妇人受孕，则月事不行，诊其脉，足少阴肾脉动甚者，妊子也。经云∶阴搏阳别，谓之有子。王注∶阴
谓尺中，搏谓独搏于指，与寸脉俱别，则为孕。故胎脉微滑，若经候三月不行，欲验之，用探胎饮，腹中微动
者，胎也，否则是经滞。《金匮》云∶妊娠下血，腹中痛，为胞阻，胶艾汤主之。腹中 痛，此木邪克土，当归
芍药汤主之。呕吐不止，此为恶阻，参姜半夏汤主之。常服易产，当归散主之，徐之才曰∶受孕一月，名胎胚，
足厥阴肝脉养之。二月名胎膏，足少阳胆脉养之。三月名始胞，手少阴心脉养之。四月形体成，手少阳三焦脉
养之。五月男女分，足太阴脾脉养之。六月筋骨具，足阳明胃脉养之。七月毛发生，手太阴肺脉养之。八月脏
腑具，手阳明大肠脉养之。九月谷气入胃，足少阴肾脉养之。十月足太阳膀胱脉养之。脏腑齐通，纳天地气于
丹田，俟时而生。亦有未及期而产，或过期而产者。凡怀孕则血留气聚，脉多滑数。其殒胎多在三月，是血热。
故胎前症治，率以
清热凉血为主，盖胎得凉则安。其有外邪，则邪去胎自安。若妊妇禀弱脉微，症属虚寒，法当温补者，又当别
论也。
《女科纂要》云∶产前当补脾清热养血，如《金匮》当归散之类。盖补脾则中气固，而无半产胎动之虞。
清热则火不妄动，而无胎漏烦淋之患。养血则胎有所资，而无坐草艰难之苦。至八九月，仍加顺气之剂，俾
气顺而骨自开，血足而胎自滑。
〔恶阻〕受孕二三月间，冲任上壅，气不下行，呕吐痰水，头重目眩，懒动嗜卧，恶食喜酸，或偏嗜一
物，间作寒热，为阻病。《千金》用半夏茯苓汤，及茯苓丸。今人以半夏动胎鲜用，通用白术汤、二香散、
竹茹汤、人参丁香散、缩砂散，然半夏实未动胎也。脾虚食少者，六君子汤。胃虚多痰者，橘皮汤。饮食停滞
者，香砂汤加神曲，谷芽。胀满不安者，小和中饮，或香壳散。肝气致逆者，解肝煎。气滞兼痰者，七气汤。
中寒吐逆者，温胃饮。
〔胎漏〕妊娠血下，冲任经虚，不能约制也。通治安胎当归汤。络虚者，胶艾四物汤。气虚者，四君子
汤去茯苓，加人参、阿胶、枣。漏血腹痛者，钩藤汤。漏血发热者，加味逍遥散。入房致损者，八珍汤加胶、
艾。亦有妊后按月经至，而胎不损者，系阴血有余，不必强止，但与凉血。胎漏黄浆，或如豆汁，炙 六两，
糯米五合，煎汤分四服。或苎根二两， 五两，水酒煎服。若肝脾湿热，升阳除湿汤。肝脾郁结，加味归脾汤。
肝经风热，防风黄芩丸。妊娠溺血，胎漏血自人门出，尿血血自溺门出，热乘血分，渗入脬中，续断汤。兼痛，
导赤散。怒动肝火，小柴胡汤加山栀。膀胱血热，四物汤加山栀、发灰。因暑渴烦，益元散。稍虚者，胶艾四
物汤。症久，用龙骨一钱，蒲黄末五钱，酒调服。
〔胎动〕此胎气热，动而不安也。通治安胎散加减。风热伤络失安者，钩藤汤。胎气逆上喘急者，紫苏
饮加桑皮、杏仁。饮酒房室损动者，四君子汤、十圣散。触损胞宫者，血下腰痛，胶艾汤立安。有微热去艾叶、
甘草，加续断、葱白。若负重跌坠，凝瘀作痛，用黑糖熬膏，入红酒，童便调服，嚼连皮胡桃肉，痛即止。
如未止，必血下胎伤。益母地黄汤，安胎饮加减。若因母病致胎不安，但治母病，胎自安。暴下水，胎必堕，
急用补气安
胎药救之。凡胎漏胎动皆下血，而胎动有腹痛，胎漏无腹痛。故胎动宜行气，胎漏宜清热。
〔胎不长〕胎之长养，全赖母气。其精血虽由肝肾，输运专恃乎脾。脾衰食减者，异功散加砂仁。
心脾不足者，归脾汤加减。元气不足者，大剂保元汤。增助母气，则儿受荫，自无干萎之患。若气虚兼衰者，
八珍汤。
〔胎大〕孕至七八月胎大，宜布束之则腰健，内服达生散。如膏梁安逸，身肥胎大，须防难产。宜瘦胎
饮，或枳壳散。
〔胎堕〕胎动不安，势必下堕。多由妊母衰病，或触损颠仆所致。然堕在三五七单月居多，且前次三月
堕，后次至期必堕，乘其虚也，须早服养气血，护胎元之剂。加减八珍汤，添续断、陈皮、杜仲、砂仁。盖气
虚则提摄不固，血虚则灌溉不周。胎元饮加减，或泰山磬石散。孕后最忌腰痛，胞系于肾，而腰为肾府，腰痛
则防堕。千金保孕丸。必察所伤之由，予培其损，若待临期，则无及矣。
〔半产〕俗名小产。由冲任气虚，不能摄养。或因闪动，及热病温疟之类，其险甚于大产。凡孕未足月，
痛而欲产。八珍汤去茯苓、熟地，加阿胶、艾叶、炙甘草、黄 。若胎下血不止，用参、 、术、草、胶、艾、
归、杜等。虚热，加炮姜、五味子。寒热腹痛，手按益痛者，宜散瘀，芎、归、延胡、桃仁、香附、丹皮、泽
兰、童便选用。按之痛缓为血虚，宜温补，八珍汤去芍，加炮姜。痛而呕泻为胃虚，六君子汤加炮姜。去血多
发热，圣愈汤。汗不止，保元汤。发热烦躁，筋惕肉 ，十全大补汤。大渴面赤，脉洪而虚，当归补血汤。身
热面赤，脉沉而微，四君子汤加姜、附。东垣曰∶正产及半产，漏下昏冒不省，瞑目无知。由心血暴亡，心神
失养，包络火升，故令昏冒。火胜其肺，故令目瞑。不可用寒凉泻火之药，盖瞑目之病，悉属阴。即如伤寒郁冒，
得汗乃解，必补而升举之，如补中益气汤加麦冬、五味，或大剂独参汤尤妥。助其阳，则目张而神苏矣。
〔子烦〕烦出于肺，躁出于肾。妊娠心惊胆怯，终日烦闷，系心肺虚热。竹叶汤。夏令心火乘肺，胎动心
烦，宜生脉散，或
麦冬汤。心肺壅热，犀角散。肝火致烦，加味逍遥散，肺胃燥热，竹茹汤。肾亏火躁，加味地黄汤。烦躁口干，
知母丸。
〔子悬〕胎气凑上，胸膈满闷，必素多郁闷，痰气壅塞，致胎气乘郁火升自心下。急以童便灌之，次
以紫苏饮四五服。若胎上逼，心烦闷，脉浮滑者，葱白二七茎，煮汁饮，胎立安。胎上冲心，烦痛欲死者，
当归汤，痛立止。
〔子肿〕因土不制水，小便闭涩，致面目肢体浮肿。然有水气，有胎气。其胎中夹水，水血相搏，浸
渍肌肉令肿者，为水气。立斋云∶胸腹急胀，胁肋不分，溺闭者，千金鲤鱼汤。脾虚者，佐以四君子汤。水
溢肢体，面目虚浮者，全生白术散、六君子汤。脾虚湿热，下部肿者，补中益气汤加半夏、茯苓。饮食失节
呕泻者，六君子汤加神曲、砂仁、炮姜。若胎至七八月，胫膝渐肿，足趾出黄水者，为胎气，非水也，至分
娩方消。宜天仙藤散。郑虚庵云∶身半以上肿者发汗，身以下肿者利小便，上下俱肿者，汗利分消其湿。
〔子嗽〕妊娠咳嗽，胸膈不利者，百合散。风邪伤肺者，香苏散。寒邪伤肺者，小建中汤。火邪伤
肺者，紫菀汤。肺胃气虚者，异功散。脾肺气虚者，六君子汤加当归。
〔子喑〕岐伯曰∶人有重身，九月而喑，此胞络脉绝也。胞络脉系于肾，少阴脉贯肾，系舌本，当十月
复。石顽曰∶不语者，多痰蔽心窍，浓煎生脉散，服地黄丸。助肺肾之气以养胎，若与通声开发之药，则误矣。
〔子痫〕妊娠受风，痰涌发搐，口噤身强，冒昧不醒，须臾自苏，此阴火豉动其痰。宜清热化痰理气，
仍以安胎为主，勿过用风药。血虚胆火，加味逍遥散加羌活、羚羊角、枣仁、钩藤，豆淋酒煎服。肝胆风热，
钩藤汤。气逆痰滞，紫苏饮。脾郁痰滞，二陈汤加竹沥、姜汁。中风口噤，目吊，角弓反张，羚羊角散。
〔子晕〕此症属气与痰，虚阳上升，则痰动，古谓无痰不作眩晕也。目昏发厥，用紫苏饮去葱、姜，
加炒甘菊、羚羊角。若口噤不能言，用白术三钱，荆芥穗二钱，黑豆三合炒，淋酒煎服。得汗即愈。
〔子淋〕此小肠膀胱虚热，虚则不能制水，热则不能通利，故溺频涩而成淋。本事安营散。然胞系于肾，
若肾经虚，移热于膀胱，溺数而痛，宜生料六味丸加麦冬、五味子、桂心、车前。膀胱阳虚，阴无以化，肾
气丸。肺气虚而频数短少，生脉散加山药、泽泻。小肠热而赤涩，导赤散。肺虚膀胱热而气化不行，生脉合
导赤散。肺经蕴热，黄芩清肺饮。肝经湿热，加味逍遥散。头眩溺不利，葵子茯苓汤。
