〔丹〕阳施阴化，胎孕乃成。血气虚损，不足营养，其胎自堕。或劳怒伤情，内火便
动，亦能堕胎。推原其本，皆因于热，火能消物，造化自然。《病源》乃谓风冷伤于子脏
而堕，此未得病情者也。予见贾氏妇，但有孕至三月左右必堕，诊其脉，左手大而无力，
重取则涩，知其血少也。以其妙年，只补中气，使血自荣。时正夏初，教以浓煎白术汤
下黄芩末一钱，服三四十帖，遂得保全其生，因而思之，堕因内热而虚者，于理为多，曰
热曰虚，当分轻重。盖孕至三月，正属相火，所以易堕，不然何以黄芩、熟艾、阿胶等为
安胎妙药耶？好生之工，幸无轻视。一妇年三十余，或经住或成形未具，其胎必堕，察
其性急多怒，色黑气实，此相火太盛，不能生气化胎，反食气伤精故也。因令住经第二
月，用黄芩、白术、当归、甘草，服至三月尽止药，后生一子。一妇经住三月后，尺
脉或涩或微弱，其妇却无病，知是子宫真气不全，故阳不施，阴不化，精血虽凝，终不
成形。至产血块或产血胞。一妇腹渐大如怀子，至十月求易产药，察其神色甚困难，与
之药，不数日生白虫半桶。盖由妇之元气太虚，精血虽凝，不能成胎而为秽腐，蕴积之
久，湿化为热，湿热生虫，理之所有，亦须周十月之气，发动而产，终非佳兆。其妇不
及月死。湿热生虫，譬之沟渠污浊，积久不流，则诸虫生于其间矣。
汪石山治一妇长瘦，色黄白，性躁急、年三十余，常患堕胎，已七八见矣。诊其脉，皆
柔软无力，两尺虽浮而弱，不任寻按。曰∶此因胎堕太多，气血耗甚，胎无滋养，故频堕，
譬之水涸而禾枯，土削而木倒也。况三月五月，正属少阳火动之时，加以性躁而急发之，
故堕多在三五七月也。宜大补阴汤去桂加黄柏、黄芩煎服，仍用研末蜜丸服之，庶可保
生，服半年胎固而生二子。
钱仲阳治一孕妇病，医言胎且堕。钱曰∶妊者五脏传养，率六旬乃更，候其月偏补之，
何必堕。已而母子皆全。
陈斗岩治一妇有胎四月堕下，逾旬腹肿发热，气喘，脉洪盛，面赤口鼻舌青黑。陈
诊之曰∶脉洪盛者，胎未堕也。面赤，心火盛而血干也。舌青口鼻黑，肝既绝而胎死矣。
内外皆曰胎堕久矣。复诊色脉如前，以蛇蜕煎汤下平胃散加芒硝、归尾一倍服之。须臾，
腹鸣如雷，腰腹阵痛，复一死胎随下，病亦
愈。
程仁甫治一妇，年近四十，禀气素弱，自去其胎，五日内渐渐腹胀如鼓，至心前上，吐
不能食，用补药不效。诊六脉微弱，但只叫胀死，此乃损伤脾气而作胀，然急则治其标，
若泥丹溪法恐缓不及事矣。用桃仁承气加枳实、浓朴，倍硝、黄，煎服四分，吐去其一，
次早仍不通，事急，又服琥珀丸三钱，至申时大通，胀减，但体倦四肢无力，口不知味，
发热，再用参、 、归、芍、楂、术、陈皮八剂而安。
江应宿治汪镐妻，三十五岁，厌产误服打胎药，下血如崩旬余，腹痛一阵即行，或
时鼻衄，诸药不效。诊得六脉数而微弦，乃厥阳之火泛逆，投四物换生地黄，加阿胶、炒
黑山栀、蒲黄，一剂愈。
薛氏云∶大抵治法，须审某月属某经育养而药之。
济生芎 补中汤 治怀孕血气虚弱，不能卫养，以致数月而堕，名曰半产。（每见妇人
孕不能满十月而损堕，得服此遂安全。）
芎 五味子 阿胶（蛤粉炒） 干姜（炮，各一钱） 黄 （去芦，蜜炙） 当归（酒浸）
白芍药 白术（各一钱半） 杜仲（去粗皮，炒去丝） 人参 木香（不见火） 甘草（各五分，炙）
上作一服，水二盅，煎至一盅，不拘时服。
阿胶汤 治妊娠数堕胎，小腹 痛不可忍。
阿胶（炙燥） 熟干地黄（焙） 艾叶（微炒） 芎 当归（切，焙） 杜仲（去粗皮，炙，锉）
白术（各一两）
上 咀，每服四钱，水一盏半，枣三枚，擘破，同煎至八分，去滓食前温服。
杜仲丸 治妊娠三两个月，胎动不安，防其欲堕，宜预服之。
杜仲（姜制，炒去丝） 续断（酒浸，各二两）
为末，煮枣肉杵丸梧子大。每服七十丸，米饮下。
四制艾附丸 治妇人数堕胎，由气不升降，所以胎气不固，尤宜服此。
香附（杵去毛，净一斤，分四分，一分酒浸，一分醋，一分童便，一分盐水，各浸七日，取出焙干）
为细末，醋煮糊和丸梧子大，每服七十丸，空心温酒下。肥人只根据本方，瘦人加泽
兰叶、赤茯苓各二两。
一方 用香附子（一斤） 艾叶（四两） 当归（二两。俱用醋煮）
《删繁方》治妊娠怀胎数落而不结实，或冷或热，百病之源。（《经心录》同。）
甘草 黄 人参 川芎 白术 地黄 吴茱萸（各等分） （一方有当归、干姜。）
上为末，空心温酒调二钱。忌菘菜、桃、李、雀肉、醋物。
〔娄〕按∶丹溪论俱是虚热而无寒者，今姑存此一方，以俟施之于千百而一者也。醋
