pain). If the uterus (Zizang) is injured, it leads to fetal movement and vaginal bleeding. There are various causes for heart pain during pregnancy; treatment should be based on a thorough examination of pulse and symptoms.
[Formula]
Huolong San (Fire Dragon Powder)
Chuanlianzi (Toosendan Fruit) and Huixiang (Fennel Fruit), each 3 qian; Aiye (Mugwort Leaf), 1.5 qian, stir-fried with salt water.
Decoct in water and take orally.
Shounian San (Hand-Picking Powder)
Yanhusuo (Corydalis Rhizome), Wulingzhi (Trogopterus Dung), Caoguo (Black Cardamom Fruit), Ruxiang (Frankincense), Moyao (Myrrh).
Grind into powder, take 1 qian per dose.
[Song] Pain attacking up and down in the chest and abdomen indicates a struggle between yin-yang pathogens and righteous qi. The original formula Danggui Shaoyao San (Angelica and Peony Powder) is indicated; Xiangfu (Cyperus Rhizome) and Sharen (Amomum Fruit) are also effective.
[Discussion] Chest and abdominal pain may result from pre-existing cold pain or recent exposure to wind-cold, both arising from deficiency of the zang-organs. When pathogens and righteous qi contend and converge in the qi mechanism, they move up and down with the qi. Ascending to the chest causes chest pain; descending to the abdomen causes abdominal pain.
Zhang Zhongjing stated: For women suffering from abdominal pain during pregnancy, Danggui Shaoyao San (Angelica and Peony Powder) is indicated.
[Formula]
Danggui Shaoyao San (Angelica and Peony Powder)
Danggui (Angelica Sinensis Root), 3 liang; Baishao (White Peony Root), 1 jin; Fuling (Poria), 4 liang; Baizhu (Atractylodes Macrocephala Rhizome), 4 liang; Zexie (Alisma Rhizome), 8 liang; Chuanxiong (Ligusticum Rhizome), 3 liang.
Grind into powder, take 1 qian per dose.
Suosha Yin (Amomum Decoction)
Sharen (Amomum Fruit), stir-fried.
Grind into powder, mix with wine and take 2 qian. It is considered effective when warmth is felt in the abdomen and the fetus becomes stable.
[Song] The fetal sac in pregnant women is connected to the Kidney Meridian; any slight disturbance causes instability. Qing'e Wan (Green Helmet Pill) combined with Tongqi San (Qi-Regulating Powder) regulates the Liver and Kidneys, yet one may still worry that the fetal foundation will not endure long.
[Discussion] He Song'an stated: Lower back pain with a large pulse and unceasing pain indicates Kidney deficiency, treated with Qing'e Wan (Green Helmet Pill). A choppy pulse with symptoms lighter in the day and heavier at night indicates stagnation of qi and blood, treated with Suosha Yin (Amomum Decoction). A floating pulse indicates invasion by wind-pathogens, treated with Dadouzi Tang (Soybean Purple Decoction). A excess pulse indicates sprain or trauma, treated with Tongqi San (Qi-Regulating Powder). The general principle is to prioritize stabilizing the fetus.
[Formula]
Tongqi San (Qi-Regulating Powder)
Buguzhi (Psoralea Fruit).
Stir-fry until cooked, grind into powder. Chew with walnut meat and swallow with wine, 3 qian per dose.
Qing'e Bulao Wan (Green Helmet Anti-Aging Pill)
Duzhong (Eucommia Bark), 1 jin, stir-fried with ginger juice; Buguzhi (Psoralea Fruit), 4 liang, stir-fried with salt and wine; Taorou (Peach Kernel/Meat), 10 pieces.
Form pills with honey and take orally.
Lu Jiao San (Deer Horn Powder)
Deer horn, 6 cun long.
Heat until red-hot, quench in wine. Repeat heating and quenching several times, then drink the wine.