妊娠心腹痛，或宿有冷痞痰饮结聚，或新触风寒，邪正相击。若胸腹膨满，按之而痛，乃饮食停
滞，用人参养胃汤；按之不痛，乃脾胃受伤，以六君补之。腹中满痛叉心，不得饮食《千金》芩术芍
药汤。如不时腹痛，名曰胎痛。有血虚，有气滞二因，然血虚居多，用熟地三钱、当归一钱，
煎汤治之。不应，加参、术、陈皮，丹溪用四物去川芎，倍加熟地。若气滞者，紫苏饮治之；若痛而
重坠，因中气虚陷，用补中益气汤。
如胃口痛，多因脾虚，存食不消，宜养胃消食，《纲目》用平胃散，加枳壳、山楂。予谓∶平胃
散恐致损胎，非所宜也，宜养胃汤加减。
妊娠胁痛，有因哭泣，因内伤，因恼怒，不宜破气，宜用童便和酒服之，或紫苏饮去参，用白芍、
当归，加砂仁、童便。
妊娠脐下冷痛，腹胀虚疼，小便频数，大便虚滑，皆食生冷所致，小建中加炮姜、木香。不应，
更加茴香、良姜。
妊娠少腹痛，虚热，紫苏饮；虚寒，胶艾汤。若小腹近下处肿胀，浮薄发光者，孕痈也，《千金》
托里散，或薏苡仁煎汁饮。若心腹急痛，烦闷面青，冷汗气绝，血下不止，其胎上冲者，不可治也。
妊娠腰痛，有肾虚作痛，则脉大而痛不已，急服八珍加胶艾、黄 ，或紫苏饮加减。有劳力任重，
致伤胞系欲脱，宜安胎饮，加杜、续。有房事不节，致伤胞系，用熟地、当归、阿胶、砂仁、竹茹、
炙草，调男子裤裆灰一钱，禁房事百日要紧。有湿热脉缓，遇天阴或久坐而痛，多下白物，二妙散加
柴胡、防风、茯苓、半夏。有寒湿腰重如带物而冷者，用紫苏饮加减，易健脾温燥药。有气血凝滞脉
涩，而日轻夜重，不得卧，遍身拘急不舒而痛，眼生黑花，紫苏饮加枳壳、桔梗。有闷锉脉实，胶艾
芎归汤，或佛手散，或熬枯黑糖，冲童便，酒调服。有走注痛，败血入经之症，四乌汤加薄、桂、杜、续。
妊娠背脊痛，气滞也，紫苏饮治之。
妊娠腰腹及背痛，夫肾主腰，劳损经虚，风冷乘之则腰痛，乘虚入腹则腹痛，故腰腹相引而痛，
痛不止，恐坠胎。又有劳伤腰腹背痛，补中益气加杜仲。然多有因病淋症而痛者，宜体察之，止用
加味导赤汤治淋，淋止痛除。
妊娠环跳穴痛，属肾虚，宜六味地黄汤加杜、续，或《千金》保孕丸。
妊娠目赤痛，咽喉痛，口鼻唇舌疮痛，俱用凉膈散加减。
妊娠负重跌仆，凝血作痛，欲服活血药，则恐伤胎，不服则所伤之血，留而不去。治之者，当先
辨胎之死生，如无别症，只用黑糖熬枯，入陈酒、童便调服。细嚼连皮胡桃过口，死者当下，生者
其痛即止。若因怒跌仆，或手足抽搐者，紫苏饮加钩藤。倘去血过多，八珍汤去茯苓，加阿胶、艾
叶、黄 。
人参养胃汤 治食滞痞满。
人参 苍术（米泔水浸，去皮，麻油拌炒黄色） 陈皮（去白） 藿香 制夏 浓朴（去皮，姜
汁炒） 茯苓 草果 炙草 姜 枣 乌梅
引水煎服。
《千金》芩术芍药汤 治妊娠腹中满痛，叉手，不得饮食。
白术（六钱土炒） 黄芩（二钱） 白芍（四钱）
上三味，水煎，分三服。半日令尽。
紫苏饮 治妊娠临月浮肿喘胀，并子悬症，胎不安，上 作痛，或临产气结不下等症。
当归（酒洗） 紫苏 川芎 芍药（酒炒） 陈皮 大腹皮（黑豆水煮，制净各一钱） 人参
炙草（各五分）
引加生姜三、五片，葱白七寸，水煎服。感冒风寒，去腹皮，加香豉，胎动不安，加炒黄芩、
土炒白术；胎不运动，加木香、砂仁。
胶艾汤 治妇人漏下，或半产后下血不绝，或妊娠下血腹痛，亦治损伤冲任，月水过多，
淋漓不断。
干地黄（二钱） 芍药（一钱半） 阿胶（蒲黄炒成珠） 艾叶 当归（各一钱） 川芎 甘草（各分）
《千金》托里散 治半身以下湿热疼重而肿。
浓黄柏（姜汁制数次） 苍术（茅山者佳，去皮，切片。麻油拌炒黄色）
等分为散，姜汁调，空心温酒送二钱。
胶艾芎归汤 治妊娠二、三月至八、九月，顿仆跌伤，胎动不安，腰腹疼痛欲死，已有所下。
阿胶（蛤粉或蒲黄炒珠） 川芎 当归 干地黄 艾叶
