唐右 腰为肾府，胎脉亦系于肾，肾阴不足，冲任亦亏，妊娠四月，忽然腹痛坠胀，腰酸流红，脉细小而
弦。胎气不固，营失维护，虑其胎堕。急拟胶艾四物汤养血保胎。
阿胶珠（二钱） 生白术（一钱五分） 浓杜仲（二钱） 大白芍（一钱五分） 广艾炭（八分） 炒条芩（一钱
五分） 川断肉（二钱） 苎麻根（二钱） 白归身（二钱） 生地炭（四钱） 桑寄生（二钱）
朱右 怀孕足月，漏红迭见，是血有热，冲任不固。胎之生发由于血，今血溢妄行，胎萎不长，不能根据时而
产也。拟养血清热，而固胎元。
阿胶珠（二钱） 生地炭（四钱） 白归身（二钱） 炙黄 （三钱） 苎麻根（二钱） 炒条苓（一钱五分）
嫩白薇（一钱五分） 大白芍（一钱五分） 西洋参（一钱五分） 藕节炭（二枚）
严右 咳嗽较减之后，忽然流红甚多，舌质淡红，脉弦小而数。怀麟七月，正属手太阴司胎，太阴原有燥
邪，引动肝火，由气入营，血得热以妄行，颇虑热伤胎元，致成小产。急拟养营泄热以保胎，佐入滋水清肝而
润肺。
蛤粉炒阿胶（三钱） 生地炭（三钱） 侧柏炭（一钱五分） 浓杜仲（三钱） 生白术（一钱五分）
光杏仁（三钱） 冬桑叶（三钱） 炒条芩（一钱） 川象贝（各二钱） 冬瓜子（三钱） 鲜藕（去皮、切片、入
煎，四两） 枇杷叶露（后入，四两）
蔡右 怀麟八月，腰酸流红。疫喉痧四天，寒热不退，痧子隐隐，布而不透，咳嗽泛恶，咽喉 红作痛，舌
质红，苔粉白，脉象濡滑而数。风温疫疠之邪，蕴袭肺胃二经，两两相衡，自以清温解疫为要。疫邪一日不
解，则胎元一日不安，急拟辛凉汗解，宣肺化痰，不必安胎，而安胎止漏之功即在是矣。
薄荷叶（八分） 苦桔梗（一钱） 连翘壳（三钱） 荆芥穗（一钱五分） 江枳壳（一钱） 光杏仁（三钱）
净蝉衣（八分） 轻马勃（八分） 象贝母（三钱） 淡豆豉（三钱） 熟牛蒡（二钱） 鲜
竹茹（二钱） 芫荽子（一钱五分）
唐右 受寒停滞，脾胃为病，清浊混淆，腹痛泄泻，似痢不爽，有坠胀之状，胸闷不纳，舌光无苔，按脉濡
迟。怀娠四月，颇虑困泻动胎。急拟和中化浊，佐保胎元。
藿香梗（一钱五分） 云茯苓（三钱） 六神曲（三钱） 陈广皮（一钱） 炒扁豆衣（三钱） 焦楂炭（三钱）
生白术（一钱五分） 大腹皮（二钱） 带壳砂仁（八分） 焦谷芽（四钱） 陈莱菔子（三钱） 干荷叶（一角）
吴右 牙齿属胃，胃火循经上升，风热之邪未楚，左颧面肿红已退，右颧面漫肿又起。内热口干，心中
杂，舌质淡红，脉象滑数。怀麟足月，胎火内炽，拟辛凉清解，而清胎热。
薄荷叶（八分） 天花粉（三钱） 生赤芍（二钱） 熟牛蒡（二钱） 生甘草（八分） 大贝母（三钱）
冬桑叶（三钱） 苦桔梗（一钱） 炙僵蚕（三钱） 甘菊花（三钱） 金银花（三钱） 连翘壳（三钱） 鲜竹叶
（三十张） 活芦根（去节，一尺）
戴右 怀麟十二月，漏红五六次，腹已大，乳不胀，脉弦小而滑。冲任亏损，肝火入营，血热妄行，不得养
胎，故胎萎不长，不能根据期而产也。当宜益气养血，清营保胎，俾气能摄血，血足荫胎，胎元充足，瓜熟自然蒂落。
吉林参须（一钱） 生黄 （三钱） 生地炭（三钱） 浓杜仲（三钱） 生白术（二钱） 白归身（二钱）
阿胶珠（二钱） 炒条芩（一钱） 侧柏炭（一钱五分） 生白芍（二钱） 桑寄生（三钱） 鲜藕（切片入煎，一两）
张右 妊娠九月，便溏旬余，漏红色紫，腰不酸，腹不坠，殊非正产之象。良由肝虚不能藏血，脾虚不能统
血，中焦变化之汁，尽随湿浊以下注也。舌苔薄腻，脉象弦滑。当宜培养中土，而化湿浊。俾得健运复常，则
生气有权，而胎元易充易熟矣。
生白术（三钱） 云茯苓（三钱） 春砂壳（八分） 桑寄生（二钱） 炒淮药（三钱） 陈广皮（一钱）
焦楂炭（三钱） 藕节炭（二枚） 炒扁豆衣（三钱） 煨木香（五分） 焦麦芽（三钱） 干荷叶（一角）
二诊 孕已足月，腹痛腰酸，谷道坠胀，中指跳动，正产之时已届。气足则易送胎，血足则易滑胎。惟宜
大补气血，以充胎元，水足则舟行无碍之意。
炙黄 （五钱） 抱茯神（三钱） 陈广皮（一钱） 大白芍（一钱五分） 大熟地（五钱） 菟丝子（二钱）
炒黑荆芥（八分） 生白术（二钱） 白归身（三钱） 大川芎（五分） 红枣（五枚）
Ms. Tang: The lower back is the mansion of the Kidney, and the fetal pulse is also related to the Kidney. Insufficiency of Kidney Yin leads to deficiency in the Chong and Ren vessels. At four months of pregnancy, sudden abdominal pain, bearing-down sensation, and distension occurred, accompanied by soreness of the lower back and vaginal bleeding. The pulse was fine and wiry. The fetal Qi was unstable, and Ying blood failed to maintain it; there was concern for miscarriage. An urgent prescription of Ejiao Siwu Decoction (Donkey-hide Gelatin Four Substances Decoction) was formulated to nourish blood and preserve the fetus.
