丹溪云∶阳施阴化，胎孕乃成，血气虚损，不足营养，其胎自堕。或劳怒伤情，内火便动，
亦能堕胎，推原其本，皆因热火消物，造化自然。《病源》乃谓风冷伤于子脏而堕，此未得病
情者也。予见贾氏妇，但有孕，至三月左右必堕，诊其脉，左手大而无力，重取则涩，知其血
少也，以其妙年，只补中气，使血自荣。时正初夏，教以浓煎白术汤（单用白术补中，以营出
中焦，土生万物也），下黄芩末一钱，服三四十
帖，遂得保全其生。因而思之，堕因内热而虚者，于理为多，曰热曰虚，当分轻重，盖孕至三
月，正属相火，所以易堕，不然何以黄芩、熟艾（熟艾性温，亦助相火，若果有热，或恐不宜）、
阿胶等为安胎妙药耶！好生之工，幸无轻视。
一妇年三十余，或经住，或成形未具，其胎必堕。察其性急多怒，色黑气实，此相火太
盛，不能生气化胎，反食气伤精故也。因令住经第二月，用黄芩、白术、当归、甘草，服至三
月尽，止药，后生一子。
一妇住经三月后，尺脉或涩或微弱，其妇却无病，知是子宫真气不全，故阳不施阴不
化，精血虽凝，终不成形，至产血块，或产血胞。
一妇腹渐大如怀子，至十月求易产药。察其神色甚困，难与之药，不数日，生白虫半桶。
盖由妇之元气太虚，精血虽凝，不能成胎而为秽腐，蕴积之久，湿化为热，湿热生虫，理之所
有，亦须周十月之气，发动而产，终非佳兆，其妇不及一月而死，湿热生虫，譬之沟渠污浊，
积久不流，则诸虫生于其间矣。
汪石山治一妇长瘦，色黄白，性躁急，年三十余，常患堕胎，已七八见矣。诊其脉，皆柔
软无力，两尺虽浮而弱，不任寻按，曰此因胎堕太多，气血耗甚，胎无滋养，故频堕。譬之水
涸而禾枯，土削而木倒也，况三月五月，正属少阳火动之时，加以性躁而急发之，故堕多在
三、五、七月也。宜大补阴汤，去桂加黄柏、黄芩煎服，仍用研末，蜜丸服之，庶可保生。服半
年，胎固，而生二子。
钱仲阳治一孕妇病，医言胎且堕。钱曰∶妊者五脏传养，率六旬，乃更候其月，偏补之，
何必堕，已而母子皆全。
陈斗岩治一妇有胎，四月堕下，逾旬腹肿发热，气喘脉洪盛，面赤，口鼻舌青黑。陈诊之
曰∶脉洪盛者，胎未堕也，面赤，心火盛而血干也；舌青，口鼻黑，肝既绝而胎死矣。内外皆
曰，胎堕久矣。复诊，色脉如前，以蛇蜕煎
汤，下平胃散加芒硝、归尾一倍，服之，须臾腹鸣如雷，腰腹阵痛，复一死胎随下，病亦愈。
程仁甫治一妇，年近四十，禀气素弱，自去其胎，五日内，渐渐腹胀如鼓，至心前，上吐
不能食，用补药不效。诊六脉微弱，但只叫胀死，此乃损伤脾气而作胀，然急则治标，若泥
丹溪法，恐缓不及事，用桃仁承气加枳实、浓朴，倍硝、黄，煎服四分，吐去其一，次早仍不
通，事急，又服琥珀丸三钱，至申时大通，胀减，但体倦，四肢无力，口不知味，发热，再用
参、 、归、芍、楂、术、陈皮，八剂而安。
江应宿治汪镐妻三十一岁，厌产，误服打胎药，下血如崩，旬余，腹痛一阵即行，或时鼻
衄，诸药不效，诊得六脉数而微弦，乃厥阴之火泛逆，投四物换生地黄，加阿胶、炒黑山栀、
蒲黄一剂愈。
薛氏云∶大抵治法，须审某月属某经育养而药之。
芎 补中汤 治怀妊血气虚弱，不能卫养，以致数月而堕，名曰半产。（每见妇人孕不满十
月而损堕，得服此遂安全。）
川芎 五味子 阿胶（蛤粉炒） 干姜（炮，各一钱） 黄 （去芦，蜜炙） 当归（酒浸）
白芍药 白术（各一钱半） 人参 杜仲（去皮） 木香（不见火） 甘草（炙，各五分）
上作一服，水二盅煎至一盅，不拘时服。
阿胶汤 治妊娠数堕胎，小腹绞痛不可忍。
阿胶（炙燥） 熟干地黄（焙） 艾叶（微炒） 川芎 当归（切焙） 杜仲（去粗皮炙，锉）
白术（各一两）
上 咀，每服四钱，枣三枚，水煎，食前温服。
千金保胎丸 凡女人受孕，经三月而胎堕者，虽气血不足，乃中冲脉有伤，中冲脉即
阳明胃经，供应胎孕，至此时必须节饮食，绝欲戒怒，庶免小产之患，服此可以保全。（三月
虽手心主养胎，而实十二经皆受气于阳明，阳
明属中冲，故中冲伤，胎亦堕也，此方极稳当）
白术（土炒） 熟地黄（姜汁炒） 杜仲（姜汁炒，各四两） 当归（酒洗） 续断（酒洗）