附丸 治数堕胎。（方见血崩。）
《千金》疗妊娠三个月，胎欲堕方。 灸膝下一寸，七壮。妊子不成，时时受胎后漏
下五色，疼痛。灸胞门。（关门左边二寸，名胞门，右边二寸，名子户。）
〔胎堕后为半产〕
夫妊娠日月未足，胎气未全而产者，谓之半产。盖由妊妇冲任气虚，不能滋养于胎，
胎气不固，或 扑闪坠，致气血损动，或因热病温疟之类，皆令半产。仲景谓寒虚相搏，
此名为革，妇人则半产漏下是也。又云∶半产俗呼小产，或三四月，或五六月，皆为半
产，以男女成形故也。或因忧恐悲哀暴怒，或因劳力打扑损动，或触冒暑热，忌黑神散，恐
犯热药转生他疾。宜玉烛散、和经汤之类。《便产须知》云∶小产不可轻视，将养十倍于
正产可也。又云∶半产即肌肉腐烂，补其虚损，生其肌肉，益其气血，去其风邪，养其
脏气，将养过于正产十倍，无不平复，宜审之。
〔薛〕小产重于大产，盖大产如栗熟自脱，小产如生采破其皮壳，断其根蒂也。但
人轻忽致死者多。治法宜补形气，生新血，去瘀血。若未足月，痛而欲产，芎归补中汤倍
加知母止之。若产而血不止，人参黄 汤补之。若产而心腹痛，当归川芎汤主之。胎气
弱而小产者，八珍汤固之。若出血过多而发热，圣愈汤。汗不止，急用独参汤。发热烦
躁，肉 筋惕，八珍汤。大渴面赤，脉洪而虚，当归补血汤。身热面赤，脉沉而微，四
君、姜、附。东垣云∶昼发热而夜安静，是阳气自旺于阳分也，昼安静而夜发热，是阳
气下陷于阴中也，如昼夜俱发热者，是重阳无阴也。当峻补其阴。王太仆云∶如大寒而
甚，热之不热，是无火也。热来复去，昼见夜伏，夜发昼止，时节而动，是无火也。如
大热而甚，寒之不寒。是无水也。热动复止，倏忽往来，时动时止，是无水也。若阳气自
旺者，补中益气汤，阳气陷于阴者，四物二连汤。重阳无阴者，四物汤，无火者，八味
丸。无水者，六味丸。一妊妇五月服剪红丸堕胎，腹中胀痛，服破血药益甚，手按之
愈痛。余曰∶此峻药重伤，脾胃受患，用八珍倍参、 、半夏、乳、没，二剂痛止，数
剂全愈。史仲子室，年甫二十，疫胎堕，时咳，服清肺解表，喘急不寐，请视。余曰∶脾
土虚不能生肺金，药重损之，与补中益气加茯苓、半夏、五味、炮姜，四剂渐愈；再往
视，又与八珍加五味及十全大补汤而全愈。陈氏妇张，素怯弱，生女自乳，因病疥年余，
遂致羸困，复因执丧礼劳顿，数欲眩仆。一日感气，忽患心脾高肿作疼，手不可按，呕
吐不止，六脉微细之极。陈翁自以脉虽虚而病形则实，误臆诸痛不可补气，乃用青皮、香
附、吴萸等药而愈。继复患疟且堕胎，又自投理气行血之药，病去元气转脱，再投参、
补剂不应矣。六脉如丝欲绝，思非附子不能起，因亟请薛诊之，云∶此由理气损真之误
也。连投参、 、归、术、附子、姜、桂六剂，间用八味丸五日，眠食渐甘，六脉全复。
薛谕之云∶向使心脾疼时即服此药，疟亦不作矣。一妊妇堕胎，昏愦不省，自汗发搐，
时吐痰，自用养血化痰之剂，昏愦不省，痰涎涌出，彼以为中风，欲用祛风化痰。予曰∶
此属脾气虚寒所致，遂用十全大补加炮姜二十余剂，寻愈。
生地黄汤 治妊娠胎气损动，气血不调，或 扑闪坠，以致胎堕，堕后恶滞不尽，腹
中痛。
生干地黄（焙，一两） 大黄（暴，煨） 芍药 白茯苓（去黑皮） 当归（切炒）
细辛（去苗） 甘草（炙） 黄芩（去黑皮） 桂（去粗皮。各半两）
上 咀，每服五钱匕，水一盏半，入生姜、大枣拍碎，同煎至一盏，去滓不拘时温服。
人参汤 治半产后血下过多，心惊体颤，头目运转，或寒或热，脐腹虚胀疼痛。
人参 麦门冬（去心，焙） 生干地黄（焙） 当归（洗，焙） 芍药 黄
白茯苓（去皮） 甘草（炙。各一两）
咀，每服三钱，水一盏，煎至七分，去滓食前温服。
〔大〕堕胎后复损经脉，而下血不止，甚则烦闷至死，皆以调补胃气为主。
〔薛〕前证若肝经血热，用四物、参术、山栀。肝经风热，用防风、黄芩丸，肝经怒
火，用加味逍遥散。脾经气虚，用四君、归、地。脾经郁滞，用加味归脾汤。气滞不和，用
紫苏饮。骨气下陷，用补中益气汤。
人参黄 汤 治小产气虚，血下不止。
人参 黄 （炒） 当归 白术（炒） 白芍药（炒） 艾叶（各一钱） 阿胶（炒，二钱）
上作一剂，水煎服。
治妊娠损动，下血不止，腹痛，宜服此。
阿胶（一两，炒） 艾叶（半两）
水一大盏，煎六分，去滓空心服。
治妊娠损动下血不止方。
甘草（一两，炙） 阿胶（二两） 鸡子（一个）
上以水二大盏，煮甘草一盏，三分，去滓下鸡子、胶，候胶烊，搅匀分三服。
