后交合有孕，及变胎而一男一女者，何与？岂奇日受男，而偶日复受女之理乎？俞子木
又谓∶微阳不能射阴，弱阴不能摄阳，信斯言也。世有 羸之夫，祛弱之妇，屡屡受
胎，而血气方刚，精力过人者，往往有终身不育者，何与？丹溪论以妇人经水为主，然
当富贵之家，侍外家亦多，其中宁无月水如期者？又有经前夫频育，而娶此以图易，则不
受胎，岂能受于彼，而不能受于此耶！大抵父母生子，如天地生物。《易》曰∶坤道其
顺乎，承天而时行，知地之生物，不过顺承乎天，则知母之生子，亦不过顺承乎父而
已。知母之顺承乎父，则种子者，当以男子为主矣，岂可专责之于妇人耶！在男子则不
拘老少强弱，康宁病患，精之易泄难泄，只以交感之时，百脉齐到为善耳。若男女之
辨，不以精血先后为拘，不以经尽几日为拘，不以夜半前后交感为拘，不以父母强弱
为拘，只以精血各由百脉齐到者，别胜负耳。此精之百脉齐到，胜乎血则成男，血之
百脉齐到，胜乎精则成女矣。百脉齐到者，畅遂之极，而无一毫勉强是也。（此成胎以百脉
齐到分男女也。）
李东壁曰∶《易》云一阴一阳之谓道，男女媾精，万物化生，干道成男，坤道成
女，此盖言男女生生之机，阴阳造化之良能也。齐褚澄言∶血先至裹精则生男，精先至
裹血则生女，阴阳均至，非男非女之身，精血散分，骈胎品胎之兆。《道藏》言∶月水
亡后，一三五日成男，二四六日成女。东垣言∶血海始净，一二日成男，三四五成女。
《圣济经》言∶因气而左动，阳资之则成男，因气而右动，阴资之则成女。丹溪乃非褚
氏，而是东垣，主《圣济》左右之说立论，窃谓褚氏未可非也，东垣亦未尽是也。盖褚
氏以精血之先后言，《道藏》以日数之奇偶言，东垣以女血之盈亏言，《圣济》、丹溪以
子宫之左右言，会而通之，理自得矣。
丹溪曰∶或问双胎者，何也？曰∶精气有余，歧而分之，血因分而摄之也。若男女
同孕者，刚日阳时，柔日阴时，感则阴阳混杂，不属左不属右，受气于两岐之间也。亦
有三胎四胎者，犹是而已。《人镜经》曰∶精气盛则成二男，血气盛则成二女，精血皆
盛，则成一男一女，精血混杂，则成非男非女。男不可为父，得阳道之亏者也。女不可
为母，得阴道之塞者也。皆非纯气，或感邪崇鬼怪之 气，则成异类也。
（张）按∶《经》曰∶阳予之正，阴为之主，盖谓阳施正气，万物方生，阴为主持，
群形乃立。更观《易》论，坤道其顺乎天而时行，则知地之生物，顺承乎天，而母之生
子，亦不过顺承乎父，则种子者，当以男子为主，岂可专责之于妇人哉！此诚天生地成
之大道，阳施阴长之至理。每见男子六脉洪大，尺脉有力者，子多女少，六脉沉细，尺
脉沉微者，子少女多，生男亦夭，此属验也。况两神相搏。合而成形，神也者，无形
之谓也。惟其无形，故能生出有形，盖造化之理，皆生于无也，岂日数精粕有迹之谓
欤！故神者，生身之本也。然必因乎精气何也？盖神本无体，以气为体，精无定形，以
气而形，体物有三，根本则一，主虽惟神，养其精气，神必附物，精能凝神，三者互
用，不可相离，平叔所谓穷取生身受气初，夫水之精为志，而火之精即神也。盖欲无火
不动，惟此一点无形元阳之真火，以鼓无形默用之真神，《经》曰∶根于中者，命曰神
机，盖以神为机发之主，动用之道，不期然而然，物莫之知。若可以言语形容者，便非
神之为用矣。更观邪淫苟合者，无心种子，偶意为之，易成胎孕，盖心专神笃，欲火炽
而氤氲之气浓密也。安居妙合者，专心种玉，而兢兢业业，每见无功，盖心耗神驰，
欲火衰而之气反薄矣。可见莫非由于神也，莫非由于火也，更莫非重于阳之为用也。既
禀天地之道，而阴阳之理不能外之，故阳旺多生男，阴旺多生女，即干道成男，坤道成
女之义也。更观古载生人之候，常多外因有感而成，即此情之感触，亦莫非神之为用，
然神之为神，莫非火之为精也。若无火以充其神，则无气以生其精，三者既失，则一团
死灰矣，焉有阳和化育之道，情性感触之用哉！古云三月始胎，未有定仪，气类潜感，
造化密移，此亦天地化工之所有，何得执而为尽？无先哲立言曰∶阳生阴长。又曰∶阳
生阴化。云长云化，岂无用意于其间乎？
孕一月名始膏，二月名始胚，三月名始胎。当胚膏之始，真气方遇，如桃花凝聚，
其柔脆易伤也。食必忌辛辣，恐散其凝结，味必稍甘美，欲扶其柔脆，二气既凝，如泥
在钧，如金在熔，惟陶冶之所成，食气于母，所以养其形，食味于母，所以养其精，
形精为滋育，气味为本，故天之五气，地之五味，母食之而子又食之，外则充乎形质，
内则滋乎胎气，母寒亦寒，母热亦热，母饱亦饱，母饥亦饥，因虚而感，随感而变，膏
梁之家，纵恣口腹，暴怒淫欲，饮食七情之火，钟之于内，胎气受之，怯者，即变为
病，壮者，毒不即发，而痘疹疮惊，贻祸于后焉。故胎前可不慎为调摄乎！
巢氏曰∶妊娠一月，凝成一粒，如露珠然，乃太极动而生阳，名胚胎。天一生水，
谓之胚，足厥阴脉养之，经水即闭，饮食稍异。二月名始膏，变成赤色，如桃花瓣，乃
太极静而生阴，地二生火，谓之 ，足少阳脉养之，吐逆恶阻，或偏嗜一物，以见一
脏之虚也。三月名始胎，手厥阴脉养之，形象始化，乃分男女，乃太极之干道成男，坤
道成女也。四月始受水精以成血脉，形像具，六腑成，手少阳脉养之。五月始受火精
以成阴阳之气，筋骨已成，毛发始生，足太阴脉养之。六月始受金精以成筋。口目皆
成，足阳明脉养之。七月始受木精以成骨，游其魂，能动左手，手太阴脉养之。八月始
受土精以成皮肤，形骸渐长，九窍皆成，游其魂，能动右手，手阳明脉养之。九月始受
石精，以成皮毛，百节毕备，三转其身，足少阴脉养之。十月足太阳脉养之，精神备
足，受气而生。独君主无为，故无所养，然堕胎须防一三五七月者，盖单月皆脏养胎，
而三月又相火所主，胎最易动，尤宜慎之，当服清热凉血安胎之药。然诸经有多气少血
者，有多血少气者，宜各以按月养胎之脏腑气血虚实调之，自无堕胎之患矣。
有养胎以五行，分四时论者。凡人自受胎于胞门，则手足十二经脉，其气血周流，
俱以拥养胎元，岂有逐月分经，某经养某月之胎之理？马玄台已驳之矣，故不具载。巢
氏一月二月是论受胎之月数为近理也。
《圣济》曰∶或者以妊娠勿治，有伤胎破血之论，岂知邪气暴戾，正气衰微，苟执方无权，纵而勿药，则母
