《产宝百问》曰∶妊娠成形，胎息未实，或因房室惊触，劳力过度，伤动胞胎，或因食毒物，致令子宫虚
滑，经血淋沥。若不急治，败血凑心，子母难保。
陈良甫曰∶妊娠漏胎，谓妊娠数月，而经水时下也。此由冲任脉虚，不能约制手太阳少阴之经血故也。冲
任之脉，为经络之海，起于胞内，手太阳小肠脉，手少阴心脉，二经相为表里，上为乳汁，下为月水。有娠之
人，经水所以断者，壅之养胎也。冲任气虚，则胞内泄，不能制其经血，故月水时下，名胞漏，血尽则毙。又有
因劳役喜怒，哀乐不节，饮食生冷，触冒风寒，遂致胎动，若母有宿疾，子脏为风冷所乘，气血失度，使胎
不安，故令下血也。
朱丹溪曰∶胎漏多因于血热，然有气虚血少者，故《良方》论有下血服凉血药，而下血益甚，食少体倦，
此脾气虚而不能摄血也。
《大全》曰∶妊娠忽然下黄汁如胶，或如豆汁，胎动腹痛。
薛立斋按∶前证肝脾湿热，用升阳除湿汤。若肝脾风热，加味逍遥散。肝脾郁怒，加味归脾汤。脾胃气虚，
钱氏白术散。若脾气下陷，补中汤。肝经风热，防风黄芩丸，风入肠胃，用胃风汤。
薛立斋曰∶妊娠下血不止，名胎漏。血虚用二黄散，血去多用八珍汤，未应，用补中汤。若因事而动，下
血，用枳壳汤加生熟
地，未应，或作痛，更加当归。血不止，八珍汤加胶、艾。若因怒气，用小柴胡汤。若因风热，一味防风丸。
若因血热，一味子芩丸。若脾气虚弱，六君子汤。中气下陷，补中汤。若气血盛而下血者，乃儿饮少也，不
必服药。《千金方》治妊娠下血不止，名曰漏胎，血尽子死，方用生地八两，清酒捣汁，服之无时，能多服佳。
慎斋按∶以上七条，序胎前有胎漏下血之证也。妊娠胎漏，《金匮》主于 病痼害，巢氏主于荣经有风，
是属有余客邪为病也。若《产宝》以下，《大全》、丹溪主于气虚血虚，是属内伤不足为病也。观立斋用药一
条，已分有余不足证治矣。
《产宝百问》说：妊娠期间胎儿成形，但胎气尚未稳固，可能因为房事、惊吓触动，或者过度劳累用力，损伤了胞胎；也可能因为食用有毒食物，导致子宫虚弱滑利，经血淋漓不断。如果不紧急治疗，败血攻心，母子都难以保全。
陈良甫说：妊娠漏胎，是指怀孕数月后，月经仍然时下时止。这是由于冲脉和任脉虚弱，不能约束手太阳小肠经和手少阴心经的经血所致。冲脉和任脉是经络之海，起源于胞宫内部。手太阳小肠经和手少阴心经互为表里，上行化为乳汁，下行化为月经。怀孕的人，月经之所以停止，是因为气血壅滞以滋养胎儿。如果冲任二脉气虚，则胞宫内泄，不能控制经血，所以月经时下，称为胞漏，如果血液流尽则会死亡。又有因为劳累、喜怒无常、哀乐不节制，饮食生冷，或受风寒侵袭，导致胎动不安；如果母亲有旧疾，子宫被风冷邪气乘虚而入，气血失调，使胎儿不安稳，从而导致下血。
朱丹溪说：胎漏大多因为血热引起，但也有气虚血少的情况，所以《良方》中论述有服用凉血药后，下血反而更严重，伴有食欲不振、身体疲倦，这是脾气虚弱不能统摄血液所致。
《大全》说：妊娠突然流出黄色汁液，像胶一样，或者像豆汁一样，伴有胎动腹痛。
薛立斋按语：前面的证候属于肝脾湿热，使用升阳除湿汤。如果是肝脾风热，加味逍遥散。肝脾郁怒，使用加味归脾汤。脾胃气虚，用钱氏白术散。如果是脾气下陷，用补中益气汤。肝经风热，用防风黄芩丸，风邪侵入肠胃，用胃风汤。
薛立斋说：妊娠下血不止，称为胎漏。血虚用二黄散，失血多用八珍汤，如果无效，用补中益气汤。如果因事情刺激而动胎，下血，用枳壳汤加生地黄和熟地黄，如果无效，或者出现疼痛，再加当归。血仍不止，用八珍汤加阿胶、艾叶。如果因为怒气引起，用小柴胡汤。如果因为风热，用一味防风丸。如果因为血热，用一味子芩丸。如果脾气虚弱，用六君子汤。中气下陷，用补中益气汤。如果气血旺盛而下血，这是因为胎儿吸食营养较少，不必服药。《千金方》治疗妊娠下血不止，称为漏胎，如果血流尽胎儿会死，方剂用地黄八两，清酒捣汁，随时服用，能多服更好。
慎斋按语：以上七条，叙述了胎前有胎漏下血的证候。关于妊娠胎漏，《金匮要略》主张病痼害（原有久病），巢元方主张荣经有风，这属于有余的客邪致病。而《产宝》以下，《大全》、朱丹溪主张气虚血虚，这属于内伤不足致病。看薛立斋用药的一条，已经区分了有余和不足证的治法了。
Chanbao Baiwen (Hundred Questions on Childbirth) states: During pregnancy, when the fetus is formed but the fetal qi is not yet solid, it may be due to sexual intercourse, fright or shock, or excessive labor and exertion, which damages the fetal sac. It may also be caused by consuming toxic foods, leading to a deficiency and slipping of the uterus, resulting in dripping menstrual blood. If not treated urgently,敗血 (defective blood) will rush to the heart, endangering both mother and child.