龙骨散 疗因损娠，下恶血不止。
龙骨 当归 地黄（各二两） 艾叶（一两，炒） 地榆 阿胶 芍药 干姜（各一两半）
蒲黄（一两二钱半） 牛角 （炙焦，二两半。共为细末）
上食前用米饮调下二钱。
《千金》疗落胎下血不止方。
上以生地黄汁一小盏，调代赭石末一钱，日三服。
治妊娠下血不止疼痛方。亦治小便不禁。
家鸡翎（烧灰） 细研，以温酒调下二钱，如人行五里再服，以效为度。
《千金》疗妊娠胎堕下血不止方。
以丹参（十二两） 细切，酒五升，煮取三升，分三服。
《补遗》催生如神散，妙。
又方 香附子为末，米饮调下。
当归酒 治妊娠堕胎后血不出。
当归（炙，令香） 芍药（炒，各二两）
咀，每服三钱匕，无灰酒一盏，入生地黄汁一合，银器内慢火煎至七分，去滓温
服，以恶血下为度。
乌金散 治妊娠堕胎后恶血不下，兼治诸疾血病。
好墨（二两，折、二寸挺子，烧通赤，用好醋一升，蘸七遍，又再烧通赤，放冷，别研
为末） 没药（研） 麒麟竭（各二钱半） 麝香（一钱）
上为细末，每服温酒调下一钱匕。如血迷心，用童便加酒，调下二钱匕。
治妊娠堕胎后血不出，少腹满痛。
用羚羊角烧灰，细研如面，每服三钱，不拘时，以豆淋酒调下。
治妊娠堕胎下血不尽，苦烦满欲极，时发寒热狂闷。
鹿角屑（一两，熬）
上用水一大盏，煎豉一合，取汁六分，分三服，调鹿角屑二钱服，日三，须臾血下。
红蓝花散 治堕胎后血不出奔心，闷绝不识人。
红蓝（微熬过） 男子发（烧存性） 京墨（烧红） 血竭（研） 蒲黄（隔纸炒，各等分）
上为细末，以童便小半盏，调二钱服之，立效。
白蜜汤 治堕胎后恶血不出。
白蜜（二两） 生地黄（取汁，一盏） 酒（半盏）
上汁与酒，共入铜器中煎五七沸，入蜜搅匀，分两服，服三剂，百病可愈。
猪膏饮 治堕胎血不出上抢心，疼痛烦愦。
猪膏（七合） 白蜜（三合） 生地黄（切，二两）
上先将猪膏、地黄相和，煎令赤色，去地黄，纳蜜搅匀，分温二服，相次再服。
当归汤 治妊娠堕胎，胞衣不出。
当归（切，炒） 牛膝（酒浸，切、焙。各一两半） 木通（锉） 滑石（研，各二两）
冬葵子（炒，二合） 瞿麦穗（一两）
上 咀，每服三钱，水一盏半，煎至七分，去滓温服。未下再服，以下为度。
地黄汤
蒲黄（炒） 生姜（切，炒。各二钱半） 生地黄（半两，以铜、竹刀切，炒）
上以无灰酒三盏，于银器内同煎至二盏，去滓分三服，未下再作服。
泽兰汤
泽兰叶（切，研） 滑石末（各半两） 生麻油（少许）
上以水三盏，先煎泽兰至一盏半，去滓，入滑石末并油，更煎三沸，顿服之，未下更服。
蒲黄酒（作丸名槐子丸。）
蒲黄（炒，一合） 槐子（十四枚，为末）
上以酒三盏，煎至二盏，去滓分温二服，未下更作服。又治妊娠不足月，欲产腹痛，为
末，蜜丸酒下。
[Danxi] When Yang energy is distributed and Yin energy transforms, conception occurs. If Qi and Blood are deficient and insufficient to nourish the fetus, spontaneous abortion will occur. Alternatively, if labor or anger injures the emotions, causing internal Fire to move, it can also lead to miscarriage. Tracing back to the root cause, all stem from Heat; Fire consumes things, which is the natural law of creation. *Zhubing Yuanhou Lun* (Treatise on the Pathogenesis and Symptoms of All Diseases) claims that Wind-Cold injuring the uterus causes miscarriage, which fails to grasp the essence of the disease. I once observed a woman surnamed Jia who invariably miscarried around the third