（附妊娠经来）
脉经云∶妇人经月下，但为微少，师脉之，反言有躯。其后审然，其脉何类，何以别之？师
曰∶寸口脉阴阳俱平，荣卫调和，按之则滑，浮之则轻，阳明少阴，各如经法，身反洒淅，不欲
饮食，头痛心乱，呕吵欲吐，呼则微数，吸则不惊。阳多气溢，阴滑气盛，当作血盛，滑则多
实，六经养成，所以月见，阴见阳精，汁凝胎散，散者损堕。设复阳盛，双妊二胎，今阳不
足，故令激经也。（滑脉主血有余，今经又少，故知孕。）大抵妊娠经来不多，而饮食精神如故，六脉和
缓，滑大无病者，血盛有余也，儿大能饮，自不来矣。
大全云∶夫妊娠漏胎者，谓妊娠数月，而经水时下也。此由冲任脉虚，不能约制手太阳
少阴之经血故也。冲任之脉，为经络之海，起于胞内；手太阳，小肠脉也，手少阴，心脉也。
是二经为表里，上为乳汁，下为月水。有娠之
人，经水所以断者，壅之养胎，蓄之以为乳汁也。冲任气虚，则胞内泄，不能制其经血，故月
水时下，亦名胞漏血，血尽则人死矣。又有因劳役喜怒哀乐不节，饮食生冷，触冒风寒，遂
致胎动，若母有宿疾，子脏为风冷所乘，气血失度，使胎不安，故令下血也。（此言漏胎有
三，冲任虚者，血海自虚也；七情、饮食、胃寒者，因有所感也；宿疾者，气血失于荣养也）
曾有一娠妇，月信不绝，而胎不损，问产科熊宗古。答曰∶妇人血盛气衰，其人必肥，既
娠之后，月信常来，而胎不动。若晚进观之，便以为漏胎，若作漏胎治之，则胎必堕，若不作
漏胎治，则其胎未必堕，今推宗古之言，诚有旨也。巢氏曰∶妇人经闭不利，别无所苦者，是
谓有子，以其经血蓄之以养胎，壅之为乳汁也，有子之后，蓄以养胎矣，岂可复能散动耶？
所以然者，有妊而月信每至，是亦未必因血盛也。若谓妇人荣经有风，则经血喜动，以其风
胜则可也（漏胎用风药，亦是升举肝气，使血不漏，则胎自固，不但疏风已也），既荣经为风
所胜，则所来者，非养胎之血，以此辨之。若作漏胎治之，必服保养补胎之药，且胎不损。强
以药滋之，乃所谓实实虚虚也，其胎终堕宜矣。若医者，知荣经有风之理，专以一药治风，
经信可止，或不服药，胎亦无恙。然而有胎本不固，而因房室不节，先漏而后堕者，须作漏
胎治之，此又不可不审也。
方氏曰∶胎动胎漏皆下血，而胎动有腹痛，胎漏无腹痛为异尔，故胎动宜行气，胎漏
宜清热。（精悉）
李氏曰∶尿血自尿门下血，漏胎自人门下血，妊娠尿血，属胞热者多，四物汤加山栀、发
灰，单苦 菜饮亦妙；因暑者，益元散加升麻煎汤下；稍虚者，胶艾四物汤；久者，用龙骨一
钱，蒲黄五钱为末，酒调服。
脉经曰∶妇人怀躯六月七月，暴下斗余水，其胞必倚而堕，此非时孤浆预下故也。（孤
浆预下，必倚而堕，此气血两虚也）
薛氏曰∶胎漏黄汁下，或如豆汁。若因肝脾湿热，用升阳除湿汤；血崩肝脾风热，用加
味逍遥散；肝脾郁怒，用加味归脾汤；脾胃气虚，用钱氏白术散；若脾气下陷，用补中益气
汤；肝经风热，用防风黄芩丸；风入肠胃，用胃气汤。
加减胶艾汤 治胎动漏血有效。
阿胶（炒成珠） 当归 川芎 白芍药（炒） 地榆（各一钱） 艾叶（炒） 甘草（各五分）
上锉一服，水煎饥服。胎漏血多，起于气恼血逆火动之故，可加炒黄芩、炒香附、炒
砂仁研细同煎。或有受胎至四五个月即堕，或至六七个月漏血要堕者，宜前方去艾叶、地
榆，加白术、黄芩、茯苓、熟地黄、续断。有气盛，亦加香附、砂仁。气虚，加人参、黄 之
类。如伤堕多次，受孕后便宜服千金紫苏饮，及前加减法。汤丸相间，庶免再堕。
安胎饮 治妊娠卒然腰痛，下血不已。
当归 川芎 白芍药（炒） 熟地黄 阿胶（炒） 艾叶 黄 （各一钱） 甘草（炙） 地榆（各五分）
上锉一剂，加姜、枣，水煎服。
大全方 治妊娠三四月腹痛，时时下血。
当归 熟地黄 艾叶（各六两） 续断（二两） 阿胶 鸡苏 竹茹（各一两）
上用水一升煎取七合，空心再服。
如圣汤 治胎动腹痛，或为胎漏。