阿胶（蛤粉炒） 香附米（四制） 益母草 条芩（炒各二两） 陈皮 川芎 艾叶（醋炙，各一两）
砂仁（炒，五钱）
上为细末，煮枣肉为丸，如桐子大，每服百丸，空心米汤下。
杜仲丸 治妊娠三两个月，胎动不安，防其欲堕，宜预服之。
杜仲（去粗皮，姜汁炒，去丝）
上为末，枣肉杵丸，桐子大，每服七十丸，米饮下。（胎系于肾，故用杜仲补肾。若云胎
动不安，则有脾虚、气虚、血虚、有寒、有热之不同，又当因病而药之，不可执也）
删繁方 治妊娠怀胎，数落而不结实，或冷或热，百病之源。
黄 人参 白术 甘草 川芎 地黄 吴茱萸（各等分）
一方有当归、干姜。
上为末，空心温酒调下二钱。忌菘菜、桃李、雀肉、醋物。
楼氏曰∶按丹溪论，俱是虚热而无寒者，今姑存此一方，以俟施之于千百而一者也。
（此言宜玩）
朱丹溪说：阳气施放，阴气化生，胎孕才能形成。如果血气虚损，不足以营养胎儿，胎儿就会自然流产。或者因为劳累、愤怒导致情志受伤，体内火气便随之而动，也能导致堕胎。推究其根本原因，都是因为热火消耗了物质，这是造化自然的规律。《诸病源候论》却说是风冷伤害了子宫而导致堕胎，这没有掌握疾病的真实情况。我见过贾氏的妇人，只要怀孕，到了三个月左右必然流产，诊察她的脉象，左手脉大而无力，重按则涩滞，知道她是血少。因为她正值青春年少，我只补益中气，使血液自然充盈。当时正值初夏，教她浓煎白术汤（单用白术补益中气，因为营气出于中焦，土能生养万物），送服黄芩末一钱，服用三四十帖后，终于保全了胎儿。由此思考，因内热而虚导致的堕胎，在情理上占多数。所谓热与虚，应当区分轻重。大概怀孕到三个月，正属于相火旺盛之时，所以容易流产，否则为什么黄芩、熟艾（熟艾性温，也会助长相火，如果确实有热，或许不宜使用）、阿胶等是安胎的妙药呢？希望爱惜生命的医生，不要轻视这一点。
一位三十多岁的妇女，有时月经停止，有时胎儿成形但未发育完全，胎儿必然流产。观察她性格急躁易怒，面色黑而气实，这是相火太盛，不能生气化胎，反而消耗元气损伤精血所致。因此让她在停经第二个月时，服用黄芩、白术、当归、甘草，服至第三个月结束停药，后来生下一个儿子。
一位妇女停经三个月后，尺脉或涩或微弱，这位妇女却没有其他病症，知道是子宫真气不全，所以阳气不施放，阴气不化生，虽然精血凝结，最终不能成形，生产时排出血块，或者是胎盘胞衣。
一位妇女腹部逐渐增大像怀孕一样，到了十个月求取易产的药物。观察她的神色非常困倦，难以给她用药，没过几天，生出了半桶白虫。这是因为妇人的元气太虚弱，虽然精血凝结，但不能成胎而化为秽浊腐败之物，蕴积久了，湿气转化为热，湿热生虫，这是道理中有的情况，也需要经过十月的气运发动而产出，终究不是好兆头，这位妇女不到一个月就死了。湿热生虫，就像沟渠污浊，积聚久了不流动，那么各种虫子就会生在其中。
汪石山治疗一位身材瘦长、面色黄白的妇女，性格急躁，三十多岁，经常患流产，已经发生过七八次了。诊察她的脉象，都柔软无力，两尺脉虽然浮而弱，不耐寻按，说这是因为流产太多，气血耗损严重，胎儿缺乏滋养，所以频繁流产。好比水干涸而禾苗枯死，土壤削薄而树木倒下，何况三月五月，正是少阳火动的时候，加上性格急躁引发它，所以流产多发生在三、五、七月。适宜用大补阴汤，去掉桂枝，加入黄柏、黄芩煎服，仍然制成粉末，蜜丸服用，才可以保全生命。服用半年，胎气稳固，生下了两个儿子。
钱仲阳治疗一位孕妇患病，医生说胎儿快要流产了。钱仲阳说：妊娠期间五脏传递营养，通常六十天，才更替按月调养，偏重补益某月所主之经，何必会流产，后来母子都保全了。
陈斗岩治疗一位妇女怀孕，四个月时流产，过了十天腹部肿胀发热，气喘脉象洪盛，面赤，口鼻舌青黑。陈斗岩诊察说：脉象洪盛的，说明胎儿未死；面赤，是心火盛而血干；舌青，口鼻黑，是肝气已绝而胎儿死亡了。内外人都说，胎儿已经流产很久了。再次诊察，神色脉象如前，用蛇蜕煎汤，送服平胃散加芒硝、归尾一倍，服用后，须臾间腹鸣如雷，腰腹阵痛，随即排出一个死胎，病也好了。
