凡妊娠经水壅之以养胎，蓄之以为乳。其冲、任气虚，不能约制，故月水时下，名曰胞
漏，血尽子死。然亦有妊妇血盛，月信常来而胎不动，俗呼狗儿胎也。若以胎漏治之，则胎
必堕，若不以胎漏治之，其胎未必堕。亦有脉见滑数而别无风热病，经脉如常，但较前略少
。此因胎小血盛有余而然。俟迟至三、四月外，儿大能饮，经脉自止。今常见怀胎七八月而
生子者，人但以血止为度，谓之不足月，然其受胎于未止之前，至此而足月，人实不知也。
又有壮盛孕妇，按月去血点滴，若无腰酸胎动，不须服药，此血气强盛，至四、五月后自然
经止。如孕妇虚羸，腰常酸痛，并胎动而按月下血点滴，或下血不止，此非血有余，乃胎漏
也。宜服加味补中安胎饮。又云∶胎漏多因于血热，然亦有气虚血少，服凉药而下血益甚，
食少体倦者。此脾气虚而不能摄血也，宜归脾等方加减，当以脉候察之。
凡堕胎之病，多在三、五、七月，如前次三月曾堕，后必如期乘其所虚而亦堕。必预服
尊生安胎饮、或胎元饮加减用之，或太山磐石散、安胎万全神应散等方。对症择用，以预防
之，须常服过七月，可无患矣。更宜戒房欲、气恼、劳役、爆炙诸食。又有受孕一月即堕者
，人皆不觉，止知其为按月经行，不知暗堕于中矣。凡人经尽初交得孕后，最宜将息绝欲，
若再交接以扰子宫，其胎或一月、三五月必堕。试思驴马有孕，牡者近则踢之，名曰护胎。
所以绝无小产之患，人可不慎欤！至若劳怒举重亦堕，洗下体则窍开亦堕。今之无子者，大
半一月堕胎，非尽不受孕也。至于顿扑伤动胎气，宜服胶艾安胎散。
三四月前胎未成形，名曰堕胎。至五六月后，胎已成形，名曰半产，俗人均曰小产。总
属妊妇气血虚弱，胎元不固。盖气虚则提摄不固，血弱则灌溉不周，多致小产。况妇人肾以
系胞，而腰为肾之腐，腰痛则堕，不可不防。凡治胎漏者，当预培其根，宜用千金保孕丸，
又有止漏绝神丹，治漏胎甚效。大凡孕妇暴下水者，其胎必堕，若徐徐下水，可用补气安胎
药治之。有胎漏黄浆，或如豆汁，胎动腹痛，乃肝脾湿热，用升阳除湿汤，大全治用黄 一
两，川芎一钱，糯米一合煎服。要知小产与大产不同∶大产如果熟自落，栗熟自开，半产如
生摘其瓜，生剥其栗，岂不较正产为尤重耶！人皆疏忽不以为重，而轻易视之，因而致病者
不少，因而致死者恒多。然此证始因敛血以成胎，继因精血以长养，终因精血不足面萎堕，
故瘀血甚少。倘有腹痛，成块有形，多属血虚气逆，惟有先用生化汤去瘀生新为妙，后须大
加温补。若但知消瘀破滞，则逆气愈攻而愈升，多致不救，戒之戒之！妊妇三月后，尺脉或
涩或微弱，胎必不固。惟脉洪盛者，胎不堕耳。所以《脉诀》内云∶胎脉弦牢滑利安，沉细
而微归泉路，正此之谓也。虽半产皆气血不足，然有禀质偏阴偏阳，或寒或热之异，自当凭
脉调治。如阴虚内热而用艾、附、白术、砂仁温暖之剂，则阴道愈消，如草木之无雨露，自
然枯萎。如阳虚内寒而用芩、芍凉血之剂，则脾胃虚寒、气血亦弱，犹果实春夏易生，秋冬
少结也。总之，三月以前，宜养脾胃，四月以后，宜壮腰肾、补血顺气，佐以清热，此大法
也。
加味补中安胎饮∶凡妊妇元气壮盛，受胎后尚有经来数点，乃血气盛故耳。若不腰痛胎
酸，不必服药，如虚赢孕妇，下血不止，或按月下血点滴，名曰胎漏，多因劳而气血两虚，
或喜食爆炙热物过多而致。宜谨房事，并服补药以保全也。人参一钱，白术（土炒）、当归
（
煎服
归脾汤（附∶加味归脾汤、济生归脾汤）∶治心脾郁结，经闭发热，并治脾虚不能摄血，
致血妄行。又经带胎漏等证，由于劳伤心脾、发热体倦、食少不眠、怔忡惊悸等证。人参、
白术（土炒）、茯神、枣仁（炒）、龙眼肉各二钱，黄 一钱五分（炙），归身、远志肉（甘
草水
柴胡
尊生安胎饮∶治血虚有火，曾三月堕胎，宜服此方。并预防五月七月之堕，亦治胎动、
胎漏。归身（酒洗）、白芍（酒炒）、熟地、生地、砂仁、阿胶（炒珠）各一钱，杜仲（盐水
炒去
五分，
之，用
景岳胎元饮∶治妇人冲任失守，胎元不安不固，随症加减，或间日或二三日服一二剂。
人参（随宜）、当归（酒洗）、杜仲（盐水炒断丝）、白芍（酒炒）各二钱，熟地二三钱，白
术一钱
下元不固
但氏、术
八分，或
腹作痛，
制续断肉
泰山磐石散∶见前卷九。治妇人血气两虚，或肥而不实，或瘦而血热，或肝脾素虚，倦
怠少食，屡有堕胎之患，此方平和，兼养脾胃，气血。觉有热者倍黄芩，少用砂仁。觉胃弱
者，多用砂仁，少加黄芩。更宜戒欲事恼怒，远酒醋辛热之物，可永保无堕。
经验易产丸∶酒炒续断一两，土炒淮山药一两，制川芎五钱，酒炒全当归二两，川杜仲
一两（用糯米粥拌匀晒干，炒去丝），可研细末。用桂元肉五十枚，煎浓汁和蜜为丸，分作
三
可
