【歌】心痛多端仔细占，风寒痰热总相兼，火龙散共砂仁散，痛甚延胡及手拈。
【论】大全曰∶妊娠心痛乃气邪痰饮交结，若伤心正经为真心痛，则爪甲青，旦发夕死，夕发旦死。若伤支
络，则乍安乍作，名厥心痛。若伤于子脏，则胎动而下血。妊娠心痛，非止一端，当审脉症而治之。
【方】
火龙散
川楝子 茴香（各三钱） 艾叶（一钱五分，盐水炒）
水煎服。
手拈散
延胡索 五灵脂 草果 乳香 没药
末服一钱。
【歌】上下攻冲胸腹疼，阴阳邪正互相争，当归芍药原方治，香附砂仁亦有能。
【论】胸腹痛者，或宿有冷痛，或新触风寒，皆由脏虚而致也。邪正相搏而并于气，随气上下，上冲于胸则
胸痛，下攻于腹则腹痛也。
张仲景曰∶妇人怀娠腹中疼痛，当归芍药散。
【方】
当归芍药散
当归（三两） 白芍（一斤） 茯苓（四两） 白术（四两） 泽泻（八两） 川芎（三两）
末服一钱。
缩砂饮
砂仁（炒）
为末酒调二钱，觉腹中热胎即安。
【歌】妊妇胞胎系肾经，一毫触犯不安宁，青蛾通气调肝肾，还恐胎元不久停。
【论】何松庵曰∶腰痛脉大而痛不已者，肾虚也，青蛾丸。脉涩而日轻夜重者，气血凝滞也，缩砂饮。脉浮
者，为风邪所乘，大豆紫汤。脉实者，闪挫也，通气散，总以安胎为主。
【方】
通气散
补骨脂
炒为末，嚼胡桃以酒服三钱。
青娥不老丸
杜仲（一斤，姜炒） 补骨脂（四两，盐酒炒） 桃肉（十枚）
蜜丸服。
鹿角散
鹿角长六寸，烧赤淬酒中，又烧又淬，取酒服。
[Song] Heart pain has many manifestations and requires careful differentiation; it is generally caused by the combination of wind-cold, phlegm, and heat. Huolong San (Fire Dragon Powder) or Sharen San (Amomum Powder) may be used. If the pain is severe, Yanhusuo (Corydalis Rhizome) and Shounian San (Hand-Picking Powder) can be employed.
[Discussion] *Daquan* states: Heart pain during pregnancy is caused by the entanglement of qi pathogenic factors and phlegm-fluids. If the main meridian of the heart is injured, it is called "Zhenxintong" (True Heart Pain), characterized by cyanosis of the fingernails; if onset occurs in the morning, death follows in the evening, and vice versa. If the collateral branches are injured, the pain comes and goes intermittently, known as "Juexintong" (Rebellious Heart Pain). If the uterus (Zizang) is injured, it leads to fetal movement and vaginal bleeding. There are various causes for heart pain during pregnancy; treatment should be based on a thorough examination of pulse and symptoms.
[Formula]
Huolong San (Fire Dragon Powder)
Chuanlianzi (Toosendan Fruit) and Huixiang (Fennel Fruit), each 3 qian; Aiye (Mugwort Leaf), 1.5 qian, stir-fried with salt water.
Decoct in water and take orally.
Shounian San (Hand-Picking Powder)
Yanhusuo (Corydalis Rhizome), Wulingzhi (Trogopterus Dung), Caoguo (Black Cardamom Fruit), Ruxiang (Frankincense), Moyao (Myrrh).
Grind into powder, take 1 qian per dose.
[Song] Pain attacking up and down in the chest and abdomen indicates a struggle between yin-yang pathogens and righteous qi. The original formula Danggui Shaoyao San (Angelica and Peony Powder) is indicated; Xiangfu (Cyperus Rhizome) and Sharen (Amomum Fruit) are also effective.
[Discussion] Chest and abdominal pain may result from pre-existing cold pain or recent exposure to wind-cold, both arising from deficiency of the zang-organs. When pathogens and righteous qi contend and converge in the qi mechanism, they move up and down with the qi. Ascending to the chest causes chest pain; descending to the abdomen causes abdominal pain.
Zhang Zhongjing stated: For women suffering from abdominal pain during pregnancy, Danggui Shaoyao San (Angelica and Peony Powder) is indicated.
[Formula]
Danggui Shaoyao San (Angelica and Peony Powder)
Danggui (Angelica Sinensis Root), 3 liang; Baishao (White Peony Root), 1 jin; Fuling (Poria), 4 liang; Baizhu (Atractylodes Macrocephala Rhizome), 4 liang; Zexie (Alisma Rhizome), 8 liang; Chuanxiong (Ligusticum Rhizome), 3 liang.
Grind into powder, take 1 qian per dose.
Suosha Yin (Amomum Decoction)
Sharen (Amomum Fruit), stir-fried.
Grind into powder, mix with wine and take 2 qian. It is considered effective when warmth is felt in the abdomen and the fetus becomes stable.
[Song] The fetal sac in pregnant women is connected to the Kidney Meridian; any slight disturbance causes instability. Qing'e Wan (Green Helmet Pill) combined with Tongqi San (Qi-Regulating Powder) regulates the Liver and Kidneys, yet one may still worry that the fetal foundation will not endure long.
[Discussion] He Song'an stated: Lower back pain with a large pulse and unceasing pain indicates Kidney deficiency, treated with Qing'e Wan (Green Helmet Pill). A choppy pulse with symptoms lighter in the day and heavier at night indicates stagnation of qi and blood, treated with Suosha Yin (Amomum Decoction). A floating pulse indicates invasion by wind-pathogens, treated with Dadouzi Tang (Soybean Purple Decoction). A excess pulse indicates sprain or trauma, treated with Tongqi San (Qi-Regulating Powder). The general principle is to prioritize stabilizing the fetus.
[Formula]
Tongqi San (Qi-Regulating Powder)
Buguzhi (Psoralea Fruit).
Stir-fry until cooked, grind into powder. Chew with walnut meat and swallow with wine, 3 qian per dose.
Qing'e Bulao Wan (Green Helmet Anti-Aging Pill)
Duzhong (Eucommia Bark), 1 jin, stir-fried with ginger juice; Buguzhi (Psoralea Fruit), 4 liang, stir-fried with salt and wine; Taorou (Peach Kernel/Meat), 10 pieces.
Form pills with honey and take orally.
Lu Jiao San (Deer Horn Powder)
Deer horn, 6 cun long.
Heat until red-hot, quench in wine. Repeat heating and quenching several times, then drink the wine.