怀孕六七月，暴下浆水斗余，胎亦必从而堕，此元气虚而血伤也。
胎动腹痛，忽下黄汁如胶，或如豆汁。宜黄 糯米汤。（补二十八。）
气血壅养胎元，六淫七情，皆足以动其血气，气逆而火上乘之，故血溢于口。但火有虚焰、实热之分，治有清火、
补水之异。若以寻常治血之法，行血消血，动用四物，胎必堕矣。
火从胎气上升，载血而出。生地、麦冬、白芍、黄芩、阿胶、蒲黄炭、香附炭。
肝经风热。防风、黄芩。
肝经怒火。小柴胡汤去半夏，加山栀、生地，或投加味消遥散。（和十、补二十一。）
全以清热安胎为主，然安胎而仍用参、术等味，则邪热固闭，反致胎下。只要随症用药，勿犯胎气，始为合法。
恶寒头痛。邪在表也，宜香苏散。（散十八。）若烦渴，则邪在半表半里，黄龙汤。（和十五。）
发热躁渴，溲赤便闭，或下利赤水。邪在里也，三黄解毒汤。（寒二十。）
热极斑如锦纹。四物汤去川芎，加黄芩、玄参、知母、大青叶。（补七。）
壮热百节痛。宜柴胡、葛根、黄芩、山栀、知母、大青。
热结于胃，胸口烦闷。宜凉膈滋阴丸。（寒二十一。）
汗下后，热不止。宜加味竹叶汤。（寒二十二。）
病热而呕，不食而烦。宜芦根清胃饮。（寒二十四。）
下后胁热利不止。黄芩汤。（寒二十四。）
斑赤黑，小便如血，气断如绝，胎落而未落。宜用栀子、黄芩、生地、青黛、葛根、升麻、杏仁、葱白，煎汤速
服之。
心惊发热。辰砂安神丸。（补二十九。）
心气虚不能主血。补心汤。（补三十。）
胃经火动。犀角地黄汤。（寒二十五。）
肺受火克。清肺饮。（寒二十七。）
膏粱积热。加味清胃散。（寒二十六。）
肾水亏而阴火动。加味六味丸。（补五十。）
吐衄口噤项强类中风。加味安胎饮。（补三十。）
口鼻出血。血热冲伤胞络也，治当凉胎为主。衄血汤。（寒二十九。）
In the sixth or seventh month of pregnancy, if there is a sudden profuse discharge of watery fluid exceeding one dou, the fetus will inevitably be miscarried. This is due to deficiency of Yuan Qi (Original Qi) and damage to Blood.
When fetal movement is accompanied by abdominal pain, and suddenly yellow juice resembling glue or bean dregs is discharged, Huangqi Nuomi Tang (Huangqi and Glutinous Rice Decoction) is indicated. (Refer to Supplemental Chapter 28.)
Qi and Blood converge to nourish the fetal origin. However, the Six Exogenous Pathogens (Six Evils) and Seven Emotional Factors are sufficient to disturb Qi and Blood. If Qi rebels and Fire ascends, Blood may溢 (overflow/bleed) from the mouth. Fire can be classified as Deficient Flame (Deficiency Fire) or Excess Heat, and treatments differ between clearing Fire and nourishing Water (Yin). If ordinary hemostatic methods are used, such as promoting blood circulation and resolving blood stasis, or employing Siwu Tang (Four Substances Decoction), the fetus will surely be miscarried.
Fire rises with the fetal Qi, carrying Blood out. Ingredients include Shengdi Huang (Rehmanniae Radix Praeparata), Maidong (Ophiopogonis Tuber), Baishao (Paeoniae Radix Alba), Huangqin (Scutellariae Radix), Ejiao (Asini Corii Colla), Puhuang Tan (Pollen Typhae Carbonized), and Xiangfu Tan (Cyperi Rhizoma Carbonized).
Wind-Heat in the Liver Channel: Fangfeng (Saposhnikoviae Radix), Huangqin (Scutellariae Radix).
Liver-Fire Anger: Xiaochaihu Tang (Minor Bupleurum Decoction) without Banxia (Pinelliae Rhizoma), plus Zhizi (Gardeniae Fructus) and Shengdi Huang (Rehmanniae Radix Praeparata); or Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) may be administered. (Refer to Harmonizing Chapter 10, Supplemental Chapter 21.)