鲤鱼皮（鲤鱼皮之用，奇） 当归（酒浸） 白芍药 熟地黄（酒蒸） 川芎 川续断（酒浸） 阿
胶（蛤粉炒成珠） 甘草（炙，各等分）
上 咀，每服四钱，加苎根少许，生姜五片，水煎温服。
安胎当归汤 治妊娠举动惊悸，胎不安，小腹痛引腰络，下血。
当归 川芎 阿胶（炒） 人参（各一两） 大枣（十二枚） 艾叶（一把）
一方有甘草，无参、枣。
上以水酒各三升，煮至三升，纳胶令烊，分三服。
枳壳汤 治胎漏下血，及因事下血。
枳壳（去穣，麸炒） 黄芩（各半两） 白术（一两）（白术为君，不用血药，又是一法）
上锉，水煎，食前温服。一方加生地，入少酒煎。
当归寄生汤 治妊娠胎漏，非时下血。
当归 川芎 艾叶 白术（各一钱） 人参 桑寄生 续断 熟地黄（各二钱）
上水煎，空心温服。
二黄散 治妇人胎漏下血。
生地黄 熟地黄（各等分）
上为细末，每服二钱，煎白术、枳壳汤调食前服，或 咀，水煎服。
（白术、枳壳煎汤，调地黄末，意见超卓）
阿胶散 治妊娠无故卒然下血。
阿胶（蛤粉炒成珠，二两，为末） 生地黄（半斤，捣取汁）
上以清酒三升，（用清酒妙）搅匀，温热，分三服。
一方 治胎漏下血不止，胞干即死，宜急治之。
生地黄汁（一升） 陈酒（五合）
上同煎三五沸，温三服，以止为度。
榆白皮散 治妊孕胎漏去血，恐其难产，常宜服之。
榆白皮 葵很 大麻仁 瞿麦（各二钱） 木通（一钱） 牛膝（酒浸焙，一钱半）
上 咀，水煎温服。
一方 治妊娠忽暴下血数升，胎燥不安。（此方治胎燥则可，若脾虚滑泄者禁用）
榆白皮（三两） 熟地黄（四两） 当归 生姜（各二两） 葵子（一升，《肘后方》不用）
上锉，以水五升煮取二升半，分三服，不瘥，更作服之。
子芩散 治肝经有热，妄行下血。
细条黄芩炒为末，每服一钱，以秤锤烧赤淬酒热调服。若脾胃虚，不宜用。
防风丸 治肝经有风，以致血得风而流
散不归经。
防风为末，每服一钱，白汤调服。
防风黄芩丸 治肝经有风热，致血崩便血尿血。
黄芩（炒焦） 防风（各等分）
上为末，酒糊丸，如桐子大，每服三五十丸，食远或食前、米饮或温酒送下。
上三方治肝经风热之剂。
桂枝茯苓丸 仲景云∶妇人宿有 病（凡遇此症，最宜斟酌），经断未及三月，而得漏下
不止，胎动在脐上者，为 痼害；妊娠六月动者，前三月经水利时，胎也。下血者，后断三
月， 也，所以血不止者，其 不去故也，当下其 ，桂枝茯苓丸止之。（楼氏曰∶凡胎动多当脐，今
动在脐上，故知是 也）。
桂枝 茯苓 牡丹皮 桃仁（去皮尖，炒） 芍药（各等分）
上五味末之，炼蜜丸，如兔屎大，每日食前服一丸，不知，加至三丸。
本事方 治胎漏下血不止。
取桃树上干不落桃子烧灰，和水服瘥。《本草》云∶桃奴破血，又治伏梁气积。
上二方，治 病破血之剂。
大全方 治妊娠忽然下黄汁如胶，或如豆汁等物，或胎动腹痛。
黄 （炒，六两） 糯米（五合）
上以水七升煎取二升，分为四服。
银苎酒 治妊娠下黄汁，或如赤豆。
苎根（去黑皮切，二两） 银（五两，或金银首饰）（黄赤为热，故用苎根以凉之；下黄赤为肝
气之疏泄，故重用银以镇之）
上用水酒各一大盏，煎服。
上二方治漏下黄豆汁之症。
（附注：妊娠期间出现类似月经的出血）
《脉经》记载：妇女在怀孕后仍有少量阴道出血，医生诊脉时，反而说是有孕。后来证实确实如此，这种脉象是什么样的？如何辨别呢？老师说：寸口脉阴阳两部都平和，营卫之气调和，重按感觉滑利，轻取感觉浮而柔和，阳明经和少阴经的脉象符合正常规律。身体反而感到怕冷战栗，不想吃东西，头痛心烦，恶心欲吐，呼气稍快，吸气不急促。阳气偏盛则气机外溢，阴血滑利则气血旺盛，这应当是血气充盛的表现。脉滑主血有余，现在月经量少，所以知道是怀孕。大抵上，妊娠期间有少量出血，但饮食和精神状态如常，六脉和缓，滑大而无病态，这是血气充盛有余所致。胎儿长大后会吸收血液营养，出血自然就会停止。