〔溃溺〕妊妇溃溺不知，胎满故也，千金白薇散。立斋以胞中有热，加味逍遥散。脾肺气虚，补中益气汤
加益智仁。肝肾虚热，六味丸。
〔转胞〕胎逼及脬，压在一边，脬系转捩，脐下急痛，溺数或闭也。若举起其胎，如补中益气汤。服
后探吐以提其气，溺自出矣。丹溪用参术饮，服后探吐，八次而效。
〔伤风〕头重鼻塞，发热恶风，香苏散去香附，加葱、豉。热服，取微汗。若咳嗽多痰，加桔梗，或
紫苏饮加葱、豉。《本草》∶葱能通阳安胎，豆豉能解肌取汗。
〔伤寒〕身背拘急，发热恶寒，《千金》用葱白十茎，生姜二两，水煎。热服取汗，或葱豉汤。汗出
即安。或量加薄荷、山栀。若妊妇热病，亦用葱豉，加薄荷、山栀等。忌用发表诸药。若温热时行，邪气内犯，
热毒迫胎，并宜千金石膏大青汤。
〔孕疟〕寒热有时，感六淫食滞之邪而发热，邪甚则损胎，故以安胎为主。初起头痛喜呕，胸满胁痛
而寒热者，小柴胡汤主之。寒多热少者，人参养胃汤。寒少热多者，清脾饮去半夏。寒呕多痰者，二陈汤，或柴
陈煎去黄芩。脾虚食减者，六君子汤，不应，补中益气汤。久疟正气衰，或间二日发者，必扶正。如异功散加
当归、砂仁、鳖甲、首乌、山药、大枣、姜煎服。尝见胎前阴疟不愈，产后延成蓐损者，多矣。
〔孕痢〕《张氏医通》曰∶孕痢有三禁五审∶一禁荡涤肠胃，使胎气下坠；二禁渗利膀胱，使阴液脱亡；
三禁兜涩滞气，使后重转加。故治先调气，以陈皮、煨木香、浓朴之属。开通壅滞，则后重除矣。一审饮食之
进不进，清理积滞，加栀、连、砂、枳、
曲、半等。则饮食进矣；二审溲之通不通，升清降浊，补中加茯苓之类。则水道通矣；三审腹之痛不痛，
红痢急痛者为火，宜芩、连、栀、芍等，白痢虚痛者为寒，宜丁香、肉果、煨姜等；四审后之重不重，初痢后
重，宜开通其滞，即香、朴、陈、枳等。久痢后重，宜升举其阳，举元煎。五审身之热不热，加人迎浮数，
先用和营透表，宜当归、紫苏、薄荷、白芍、生姜等。疏解后，再行清理。若初起未发热，痢久卫虚，因感
冒而发热者，左三部必浮缓，须理中汤加桂枝表里合治。若痢久身热，脉来渐小，或虚大少力。此真阴内亡，
虚阳外露。平人或可辛温峻补以敛之，妊娠又难轻用桂、附。惟藉参、术、姜、萸、胶、艾之属。大剂煎服，
庶可挽回。五审既明，三禁勿犯，再察其积之稠不稠，色之鲜不鲜。倘粘稠如糊，暂与清理。若汁沫如水，
色晦如尘，急须温理其气。故凡沫之清稀不稠，色之瘀晦不鲜者，皆系虚寒，急投参、苓、姜、艾或可保全。
尝治妊娠腹胀后重，白痢粘稠，用浓朴汤去干姜。妊娠腹痛食少，白沫清稀，用甘草干姜汤，或理中汤。腹胀
后重，痢兼赤白，朴姜参甘半夏汤。能食后重，血痢稠粘，用芩芍汤送香连丸。少腹重痛痢血，或鲜或瘀，
用连理汤合千金三物胶艾汤。发热后重，阴虚血痢，用驻车丸。热毒内攻，噤口不食，腹胀后重，脓血稠粘，
用白头翁汤加甘草、阿胶。脓血清稀，久痢胎动，用千金胶艾榴皮汤。疟痢气虚，胎坠溺数，用补中益气汤。
以上皆孕痢。方内并加砂仁以调气，乌梅以调血，未尝不随手辄效也。
〔伤暑〕妊娠感暑，烦渴闷乱，黄连香薷饮、十味香薷饮。热甚而渴，香薷饮加麦冬、五味子、石膏、
黄芩、知母、花粉之属。
〔诸痛〕胎前头痛，川芎茶调散。宿有偏正头风，前散加甘菊花。心气痛，火龙散。心痛闷绝，产宝丸。
胃脘痛，养胃汤。胁痛，解肝煎去半夏。背痛气滞，紫苏饮。腹痛因寒因食，并正气散。腰痛，通气散。肾
虚腰痛，大补元煎。小腹痛，络虚为风寒所袭，紫苏饮加姜。寒气滞痛，香附、小茴等，温而散之。腰腹痛，
胎不安，当归阿胶甘草葱白汤。胎动血下，腰腹急痛，苎根汤。
〔孕痈〕小腹近下肿痛，皮薄光亮者，痈也。千金托里散。若急痛烦闷，胎气上冲，面青汗冷，血下不
止者，不治。
〔乳泣〕未产，乳汁先下，名乳泣。生子多不育。
〔腹啼〕儿在腹中啼哭者，因妊娠登高举臂，儿口脱出脐带，以此致啼。若令妊妇曲腰就地，如拾物状，
或令扫地，脐带血管，仍入儿口，即止。亦有胎热不安致啼者，浓煎黄连汁，常呷之，即止。又妊妇腹内钟鸣，
用空房下鼠穴中土一块，令妊妇口噙之，即止。
〔鬼胎〕鬼胎，脉多沉细弦涩，大小不调。或由经行饮冷，血蓄冲任而成者，或由停痰蓄水与络中瘀积
互结而成。皆内因之病，实非外感之邪。其腹虽渐大，亦且微动，究与其胎各别。治以理气行血为主。加莪术、
Upon conception, menstruation ceases. Upon pulse diagnosis, if the pulse of the Foot-Shaoyin Kidney Meridian (Zu Shao Yin Shen Jing) is notably vigorous, it indicates pregnancy. The Classics state: "When the Yin pulses beat strongly and are distinct from the Yang, it signifies conception." Wang Bing's commentary explains: "Yin" refers to the Chi (Cun Kou) position at the wrist; "Bo" (beat) refers to a distinct, strong sensation under the fingers, differing significantly from the Cun (Inch) position, which indicates pregnancy. Therefore, the pregnancy pulse is typically slightly slippery. If menstruation has ceased for three months and one wishes to verify pregnancy, one may use Tan Tai Yin (Probe Fetus Decoction); if there is a slight movement in the abdomen, it is pregnancy; otherwise, it is menstrual stagnation. *Jin Gui Yao Lue* states: "Vaginal bleeding during pregnancy accompanied by abdominal pain is called Bao Zu (Womb Obstruction), treated with Jiao Ai Tang (Collagen and Moxa Decoction)." Abdominal pain caused by Liver Wood pathogen overacting on Spleen Earth is treated with Dang Gui Shao Yao Tang (Angelica and Peony Decoction). Persistent vomiting, known as E Zu (Obstruction Nausea), is treated with Shen Jiang Ban Xia Tang (Ginseng, Ginger, and Pinellia Decoction). Regular consumption of Dang