程仁甫治疗一位妇女，年近四十，禀赋之气素来虚弱，自己打掉了胎儿，五天内，渐渐腹胀如鼓，直到心前区，上吐不能进食，用补药无效。诊察六脉微弱，只叫喊胀得要死，这是损伤脾气而导致胀满，然而急则治标，如果拘泥于丹溪的方法，恐怕来不及办事，用桃仁承气汤加枳实、厚朴，加倍芒硝、大黄，煎服四分之一的量，吐出三分之一，第二天早上仍然不通畅，事情紧急，又服用琥珀丸三钱，到申时大便大通，胀满减轻，但身体疲倦，四肢无力，口不知味，发热，再用人参、[此处原文缺字，推测为黄芪或类似补气药]、当归、白芍、山楂、白术、陈皮，八剂后安稳。
江应宿治疗汪镐的妻子三十一岁，厌恶分娩，误服打胎药，下血如崩漏，十多天后，腹痛一阵即行，有时流鼻血，各种药物无效，诊得六脉数而微弦，这是厥阴之火泛逆，投用四物汤换生地黄，加阿胶、炒黑山栀、蒲黄，一剂痊愈。
薛氏说：大致治疗方法，必须审察某月属于哪一经育养而用药。
芎劳补中汤 治疗怀孕血气虚弱，不能卫护养育，以致几个月而流产，名叫半产。（常见妇人怀孕不满十个月而损伤流产，得到服用此方遂安全。）
川芎 五味子 阿胶（蛤粉炒） 干姜（炮，各一钱） 黄芪（去芦，蜜炙） 当归（酒浸） 白芍药 白术（各一钱半） 人参 杜仲（去皮） 木香（不见火） 甘草（炙，各五分）
以上作一服，水二盅煎至一盅，不拘时候服用。
阿胶汤 治疗妊娠多次流产，小腹绞痛不可忍受。
阿胶（炙燥） 熟干地黄（焙） 艾叶（微炒） 川芎 当归（切焙） 杜仲（去粗皮炙，锉） 白术（各一两）
以上切碎，每服四钱，枣三枚，水煎，食前温服。
千金保胎丸 凡是女人受孕，经三月而流产的，虽然气血不足，乃是冲脉有伤，冲脉即阳明胃经，供应胎孕，到这个时候必须节制饮食，断绝性欲，戒除愤怒，以免小产的祸患，服用这个可以保全。（三月虽由手心主养胎，而实际十二经皆受气于阳明，阳明属冲脉，所以冲脉受伤，胎儿也会流产，此方极稳当）
白术（土炒） 熟地黄（姜汁炒） 杜仲（姜汁炒，各四两） 当归（酒洗） 续断（酒洗） 阿胶（蛤粉炒） 香附米（四制） 益母草 条芩（炒各二两） 陈皮 川芎 艾叶（醋炙，各一两） 砂仁（炒，五钱）
以上为细末，煮枣肉为丸，如梧桐子大，每服一百丸，空心米汤送下。
杜仲丸 治疗妊娠三两个月，胎动不安，防止其欲流产，适宜预先服用。
杜仲（去粗皮，姜汁炒，去丝）
以上为末，枣肉杵丸，梧桐子大，每服七十丸，米饮送下。（胎系于肾，所以用杜仲补肾。如果说胎动不安，则有脾虚、气虚、血虚、有寒、有热的不同，又应当因病而用药，不可固执）
删繁方 治疗妊娠怀胎，多次掉落而不结实，或冷或热，百病之源。
Zhu Danxi stated: When Yang exerts and Yin transforms, conception occurs. If Qi and Blood are deficient and insufficient to nourish the fetus, spontaneous abortion will happen naturally. Alternatively, labor or anger may injure the emotions, causing internal Fire to move, which can also lead to miscarriage. Tracing back to the root cause, it is all due to Heat-Fire consuming substances, following the natural laws of creation. *The Source of Diseases* attributes miscarriage to Wind-Cold injuring the uterus, which fails to grasp the true nature of the disease. I observed a woman surnamed Jia