《妇人大全良方》记载：所谓妊娠漏胎，是指怀孕数月后，仍有阴道周期性出血。这是由于冲任二脉虚弱，不能制约手太阳小肠经和手少阴心经的经血所致。冲脉和任脉，是经络之海，起源于胞宫；手太阳经是小肠经，手少阴经是心经。这两条经脉互为表里，向上化为乳汁，向下化为月经。怀孕的人，月经之所以停止，是因为血液壅滞以滋养胎儿，蓄积起来作为乳汁。如果冲任气虚，胞宫内部失固，不能控制经血，所以月经每月都有少量流出，这也叫胞漏血，如果血液流尽人就会死亡。又有因为劳累、喜怒忧思等情绪没有节制，饮食生冷，或者感受风寒，导致胎动不安。如果母亲有旧疾，子宫被风冷邪气侵袭，气血失去常态，使胎元不安稳，所以导致下血。（这里说的漏胎有三种情况：冲任虚损的，是血海自身空虚；七情、饮食、胃寒引起的，是因为受到外感或内伤；旧疾引起的，是气血失去濡养。）
曾经有一位孕妇，月经一直不断，但胎儿没有受损，她咨询产科医生熊宗古。熊回答说：妇人如果血气盛而气衰，身体必定肥胖，怀孕之后，月经常来，但胎元不动。如果晚些时候观察，就以为是漏胎，如果按照漏胎治疗，那么胎元必然堕掉；如果不按照漏胎治疗，那么胎元未必会堕。现在推究熊宗古的话，确实很有深意。巢元方说：妇女月经闭止不通利，如果没有其他痛苦，这就是怀孕，因为经血蓄积用来滋养胎儿，壅滞化为乳汁。有了胎儿之后，血液蓄积用来养胎，怎么还会散乱流动呢？之所以这样，是因为怀孕而月经每月都来，这也不一定都是因为血盛。如果说妇人荣经有风邪，那么经血喜欢流动，这是因为风性善行数变（治疗漏胎使用风药，也是提升肝气，使血液不漏泄，从而胎元自固，不仅仅是疏风而已）。既然荣经被风邪所胜，那么流出来的血，就不是用来养胎的血，以此加以辨别。如果当作漏胎治疗，必然服用保养补胎的药物，而且胎元不会受损。强行用药滋补，这就叫做“实实虚虚”（使实证更实，虚证更虚），胎元最终堕掉也是应该的。如果医生懂得荣经有风的道理，专门用一味药治风，月经就可以停止，或者不服药，胎元也无恙。然而，有的胎元本来就不稳固，因为房事不节制，先出现漏血然后堕胎的，必须当作漏胎治疗，这又不可不仔细审察。
方氏说：胎动和胎漏都会下血，但胎动伴有腹痛，胎漏没有腹痛，这是它们的区别。所以胎动适宜行气，胎漏适宜清热。（分析精辟）
李氏说：尿血是从尿道口出血，漏胎是从阴道口出血。妊娠尿血，多属于胞热，可用四物汤加山栀、发灰，单用苦菜饮也很好；因暑邪引起的，用益元散加升麻煎汤送服；稍微体虚的，用胶艾四物汤；病程久的，用龙骨一钱、蒲黄五钱研为末，酒调服。
《脉经》说：妇女怀孕六个月或七个月，突然大量出血如水状（斗余水），其胞宫必然倾斜而堕胎，这不是正常的羊水提前破裂。（羊水提前破裂，必然导致堕胎，这是气血两虚的表现）
薛氏说：胎漏流出黄色汁液，或者像豆汁一样。如果是由于肝脾湿热，用升阳除湿汤；血崩属于肝脾风热的，用加味逍遥散；肝脾郁怒的，用加味归脾汤；脾胃气虚的，用钱氏白术散；如果脾气下陷，用补中益气汤；肝经风热的，用防风黄芩丸；风邪侵入肠胃的，用胃气汤。
加减胶艾汤：治疗胎动漏血有效。
阿胶（炒成珠状） 当归 川芎 白芍药（炒） 地榆（各一钱） 艾叶（炒） 甘草（各五分）
以上药物锉碎为一剂，加水煎煮，空腹温服。如果胎漏出血多，是由于气恼、血逆、火动引起的，可加入炒黄芩、炒香附、炒砂仁研细同煎。如果有受孕至四五个月即堕胎，或者至六七个月漏血将要堕胎的，宜用前方去掉艾叶、地榆，加入白术、黄芩、茯苓、熟地黄、续断。如果气盛，也加入香附、砂仁。如果气虚，加入人参、黄芪之类。如果多次流产，受孕后应尽早服用千金紫苏饮，以及前面的加减方法。汤剂和丸剂交替服用，以免再次堕胎。
安胎饮：治疗妊娠突然腰痛，下血不止。
当归 川芎 白芍药（炒） 熟地黄 阿胶（炒） 艾叶 黄芪（各一钱） 甘草（炙） 地榆（各五分）
以上药物锉碎为一剂，加生姜、大枣，加水煎服。