Ejiao Zhu (Frittered Donkey-hide Gelatin) [2 qian] Sheng Baizhu (Raw Atractylodis Macrocephalae Rhizoma) [1.5 qian] Nong Duzhong (Thick Eucommiae Cortex) [2 qian] Da Baishao (Large Paeoniae Radix Alba) [1.5 qian] Guang Aitan (Charred Artemisiae Argyi Folium) [0.8 fen] Chao Huangqin (Stir-fried Scutellariae Radix) [1.5 qian] Chuan Duanyurou (Cortex Dipsaci) [2 qian] Zhuma Gen (Radix Boehmeriae niveae) [2 qian] Bai Guishen (Radix Angelicae Sinensis) [2 qian] Sheng Ditanc (Charred Rehmanniae Radix) [4 qian] Sangjisheng (Ramulus Taxilli) [2 qian]
Ms. Zhu: At full term of pregnancy, recurrent vaginal spotting indicates heat in the blood and instability of the Chong and Ren vessels. The growth and development of the fetus depend on blood. Now that blood is overflowing and acting recklessly, the fetus is withered and fails to grow, preventing delivery at the expected time. The treatment aims to nourish blood and clear heat to secure the fetal origin.
Ejiao Zhu (Frittered Donkey-hide Gelatin) [2 qian] Sheng Ditanc (Charred Rehmanniae Radix) [4 qian] Bai Guishen (Radix Angelicae Sinensis) [2 qian] Zhi Huangqi (Honey-fried Astragali Radix) [3 qian] Zhuma Gen (Radix Boehmeriae niveae) [2 qian] Chao Huangqin (Stir-fried Scutellariae Radix) [1.5 qian] Nen Baiwei (Herba Cynanchi Stauntonii) [1.5 qian] Da Baishao (Large Paeoniae Radix Alba) [1.5 qian] Xiyangshen (Radix Panacis Quinquefolii) [1.5 qian] Oujietan (Charred Lotus Rhizoma Node) [2 pieces]
Ms. Yan: After the cough subsided, heavy vaginal bleeding suddenly occurred. The tongue was pale red, and the pulse was wiry, fine, and rapid. At seven months of pregnancy, the Hand-Taiyin Lung meridian governs the fetus. The Taiyin originally had dryness pathogen, which stirred up Liver fire, moving from the Qi level to the Ying level. Blood, heated, acted recklessly. There was considerable concern that heat would damage the fetal origin, leading to premature birth. An urgent prescription aimed to nourish Ying and drain heat to preserve the fetus, assisted by moistening water to clear Liver fire and moisten the Lung.