month of pregnancy. Her pulse was large but forceless on the left hand, and choppy upon heavy pressure, indicating Blood deficiency. Since she was young, I only tonified Middle Qi, allowing Blood to naturally flourish. It was early summer, so I instructed her to take one qian of Huangqin Powder with thickly decocted Baizhu Tang. After taking 30-40 doses, she successfully preserved the pregnancy. Reflecting on this, miscarriages due to internal Heat combined with deficiency are common. One must distinguish the severity of Heat and Deficiency. Generally, by the third month of pregnancy, Xiang Huo (Ministerial Fire) is at its peak, making miscarriage likely; otherwise, why are Huangqin (Scutellariae Radix), Shu Ai Ye (Artemisiae Argyi Folium), and Ejiao (Colla Corii Asini) considered excellent fetal-calming herbs? Physicians engaged in life-saving work should not underestimate this issue.
Another woman, over thirty years old, experienced recurrent miscarriages, sometimes after amenorrhea, sometimes when the fetus formed but failed to develop fully. Observing her irritable nature, dark complexion, and robust Qi, I diagnosed excessive Xiang Huo failing to generate Qi and transform the fetus, instead consuming Qi and damaging Essence. I prescribed Huangqin, Baizhu, Danggui, and Gancao starting from the second month of amenorrhea, stopping at the end of the third month. She subsequently gave birth to a son.
Another woman had a choppy or weak-rim pulse three months after amenorrhea, yet had no other symptoms. I determined her uterine True Qi was incomplete, preventing Yang from distributing and Yin from transforming. Although Jing and Blood coagulated, they could not form a fetus, resulting in the expulsion of blood clots or placental tissue.
