火。庶胎得安。脉实者。加酒大黄下之。下迟则伤胎也。亦有伤胎下血。心神无主而谵语。虽用
峻补。亦难得效。若舌青者。子死腹中。急当
下之。若双胎一生死者。必腹中半边冷。半边热。因母患热证。脏腑热甚蒸其胎。儿因致死。但
服黑神散加生蒲黄以暖其胎。胎即出矣。胎未死。并泥涂脐以越胎气。多有保全者。
子悬 胎气凑泊上心。忽然昏晕。人事不省。谓之子悬。必妊娠素多郁闷。痰气壅塞。致胎
不安。乘其郁火升迫心下。喘胀腹痛。甚则忽然仆地。急宜童便灌之。次以紫苏饮加钩藤、茯苓、
姜汁、童便。将产时昏眩。亦宜紫苏饮。若误作中风。治之必殆。
子痫 妊娠体虚受风。则口噤背强。冒闷不识人。须臾自苏。良久复作。谓之风痉。亦名子
痫。甚则角弓反张。逍遥散加羌活、羚羊角、枣仁、钩藤。豆淋酒煎服。郑守恒云。子痫一证。
人不易识。或眩晕。或冷麻。重至仆地不省人事。验其平日眼目昏沉。或认白为黑。认黑为白。
是其渐也。
乳泣腹啼 未产乳汁先下。此名乳泣。生子多不育。又有儿在腹中啼哭者。因妊妇登高举臂。
脱出儿口中血乳。以此作声。令妊妇曲腰就地。如拾物状。或令扫地。仍入儿口即止。亦有胎热
不安而啼者。以黄连浓煎汁。妊妇时时呷之。
鬼胎 古人论鬼胎之说。皆由其人阳气不足。或肝气郁结。不能生发。致阴血不化而为患也。
有因经行时饮冷。停经而成者。有郁痰惊痰湿热。凝滞而成者。有因恚怒气食。瘀积互结而成者。
故凡鬼胎之脉。必沉细弦涩。或有时虚浮。有时沉紧。皆阳气不充之验。其腹虽渐大。而漫起重
坠。终与好胎不同。当脐或脐下左旁虽微动。亦与真胎迥别。治宜理气行血为主。如因于郁者。
逍遥散加莪术、乌药、香附、麝香。因于寒者。理中加乌头、蓬术、香附。因于痰者。导
痰加香附、乌药、干漆、炒桃仁。因于惊者。四七汤加茯神、辰砂、桂心、麝香。因于气食者。
大七气加酒曲。因于湿热者。当归龙荟丸加蓬术、苏木、香附。因血结者。代抵当去芒硝、大黄。
加焰硝、硫黄、五灵脂。虚人。只用十全大补加桂、附。是可缓图收功。不可峻用巴豆、芫花、
莽草、鬼臼等毒药急追取咎也。尝见得孕经止。尺脉或涩或微弱。而无他病。此子宫真气不全。
精血虽凝而阴不能化。终不成形。每至产时而下血块血胞。若此必大剂温补预调。而后方能成孕也。
下私胎法 妊娠诸病。以安胎为主。慎勿妄下。夭伤人命。造孽非小。有生育多。畏产而欲
下者。当与安胎之品。惟私胎方可下之。香桂散加乌头尖一钱立效。若本元虚寒者。得辛温之药。
愈助其生发之气。宜土牛膝一两。归尾三钱。川芎一钱。苏木三钱。桃仁泥三钱。穿山甲一钱。
三四服必下。煎成加麝香尤速。或曲四两。酒三大盏。煎取一盏五分。绵滤。分温三服立下。又
方。大曲五升。清酒一斗。煮二沸。去滓。分五服。隔宿勿食。但再服。其子如糜。母无疾苦。
又方。麦 一升为末。和水煮二升。服之立下。又方。以附子二枚为末。醇酒和涂右足。去之大
良。然不若以牛膝粗者取五七寸。候着子宫。将二指夹着送进。捻入三寸许以线系定。用帛兜束
腰中。不使退出。毋论月数多少。一夕即下。无不应者。
断子法 用酒曲一升。无灰酒五升。煮至二升半。滤去滓。分三服。经候至前一日。晚进一
服。次早五更一服。天明二服。月经即行。终身无妊矣。此千金下死胎法也。若妇人四十余。欲
其经断。以前方加牛膝、紫葳各一两。经行后。如前法服之即断。又木耳 灰存性。熬枯黑糖调。
经行后。或产后月内服之。即不孕。孕妇服。其胎即下。又头蚕子三钱。 灰存性。产后三五七
朝内。陈酒调服。则终身不孕。虽虚人亦无妨碍。
