胎前清热与养血，
妇人无病，月事时下，乃能受孕。气血充实，则可保十月分娩，子母无虞。若冲任不充，偶然受孕，气
血不足荣养其胎、宜预服八珍汤，补养气血以防之，免其坠堕。或原有热而后受孕，或孕后挟热及七情劳役动火，
轻则胎动不安，重则遇三、五、七阳月必堕，火能消物故也，宜安胎丸常服，以消其热，热清则血循经而不妄行，
所以养胎也。谚云∶胎前不宜热，良有以哉！
月分根据经善调燮；
各经气血多少、虚实不调，则胎孕不安，根据经调之，免堕胎患，大忌男女交合。
一足厥阴二少阳，
夫人之有生也，母之血室方开，父之精潮适至，阴幕既翕，如布袋绞纽，而精血乘冲气自然旋转不息，如
蜣螂之 粪，吞啖含受成一团圆，璇玑九日一息不停，然后阴阳大定，玄黄相包，外似红条纹玛瑙，其中自然虚
成一窍，空洞虚圆，与鸡子黄中一穴相似，而团圆之外，气自凝结为胞衣，初薄渐浓，如彼米饮、豆浆面上自
结一皮，中窍日生，从无入有，精血日化，从有入无，九日之后，次九又九，凡二十七日，即成一月之数，窍
自然凝成一粒，如露珠然。乃太极动而生阳，天一生水，谓之胚，足厥阴脉所主也。此月经闭无潮，无痛，饮食
稍异平日，不可触犯，及轻率服药。又三九二十七日，即二月数，此露珠变成赤色，如桃花瓣子。乃太极静而生
阴，地二生火，谓之 ，足少阳脉所主也。此月腹中或动或不动，犹可狐疑，若吐逆思酸，名曰恶阻，有孕明
矣。或偏嗜一物，乃一脏之虚，如爱酸物，乃肝脏止能养胎而虚也。二三个月间，忽心腹痛不安者，用当归三
钱，阿胶、甘草各二钱，葱四茎煎服。
三四胞络三焦诀；
又三九二十七日，即三月数，百日间变成男女形影，如清鼻涕中，有白绒相似，以成人形。鼻与雌雄二器先就
分明，其诸全体隐然可悉，斯谓之胎。乃太极之干道成男，坤道成女，手厥阴脉相火所主。胎最易动，古芩术
汤，或为丸频服最妙。如无恶阻等证，胎有可疑者，用验胎法∶以川芎为末一钱，五更艾汤调服，服后腹中不
觉动者，则为经病；如觉微动者，则为有孕。或因惊恐坠堕，胎气不和，转动不能，脐腹疼痛者，温酒调下二
钱，加当归尤妙。如胎不安，及腰背痛不可忍者，古杜续丸。四月男女已分，始受水精以成血脉，形像具，六
腑顺成，手少阳脉所主。多心腹膨胀，饮食难消，甚者用平胃散，换白术加香附、乌药、大腹皮。如因惊怒动
胎下坠，小腹痛引腰胁，小便疼痛下血者，安胎当归汤。四五个月，忽心腹 痛者，用大枣十四枚炒黑，盐一
钱烧赤，为末，取一撮，酒调服之立愈。
五脾六胃七肺金，
五月始受火精以成阴阳之气，筋骨四肢已成，毛发始生，足太阴脉所主。六月始受金精以成筋，口目皆成，
足阳明脉所主。五六月胎不安者，安胎饮、固胎饮选用。七月始受木精以成骨，皮毛已成，游其魂能动左手，
手太阴脉所主。如胎气不安常处者，亦名阻病，宜旋复花散。
八手阳明成窍穴∶
八月始受土金以成皮肤，形骸渐长，九窍皆成，游其魄能动右手，手阳明脉所主。如胎不安者，单砂仁略炒
为末，米饮下，止痛行气甚捷，但非八九个月内不可多服。如胎肥大者，束胎丸。
九肾十膀神气完，
九月始受石精以成皮毛，百节毕备，三转
其身，足少阴脉所主。十月受气足，五脏六腑齐，通纳天地气于丹田，使关节、人神皆备，足太阳脉所主。
惟手少阴、太阳经无所专主者，以君主之官无为而已。此两月素难产者，达生散；素肥盛及奉养安逸太过者，
枳甘散；素怯弱者，益气救生散。
半产须防三七月；
半产多在三五个月及七个月内。若前次三个月而堕，则下次必如期复然。凡半产后，须多服养气血、固胎
元之药，以补其虚损。下次有胎，先于两个月半后，即服清热安胎药数帖，以防三月之堕。至四个半月后，再
服八九帖，防过五月。又至六个半月后，再服五七帖，以防七月。及至九个月，可保无虞。
间有感伤并杂证，
妊孕伤寒，详见三卷，寻常感风咳嗽，头痛发热，参苏饮去半夏热服，令肌体微润而已。风热甚者，双解
散去硝、黄、麻黄、石膏。感寒胸满欲呕，苦腹满痛，大便清者，大正气散去半夏，加吴萸、阿胶。感暑眩冒、
烦渴、尿赤、惊惕，呕吐、脐下苦急者，香薷散合古芩术汤，或十味香薷散。感湿腹胀，身重者，平胃散；泄
者三白汤加砂仁、浓朴，苍术，内热加黄芩。内伤七情，气滞不行者，紫苏饮，内伤劳役以致小腹常坠，甚则
子宫坠出者，气陷也，补中益气汤；如因房劳者，八物汤加酒炒黄 为君，防风、升麻为使。内伤饮食，胸胁
满痛者，平胃散换白术，加山楂、麦芽、黄连。内伤姜、椒、热酒、腥膻，炙爆，以致胎热，令母两目失明、
头痛、腮肿、项强者，消风散，或四物汤加芩、连、荆、防。内伤生冷冰血，或外又感寒，以致胎冷不转，脐
腹绞痛，肠鸣泄泻者，宜从权以理中汤之剂治之，泄甚加木香、诃子、陈皮、白芍、粟米，中病即止。因感伤
以致胎虚寒者，八物汤加吴萸、阿胶。《病原》谓风冷伤于子脏而堕者，此类间亦有之，非常法也。杂病与