将羸弱，子安能保？上古圣人，谓重身毒之，有故无殒，衰其大半而止，盖药之性味本以疗疾，诚能处以中庸，与疾
适当，且知半而止之，亦何疑于攻治哉！慎之者，恐克削破血，有伤胎孕耳。
安胎之法有二，如母病以致动胎者，但疗母则胎自安；若胎气不固，或有触动以致母病者，宜安胎则母自愈。
妇人年幼，天癸未行行属少阴，天癸既行属厥阴，天癸既绝属太阴，治胎产病从厥阴者，是祖气生化之原也。
治法无犯胃气者，是后天化生之源也。及上中下三禁，谓不可汗、不可下、不可利小便，恐亡其津液，而
伤其生气也。
夫二气之感，凝而成形，气血旺，则胎易成而无病，气血弱，则胎多病而难育，食气于母，
所以养其精，食味于母，所以养其形，故胎元以脾胃饮食为本，母子咸赖之今人膏梁浓味，抑郁气恼，而气血渐
亏，痰火必炽，而恶阻、子痫、子肿等病作矣。然胎
前诸症，皆以安胎为主，务使气血和平，则百病不生。若气旺而热，热则耗气血，而胎不安，当清
热养血为主。若起居饮食调养得宜，绝嗜欲安养胎气，则虽成另证，无大害也。丹溪曰∶白术、黄 为安胎
之圣药。俗医谓温剂可以养胎，不知胎前最宜清热，令血循经不妄行，故能养胎。白术益脾以培万物
之母，条芩泻火，能滋子户之阴，与其利而除其害，其胎自安，故黄芩安胎为上中二焦药。益母草治血行
气，有补阴之功，胎前无滞，产后无虚，以行气中有补也。胎至三月、四月忽腹痛，惟砂仁及些
少木香，能治痛行气以安胎也。八九月必须顺气，用枳壳、紫苏之属，但气虚者宜补气以行滞，用参、
术、陈皮、归、芍、甘草、腹皮；气实者，耗气以抑阳，用芩、术、陈皮、甘草加枳壳。如
将临月，胎热者以三补丸加香汤白芍或地黄膏。血虚者，不外四物地黄，加以益母草，预为分娩地步也。至
于世医安胎，多用艾、附、砂仁为害尤甚。不知血气清和，无火煎烁，则胎安而固，气
虚则提不住，血热则溢妄行，胎欲不堕，其可得乎。香附虽云快气开郁，多用则损正气。砂仁快脾气，
多用亦耗真气，香燥之品，气血两伤，求以安胎，适足以损胎矣。惟寒郁气滞者宜之。
赵养葵曰∶或问白术黄芩，安胎之圣药，胎前必不可缺乎？曰∶未尽然也。胎茎之系于肾，犹钟之系于梁，栋柱
不固，栋梁必挠，所以安胎先固两肾，使肾中和暖，始脾有生气，何必定以白术黄芩为安胎耶？凡腹中有热，胎不安者，
宜用凉药。然腹中有寒，胎亦不安，必用温药，此常法也。况两肾中具水火之原，为冲任之根，而胎元之所系甚要，非
白术黄芩之所安也。如肾中无水胎不安者，用六味地黄壮水，肾中无火者，用八味地黄益火。调经当用杜仲、续断、
阿胶、艾叶、当归、五味，出入于六味、八味汤中为快捷方式，总之一以贯之也。诸书之所不及，余特表而出之，此赵氏
之创论也。且脏性所禀之寒热不同，有脏寒不孕，服八味十补而始受娠者，则受娠之后，仍宜照常服之，盖脏腑服
惯，则不觉桂附之热，飞以为常，竟相安于无事，更可长养胎元也。若停止暖药，加以条芩清热之品，要知能安补阳
升举者，必不利补阴降下矣，势必反致坠胎之患，而且有损于胎元。极虚之人脏腑，春夏阳和，升长之气少，秋冬阴
寒，降下之气多也。（张）常治恶阻久吐不止，脉微肢冷者，竟用附子理中汤加五味子，连服数日乃安，但必参术炙
草倍加，则能乘载胎元，其姜附之性，惟从参术以温补中焦，即附子走下之力，不能独发以施其用矣。
古人用黄芩安胎，是因子气过热不宁，故用苦寒以安之，然气血旺脾胃和，胎自无虞，一或有乖，
其胎即堕，是以胎无全赖气血以滋养，而气血又藉谷气以化生，故脾为一身之津梁，主内
外诸气，而胎息运化之机全赖脾土，故用白术以助之，然惟形瘦血热，营行过疾，胎常上逼，过动不安者为
相宜。若形盛气衰，胎常下坠者，非人参举之不安。血虚火旺，腹常不运者，非香砂耗之不安。血虚火旺，
腹常急痛者，非归芍养之不安。体肥痰盛，呕逆眩晕者，非半、苓豁之不安。则桂枝汤、香苏散、葱白香豉
汤，谅所宜用。伏邪时气，尤宜急下，此即安胎之要诀。下药中独芒硝切不可犯，若有客犯而用白术，便
热邪留恋不解，若素患虚寒而服黄芩，则中气脾胃愈伤，皆仅足以伤胎矣。
地之体本重，然得天气以包举之，则生
机不息。若重阴泣寒之区，天日之光不显，则物生实罕，如其人之体肌肉丰盛，乃血之
荣旺，但血旺易至气衰，久而弥觉其偏也。夫气与血，两相维而不可偏，气为主则血
流，血为主则气反不流，非气之衰也，气不流有似乎衰耳。故一切补肌药皆不可用，而
耗气之药，反有可施，缘气得辅则愈锢，不若耗之以助其流动，久之血仍归于统握中
矣。湖阳公主体肥难产，南山道士迸瘦胎方而产得顺利，盖肥满之躯，胎处其中，全无
空隙，以故伤胎之药，止能耗其外之气，而不能耗其内之真气，此用药之妙也。故胎前
宜顺气，气顺则不滞，枳壳散、束胎饮，皆为气实肥盛安佚郁闷者立法耳。若气体虚
弱，元气不足，或虚气胀满，或虚寒腹痛，必须参术大补，岂谓胎前必用耗气药乎？
妇人妊娠，惟在抑阳助阴，然胎前药，最恶群队。若药无专一，则阴阳交错，别生
他病，惟南山道士枳壳散，所以抑阳，四物汤所以助阴，但枳壳散少寒单服，恐有胎寒
腹痛之患。以内补丸佐之，则阳不至强，阴不至弱，阴阳调而孕安，盖妇人平居，阳气
微盛，无诸疾病，则受娠自能经闭以养胎。若阳气太盛，则阳搏于阴，乃经脉妄行，
胎始不固，故贵抑阳助阴者此耳。
丹溪曰∶世之难产者，往往见于郁闷安佚之人，富贵豢养之家。若贫贱辛苦者，无
有也。方书只有瘦胎饮一，按其方为湖阳公主设也，实非极至之论。彼湖阳公主，奉养
太过，其气必实，耗其气使之和平，故易产，此南山道士迸瘦胎枳壳散，抑阳降气，
温隐居加木香、当归佐之。若形肥人其气必虚，久坐其气不运，而气愈弱，儿在胞胎，
