妊娠胎动不安者，由冲任经虚，受胎不实也。有饮酒房事过度、损动不安；有忤触伤仆而动不安；有怒气伤肝、或
郁结不舒，触动血脉不安；有过服暖药并犯禁之药动而不安；有因母病而胎动者，但治母病其胎自安；有因胎不坚固动
及母病者，但当安胎，其母自愈。若面赤、舌青，是儿死也；面青、舌赤，是母死也；唇、口、面、舌俱青，吐沫者，
是子母俱死。然胎动与胎漏，皆有下血，胎动则腹痛，胎漏无腹痛。胎动宜调气，胎漏宜清热。然子宫久虚，多令坠胎，
其危同于风烛，非正产可比，急以杜仲丸预服，以保胎元。
胞衣未下，急于胎之未生。子死腹中，危于胎之未下。盖胞衣未下，子与母气尚通呼吸，若子死腹中，胞脏气寒，
胎血凝 ，气不升降。古方多以行血顺气药及硝石、水银、 砂之类。但其胎已死，则躯形已冷，血凝气聚，复以至寒
之药下之，不惟无益，而害母命者多矣，不知古人立方深于用意。盖子死之故，因有二端，用药寒温各存至理，有妊娠
胎漏血尽子死者；有坠堕颠仆内伤子死者；有久病胎萎子死者。以附子汤进三服，使胞脏温暖，凝血流动。盖附子能破
寒气堕胎，此用温药之意也。有因伤寒热病温疟之类，胎受邪热毒瓦斯，内外交攻，因致胎死留于胞脏。古人深虑胎受毒
气必然胀大，故用朴硝、水银、 砂之药，不惟使胎不胀，又能使胎形化烂，再副以行血、顺气之药，死胎即下。此
古人立方之至意也。
凡脉三阳俱盛，名曰双躯。若少阴微紧者（谓督脉），血即凝浊，经养不周，胎即偏夭，其一独死，其一独生，不
去其死，害母失胎，千金神造散主之。是方 治双胎，一胎生、一胎死者，用蟹爪以去其死，阿胶以安其生，甘草和药
性，立方之心意深远矣。
人之胃气壮实，冲任荣和，则胎得其所，如鱼处深涧，自然和畅。若气血虚弱，无以滋养，其胎终不能成宜下之，
以免其祸。然胎伤宜下、而下法最宜谨慎。如胎死腹中，心先 舌青、腹冷、口秽的确，方可用下，也必先固妊妇本元，
补气养血而后下之。如遇有不安，未能详审，遂用峻厉攻伐，能免不测之祸。此要诀云顺其自然四字，最妙。立斋亦云∶
胎果不能安者，方可议下。慎之、慎之，前贤之垂戒深矣。若欲下之，朴硝断不可少。
妊娠期间出现胎动不安，是由于冲脉和任脉（调节月经和孕育的经脉）虚弱，导致受孕不实。有的因为饮酒或房事过度，损伤身体导致胎动不安；有的因为受到惊吓、撞击或跌倒而致胎动不安；有的因为愤怒伤肝，或者情绪郁结不舒，触动血脉导致胎动不安；有的因为过服温热性质的药物以及触犯禁忌的药物导致胎动不安；有的因为母亲患病而导致胎动，此时只需治疗母亲的疾病，胎儿自然就会安定；有的因为胎儿本身不坚固，胎动进而引发母亲生病，此时只需安胎，母亲自然会痊愈。如果孕妇面色红赤、舌质青紫，这是胎儿死亡的表现；如果面色青紫、舌质红赤，这是母亲死亡的表现；如果嘴唇、口唇、面部、舌质全部发青，且呕吐涎沫，这是母子俱死的表现。然而胎动与胎漏（妊娠期阴道少量出血），都有下血的症状，但胎动伴有腹痛，胎漏则没有腹痛。胎动适宜调理气机，胎漏适宜清热。如果子宫长期虚弱，多会导致堕胎，其危险性如同风中残烛，不能与正常分娩相比，应紧急预先服用杜仲丸，以保护胎元。
胎盘未排出，情况危急程度仅次于胎儿未出生时。胎儿死于腹中，比胎盘未排出更加危险。因为胎盘未排出时，胎儿与母体的气息尚相通连，若胎儿死于腹中，胞宫脏气寒冷，胎血凝滞，气机不能升降。古方多用行血顺气的药物以及硝石、水银、硇砂之类的药物。但是胎儿已经死亡，躯体已经变冷，血液凝滞，气机聚结，再用极寒的药物攻下，不仅无益，反而害死母亲的情况很多了，这说明古人制定方剂时用心深远。胎儿死亡的原因，大概有两类，用药的寒温各有至理：有因妊娠胎漏，失血过多导致胎儿死亡的；有因坠跌、颠仆内伤导致胎儿死亡的；有因久病导致胎儿萎弱死亡的。用附子汤进服三剂，使胞宫温暖，凝血流动。因为附子能破除寒气并堕胎，这里使用温药的意思在于此。有因伤寒、热病、温疟等病症，胎儿受到邪热毒气的侵袭，内外交攻，导致胎儿死亡留在胞宫中。古人深深考虑到胎儿受毒气必然胀大，所以使用朴硝、水银、硇砂的药物，不仅能使胎儿不胀大，还能使胎儿形体化烂，再配合行血、顺气的药物，死胎即可排出。这是古人制定方剂的深意所在。
凡是寸关尺三部脉象都盛大，名叫双胎。如果少阴脉微紧（指督脉），血液就会凝浊，经血滋养不足，胎儿就会偏夭折，其中一个独自死亡，另一个独自存活，如果不除去死胎，会伤害母亲并失去活胎，由千金神造散主治。这个方子治疗双胎，一胎生、一胎死的情况，用蟹爪去除死胎，用阿胶安固活胎，甘草调和药性，立方的心意深远啊。
人的胃气壮实，冲任二脉气血调和，那么胎儿就能安居，像鱼处在深涧中一样，自然和畅。如果气血虚弱，无法滋养，胎儿最终不能成形，应当攻下，以避免祸患。然而胎伤需要攻下时，下法最需谨慎。如胎儿死于腹中，必须确有心痛、舌青、腹部冷、口中有秽臭气，才可以攻下，但也必须先固护孕妇的本元，补气养血之后才能攻下。如果遇到胎动不安，未能详细审察，就使用峻烈攻伐的药物，难免发生不可预测的祸患。这要诀说“顺其自然”四个字，最为精妙。立斋也说：胎儿果然不能保全时，才可以讨论攻下之法。谨慎啊，谨慎啊，前贤的告诫很深了。如果想要攻下，朴硝是绝对不可少的。
When fetal movement and insecurity occur during pregnancy, it is due to the deficiency of the Chong and Ren meridians (meridians regulating menstruation and gestation), resulting in an unstable conception. Some cases arise from excessive drinking or sexual intercourse, damaging the body and causing fetal movement; some from fright, trauma, or falls leading to fetal movement; some from anger injuring the Liver or emotional stagnation disturbing the blood vessels and causing fetal movement; some from overconsumption of warm-natured herbs or violation of dietary/behavioral taboos causing fetal movement; some are caused by maternal illness, in which case treating the mother's illness will naturally stabilize the fetus; others result from an inherently weak fetus whose movement subsequently affects the mother, in which case stabilizing the fetus will naturally cure the mother. If the face is red and the tongue is cyanotic, this indicates fetal death; if the face is cyanotic and the tongue is red, this indicates maternal death; if the lips, mouth, face, and tongue are all cyanotic accompanied by vomiting of froth, this indicates death of both mother and child. However, both fetal movement (Tai Dong) and threatened miscarriage with bleeding (Tai Lou) involve vaginal bleeding, but fetal movement is accompanied by abdominal pain, whereas threatened miscarriage with bleeding is not. Fetal movement is suitable for regulating Qi, while threatened miscarriage with bleeding is suitable for clearing heat. If the uterus has been deficient for a long time, it often leads to abortion, a danger comparable to a candle in the wind, not comparable to normal delivery; one should urgently take Duzhong Wan (Eucommia Decoction) in advance to protect the fetal origin.