男子一同，但孕妇服药，禁忌不犯则不动胎。如子疟热多，清脾饮去半夏；寒多，人参养胃汤去半夏；久不愈
者，胜金丹截之。胎痢热者，古芩术汤、黄芩汤；虚者胃风汤、香连丸。伤冷疟痢交作者，醒脾饮子。胎惊心
中怔忡，睡卧不宁，热者朱砂安神丸；虚者定志丸。余可类推。
调治须知三禁法。
妇人天癸未行，属少阳；天癸已行，属厥阴；天癸已绝，属太阴。胎产之病，治厥阴经者，是祖化之源
也，治无犯胃气及上二焦，为三禁，不可汗、下、利小便是也，汗则痞满，下则伤脾，利小便则亡津液。旧以四
物汤为主，如伤寒各经加减法例。莫若外感时气，从四物汤合小柴胡汤；阴证四物汤合理中汤、古芩术汤，伤
寒最妙。杂病四物汤、四君子汤、二陈汤加减。间有服毒药而不致胎动者，乃病邪重，胎元实也，岂可视为常
法！且阴阳和而后有胎，凡胎家有病，亦不必太攻也。经曰∶妇人重身，毒之有故无殒，然衰其大半而止。如
阴阳调和者，不可妄服药饵。三五月前，一毫辛散、滑利禁用。七八月间，倘有秘结，乃敢滑利，又当慎其素惯
堕胎，及难产而斟酌之。
胎动心腹腰作疼，甚则下血如经行；或因七情气不顺，或因外感风寒凝；
受胎不坚，或因惊恐，或因喜怒不常，或因冲任二经原挟风寒而受胎，或因登厕风冷攻入阴户，以致胎
动，而母心腹作痛，甚则腰痛下血，当安胎而母自定。胎动因七情气逆，心腹胀满疼痛者，紫苏饮；因外感发
热、头痛、呕逆、胸胁胀满者，安胎饮加柴胡、大腹皮；气血虚者，安胎饮倍参、术；虚热者，固胎饮。腹痛
服安胎药不止者，须辨寒热虚实，寒者，理中汤加砂仁、香附；热者，黄芩汤；血虚胎痛者，四物汤，或平胃
散加苏盐煎汤，吞二宜丸；气虚痛者，四君子汤加芍药、当归；气实心腹胀痛者，用香附、枳壳等分为末，空心
白汤下。心痛寒者，艾叶、小茴、川楝等分，空心水煎，或草豆蔻丸；热者，二陈汤去半夏，加山栀、黄
芩。心腹痛，素有冷气，腹痛冲心，如刀刺者，四物汤去地黄，加茯苓、浓朴、人参、吴萸、桔梗、枳壳、
甘草，水煎服。心腹大痛，气欲绝者，古芎归汤加茯苓、浓朴等分，水煎服。单方用鲤鱼如食治，入大枣十四
枚，炒盐一钱，酒少许，煮汁饮之；不饮酒者，用鲤鱼和粳米、姜葱煮粥、十日一食，善能护胎长胎。腰痛最
为紧急，酸痛者，必欲产也；因七情者，紫苏饮加杜仲、续断；因闪挫者，用破故纸二钱为末，胡桃肉一个，
研匀，空心酒调服；素虚痛者，青娥丸；腰痛如折，不能转侧者，用鹿角五钱，火 酒淬，再 再淬，以碎为
度，研末酒调服。胎动下血者，胶艾芎归汤，或加砂仁、秦艽、卷柏、桑螵蛸、桑寄生、杜仲。下血腹痛难忍，
或下黄汁如漆，如豆汁者，用野苎根、金银花根各五钱，水、酒各半盏煎服，下血产门痛者，用单黄连末一钱，
酒调服。
或因母病或压坠，
有因母病以致胎动者，但治母病而胎自安矣。如母有宿疾而胎不旺者，长胎白术丸。有羸瘦挟痰，气血
枯竭，胎终不可保者，用牛膝四分，木香、桂心、蟹爪各二分为末，空心温酒调服，下之免害其分娩，又用红酒
曲五两，渍酒十盏，煎二沸去渣，分五服，隔宿四服，次早再服。其子如糜，令母肥盛无疾，或麦芽、神曲煎
服，寻常古芎归汤最妙。孕妇或从高坠下，重物所压，致动胎元，心腹痛甚，下血者，用砂仁略炒勿焦，为末，
热酒、盐汤、艾汤皆可调服。觉腹中热，其胎即安，胎家无所不治，功同芩、术。如去血过多者，古芎归汤加
胶、艾。
健脾养血总安宁。
通用古芩术汤，加阿胶。风邪加生姜、豆豉；寒加葱白，或干生姜少许；热加天花粉；寒热加柴胡；项
强加葱白；温热腹痛加白芍；腹胀加浓朴；下血加艾叶、地榆；腰痛加杜仲；惊悸加黄连；烦渴加麦门冬、乌
梅；思虑过加茯神；痰呕加旋复花、半夏曲；劳役加黄 ；气喘去白术加香附；便燥加麻子仁；素惯难产加枳
壳、苏叶；素惯堕胎加杜仲；素血虚加芎、归，此安胎之圣药也。凡卒有所下，急则一日三五服，缓则五日、
十日一服。常服安胎易产，所生男女又无胎毒，盖妊孕脾土运化迟滞则生湿，湿则生热，故用黄芩清热以养血，
白术健脾以燥湿。安胎丸、金匮当归散、加味养荣丸，皆此方而推之也。
胎漏下血腹不痛，
心腹痛而下血者，为胎动；不痛者，为胎漏。
血多为热少为虚；
热者，下血必多。内热作渴者，四物汤加白术、芩、连、益母草，或金匮当归散、加味养荣丸。血黑成片
者，三补丸加香附、白芍。血虚来少者，古胶艾汤，或合四物汤、长胎白术丸。气虚者，四君子汤加黄芩、阿
胶。因劳役感寒，以致气虚下血欲坠者，芎归补中汤；或下血如月信，以致胞干，子母俱损者，用熟地、炒干
姜各二钱为末，米饮调服。
惟有犯房难救止，
胎漏亦有肥盛妇人月水当来者，或因登厕，风攻阴户者，虽不服药，亦或无恙，但作胎漏，遽用涩药治
之反堕。惟犯房下血者，乃真漏胎也，八物汤加胶，艾救之。
偶然尿血莫模糊。
尿血自尿门下血，胎漏自人门下血。妊娠尿血属胞热者多，四物汤加山栀、发灰，单苦 菜饮亦炒。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。