大全方：治疗妊娠三四月腹痛，时时下血。
当归 熟地黄 艾叶（各六两） 续断（二两） 阿胶 鸡苏 竹茹（各一两）
以上用水一升煎取七合，空腹分两次服用。
如圣汤：治疗胎动腹痛，或者为胎漏。
鲤鱼皮（鲤鱼皮的用途很奇特） 当归（酒浸） 白芍药 熟地黄（酒蒸） 川芎 川续断（酒浸） 阿胶（蛤粉炒成珠） 甘草（炙，各等分）
以上药物切碎，每次服用四钱，加苎根少许，生姜五片，加水煎煮温服。
安胎当归汤：治疗妊娠举动惊悸，胎元不安，小腹痛牵引腰络，下血。
当归 川芎 阿胶（炒） 人参（各一两） 大枣（十二枚） 艾叶（一把）
一方中有甘草，无人参、大枣。
以上用水和三升酒，煮至三升，放入阿胶使其溶化，分三次服用。
枳壳汤：治疗胎漏下血，以及因事引发的下血。
枳壳（去瓤，麸炒） 黄芩（各半两） 白术（一两）（白术为君药，不用补血药，这是一种不同的方法）
以上药物锉碎，加水煎煮，饭前温服。一方中加入生地黄，入少许酒煎煮。
当归寄生汤：治疗妊娠胎漏，非经期下血。
当归 川芎 艾叶 白术（各一钱） 人参 桑寄生 续断 熟地黄（各二钱）
以上加水煎煮，空腹温服。
二黄散：治疗妇人胎漏下血。
生地黄 熟地黄（各等分）
以上研为细末，每次服用二钱，用白术、枳壳煎汤调匀，饭前服用，或者切碎，加水煎服。
（用白术、枳壳煎汤，调地黄末，见解高超）
阿胶散：治疗妊娠无故突然下血。
阿胶（蛤粉炒成珠，二两，研为末） 生地黄（半斤，捣取汁）
以上用清酒三升，（用清酒很好）搅匀，温热，分三次服用。
一方：治疗胎漏下血不止，胞宫干燥即死，宜紧急治疗。
生地黄汁（一升） 陈酒（五合）
以上同煎三五沸，分三次温服，以止血为度。
榆白皮散：治疗妊娠胎漏去血，担心难产，常宜服用此药。
榆白皮 葵根 大麻仁 瞿麦（各二钱） 木通（一钱） 牛膝（酒浸焙干，一钱半）
以上切碎，加水煎煮温服。
一方：治疗妊娠忽然暴下血数升，胎燥不安。（此方治疗胎燥可以，但如果脾虚滑泄者禁用）
榆白皮（三两） 熟地黄（四两） 当归 生姜（各二两） 葵子（一升，《肘后方》不用）
以上锉碎，用水五升煮取二升半，分三次服用，不好，再制作服用。
子芩散：治疗肝经有热，妄行下血。
细条黄芩炒为末，每次服用一钱，用烧红的秤锤淬入酒中，趁热调服。如果脾胃虚，不宜使用。
防风丸：治疗肝经有风，导致血液随风流散，不归经。
防风为末，每次服用一钱，白开水调服。
防风黄芩丸：治疗肝经有风热，导致血崩、便血、尿血。
黄芩（炒焦） 防风（各等分）
以上研为末，酒糊丸，如梧桐子大，每次服用三五十丸，饭后或饭前，米饮或温酒送下。
以上三方是治疗肝经风热的药剂。
桂枝茯苓丸：张仲景说：妇女素有癥块病（凡遇到此症，最宜斟酌），月经停止不到三个月，却出现漏下不止，胎动在脐上的，为癥痼害；怀孕六个月胎动的，前三个月月经通畅时，是正常胎动。下血的，是停经三个月后的癥病，所以血不止的原因，是癥块不去除的缘故，当下其癥块，用桂枝茯苓丸止之。（楼氏说：凡是胎动多在脐部，现在动在脐上，所以知道是癥块。）
桂枝 茯苓 牡丹皮 桃仁（去皮尖，炒） 芍药（各等分）
以上五味药研为末，炼蜜为丸，如兔屎大，每日饭前服一丸，无效，加至三丸。
本事方：治疗胎漏下血不止。
取桃树上干枯不落下的桃子烧成灰，和水服用痊愈。《本草》说：桃奴破血，又治伏梁气积。
以上二方，是治疗癥病破血的药剂。
大全方：治疗妊娠忽然下黄汁如胶，或者像豆汁等物，或者胎动腹痛。
黄芪（炒，六两） 糯米（五合）
以上用水七升煎取二升，分为四次服用。
银苎酒：治疗妊娠下黄汁，或者像赤豆。
苎根（去黑皮切，二两） 银（五两，或金银首饰）（黄赤为热，故用苎根以凉之；下黄赤为肝气之疏泄，故重用银以镇之）
以上用水和酒各一大盏，煎服。
以上二方治疗漏下黄豆汁的症状。