凡妊娠期间，经血被壅滞以滋养胎儿，蓄积以化生乳汁。如果冲脉、任脉（调节月经和生殖的主要经脉）气虚，不能固摄制约，导致每月仍有少量阴道出血，称为胞漏（妊娠期阴道少量出血），若血液耗尽则胎儿死亡。然而也有孕妇血气旺盛，月经照常来潮而胎动正常，俗称“狗儿胎”。如果用治疗胎漏的方法去治它，胎儿必定流产；如果不按胎漏治疗，胎儿未必会流产。也有脉象滑数但没有风热病症，月经如常但比平时略少。这是因为胎儿较小而母体血气有余所致。等到怀孕三、四月以后，胎儿长大需要更多营养，月经自然会停止。现在常见怀孕七八个月就分娩的情况，人们只以月经停止为足月标准，称之为不足月，但实际上受孕是在月经停止之前，到此时才算是足月，人们实在不知道这一点。
又有身体强壮的孕妇，按月有少量点滴出血，如果没有腰酸、胎动不安的症状，不需要服药，这是因为气血强盛，到了四、五月后自然月经停止。如果孕妇虚弱消瘦，腰部经常酸痛，并伴有胎动且按月有少量下血，或者下血不止，这并非血有余，而是胎漏。适宜服用加味补中安胎饮。又说：胎漏多因血热引起，但也有因气虚血少，服用凉药后下血反而加重，伴有食欲不振、身体疲倦的。这是脾气虚弱不能统摄血液所致，适宜用归脾汤等方剂加减，应当通过脉诊来辨别。
凡是堕胎的病，多发生在怀孕第三、五、七月，如果前次在三月曾堕胎，后次必然会在相应月份乘其虚弱之时再次堕胎。必须预先服用尊生安胎饮、或胎元饮加减使用，或太山磐石散、安胎万全神应散等方剂。对症选择使用，以预防之，必须常服过七月，就可以没有祸患了。更宜戒除房事、生气恼怒、劳累过度以及爆炒炙烤类食物。又有受孕一个月即堕胎的，人们都不察觉，只知道是按时来月经，不知道暗中已经堕胎了。大凡人在月经刚结束初次同房受孕后，最宜静养禁欲，如果再行房事扰动子宫，胎儿或在一个月、或在三五个月时必定堕胎。试想驴马有孕，公兽靠近就会踢开它，名叫护胎。所以完全没有小产的祸患，人难道可以不谨慎吗！至于劳累、愤怒、举重也会堕胎，清洗下身则阴窍打开也会堕胎。现在无子的人，大半是因为一个月堕胎，并非完全不受孕。至于突然跌倒损伤胎气，适宜服用胶艾安胎散。
怀孕三四月前胎儿未成形，称为堕胎。到五六月后，胎儿已成形，称为半产，俗人都叫小产。总属于孕妇气血虚弱，胎元不稳固。因为气虚则提摄不固，血弱则灌溉不周，多导致小产。况且妇人肾系胞宫，而腰为肾之外府，腰痛则易堕胎，不可不防备。凡是治疗胎漏，应当预先培补根本，适宜用千金保孕丸，又有止漏绝神丹，治疗漏胎非常有效。大凡孕妇突然大量流下水样物，胎儿必定流产，如果是慢慢流下水样物，可用补气安胎药治疗。有胎漏流出黄浆，或像豆汁一样，伴有胎动腹痛，这是肝脾湿热，用升阳除湿汤，大全方用法是用黄芪一两，川芎一钱，糯米一合煎服。要知道小产与大产不同：大产如果实成熟自然掉落，栗子成熟自然裂开，半产如同生摘瓜果，生剥栗子，岂不比正产更为严重吗！人们都疏忽不以为重，而轻易看待，因而致病者不少，因而致死的多。然而此证开始因收敛血液以成胎，接着因精血以长养，最终因精血不足而萎落堕胎，所以瘀血很少。如果有腹痛，结成块状有形，多属血虚气逆，惟有先用生化汤去除瘀血、生成新血为妙，之后须大加温补。如果只知道消瘀破滞，则逆气越攻越升，多导致无法救治，切记切记！孕妇三个月后，尺脉或涩或微弱，胎儿必定不稳固。只有脉象洪盛的，胎儿才不会流产。所以《脉诀》内说：胎脉弦牢滑利则安，沉细而微则归泉路（指死亡），正是这个意思。虽然半产都是气血不足，但有禀赋偏阴偏阳，或寒或热的差异，自然应当凭脉调治。如阴虚内热而用艾叶、附子、白术、砂仁温暖之剂，则阴血愈消耗，如草木没有雨露滋润，自然枯萎。如阳虚内寒而用黄芩、芍药凉血之剂，则脾胃虚寒、气血也弱，犹如果实春夏容易生长，秋冬少结果实。总之，三月以前，宜调养脾胃，四月以后，宜壮腰肾、补血顺气，佐以清热，这是大法。
加味补中安胎饮：凡是孕妇元气壮盛，受胎后还有少量经血来潮，这是血气旺盛的缘故。如果不腰痛胎酸，不必服药，如虚弱消瘦的孕妇，下血不止，或按月有少量下血，称为胎漏，多因劳累而气血两虚，或喜食爆炒炙烤热物过多所致。宜谨守房事，并服用补药以保全胎儿。人参一钱，白术（土炒）、当归（酒洗）、黄芪（蜜炙）、陈皮、升麻、柴胡、甘草（炙）各适量，生姜、大枣为引，水煎服。
归脾汤（附：加味归脾汤、济生归脾汤）：治疗心脾郁结，经闭发热，并治疗脾虚不能统摄血液，导致血液妄行。又治疗经带胎漏等证，由于劳伤心脾、发热体倦、食欲不振、失眠、怔忡惊悸等证。人参、白术（土炒）、茯神、枣仁（炒）、龙眼肉各二钱，黄芪一钱五分（炙），当归身、远志肉（甘草水泡过）、木香各五分，生姜、大枣为引，水煎服。
尊生安胎饮：治疗血虚有火，曾经三月堕胎，适宜服用此方。并预防五月七月之堕，也治疗胎动、胎漏。当归身（酒洗）、白芍（酒炒）、熟地黄、生地黄、砂仁、阿胶（炒珠）各一钱，杜仲（盐水炒断丝）、续断（盐水炒）、黄芩（酒炒）各五分，人参、白术各一钱，水煎服。
景岳胎元饮：治疗妇人冲任失守，胎元不安不固，随症加减，或间日或二三日服一二剂。人参（随宜）、当归（酒洗）、杜仲（盐水炒断丝）、白芍（酒炒）各二钱，熟地黄二三钱，白术一钱，陈皮五分，炙甘草五分，水煎服。主治肾虚下元不固，或腹痛，或腹作痛，加制续断肉八分，或加五味子八分。