恶心阻食名恶阻，
或大吐，或时吐清水，恶闻食臭，由子宫经络络于胃口，故逢食气，引动精气冲上，必食吐尽而后精气
乃安。亦有娱交合而子宫秽盛者，过百日则愈。
瘦人多热肥人痰；
二陈汤加竹茹、生姜，热加芩、连；因怒
者，单黄连丸，茯苓煎汤下。
亦有无阴并气弱，
无阴则呕者，左脉必弱，头疼全不入食者，八物汤合二陈汤，加枳、梗。气弱者，四君子汤加陈皮、麦
门冬，浓朴、竹茹；日久水浆不入口，吐清水者，并加丁香。恶闻食气，多卧少起者，旋复花散。
或因胎动别证兼。
三四个月病恶阻者，多因胎动不安，或兼腰腹疼痛者，保胎饮；兼疟痢，口中无味，及曾伤风冷者，醒
脾饮子；兼伤食者，二陈汤加砂仁、香附，或单白术为丸，或单砂仁为末，米饮下。甚者，红丸子极效。
子烦躁闷乱心神，火盛克肺好生嗔；
妊孕心烦躁闷，谓之子烦。多受胎四五个月间，相火用事；或应天令五六月间，君火大行，俱能乘肺，
以致烦躁，胎动不安。大抵相火盛者，单知母为末，蜜丸芡实大，每三丸酒下，日月未足，欲产及虽产者亦效；
君火盛者，单黄连丸；心神不安者，朱砂安神丸；烦甚恐伤胎者，罩胎散。切不可以虚烦药治。
或有停痰胸膈滞，亦令烦躁不宜人。
或有停痰积饮，滞于胸膈之间，亦令烦躁胎动不安者，用茯苓、防风、麦门冬、黄芩等分，竹叶减半，水
煎，入竹沥调服。
子悬心腹胀满痛，胎气凑心相火哄；
妊孕四五个月以来，相火养胎，以致胎热气逆凑心，胸膈胀满疼痛，谓之子悬，宜紫苏饮；有郁，心腹
胀满甚者，加莪术及丁香少许。不食者，古芩术汤倍白术，加芍药。
甚则闷绝欲伤人，
火盛极，一时心气闷绝而死，紫苏饮连进救之。
误药子死不能动。
此证两尺脉绝者，有误服动胎药，子死腹中，则憎寒、手指唇爪俱青，全以舌证为验，古芎归汤救之。
胎水遍身虚肿浮，
妊孕经血闭以养胎，胎中挟水湿，与血相搏，湿气流溢，故令面目肢体遍身浮肿；名曰胎水，又曰子肿，
多五六个月有之。原因烦渴引饮太过，或泄泻损伤脾胃，脾虚不能制水，血化为水所致，宜五皮散，倍加白术
Clearing Heat and Nourishing Blood in Pregnancy,
If a woman is free from disease and menstruates regularly, she can conceive. When Qi and blood are abundant, she can ensure a full ten months of pregnancy and safe delivery, with no danger to mother or child. If the Chong and Ren meridians (Penetrating and Conception Vessels) are deficient and conception occurs by chance, insufficient Qi and blood may fail to nourish the fetus. In such cases, one should take Bazhen Tang (Eight Treasure Decoction) in advance to tonify Qi and blood and prevent miscarriage. Alternatively, if there was pre-existing internal heat before conception, or if heat arises during pregnancy due to emotional disturbances or overwork stirring up fire, mild cases result in fetal restlessness, while severe cases lead to miscarriage in the third, fifth, or seventh lunar months, as fire consumes all things. One should regularly take Antai Wan (Fetus-Stabilizing Pill) to clear heat; once heat is cleared, blood follows its vessels without erratic flow, thereby nourishing the fetus. As the proverb says: "Heat is undesirable during pregnancy," which is indeed true.