The retention of the placenta is critical, though less so than before birth. Fetal death in utero is more critical than placental retention. When the placenta is retained, the fetus and mother still share respiratory connection; however, if the fetus dies in utero, the uterine qi becomes cold, fetal blood coagulates, and Qi fails to ascend and descend. Ancient formulas often used blood-invigorating and Qi-smoothing herbs along with Niter (Xiaoshi), Mercury (Shuiyin), and Ammonium Chloride (Naosha). But since the fetus is already dead, its body is cold, blood is coagulated, and Qi is stagnant, using extremely cold purgatives is not only ineffective but often fatal to the mother. This reveals the profound intent behind ancient formula creation. There are two main causes of fetal death, each requiring specific thermal properties: death due to hemorrhage from threatened miscarriage exhausting blood; death due to internal injury from falls or trauma; death due to fetal atrophy from chronic illness. Administering Fuzi Tang (Aconite Decoction) three times warms the uterus and mobilizes coagulated blood. Aconite can break cold and induce abortion; here, warm herbs are used for this purpose. In cases of Cold Damage, febrile diseases, or warm malaria where the fetus is attacked by pathogenic heat and toxins internally and externally, leading to fetal death retained in the uterus, ancients feared the fetus would swell due to toxic gas. Thus, they used Mirabilite (Puxiao), Mercury, and Ammonium Chloride to prevent swelling and rot the fetal form, assisted by blood-invigorating and Qi-smoothing herbs to expel the dead fetus. This represents the ultimate intent of ancient formula design.
When the pulse at the Cun, Guan, and Chi positions on both hands is vigorous, it is called twin pregnancy. If the Shaoyin pulse (referring to the Du meridian) is slightly tight, blood becomes turbid and coagulated, nourishment is insufficient, and one fetus may die prematurely while the other survives. If the dead fetus is not expelled, it harms the mother and endangers the live fetus; this is treated with Qianjin Shenzao San (Thousand Gold Divine Creation Powder). This formula treats twins where one is alive and one is dead: using Crab Claw (Xiezhua) to remove the dead fetus, Donkey-hide Gelatin (Ejiao) to secure the live fetus, and Licorice (Gancao) to harmonize the properties, showing profound intent in its formulation.
If a person's Stomach Qi is robust and the Chong and Ren meridians have harmonious Ying and Wei, the fetus resides comfortably, like a fish in a deep ravine, naturally smooth. If Qi and Blood are deficient and unable to nourish, the fetus cannot develop properly, and expulsion may be necessary to avoid disaster. However, when expulsion is indicated for fetal injury, the purgative method must be applied with extreme caution. Only when fetal death in utero is confirmed by heart pain, cyanotic tongue, cold abdomen, and foul breath should purgatives be used. One must first consolidate the pregnant woman's Yuan Qi, tonify Qi and nourish Blood, and then purge. If fetal insecurity is present without thorough examination, and harsh attacking drugs are used, unpredictable disasters may ensue. The essential principle "following nature" is most excellent. Lizhai also stated: only when the fetus truly cannot be preserved should expulsion be considered. Be cautious, be cautious; the warnings of former sages are profound. If expulsion is desired, Mirabilite (Puxiao) is indispensable.