Gui San (Angelica Powder) facilitates delivery. Xu Zhicai stated: At one month of conception, named Tai Pei (Fetal Embryo), it is nourished by the Foot-Jueyin Liver Meridian (Zu Jue Yin Gan Jing). At two months, named Tai Gao (Fetal Paste), it is nourished by the Foot-Shaoyang Gallbladder Meridian (Zu Shao Yang Dan Jing). At three months, named Shi Bao (Beginning of Womb), it is nourished by the Hand-Shaoyin Heart Meridian (Shou Shao Yin Xin Jing). At four months, the form is established, nourished by the Hand-Shaoyang Sanjiao Meridian (Shou Shao Yang San Jiao Jing). At five months, male and female characteristics differentiate, nourished by the Foot-Taiyin Spleen Meridian (Zu Tai Yin Pi Jing). At six months, sinews and bones are complete, nourished by the Foot-Yangming Stomach Meridian (Zu Yang Ming Wei Jing). At seven months, hair grows, nourished by the Hand-Taiyin Lung Meridian (Shou Tai Yin Fei Jing). At eight months, zang-fu organs are complete, nourished by the Hand-Yangming Large Intestine Meridian (Shou Yangming Da Chang Jing). At nine months, grain qi enters the stomach, nourished by the Foot-Shaoyin Kidney Meridian (Zu Shao Yin Shen Jing). At ten months, the Foot-Taiyang Bladder Meridian (Zu Tai Yang Pang Guang Jing) nourishes it. When the zang-fu qi is unobstructed, heaven and earth qi are gathered in the Dantian, awaiting the time for birth. Some deliver before or after the due date. Generally, during pregnancy, blood gathers and qi accumulates, resulting in a slippery and rapid pulse. Miscarriage often occurs at three months due to Blood Heat. Therefore, treatment for pregnancy conditions primarily focuses on Clearing Heat and Cooling Blood, as the fetus finds peace in coolness. If external pathogens are present, removing the pathogen ensures fetal peace. However, if the pregnant woman has a weak constitution with a faint pulse and symptoms of Deficiency-Cold, warming and tonifying methods should be applied differently.
*Nv Ke Zuan Yao* states: Before delivery, one should Tonify the Spleen, Clear Heat, and Nourish Blood, such as using Dang Gui San from *Jin Gui*. Tonifying the Spleen stabilizes Middle Qi, preventing miscarriage and fetal movement. Clearing Heat prevents erratic Fire, avoiding vaginal spotting and irritability/dysuria. Nourishing Blood provides resources for the fetus, preventing difficult labor. In the eighth and ninth months, add Qi-regulating agents to ensure smooth Qi flow for bone opening and sufficient Blood for easy delivery.
[Obstruction Nausea] During the second or third month of conception, Chong and Ren vessels become obstructed upward, preventing Qi from descending, leading to vomiting of phlegm-water, heavy head, dizzy eyes, lethargy, aversion to food but craving sour tastes, or specific food cravings, with occasional chills and fever. This is called Zu Bing (Obstruction Disease). *Qian Jin Fang* uses Ban Xia Fu Ling Tang (Pinellia and Poria Decoction) and Fu Ling Wan (Poria Pill). Modern practitioners rarely use Ban Xia (Pinellia Rhizome) fearing it disturbs the fetus, preferring