Monthly Adjustments According to Meridians;
Imbalances in the abundance, deficiency, or harmony of Qi and blood in the various meridians can destabilize pregnancy. Regulation according to the affected meridian prevents miscarriage. Coitus is strictly forbidden.
First Month: Foot Jueyin Liver Meridian; Second Month: Foot Shaoyang Gallbladder Meridian;
Human life begins when the mother's uterus opens and the father's sperm arrives. The vaginal opening closes like a tied bag, and sperm and blood rotate naturally via the Chong vessel, similar to how dung beetles roll balls. After nine days of continuous rotation, Yin and Yang stabilize, and heaven and earth essence combine. Externally resembling red striped agate, internally forming a hollow cavity similar to the yolk of an egg. Outside this sphere, Qi condenses into the placenta, initially thin then thickening like the skin on soy milk. The central cavity grows from nothing to something, with essence and blood transforming daily. After nine days, plus two more sets of nine (total 27 days), one lunar month is complete, and the cavity forms a droplet-like embryo. This stage, where Taiji moves to generate Yang and Heaven generates Water, is called the "Pei" (Embryo), governed by the Foot Jueyin Liver Meridian. Menstruation stops without pain, and diet may change slightly; avoid taboos and careless medication. Another 27 days (total 54 days, second month) sees the droplet turn red like peach petals. Here, Taiji stillness generates Yin and Earth generates Fire, forming the "Tai" (Fetus), governed by the Foot Shaoyang Gallbladder Meridian. Abdominal movement may be felt or not. Symptoms like nausea and craving sour foods indicate "Ezu" (Morning Sickness), confirming pregnancy. Craving specific foods indicates organ deficiency; e.g., craving sour suggests Liver deficiency. For sudden heart/abdominal pain in months 2-3, use Dang Gui (3 qian), Ejiao and Gancao (2 qian each), and 4 stalks of Congbai decocted.