Another woman’s abdomen enlarged as if pregnant. At ten months, she sought parturition aids. Her expression showed great distress. After administering medicine, she expelled half a bucket of white worms within days. This was due to extreme deficiency of Yuan Qi; although Jing and Blood coagulated, they failed to form a fetus and instead became turbid decay. Accumulating over time, Dampness transformed into Heat, and Damp-Heat generated worms. This is logical. However, it still required the full ten months of Qi activation to expel, which was an ominous sign. The woman died within a month. Damp-Heat generating worms is like stagnant sewage in a ditch; over time, various insects breed within it.
Wang Shishan treated a thin, yellow-complexioned woman in her thirties who suffered frequent miscarriages, having experienced them seven or eight times. Her pulses were soft and forceless; both Chi pulses were floating but weak, unable to withstand deep pressure. He stated: "Due to numerous miscarriages, Qi and Blood are severely depleted, leaving the fetus without nourishment, hence frequent miscarriages. It is like water drying up causing crops to wither, or soil eroding causing trees to fall. Moreover, the third and fifth months correspond to the activation of Shaoyang Fire. Combined with her irritable temperament, miscarriages often occur in the third, fifth, and seventh months." He prescribed Da Bu Yin Tang, removing Guizhi and adding Huangbai and Huangqin, decocted and taken as honey pills. After six months of treatment, the fetus stabilized, and she bore two sons.
Qian Zhongyang treated a pregnant woman whose physician predicted imminent miscarriage. Qian said: "During pregnancy, the five Zang organs transmit nourishment to the fetus, renewing every sixty days. Wait for the appropriate month to supplement accordingly; why would it miscarry?" Mother and child remained safe.
