《金匮要略》曰∶妇人怀妊六七月，脉弦，发热，其胎愈胀，腹痛恶寒者，少腹如扇。所以然者，子脏开故
也，当以附子汤温其脏。
徐忠可曰∶六七月胃肺养胎，而气为寒所滞，故胎愈胀。寒在内，腹痛恶寒。然恶寒有属表者，此连腹痛，
则知寒伤内矣。少腹如扇，阵阵作冷，若或扇之，此状恶寒之异也。且独在少腹，因子脏受寒不能合，故少腹
独甚。开者，不敛也。子脏即子宫。附子能入肾，温下焦，故宜附子汤温其经。
《大全》曰∶妊娠心腹痛，或宿有冷疼，或新触风寒，皆因脏虚而致发动也。邪正相击，而并于气，随气
上下，上冲于心则心痛，下攻于腹则腹痛。妊娠痛，邪正二气交攻于内。若不瘥，痛冲胞胎，必致动胎，甚则
伤堕。
陈良甫曰∶妊娠心腹疼痛，多是风寒湿冷痰饮，与脏气相击，故令腹痛攻不已，则致胎动。
《大全》曰∶妊娠四五月后，每常胸腹间气刺满痛，或肠鸣，以致呕逆减食。此由忿怒忧思过度，饮食失
节所致。蔡元度宠人有子，夫人怒欲逐之，遂成此病，医官王师复处以木香散，莪术、木香、丁香、甘草，盐
汤下，三服而愈。
方约之按∶此方所言，妇人忿怒忧思过度，以致胸腹间气刺满痛，此言良是。盖妇人上有舅姑丈夫，事触物
忤，不能自决，忧思忿怒，沉郁于中。故丹溪云∶气郁便是火，火载胎上，荣卫不通，则胸腹间胀满痛作矣。
慎斋按∶以上四条，序胎前腹痛，有风寒客邪，痰饮七情，为有余之病也。
《金匮要略》说：妇女怀孕六七月时，脉象弦，伴有发热，胎儿胀感加重，腹痛且怕冷，小腹部感觉像被扇子扇风一样冷。之所以这样，是因为子宫（子脏）开张的缘故，应当用附子汤来温暖子宫。
徐忠可说：怀孕六七月时，由胃和肺滋养胎儿，但气机被寒邪阻滞，所以胎儿胀感加重。寒邪在体内，导致腹痛和怕冷。然而，怕冷也有属于表证的，这里伴随腹痛，就知道是寒邪伤了内脏。小腹部像被扇子扇风一样，阵阵发冷，好像有人在扇风，这是怕冷症状的特殊表现。而且只有小腹部严重，因为子宫受寒不能闭合，所以小腹部特别严重。“开”，指不收敛。子宫即子宫。附子能入肾经，温暖下焦，所以适宜用附子汤温暖经脉。
《妇人大全良方》说：妊娠期间心腹疼痛，或者是平时就有冷痛，或者是新近触犯风寒，都是因为脏腑虚弱而引发的。邪气与正气相互搏击，并随气机运行，向上冲逆到心脏则引起心痛，向下攻冲到腹部则引起腹痛。妊娠期的疼痛，是邪气和正气在体内交争。如果不痊愈，疼痛冲击胞胎，必然导致动胎，严重时甚至会造成流产或堕胎。
陈良甫说：妊娠期间心腹疼痛，多是风寒湿冷、痰饮等邪气，与脏腑之气相互搏击，所以导致腹痛攻冲不止，进而引起胎动不安。
《妇人大全良方》说：妊娠四五月以后，经常感到胸腹部有气刺满痛，或者肠鸣，以致呕吐逆气、食欲减退。这是由于愤怒、忧思过度，以及饮食失节所导致的。蔡元度宠爱的小妾生了儿子，夫人愤怒想要驱逐她，于是形成了这个病证，医官王师复开具了木香散（莪术、木香、丁香、甘草），用盐汤送服，服用三剂后痊愈。
方约之按语：这个方子所说的情况，妇人因愤怒、忧思过度，导致胸腹部气机阻滞、刺痛、胀满疼痛，这种说法是正确的。大概妇人上有公婆丈夫，做事常遇到违逆之物，不能自主决断，忧思愤怒，郁结在心中。所以丹溪说：气郁就会化火，火气载着胎气上逆，营卫不通畅，那么胸腹部就会出现胀满疼痛。
The *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) states: When a woman is pregnant for six or seven months, if the pulse is wiry (Xian), accompanied by fever, and the sensation of fetal distension increases, with abdominal pain and aversion to cold, feeling as if the lower abdomen is being fanned. The reason for this is that the Zi Zang (uterus) is open; therefore, Fuzi Tang (Aconite Decoction) should be used to warm the uterus.