Third and Fourth Months: Bao Luo and Sanjiao;
Another 27 days (total 81 days, third month) brings male/female differentiation within 100 days, resembling white fluff in nasal mucus, taking human form. Nose and genitalia are distinct; the whole body is visible. This is the "Tai," governed by Hand Jueyin Pericardium Meridian (Ministerial Fire). The fetus is easily disturbed; Gu Qinshu Tang or pills are best. To verify pregnancy if uncertain without morning sickness: take 1 qian of Chuanxiong powder with mugwort water at dawn. No movement indicates menstrual disorder; slight movement indicates pregnancy. For trauma-induced fetal instability with umbilical/abdominal pain, take 2 qian with warm wine, adding Dang Gui is better. For severe backache and fetal unrest, use Gu Duxu Wan. By the fourth month, sexes are distinct, blood vessels form via Water Essence, six fu organs develop, governed by Hand Shaoyang Sanjiao Meridian. Bloating and indigestion occur; use Pingwei San replacing Baizhu with Xiangfu, Wuyao, and Dafupi. For fear/anger-induced downward pressure with lower abdominal pain radiating to waist/flanks and hematuria, use Antai Danggui Tang. For sudden heart/abdominal pain in months 4-5, take 14 roasted jujubes and 1 qian red-hot salt, powdered, mixed with wine for immediate relief.
Fifth Month: Spleen; Sixth Month: Stomach; Seventh Month: Lung Metal;
The fifth month receives Fire Essence to form Yin/Yang qi; bones, muscles, limbs are formed, hair begins to grow, governed by Foot Taiyin Spleen Meridian. The sixth month receives Metal Essence to form sinews; mouth and eyes form, governed by Foot Yangming Stomach Meridian. For fetal unrest in months 5-6, select Antai Yin or Gutai Yin. The seventh month receives Wood Essence to form bones; skin and hair are complete, the soul moves the left hand, governed by Hand Taiyin Lung Meridian. For persistent fetal unrest ("Zubo"), use Xuanfuhua San.
Eighth Month: Hand Yangming Forms Orifices;
The eighth month receives Earth/Metal to form skin; body grows, nine orifices form, the po moves the right hand, governed by Hand Yangming Large Intestine Meridian. For fetal unrest, use Shaoren (Amomum) lightly roasted and powdered, taken with rice gruel for quick pain relief and Qi movement, but do not overuse in months 8-9. For large fetus, use Shutai Wan.
Ninth Month: Kidney; Tenth Month: Bladder Spirit Complete;
The ninth month receives Stone Essence to form hair/skin; joints complete, body turns three times, governed by Foot Shaoyin Kidney Meridian. The tenth month has sufficient Qi, five zang and six fu organs are complete, absorbing heaven/earth Qi into the Dantian, preparing joints and spirit, governed by Foot Taiyang Bladder Meridian. Hand Shaoyin Heart and Hand Taiyang Small Intestine meridians have no specific control because the Ruler remains inactive. For habitual dystocia, use Dasheng San; for obese/easily indulgent women, use Zhigan San; for weak women, use Yiqi Jiusheng San.
Preventing Miscarriage in Months 3, 5, and 7;
Miscarriages often occur in months 3, 5, and 7. If miscarriage occurred at three months previously, it will likely recur. After miscarriage, tonify Qi/blood and secure the fetus. For next pregnancy, start clearing heat/stabilizing fetus at 2.5 months to prevent month-3 miscarriage. At 4.5 months, take 8-9 doses to prevent month-5 miscarriage. At 6.5 months, take 5-7 doses to prevent month-7 miscarriage. By month 9, safety is assured.
