饮食如常烦不卧，不得小便转胞称。举胎救急丹溪法，四物升麻参术陈。服后探吐吐再服，不应阿
胶入五苓。
【注】妊娠胎压，胞系了戾不得小便，饮食如常，心烦不得卧者，名曰转胞。宜用丹
溪举胎法∶令稳婆香油涂手举胎起，则尿自出，以暂救其急。然后以四物汤加升麻、人
参、白术、陈皮煎服。服后以指探吐，吐后再服再吐，如此三四次，则胎举而小便利矣。
如不应，则是有饮，用五苓散加阿胶以清利之。
四物汤（方见首卷）
加味五淋散
子淋频浊窘涩疼，五淋栀苓归芍芩，甘草再加生地泽，车前滑石木通寻。
【注】孕妇小便频数窘涩，点滴疼痛，名曰子淋。宜五淋散，即黑栀、赤茯苓、当归、
白芍、黄芩、甘草，加生地、泽泻、车前子、滑石、木通，以清热而利水，则小便自通矣。
妊娠经来名激经，胎漏下血腹不疼，若是伤胎腹必痛，尿血漏血要分明。
【注】妇人受孕之后，仍复行经者，名曰激经，为血有余。若孕妇无故下血，或下黄
汁豆汁而腹不痛者，谓之胎漏。若其胎已伤而下血者，其腹必疼。孕妇又有尿血一证，腹
亦不痛，然与胎漏之证又不同。盖尿血出于
溺孔，漏血出自人门，三者俱下血而各不同治者，不可不详辨也。
阿胶汤 黄 汤 银苎酒 加味四物汤
激经无病不须治，子大能食经自停。胎漏下血多因热，四物阿胶栀侧芩；或下黄汁豆汁样，黄
糯米苎根银；若是尿血膀胱热，四物血余共茅根。
【注】激经无他证相兼者，不须用药，其胎壮子大能食其血而经自停。若胎漏下血，
多属血热，宜阿胶汤清之。其方即四物汤加阿胶、黑栀、侧柏叶、黄芩也。或漏下黄汁，
或如豆汁甚多者，其胎干枯必倚而堕，宜用黄 汤，即黄 二两，糯米一合煎服；或银
苎酒，即芒麻根，纹银煎酒服。若尿血，则是膀胱血热，宜四物汤加血余、白茅根以凉
之。
四物汤（方见首卷）
饮食正常但心烦无法安卧，小便不通称为转胞。急救可取丹溪的举胎法，用四物汤加升麻、人参、白术、陈皮。服用后探喉催吐，吐后再服；若无效，则加入阿胶配合五苓散。
【注】妊娠期间因胎儿压迫，导致膀胱系膜扭曲（了戾）而小便不通，饮食如常，心烦不得安卧者，名为转胞。宜采用丹溪的举胎法：让接生婆涂香油于手，托举胎儿使其位置升高，则尿液自然流出，以暂时缓解急症。随后服用四物汤加升麻、人参、白术、陈皮煎剂。服药后用手指探喉催吐，吐后再服药再催吐，如此反复三四次，则胎儿被托起，小便自通。如果仍无效，说明体内有水饮停滞，应使用五苓散加阿胶以清热利湿。
四物汤（方剂见首卷）
加味五淋散
孕妇小便频数、浑浊、窘迫涩痛，可用五淋散，即黑栀子、赤茯苓、当归、白芍、黄芩、甘草，再加生地、泽泻、车前子、滑石、木通。
【注】孕妇小便频数、窘迫涩滞、点滴刺痛，名为子淋。宜用五淋散，即黑栀子、赤茯苓、当归、白芍、黄芩、甘草，加生地、泽泻、车前子、滑石、木通，以清热利水，则小便自然通畅。
妊娠期间仍有月经来潮称为激经，胎漏下血但腹部不疼痛。若是伤胎则腹部必然疼痛，尿血与漏血需仔细分辨。
【注】妇女受孕之后，仍然行经者，名为激经，这是因为血气有余。若孕妇无故下血，或流出黄色汁液、豆汁样液体而腹部不痛者，称为胎漏。若胎儿已受损而下血，则腹部必然疼痛。孕妇还有一种尿血证，腹部也不痛，但这与胎漏不同。因为尿血出自尿道口，漏血出自阴道口，三者虽然都表现为下血，但治疗方法各不相同，不可不详细辨别。
阿胶汤、黄耆糯米汤、银苎酒、加味四物汤
激经若无其他病症兼夹，无需治疗，待胎儿壮实、大口吸食母血后，月经自然停止。胎漏下血多因血热，可用四物汤加阿胶、黑栀子、侧柏叶、黄芩；若流出黄色汁液或豆汁样液体且量多者，可用黄耆糯米汤，即黄耆二两、糯米一合煎服；或用银苎酒，即芒麻根、纹银煎酒服。若是尿血，则是膀胱血热，宜用四物汤加血余、白茅根以凉血。
四物汤（方剂见首卷）
Diet remains normal but restlessness prevents sleep; inability to urinate is termed *Zhuanbao* (Torsion of the Bladder). For emergency relief, apply Danxi's method of lifting the fetus: use Siwu Tang (Four Substances Decoction) augmented with Shengma (Cimicifugae Rhizoma), Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), and Chenpi (Citri Reticulatae Pericarpium). After ingestion, induce vomiting by stimulating the throat; if ineffective, add Ejiao (Colla Corii Asini) to Wuling San (Five-Ingredient Powder with Poria).