Chen Liangfu states: Pregnancy leakage (Tai Lou) refers to the condition where, several months into pregnancy, menstruation still occurs intermittently. This is caused by the deficiency of the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel), which fail to restrain the blood of the Hand-Taiyang Small Intestine Meridian and Hand-Shaoyin Heart Meridian. The Chong and Ren vessels are the sea of meridians, originating from inside the Bao Gong (Uterus). The Hand-Taiyang Small Intestine Meridian and Hand-Shaoyin Heart Meridian are exterior-interior pairs; their qi ascends to form milk and descends to form menstruation. In pregnant women, menstruation stops because blood and qi are congested to nourish the fetus. If the qi of the Chong and Ren vessels is deficient, the interior of the uterus leaks, failing to control menstrual blood, thus causing intermittent menstruation, known as Bao Lou (Fetal Sac Leakage); if the blood is exhausted, death ensues. Additionally, due to overwork, uncontrolled emotions (anger, joy, sorrow, happiness), irregular diet of cold/raw foods, or exposure to wind-cold, fetal movement may occur. If the mother has chronic diseases, the Zang Zang (Uterus) is invaded by wind-cold pathogens, leading to imbalance of qi and blood, making the fetus unstable and causing bleeding.
Zhu Danxi states: Fetal leakage is mostly caused by Blood Heat (Xue Re), but there are cases of Qi Deficiency and Blood Deficiency. Therefore, in Liangfang (Excellent Prescriptions), it is discussed that taking cooling-blood medicines can exacerbate bleeding, accompanied by poor appetite and fatigue, which indicates Spleen Qi Deficiency failing to control the blood.
Daquan (General Collection) states: In pregnancy, sudden discharge of yellow fluid resembling glue or bean juice occurs, accompanied by fetal movement and abdominal pain.
Xue Lizhai's commentary: The aforementioned symptoms belong to Damp-Heat in the Liver and Spleen, treated with Sheng Yang Chu Shi Tang (Yang-Raising Damp-Removing Decoction). If it is Wind-Heat in the Liver and Spleen, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). For Liver-Spleen Stagnation and Anger, use Jiawei Guipi Tang (Modified Restore the Spleen Decoction). For Spleen-Stomach Qi Deficiency, use Qian Shi Baizhu San (Qian’s Atractylodes Macrocephala Powder). If Spleen Qi sinks, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). For Liver Meridian Wind-Heat, use Fangfeng Huangqin Wan (Saposhnikovia and Scutellaria Pill); if wind enters the intestines and stomach, use Weifeng Tang (Stomach Wind Decoction).
Xue Lizhai states: Continuous bleeding during pregnancy is called Tai Lou (Fetal Leakage). For Blood Deficiency, use Erhuang San (Two Yellow Powders); for significant blood loss, use Bazhen Tang (Eight Treasures Decoction); if ineffective, use Buzhong Yiqi Tang. If bleeding occurs due to emotional or physical agitation, use Zhike Tang (Citrus Aurantium Decoction) added with Sheng Dihuang (Rehmannia Root, Raw) and Shu Dihuang (Rehmannia Root, Prepared); if ineffective or pain develops, add Danggui (Angelica Sinensis). If bleeding persists, use Bazhen Tang added with Ejiao (Donkey-hide Gelatin) and Aiye (Mugwort Leaf). If caused by anger, use Xiaochaihu Tang (Minor Bupleurum Decoction). If caused by Wind-Heat, use Yiwu Fengfeng Wan (Single Herb Saposhnikovia Pill). If caused by Blood Heat, use Yiwu Ziqing Wan (Single Herb Scutellaria Seed Pill). If Spleen Qi is weak, use Liujunzi Tang (Six Gentlemen Decoction). If Middle Qi sinks, use Buzhong Yiqi Tang. If bleeding occurs despite abundant Qi and Blood, it is because the fetus consumes less nourishment, so no medicine is needed. Qianjin Fang (Essential Prescriptions Worth a Thousand Gold) treats continuous bleeding in pregnancy, called Lotou (Leaking Fetus), where exhaustion of blood leads to fetal death; the formula uses eight liang of Shengdi (Raw Rehmannia Root), pounded with clear wine to extract juice, taken at any time, preferably in larger doses.
Shenzhai's commentary: The above seven items describe the syndrome of fetal leakage and bleeding before delivery. Regarding pregnancy fetal leakage, Jingui Yaolue (Essential Prescriptions of the Golden Cabinet) attributes it to Bing Gu Hai (chronic disease hindrance), while Chao Shi (Chao Yuanfang) attributes it to Feng (Wind) in the Ying Jing (Nutritive Vessels), categorizing these as pathogenic excess factors. In contrast, Chanbao, Daquan, and Zhu Danxi attribute it to Qi Deficiency and Blood Deficiency, categorizing these as internal injury and insufficiency. Observing Xue Lizhai’s prescription guidelines, the treatment for excess and deficiency syndromes is already distinguished.