Bai Zhu Tang (Atractylodes Macrocephala Decoction), Er Xiang San (Two Fragrances Powder), Zhu Ru Tang (Bamboo Shavings Decoction), Ren Shen Ding Xiang San (Ginseng and Clove Powder), or Suo Sha San (Amomum Powder). However, Ban Xia does not truly disturb the fetus. For Spleen Deficiency with poor appetite, use Liu Jun Zi Tang (Six Gentlemen Decoction). For Stomach Deficiency with much phlegm, use Ju Pi Tang (Tangerine Peel Decoction). For food stagnation, use Xiang Sha Tang (Costus and Amomum Decoction) plus Shen Qu (Medicated Leaven) and Gu Ya (Sprouted Grain). For distension and discomfort, use Xiao He Zhong Yin (Minor Harmonizing Middle Drink) or Xiang Qiao San (Fragrant Shell Powder). For rebellious Liver Qi, use Jie Gan Jian (Resolve Liver Decoction). For Qi stagnation with phlegm, use Qi Qi Tang (Seven Qi Decoction). For Cold-Induced vomiting, use Wen Wei Yin (Warm Stomach Drink).
[Vaginal Spotting] Vaginal bleeding during pregnancy occurs because the Chong and Ren vessels are deficient and cannot restrain blood. Use Tong An Tai Dai Dang Gui Tang (Universal Fetus-Stabilizing Angelica Decoction). For collateral deficiency, use Jiao Ai Si Wu Tang (Collagen, Moxa, and Four Substances Decoction). For Qi deficiency, use Si Jun Zi Tang (Four Gentlemen Decoction) minus Fu Ling (Poria), plus Ren Shen (Ginseng), E Jiao (Donkey-Hide Gelatin), and Da Zao (Jujube). For spotting with abdominal pain, use Gou Teng Tang (Uncaria Decoction). For spotting with fever, use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder). For damage from intercourse, use Ba Zhen Tang (Eight Treasures Decoction) plus E Jiao and Ai Ye (Moxa Leaf). Some women experience monthly bleeding without fetal loss due to excess Yin Blood; no strong hemostasis is needed, only cooling blood. For yellow discharge resembling bean juice, use Zhi Gan Cao (Honey-Fried Licorice Root) 6 liang and Nu Mi (Glutinous Rice) 5 he, decocted and divided into four doses. Or use Zhu Gen (Rhizoma Bambusae Mutabilis) 2 liang and Gan Cao (Licorice Root) 5 liang, decocted with water and wine. For Liver-Spleen Damp-Heat, use Sheng Yang Chu Shi Tang (Raise Yang and Expel Dampness Decoction). For Liver-Spleen Stagnation, use Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction). For Liver Meridian Wind-Heat, use Fang Feng Huang Qin Wan (Saposhnikovia and Scutellaria Pill). For gestational hematuria, where bleeding comes from the vagina (spotting) vs. urethra (urinary blood), caused by heat entering the blood level and permeating the bladder, use Xu Duan Tang (Dipsacus Decoction). With pain, use Dao Chi San (Direct Outward Yellow Powder). From anger stirring Liver Fire, use Xiao Chai Hu Tang (Minor Bupleurum Decoction) plus Shan Zhi (Gardenia Fruit). For Bladder Blood Heat, use Si Wu Tang (Four Substances Decoction) plus Shan Zhi and Fa Hui (Hair Ash). For summer-heat thirst and irritability, use Yi Yuan San (Benefit Origin Powder). For slight deficiency, use Jiao Ai Si Wu Tang. For chronic cases, use Long Gu (Dragon Bone) 1 qian and Pu Huang (Typha Pollen) 5 qian, mixed with wine.
