朱丹溪曰∶有妇经住三月后，尺脉或涩，或微弱，其妇却无病，知是子宫真气不全。故阳不施，阴不化，
精血虽凝，终不成形，至产血块，或产血胞也。唯脉洪盛者，胎不堕。
王海藏曰∶堕胎皆由气血虚损，不能荣养胎元而堕。或七情太甚，内火发动，火能消物而堕，或过伤劳役
饥饱，动胎而堕。或过于房事，触动其胎而堕。或劳力跌扑闪挫，伤动其胎而堕。或大怒悲哀，伤动心肝之血
而堕。然小产重于大产，由于胎脏损伤，胞系腐烂故也。治宜补虚生肌肉，养脏气，生新血，去瘀血为主。或
素有堕胎之患者，宜按证治之。
王节斋曰∶妇人堕胎，多在三五七月。除跌扑损伤外，若前次三月而堕，则下次亦必如期而堕。故于产后，
须多服养气血之剂，以固胎元而补其虚。如养胎全在脾胃，譬犹盅悬于梁，梁软则盅下坠，折则堕矣。故白术
为补脾安胎之要药也。若因气者，多加砂仁，少佐木香以行气。
慎斋按∶以上十条，序胎前有堕胎证也。妊娠堕胎，有客邪外伤而堕者，有气血虚弱而堕者，有劳力房事
动火而堕者，前条已备病机之要。而保胎之法，节斋之论，在养脾胃其本也。莫若《千金》保胎丸，用白术、
黄芩、熟地、当归、杜仲、续断、阿胶、香附、益母、川芎、陈皮、砂仁、艾叶，枣肉丸一方为最妙。赵养葵得
其意，以六味丸加杜仲、续断、阿胶、五味，急滋肾水，以固胎元。正以胎系于肾，肾气壮则胎固而可安。此
正补脾不如补肾之要妙也。
朱丹溪说：有妇女月经停止三个月后，尺脉或涩滞，或微弱，这位妇女却没有其他病症，知道这是子宫真气不足。因此阳气不能施化，阴精不能转化，虽然精血已经凝结，最终也不能成形，到生产时排出的是血块，或者是血胞。只有脉象洪大旺盛的，胎儿才不会流产。
王海藏说：流产都是因为气血虚损，不能滋养胎元而导致流产。或者七情（喜、怒、忧、思、悲、恐、惊）过于强烈，引发内火，火能消蚀物体导致流产；或者过度劳累、饥饱失调，扰动胎气导致流产；或者房事过度，触动胎气导致流产；或者用力劳动、跌打损伤、闪挫扭伤，伤动胎气导致流产；或者大怒悲哀，伤动心肝之血导致流产。然而小产重于大产，这是因为胎脏受损，胞系腐烂的缘故。治疗应当以补虚、生肌肉、养脏气、生新血、去瘀血为主。如果有习惯性流产病史的患者，应当根据具体证候进行治疗。
王节斋说：妇人流产，多发生在怀孕第三、五、七月。除了跌打损伤外，如果前一次在三个月时流产，那么下一次也必定会如期流产。所以在产后，必须多服用调养气血的药物，以巩固胎元并补充虚弱。因为养胎完全依赖于脾胃，好比容器悬挂在梁上，梁软则容器下坠，梁折则容器坠落。所以白术是补脾安胎的重要药物。如果是因气滞引起的，多加砂仁，少量佐以木香来行气。
慎斋按语：以上十条，叙述了胎前有流产证候的情况。妊娠流产，有因外感客邪外伤而流产的，有因气血虚弱而流产的，有因劳累、房事动火而流产的，前面的条文已经备述了病机的要点。而保胎的方法，王节斋的论述，在于调养脾胃作为根本。不如《千金方》中的保胎丸，使用白术、黄芩、熟地黄、当归、杜仲、续断、阿胶、香附、益母草、川芎、陈皮、砂仁、艾叶，用枣肉制成丸剂，这一方最为巧妙。赵养葵领会其意，在六味地黄丸基础上加入杜仲、续断、阿胶、五味子，紧急滋补肾水，以巩固胎元。正因为胎气系于肾，肾气壮盛则胎固而可安。这正是补脾不如补肾的要妙之处。
Zhu Danxi stated: In some women, after menstruation has ceased for three months, the chi pulse (pulse at the wrist position corresponding to the kidneys and lower jiao) may be choppy or weak. If the woman presents with no other symptoms, it indicates insufficiency of the true qi in the uterus. Consequently, yang fails to transform and yin fails to differentiate; although essence and blood have coagulated, they ultimately fail to form a fetus. At delivery, what is expelled are blood clots or the gestational sac. Only when the pulse is full and vigorous will the fetus not miscarry.