The treatment focuses primarily on clearing Heat and calming the fetus. However, if Tonifying herbs like Renshen (Ginseng Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma) are still used for calming the fetus, the pathogenic Heat will be sealed inside, potentially causing the fetus to fall. One must prescribe according to symptoms and avoid offending the fetal Qi; this is the correct method.
Chills and headache indicate the pathogen is at the Exterior. Xiangsu San (Perillae and Liquorice Powder) is indicated. (Refer to Dispersing Chapter 18.) If there is irritability and thirst, the pathogen is at the Half-Exterior and Half-Interior. Huanglong Tang (Yellow Dragon Decoction) is indicated. (Refer to Harmonizing Chapter 15.)
Fever, restlessness, thirst, dark urine, constipation, or diarrhea with red watery stool indicate the pathogen is in the Interior. Sanhuang Jiedu Tang (Three Yellows Detoxification Decoction) is indicated. (Refer to Cooling Chapter 20.)
Extreme Heat resulting in macules resembling brocade patterns. Siwu Tang (Four Substances Decoction) without Chuanxiong (Ligustici Chuanxiong Rhizoma), plus Huangqin (Scutellariae Radix), Xuanshen (Scrophulariae Radix), Zhimu (Anemarrhenae Rhizoma), and Daqingye (Isatidis Folium). (Refer to Supplemental Chapter 7.)
High fever with pain in all joints. Chaihu (Bupleuri Radix), Gegen (Puerariae Lobatae Radix), Huangqin (Scutellariae Radix), Zhizi (Gardeniae Fructus), Zhimu (Anemarrhenae Rhizoma), and Daqing (Isatidis Folium) are suitable.
Heat accumulation in the Stomach causing chest stuffiness and oppression. Liangge Ziyin Wan (Cool Diaphragm and Nourish Yin Pill) is indicated. (Refer to Cooling Chapter 21.)
After sweating or purging, if fever persists. Jiawei Zhuye Tang (Modified Bamboo Leaf Decoction) is indicated. (Refer to Cooling Chapter 22.)
Disease with fever, vomiting, anorexia, and irritability. Lugen Qingwei Yin (Phragmitis Rhizoma Stomach-Clearing Drink) is indicated. (Refer to Cooling Chapter 24.)
After purging, if胁 (hypochondriac) heat and diarrhea persist. Huangqin Tang (Scutellaria Decoction) is indicated. (Refer to Cooling Chapter 24.)
Macules are red-black, urine resembles blood, Qi is nearly absent, and the fetus has fallen but not completely expelled. Zhizi (Gardeniae Fructus), Huangqin (Scutellariae Radix), Shengdi Huang (Rehmanniae Radix Praeparata), Qingdai (Indigo Naturalis), Gegen (Puerariae Lobatae Radix), Shengma (Cimicifugae Rhizoma), Xingren (Armeniacae Semen Amarum), and Congbai (Allii Fistulosi Bulbus) should be decocted and taken quickly.
Palpitations with fever. Chen Sha An Shen Wan (Cinnabar Calming Spirit Pill) is indicated. (Refer to Supplemental Chapter 29.)
Heart Qi deficiency failing to control Blood. Buxin Tang (Tonify Heart Decoction) is indicated. (Refer to Supplemental Chapter 30.)
Stomach Channel Fire agitation. Xijiao Dihuang Tang (Rhinoceros Horn and Rehmannia Decoction) is indicated. (Refer to Cooling Chapter 25.)
Lung受 (affected) by Fire suppression. Qingfei Yin (Clear Lung Drink) is indicated. (Refer to Cooling Chapter 27.)
Heat accumulation from rich and greasy diet. Jiawei Qingwei San (Modified Stomach-Clearing Powder) is indicated. (Refer to Cooling Chapter 26.)
Kidney Water deficiency leading to stirring of Yin Fire. Jiawei Liuwei Wan (Modified Six-Ingredient Pill with Rehmannia) is indicated. (Refer to Supplemental Chapter 50.)
Vomiting blood, epistaxis, jaw lock, neck stiffness, resembling stroke. Jiawei Antai Yin (Modified Fetus-Calming Drink) is indicated. (Refer to Supplemental Chapter 30.)
Epistaxis and oral bleeding. This is caused by Blood Heat rushing and damaging the Bao Luo (Uterine Collaterals). Treatment should focus on cooling the fetus. Xueni Tang (Nose-Bleeding Decoction) is indicated. (Refer to Cooling Chapter 29.)