交合之后受孕，以及怀胎后生下一男一女的情况，是什么原因呢？难道是奇日受胎生男，偶日复受胎生女的道理吗？俞子木又说：微弱的阳气不能射入阴中，虚弱的阴气不能摄持阳气，相信这话。世上有身体瘦弱衰败的丈夫和体弱多病的妻子，却屡屡受孕；而血气方刚、精力过人的人，往往终身不育，这是什么原因呢？朱丹溪论述以妇人的月经为主，然而富贵人家，侍妾众多，其中难道没有月经如期而至的吗？又有在娘家时频繁生育，嫁过来想换个环境却不再受孕的，难道能在彼处受孕，却不能在此处受孕吗！大抵父母生子，如同天地化生万物。《易经》说：地道柔顺，承奉天道而按时运行，知道大地化生万物，不过是顺承天道，那么母亲生子，也不过是顺承父亲罢了。知道母亲顺承父亲，那么求子的关键，应当以男子为主了，怎么能专门责备妇人呢！对于男子来说，不论老少强弱，健康或患病，精液易泄还是难泄，只要在交感之时，百脉气血同时到达即可。至于男女之辨，不拘泥于精血先后的顺序，不拘泥于月经干净后几天，不拘泥于夜半前后交感的时间，不拘泥于父母体质的强弱，只以精血各自由百脉同时到达来辨别胜负罢了。这精液的百脉同时到达，胜过血液则成男，血液的百脉同时到达，胜过精液则成女了。所谓百脉同时到达，就是畅达遂意到了极点，而没有丝毫勉强的情况。（这是通过百脉是否同时到达来区分胎儿性别的。）
李东壁（李时珍）说：《易经》讲一阴一阳叫做道，男女交媾精气结合，万物化生，乾道成就男性，坤道成就女性，这大概是说明男女生生不息的机理，阴阳造化的良能啊。褚澄说：血液先到包裹精液则生男，精液先到包裹血液则生女，阴阳均等到达，则生非男非女的身体，精血散分，则是双胎或多胎的征兆。《道藏》说：月经结束后，初一、初三、初五成男，初二、初四、初六成女。李东垣说：血海刚刚干净，第一二天成男，第三四五天成女。《圣济经》说：因气机向左动，阳气资助则成男，因气机向右动，阴气资助则成女。朱丹溪否定褚氏的观点，而赞同李东垣，依据《圣济经》左右之说立论，我认为褚氏不可非议，李东垣也未尽正确。大概褚氏是从精血先后的角度说的，《道藏》是从日数的奇偶角度说的，李东垣是从女子血的盈亏角度说的，《圣济经》和朱丹溪是从子宫的左右角度说的，融会贯通它们，道理自然明了。
朱丹溪说：有人问双胞胎是怎么回事？回答说：精气有余，分流而成，血液随之分流摄取它。如果男女同孕，是在刚日阳时、柔日阴时，感应导致阴阳混杂，不属于左也不属于右，受气于两歧之间。也有三胎四胎的，也是同样的道理。《人镜经》说：精气盛则成两个男孩，血气盛则成两个女孩，精血都盛，则成一男一女，精血混杂，则成非男非女。男孩不能做父亲，是因为得阳道亏损的缘故。女孩不能做母亲，是因为得阴道闭塞的缘故。都不是纯气，如果感受邪祟鬼怪之气，则生成异类。
张景岳按语：《内经》说：阳给予正气，阴作为主宰，是说阳施予正气，万物才能生长，阴作为主持，各种形体才能确立。再看《易经》论述，地道顺应天道而按时运行，那么知道大地化生万物，是顺承天道，而母亲生子，也不过是顺承父亲，那么求子的关键，应当以男子为主，怎么能专门责备妇人呢！这确实是天生地成的宏大道理，阳施阴长的至理。常见男子六脉洪大，尺脉有力的，儿子多女儿少；六脉沉细，尺脉沉微的，儿子少女儿多，即使生男孩也容易夭折，这是验证过的。况且两神相搏，结合而成形，神，是指无形的东西。正因为无形，所以能生出有形，大概造化的道理，都生于无啊，哪里是日数、精粕这些有形迹的东西能决定的呢！所以神，是生命的根本。但必须凭借精气为什么呢？因为神本来没有形体，以气为形体，精没有固定的形状，以气而显形，构成事物的有三者，根本只有一个，主导虽然是神，但滋养精气，神必然依附于物，精能凝聚神，三者互相作用，不可分离，平叔所说的穷尽获取生命受气之初的状态，水的精化为志，火的精即为神。大概想要没有火就不会动，只有这一点点无形的元阳真火，以鼓动无形默用的真神，《内经》说：根源于内部的，叫做神机，是以神为发动的主宰，动用之道，自然而然，万物不知其所以然。如果可以言语形容的，就不是神的作用了。再看邪淫苟且结合的人，无心求子，偶然为之，容易成胎怀孕，因为心专神笃，欲火炽盛而氤氲之气浓密。安居和谐结合的人，专心种玉，却兢兢业业，常常不见功效，因为心耗神驰，欲火衰弱而氤氲之气反而稀薄了。可见无不由于神，无不由于火，更无不重于阳的作用。既然禀受了天地的道理，阴阳之理就不能除外，所以阳旺多生男，阴旺多生女，也就是乾道成男，坤道成女的含义。再看古书记载生人的征候，常常多由外因有感而成，这种情感的感触，也无不是神的作用，然而神之为神，无不是火之为精。如果没有火来充实神，就没有气来生精，三者既失，就是一团死灰了，哪里有阳和化育的道理，情性感触的作用呢！古话说三个月才开始成胎，还没有定型的仪态，气类潜通感应，造化秘密转移，这也是天地化工所具有的，怎么能固执认为是全部呢？先哲立言说：阳生阴长。又说：阳生阴化。说长说化，其中难道没有用意吗？
怀孕一个月叫始膏，两个月叫始胚，三个月叫始胎。当胚胎膏脂形成之初，真气方才相遇，像桃花凝聚一样，非常柔脆容易受伤。饮食必须忌辛辣，恐怕散其凝结，味道必须稍甘美，想要扶持其柔脆。二气既已凝结，像泥土在陶轮上，像金属在熔炉中，只靠陶冶而成，吃母亲的食气，所以养育其形，吃母亲的食味，所以养育其精，形精作为滋育的基础，气味为本源，所以天的五气，地的五味，母亲吃了孩子又吃，外则充实形质，内则滋养胎气，母寒亦寒，母热亦热，母饱亦饱，母饥亦饥，因虚而感邪，随感而变，富贵之家，放纵口腹，暴怒淫欲，饮食七情之火，积聚于内，胎气受到感染，体质弱的，立即变为病，体质强的，毒不立即发作，而痘疹疮惊，遗留祸患于以后。所以胎前能不谨慎调摄吗！
巢元方说：妊娠一个月，凝成一粒，像露珠那样，乃是太极动而生阳，名叫胚胎。天一生水，称为胚，足厥阴脉养之，月经即闭止，饮食稍有不同。两个月叫始膏，变成赤色，像桃花瓣，乃是太极静而生阴，地二生火，称为膏，足少阳脉养之，呕吐恶阻，或者偏嗜一种食物，以显示一脏之虚。三个月叫始胎，手厥阴脉养之，形象开始变化，乃分男女，乃是乾道成男，坤道成女。四月开始受水精以成血脉，形象具备，六腑成，手少阳脉养之。五月开始受火精以成阴阳之气，筋骨已成，毛发开始生长，足太阴脉养之。六月开始受金精以成筋，口目皆成，足阳明脉养之。七月开始受木精以成骨，游魂能动左手，手太阴脉养之。八月开始受土精以成皮肤，形骸渐长，九窍皆成，游魂能动右手，手阳明脉养之。九月开始受石精，以成皮毛，百节毕备，三次转身，足少阴脉养之。十月足太阳脉养之，精神备足，受气而生。唯独君主（心）无为，所以无所养，然而堕胎须防备一三五七月，因为单月皆由脏养胎，而三月又是相火所主，胎最易动，尤其应该谨慎，应当服用清热凉血安胎的药物。然而诸经有多气少血的，有多血少气的，应当各以按月养胎的脏腑气血虚实来调理，自然没有堕胎的祸患了。