火邪扰动，使胎儿得以安宁。若脉象实大有力，可加入酒制大黄以通下攻积。若攻下过迟，则会损伤胎元。也有因胎元受损导致下血，心神失守而出现胡言乱语者，此时即使使用峻猛的补益药物，也难以取得疗效。若见舌色青紫，提示子死腹中，应当紧急使用下法排出死胎。若是双胎中一个存活、一个死亡的情况，必然表现为腹部半边冷、半边热。这是因为母亲患有热证，脏腑热盛蒸灼胎元，导致胎儿致死。此时只需服用黑神散加生蒲黄以温暖胎气，死胎即可排出。若胎元未死，可用泥涂敷脐部以制约胎气，多有保全胎儿的案例。
子悬：胎气上冲心膈，突然昏晕，人事不省，称为“子悬”。多因孕妇平素多忧郁郁闷，痰气壅塞，导致胎气不安。郁火升腾逼迫心下，出现气喘、胀满、腹痛，严重时突然仆倒在地。急救宜灌服童便，随后服用紫苏饮加钩藤、茯苓、姜汁、童便。临产时出现昏眩，也适宜用紫苏饮。若误当作中风治疗，必定危及生命。
子痫：妊娠期间体质虚弱感受风邪，则牙关紧闭、背部强直，头目昏蒙不识人，片刻后自行苏醒，良久又发作，称为“风痉”，又名“子痫”。严重者出现角弓反张。可用逍遥散加羌活、羚羊角、酸枣仁、钩藤，用豆淋酒煎服。郑守恒说：子痫这一病症，人们不易识别。有的表现为眩晕，有的表现为肢体冷麻，重则仆倒在地不省人事。查验其平日眼目昏沉，或把白色看成黑色，把黑色看成白色，这是发病的先兆。
乳泣腹啼：未分娩前乳汁先流出，名为“乳泣”，所生子女大多难以养育。又有胎儿在腹中啼哭的情况，是因为孕妇登高举臂，导致胎儿口中血乳脱出，以此发出声音。令孕妇弯腰贴近地面，如拾物状，或令其扫地，胎儿口中之物仍入口中即停止啼哭。也有因胎热不安而啼哭的，用黄连浓煎汁，让孕妇时时少量饮用。
鬼胎：古人论述鬼胎之说，都是由于人体阳气不足，或肝气郁结，不能生发，导致阴血不化而为患。有因经期饮冷，停经而成者；有因郁痰、惊痰、湿热凝滞而成者；有因愤怒饮食，瘀积互结而成者。所以凡是鬼胎的脉象，必然沉细弦涩，或有时虚浮，有时沉紧，这都是阳气不充的征验。其腹部虽然逐渐增大，但感觉沉重坠胀，终究与正常胎孕不同。肚脐或脐下左旁虽有微动，也与真胎截然不同。治疗应以理气行血为主。如因于郁结者，用逍遥散加莪术、乌药、香附、麝香。因于寒者，用理中汤加乌头、蓬术、香附。因于痰者，用导痰汤加香附、乌药、干漆、炒桃仁。因于惊恐者，用四七汤加茯神、辰砂、桂心、麝香。因于气食停滞者，用大七气汤加酒曲。因于湿热者，用当归龙荟丸加蓬术、苏木、香附。因于血结者，用代抵当汤去芒硝、大黄，加焰硝、硫黄、五灵脂。体虚之人，只用十全大补汤加肉桂、附子，可以缓慢图谋收功，不可峻猛使用巴豆、芫花、莽草、鬼臼等毒药急迫追取死胎。曾见过怀孕后经血停止，尺脉或涩或微弱，而无其他疾病，这是子宫真气不全，精血虽凝结但阴气不能化形，最终不成胎。每到产期时下血块血胞，像这种情况必须大剂温补预先调理，之后才能成孕。
下私胎法：妊娠期间的各种疾病，以安胎为主，切勿妄用下法，夭折人命，造孽非小。有生育较多，畏惧生产而想要堕胎者，应当给予安胎之品，只有私胎（非法或非意愿妊娠）方可使用下法。香桂散加乌头尖一钱，立竿见影。若本元虚寒者，得辛温之药，愈助其生发之气，不宜用此法。宜用土牛膝一两，当归尾三钱，川芎一钱，苏木三钱，桃仁泥三钱，穿山甲一钱，服用三四次必能堕胎。煎成后加麝香效果更快。或用神曲四两，酒三大盏，煎取一盏五分，绵布过滤，分三次温服，立即堕胎。又一法：大曲五升，清酒一斗，煮至二沸，去渣滓，分五次服用，隔宿禁食，再服药，胎儿化为糜状，母体无疾苦。又一法：麦麸一升为末，和水煮至二升，服用后立即堕胎。又一法：用附子二枚为末，醇酒调和涂于右脚，去除后效果很好。然而不如用粗壮的牛膝五七寸长，候其着子宫时，将两指夹着送进，捻入约三寸处用线系定，用帛带兜束腰部，不使其退出，不论月份多少，一夜即堕，无不奏效。
