〔大全〕妊娠羸瘦，或挟疾病，脏腑虚损，气血枯竭，既不能养胎，致胎动而不坚
固，终不能安者，则可下之，免害妊妇也。
〔薛〕前证宜用腰腹背痛门方论主之。其胎果不能安者，方可议下，慎之慎之。
鸿胪张淑人痢疾后胎动，心神不安，肢体殊倦，用八珍散二十余剂渐愈。因劳加烦热头
痛，以大剂补中益气汤加蔓荆子治之，热痛顿止，仍用前散又五十余剂而安。其后生产
甚易。今大中丞许少薇公向令金坛时，夫人胎漏，疗治不止，时迫于上。许公欲因其
势遂下之，谋于余，余第令服佛手散，以为可安即安，不可安即下，顺其自然而已。既
数服，公忧疑不决。女科医者检方以进，乃用牛膝一两，酒煎服，谓牛膝固补下部药耳，
用之何害。公遂信而服之，而胎果下。余时有从母之戚，未及知，比知而驰至，则闻盈
庭皆桂麝气，盖因胞衣未下，许医又进香桂散矣，血遂暴下如大河决，不可复止，亟煎
独参汤未成而卒。公哀伤甫定而过余谢，且念余曰∶牛膝补药而能堕胎，何也？余对曰∶
生则宣而熟则补，故破血之与填精，如箭锋相拄，岂独牛膝哉？鹿角亦堕胎破血，而煎
为白胶，则安胎止血，因其熟而信其生，此之谓粗工。公叹恨无已。余故特着之，以为
世戒。
〔大全〕治妊娠母因疾病，胎不能安，可下之。
取七月七日法面（《大全》作曲。）四两，水二大盏，煎取一盏，三分，绵滤去滓，分温
三服，立下。
又方 大曲五升，清酒一斗，煮二沸，去渣，分五服，隔宿勿食，但再服，其子如糜，
母无疾苦。（千金不传，炒。）
又方 麦 一升为末，和水煮二升，服之即下。（神效）
又方 附子（二枚） 为末，以淳苦酒和涂右足，去之，大良。
又方 取鸡子一枚，以三指撮盐放鸡子中，服之立出。
按∶陈良甫所列有牛膝汤、桂心散诸方，娄全善皆不之取，而独取此数方，其见卓矣。
〔断产〕
〔丹〕断子法 用白面曲一升，无灰酒五升，打作糊，煮二升半，用绢帛滤去渣，作
三服，候前月经将来日，晚下吃一服，次日五更吃一服，天明吃一服，月经即行，终身
绝子。
〔大〕断产验方 故蚕纸方圆一尺，烧为末，酒饮调服，终身不复怀孕。
又方 用油煎水银一日方息，空心服枣核大一丸，永断孕，不损人。
四物汤每服五钱，加芸苔子二钱，于经行后空心温服。
〔薛〕前云用蚕故纸尺许烧灰为末，产后酒服之，血虚者终不复孕。大抵断产之剂，
多用峻厉，往往有不起者，是则产之害未若断产之害也。吾闻阁老张罗峰、太常李恒斋
俱因服断产之剂，自谓形体俱怯，遇劳必病，有由然矣。
按∶《夷坚志》载∶东京女子白牡丹，以售堕胎药生，得恶报。今虽列如上方，以备
万一之用，用者尚其慎之。
【《大全》】妊娠期间身体消瘦羸弱，或者兼夹疾病，导致脏腑虚损，气血枯竭，既然不能滋养胎儿，致使胎动不安且不能坚固，最终无法安胎的，可以采用下胎法，以免危害孕妇。
【薛己】上述证候应当参考《腰腹背痛门》中的方论进行治疗。如果胎儿确实无法保全，才可以考虑使用下胎法，务必谨慎再谨慎。
鸿胪寺官员张淑人在患痢疾后出现胎动，心神不宁，肢体极度疲倦，服用八珍散二十多剂后逐渐痊愈。后因劳累加重，出现烦热、头痛症状，用大剂量补中益气汤加蔓荆子治疗，热痛立刻停止，随后继续服用前一方五十多剂而胎安。后来生产非常顺利。当时大中丞许少薇公在担任金坛县令时，其夫人出现胎漏（妊娠期阴道少量出血），经过治疗出血不止，当时情况危急。许公想顺应病势让胎儿排出，向我咨询，我只让他服用佛手散，认为可以安胎就安胎，不能安胎就下胎，顺其自然罢了。服药几次后，许公忧虑怀疑，犹豫不决。另一位妇科医生检查药方后呈上，竟然使用牛膝一两，用酒煎服，说牛膝本来是补益下部的药物，用它有什么害处呢？许公于是相信并服用，结果胎儿果然排出。我当时正逢母亲去世的丧事，来不及知道此事，等我得知消息赶到时，只听到满屋都是肉桂和麝香的气味，原来因为胞衣未下，许医又使用了香桂散，导致血液突然大量涌出像大河决堤一样，无法再止住，急忙煎煮独参汤，药还没熬成就去世了。许公哀伤刚定就来向我致谢，并且疑惑地问我：“牛膝是补药却能堕胎，为什么呢？”我回答说：“生品具有宣通作用，熟品才具有补益作用，所以破血与填精的作用，如同箭锋相对，针锋相对，难道只有牛膝是这样吗？鹿角也能堕胎破血，但煎制成白胶（阿胶）后，就能安胎止血，因为将其视为熟品而相信它能补益，这就是所谓的粗工（庸医）。许公叹息悔恨不已。我特意记录此事，作为世人的警戒。
【《大全》】治疗妊娠期间母亲因患病，胎儿不能安稳，可以使用下胎法。
取七月七日采集的面曲四两，水两大盏，煎取一盏，分三次过滤去渣，温服，胎儿即可立即排出。
另一首方：大曲五升，清酒一斗，煮沸两次，去渣，分五次服用，隔宿禁食，只需再服用一次，胎儿就会如糜粥般排出，母亲没有痛苦。（此方出自《千金方》，需炒制。）
又一首方：麦麸一升研为末，和水煮至二升，服用后即可排出。（神效）
又一首方：附子（两枚）研为末，用纯苦醋调和涂抹右脚，洗去，效果很好。
又一首方：取鸡蛋一枚，用三指撮取的盐放入鸡蛋中，服用后立即排出。
按语：陈良甫所列有牛膝汤、桂心散等方，娄全善都不采用，唯独选取这几首方，他的见识卓越啊。
【断产】
【朱丹溪】断子法：用白面曲一升，无灰酒五升，调成糊状，煮至二升半，用绢帛过滤去渣，分三次服用。等到下次月经来潮的前一天晚上吃一服，第二天五更天吃一服，天亮时吃一服，月经即行，终身绝育。
【《大全》】断产验方：旧的蚕纸一方尺，烧成灰，用酒调服，终身不再怀孕。
又一首方：用油煎熬水银一天直到停止挥发，空腹服用如枣核大一丸，永久断孕，不损伤人体。