有以五行养胎，分四季论述的。凡人自从在胞门受胎，手足十二经脉，其气血周流，都用来拥养胎元，哪有逐月分经，某经养某月之胎的道理？马玄台已经驳斥过，所以不详细记载。巢氏一月二月是论受胎的月数比较近于情理。
《圣济经》说：有人以为妊娠不要治疗，有伤胎破血的议论，哪里知道邪气暴戾，正气衰微，如果固执方剂不知权变，放任而不用药，那么母亲将瘦弱，孩子怎能保全？上古圣人，谓重身有毒，有病则无殒，衰减大半就停止，大概药物的性味本是用来疗疾，诚能处以中庸，与疾病适当，并且知道减半就停止，又有什么可疑于攻治的呢！慎重的，是怕克削破血，有伤胎孕罢了。
安胎的方法有两种，如母亲生病以致动胎的，只要治疗母亲则胎自然安；如果胎气不固，或有触动以致母亲生病的，宜安胎则母亲自愈。
妇人年幼，天癸未行属少阴，天癸已行属厥阴，天癸已绝属太阴，治疗胎产病从厥阴入手，是祖气生化之源。治疗方法不犯胃气，是后天化生之源。以及上中下三禁，谓不可发汗、不可泻下、不可利小便，恐怕亡其津液，而伤其生气。
阴阳二气的感应，凝结而成形，气血旺盛，则胎易成而无病，气血虚弱，则胎多病而难育，吃母亲的食气，所以养育其精，吃母亲的食味，所以养育其形，所以胎元以脾胃饮食为本，母子都依赖它。今人膏粱厚味，抑郁气恼，而气血逐渐亏损，痰火必炽盛，而恶阻、子痫、子肿等疾病发作了。然而胎前诸症，都以安胎为主，务必使气血和平，则百病不生。如果气旺而热，热则耗气血，而胎不安，当以清热养血为主。如果起居饮食调养得当，断绝嗜欲安养胎气，那么即使形成其他病症，也没有大害。朱丹溪说：白术、黄芩是安胎的圣药。俗医认为温剂可以养胎，不知道胎前最宜清热，令血循经不妄行，故能养胎。白术益脾以培万物之母，黄芩泻火，能滋子户之阴，与其利而除其害，胎自然安，所以黄芩安胎为上中二焦药。益母草治血行气，有补阴之功，胎前无滞，产后无虚，以行气中有补。胎至三月、四月忽腹痛，只有砂仁及少量木香，能治痛行气以安胎。八九月必须顺气，用枳壳、紫苏之类，但气虚者宜补气以行滞，用人参、白术、陈皮、当归、芍药、甘草、腹皮；气实者，耗气以抑阳，用黄芩、白术、陈皮、甘草加枳壳。如临近分娩，胎热者以三补丸加香汤白芍或地黄膏。血虚者，不外乎四物地黄，加以益母草，预为分娩做准备。至于世医安胎，多用艾叶、附子、砂仁，为害尤为严重。不知道血气清和，无火煎烁，则胎安而固，气虚则提不住，血热则溢妄行，胎欲不堕，怎么可能呢。香附虽云快气开郁，多用则损正气。砂仁快脾气，多用亦耗真气，香燥之品，气血两伤，求以安胎，适足以损胎。只有寒郁气滞者适宜。
赵养葵说：有人问白术黄芩，是安胎的圣药，胎前必不可缺吗？回答说：不尽然。胎茎系于肾，如同钟系于梁，栋柱不固，栋梁必弯，所以安胎先固两肾，使肾中和暖，始脾有生气，何必一定以白术黄芩为安胎呢？凡腹中有热，胎不安的，宜用凉药。然而腹中有寒，胎也不安，必用温药，这是常法。况且两肾中具水火之源，为冲任之根，而胎元所系甚要，不是白术黄芩所能安的。如肾中无水胎不安的，用六味地黄壮水，肾中无火的，用八味地黄益火。调经当用杜仲、续断、阿胶、艾叶、当归、五味子，出入于六味、八味汤中为快捷方式，总之一以贯之。诸书所不及，我特意表而出之，这是赵氏的创论。而且脏性所禀的寒热不同，有脏寒不孕，服八味十补才受孕的，则受孕之后，仍宜照常服用，因为脏腑服惯，则不觉桂附之热，视为平常，竟相安无事，更可长养胎元。若停止暖药，加上条芩清热之品，要知道能安补阳升举者，必不利补阴降下，势必反致坠胎之患，而且有损于胎元。极虚之人脏腑，春夏阳和，升长之气少，秋冬阴寒，降下之气多。张景岳常治恶阻久吐不止，脉微肢冷的，竟用附子理中汤加五味子，连服数日乃安，但必人参、白术、炙甘草倍加，则能乘载胎元，其姜附之性，惟从参术以温补中焦，即附子走下之力，不能独发以施其用。
古人用黄芩安胎，是因为子气过热不宁，故用苦寒以安之，然而气血旺脾胃和，胎自然无虞，一或有乖违，其胎即堕，所以胎完全依赖气血以滋养，而气血又藉谷气以化生，所以脾是一身的津梁，主内外诸气，而胎息运化之机全赖脾土，所以用白术以助之，然而只有形瘦血热，营行过疾，胎常上逼，过动不安的才适宜。若形盛气衰，胎常下坠的，非人参举之不安。血虚火旺，腹常不运的，非香砂耗之不安。血虚火旺，腹常急痛的，非归芍养之不安。体肥痰盛，呕逆眩晕的，非半夏、茯苓豁之不安。则桂枝汤、香苏散、葱白香豉汤，谅所宜用。伏邪时气，尤宜急下，这就是安胎的要诀。下药中独芒硝切不可犯，若有客邪而用白术，便热邪留恋不解，若素患虚寒而服黄芩，则中气脾胃愈伤，都仅足以伤胎。
地的本体本重，然而得天气以包举之，则生机不息。若重阴泣寒之区，天日之光不显，则物生实在罕见，如其人之体肌肉丰盛，乃是血之荣旺，但血旺易至气衰，久而弥觉其偏。气和血，两相维系而不可偏，气为主则血流，血为主则气反不流，不是气之衰，气不流有似乎衰耳。所以一切补肌药皆不可用，而耗气之药，反有可施，缘气得辅则愈锢，不如耗之以助其流动，久之血仍归于统握中了。湖阳公主体肥难产，南山道士进献瘦胎方而产得顺利，盖肥满之躯，胎处其中，全无空隙，所以伤胎之药，只能耗其外之气，而不能耗其内之真气，这是用药的妙处。所以胎前宜顺气，气顺则不滞，枳壳散、束胎饮，都是为气实肥盛安佚郁闷者立法。若气体虚弱，元气不足，或虚气胀满，或虚寒腹痛，必须人参白术大补，岂谓胎前必用耗气药呢？
妇人妊娠，只在抑阳助阴，然而胎前药，最恶群队杂乱。若药无专一，则阴阳交错，别生他病，只有南山道士枳壳散，所以抑阳，四物汤所以助阴，但枳壳散少寒单服，恐有胎寒腹痛之患。以内补丸佐之，则阳不至强，阴不至弱，阴阳调而孕安，盖妇人平居，阳气微盛，无诸疾病，则受娠自能经闭以养胎。若阳气太盛，则阳搏于阴，乃经脉妄行，胎始不固，所以贵抑阳助阴者为此。