[Fetal Movement] This indicates fetal Qi is heated and restless. Use Tong An Tai San (Universal Fetus-Stabilizing Powder) modified. For wind-heat damaging collaterals causing unrest, use Gou Teng Tang. For rebellious fetal Qi causing wheezing, use Zi Su Yin (Perilla Drink) plus Sang Bai Pi (Mulberry Root Bark) and Xing Ren (Apricot Seed). For damage from alcohol or intercourse, use Si Jun Zi Tang or Shi Sheng San (Ten Saints Powder). For trauma to the uterus causing bleeding and lower back pain, Jiao Ai Tang stabilizes immediately. If slight fever exists, remove Ai Ye and Gan Cao, adding Xu Duan (Dipsacus Root) and Cong Bai (Scallion White). For injury from carrying heavy loads or falling, causing stasis pain, use Black Sugar paste mixed with Red Wine and Tong Bian (Child's Urine), chewing Walnut Meat with skin stops pain. If pain persists, blood loss and fetal injury occur. Use Yi Mu Di Huang Tang (Motherwort and Rehmannia Decoction) or An Tai Yin (Fetus-Stabilizing Drink) modified. If maternal illness causes fetal unrest, treat the mother's illness, and the fetus will stabilize. Sudden large fluid loss implies inevitable miscarriage; urgently use Qi-tonifying Fetus-Stabilizing medicine. Both spotting and fetal movement involve bleeding, but fetal movement includes abdominal pain while spotting does not. Thus, fetal movement requires Qi-moving, while spotting requires Heat-clearing.
[Fetal Growth Failure] Fetal growth relies entirely on maternal Qi. Although essence and blood originate from Liver and Kidney, transport depends on Spleen. For Spleen decline and poor appetite, use Yi Gong San (Yi Palace Powder) plus Sha Ren (Amomum Fruit). For Heart-Spleen insufficiency, use Gui Pi Tang (Restore the Spleen Decoction) modified. For Yuan Qi deficiency, use large doses of Bao Yuan Tang (Protect Origin Decoction). Enhancing maternal Qi benefits the fetus, preventing dryness and atrophy. For Qi deficiency with decline, use Ba Zhen Tang.
[Large Fetus] At seven or eight months, when the fetus is large, binding the waist with cloth strengthens the back; internally use Da Sheng San (Great Life Powder). For those accustomed to rich food and ease, leading to obesity and large fetus, prevent difficult labor with Shou Tai Yin (Slim Fetus Drink) or Zhi Qiao San (Immature Tangerine Peel Powder).
[Fetal Miscarriage] Unstable fetal Qi inevitably leads to miscarriage. Often caused by maternal weakness/illness or trauma/falls. Miscarriages often occur in odd-numbered months (1, 3, 5, 7). If a miscarriage occurred at three months previously, it will likely recur at that time due to underlying deficiency. Early administration of Qi-and-Blood-tonifying, Fetal-Origin-protecting agents is necessary. Use Jia Ba Zhen Tang (Modified Eight Treasures Decoction) adding Xu Duan, Chen Pi (Tangerine Peel), Du Zhong (Eucommia Bark), and Sha Ren. Qi deficiency fails to hold; Blood deficiency fails to irrigate. Use Tai Yuan Yin (Fetal Origin Drink) or Tai Shan Qing Shi San (Mount Tai Rock Powder) modified. Lower back pain during pregnancy is taboo as the womb connects to the Kidney, and the waist is the mansion of the Kidney; pain warns of miscarriage. Use Qian Jin Bao Yun Wan (Thousand Years Pregnancy-Preserving Pill). Investigate the cause of injury and tonify the deficit; waiting until term is too late.
[Partial Delivery / Small Birth] Commonly known as Xiao Chan (Small Production). Caused by Chong-Ren Qi deficiency failing to nurture. Due to sprains, febrile diseases, or warm malaria, it is more dangerous than full-term delivery. For pre-term labor pains, use Ba Zhen Tang minus Fu Ling and Shu Di Huang (Prepared Rehmannia), plus E Jiao, Ai Ye, Zhi Gan Cao (Honey-Fried Licorice), and Huang Qi (Astragalus). For continuous bleeding after partial expulsion, use Ren Shen, Huang Qi, Bai Zhu (Atractylodes), Gan Cao, E Jiao, Ai Ye, Dang Gui (Angelica), and Du Zhong. For deficiency-heat, add Pao Jiang (Roasted Ginger) and Wu Wei Zi (Schisandra). For cold-heat abdominal pain worsened by pressure, resolve stasis using Xiong (Ligusticum), Gui, Yan Hu Suo (Corydalis), Tao Ren (Peach Kernel), Xiang Fu (Cyperus), Dan Pi (Moutan), Ze Lan (Lycopus), and Tong Bian. Relieved pressure indicates Blood Deficiency; use warming tonification, Ba Zhen Tang minus Shao Yao (Peony), plus Pao Jiang. Pain with vomiting/diarrhea indicates Stomach Deficiency; use Liu Jun Zi Tang plus Pao Jiang. Excessive blood loss with fever uses Sheng Yu Tang (Holy Recovery Decoction). Profuse sweating uses Bao Yuan Tang. Fever, irritability, and muscle twitching use Shi Quan Da Bu Tang (Complete Great Tonifying Decoction). Thirst, red face, and surging-empty pulse use Dang Gui Bu Xue Tang (Angelica Tonifying Blood Decoction). Body heat, red face, and deep-micro pulse use Si Jun Zi Tang plus Sheng Jiang (Fresh Ginger) and Fu Zi (Aconite). Li Dongyuan stated: Normal or partial delivery with profuse bleeding, coma, and unconsciousness results from sudden Heart Blood loss, Heart Spirit malnourishment, and Pericardium Fire rising, causing coma. Fire overcoming Lung causes closed eyes. Do not use cold-cooling fire-draining herbs, as closed eyes belong to Yin. Similar to Shaoyang depression resolving with sweat, one must tonify and lift, e.g., Bu Zhong Yi Qi Tang (Tonify Middle and Augment Qi Decoction) plus Mai Dong (Ophiopogon) and Wu Wei Zi, or large dose Du Shen Tang (Single Ginseng Decoction). Boosting Yang opens the eyes and restores spirit.
