丹溪曰阳施阴化胎孕乃成血气虚乏不足荣养其胎则堕譬如枝枯则果落藤痿则花坠又有劳
恐
伤情内火便动亦能堕胎譬如风撼其木人折其枝也火能消物造化自然病源乃谓风冷伤于子脏而
随此未得病情者也予见贾氏妇但有孕至三个月左右必堕诊其脉左手大而无力重则涩知其血虚
也以其壮年只补中气使血自荣时正初夏教以浓煎白术汤下黄芩末一钱与数十帖得保全而生因
而思之随于内热而虚者于理为多曰热曰虚盖孕至三月上属相火所以易堕不然何以黄芩熟艾阿
胶等为安胎妙药耶
丹溪曰世之难产者往往见于郁闷安佚之人富贵奉养之家若贫贱者鲜有之古方止有瘦胎饮
一论
而其方为湖阳公主作也恐非至到之言盖用之者其难自若子族妹苦于难产遇胎则触而去之予甚
悯
焉视其形肥而勤于女工知其气虚久坐气不运而愈弱儿在胞胎因母气虚不能自运耳当补其母之
气则儿健易产令其有孕至五六月来告遂于大全良方紫苏饮加补气药与之数十帖因得男甚快因
以此方随母之性禀与时令加减服者无不应用临蓐时腹不觉痛产母亦无病因名方曰达生散云
丹溪曰或问妇人一门无非经候胎产用药温热于理颇通吾子其妄言乎予曰妇人以血为主血
属阴
易于亏欠非善于调摄者不能保全也余方是否若神仙聚宝丹则有不能忘言者其方治血海虚寒虚
热盗汗理宜补养琥珀之燥麝香之散可以用乎面色痿黄肢体浮肿理宜导湿乳香没药自可治血可
以用乎胎前产后虚实不同逐败养新攻补杂病积块坚证赤白崩漏宜于彼者必妨于此而欲以一方
通
治乎世人以其品贵名雅又喜其常服可以安神去邪令人有子殊不知积温成熟香窜散气服者无不
被祸自非五脏能言医者终不知觉及至变生他证悖理肉汁发阴经之火易成内伤之病先哲具有训
戒或以羊鸡浓汁作糜而又常服当归丸当归建中汤四圣理中丸虽是滋补悉犯桂附干姜 热之剂
脏腑无寒何处消受若夫儿之初生母腹顿宽便啖鸡子且吃火盐不思鸡子难化火盐发热展转为病
医者不识委指他病率尔用药宁不误人予每见产妇之无疾者必教以却去黑神散与夫鸡子火盐诸
般肉食且与白粥将理间以些小石首鲞鱼令甘淡食之至半月以后与少肉虽鸡子亦须豁开煮之大
能养胃却痰彼当富贵之家骄恣之妇率有白带头风气痛膈满痰逆口干经事不调发脱体热皆是阳
胜阴虚之病天生血气本自和平日胜日虚又焉知此等谬妄有以启之耶
丹溪说：阳施阴化，胎孕才能形成。如果血气虚乏，不足以荣养胎儿，就会导致流产。这就像树枝枯槁则果实脱落，藤蔓萎软则花朵坠落一样。又有因劳累、惊恐、情志内伤导致内火妄动，也能引起堕胎，这就像风吹撼树木、人折断树枝一样。火热之性能消蚀万物，这是造化的自然规律。《病源》却说是风冷损伤了子脏（子宫），这种说法并没有探求到真正的病情本质。我曾诊治贾氏的妇人，她每次怀孕到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，知道她是血虚所致。因为她正值壮年，我只用补益中气的方法，使血液自然能够荣养胎儿。当时正值初夏，我教导她用浓煎的白术汤送服一钱黄芩末，服用了几十帖后，得以保全胎儿并顺利生产。由此我思考，随着内热而致虚的情况在道理上居多。所谓“热”和“虚”，大概是因为怀孕到第三个月时，属相火当令，所以容易流产。否则，为什么黄芩、熟艾、阿胶等药物是安胎的妙药呢？
丹溪说：世间的难产者，往往出现在郁闷安逸、富贵奉养的人家中，而贫贱之人很少出现。古方中只有瘦胎饮这一篇论述，但该方是为湖阳公主所创，恐怕不是非常确切的言论。因为使用它的人，难产情况依然如故。我的堂妹苦于难产，遇到怀孕就触犯邪气而流产，我非常怜悯她。观察她的形体肥胖但勤于女工，知道她气虚，久坐导致气机不运而更加虚弱。胎儿在胞胎中，因为母亲气虚不能自行推动分娩。应当补益母亲的气，那么胎儿健壮就容易生产。让她在有孕五六月时来告知，于是我在《大全良方》的紫苏饮基础上加入补气药，给她服用了数十帖，最终生下一名男婴，非常顺利。因此，我以此方为基础，根据母亲的体质禀赋与时令变化进行加减，服用者无不适用。临产时腹部不觉疼痛，产母也没有病因困扰，所以我将此方命名为“达生散”。
丹溪说：有人问：“妇人一门疾病无非是经候、胎产，用药温热在道理上颇为通达，您为何说是妄言呢？”我说：“妇人以血为主，血属阴，易于亏欠，不善于调摄的人不能保全身体。”我的方剂是否恰当？至于神仙聚宝丹，则有不能不言之处。该方治疗血海虚寒、虚热、盗汗，按理应该补养。琥珀性燥，麝香性散，可以用吗？面色萎黄、肢体浮肿，理应导湿；乳香、没药虽可治血，可以用吗？胎前产后虚实不同，逐瘀败血与滋养新血，攻法与补法混杂，对于积块坚证、赤白带下、崩漏等疾病，适宜于此方的情况必定妨碍于彼方，难道想用一方通治世人吗？世人因其药材名贵、名字雅致，又喜欢它常服可以安神去邪、令人有子，却不知道积聚温燥成熟，香窜之品会耗散气机，服用者无不遭受祸害。如果不是五脏能说话，医者终究不会察觉。等到变生其他病症，违背常理，肉汁引发阴经之火，容易成为内伤之病。