朱丹溪说：世之难产者，往往见于郁闷安佚之人，富贵豢养之家。若贫贱辛苦者，没有这种情况。方书只有瘦胎饮一方，按其方是为湖阳公主设的，实在不是极至之论。那湖阳公主，奉养太过，其气必实，耗其气使之和平，故易产，这是南山道士进献瘦胎枳壳散，抑阳降气，温隐居加木香、当归佐之。若形肥人其气必虚，久坐其气不运，而气愈弱，儿在胞胎，
After intercourse, conception occurs, and in cases where a male and female child are born from one pregnancy, what is the reason? Is it the principle that conception on an odd day yields a male, and conception on an even day yields a female? Yu Zimu further stated: "Weak Yang cannot penetrate Yin, and weak Yin cannot grasp Yang." Believing this statement, there are men who are emaciated and frail, and women who are weak, yet they conceive repeatedly; whereas those with robust blood and Qi (vital energy) and superior vitality often remain infertile throughout their lives. What is the reason for this? Danxi argued that menstruation in women is primary. However, in wealthy families with many concubines, surely not all have regular menstruation? Furthermore, some women who frequently bore children in their maiden home fail to conceive after marriage, hoping for a change of fortune. How can they conceive in one place but not another? Generally speaking, parents giving birth to children is like Heaven and Earth generating all things. The *Yi Jing* (Book of Changes) states: "The way of Kun (Earth) is its compliance, receiving from Heaven and acting in accordance with time." Knowing that Earth generates all things by complying with Heaven, we understand that mothers giving birth to children also comply with fathers. Understanding that mothers comply with fathers, the key to seed generation should lie primarily with men, rather than solely blaming women. For men, regardless of age, strength, health, or illness, whether semen is easy or difficult to ejaculate, the ideal condition is that when intercourse occurs, the Qi and Blood of all meridians arrive simultaneously. Regarding the distinction between male and female fetuses, one should not be bound by the sequence of sperm and ovum arrival, the number of days after menstruation ends, the time of intercourse relative to midnight, or the physical strength of the parents. One should only distinguish based on which reaches fullness through the simultaneous arrival of Qi and Blood via all meridians. If the sperm's arrival via all meridates prevails over the blood, a male is formed; if the blood's arrival prevails over the sperm, a female is formed. "Simultaneous arrival via all meridians" refers to the utmost smoothness and freedom, without any forcefulness. (This distinguishes fetal sex by whether all meridians arrive simultaneously.)