泰山磐石散：见前卷九。治疗妇人气血两虚，或肥胖而不结实，或瘦而血热，或肝脾素虚，倦怠少食，屡有堕胎之患，此方平和，兼养脾胃，气血。觉得有热者倍用黄芩，少用砂仁。觉得胃弱者，多用砂仁，少加黄芩。更宜戒除房事恼怒，远离酒醋辛热之物，可永远保证不流产。
经验易产丸：酒炒续断一两，土炒淮山药一两，制川芎五钱，酒炒全当归二两，川杜仲一两（用糯米粥拌匀晒干，炒去丝），可研细末。用桂圆肉五十枚，煎浓汁和蜜为丸，分作三次服用。
During pregnancy, menstrual blood is retained to nourish the fetus and accumulated to transform into milk. If the Qi of the Chong (Penetrating Vessel) and Ren (Conception Vessel) [Chong Mai (Penetrating Vessel), Ren Mai (Conception Vessel)] is deficient and cannot restrain it, causing slight vaginal bleeding monthly, it is called Bao Lou (Uterine Bleeding during Pregnancy). If the blood is exhausted, the fetus dies. However, there are also pregnant women with abundant blood whose menstruation continues normally without fetal movement, commonly known as "Gou'er Tai" (Dog Fetus). If treated as Bao Lou, the fetus will certainly abort; if not treated as Bao Lou, the fetus may not abort. There are also cases where the pulse is slippery and rapid but there are no wind-heat symptoms, and menstruation is normal but slightly less than before. This is due to a small fetus and surplus maternal blood. By the third or fourth month, when the fetus grows larger and requires more nourishment, menstruation will naturally stop. It is common now to see births at seven or eight months of pregnancy. People consider full term only after menstruation stops, calling earlier births premature. However, conception occurred before menstruation stopped, so by this time it is actually full term, though people do not realize this.
There are also robust pregnant women who have slight spotting monthly. If there is no lower back soreness or fetal restlessness, medication is unnecessary because their Qi and Blood are strong, and menstruation will naturally cease by the fourth or fifth month. If a pregnant woman is weak and emaciated, with frequent lower back soreness, fetal restlessness, and monthly spotting or continuous bleeding, this is not