先哲具有训诫，或者用羊鸡浓汁煮粥，而又常服当归丸、当归建中汤、四圣理中丸，虽然都是滋补之剂，但都犯了桂枝、附子、干姜等热剂的禁忌。脏腑没有寒症，哪里承受得住？至于婴儿初生，母亲腹中顿宽，便吃鸡蛋且吃火盐，不考虑鸡蛋难消化、火盐发热，辗转反侧成为疾病。医者不识此理，随意指向其他疾病，贸然用药，岂不误人？我每见产妇无疾者，必教导她们去除黑神散以及鸡蛋、火盐等各种肉食，只给白粥调理，间或给予少许石首鱼鲞鱼，令其食用甘淡食物。直到半月以后，才给予少量肉类，即使是鸡蛋也必须剖开煮熟，这样大能养胃祛痰。那些富贵之家骄纵的妇女，往往有白带头风、气痛、膈满、痰逆、口干、经事不调、发脱、体热等症状，这些都是阳胜阴虚的疾病。天生血气本自平和，平日胜气日盛，正气日虚，又怎么知道这些谬妄是由什么引起的呢？
Danxi stated: When Yang acts and Yin transforms, conception is achieved. If Qi and Blood are deficient and insufficient to nourish the fetus, abortion will occur. This is like a withered branch causing fruit to fall, or a withered vine causing flowers to drop. Furthermore, labor, fear, and emotional injury can stir up internal fire, which can also cause abortion, just as wind shakes trees or humans break branches. Fire has the nature to consume things; this is the natural order of creation. The *Bing Yuan* (Source of Diseases) claims that wind-cold injures the Zizang (uterus), but this view fails to grasp the true nature of the condition. I once treated a woman surnamed Jia who invariably aborted around three months of pregnancy. Her pulse was large and powerless on the left hand, and choppy upon heavy pressure, indicating Blood deficiency. As she was in her prime years, I only tonified Middle Qi so that Blood could naturally nourish the fetus. It was early summer, so I instructed her to take one qian of Huangqin (Scutellariae Radix) powder with strongly decocted Baizhu Tang (Atractylodis Macrocephalae Decoction). After taking dozens of doses, she preserved the fetus and delivered safely. Reflecting on this, cases involving internal heat leading to deficiency are more common logically. The terms "heat" and "deficiency" arise because the third month of pregnancy corresponds to the phase of Ministerial Fire, making it prone to abortion. Otherwise, why are Huangqin (Scutellariae Radix), Shu Ai Ye (Artemisiae Argyi Folium Preparatum), and Ejiao (Asini Corii Colla) considered excellent drugs for calming the fetus?