Li Dongbi (Li Shizhen) said: The *Yi Jing* says, "One Yin and one Yang is called the Dao. The coupling of male and female essence gives rise to the transformation of all things. The Dao of Qian (Heaven) forms males, and the Dao of Kun (Earth) forms females." This describes the generative mechanism of men and women and the beneficial capacity of Yin-Yang creation. Chu Cheng stated: "If blood arrives first and envelops essence, a male is born; if essence arrives first and envelops blood, a female is born. If Yin and Yang arrive equally, a body neither male nor female is formed; if essence and blood scatter separately, it indicates twins or multiple births." The *Daozang* (Taoist Canon) states: "After menstruation ceases, conception on days 1, 3, and 5 results in a male, while days 2, 4, and 6 result in a female." Li Dongyuan stated: "When the Sea of Blood is just cleared, conception on days 1-2 results in a male, and days 3-5 results in a female." The *Shengji Jing* states: "If Qi moves to the left, Yang nourishes it to form a male; if Qi moves to the right, Yin nourishes it to form a female." Danxi rejected Chu’s view and endorsed Dongyuan’s, basing his theory on the left-right concept of the *Shengji Jing*. I believe Chu’s view should not be dismissed, nor is Dongyuan’s entirely correct. Chu spoke from the perspective of the sequence of essence and blood; the *Daozang* from the parity of days; Dongyuan from the waxing and waning of female blood; and the *Shengji Jing* and Danxi from the left and right of the uterus. Integrating these perspectives reveals the underlying logic.
Danxi asked: "What causes twins?" He answered: "When Essence and Qi are abundant, they split and divide, and Blood follows to capture them. If a male and female are conceived together, it occurs during Yang times of Yang days and Yin times of Yin days, causing Yin and Yang to mix. It belongs neither to the left nor the right, but receives Qi between the two divisions. There are also triplets and quadruplets, following the same principle." The *Renjing Jing* states: "Abundant Essence and Qi produce two males; abundant Blood and Qi produce two females; abundant Essence and Blood produce one male and one female; mixed Essence and Blood produce a being neither male nor female. A male unable to become a father suffers from deficiency of the Yang path; a female unable to become a mother suffers from obstruction of the Yin path. Neither possesses pure Qi. If influenced by evil spirits or ghosts, abnormal forms may result."
Zhang [Jingyue] commented: The *Classic* states: "Yang provides the upright Qi, Yin acts as the master." This means Yang imparts upright Qi, allowing all things to grow, while Yin presides, establishing various forms. Observing the *Yi Jing*, Kun complies with Heaven and acts in time, indicating that Earth generates things by complying with Heaven, and mothers give birth by complying with fathers. Thus, the focus of conception should be on the man, not solely on the woman. This is indeed the great principle of Heaven creating and Earth completing, and the ultimate truth of Yang imparting and Yin growing. I often observe that men with surging six pulses and strong Chi (Cun-Kou) pulses tend to have more sons than daughters, while those with deep, fine six pulses and faint Chi pulses tend to have more daughters than sons, and even if they have sons, they may die young. This is verified. Moreover, when two Spirits interact, they combine to form shape. "Spirit" refers to the formless. Because it is formless, it can generate the有形 (form). The principle of creation arises from the formless. Is it merely about days and tangible essence? Therefore, Spirit is the root of life. But why must it rely on Essence and Qi? Spirit has no form, taking Qi as its form; Essence has no fixed shape, manifesting through Qi. These three constitute matter, sharing one root. Although Spirit is the master, nourishing Essence and Qi allows Spirit to attach to objects; Essence can condense Spirit. They use each other mutually and cannot be separated. As Pingshu said, "Exhaustively seek the beginning of receiving life and Qi." The essence of Water becomes Zhi (Will), and the essence of Fire becomes Shen (Spirit). Without Fire, there is no movement. Only this point of formless Yuan Yang True Fire can drum up the formless, silent operation of True Spirit. The *Classic* says: "Rooted within, it is called Shen Ji (Spirit Mechanism)." Spirit is the master of initiation and the way of movement, occurring naturally without knowing why. If it can be described by words, it is not the function of Spirit. Consider illicit unions: unconsciously conceiving, acting by chance, often leads to pregnancy because the mind is focused and spirit is sincere, desire fire is intense, and the misty Qi is dense. In harmonious union, focusing on planting jade but acting with anxiety often fails because the mind dissipates and spirit wanders, desire fire declines, and misty Qi becomes thin. Thus, everything depends on Spirit, on Fire, and most importantly on the function of Yang. Having received the Dao of Heaven and Earth, one cannot escape Yin-Yang principles. Therefore, Yang abundance produces more males, and Yin abundance produces more females, consistent with the meaning of Qian forming males and Kun forming females. Ancient records show that birth often results from external influences and emotional stimuli, which are functions of Spirit. Spirit, however, is essentially Fire-Essence. Without Fire to fill Spirit, there is no Qi to generate Essence. Losing these three results in a lump of dead ash, lacking the way of Yang-harmonious nurturing and the utility of emotional connection. Ancients said conception begins at three months, with no fixed pattern, as Qi classes subtly sense and transform secretly. This is part of Heaven and Earth’s creative work; how can it be rigidly defined? Predecessors stated: "Yang generates, Yin grows," and "Yang generates, Yin transforms." Do "grow" and "transform" imply intent?
Pregnancy at one month is named "Start Paste," at two months "Start Embryo," and at three months "Start Fetus." At the beginning of embryo and paste formation, True Qi meets, resembling condensed peach blossoms, extremely fragile and susceptible to injury. Diet must avoid spicy foods to prevent scattering the condensation; flavors should be slightly sweet to support fragility. Once the two Qi condense, like clay on a potter's wheel or metal in a furnace, formation depends on tempering. The fetus eats the mother's food Qi to nourish its Form, and her food Flavor to nourish its Essence. Form and Essence are nurtured by Qi and Flavor, which are fundamental. Heaven's Five Qi and Earth's Five Flavors are eaten by the mother and then the fetus, externally filling the physical structure and internally nourishing fetal Qi. If the mother is cold, the fetus is cold; if hot, the fetus is hot; if full, the fetus is full; if hungry, the fetus is hungry. Due to deficiency, pathogens enter, changing with the influence. Wealthy families indulge their appetites, leading to violent anger and lust, accumulating Fire from diet and Seven Emotions internally. Fetal Qi is affected; the weak immediately fall ill, while the strong may not show immediate symptoms but suffer later from smallpox, chickenpox, sores, or convulsions. Thus, prenatal care requires caution!