Chen Douyan treated a woman who miscarried at four months. Ten days later, her abdomen swelled, she had fever, asthma, a surging pulse, red face, and blue-black tongue and nose. Chen diagnosed: "A surging pulse indicates the fetus has not yet aborted. Red face shows Heart Fire excess and dry Blood. Blue tongue and black nose indicate Liver Qi exhaustion and fetal death." Everyone believed the fetus had been dead for a long time. Upon re-examination, he used Shed of Snake decoction to administer Pingwei San plus Mangxiao and double the amount of Guiwei. Soon, thunderous abdominal borborygmi and intermittent waist/abdominal pain occurred, followed by the expulsion of a dead fetus, and the illness resolved.
Cheng Renfu treated a nearly forty-year-old woman with inherent weakness who induced her own abortion. Within five days, her abdomen distended like a drum, rising to the epigastrium, causing vomiting and inability to eat. Tonics failed. Her six pulses were faint; she complained of unbearable distension. This was Spleen Qi injury causing distension. However, in emergencies, treat the branch first; adhering strictly to Danxi’s methods might be too slow. He used Tao Ren Chengqi Tang with Zhishi and Houpo, doubling Xiaoshuang and Dahuang. Taking one-quarter dose, she vomited some, but constipation persisted the next morning. Urgently, he administered Hu Po Wan (Amber Pill) 3 qian. By Shen hour, bowel movement was clear, distension reduced, but she felt fatigued, weak in limbs, lost taste, and had fever. He then prescribed Renshen, Huangqi, Danggui, Shaoyao, Shanzha, Baizhu, and Chenpi for eight doses to stabilize her.
Jiang Yingsu treated Wang Hao’s wife, 35, who accidentally took abortifacients due to fear of childbirth. She suffered severe bleeding for over ten days, intermittent abdominal pain, and occasional epistaxis. Medications failed. Her six pulses were rapid and slightly wiry, indicating rebellious Jueyang Fire. He prescribed Siwu Tang substituting Sheng Dihuang, adding Ejiao, Chao Hei Shan Zhi, and Puhuang. One dose cured her.
Xue stated: Generally, treatment requires assessing which meridian nourishes the fetus in a specific month and medicating accordingly.
Jisheng Xiong Lao Bu Zhong Tang: Treats pregnancy with Qi-Blood deficiency failing to protect and nourish, leading to miscarriage after several months, termed "semi-abortion" (Ban Chan). Commonly, women who lose pregnancies before ten months are saved by this formula.
Ingredients: Xiong (Ligustici Chuanxiong Rhizoma), Wuweizi (Schisandrae Fructus), Ejiao (Colla Corii Asini, fried with clam powder), Ganjiang (Dried Ginger, processed, 1 qian each), Huangqi (Astragali Radix, de-radicle, honey-fried), Danggui (Angelicae Sinensis Radix, wine-soaked), Baishao (Paeoniae Radix Alba, 1.5 qian each), Duzhong (Eucommiae Cortex, de-bark, stir-fried to remove silk fibers), Renshen (Ginseng Radix), Muxiang (Aucklandiae Radix, protected from fire), Gancao (Licorice Radix, processed, 5 fen each).
Usage: One dose, decocted in 2 zhong of water to 1 zhong, taken anytime.
Ejiao Tang: Treats recurrent miscarriage in pregnancy with unbearable lower abdominal pain.
Ingredients: Ejiao (fried dry), Shu Dihuang (Prepared Rehmanniae Radix, baked), Aiyè (Mugwort Leaf, lightly fried), Xiong, Danggui (cut, baked), Duzhong (de-bark, fried, crushed), Baizhu (1 liang each).
Usage: Coarsely powdered. Take 4 qian per dose, decoct with 1.5 sheng of water and 3 dates (split) to 0.8 sheng. Strain and take warm before meals.
Duzhong Wan: Treats fetal restlessness in the 3rd-4th month, preventing impending miscarriage; suitable for preventive use.