Intermittent Pathogenic Influences and Miscellaneous Conditions;
Pregnancy colds see Vol 3. For common wind-cough, headache, fever: Shenru Yin minus Banxia, taken hot until skin is moist. For severe wind-heat: Shuangjie San minus Xiaoshi, Huanglian, Mahuang, Shigao. For cold with chest fullness/vomiting and painful diarrhea: Da Zhengqi San minus Banxia, add Wuzhuyu, Ejiao. For summerheat with dizziness/thirst/red urine/startle/vomiting/umbilical urgency: Xiangru San combined with Gu Qinshu Tang, or Shiwei Xiangru San. For dampness with blooming/heaviness: Pingwei San; for diarrhea: Sanbai Tang plus Shaoren, Houpo, Cangzhu; add Huangqin for internal heat. For emotional stagnation: Zisu Yin. For overwork causing uterine prolapse (Qi sinking): Buzhong Yiqi Tang. For sexual exhaustion: Bawu Tang plus Jiu Chao Huangqin as chief, Fangfeng/Shengma as guides. For dietary injury with chest/hypochondriac pain: Pingwei San replace Baizhu, add Shanzha, Maiya, Huanglian. For heat from spicy/alcohol/greasy food causing blindness/headache/swelling: Xiaofeng San, or Siwu Tang plus Huangqin, Lianqiao, Jingjie, Fangfeng. For cold/raw food causing cold fetus/cramps/diarrhea: Lizhong Tang formula; add Muxiang, Hezi, Chenpi, Baishao, Sumi for severe diarrhea, stop when cured. For cold-induced fetal deficiency: Bawu Tang plus Wuzhuyu, Ejiao. Wind-cold injuring the uterus causing miscarriage is rare but possible. Miscellaneous diseases treat similarly to men, avoiding contraindicated herbs that disturb the fetus. For malaria with heat: Qingpi Yin minus Banxia; with cold: Renshen Yangwei Tang minus Banxia; chronic: Shengjin Dan. For fetal dysentery with heat: Gu Qinshu Tang, Huangqin Tang; deficiency: Weifeng Tang, Xianglian Wan. For cold malaria/dysentery mix: Xingpi Yinzi. For fetal fright/palpitations: Zhusha Anshen Wan (heat); Dingzhi Wan (deficiency). Others follow analogy.
Three Prohibitions in Treatment;
Before Tian Gui (menstruation), relate to Shaoyang; during, to Jueyin; after cessation, to Taiyin. Treating Jueyin in pregnancy addresses the source of generation. Avoid damaging Stomach Qi and Upper/Middle Jiao. Three prohibitions: sweating, purging, diuresis. Sweating causes fullness; purging damages Spleen; diuresis depletes fluids. Traditionally use Siwu Tang modified like Shaoyang patterns. For exterior pathogens, combine Siwu Tang with Xiao Chaihu Tang. For Yin patterns, combine Siwu Tang with Lizhong Tang/Gu Qinshu Tang. For miscellaneous diseases, modify Siwu, Sijunzi, Erchen Tangs. Rarely, toxic herbs don't disturb fetus if pathogen is heavy and fetus strong, but this is not standard. Harmony precedes pregnancy; treat illness gently. Scripture: "In heavy pregnancy, toxins cause no harm if there is a cause, but stop when half the pathogen is gone." Do not medicate if harmonious. Before months 3-5, forbid acrid dispersants and slippery lubricants. In months 7-8, if constipated, use lubricants cautiously, considering history of miscarriage/dystocia.