Chao [Yuanfang] stated: In the first month of pregnancy, a grain-like substance condenses, like a dewdrop, representing Taiji moving to generate Yang, named Pei (Embryo). "Heaven generates Water," called Pei, nourished by the Foot Jueyin Meridian; menstruation stops, and diet changes slightly. In the second month, named "Start Paste," it turns red like a peach blossom petal, representing Taiji stillness generating Yin. "Earth generates Fire," called Gao (Paste), nourished by the Foot Shaoyang Meridian; vomiting and aversion to food occur, or specific cravings appear, indicating deficiency in one Zang organ. In the third month, named "Start Fetus," nourished by the Hand Jueyin Meridian, the image begins to differentiate into male and female, representing Qian forming males and Kun forming females. In the fourth month, it receives Water Essence to form blood vessels; the image is complete, Six Fu organs form, nourished by the Hand Shaoyang Meridian. In the fifth month, it receives Fire Essence to form Yin-Yang Qi; bones and sinews are formed, hair begins to grow, nourished by the Foot Taiyin Meridian. In the sixth month, it receives Metal Essence to form sinews; mouth and eyes form, nourished by the Foot Yangming Meridian. In the seventh month, it receives Wood Essence to form bones; the Hun (Ethereal Soul) roams, enabling movement of the left hand, nourished by the Hand Taiyin Meridian. In the eighth month, it receives Earth Essence to form skin; the body frame grows, nine orifices form, the Hun roams, enabling movement of the right hand, nourished by the Hand Yangming Meridian. In the ninth month, it receives Stone Essence to form hair and fur; all joints are complete, it turns three times, nourished by the Foot Shaoyin Meridian. In the tenth month, nourished by the Foot Taiyang Meridian, Spirit and Qi are sufficient, receiving Qi to be born. The Monarch (Heart) is non-actionable, so it does not nourish. However, miscarriage must be guarded against in months 1, 3, 5, and 7, as single months are nourished by Zang organs, and the third month is governed by Ministerial Fire, making the fetus most prone to movement. Caution is needed, and heat-clearing, blood-cooling, and fetal-anchoring herbs should be taken. Since various meridians have varying amounts of Qi and Blood, regulation according to the monthly nourishing Zang organs' Qi-Blood deficiency or excess prevents miscarriage.
Some discuss fetal nourishment using the Five Elements and Four Seasons. From conception in the Bao Men (Womb Gate), the Qi and Blood of the twelve meridians circulate to nourish the fetal origin. How can there be a theory of specific meridians nourishing specific months? Ma Xuantai refuted this, so it is not detailed here. Chao’s discussion of months 1 and 2 regarding conception timing is closer to reason.
The *Shengji Jing* states: Some argue against treating pregnancy due to fears of harming the fetus or breaking blood. They do not know that if pathogenic Qi is fierce and Healthy Qi is weak, sticking rigidly to formulas without flexibility and refusing medication will cause the mother to weaken, endangering the child. Ancient sages said, "For pregnant women with toxicity, if there is a cause, there is no destruction; reduce it by more than half and stop." Drug properties and flavors are meant to treat disease. If administered moderately and appropriately, stopping at half, why doubt treatment? Caution is only against harsh purgatives or blood-breaking agents that harm pregnancy.
There are two methods for anchoring the fetus: If the mother’s illness causes fetal movement, treating the mother anchors the fetus. If fetal instability causes maternal illness, anchoring the fetus cures the mother.
For young women, before Tian Gui (menstrual essence) appears, it belongs to Shaoyin; after it appears, it belongs to Jueyin; after it ceases, it belongs to Taiyin. Treating obstetric diseases via Jueyin addresses the source of ancestral Qi generation. Treatment methods must not violate Stomach Qi, the source of postnatal generation. Also, the Three Prohibitions (Upper, Middle, Lower): no sweating, no purging, no promoting urination, to prevent loss of Body Fluids and damage to Life-generating Qi.
The interaction of Yin and Yang Qi condenses to form shape. Abundant Qi and Blood make conception easy and healthy; deficient Qi and Blood lead to sickly and difficult pregnancies. Eating the mother's food Qi nourishes Essence; eating her food Flavor nourishes Form. Thus, fetal origin relies on Spleen-Stomach and diet, sustaining both mother and child. Modern people consume rich foods, suffer from depression and anger, leading to Qi-Blood deficiency and rampant Phlegm-Fire, causing morning sickness, eclampsia, and edema. Prenatal symptoms should prioritize anchoring the fetus, ensuring Qi-Blood harmony to prevent disease. If Qi is abundant and Hot, consuming Qi-Blood, the fetus is unstable; clear Heat and nourish Blood. With proper lifestyle and diet, avoiding desires, even other conditions pose little danger. Danxi said: Bai Zhu (Atractylodes Macrocephala Rhizome) and Huang Qin (Scutellaria Baicalensis Root) are sacred medicines for anchoring the fetus. Quack doctors believe warm agents nourish the fetus, not realizing clearing Heat is best prenatally to keep Blood in channels, thus nourishing the fetus. Bai Zhu benefits the Spleen to nurture the Mother of All Things; Huang Qin clears Fire to nourish the Yin of the Child Chamber. Removing harm ensures safety, so Huang Qin anchors the fetus for Upper and Middle Jiao. Yi Mu Cao (Leonurus Japonicus Herb) regulates Blood and moves Qi, having Yin-nourishing effects, leaving no stagnation prenatally and no deficiency postnatally, as moving Qi contains tonification. If abdominal pain occurs suddenly at 3-4 months, Sha Ren (Amomi Fructus) and a little Mu Xiang (Aucklandiae Radix) can relieve pain, move Qi, and anchor the fetus. At 8-9 months, Qi must be smoothed using Zhi Ke (Aurantii Fructus) and Zi Su (Perillae Folium). For Qi deficiency, tonify Qi to move stagnation using Ren Shen (Ginseng Radix), Bai Zhu, Chen Pi (Citri Reticulatae Pericarpium), Dang Gui (Angelica Sinensis Radix), Bai Shao (Paeoniae Radix Alba), Gan Cao (Glycyrrhizae Radix), and Fu Pi (Moutan Cortex); for Qi excess, deplete Qi to suppress Yang using Huang Qin, Bai Zhu, Chen Pi, Gan Cao, and Zhi Ke. Near term, for fetal Heat, use San Bu Wan plus Xiang Tang Bai Shao or Di Huang Gao. For Blood deficiency, use Si Wu Tang with Di Huang and Yi Mu Cao to prepare for delivery. Worldly doctors often use Ai Ye (Artemisiae Argyi Folium), Fu Zi (Aconiti Lateralis Radix Praeparata), and Sha Ren, causing severe harm. They do not know that clear and harmonious Qi-Blood without Fire scorching ensures safety. Qi deficiency fails to hold; Blood Heat causes reckless flow. How can the fetus not miscarry? Xiang Fu (Cyperi Rhizoma) opens depression but harms Righteous Qi if overused. Sha Ren moves Spleen Qi but consumes True Qi if overused. Acrid-dry agents injure both Qi and Blood; seeking to anchor the fetus only damages it. They are suitable only for Cold stagnation.