who, whenever pregnant, would inevitably miscarry around the third month. Her pulse was large and powerless on the left hand, and choppy upon heavy pressure, indicating Blood deficiency. Since she was young, I only tonified Middle Qi, allowing Blood to become abundant naturally. At that time, it was early summer. I instructed her to decoct Baizhu Tang (using only Baizhu to tonify Middle Qi, as Ying Qi originates from the Middle Jiao, and Earth generates all things), taking one qian of Huangqin powder with it. After taking thirty to forty doses, she successfully carried the pregnancy to term. Reflecting on this, miscarriages caused by internal Heat and deficiency are more common in principle. One must distinguish the severity of Heat and Deficiency. Generally, at three months of pregnancy, the Ministerial Fire is active, making miscarriage prone; otherwise, why are Huangqin, Shu Ai (Shu Ai is warm-natured and may assist Ministerial Fire, so it might not be suitable if there is actual Heat), and Ejiao considered excellent herbs for stabilizing the fetus? Physicians who cherish life should not underestimate this.
A woman in her thirties experienced amenorrhea or incomplete fetal development followed by inevitable miscarriage. Observing her irritable temperament, dark complexion, and robust Qi, this indicated excessive Ministerial Fire, which failed to generate Qi and transform the fetus, instead consuming Qi and damaging Essence. Therefore, during the second month after missed menses, she was prescribed Huangqin, Baizhu, Danggui, and Gancao. She took them until the end of the third month, then stopped medication, and subsequently gave birth to a son.