Fetal Restlessness with Heart/Abdominal/Waist Pain, Even Bleeding Like Menstruation; Due to Emotional Qi Stagnation or External Wind-Cold;
Unstable fetus due to fright, irregular emotions, pre-existing wind-cold in Chong/Ren, or cold entering vagina during defecation causes fetal restlessness, maternal heart/abdominal pain, even backache/bleeding. Stabilize fetus to calm mother. For emotional Qi reversal with fullness/pain: Zisu Yin. For external heat/headache/vomiting/chest fullness: Antai Yin plus Chaihu, Dafupi. For Qi/Blood deficiency: Antai Yin double Renshen, Baizhu. For deficiency heat: Gutai Yin. For pain unrelieved by stabilizers, differentiate cold/heat/deficiency/excess. Cold: Lizhong Tang plus Shaoren, Xiangfu. Heat: Huangqin Tang. Blood deficiency pain: Siwu Tang, or Pingwei San plus Su Yan decoction swallowing Eryi Wan. Qi deficiency pain: Sijunzi Tang plus Baishao, Danggui. Qi excess/fullness/pain: Xiangfu/Zhiqiao equal parts powder, taken empty stomach with plain water. Heart pain cold: Aiye, Huixiang, Chuanliandu equal parts water decoction, or Caodoukou Wan. Heart pain heat: Erchen Tang minus Banxia, add Zhizi, Huangqin. Chronic cold qi stabbing heart: Siwu Tang minus Dihuang, plus Fuling, Houpo, Renshen, Wuzhuyu, Jiegeng, Zhiqiao, Gancao water decoction. Severe pain/near collapse: Gu Xiong Gui Tang plus Fuling, Houpo equal parts water decoction. Single remedy: Carp soup with 14 jujubes, 1 qian roasted salt, little wine; or carp/rice/ginger/scallion porridge every 10 days to protect/grow fetus. Waist pain is urgent; soreness implies imminent birth. Emotional: Zisu Yin plus Duzhong, Xuduan. Sprain: Pugu Zhi powder + Walnut meat, wine empty stomach. Deficiency: Qing'e Wan. Break-like pain immobility: Lu Jiao (Deer horn) quenched in wine repeatedly until crushed, powder with wine. Bleeding: Jiao Ai Xiong Gui Tang, or plus Shaoren, Qinjiao, Juanbai, Sangpiaoxiao, Sangjisheng, Duzhong. Severe bleeding/yellow discharge: Yezhu Gen, Jinyinhua Gen 5 qian each, water/wine decoction. Bleeding/vaginal pain: Huanglian powder 1 qian, wine.
Due to Maternal Illness or Trauma;
If maternal illness disturbs fetus, treat mother only. For chronic illness with weak fetus: Changtai Baizhu Wan. For emaciation/phlegm/depleted Qi-blood where fetus cannot be saved: Niuxi, Muxiang, Guixin, Xiezhuao powder, warm wine empty stomach to expel dead fetus safely. Then Hongqu wine decoction divided into 5 doses over 2 nights/morning. If fetus disintegrates, make mother healthy, or use Maiya/Shenqu decoction. Standard Gu Xiong Gui Tang is best. For falls/pressure causing severe pain/bleeding: Shaoren lightly roasted powder, taken with hot wine/salt water/mugwort tea. Feeling warmth in abdomen stabilizes fetus. Works like Huangqin/Baizhu. For excessive bleeding: Gu Xiong Gui Tang plus Ejiao, Aicao.
Strengthen Spleen/Nourish Blood for Peace;
General Gu Qinshu Tang plus Ejiao. Wind: Shengjiang, Douchi. Cold: Congbai or dry Shengjiang. Heat: Tianhuafen. Cold/Heat: Chaihu. Neck stiffness: Congbai. Warmth/pain: Baishao. Bloating: Houpo. Bleeding: Aicao, Diyü. Backache: Duzhong. Palpitations: Huanglian. Thirst: Maidong, Wumei. Overthinking: Fushen. Phlegm/vomit: Xuanfuhua, Banxia Qu. Overwork: Huangqin. Asthma: Remove Baizhu, add Xiangfu. Dry stool: Maziren. Habitual dystocia: Zhiqiao, Ziyè. Habitual miscarriage: Duzhong. Blood deficiency: Xiong, Gui. These are holy medicines for stabilizing fetus. Acute bleeding: 3-5 times/day; slow: every 5-10 days. Regular use ensures easy delivery and no fetal toxin. Pregnancy spleen transport is sluggish, generating damp-heat. Huangqin clears heat/nourishes blood; Baizhu strengthens spleen/dries damp. Antai Wan, Jin Gui Dang Gui San, Jia Wei Yang Rong Wan derive from this.
Fetal Leakage Bleeding Without Abdominal Pain;
Heart/abdominal pain with bleeding is Fetal Restlessness; painless bleeding is Fetal Leakage.
Heavy Bleeding Indicates Heat, Light Indicates Deficiency;
Heat causes heavy bleeding. Internal heat/thirst: Siwu Tang plus Baizhu, Huangqin, Lianqiao, Yimucao, or Jin Gui Dang Gui San/Jia Wei Yang Rong Wan. Black clots: Sanbu Wan plus Xiangfu, Baishao. Light bleeding/deficiency: Gu Jiao Ai Tang, or combined with Siwu Tang/Changtai Baizhu Wan. Qi deficiency: Sijunzi Tang plus Huangqin, Ejiao. Overwork/cold causing Qi deficiency/downward bleeding/prolapse: Xiong Gui Buzhong Tang. Or bleeding like menstruation drying womb harming both: Shudi, Chao Ganjiang 2 qian each, powder with rice gruel.