Wang Haizang stated: Miscarriage is invariably caused by deficiency and damage of qi and blood, which fail to nourish the fetal origin. It may also result from excessive emotional stimulation, triggering internal fire that consumes substances and causes miscarriage; or from overexertion, irregular diet, disturbing the fetus; or from excessive sexual activity, agitating the fetus; or from physical labor, falls, or sprains, injuring the fetus; or from extreme anger or grief, damaging the blood of the heart and liver. However, spontaneous abortion (small birth) is more severe than term delivery because it involves damage to the uterine organ and decay of the placental membranes. Treatment should primarily focus on tonifying deficiency, generating flesh, nourishing visceral qi, generating new blood, and eliminating stasis. Patients with a history of habitual miscarriage should be treated according to their specific patterns.
Wang Jiezhai stated: Female miscarriages often occur during the third, fifth, or seventh months of pregnancy. Excluding traumatic injury, if a previous miscarriage occurred at three months, the next one will likely occur at the same time. Therefore, after delivery, one must take ample formulas to nourish qi and blood to consolidate the fetal origin and replenish deficiency. Nourishing the fetus relies entirely on the spleen and stomach, akin to a vessel hanging from a beam; if the beam is soft, the vessel sinks; if it breaks, the vessel falls. Thus, Atractylodis Macrocephalae Rhizoma (Baizhu, 白术) is a crucial herb for strengthening the spleen and calming the fetus. If the cause is qi stagnation, add more Amomum Fructus (Sharen, 砂仁), and assist slightly with Aucklandiae Radix (Muxiang, 木香) to move qi.
Shenzhai commented: The above ten items describe conditions preceding miscarriage during pregnancy. Pregnancy loss can be caused by external pathogenic factors and trauma, deficiency of qi and blood, or disturbance of fire due to exertion and sexual activity; the preceding texts have already covered the essential pathogenesis. Regarding methods to preserve the fetus, Wang Jiezhai’s discussion emphasizes nourishing the spleen and stomach as the root. The formula Bao Tai Wan (Fetus-Preserving Pill) from *Qianjin Fang* is considered the most excellent, comprising Atractylodis Macrocephalae Rhizoma (Baizhu, 白术), Scutellariae Radix (Huangqin, 黄芩), Rehmanniae Radix Praeparata (Shudihuang, 熟地), Angelicae Sinensis Radix (Danggui, 当归), Eucommiae Cortex (Duzhong, 杜仲), Dipsaci Radix (Xuduan, 续断), Asini Corii Colla (Ejiao, 阿胶), Cyperi Rhizoma (Xiangfu, 香附), Leonuri Herba (Yimucao, 益母), Chuanxiong Rhizoma (Chuanxiong, 川芎), Tangerine Peel (Chenpi, 陈皮), Amomum Fructus (Sharen, 砂仁), and Mugwort Leaf (Aiyè, 艾叶), made into pills with date paste. Zhao Yangkui grasped its essence by adding Eucommiae Cortex (Duzhong, 杜仲), Dipsaci Radix (Xuduan, 续断), Asini Corii Colla (Ejiao, 阿胶), and Schisandrae Fructus (Wuweizi, 五味) to Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia). This urgently nourishes kidney water to consolidate the fetal origin. Since the fetus is anchored by the kidney, robust kidney qi ensures the fetus remains secure. This illustrates the profound principle that tonifying the kidney is superior to tonifying the spleen in this context.