Danxi stated: Difficult labor often occurs among people who are depressed yet comfortable, and those from wealthy families enjoying luxurious provisions, whereas it is rare among the poor and lowly. Ancient prescriptions only contain one discussion on Shoutai Yin (Thin Fetus Drink), but this formula was created for Princess Huyang and may not be entirely accurate. Those who used it found their difficult labor unchanged. My cousin suffered from difficult labor, aborting whenever she conceived. I felt great pity for her. Observing her obese physique but diligence in female work, I determined she had Qi deficiency. Prolonged sitting caused Qi stagnation, weakening her further. The fetus remained in the womb because the mother's Qi was too weak to propel it. Tonifying the mother's Qi would make the fetus robust and delivery easier. She consulted me at five or six months of pregnancy. I added Qi-tonifying herbs to Zisu Yin (Perillae Decoction) from *Daquan Liangfang* and administered dozens of doses. She subsequently delivered a healthy boy with great ease. Thus, based on this formula, I adjusted it according to the mother's constitution and seasonal changes. It proved effective for all users. During delivery, there was no abdominal pain, and the mother had no underlying pathology. Therefore, I named this formula Dasheng San (Life-Reaching Powder).
Danxi stated: Someone asked, "Women's diseases mainly involve menstruation, pregnancy, and childbirth. Using warm and hot drugs seems logical. Why do you call it nonsense?" I replied, "Women are governed by Blood. Blood belongs to Yin and is easily depleted. Only those skilled in regulation can preserve their health." Are my formulas appropriate? Regarding Shenxian Jubao Dan (Immortal Gathering Treasure Pill), I must speak out. This formula treats Blood Sea deficiency cold, deficiency heat, and night sweats. Logically, it should be nourishing. However, Hupo (Succinum) is drying, and Shexiang (Moschus) is dispersing; can they be used? For sallow complexion and limb edema, dampness should be guided out. Ruxiang (Olibanum) and Moyao (Myrrha) treat Blood; can they be used? Pregnancy and postpartum conditions differ in excess and deficiency. Expelling stasis and nourishing new blood, attacking and tonifying methods are mixed. For solid masses, leukorrhea, and metrorrhagia, what suits one situation hinders another. Can one formula treat everyone? People like it because its ingredients are precious and its name elegant, believing regular use calms the spirit, dispels evil, and aids conception. They do not realize that accumulated warmth matures into heat, and aromatic dispersants scatter Qi. Users inevitably suffer harm. Unless the five Zang organs could speak, physicians would never realize it. By the time other syndromes develop, violating reason, meat broths ignite Yin channel fire, easily causing internal injury diseases. Sages have warned against this. Some eat millet porridge made with rich mutton or chicken broth and regularly take Danggui Wan (Angelica Sinensis Pill), Danggui Jianzhong Tang (Angelica Sinensis Decocted Middle Warming Decoction), or Sixian Lizhong Wan (Four Sages Regulating Middle Pills). Although these are tonics, they violate the prohibitions of Guizhi (Cinnamomi Ramulus), Fuzi (Aconiti Lateralis Radix Preparata), and Ganjiang (Zingiberis Rhizoma). Where can organs without cold endure such treatment? As for newborns, when the mother's abdomen suddenly feels lighter, they immediately eat eggs and consume fire salt. They do not consider that eggs are hard to digest and fire salt generates heat, leading to illness through repeated disturbance. Physicians fail to recognize this, arbitrarily diagnosing other diseases and prescribing rashly, surely misleading patients. Whenever I see postpartum women without disease, I instruct them to discard Heishen San (Black Spirit Powder), eggs, fire salt, and various meats. I provide only white rice gruel for care, occasionally allowing small amounts of dried hairtail fish, advising a bland diet. After half a month, small amounts of meat are given. Even eggs must be split and boiled thoroughly to greatly benefit the Stomach and resolve phlegm. Women from wealthy, indulgent families often suffer from leukorrhea, headache due to wind, Qi pain, chest fullness, rebellious phlegm, dry mouth, irregular menstruation, hair loss, and body heat. These are all diseases of Yang excess and Yin deficiency. Innate Qi and Blood are originally harmonious. Daily excessive consumption leads to daily depletion of Zheng Qi. How can they know these absurdities are provoked by such habits?