《大全》曰∶娠妇心痛，乃风邪痰饮交结。若伤心经，为真心痛，旦发夕死，夕发旦死
。若伤心支络，则乍安乍发。若伤于子脏，则胎动而血下。
按薛氏曰∶前症若饮食所伤，用平胃散加枳壳、山楂。若因错杂诸邪，当审其因而治之
。
(附子痛、小腹痛)
《大全》云∶娠妊心腹痛者，或由宿有冷疼，或新触风寒，皆由脏虚而致动也。邪正相
击而
并于气，随气上下，上冲于心则心痛，下攻于腹则腹痛，故令心腹痛也。娠妊而痛者，邪正
二气交攻于内也。若不时差者，其痛冲击胞络，必致动胎，甚则伤堕也。又云∶娠妊心腹疼
痛，多是风寒湿冷痰饮与脏气相击，故令腹痛，攻冲不已，则致胎动也。
按薛氏曰；前症若风寒痰饮，用金沸草散，杂病咳嗽，胎气郁结，加香附、川芎。若饮
食停
滞，用六君子加紫苏、枳壳。若怒动肝火，前药更加柴、栀。若郁结伤脾，用归脾汤加枳壳
、山栀。
仲景云∶妇人怀胎，腹中诸疾痛，当归芍药散主之。《脉经》曰∶妇人有胎腹痛，其人
不安
。若胎动痛，不动欲知生死，令人摸之，如覆杯者生，如肘颈参差起者死。又冷者死，温者
生。
薛氏曰∶若腹中不时作痛，或小腹重坠，名曰胎痛。用地黄当归汤。未应，加参、术、
陈皮。或因脾气虚，用四君子加归、地。中气虚，补中益气汤(真虚者可用)。
《大全》云∶娠妊小腹痛者，由络虚风寒相搏，痛亦令胎动也。宜紫苏饮加生姜。若腹
胀痛，用安胎饮加升麻、白术，不应，兼用补中益气汤。
*Daquan* states: Heart pain in pregnant women is caused by the entanglement of wind pathogen and phlegm-fluid. If the Heart Meridian (Heart Channel) is damaged, it becomes "True Heart Pain" (Zhen Xin Tong), where onset in the morning leads to death in the evening, and onset in the evening leads to death in the morning. If the collateral branches of the Heart are damaged, the pain comes and goes intermittently. If the Zi Zang (uterus) is injured, it causes fetal movement accompanied by vaginal bleeding.
According to Xue Ji: For the aforementioned symptoms caused by dietary injury, use Pingwei San (Calm the Stomach Powder) with added Zhike (Aurantii Fructus Immaturus) and Shanzha (Crataegi Fructus). If caused by a mixture of various pathogens, one should investigate the cause and treat accordingly.
(Attached: Heart pain, Lower abdominal pain)
*Daquan* states: Heart and abdominal pain during pregnancy may arise from pre-existing cold pain or recent exposure to wind-cold. Both result from deficiency in the Zang organs leading to disease activation. When pathogenic and healthy Qi clash and move together with the Qi mechanism, rising to attack the Heart causes heart pain, while descending to attack the abdomen causes abdominal pain, thus resulting in heart and abdominal pain. Pain during pregnancy is due to the mutual attacking of pathogenic and healthy Qi internally. If not relieved promptly, this pain impacts the Bao Luo (uterine collaterals), inevitably causing fetal movement, and in severe cases, miscarriage or abortion. It also states: Heart and abdominal pain during pregnancy is mostly caused by wind-cold-dampness, cold, phlegm-fluid clashing with Zang Qi, leading to abdominal pain. If the attacking sensation continues without relief, it causes fetal movement.
According to Xue Ji: For the aforementioned symptoms caused by wind-cold and phlegm-fluid, use Jinfei Cao San (Boiling Down Herb Powder); for miscellaneous diseases with cough and constrained fetal Qi, add Xiangfu (Cyperi Rhizoma) and Chuanxiong (Ligustici Chuanxiong Rhizoma). For food stagnation, use Liujunzi Tang (Six Gentlemen Decoction) with added Zisu (Perillae Folium) and Zhike. For anger stirring Liver Fire, add Chaihu (Bupleuri Radix) and Zhizi (Gardeniae Fructus) to the previous prescriptions. For constraint injuring Spleen Qi, use Guipi Tang (Restore the Spleen Decoction) with added Zhike and Shanzhi (Gardeniae Fructus).
Zhang Zhongjing states: For women who are pregnant and suffer from various pains in the abdomen, Danggui Shaoyao San (Angelica Sinensis and Peony Powder) is the primary treatment. *Mai Jing* (Pulse Classic) states: Women with fetal abdominal pain feel uneasy. If there is pain due to fetal movement, but the fetus has not yet moved and one wishes to know if it is alive or dead, let someone palpate the abdomen. If it feels like an inverted cup (smooth and rounded), the fetus is alive; if it feels uneven like elbows and necks protruding irregularly, the fetus is dead. Furthermore, if the abdomen is cold, the fetus is dead; if warm, the fetus is alive.
Xue Ji states: If there is intermittent pain in the abdomen or a heavy dragging sensation in the lower abdomen, it is called "Tai Tong" (Fetal Pain). Use Dihuang Danggui Tang (Rehmannia and Angelica Decoction). If ineffective, add Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), and Chenpi (Citri Reticulatae Pericarpium). If due to Spleen Qi deficiency, use Sijunzi Tang (Four Gentlemen Decoction) with added Danggui (Angelicae Sinensis Radix) and Dihuang (Rehmanniae Radix). If due to Middle Qi deficiency, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) (can be used for true deficiency).
*Daquan* states: Lower abdominal pain during pregnancy is caused by deficiency in the collaterals and the clashing of wind-cold. The pain can also cause fetal movement. One should use Zisu Yin (Perilla Infusion) with added Shengjiang (Zingiberis Rhizoma Recens). If there is abdominal distension and pain, use Antai Yin (Stabilize the Fetus Infusion) with added Shengma (Cimicifugae Rhizoma) and Baizhu. If ineffective, combine with Buzhong Yiqi Tang.