Another woman had a choppy or weak and faint Chi pulse three months after missed menses, yet had no other symptoms. This indicated incomplete True Qi in the uterus, resulting in Yang failing to exert and Yin failing to transform. Although Jing and Blood condensed, they could not form a fetus. During delivery, blood clots or placental membranes were expelled.
A woman’s abdomen gradually enlarged like pregnancy. At ten months, she sought medicine for easy delivery. Her spirit and color showed extreme exhaustion, making medication difficult. Not long after, she delivered half a bucket of white worms. This was due to severe deficiency of Yuan Qi; although Jing and Blood condensed, they could not form a fetus but turned into foul and putrid matter. Accumulated over time, Dampness transformed into Heat, and Damp-Heat generated worms. This follows logical principles, requiring the full ten months of Qi movement to expel the material. It was ultimately an ill omen; the woman died within a month. Damp-Heat generating worms is like stagnant, filthy ditches where various insects breed after long accumulation without flow.
Wang Shishan treated a thin, yellowish-white woman in her thirties with an irritable temperament who suffered recurrent miscarriages, having experienced seven or eight such incidents. Her pulses were soft and powerless; the Chi positions were floating and weak, unresponsive to pressing. He stated that frequent miscarriages had severely depleted Qi and Blood, leaving the fetus without nourishment, hence the frequent losses. It is like water drying up causing crops to wither, or soil eroding causing trees to fall. Moreover, the third and fifth months correspond to the activation of Shaoyang Fire. Combined with her irritable nature triggering it, miscarriages often occurred in the third, fifth, and seventh months. He prescribed Da Bu Yin Tang, removing Guizhi and adding Huangbai and Huangqin, decocted and taken orally. The remaining herbs were powdered and made into honey pills for maintenance. After six months of treatment, the fetus stabilized, and she gave birth to two sons.
Qian Zhongyang treated a pregnant woman whose physician predicted imminent miscarriage. Qian said: "During pregnancy, the five Zang organs transmit nourishment. Usually, after sixty days, adjustments are made monthly, supplementing specifically according to the month. Why would miscarriage occur?" Subsequently, both mother and child were preserved.
Chen Douyan treated a woman who miscarried at four months. Ten days later, her abdomen swelled, she had fever, asthma, a surging pulse, red face, and blue-black tongue, mouth, and nose. Chen diagnosed: A surging pulse indicates the fetus is still alive; a red face signifies excess Heart Fire and dried Blood; a blue tongue and black mouth/nose indicate Liver Qi exhaustion and fetal death. Everyone believed the fetus had been dead for a long time. Upon re-examination, the signs remained the same. He used Shed Snake Decoction to administer Pingwei San plus Mangxiao and double the amount of Guiwei. After ingestion, borborygmus sounded like thunder, and intermittent lower abdominal pain occurred, followed by the expulsion of a dead fetus, and the illness resolved.
Cheng Renfu treated a woman nearing forty, constitutionally weak, who induced abortion herself. Within five days, her abdomen distended like a drum up to the epigastrium, accompanied by vomiting and inability to eat. Tonics were ineffective. Her six pulses were weak and faint; she complained of unbearable distension. This was distension caused by Spleen Qi injury. However, in emergencies, treat the branch first. Adhering strictly to Danxi’s method might be too slow. He used Taoren Chengqi Tang added with Zhishi and Houpo, doubling Mangxiao and Dahuang. Taking one-quarter dose resulted in vomiting one-third of the content. The next morning, bowel movement was still obstructed. Given the urgency, he administered Hu Po Wan (Amber Pill) three qian. By Shen hour, there was a massive bowel movement, distension decreased, but she felt fatigued, limbs were weak, taste was lost, and fever persisted. He then prescribed Renshen, [missing character, likely Huangqi], Danggui, Baishao, Zhaxie, Baizhu, and Chenpi. After eight doses, she recovered.