四乌汤 治血中气滞，小腹急痛。
熟地 当归（各二钱酒洗） 川芎（八分） 白芍（一钱半酒炒） 乌药（六分） 香附（七分制）
炙草（五分）
加味导赤汤 治孕妇小便少又涩痛者，谓之子淋，又治溺血。
人参 生地 条芩 木通 甘草梢 麦冬（去心） 赤芍（各一钱） 淡竹叶十五片
东垣凉膈散 孕妇有热病，如目赤、口舌疮之类，各随其症加减用之。
黄芩（酒炒） 黄连（酒炒） 山栀仁（酒炒） 连翘（去心） 桔梗 生草（各等分） 薄荷叶
（少许）
妊娠期间出现心腹疼痛，或者原本就有冷痞、痰饮结聚，或者是新近感受风寒，邪气与正气相互搏击。如果胸腹部膨满，按压时感到疼痛，这是饮食停滞所致，使用人参养胃汤；按压时不痛，这是脾胃受伤所致，用六君子汤补益。腹部胀满疼痛且牵连心胸，不能进食，用《千金方》的芩术芍药汤。如果不定时腹痛，称为胎痛。有血虚和气滞两种原因，然而血虚居多，用熟地黄三钱、当归一钱，煎汤治疗。如果无效，加入人参、白术、陈皮，丹溪用四物汤去掉川芎，加倍增加熟地黄。如果是气滞引起的，用紫苏饮治疗；如果疼痛伴有沉重下坠感，是因为中气虚弱下陷，用补中益气汤治疗。
如果胃口疼痛，多因脾虚，食物存留不消化，宜养胃消食，《本草纲目》用平胃散，加枳壳、山楂。我认为：平胃散恐怕会损伤胎儿，不太适宜，宜用养胃汤加减。
妊娠期间胁肋疼痛，有因哭泣引起，有因内伤引起，有因恼怒引起，不宜使用破气药物，宜用童便和酒送服，或者紫苏饮去掉人参，用白芍、当归，加砂仁、童便。
妊娠期间脐下冷痛，腹胀虚疼，小便频数，大便虚滑，都是食用生冷食物所致，用小建中汤加炮姜、木香。如果无效，再加茴香、良姜。
妊娠期间少腹疼痛，属虚热，用紫苏饮；属虚寒，用胶艾汤。如果小腹靠近下部肿胀，皮肤浮薄发亮，这是孕痈，用《千金方》的托里散，或者薏苡仁煎汁饮用。如果心腹急痛，烦闷面色青，冷汗出甚至气绝，阴道流血不止，胎气上冲的，无法治疗。
妊娠期间腰痛，有肾虚作痛，则脉大且疼痛不止，急服八珍汤加阿胶、艾叶、黄芩，或者紫苏饮加减。有因劳累负重，导致胞系受损欲脱，宜用安胎饮，加杜仲、续断。有因房事不节，导致胞系受伤，用熟地黄、当归、阿胶、砂仁、竹茹、炙甘草，调男子裤裆灰一钱，禁止房事百日要紧。有湿热脉缓，遇到阴天或久坐而痛，多排出白色分泌物，用二妙散加柴胡、防风、茯苓、半夏。有寒湿腰重如带重物且冷者，用紫苏饮加减，替换为健脾温燥的药物。有气血凝滞脉涩，白天轻晚上重，无法躺卧，全身拘急不适而痛，眼生黑花，用紫苏饮加枳壳、桔梗。有闷痛脉实，用胶艾芎归汤，或者佛手散，或者熬枯黑糖，冲童便，酒调服。有走注痛（疼痛游走不定），是败血入经的症状，用四乌汤加薄荷、肉桂、杜仲、续断。
妊娠期间腰腹及背痛，肾主腰部，劳损经脉空虚，风冷乘虚侵袭则腰痛，乘虚进入腹部则腹痛，所以腰腹相互牵引而痛，疼痛不止，恐怕会导致堕胎。又有因劳伤导致的腰腹背痛，用补中益气汤加杜仲。然而多有因病淋症而痛的，应当仔细体察，只用加味导赤汤治疗淋证，淋证止住疼痛就消除。
妊娠期间环跳穴疼痛，属于肾虚，宜用六味地黄汤加杜仲、续断，或者《千金方》的保孕丸。
妊娠期间因负重跌仆，凝血作痛，想服用活血药，恐怕损伤胎儿，不服用则受伤的血液留存不去。治疗者，应当先辨别胎儿的死生，如果没有其他症状，只用黑糖熬枯，入陈酒、童便调服。细嚼连皮胡桃过口，胎儿死的会排出，活的疼痛立即停止。如果因愤怒跌仆，或者手足抽搐的，用紫苏饮加钩藤。倘若失血过多，用八珍汤去掉茯苓，加阿胶、艾叶、黄芩。
人参养胃汤 治疗食滞痞满。
人参 苍术（米泔水浸，去皮，麻油拌炒黄色） 陈皮（去白） 藿香 制半夏 浓朴（去皮，姜汁炒） 茯苓 草果 炙甘草 生姜 大枣 乌梅
引水煎服。
《千金方》芩术芍药汤 治疗妊娠腹中满痛，叉手护心，不能进食。