[Sub-irritability] Irritability stems from Lung; restlessness from Kidney. Palpitations and fear during pregnancy with daily irritability indicate Heart-Lung Deficiency-Heat. Use Zhu Ye Tang (Bamboo Leaf Decoction). In summer, Heart Fire overacting on Lung causes fetal movement and irritability; use Sheng Mai San (Generate Pulse Powder) or Mai Dong Tang. For Heart-Lung congestion-heat, use Xi Jiao San (Rhinoceros Horn Powder). For Liver Fire irritability, use Jia Wei Xiao Yao San. For Lung-Stomach Dry-Heat, use Zhu Ru Tang. For Kidney deficiency with Fire restlessness, use Jia Wei Di Huang Tang (Modified Rehmannia Pill). For irritability and dry mouth, use Zhi Mu Wan (Anemarrhena Pill).
[Sub-suspension] Fetal Qi rises to the chest and diaphragm causing fullness, usually due to prior depression and Phlegm-Qi congestion, causing fetal Qi to ride up with Depressive Fire from below the heart. Urgently administer Tong Bian (Child's Urine), then Zi Su Yin (Perilla Drink) 4-5 doses. If fetal Qi presses upward causing irritability and floating-slippery pulse, boil 14 Cong Bai (Scallion Whites) and drink; the fetus stabilizes immediately. If fetal Qi rushes to the heart causing severe pain, use Dang Gui Tang (Angelica Decoction); pain stops immediately.
[Sub-edema] Spleen Earth failing to control Water causes blocked urination, leading to facial and limb edema. This distinguishes between Water Qi disease and Fetal Qi disease. When water and blood clash in the womb, infiltrating muscles causing swelling, it is Water Qi. Xue Lizhai stated: For urgent chest/abdominal distension, indistinct ribs, and urinary blockage, use Qian Jin Li Yu Tang (Thousand Years Carp Decoction). For Spleen Deficiency, assist with Si Jun Zi Tang. For water overflowing limbs and puffy face, use Quan Sheng Bai Zhu San (Whole Life Atractylodes Powder) or Liu Jun Zi Tang. For Spleen Deficiency with Damp-Heat and lower body swelling, use Bu Zhong Yi Qi Tang plus Ban Xia (Pinellia) and Fu Ling. For dietary irregularity causing vomiting/diarrhea, use Liu Jun Zi Tang plus Shen Qu, Sha Ren, and Pao Jiang. If swelling of calves/knees and yellow fluid from toes occurs at 7-8 months, this is Fetal Qi, not Water Qi, resolving at delivery. Use Tian Xian Teng San (Celestial Vine Powder). Zheng Xu'an stated: Edema above the waist induces sweating; below the waist induces diuresis; both require simultaneous sweating and diuresis to drain dampness.
[Sub-cough] Pregnancy cough with chest discomfort uses Bai He San (Lily Powder). Wind invading Lung uses Xiang Su San (Fragrant Perilla Powder). Cold invading Lung uses Xiao Jian Zhong Tang (Minor Establish the Middle Decoction). Fire invading Lung uses Zi Wan Tang (Aster Decoction). Lung-Stomach Qi deficiency uses Yi Gong San. Spleen-Lung Qi deficiency uses Liu Jun Zi Tang plus Dang Gui.
[Sub-silence] Qibo stated: Pregnant women becoming mute at nine months is due to the cessation of Bao Luo (Womb Collateral) Qi. These collaterals connect to the Kidney; the Shaoyin Meridian passes through the Kidney and connects to the tongue root, recovering at ten months. Zhao Xianke stated: Muteness is often due to Phlegm obscuring the Heart Orifice; decoct Sheng Mai San thickly and take Di Huang Wan (Rehmannia Pill). Support Lung-Kidney Qi to nourish the fetus; using voice-opening drugs is erroneous.
[Sub-eclampsia] Pregnancy wind-stroke with phlegm surge, convulsions, locked jaw, stiff body, and coma, recovering spontaneously, is caused by Yin Fire stirring Phlegm. Clear Heat, resolve Phlegm, regulate Qi, prioritizing Fetus Stabilization; avoid excessive Wind-dispelling drugs. For Blood Deficiency with Gallbladder Fire, use Jia Wei Xiao Yao San plus Qiang Huo (Notopterygium), Ling Yang Jiao (Antelope Horn), Suan Zao Ren (Ziziphus Seed), and Gou Teng (Uncaria), decocted in Dou Lin Jiu (Bean-Dregs Wine). For Liver-Gallbladder Wind-Heat, use Gou Teng Tang. For rebellious Qi with Phlegm stagnation, use Zi Su Yin. For Spleen Depression with Phlegm stagnation, use Er Chen Tang (Two Aged Herbs Decoction) plus Zhu Li (Bamboo Juice) and Jiang Zhi (Ginger Juice). For stroke with locked jaw, upward eye deviation, and opisthotonos, use Ling Yang Jiao San.