(Note: Bleeding resembling menstruation during pregnancy)
*Maijing* (Pulse Classic) records: When a woman has vaginal bleeding after conception, but the flow is scanty, and the physician palpates the pulse, stating that she is pregnant, which is later confirmed. What does this pulse resemble, and how can it be distinguished? The Master said: The Cun and Kou positions of both Yin and Yang are peaceful; Ying and Wei Qi are harmonious. Pressing reveals a slippery quality, while light palpation feels floating and gentle. The Maiyang and Shaoyin pulses conform to standard methods. The body may feel chilly, there is loss of appetite, headache, mental restlessness, nausea with desire to vomit, rapid exhalation, and unlabored inhalation. Excess Yang causes Qi overflow; Yin slipperiness indicates abundant Qi and Blood. This should be considered as an abundance of Blood. A slippery pulse indicates excess Blood. With the nourishment of the Six Channels, menstruation appears. If Yin encounters Yang essence, the fluid coagulates and the fetus disperses; if dispersed, it leads to damage or abortion. If Yang becomes excessive, twin pregnancies may occur. Now, due to insufficient Yang, this results in "Ji Jing" (provoked menstruation). (A slippery pulse governs excess Blood; since menstruation is scanty now, we know it is pregnancy.) Generally, when there is slight bleeding during pregnancy, but diet and spirit remain normal, and the six pulses are harmonious, slippery, and large without disease signs, it indicates excess Blood and Qi. As the fetus grows, it consumes the blood, and bleeding will cease naturally.