白术（六钱土炒） 黄芩（二钱） 白芍（四钱）
以上三味，水煎，分三次服用。半日内服完。
紫苏饮 治疗妊娠临月浮肿喘胀，以及子悬症，胎不安，上胸部作痛，或者临产气结不下等症状。
当归（酒洗） 紫苏 川芎 芍药（酒炒） 陈皮 大腹皮（黑豆水煮，制净各一钱） 人参 炙甘草（各五分）
引加生姜三、五片，葱白七寸，水煎服。感冒风寒，去掉腹皮，加香豉；胎动不安，加炒黄芩、土炒白术；胎不运动，加木香、砂仁。
胶艾汤 治疗妇人漏下，或者半产后下血不绝，或者妊娠下血腹痛，也治疗损伤冲任，月水过多，淋漓不断。
干地黄（二钱） 芍药（一钱半） 阿胶（蒲黄炒成珠） 艾叶 当归（各一钱） 川芎 甘草（各五分）
《千金方》托里散 治疗半身以下湿热疼重而肿。
浓黄柏（姜汁制数次） 苍术（茅山者佳，去皮，切片。麻油拌炒黄色）
等分为散，姜汁调，空心温酒送二钱。
胶艾芎归汤 治疗妊娠二、三月至八、九月，顿仆跌伤，胎动不安，腰腹疼痛欲死，已有所下。
阿胶（蛤粉或蒲黄炒珠） 川芎 当归 干地黄 艾叶
四乌汤 治疗血中气滞，小腹急痛。
熟地黄 当归（各二钱酒洗） 川芎（八分） 白芍（一钱半酒炒） 乌药（六分） 香附（七分制） 炙甘草（五分）
加味导赤汤 治疗孕妇小便少又涩痛者，称为子淋，又治疗溺血。
人参 生地 条芩 木通 甘草梢 麦冬（去心） 赤芍（各一钱） 淡竹叶十五片
东垣凉膈散 孕妇有热病，如目赤、口舌疮之类，各随其症加减用之。
黄芩（酒炒） 黄连（酒炒） 山栀仁（酒炒） 连翘（去心） 桔梗 生甘草（各等分） 薄荷叶（少许）
Abdominal and epigastric pain during pregnancy may arise from pre-existing cold stagnation, phlegm-fluid retention, or recent exposure to wind-cold, where pathogenic factors clash with healthy qi. If the chest and abdomen are distended and painful upon palpation, it indicates food stagnation; treat with Renshen Yangwei Tang (Ginseng Stomach-Nourishing Decoction). If there is no pain upon palpation, it indicates spleen-stomach injury; tonify with Liujunzi San (Six-Gentlemen Powder). Abdominal fullness and pain radiating to the heart, accompanied by inability to eat, is treated with Qinshu Shaoyao Tang (Scutellaria, Atractylodes, and Peony Decoction) from *Qianjin Fang*. Irregular abdominal pain is termed "Tai Tong" (Fetal Pain). It has two causes: blood deficiency and qi stagnation, with blood deficiency being more common. Use Shudi (Rehmanniae Radix Preparata) 3 qian and Danggui (Angelicae Sinensis Radix) 1 