Only Sexual Intercourse Causes Irresistible Leakage;
Leakage in obese women mimicking period, or wind attacking vagina during defecation, may resolve without meds. But using astringents prematurely causes miscarriage. Only post-coital bleeding is true leakage; treat with Bawu Tang plus Ejiao, Aicao.
Occasional Hematuria Should Not Be Confused;
Hematuria comes from urethra; leakage from vagina. Pregnancy hematuria usually bladder heat: Siwu Tang plus Zhizi, Fazhui. Single Kuxingcai drink (roasted). Summerheat: Yi Yuan San plus Shengma decoction. Slight deficiency: Jiao Ai Siwu Tang. Chronic: Longgu 1 qian, Huyang 5 qian powder, wine.
Nausea/Obstruction Named Ezu;
Vomiting large amounts or clear water, aversion to food odors. Uterus meridians connect to stomach; food aroma stirs essence upward, vomiting clears it. Intercourse causing uterine turbidity resolves after 100 days.
Thin People Have Heat, Fat People Have Phlegm;
Erchen Tang plus Zhuru, Shengjiang; add Huangqin/Lianqiao for heat. Anger: Dan Huanglian Wan with Fuling decoction.
Also Lack of Yin and Weak Qi;
Yin lack causes vomiting, weak left pulse, headache/no appetite: Bawu Tang combined with Erchen Tang, plus Zhike, Jiegeng. Qi weakness: Sijunzi Tang plus Chenpi, Maidong, Houpo, Zhuru. Long-term inability to eat/drink/clear water: add Dingxiang. Aversion to food smell/lying down: Xuanfuhua San.
Or Other Symptoms Combined with Fetal Restlessness;
Months 3-4 Ezu due to unstable fetus/back-abdominal pain: Baotai Yin. With malaria/dysentery/taste loss/cold injury: Xingpi Yinzi. With food stagnation: Erchen Tang plus Shaoren, Xiangfu, or single Baizhu pill/Shaoren powder with rice gruel. Severe: Hong Wan.
Fetal Irritability/Confusion, Heart Spirit, Fire Excess Overcoming Lung Causes Anger;
Pregnancy irritability is "Zi Fan." Common in months 4-5 (Ministerial Fire) or 5-6 (Monarch Fire), affecting Lung causing restlessness. Ministerial fire excess: Zhimu powder, honey pills, 3 pills with wine; effective even near term/post-partum. Monarch fire excess: Dan Huanglian Wan. Spirit unrest: Zhusha Anshen Wan. Severe fear of harming fetus: Zaotai San. Do not use deficiency-irritability formulas.
Phlegm Retention in Chest/Diaphragm Also Causes Irritability;
Phlegm-fluid retention in chest causing irritability/restlessness: Fuling, Fangfeng, Maidong, Huangqin equal parts, Zhu Ye half, water decoction, mix with Zhuli (bamboo juice).
Fetal Suspension Heart/Abdominal Fullness/Pain, Fetal Qi Rushing Heart Ministerial Fire Chaos;
Months 4-5, Ministerial Fire nourishes fetus, causing heat/Qi rebellion rushing to heart, chest/abdominal fullness/pain, named "Zi Xuan." Use Zisu Yin. With depression/severe fullness: add Ezhu, Dingxiang. Anorexia: Gu Qinshu Tang double Baizhu, add Baishao.
Severe Cases Suffocate and Endanger Life;
Extreme fire suffocates heart Qi death; Zisu Yin continuously saves.
Wrong Medication Kills Fetus Preventing Movement;
Absent radial pulses suggest accidental fetal-disturbing herb ingestion, dead fetus in uterus. Signs: chills, blue fingers/lips/nails. Verify with tongue. Save with Gu Xiong Gui Tang.
Fetal Water Generalized Edema;
Menstrual blood closed to nourish fetus, fetus carries dampness fighting blood, damp flows overflowing causing facial/body edema. Named "Tai Shui" or "Zi Zhong," common months 5-6. Cause: excessive drinking/diarrhea damaging Spleen, Spleen deficiency failing to control water, blood transforming to water. Use Wupi San, double Baizhu.