Ge Fen Chao Ejiao (Donkey-hide Gelatin stir-fried with蛤粉/Glulis Pulvis) [3 qian] Sheng Ditanc (Charred Rehmanniae Radix) [3 qian] Ce Bai Tan (Charred Platycladi Cacumen) [1.5 qian] Nong Duzhong (Thick Eucommiae Cortex) [3 qian] Sheng Baizhu (Raw Atractylodis Macrocephalae Rhizoma) [1.5 qian] Guang Xingren (Light Apricot Seed) [3 qian] Dong Sangye (Winter Mulberry Leaf) [3 qian] Chao Huangqin (Stir-fried Scutellariae Radix) [1 qian] Chuan Xiangbei (Fritillariae Cirrhosae Bulbus mixed with Fritillariae Thunbergii Bulbus) [2 qian each] Dongguazi (Benincasae Semen) [3 qian] Xian Ou (Fresh Lotus Rhizoma, peeled, sliced, decocted) [4 liang] Pipa Ye Lu (Loquat Leaf Dew, added later) [4 liang]
Ms. Cai: At eight months of pregnancy, lower back soreness and vaginal bleeding occurred. She suffered from epidemic throat scarlet fever for four days, with alternating chills and fever persisting. The rash was faint and incomplete. Cough and nausea were present. The throat was red and painful. The tongue was red with a powdery white coating. The pulse was soggy, slippery, and rapid. Wind-warmth and epidemic pestilence pathogens accumulated and attacked the Lung and Stomach meridians. Balancing both, the priority is to clear warmth and resolve epidemics. As long as the epidemic pathogen remains unresolved, the fetal origin remains insecure. An urgent prescription used acrid-cool diaphoresis to release the exterior, diffuse the Lung, and transform phlegm. Specific fetal preservation was not directly targeted, but the function of preserving the fetus and stopping leakage was inherent in this approach.
Bohe Ye (Mint Leaf) [0.8 fen] Ku Jiegeng (Bitter Platycodon Root) [1 qian] Lianqiao Qiao (Forsythiae Fructum) [3 qian] Jingjie Sui (Schizonepeta Spike) [1.5 qian] Jiang Zhike (Zanthoxyli Fructum) [1 qian] Guang Xingren (Light Apricot Seed) [3 qian] Jing Chan Yi (Cleaned Cicada Slough) [0.8 fen] Qing Mabo (Light Polyporus Umbellatus) [0.8 fen] Xiang Beimu (Fritillariae Thunbergii Bulbus) [3 qian] Dan Douchi (Prepared Soybean) [3 qian] Shu Niubangzi (Prepared Arctii Fructus) [2 qian] Xian Zhuru (Fresh Bamboo Shavings) [2 qian] Yansizi (Coriandri Fructus) [1.5 qian]
Ms. Tang: Cold invasion caused stagnation, damaging the Spleen and Stomach. Clear and turbid Qi became confused, resulting in abdominal pain and diarrhea resembling dysentery but unsatisfactory, with a bearing-down sensation. Chest tightness and anorexia were present. The tongue was smooth without coating. The pulse was soggy and slow. At four months of pregnancy, there was concern that severe diarrhea might disturb the fetus. An urgent prescription aimed to harmonize the middle and transform turbidity, assisted by preserving the fetal origin.
Huoxiang Geng (Agastache Stem) [1.5 qian] Yun Fuling (Poria with Hostwood) [3 qian] Liushenqu (Six Divine Leaven) [3 qian] Chen Guangpi (Aged Tangerine Peel) [1 qian] Chao Bian Dou Yi (Stir-fried Dolichos Lablab Seed Coat) [3 qian] Jiao Zhaca Tan (Charred Crataegi Fructus) [3 qian] Sheng Baizhu (Raw Atractylodis Macrocephalae Rhizoma) [1.5 qian] Dafupi (Arecae Pericarpium) [2 qian] Daike Sharen (Amomi Fructus with Shell) [0.8 fen] Jiao Guya (Stir-fried Setaria Germ) [4 qian] Chen Laifuzi (Aged Raphani Semen) [3 qian] Gan Heye (Dried Lotus Leaf) [1 corner]
Ms. Wu: Teeth belong to the Stomach. Stomach fire ascends along the meridian. The wind-heat pathogen was not fully cleared. Swelling and redness on the left cheek had subsided, but diffuse swelling arose on the right cheek. Internal heat and dry mouth, mental restlessness. The tongue was pale red. The pulse was slippery and rapid. At full term, fetal fire was blazing internally. An acrid-cool clearing and resolving method was used to clear fetal heat.