[Note] During pregnancy, fetal pressure causes torsion of the bladder ligaments (*lao li*), resulting in urinary retention. With normal diet, restlessness, and inability to lie down comfortably, this condition is named *Zhuanbao*. One should employ Danxi’s method of lifting the fetus: have the midwife apply sesame oil to her hands and manually lift the fetus upward, which will allow urine to flow naturally, providing temporary emergency relief. Subsequently, administer a decoction of Siwu Tang (Four Substances Decoction) added with Shengma (Cimicifugae Rhizoma), Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma), and Chenpi (Citri Reticulatae Pericarpium). After taking the medicine, induce vomiting by probing the throat with a finger; repeat the process of taking medicine and inducing vomiting three or four times. This will lift the fetus and restore normal urination. If there is no response, it indicates the presence of fluid retention (*yin*); use Wuling San (Five-Ingredient Powder with Poria) added with Ejiao (Colla Corii Asini) to clear heat and promote diuresis.
Siwu Tang (Formula see Volume 1)
Jiawei Wulin San (Modified Five-Lin Powder)
Frequent, turbid, distressing, and painful urination during pregnancy can be treated with Wulin San (Five-Lin Powder), composed of Heizhi Zi (Gardeniae Fructus), Chifuling (Poria cum Lignum Quercinum), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), plus Shengdi (Rehmanniae Radix Preparata), Zexie (Alismatis Rhizoma), Cheqianzi (Plantaginis Semen), Huashi (Talcum), and Mutong (Akebiae Caulis).
[Note] Frequent, distressing, and painful urination with scanty drops in pregnant women is named *Zilin* (Pregnancy Dysuria). It is suitable to use Wulin San (Five-Lin Powder), consisting of Heizhi Zi (Gardeniae Fructus), Chifuling (Poria cum Lignum Quercinum), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Huangqin (Scutellariae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), added with Shengdi (Rehmanniae Radix Preparata), Zexie (Alismatis Rhizoma), Cheqianzi (Plantaginis Semen), Huashi (Talcum), and Mutong (Akebiae Caulis), to clear heat and promote water metabolism, thereby restoring normal urination.
Menstruation occurring during pregnancy is called *Jijing* (Provoked Menstruation); bleeding from *Tailou* (Fetal Leakage) occurs without abdominal pain. If the fetus is injured, abdominal pain must occur; hematuria and fetal leakage must be clearly distinguished.
[Note] When a woman continues to menstruate after conception, it is named *Jijing* (Provoked Menstruation), indicating an excess of blood. If a pregnant woman bleeds spontaneously, or discharges yellow fluid resembling bean juice, without abdominal pain, it is called *Tailou* (Fetal Leakage). If the fetus is damaged and bleeding occurs, abdominal pain is inevitable. Pregnant women may also suffer from hematuria, where the abdomen is not painful; however, this differs from *Tailou* (Fetal Leakage). Hematuria originates from the urethral opening, while *Tailou* (Fetal Leakage) originates from the vaginal opening. Although all three conditions involve bleeding, their treatments differ significantly and require careful differentiation.
Ejiao Tang (Donkey-Hide Gelatin Decoction), Huangqi Tang (Astragalus Decoction), Yinzhu Jiu (Silver and Ramie Root Wine), Jiawei Siwu Tang (Modified Four Substances Decoction)
If *Jijing* (Provoked Menstruation) presents without accompanying symptoms, no medication is needed; as the fetus grows strong and consumes the excess blood, menstruation will cease naturally. *Tailou* (Fetal Leakage) bleeding is mostly due to blood heat; treat with Siwu Tang (Four Substances Decoction) added with Ejiao (Colla Corii Asini), Heizhi Zi (Gardeniae Fructus), Ce Bai Ye (Biota Top Leaf), and Huangqin (Scutellariae Radix). If discharge resembles yellow fluid or bean juice and is abundant, use Huangqi Tang (Astragalus Decoction), comprising two taels of Huangqi (Astragali Radix) and one he of glutinous rice, decocted and taken orally; or use Yinzhu Jiu (Silver and Ramie Root Wine), made by decocting Mangmagen (Ramie Root) and Wen Yin (Fine Silver) in wine. If hematuria occurs, it is due to blood heat in the bladder; treat with Siwu Tang (Four Substances Decoction) added with Xueyu (Hui Capillaris) and Maogen (Imperatae Rhizoma) to cool the blood.
Siwu Tang (Formula see Volume 1)