断子法：用酒曲一升，无灰酒五升，煮至二升半，滤去渣滓，分三次服用。月经来潮前一天晚上服一次，次日清晨五更服一次，天明服第二次，月经即行，终身不再受孕。这是《千金方》中的下死胎法。若妇人四十多岁，希望月经断绝，以前方加牛膝、紫葳各一两，月经行后，按前述方法服用即可断经。又法：木耳灰存性，熬枯黑糖调服，月经行后，或产后月内服用，即不孕。孕妇服用，其胎即下。又法：头蚕子三钱，艾灰存性，产后三五七天内，陈酒调服，则终身不孕，即使是体虚之人也无妨碍。
Fire pathogen disturbs, allowing the fetus to remain safe. If the pulse is full and forceful, add wine-processed Rhizoma et Radix Rhei (Dahuang) to purge accumulation. If purgation is delayed, it will damage the fetal origin. There are also cases where damaged fetal origin leads to vaginal bleeding, and loss of heart spirit causes delirium; even using strong tonifying medicines may fail to achieve efficacy. If the tongue appears cyanotic, it indicates a dead fetus in the uterus, and urgent purgation is required to expel the dead fetus. In the case of twins where one lives and one dies, the abdomen must feel cold on one side and hot on the other. This occurs because the mother suffers from heat syndrome, with excessive internal heat steaming the fetal origin, causing fetal death. At this time, simply administer Heishen San (Black Divine Powder) with raw Flos Puerariae Lobatae (Puhuang) to warm the fetal qi, and the dead fetus will be expelled. If the fetal origin is not dead, mud can be applied to the umbilicus to restrain fetal qi, with many cases of preserving the fetus.