【薛己】前面所说用旧蚕纸尺许烧灰为末，产后用酒服用，血虚者终身不再受孕。大抵断产的药剂，多用峻烈之品，往往有导致死亡的，那么生产的危害还不如断产的危害大。我听说阁老张罗峰、太常李恒斋都因为服用断产药剂，自认为形体虚弱，遇劳必病，是有原因的。
按语：《夷坚志》记载：东京女子白牡丹，因为贩卖堕胎药而生，得到恶报。现在虽然列出如上各方，以备万一之用，使用者尚且要谨慎啊。
[Da Quan] If a pregnant woman is emaciated, or complicated by disease, resulting in deficiency and damage of the Zang-Fu organs, and exhaustion of Qi and Blood, such that she cannot nourish the fetus, causing fetal movement instability and failure to secure the pregnancy, ultimately unable to maintain the fetus, then abortion (induction of labor/abortion) may be employed to avoid harming the mother.
[Xue Ji] The aforementioned syndrome should be treated according to the formulas and discussions in the "Waist, Abdomen, and Back Pain" section. Only if the fetus truly cannot be secured should one consider inducing abortion; exercise utmost caution.
Zhang Shuren, an official of the Honglu Temple, experienced fetal movement after suffering from dysentery, with restlessness of the mind and spirit and extreme fatigue of the limbs. After taking more than twenty doses of Bazhen San (Eight Treasures Powder), he gradually recovered. Due to overexertion, symptoms of vexation, heat, headache, and pain worsened. He was treated with a large dose of Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Manjingzi (Vernoniae Semen), which immediately stopped the heat and pain. He continued taking the previous formula for another fifty doses, securing the pregnancy. Subsequently, his delivery was very smooth.
At that time, Xu Shaowei, Grand Commissioner, while serving as Magistrate of Jintan, had a wife who suffered from fetal leakage (threatened miscarriage with vaginal bleeding). Despite treatment, the bleeding did not stop, and the situation became critical. Mr. Xu wished to follow the course of the pathology to induce abortion and consulted me. I simply instructed him to take Foshou San (Buddha's Hand Powder), advising that if the fetus could be secured, so be it; if not, induce abortion, following nature. After several doses, Mr. Xu remained worried and indecisive. Another gynecological physician presented a prescription containing Niuxi (Achyranthis Bidentatae Radix) one liang, decocted in wine, claiming that Niuxi is essentially a tonic for the lower body, so what harm would there be? Mr. Xu believed this and administered it, and the fetus was indeed expelled.