Jiang Yingsu treated Wang Hao’s wife, aged thirty-one, who feared childbirth and mistakenly took abortifacient drugs, resulting in profuse bleeding like a metrorrhagia. Over ten days, she had intermittent abdominal pain and occasional epistaxis. Various medicines failed. Her six pulses were rapid and slightly wiry, indicating rebellious Flow of Fire in the Jueyin channel. He prescribed Siwu Tang with Shengdihuang replacing Shudihuang, adding Ejiao, Chao Hei Shanzhi, and Puhuang. One dose cured her.
Xue Shi stated: Generally, treatment methods require examining which meridian nourishes the fetus in a specific month and prescribing accordingly.
Xiong Lao Buzhong Tang treats pregnancy with Qi and Blood deficiency, unable to protect and nourish, leading to miscarriage after several months, termed semi-miscarriage. (Often seen in women who lose the fetus before ten months; taking this formula ensures safety.)
Chuanxiong, Wuweizi, Ejiao (stir-fried with clam powder), Ganjiang (charred, each 1 qian), Huangqi (deprived of roots, honey-fried), Danggui (soaked in wine), Baishao, Baizhu (each 1.5 qian), Renshen, Duzhong (peeled), Muxiang (not exposed to fire), Gancao (roasted, each 0.5 qian).
Take as one dose, decoct with two sheng of water to one sheng, take at any time.
Ejiao Tang treats recurrent miscarriage in pregnancy with unbearable colic in the lower abdomen.
Ejiao (roasted dry), Shu Dihuang (baked), Aye (lightly stir-fried), Chuanxiong, Danggui (cut and baked), Duzhong (scraped coarse bark, roasted, sliced), Baizhu (each 1 liang).
Crush ingredients. Take 4 qian per dose, with three dates, decoct in water, take warm before meals.
Qianjin Baotai Wan treats women who miscarry at three months after conception. Although Qi and Blood are insufficient, the Chong Mai is injured. The Chong Mai corresponds to the Stomach Meridian of Yangming, which supplies the fetus. At this stage, one must regulate diet, abstain from sexual desire, and avoid anger to prevent premature birth. Taking this formula can preserve the pregnancy. (Although the Pericardium Meridian nourishes the fetus at three months, actually all twelve meridians receive Qi from Yangming. Yangming belongs to Chong; thus, injury to Chong leads to miscarriage. This formula is very stable.)
Baizhu (soil-stir-fried), Shu Dihuang (stir-fried with ginger juice), Duzhong (stir-fried with ginger juice, each 4 liang), Danggui (washed with wine), Xuduan (washed with wine), Ejiao (stir-fried with clam powder), Xiangfu Mi (four-process processed), Yimucao, Tiaoqin (stir-fried, each 2 liang), Chenpi, Chuanxiong, Aye (vinegar-roasted, each 1 liang), Sharen (stir-fried, 5 qian).
Grind into fine powder, mix with jujube paste to make pills the size of paulownia seeds. Take 100 pills per dose with rice soup on an empty stomach.
Duzhong Wan treats fetal restlessness and threat of miscarriage in the third or second month of pregnancy. Preventive use is recommended.
Duzhong (scrape coarse bark, stir-fry with ginger juice, remove fibers).
Grind into powder, mix with jujube paste to make pills the size of paulownia seeds. Take 70 pills per dose with rice drink. (The fetus is tied to the Kidney, so Duzhong is used to tonify the Kidney. If fetal restlessness is mentioned, it may differ due to Spleen deficiency, Qi deficiency, Blood deficiency, Cold, or Heat. Medication should be tailored to the disease, not applied rigidly.)
Shanfan Fang treats pregnancy with repeated non-viable conceptions, cold or heat, the source of hundred diseases.
Huangqi, Renshen, Baizhu, Gancao, Chuanxiong, Dihuang, Wuzhuyu (equal parts).
One prescription includes Danggui and Ganjiang.
Grind into powder. Take 2 qian with warm wine on an empty stomach. Avoid Brassica vegetables, peaches, plums, sparrow meat, and vinegar items.
Lou Shi stated: According to Danxi’s discussion, these cases involve deficiency-Heat without Cold. I temporarily preserve this formula for the rare case where it applies among hundreds. (This remark deserves careful consideration.)