Bohe Ye (Mint Leaf) [0.8 fen] Tianhuafen (Trichosanthis Radix) [3 qian] Sheng Chishao (Raw Paeoniae Radix Rubra) [2 qian] Shu Niubangzi (Prepared Arctii Fructus) [2 qian] Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma) [0.8 fen] Da Beimu (Large Fritillariae Bulbus) [3 qian] Dong Sangye (Winter Mulberry Leaf) [3 qian] Ku Jiegeng (Bitter Platycodon Root) [1 qian] Zhi Jiangcan (Honey-fried Bombyx Batryticatus) [3 qian] Gan Juhua (Chrysanthemi Flos) [3 qian] Jinyinhua (Lonicerae Japonicae Flos) [3 qian] Lianqiao Qiao (Forsythiae Fructum) [3 qian] Xian Zhuye (Fresh Phragmitis Caulis leaves) [30 sheets] Huo Lugen (Living Reed Rhizome, nodes removed) [1 chi]
Ms. Dai: At twelve months of pregnancy, vaginal spotting occurred five or six times. The abdomen was large, breasts were not swollen, and the pulse was wiry, fine, and slippery. Deficiency in Chong and Ren vessels, Liver fire entering the Ying level, reckless movement of hot blood failing to nourish the fetus, resulted in a withered fetus unable to deliver on time. The treatment should tonify Qi and nourish blood, clear Ying heat to preserve the fetus, so that Qi can control blood and sufficient blood can shade the fetus. When the fetal origin is sufficient, delivery will occur naturally like a ripe melon falling from the vine.
Jilin Renshu (Ginseng Radicule from Jilin) [1 qian] Sheng Huangqi (Raw Astragali Radix) [3 qian] Sheng Ditanc (Charred Rehmanniae Radix) [3 qian] Nong Duzhong (Thick Eucommiae Cortex) [3 qian] Sheng Baizhu (Raw Atractylodis Macrocephalae Rhizoma) [2 qian] Bai Guishen (Radix Angelicae Sinensis) [2 qian] Ejiao Zhu (Frittered Donkey-hide Gelatin) [2 qian] Chao Huangqin (Stir-fried Scutellariae Radix) [1 qian] Ce Bai Tan (Charred Platycladi Cacumen) [1.5 qian] Sheng Baishao (Raw Paeoniae Radix Alba) [2 qian] Sangjisheng (Ramulus Taxilli) [3 qian] Xian Ou (Fresh Lotus Rhizoma, sliced, decocted) [1 liang]
Ms. Zhang: At nine months of pregnancy, loose stools persisted for over ten days. Vaginal bleeding was dark purple. There was no lower back soreness or abdominal bearing-down, indicating this was not normal labor. This was due to Liver deficiency failing to store blood and Spleen deficiency failing to control blood. The fluids transformed in the Middle Jiao all followed damp-turbidity downward. The tongue coating was thin and greasy. The pulse was wiry and slippery. The treatment should cultivate the Earth element (Spleen/Stomach) and transform damp-turbidity. Once healthy transportation resumes, vital Qi gains power, and the fetal origin becomes easy to fill and mature.
Sheng Baizhu (Raw Atractylodis Macrocephalae Rhizoma) [3 qian] Yun Fuling (Poria with Hostwood) [3 qian] Chun Sha Qiao (Cardamomi Fructus Shell) [0.8 fen] Sangjisheng (Ramulus Taxilli) [2 qian] Chao Huaiyao (Stir-fried Dioscoreae Rhizoma) [3 qian] Chen Guangpi (Aged Tangerine Peel) [1 qian] Jiao Zhaca Tan (Charred Crataengi Fructus) [3 qian] Oujietan (Charred Lotus Rhizoma Node) [2 pieces] Chao Bian Dou Yi (Stir-fried Dolichos Lablab Seed Coat) [3 qian] Wei Muxiang (Baked Aucklandiae Radix) [0.5 fen] Jiao Maiya (Stir-fried Hordei Fructus Germinatus) [3 qian] Gan Heye (Dried Lotus Leaf) [1 corner]
Second Visit: Pregnancy is at full term. Abdominal pain, lower back soreness, anal bearing-down sensation, and pulsation in the middle finger indicate that the time for delivery has arrived. Abundant Qi facilitates pushing out the fetus; abundant blood facilitates smooth delivery. Only great tonification of Qi and blood is needed to充实 (fill) the fetal origin, similar to the principle that sufficient water allows the boat to move unimpeded.
Zhi Huangqi (Honey-fried Astragali Radix) [5 qian] Bao Fushen (Poria with Hostwood containing Pine Root) [3 qian] Chen Guangpi (Aged Tangerine Peel) [1 qian] Da Baishao (Large Paeoniae Radix Alba) [1.5 qian] Da Shudi (Large Prepared Rehmanniae Radix) [5 qian] Tusizi (Cuscutae Semen) [2 qian] Chao Hei Jingjie (Stir-fried Black Schizonepeta Spike) [0.8 fen] Sheng Baizhu (Raw Atractylodis Macrocephalae Rhizoma) [2 qian] Bai Guishen (Radix Angelicae Sinensis) [3 qian] Da Chuanxiong (Large Ligustici Chuanxiong Rhizoma) [0.5 fen] Hongzao (Red Dates) [5 pieces]