Ingredients: Duzhong (Ginger-processed, stir-fried to remove silk fibers), Xuduan (Dioscoreae Nipponicae Rhizoma, wine-soaked, 2 liang each).
Usage: Powdered, mixed with date paste to make pills the size of wu zi. Take 70 pills with rice drink.
Si Zhi Ai Fu Wan: Treats recurrent miscarriage due to failure of Qi ascending and descending, leading to unstable fetal Qi.
Ingredients: Xiangfu (Cyperi Rhizoma, de-hair, net weight 1 jin, divided into four parts: soaked in wine, vinegar, child’s urine, and salt water respectively for 7 days each, then dried).
Usage: Powdered, bound with vinegar paste to make pills the size of wu zi. Take 70 pills with warm wine on an empty stomach. For obese patients, follow the base formula; for thin patients, add Zelan Ye (Lycopus Herba) and Chi Fuling (Polyporus with host wood) 2 liang each.
Another Prescription: Xiangfu Zi (1 jin), Aiyè (4 liang), Danggui (2 liang). All boiled in vinegar.
*Shan Fan Fang*: Treats repeated non-viable pregnancies, cold or heat, source of hundred diseases. (*Jingxin Lu* agrees.)
Ingredients: Gancao, Huangqi, Renshen, Chuanxiong, Baizhu, Dihuang, Wuzhuyu (Evodiae Fructus, equal parts). (Another version adds Danggui, Ganjiang.)
Usage: Powdered, taken with warm wine on an empty stomach (2 qian). Avoid cruciferous vegetables, peach, plum, sparrow meat, and vinegar foods.
[Lou Quanshan] Commentary: Danxi’s discussions focus solely on deficiency-heat without cold. I preserve this formula here, hoping it may apply to one in a thousand cases. Cu Fu Wan: Treats recurrent miscarriage. (See Menorrhagia section.)
*Qianjin Fang*: Treats threatened miscarriage at three months. Moxibustion on knee, one cun below, seven moxa cones. If pregnancy fails to form, with constant leakage of five-colored discharge and pain, moxa Bao Men acupoint. (Two cun left of Guanmen is Bao Men; two cun right is Zi Hu.)
[Semi-abortion after Miscarriage]
Delivery before term, with incomplete fetal Qi, is called semi-abortion (Ban Chan). This is generally due to deficiency of Chong and Ren meridians failing to nourish the fetus, leading to unstable fetal Qi, or caused by falls/blows damaging Qi and Blood, or due to febrile diseases like warm malaria. Zhang Zhongjing states that Cold and Deficiency combining creates a Ge pulse; in women, this manifests as semi-abortion and dripping bleeding. Also, semi-abortion is colloquially called Xiao Chan (small production), occurring at 3-4 or 5-6 months, because the fetus has already formed. Causes include sorrow, fear, grief, rage, overexertion, blows, or exposure to summer heat. Avoid Heishen San, as hot herbs may induce other diseases. Use Yuzhu San or Hejing Tang. *Bian Chan Xu Zhi* states: Do not underestimate small production; nurture the patient ten times more than normal delivery. It also states: Semi-abortion involves muscle rot; tonify deficiency, regenerate muscle, benefit Qi and Blood, dispel Wind-Evil, nourish Zang Qi. Nurture ten times more than normal delivery, and recovery is certain. Be prudent.