Xu Zhongke stated: During the sixth and seventh months of pregnancy, the Stomach and Lung nourish the fetus, but Qi is stagnated by cold pathogenic factors, causing increased fetal distension. Cold residing internally leads to abdominal pain and aversion to cold. Although aversion to cold can belong to exterior syndromes, since it is accompanied by abdominal pain here, it indicates that cold has injured the interior. The sensation of the lower abdomen being fanned refers to periodic chills, as if someone were fanning it; this is a distinct manifestation of aversion to cold. Moreover, the symptom is isolated to the lower abdomen because the Zi Zang (uterus), having been invaded by cold, fails to close, making the lower abdomen particularly severe. "Open" means not converging. The Zi Zang is the uterus. Fuzi (Radix Aconiti Lateralis Preparata) enters the Kidney meridian and warms the Lower Jiao (Lower Burner); thus, Fuzi Tang (Aconite Decoction) is appropriate to warm the meridians.
The *Daquan Yifang* (Great Comprehensive Medical Formulas) states: Heart and abdominal pain during pregnancy, whether pre-existing cold pain or newly contracted wind-cold, all arise from deficiency in the Zang organs triggering the condition. Evil and righteous Qi strike each other and move with Qi circulation; ascending to the heart causes heart pain, while descending to the abdomen causes abdominal pain. In pregnancy pain, evil and righteous Qi contend internally. If not resolved, the pain impacts the Bao Tai (fetus and placenta), inevitably causing fetal movement, and in severe cases, miscarriage or abortion.
Chen Liangfu stated: Heart and abdominal pain during pregnancy are mostly caused by wind-cold, dampness, cold, phlegm-fluids clashing with the Qi of the Zang organs, leading to unceasing attacking abdominal pain, which then results in fetal movement.
The *Daquan Yifang* (Great Comprehensive Medical Formulas) states: After four or five months of pregnancy, one often experiences stabbing, fullness, and pain in the chest and abdomen due to Qi, or borborygmus, leading to vomiting, regurgitation, and reduced appetite. This is caused by excessive anger and worry/thought, along with irregular diet. Cai Yuandu had a favored concubine who bore a son; the Madam was angry and wanted to expel her, resulting in this illness. Physician Wang Shifu prescribed Muxiang San (Costus Powder) containing Ezhu (Rhizoma Curcumae), Muxiang (Radix Aucklandiae), Dingxiang (Flos Caryophylli), and Gancao (Radix Glycyrrhizae), taken with salt water. After three doses, she recovered.
Fang Yuezhi commented: The prescription mentioned above addresses the condition where excessive anger and worry/thought in women lead to stabbing, fullness, and pain in the chest and abdomen due to Qi stagnation; this statement is correct. Generally, women have parents-in-law and husbands above them; when matters encounter opposition, they cannot decide independently. Worry, thought, anger, and depression sink into the center. Therefore, Danxi said: Qi stagnation becomes Fire; Fire carries the fetal Qi upward, causing Ying and Wei (Nutritive and Defensive Qi) to become obstructed, resulting in swelling, fullness, and pain in the chest and abdomen.
Shenzhai commented: The above four items describe prenatal abdominal pain caused by exogenous wind-cold pathogens, phlegm-fluids, and Seven Emotions (Qing Zhi), classifying them as excess syndromes.