*Daquan Liangfang* (Great Comprehensive Good Prescriptions) records: The condition known as "Lou Tai" (leaking fetus) refers to vaginal bleeding occurring monthly during pregnancy for several months. This is caused by deficiency of the Chong and Ren vessels, which fail to constrain the blood of the Hand-Taiyang (Small Intestine) and Hand-Shaoyin (Heart) meridians. The Chong and Ren vessels are the sea of meridians, originating from the Bao Gong (uterus). The Hand-Taiyang meridian belongs to the Small Intestine, and the Hand-Shaoyin meridian belongs to the Heart. These two meridians are exterior-interior pairs; upwards they transform into milk, downwards into menstrual water. In pregnant women, menstruation stops because blood is congested to nourish the fetus and stored to become milk. If Chong and Ren Qi are deficient, the interior of the uterus leaks, failing to control menstrual blood, hence monthly bleeding occurs. This is also called "Bao Lou Xue" (uterine leaking blood); if the blood is exhausted, death ensues. Other causes include labor, emotional imbalance (joy, anger, worry, sadness), consumption of raw/cold foods, or exposure to wind-cold, leading to fetal movement. If the mother has chronic diseases, the Zang Fu of the fetus is invaded by wind-cold, causing Qi and Blood to lose regulation, making the fetus unstable and resulting in bleeding. (This describes three types of Lou Tai: Chong-Ren deficiency implies emptiness of the Blood Sea; Seven Emotions, diet, and stomach cold imply external/internal pathogens; chronic diseases imply Qi and Blood failing to nourish.)
Once, a pregnant woman had continuous menstruation without fetal loss. She asked Obstetrician Xiong Zonggu. He replied: If a woman has abundant Blood and deficient Qi, she is likely obese. After conception, menstruation may continue without disturbing the fetus. If observed late, it might be mistaken for Lou Tai. Treating it as Lou Tai would cause abortion. Not treating it as Lou Tai means the fetus likely won't abort. Analyzing Xiong's words reveals profound meaning. Chao Yuanfang stated: If a woman has amenorrhea without other discomfort, it indicates pregnancy, as blood is stored to nourish the fetus and transform into milk. Once pregnant, blood is stored for the fetus; how could it scatter? Therefore, monthly bleeding during pregnancy is not necessarily due to Blood excess. If one claims the Ying Meridian has Wind, causing blood to move freely, this is plausible. (Using Wind herbs to treat Lou Tai lifts Liver Qi, preventing blood leakage and stabilizing the fetus, not just dispelling Wind.) Since the Ying Meridian is overcome by Wind, the flowing blood is not that meant to nourish the fetus; thus, it can be distinguished. Treating it as Lou Tai requires tonifying herbs, which might not harm the fetus. Forcing tonification is "reinforcing excess and depleting deficiency," leading to inevitable abortion. If a doctor understands the Wind in Ying Meridian theory, using a single herb to treat Wind can stop menstruation, or even without medication, the fetus remains safe. However, if the fetus is inherently unstable due to sexual indiscretion, leading to bleeding then abortion, it must be treated as Lou Tai. This requires careful examination.
Fang Shi said: Both Fetal Movement and Fetal Leaking involve bleeding, but Fetal Movement includes abdominal pain, whereas Fetal Leaking does not. Thus, Fetal Movement requires moving Qi, while Fetal Leaking requires clearing Heat. (Analysis is precise.)
Li Shi said: Hematuria bleeds from the urethra; Lou Tai bleeds from the vagina. Pregnancy hematuria is mostly due to Bladder Heat; use Si Wu Tang with Shan Zhi and Fa Hui. Single Ku Cai Yin is also effective. For Summerheat, use Yi Yuan San with Sheng Ma decocted. For slight deficiency, use Jiao Ai Si Wu Tang. For chronic cases, use Long Gu (1 qian) and Pu Huang (5 qian) powdered, taken with wine.
*Maijing* states: In the 6th or 7th month of pregnancy, sudden profuse watery bleeding indicates uterine tilt and abortion. This is premature rupture of the amniotic sac ("Gu Jiang"). (Premature rupture leads to abortion, indicating dual deficiency of Qi and Blood.)