qian, decocted in water. If ineffective, add Renshen (Ginseng), Baizhu (Atractylodis Macrocephalae Rhizoma), and Chenpi (Citri Reticulatae Pericarpium). Danxi used Siwu Tang (Four-Substance Decoction) removing Chuanxiong (Ligustici Chuanxiong Rhizoma) and doubling Shudi. For qi stagnation, use Zisu Yin (Perilla Infusion). If pain is accompanied by a heavy, bearing-down sensation due to middle qi deficiency and sinking, use Buzhong Yiqi Tang (Decoction for Reinforcing the Middle and Augmenting Qi).
Epigastric pain is often due to spleen deficiency and indigestion of retained food; nourish the stomach and digest food. *Bencao Gangmu* suggests Pingwei San (Peaceful Stomach Powder) with Zhike (Aurantii Fructus) and Shanzha (Crataegi Fructus). I argue that Pingwei San may damage the fetus and is not suitable; instead, use modified Yangwei Tang.
Hypochondriac pain during pregnancy may result from weeping, internal injury, or anger. Breaking qi methods should be avoided. Use urine from a healthy child (Tongbian) mixed with wine, or modify Zisu Yin by removing Renshen, using Shaoyao (Paeoniae Radix Alba), Danggui, adding Renchen (Amomi Fructus Rotundus), and Tongbian.
Cold pain below the umbilicus, abdominal distension with empty pain, frequent urination, and loose stools are caused by consuming raw and cold foods. Treat with Xiaojianzhong Tang (Minor Construct the Middle Decoction) plus Paojiang (Zingiberis Rhizoma Preparatum) and Muxiang (Aucklandiae Radix). If ineffective, add Huixiang (Foeniculi Fructus) and Liangjiang (Alpiniae Officinarum Rhizoma).