excess blood but Bao Lou. Jiawei Buzhong Antai Yin (Modified Cinnamon Twig and Atractylodes Decoction for Calming the Fetus) is suitable. It is also said that Bao Lou is often caused by Blood Heat, but there are cases of Qi deficiency and Blood deficiency where taking cooling herbs worsens the bleeding, accompanied by poor appetite and fatigue. This is Spleen Qi deficiency failing to control the blood. Guipi Tang (Restore the Spleen Decoction) and other formulas should be modified accordingly, and diagnosis should rely on pulse examination.
Abortion diseases mostly occur in the third, fifth, and seventh months. If an abortion occurred in the third month previously, it will likely recur in the corresponding month due to weakness. One must premedicate with Zunsheng Antai Yin (Venerable Life Fetal-Calming Decoction), or modify Taiyuan Yin (Fetal Origin Decoction), or use Taishan Panshi San (Mount Tai Porphyry Powder), Antai Wanquan Shenyingsan (Fetal-Calming Perfect Response Powder), etc., choosing according to symptoms to prevent recurrence. Continuous use until past the seventh month ensures safety. One must abstain from sexual intercourse, anger, overwork, and fried/spicy foods. Some abort within one month of conception; people are unaware, thinking it is just a regular period, not knowing the fetus was lost internally. After conception following the end of menstruation, one must rest and abstain from sex. Repeated intercourse disturbs the uterus, leading to abortion within one month or three to five months. Consider donkeys and horses: when pregnant, stallions kick away approaching males to protect the fetus, thus avoiding miscarriage. Should humans not be equally cautious? Labor, anger, lifting heavy objects, and washing the lower body (opening the orifices) can also cause abortion. Many infertile couples suffer from early abortions, not necessarily due to failure to conceive. For sudden falls damaging fetal Qi, Jiao Ai Antai San (Collage Moxa Fetal-Calming Powder) is suitable.