[Sub-dizziness] This condition involves Qi and Phlegm; Rising Deficient Yang stirs Phlegm. As the ancients said, "No Phlegm, no dizziness." For dim vision and fainting, use Zi Su Yin minus Cong and Jiang, plus Chao Gan Ju (Stir-fried Chrysanthemum) and Ling Yang Jiao. For locked jaw unable to speak, use Bai Zhu 3 qian, Jing Jie Sui (Schizonepeta Spike) 2 qian, and Hei Dou (Black Soybean) 3 he stir-fried, decocted in wine. Sweating cures it.
[Sub-strangury] Deficiency-Heat in Small Intestine and Bladder causes inability to control water (deficiency) and lack of free flow (heat), resulting in frequent, painful, scanty urination. Use Ben Shi An Ying San. Since the womb connects to the Kidney, if Kidney Deficiency transfers heat to Bladder causing painful frequency, use Sheng Liao Liu Wei Wan (Raw Material Six Ingredients Pill) plus Mai Dong, Wu Wei Zi, Gui Xin (Cinnamon Heart), and Che Qian Zi (Plantago Seed). For Bladder Yang Deficiency failing to transform Yin, use Shen Qi Wan (Kidney Qi Pill). For Lung Qi Deficiency causing frequent/scanty urine, use Sheng Mai San plus Shan Yao (Dioscorea) and Ze Xie (Alisma). For Small Intestine Heat causing red/scanty urine, use Dao Chi San. For Lung Deficiency with Bladder Heat failing to transform Qi, combine Sheng Mai San and Dao Chi San. For Lung Meridian latent Heat, use Huang Qin Qing Fei Yin (Scutellaria Clearing Lung Drink). For Liver Meridian Damp-Heat, use Jia Wei Xiao Yao San. For dizziness and difficult urination, use Kui Zi Fu Ling Tang (Abutilon and Poria Decoction).
[Urinary Incontinence] Pregnant women leaking urine unknowingly due to fetal pressure use Qian Jin Bai Wei San (Thousand Years White Willowherb Powder). Xue Lizhai attributes womb-internal heat to Jia Wei Xiao Yao San. For Spleen-Lung Qi deficiency, use Bu Zhong Yi Qi Tang plus Yi Zhi Ren (Alpinia Oxyphylla Fruit). For Liver-Kidney Deficiency-Heat, use Liu Wei Wan.
[Bladder Displacement] The fetus presses against the bladder, displacing it, twisting the bladder ligaments, causing urgent lower abdominal pain and frequent or blocked urination. Lifting the fetus, e.g., via Bu Zhong Yi Qi Tang, helps. Inducing vomiting after taking the medicine lifts the Qi, allowing urine to flow. Zhu Danxi used Shen Zhu Yin (Ginseng and Atractylodes Drink), inducing vomiting eight times for effect.
[Wind Injury] Heavy head, nasal congestion, fever, and aversion to wind use Xiang Su San minus Xiang Fu, plus Cong Bai and Chi Dou Chi (Fermented Soybean). Take hot to induce slight sweat. For cough with much phlegm, add Jie Geng (Platycodon) or use Zi Su Yin plus Cong Bai and Chi Dou Chi. Materia Medica notes: Cong Bai (Scallion) unblocks Yang and stabilizes fetus; Chi Dou Chi resolves muscle layer and induces sweat.
[Cold Damage] Back stiffness, fever, and aversion to cold use Qian Jin Fang's Cong Bai (10 stalks) and Sheng Jiang (2 liang) decocted in water. Take hot to sweat, or use Cong Chi Tang (Scallion and Fermented Soybean Decoction). Relief follows sweating. Add Bo He (Mint) or Shan Zhi as needed. For pregnant febrile diseases, also use Cong Chi Tang with Mint and Gardenia. Avoid exterior-releasing drugs. For warm-pestilential diseases with internal invasion and Heat-Toxin pressing the fetus, use Qian Jin Shi Gao Da Qing Tang (Thousand Years Gypsum and Isatis Decoction).
[Pregnancy Malaria] Periodic chills and fever from Six Evils or Food Stagnation; severe pathogens harm the fetus, so prioritize Fetus Stabilization. Initial headache, desire to vomit, chest/flank fullness with chills/fever use Xiao Chai Hu Tang. More chills than heat use Ren Shen Yang Wei Tang (Ginseng Nourish Stomach Decoction). Less chills than heat use Qing Pi Yin (Clear Spleen Drink) minus Ban Xia. Cold-vomit with much phlegm use Er Chen Tang or Chai Chen Jian (Bupleurum and Two Aged Decoction) minus Huang Qin (Scutellaria). Spleen Deficiency with poor appetite use Liu Jun Zi Tang; if ineffective, Bu Zhong Yi Qi Tang. Chronic malaria with Qi decline or every-other-day发作 requires supporting Righteous Qi. Use Yi Gong San plus Dang Gui, Sha Ren, Bie Jia (Turtle Shell), Shou Wu (Polygonum), Shan Yao, Da Zao, and Ginger. Many cases of prenatal Yin-Malaria persisting postpartum into confinement damage were observed.