Lower abdominal pain during pregnancy: if due to empty heat, use Zisu Yin; if due to empty cold, use Jiaoai Tang (Donkey-Hide Gelatin and Mugwort Decoction). Swelling near the lower abdomen with thin, shiny skin indicates "Yun Yong" (Pregnancy Abscess); treat with Tuoli San (Support the Interior Powder) from *Qianjin Fang*, or drink decoction of Yiyiren (Coicis Semen). If there is acute epigastric pain, irritability, cyanotic face, cold sweat, syncope, continuous vaginal bleeding, and fetal gas rushing upward, it is incurable.
Lower back pain during pregnancy: if due to kidney deficiency, the pulse is large and pain persists; urgently administer Bazhen Tang (Eight-Treasure Decoction) plus Ejiao (Asini Corii Colla), Aiyè (Artemisiae Argyi Folium), and Huangqin (Scutellariae Radix), or modified Zisu Yin. If caused by overexertion and heavy lifting damaging the uterine ligaments threatening miscarriage, use Antai Yin (Fetus-Securing Infusion) plus Duzhong (Eucommiae Cortex) and Xuduan (Dipsaci Radix). If caused by excessive sexual activity damaging uterine ligaments, use Shudi, Danggui, Ejiao, Renchen, Zhuru (Bambusae Caulis in Taenia), and Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata), mixed with 1 qian of ash from men's underwear crotch; strictly avoid sexual intercourse for 100 days. If damp-heat presents with a slow pulse, pain worsens on cloudy days or after prolonged sitting, with leukorrhea, use Ermiao San (Two-Marvels Powder) plus Chaihu (Bupleuri Radix), Fangfeng (Saposhnikoviae Radix), Fuling (Poria), and Banxia (Pinelliae Rhizoma). If cold-damp causes heaviness like wearing a weight and coldness, modify Zisu Yin with spleen-fortifying and warming-drying herbs. If qi-blood stagnation presents with choppy pulse, pain worse at night than day, insomnia, whole-body stiffness and pain, and visual spots, use Zisu Yin plus Zhike and Jiegeng (Platycodonis Radix). If dull pain with a forceful pulse, use Jiaoai Xiong Gui Tang (Donkey-Hide Gelatin, Ligusticum, and Angelica Decoction), or Foshou San (Buddha's Hand Powder), or burnt brown sugar mixed with Tongbian and wine. For migratory pain indicating stagnant blood entering meridians, use Siwu Tang (Note: Text says Siwu but lists ingredients for Siwu Tang variant? Text says "Si Wu Tang" but context implies a specific formula named "Si Wu Tang" here which might be a typo for something else or a specific local name, sticking to text "Si Wu Tang") plus Bohe (Menthae Haplocalycis Herba), Rougui (Cinnamomi Cortex), Duzhong, and Xuduan.
Back pain during pregnancy is due to qi stagnation; treat with Zisu Yin.
Pain involving the lower back, abdomen, and back: The kidneys govern the lower back. Fatigue depletes meridians, allowing wind-cold to invade causing back pain; invading the abdomen causes abdominal pain, leading to mutual pulling pain. Persistent pain risks miscarriage. For fatigue-induced back/abdominal pain, use Buzhong Yiqi Tang plus Duzhong. However, pain may also stem from strangury; examine carefully. Treat strangury with Jiawei Daochi Tang (Modified Guide-Out Red Decoction); once strangury resolves, pain ceases.
Pain at the Huantiao acupoint during pregnancy belongs to kidney deficiency; use Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill) plus Duzhong and Xuduan, or Baoyun Wan (Pregnancy-Preserving Pills) from *Qianjin Fang*.
Red eyes, sore throat, and sores in mouth, nose, lips, and tongue during pregnancy are all treated with modified Liangge San (Cool the Diaphragm Powder).