Before the third or fourth month, the fetus is unformed, called Duotai (Dropping Fetus). After the fifth or sixth month, the fetus is formed, called Banchan (Half Birth), commonly known as Xiaochan (Miscarriage). This generally belongs to maternal Qi and Blood deficiency and unstable fetal origin. Qi deficiency fails to hold firm; Blood deficiency fails to irrigate thoroughly, often leading to miscarriage. The Kidneys connect to the uterus, and the waist is the exterior of the Kidneys; lower back pain indicates risk of abortion, so prevention is essential. To treat Bao Lou, one must pre-nourish the root. Qianjin Baoyun Wan (Thousand Gold Pregnancy-Preserving Pill) is suitable. Zhilou Jueshen Dan (Stop Leakage Divine Spirit Elixir) is also very effective for Bao Lou. If a pregnant woman suddenly flows large amounts of water-like fluid, the fetus will abort. If the flow is gradual, Tonifying Qi and Calming the Fetus medicines can be used. Yellow discharge like bean juice with fetal restlessness and abdominal pain indicates Liver and Spleen Damp-Heat. Shengyang Chushi Tang (Raise Yang Expel Dampness Decoction) is used: Huangqi (Astragali Radix) 1 liang, Chuanxiong (Ligustici Chuanxiong Rhizoma) 1 qian, Nuomi (Oryza Sativa Glutinous Rice) 1 he, decocted and taken. Note that miscarriage differs greatly from term birth: term birth is like ripe fruit falling or nuts opening naturally; miscarriage is like picking green melons or peeling raw nuts, far more severe! People often neglect this, viewing it lightly, leading to illness and many deaths. This condition starts with blood consolidation to form the fetus, continues with essence and blood nourishing it, and ends with insufficiency causing abortion, so stasis is minimal. If there is abdominal pain with palpable masses, it is mostly Blood deficiency with rebellious Qi. Using Shenghua Tang (Generate New Decoction) first to remove stasis and generate new blood is wise, followed by strong warming tonification. If one only knows how to break stasis and stagnation, rebellious Qi will rise further, often leading to untreatable conditions. Beware! After the third month, if the Chi (Cun-Cord-Guan-Knee-Ankle) pulse is choppy or weak/faint, the fetus is unstable. Only a surging pulse indicates the fetus will not abort. Thus, *Maijue* (Pulse Classic) states: "String-taut-slippery-smooth pulses ensure safety; deep-thin-faint pulses lead to the underworld." Although miscarriage involves Qi and Blood deficiency, constitutional differences exist (Yin/Yang bias, Cold/Heat), so treatment must follow the pulse. If Yin deficiency with internal heat uses warming agents like Aijia (Moxae Folium, Aconiti Lateralis Radix Praeparata, Atractylodis Macrocephalae Rhizoma, Amomi Fructus), Yin blood will consume further, like plants without rain, naturally withering. If Yang deficiency with internal cold uses cooling agents like Huangqin (Scutellariae Radix), Baishao (Paeoniae Radix Alba), Spleen-Stomach cold and Qi-Blood weakness result, like fruits failing to bear in autumn/winter. In summary, before three months, nourish Spleen and Stomach; after four months, strengthen Waist and Kidneys, tonify Blood, smooth Qi, and assist with clearing Heat. This is the general principle.