I was then mourning the death of my mother and was unaware of the incident until I rushed to the scene. By then, the air was filled with the scent of Rougui (Cinnamomi Cortex) and Shexiang (Moschus), because since the placenta had not been expelled, Dr. Xu had prescribed Xianggui San (Fragrant Cinnamon Powder). Consequently, blood gushed forth violently like a bursting river, impossible to stop. An urgent decoction of Dushen Tang (Single Ginseng Decoction) was prepared, but he passed away before it was ready.
After his grief subsided, Mr. Xu came to thank me and asked in confusion: "Niuxi is a tonic, yet it causes abortion. Why?" I replied: "Raw herbs promote circulation and dispersion, while cooked herbs tonify. Thus, the action of breaking blood stasis versus replenishing essence are diametrically opposed, like arrowheads colliding. Is Niuxi the only herb like this? Lujiao (Cervi Cornus Colla) can also cause abortion and break blood stasis, but when decocted into Baijiao (Ejiao, Donkey-Hide Gelatin), it secures the fetus and stops bleeding. Mistaking the raw for the cooked and believing it to be a tonic characterizes a crude practitioner (incompetent doctor). Mr. Xu sighed in regret. I recorded this specifically as a warning to the world.
[Da Quan] To treat cases where the mother's illness causes fetal instability during pregnancy, abortion may be induced.
Take four liang of Mianqu (Wheat Leaven) collected on the seventh day of the seventh lunar month, add two large bowls of water, decoct to obtain one bowl, filter through cotton cloth to remove dregs, divide into three warm doses. The fetus will be expelled immediately.
Another formula: Take five sheng of Daqu (Large Leaven), one dou of Qingjiu (Clear Wine), boil twice, remove residue, divide into five doses. Fast overnight. After taking two doses, the fetus will be expelled like gruel, and the mother will suffer no distress. (From Qianjin Fang, stir-fried.)
Another formula: Take one sheng of Maifan (Wheat Bran), grind into powder, mix with water, boil to two sheng, consume. Expulsion occurs immediately. (Miraculous effect)
Another formula: Take two Fuzi (Aconiti Lateralis Radix Praeparata), grind into powder, mix with pure Kujiu (Bitter Wine/Vinegar), apply to the right foot, wash off later. Highly effective.
Another formula: Take one chicken egg, place salt (pinched with three fingers) inside the egg, consume. Expulsion occurs immediately.
Commentary: Chen Liangfu listed formulas such as Niuxi Tang and Guixin San, but Lou Quanshan rejected them all, selecting only these few. His insight was outstanding.
[Inducing Sterility]
[Zhu Danxi] Method to prevent conception: Use one sheng of Baomianqu (White Wheat Leaven) and five sheng of Wuhuijiu (Unadulterated Wine). Mix into a paste, boil to two and a half sheng, filter through silk cloth to remove residue. Divide into three doses. On the eve of the expected menstruation, take one dose at night; the next morning at wugeng (3-5 AM), take one dose; at dawn, take the final dose. Menstruation will commence, resulting in lifelong sterility.
[Da Quan] Verified Formula for Inducing Sterility: Burn one square chi of old Canzhi (Silkworm Skin/Paper) to ash, mix with wine and ingest. Lifelong prevention of pregnancy.
Another formula: Boil Shuiyin (Mercurius) in oil for one day until fumes cease. Ingest a pill the size of a jujube pit on an empty stomach. Permanently prevents pregnancy without harming the person.
Siwu Tang (Four Substance Decoction): Five qian per dose, add two qian of Yuntaizi (Brassicae Pekinensis Seed). Warmly ingest on an empty stomach after menstruation ends.
[Xue Ji] As mentioned previously, burning old silkworm skin to ash and ingesting with wine postpartum results in lifelong infertility for those with Blood deficiency. Generally, formulas for inducing sterility use harsh and drastic agents, often leading to fatal outcomes. Thus, the harm of childbirth is less than the harm of induced sterility. I have heard that Zhang Luofeng, Grand Secretary, and Li Hengzhai, Taichang Official, both suffered from physical weakness and illness upon exertion after taking sterility-inducing drugs, which explains their condition.
Commentary: "Yijian Zhi" records that Bai Mudan, a woman in Dongjing, received karmic retribution for selling abortifacients. Although the above formulas are listed here for emergency reference, users must exercise extreme caution.