Trauma from carrying heavy loads causing blood stasis pain: Using blood-invigorating herbs risks harming the fetus; not using them leaves injured blood. First determine fetal viability. If no other symptoms, use burnt brown sugar mixed with aged wine and Tongbian. Chew peeled walnuts thoroughly; if the fetus is dead, it will be expelled; if alive, pain stops immediately. If trauma resulted from anger or convulsions, use Zisu Yin plus Gouteng (Uncariae Ramulus cum Uncis). If excessive blood loss occurs, use Bazhen Tang removing Fuling, adding Ejiao, Aiyè, and Huangqin.
Renshen Yangwei Tang treats food stagnation and fullness.
Ingredients: Renshen, Cangzhu (soaked in rice water, peeled, stir-fried with sesame oil until yellow), Chenpi (peeled), Huoxiang, Zhi Banxia, Houpo (peeled, stir-fried with ginger juice), Fuling, Caoguo, Zhigancao, Shengjiang, Dazao, Wumei.
Decoct with water as guide.
Qinshu Shaoyao Tang (*Qianjin Fang*) treats abdominal fullness and pain, guarding the chest with hands, inability to eat.
Ingredients: Baizhu (6 qian, stir-fried with soil), Huangqin (2 qian), Shaoyao (4 qian).
Decoct three ingredients in water, divide into three doses. Finish within half a day.
Zisu Yin treats edema and wheezing near term, Zi Xuan syndrome (floating fetus), fetal restlessness, upper chest pain, or stuck labor qi.
Ingredients: Danggui (wine-washed), Zisu, Chuanxiong, Shaoyao (wine-fried), Chenpi, Dafupi (boiled in black bean water, processed, each 1 qian), Renshen, Zhigancao (each 5 fen).
Add 3-5 slices of Shengjiang and 7 cun of Congbai (scallion white), decoct in water. For wind-cold, remove Dafupi, add Chidou Chi (Fermented Soybean). For restless fetus, add fried Huangqin and soil-fried Baizhu. For non-moving fetus, add Muxiang and Renchen.
Jiaoai Tang treats metrorrhagia, post-miscarriage bleeding, or pregnancy bleeding with abdominal pain. Also treats damage to Chong and Ren vessels with menorrhagia.
Ingredients: Shengdihuang (2 qian), Shaoyao (1.5 qian), Ejiao (fried with Puhuang until granular), Aiyè, Danggui (each 1 qian), Chuanxiong, Gancao (each 5 fen).
Tuoli San (*Qianjin Fang*) treats damp-heat pain, heaviness, and swelling in the lower half of the body.
Ingredients: Huangbai (processed multiple times with ginger juice), Cangzhu (from Maoshan preferred, peeled, sliced, stir-fried with sesame oil until yellow).
Grind into powder, mix with ginger juice, take 2 qian with warm wine on an empty stomach.
Jiaoai Xiong Gui Tang treats trauma between 2-3 months and 8-9 months of pregnancy causing fetal restlessness, severe lower back and abdominal pain, and bleeding.
Ingredients: Ejiao (fried with Ge Fen or Puhuang), Chuanxiong, Danggui, Shengdihuang, Aiyè.
Siwu Tang treats qi stagnation in blood with acute lower abdominal pain.
Ingredients: Shudi, Danggui (each 2 qian, wine-washed), Chuanxiong (8 fen), Shaoyao (1.5 qian, wine-fried), Wuyao (6 fen), Xiangfu (7 fen, processed), Zhigancao (5 fen).
Jiawei Daochi Tang treats oliguria and dysuria in pregnant women, known as Zi Lin (Fetal Strangury), and hematuria.
Ingredients: Renshen, Shengdi, Tiaoqin, Mutong, Gancao Shao, Maidong (heart removed), Chishao (each 1 qian), Danzhuye (15 leaves).
Dongyuan Liangge San treats heat syndromes in pregnant women, such as red eyes and oral ulcers, modified according to symptoms.
Ingredients: Huangqin (wine-fried), Huanglian (wine-fried), Shanzhiren (wine-fried), Lianqiao (heart removed), Jiegeng, Sheng Gancao (equal parts), Boheye (small amount).