Zhao Yangkui asked: Are Bai Zhu and Huang Qin indispensable sacred medicines for anchoring the fetus? Answer: Not necessarily. The fetal stem ties to the Kidney like a bell to a beam; if beams are unstable, the bell bends. Thus, anchoring the fetus first secures the Two Kidneys, warming them so the Spleen has living Qi. Why insist on Bai Zhu and Huang Qin? For abdominal Heat causing instability, use cooling drugs. For abdominal Cold, use warming drugs—this is standard. The Two Kidneys contain the source of Water and Fire, the root of Chong and Ren meridians, crucial for fetal origin, beyond Bai Zhu and Huang Qin. For Kidney Water deficiency, use Liu Wei Di Huang Wan to strengthen Water; for Fire deficiency, use Ba Wei Di Huang Wan to benefit Fire. Regulating menstruation uses Du Zhong (Eucommiae Cortex), Xu Duan (Dipsaci Radix), E Jiao (Asini Corii Colla), Ai Ye, Dang Gui, and Wu Wei Zi (Schisandrae Fructus), varying within Liu Wei or Ba Wei Decoctions. This is Zhao’s innovation. Organ nature varies in Cold/Heat; some with Cold organs fail to conceive until taking Ba Wei or Shi Bu, then continuing post-conception as organs adapt to Gui Zhi/Fu Zi heat, peacefully nurturing the fetus. Stopping warm drugs and adding Huang Qin may cause miscarriage due to conflicting actions. Extremely deficient persons have less ascending Qi in Spring/Summer and more descending Qi in Autumn/Winter. Zhang [Jingyue] treated prolonged vomiting with faint pulse and cold limbs using Fu Zi Li Zhong Tang plus Wu Wei Zi, stabilizing after days, but heavily dosed with Ren Shen, Bai Zhu, and Zhi Gan Cao to support the fetus. Ginger and Fu Zi warmth supports the Middle Jiao via Ginseng and Atractylodes, preventing Fu Zi’s downward force from acting alone.
Ancients used Huang Qin to anchor the fetus because fetal Qi was too hot and restless, using bitter-cold to calm it. However, with robust Qi-Blood and harmonious Spleen-Stomach, the fetus is safe; otherwise, it miscarries. The fetus relies on Qi-Blood for nourishment, which derives from Grain Qi. The Spleen is the hub of the body, governing internal and external Qi, and fetal respiration/digestion relies entirely on Spleen Earth. Thus, Bai Zhu assists. However, it suits only thin individuals with Blood Heat, rapid Ying circulation, upward fetal pressure, and restlessness. For obese individuals with Qi deficiency and downward fetal pressure, Ren Shen lifting is needed. For Blood deficiency with Fire Hyperactivity and abdominal stagnation, Sha Ren/Xiang Mu depletion is needed. For Blood deficiency with Fire Hyperactivity and acute abdominal pain, Dang Gui/Bai Shao nourishment is needed. For obesity with Phlegm abundance, vomiting, and dizziness, Ban Xia (Pinelliae Rhizoma) and Fu Ling (Poria) resolving is needed. Then Gui Zhi Tang, Xiang Su San, or Cong Bai Xiang Chi Tang are appropriate. For latent pathogens and seasonal Qi, urgent purging is needed—this is the secret of anchoring the fetus. Mang Xiao (Natrii Sulfas) must never be used in purgatives; if external pathogens exist and Bai Zhu is used, Heat lingers. If chronic Cold deficiency takes Huang Qin, Middle Qi/Spleen-Stomach is damaged, harming the fetus.
Earth is heavy, but Heaven’s Qi encompasses it, sustaining life. In cold, dark regions, growth is rare. Similarly, fleshy bodies indicate abundant Blood, but Blood abundance easily leads to Qi deficiency, becoming unbalanced over time. Qi and Blood sustain each other; if Qi dominates, Blood flows; if Blood dominates, Qi stagnates—not due to Qi deficiency, but lack of flow. Thus, flesh-tonifying drugs are contraindicated; Qi-depleting drugs may be applied. Qi aided becomes stuck; depleting it aids flow, eventually returning Blood to control. Princess Huyang had difficult labor due to obesity; the Daoist of Nanshan prescribed Shou Tai Fang (Slimming Fetus Formula), resulting in smooth delivery. In obese bodies, the fetus occupies space with no gap; damaging drugs only deplete external Qi, not internal True Qi. This is the subtlety of用药. Thus, smoothing Qi is best prenatally; stagnant Qi causes issues. Zhi Ke San and Shu Tai Yin are for Qi-excess, obese, sedentary, depressed types. For Qi weakness, insufficient Yuan Qi, false distension, or Cold pain, Ren Shen and Bai Zhu tonification is necessary. Who says prenatal care always requires Qi-depleting drugs?
Pregnancy requires suppressing Yang and assisting Yin. Prenatal drugs must avoid complex mixtures. Lack of specificity causes Yin-Yang confusion and new diseases. Nan Shan Daoist’s Zhi Ke San suppresses Yang; Si Wu Tang assists Yin. Taking Zhi Ke San alone may cause Cold Pain; supplement with Nei Bu Wan to balance Yin-Yang. Normally, women have slight Yang abundance; without disease, menstruation stops to nourish the fetus. If Yang is too abundant, it attacks Yin, causing erratic menstruation and fetal instability. Hence, suppressing Yang and assisting Yin is valued.
Danxi said: Difficult labor often occurs in depressed, sedentary people from wealthy families. Poor, hardworking women rarely experience this. Medical texts only list Shou Tai Yin, designed for Princess Huyang, not the ultimate theory. She was over-nourished, her Qi was Excess; depleting Qi brought harmony, easing birth. The Daoist’s Zhi Ke San suppresses Yang and descends Qi, assisted by Wen Ju Ju adding Mu Xiang and Dang Gui. Obese people have Qi Deficiency; sitting long stagnates Qi, weakening it further. The child in the womb,