Zixuan (Fetal Suspension): Fetal qi rushes upward to the heart and diaphragm, causing sudden fainting and unconsciousness, termed "Zixuan." It often arises because the pregnant woman has been prone to depression and melancholy, leading to phlegm-qi obstruction and fetal unrest. Rising郁 fire forces itself below the heart, causing panting, distension, abdominal pain, and in severe cases, sudden collapse. Emergency treatment involves administering fresh human urine (Tongbian), followed by Zisu Yin (Perilla Decoction) added with Ramulus Uncariae Cum Uncis (Gouteng), Poria Cocos (Fuling), ginger juice, and fresh human urine. Dizziness at the time of delivery should also be treated with Zisu Yin. Misdiagnosing this as wind-stroke will surely endanger life.
Zixian (Eclampsia): During pregnancy, if a weak constitution contracts wind pathogens, it results in locked jaws, back rigidity, mental confusion, and inability to recognize people, followed by spontaneous recovery after a moment, recurring later. This is termed "Wind Spasm" or also "Zixian." In severe cases, opisthotonos occurs. Xiaoyao San (Free and Easy Wanderer Powder) added with Radix Notopterygii (Qianghuo), Cornu Saigae Tataricae (Lingyangjiao), Semen Ziziphi Spinosae (Zaoren), and Ramulus Uncariae Cum Uncis (Gouteng) decocted in Doulin Jiu (Soybean-infused Wine) for oral administration. Zheng Shouheng stated: Zixian is difficult to identify. Symptoms may include dizziness or cold numbness, progressing to collapse and unconsciousness. Checking the patient's usual state reveals dull eyes, or misperceiving white as black and black as white, which are prodromal signs.
Ruqi Futí (Breast Milk Weeping and Fetal Crying): Breast milk flows before delivery, named "Ruqi"; children born from this are often unable to survive. Another phenomenon is a fetus crying in the womb, caused by the pregnant woman climbing high and raising her arms, causing blood and milk from the fetal mouth to escape and make sound. Instruct the pregnant woman to bend her waist to the ground, as if picking up an object, or sweep the floor; when the substance returns to the fetal mouth, the crying stops. Some cases involve fetal crying due to fetal heat unrest, treated by having the pregnant woman sip frequently concentrated decoction of Radix Coptidis (Huanglian).
Guotai (Ghost Fetus): Ancient discussions on Guotai attribute it to insufficient yang qi or liver qi stagnation failing to generate, leading to untransformed yin blood causing pathology. Causes include drinking cold beverages during menstruation leading to amenorrhea; stagnation of depressive phlegm, fright-phlegm, or damp-heat; or accumulation of blood stasis from anger and improper diet. Therefore, the pulse of Guotai is invariably deep, fine, wiry, and choppy, or sometimes floating and superficial, sometimes deep and tight, all verifying insufficient yang qi. Although the abdomen gradually enlarges, it feels heavy and dragging, distinctly different from a normal pregnancy. Slight movement near the umbilicus or left lower abdomen is also radically different from a true fetus. Treatment should focus on regulating qi and moving blood. For cases due to stagnation, use Xiaoyao San added with Rhizoma Curcumae Longae (Ezhu), Rhizoma Linderae (Wuyao), Rhizoma Cyperi (Xiangfu), and Moschus (Shexiang). For cold, use Lizhong Tang added with Radix Aconiti Lateralis Preparata (Wutou), Rhizoma Curcumae Phaeocaulis (Pengzhu), and Rhizoma Cyperi (Xiangfu). For phlegm, use Daotan Tang added with Rhizoma Cyperi (Xiangfu), Rhizoma Linderae (Wuyao), Resina Drynariae (Ganqi), and fried Semen Persicae (Taoren). For fright, use Siqi Tang added with Poria Cocos cum Woods (Fushen), Cinnabar (Chensha), Cortex Cinnamomi (Guixin), and Moschus (Shexiang). For qi and food stagnation, use Daqi Qi Tang added with fermented dough (Jiuqu). For damp-heat, use Danggui Longhui Wan added with Rhizoma Curcumae Phaeocaulis (Pengzhu), Tam Sappan Lignum (Sumu), and Rhizoma Cyperi (Xiangfu). For blood knotting, use Daidang Tang minus Mangxiao and Dahuang, adding Yanxiao, Liuhuang, and Feces Trogopterori (Wulingzhi). For deficient persons, only use Shiquan Dabu Tang added with Cortex Cinnamomi (Guizhi) and Radix Aconiti Lateralis Preparata (Fuzi); this allows for gradual success. Do not harshly employ toxic drugs like Crotonis Fructus (Baidu), Genkwa Flos (Yuanhua), Herba Isatidis (Mangcao), or Akebiae Fructus (Guijiu) for urgent expulsion. I have observed pregnancies where menstruation stopped, with chi pulse being choppy or weak without other diseases; this indicates incomplete true qi of the uterus. Although essence and blood condense, yin fails to transform, ultimately failing to form a fetus. Menstrual clots and membranes are discharged at term. Such cases require large doses of warming tonics for pre-conditioning before conception can occur.