Jiawei Buzhong Antai Yin: For robust pregnant women with slight bleeding after conception due to abundant Qi and Blood. If no back pain or fetal soreness, no medicine is needed. For weak/emaciated women with continuous bleeding or monthly spotting (Bao Lou), often caused by labor-induced Qi-Blood deficiency or excessive consumption of fried/spicy hot foods. Abstain from sex and take tonics to preserve the fetus. Renshen (Ginseng Radix) 1 qian, Baizhu (Atractylodis Macrocephalae Rhizoma, earth-fried), Danggui (Angelicae Sinensis Radix, wine-washed), Huangqi (Astragali Radix, honey-roasted), Chenpi (Citri Reticulatae Pericarpium), Shengma ( Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), Gancao (Glycyrrhizae Radix et Rhizoma, roasted) in appropriate amounts, Shengjiang (Zingiberis Rhizoma Recens), Dazao (Jujubae Fructus) as guides, decocted in water and taken.
Guipi Tang (Appendix: Jiawei Guipi Tang, Jisheng Guipi Tang): Treats Heart-Spleen constraint, amenorrhea with fever, and Spleen deficiency failing to control blood causing hemorrhage. Also treats menstrual disorders, leukorrhea, and Bao Lou due to Heart-Spleen injury from labor, fever, fatigue, poor appetite, insomnia, palpitations, and fright. Renshen, Baizhu (earth-fried), Fushen (Poria with Hostwood), Zaoren (Ziziphi Spinosae Semen, roasted), Longyanrou (Longan Aril) each 2 qian, Huangqi 1.5 qian (roasted), Dangguishen (Angelicae Sinensis Radix), Yuanzhi (Polygalae Radix, soaked in Licorice water), Muxiang (Aucklandiae Radix) each 0.5 qian, Shengjiang, Dazao as guides, decocted in water and taken.
Zunsheng Antai Yin: Treats Blood deficiency with Fire, history of third-month abortion. Suitable for preventing fifth/seventh-month abortions and treating fetal restlessness/Bao Lou. Dangguishen (wine-washed), Baishao (wine-fried), Shudihuang (Rehmanniae Radix Preparata), Shengdihuang (Rehmanniae Radix), Sharen (Amomi Fructus), Ejiao (Asini Corii Colla, fried into beads) each 1 qian, Duzhong (Eucommiae Cortex, salt-water fried to break fibers), Xuduan (Dipsaci Radix, salt-water fried), Huangqin (Scutellariae Radix, wine-fried) each 0.5 qian, Renshen, Baizhu each 1 qian, decocted in water and taken.
Jingyue Taiyuan Yin: Treats loss of Chong-Ren control, unstable fetal origin. Modify according to symptoms, take every other day or every two-three days. Renshen (as needed), Danggui (wine-washed), Duzhong (salt-water fried to break fibers), Baishao (wine-fried) each 2 qian, Shudihuang 2-3 qian, Baizhu 1 qian, Chenpi 0.5 qian, Zhigancao 0.5 qian, decocted in water and taken. Indicated for Kidney deficiency with unstable lower origin, or abdominal pain. Add Zhixuduan (Prepared Dipsacus Root) 0.8 qian, or Wuweizi (Schisandrae Chinensis Fructus) 0.8 qian.
Taishan Panshi San: See Volume 9. Treats women with Qi-Blood deficiency, obesity without solidity, thinness with Blood heat, or inherent Liver-Spleen deficiency with fatigue and poor appetite, prone to repeated abortions. This formula is mild, nourishing Spleen-Stomach and Qi-Blood. If heat is felt, double Huangqin and reduce Sharen. If stomach weakness is felt, increase Sharen and reduce Huangqin. Abstain from sexual anger and avoid alcohol, vinegar, and spicy-hot foods to permanently prevent abortion.
Jingyan Yichan Wan: Jiuxu duan (Wine-processed Dipsacus Root) 1 liang, Tuchaohuaishanyao (Earth-fried Dioscoreae Hypoglaucae Rhizoma) 1 liang, Zhichuanxiong (Processed Ligustici Chuanxiong Rhizoma) 5 qian, Jiuxuan danggui (Wine-processed Angelicae Sinensis Radix) 2 liang, Chuanduzhong (Sichuan Eucommia Cortex 1 liang, mixed with glutinous rice porridge, dried, fried to remove fibers). Grind into fine powder. Use 50 Guiyuanrou (Longan Arils), decoct in thick juice, mix with honey to form pills. Divide into three doses.