[Pregnancy Dysentery] *Zhang Shi Yi Tong* states: Three Prohibitions and Five Examinations for Pregnancy Dysentery. Prohibition 1: No purgatives to prevent fetal Qi sinking. Prohibition 2: No diuretics to prevent Yin fluid depletion. Prohibition 3: No astringents to prevent worsening heaviness. Treatment starts with regulating Qi using Chen Pi, Wei Mu Xiang (Baked Costus), and Hou Po (Magnolia Bark) to open congestion and relieve heaviness. Examination 1: Appetite? Clear stagnation with Zhi, Lian, Sha, Zhi, Qu, Ban to restore appetite. Examination 2: Urination? Raise clear/Lower turbid, add Fu Ling to Bu Zhong Yi Qi Tang to unblock waterways. Examination 3: Abdominal pain? Red dysentery with urgent pain is Fire; use Qin, Lian, Zhi, Shao. White dysentery with empty pain is Cold; use Ding Xiang (Clove), Rou Guo (Nutmeg), Wei Jiang (Baked Ginger). Examination 4: Heaviness? Initial heaviness requires opening stagnation (Mu Xiang, Hou Po, Chen Pi, Zhi Shi). Chronic heaviness requires raising Yang, use Ju Yuan Jian. Examination 5: Fever? If Ren Ying pulse is floating/rapid, first harmonize Ying and release exterior with Dang Gui, Zi Su, Bo He, Bai Shao, Sheng Jiang. After releasing, clear internally. If initial no fever but later fever from cold invasion due to long-term dysentery weakening Wei Qi, Left三部 pulse is floating/slow; use Li Zhong Tang plus Gui Zhi (Cinnamon Twig) for interior-exterior treatment. If long-term dysentery with body heat, shrinking or empty-large-weak pulse indicates True Yin exhaustion and Floating Yang exposure. While normal patients might use pungent-warm strong tonics, pregnant women should avoid Gui/Fu. Rely on Ren Shen, Bai Zhu, Sheng Jiang, Yu Zhu (Cornus), E Jiao, Ai Ye. Large dose decoction can save. Once Five Examinations are clear and Three Prohibitions avoided, check stool viscosity/color. Thick/paste-like needs clearing. Watery/mucus/dull color needs warming Qi regulation. Clear/thin mucus and dull/stagnant color indicate Deficiency-Cold; urgently use Ren Shen, Fu Ling, Sheng Jiang, Ai Ye. Cases of pregnancy abdominal distension/heaviness with thick white dysentery used Hou Po Tang minus Gan Jiang. Pregnancy abdominal pain/poor appetite with thin white mucus used Gan Cao Gan Jiang Tang or Li Zhong Tang. Distension/heaviness with red-white dysentery used Pu Jiang Shen Gan Ban Xia Tang. Eating with heaviness and sticky bloody dysentery used Qin Shao Tang delivering Xiang Lian Wan. Lower abdominal heaviness/pain with fresh/stagnant bloody dysentery used Lian Li Tang combined with Qian Jin San Wu Jiao Ai Tang. Fever/heaviness with Yin-Deficiency bloody dysentery used Zhu Che Wan. Heat-Toxin attacking, anorexia, distension/heaviness, pus/blood mixture used Bai Tou Weng Tang plus Gan Cao, E Jiao. Thin pus/blood, chronic dysentery with fetal movement used Qian Jin Jiao Ai Liu Pi Tang. Malaria-dysentery Qi deficiency, fetal dropping/frequent urination used Bu Zhong Yi Qi Tang. All these pregnancy dysentery formulas add Sha Ren to regulate Qi and Wu Mei (Mume Fruit) to regulate Blood, always effective.
[Summer-Heat Injury] Pregnancy summer-heat with irritability/thirst/confusion uses Huang Lian Xiang Ru Yin (Coptis and Elsholtzia Drink) or Shi Wei Xiang Ru Yin. Severe heat/thirst uses Xiang Ru Yin plus Mai Dong, Wu Wei Zi, Shi Gao (Gypsum), Huang Qin, Zhi Mu (Anemarrhena), Hua Fen (Tiger Lily Bulb).
[Various Pains] Prenatal headache uses Chuan Xiong Cha Tiao San (Ligusticum Tea-Tuning Powder). Chronic migraines add Gan Ju Hua (Chrysanthemum). Heart Qi pain uses Huo Long San. Heart pain with fainting uses Chan Bao Wan. Epigastric pain uses Yang Wei Tang. Flank pain uses Jie Gan Jian minus Ban Xia. Back pain with Qi stagnation uses Zi Su Yin. Abdominal pain from Cold/Food uses Zheng Qi San. Lower back pain uses Tong Qi San. Kidney Deficiency lower back pain uses Da Bu Yuan Jian. Lower abdominal pain from Wind-Cold attacking deficient collaterals uses Zi Su Yin plus Sheng Jiang. Cold-Qi stagnation pain uses Xiang Fu, Xiao Hui (Fennel) to warm and disperse. Waist/abdominal pain with fetal unrest uses Dang Gui, E Jiao, Gan Cao, Cong Bai Tang. Fetal movement with bleeding, urgent waist/abdominal pain uses Zhu Gen Tang.
[Pregnancy Carbuncle] Swelling/pain near lower abdomen with thin/shiny skin indicates carbuncle. Use Qian Jin Tuo Li San (Thousand Years Supporting Interior Powder). If urgent pain, irritability, fetal Qi rushing up, blue face, cold sweat, and continuous bleeding, it is untreatable.
[Milk Weeping] Milk secretion before delivery is called Ru Qi. Offspring often fail to survive.
[Abdominal Crying] Fetus crying in womb due to mother climbing/lifting arms, causing fetal mouth to detach from umbilical cord. Having the mother bend down as if picking something or sweeping repositions the cord/vessel into the fetal mouth, stopping crying. Fetal Heat unrest crying is stopped by sipping thickly decocted Huang Lian (Coptis) juice. Ringing in the womb is stopped by holding soil from a rat hole in an empty room in the mouth.
[Ghost Fetus] Ghost Fetus presents with deep-thin-stringy-choppy pulses, irregular sizes. Caused by drinking cold during menstruation leading to Blood accumulation in Chong/Ren, or Phlegm/Water retention combining with Collateral stasis. These are internal causes, not external pathogens. Abdomen enlarges slightly with movement, distinct from true fetus. Treatment prioritizes regulating Qi and moving Blood, adding E Zhu (Curcuma Zedoaria)...