Method for Aborting Illicit Pregnancy: Diseases during pregnancy prioritize securing the fetus; never recklessly use purgatives, as killing life creates great sin. Those with multiple births fearing delivery and wishing to abort should be given fetal-securing agents; only illicit pregnancies may be aborted. Xianggui San added with one qian of Wutou Jian (Aconite Tip) acts immediately. If the original constitution is deficient and cold,辛-warm medicines would further aid generation, so this method is unsuitable. Use Tu Niuxi (Achyranthes Bidentata Root) 1 liang, Danggui Wei (Angelica Sinensis Tail) 3 qian, Chuanxiong 1 qian, Sumu 3 qian, Tao Ren Ni (Peach Kernel Paste) 3 qian, and Shanjiapia (Pangolin Scale) 1 qian; three to four doses will induce abortion. Adding Moschus (Shexiang) to the decoction accelerates effect. Alternatively, use Shenqu (Medicated Leaven) 4 liang and clear wine 3 large cups, decoct to 1.5 cups, filter through silk, divide into three warm doses for immediate abortion. Another formula: Daqu (Large Medicated Leaven) 5 sheng, clear wine 1 dou, boil twice, remove dregs, divide into five doses; fast overnight, then take again; the fetus turns to mush, and the mother suffers no distress. Another formula: Maifan (Wheat Bran) 1 sheng powdered, boiled with water to 2 sheng; ingestion induces immediate abortion. Another formula: Powder two Fuzi (Prepared Aconite Root), mix with pure wine, apply to the right foot; removal yields good results. However, better is to take a thick Tu Niuxi root 5-7 cun long, insert it towards the uterus until it touches, push in about 3 cun, tie with thread, secure waist with cloth bandage to prevent exit; regardless of gestational age, abortion occurs within one night, always effective.
Sterilization Method: Use 1 sheng of Jiuqu (Medicated Leaven) and 5 sheng of Wuhui Jiu (Unbleached Wine), boil down to 2.5 sheng, filter dregs, divide into three doses. Take one dose the evening before expected menstruation, one dose at 5 AM next day, and the second dose at dawn; menstruation will flow, and lifelong sterility ensues. This is the Dead Fetus Expulsion Method from Qianjin Fang. For women over forty desiring menopause, add Niuxi and Ziwei to the previous formula, each 1 liang; after menstruation, take as before to stop periods. Another method: Mu'er Hui (Wood Ear Ash) preserved by burning, mixed with scorched brown sugar; taken after menstruation or within a month postpartum, it prevents pregnancy. Pregnant women taking it will abort. Another method: Tou Canzi (First-generation Silkworm Eggs) 3 qian and Ai Hui (Mugwort Ash) preserved by burning, taken with aged wine within 3, 5, or 7 days postpartum, ensures lifelong sterility, even in deficient persons without harm.