Xue Shi said: Lou Tai may discharge yellow fluid or bean-jelly-like substance. If due to Liver-Spleen Damp-Heat, use Sheng Yang Chu Shi Tang. For Blood Flooding due to Liver-Spleen Wind-Heat, use Jia Wei Xiao Yao San. For Liver-Spleen Stagnation and Anger, use Jia Wei Gui Pi Tang. For Spleen-Stomach Qi Deficiency, use Qian Shi Bai Zhu San. For Sinking Spleen Qi, use Bu Zhong Yi Qi Tang. For Liver Meridian Wind-Heat, use Fang Feng Huang Qin Wan. For Wind invading Stomach-Intestines, use Wei Qi Tang.
**Jia Jian Jiao Ai Tang**: Effective for Fetal Movement and Leaking.
E Jiao (fried to pearls), Dang Gui, Chuan Xiong, Bai Shao Yao (fried), Di Yu (each 1 qian), Ai Ye (fried), Gan Cao (each 0.5 qian).
Decoct one dose, take warm on an empty stomach. If bleeding is heavy due to Qi stagnation, Blood rebellion, or Fire agitation, add fried Huang Qin, fried Xiang Fu, and fried Sha Ren. For miscarriage at 4-5 months or threatened abortion at 6-7 months, remove Ai Ye and Di Yu from the above formula, add Bai Zhu, Huang Qin, Fu Ling, Shu Di Huang, and Xu Duan. If Qi is excessive, add Xiang Fu and Sha Ren. If Qi is deficient, add Ren Shen and Huang Qi. For multiple miscarriages, take Qian Jin Zi Su Yin early after conception, along with previous modifications. Alternate between decoctions and pills to prevent further miscarriage.
**An Tai Yin**: For sudden lower back pain and continuous bleeding during pregnancy.
Dang Gui, Chuan Xiong, Bai Shao Yao (fried), Shu Di Huang, E Jiao (fried), Ai Ye, Huang Qi (each 1 qian), Gan Cao (roasted), Di Yu (each 0.5 qian).
Decoct one dose with Ginger and Jujube, take orally.
**Da Quan Fang**: For abdominal pain and intermittent bleeding in the 3rd-4th month of pregnancy.
Dang Gui, Shu Di Huang, Ai Ye (each 6 liang), Xu Duan (2 liang), E Jiao, Ji Su, Zhu Ru (each 1 liang).
Decoct with 1 sheng of water to obtain 7 he, take twice on an empty stomach.
**Ru Sheng Tang**: For Fetal Movement with abdominal pain or Fetal Leaking.
Li Yu Pi (usage is unique), Dang Gui (soaked in wine), Bai Shao Yao, Shu Di Huang (steamed in wine), Chuan Xiong, Chuan Xu Duan (soaked in wine), E Jiao (fried with Ge Fen to pearls), Gan Cao (roasted, equal parts).
Chop, take 4 qian per dose, add some Zhu Gen and 5 slices of Ginger, decoct with water, take warm.
**An Tai Dang Gui Tang**: For palpitations due to movement, fetal instability, lower abdominal pain radiating to the waist, and bleeding.
Dang Gui, Chuan Xiong, E Jiao (fried), Ren Shen (each 1 liang), Da Zao (12 pieces), Ai Ye (1 bundle).
Alternative formula has Gan Cao, no Ren Shen or Da Zao.
Decoct with 3 sheng of water and 3 sheng of wine down to 3 sheng, melt E Jiao into it, divide into three doses.
**Zhi Ke Tang**: For Fetal Leaking bleeding and bleeding triggered by events.
Zhi Ke (pulp removed, bran-fried), Huang Qin (each 0.5 liang), Bai Zhu (1 liang). (Bai Zhu is the sovereign herb; avoiding blood-tonics is another method.)
Chop, decoct with water, take warm before meals. Alternative adds Sheng Di Huang and a little wine.
**Dang Gui Ji Sheng Tang**: For Fetal Leaking and non-menstrual bleeding.
Dang Gui, Chuan Xiong, Ai Ye, Bai Zhu (each 1 qian), Ren Shen, Sang Ji Sheng, Xu Duan, Shu Di Huang (each 2 qian).
Decoct with water, take warm on an empty stomach.
**Er Huang San**: For Fetal Leaking bleeding.
Sheng Di Huang, Shu Di Huang (equal parts).
Powder finely, take 2 qian per dose, mixed with Bai Zhu and Zhi Ke decoction before meals, or decoct directly.
(Using Bai Zhu and Zhi Ke decoction to mix with Di Huang powder shows superior insight.)
**E Jiao San**: For sudden unexplained bleeding during pregnancy.
E Jiao (fried with Ge Fen to pearls, 2 liang, powdered), Sheng Di Huang (0.5 jin, juice pressed).
Mix with 3 sheng of clear wine, warm, divide into three doses.
**Alternative Formula**: For persistent Fetal Leaking bleeding; dryness of the uterus leads to death, so treat urgently.
Sheng Di Huang Juice (1 sheng), Chen Jiu (aged wine, 5 he).
Boil together for 3-5 boils, take warm in three doses, until bleeding stops.
**Yu Bai Pi San**: For Fetal Leaking blood loss, to prevent difficult labor, suitable for regular use.
Yu Bai Pi, Kui Gen, Da Ma Ren, Qu Mai (each 2 qian), Mu Tong (1 qian), Niu Xi (wine-soaked, roasted, 1.5 qian).
Chop, decoct with water, take warm.
**Alternative Formula**: For sudden profuse bleeding (several sheng) and fetal restlessness. (Suitable for fetal dryness; contraindicated in Spleen deficiency with loose stools.)
Yu Bai Pi (3 liang), Shu Di Huang (4 liang), Dang Gui, Sheng Jiang (each 2 liang), Kui Zi (1 sheng, not used in *Zhou Hou Fang*).
Chop, decoct with 5 sheng of water to obtain 2.5 sheng, divide into three doses. Repeat if ineffective.
**Zi Qin San**: For Liver Meridian Heat causing reckless bleeding.
Fine Huang Qin strips fried and powdered, take 1 qian per dose, mixed with wine quenched with a red-hot weight, take warm. Contraindicated in Spleen-Stomach deficiency.
**Fang Feng Wan**: For Liver Meridian Wind causing blood to scatter and fail to return to the vessels.
Fang Feng powdered, take 1 qian per dose, mixed with plain boiled water.
**Fang Feng Huang Qin Wan**: For Liver Meridian Wind-Heat causing flooding, hematochezia, and hematuria.
Huang Qin (charred), Fang Feng (equal parts).
Powder, make pills with wine paste, size of wutong seeds. Take 30-50 pills per dose, with rice drink or warm wine, before or after meals.
The above three formulas treat Liver Meridian Wind-Heat.
**Gui Zhi Fu Ling Wan**: Zhang Zhongjing said: Women with existing masses (Zheng), who have missed their period for less than three months but experience continuous spotting, with fetal movement above the umbilicus, have a Zheng mass harming the fetus. If fetal movement occurs at six months, and periods were normal for the first three months, it is a normal fetus. Spotting after three months of amenorrhea indicates a Zheng mass. The reason for continuous bleeding is the persistence of the Zheng mass. It should be expelled using Gui Zhi Fu Ling Wan. (Lou Shi said: Fetal movement usually occurs at the umbilicus; movement above suggests a Zheng mass.)
Gui Zhi, Fu Ling, Mu Dan Pi, Tao Ren (skin and tip removed, fried), Shao Yao (equal parts).
Powder the five ingredients, make pills with refined honey, size of rabbit droppings. Take one pill before meals daily; increase to three pills if ineffective.
**Ben Shi Fang**: For persistent Fetal Leaking bleeding.
Burn dried peaches that remained on peach trees to ash, mix with water and take until cured. *Ben Cao* states: Tao Nu breaks blood stasis and treats Fu Liang Qi accumulation.
The above two formulas are blood-breaking agents for treating Zheng masses.
**Da Quan Fang**: For sudden discharge of yellow glue-like or bean-jelly-like fluid, or Fetal Movement with abdominal pain.
Huang Qi (fried, 6 liang), Mi Nan (5 he).
Decoct with 7 sheng of water to obtain 2 sheng, divide into four doses.
**Yin Zhu Jiu**: For discharge of yellow fluid or red-bean-like substance during pregnancy.
Zhu Gen (black skin removed, sliced, 2 liang), Silver (5 liang, or silver jewelry). (Yellow/red indicates Heat, so Zhu Gen cools; discharge of yellow/red indicates Liver Qi dispersion, so Silver suppresses it heavily.)
Decoct with one large cup of water and wine, take orally.
The above two formulas treat symptoms of yellow-red bean-jelly discharge.