[Xue Ji] Small production is more serious than large production. Large production is like a ripe chestnut falling naturally; small production is like picking unripe fruit, breaking the shell, and cutting the root. Many die due to negligence. Treatment should tonify Form and Qi, generate new Blood, and remove stasis. If pre-term labor pain occurs, use Xiong Gui Bu Zhong Tang with doubled Zhimu to stop it. If bleeding continues post-delivery, tonify with Renshen Huangqi Tang. If heart/abdominal pain occurs post-delivery, use Danggui Chuanxiong Tang. For weak fetal Qi causing small production, solidify with Bazhen Tang. For excessive bleeding with fever, use Shengyu Tang. For incessant sweating, urgently use Duchen Tang. For fever, irritability, muscle twitching, use Bazhen Tang. For extreme thirst, red face, surging but empty pulse, use Danggui Buxue Tang. For body heat, red face, deep and faint pulse, use Sijunzi Tang with Jiang and Fu. Dongyuan said: Fever by day, quiet by night, indicates Yang flourishing in Yang divisions; quiet by day, fever by night, indicates Yang sinking into Yin; fever day and night, indicates Re-Yang without Yin. Severe tonification of Yin is required. Wang Taipu said: Extreme cold unresponsive to heat therapy indicates absence of Fire. Heat coming and going, present by day hidden by night, active seasonally, indicates absence of Fire. Extreme heat unresponsive to cold therapy indicates absence of Water. Heat fluctuating suddenly, indicating absence of Water. If Yang flourishes spontaneously, use Buzhong Yiqi Tang; if Yang sinks into Yin, use Siwu Erlian Tang. For Re-Yang without Yin, use Siwu Tang; for absence of Fire, use Bawei Wan; for absence of Water, use Liuwei Wan.
A pregnant woman took Jianhong Wan at five months to abort, resulting in abdominal distension and pain. Blood-breaking herbs worsened it, and palpation increased pain. I said: This is severe injury from harsh drugs affecting the Spleen and Stomach. Use Bazhen Tang with doubled Renshen, Huangqi, Banxia, Rushiang, and Moyao. Two doses stopped pain; several doses cured her.
Shi Zhongzi’s wife, twenty years old, suffered fetal loss due to epidemic toxin, with cough. Lung-clearing and exterior-releasing herbs caused wheezing and insomnia. I said: Spleen Earth deficiency fails to generate Lung Metal; heavy medicines damaged it further. Prescribed Buzhong Yiqi Tang with Fuling, Banxia, Wuweizi, and Paojiang. Four doses improved; subsequent visits added Bazhen Tang with Wuweizi and Shiquan Dabu Tang for full recovery.
Chen’s wife Zhang, inherently frail, breastfed her daughter, suffered from scabies for over a year becoming emaciated, then exhausted by mourning rites, frequently dizzy. One day, catching a pathogen, she developed sudden high swelling and pain in Heart/Spleen, intolerable to touch, with incessant vomiting. Six pulses were extremely faint. Chen’s father thought the pulse was deficient but the pathology was excess, erroneously believing pain cannot be treated with Qi-tonics. He used Qingpi, Xiangfu, Wuzhuyu, etc., and she recovered. Later, she contracted malaria and miscarried, self-medicating with Qi-regulating and Blood-moving herbs. Disease subsided but Yuan Qi collapsed. Renshen and Huangqi tonics failed. Pulses were thread-like and near extinction. Only Fuzi could revive her. Xue Ji diagnosed: Error of regulating Qi damaging True Qi. Continuous administration of Renshen, Huangqi, Danggui, Baizhu, Fuzi, Jiang, Guizhi for six doses, interspersed with Bawei Wan for five days, restored sleep, appetite, and pulses. Xue advised: Had she taken these meds during Heart/Spleen pain, malaria would not have occurred.
A pregnant woman miscarried, fell into coma, sweated profusely, convulsed, and expectorated phlegm. Self-medication with Blood-nourishing and Phlegm-resolving herbs worsened coma and phlegm. Patient suspected stroke and wanted wind-dispelling herbs. I said: This is Spleen Qi deficiency and Cold. Used Shiquan Dabu Tang with Paojiang for over twenty doses, recovering soon.
Shengdihuang Tang: Treats pregnancy with fetal Qi disturbance, Qi-Blood imbalance, or falls causing miscarriage, with residual lochia and abdominal pain post-miscarriage.
Ingredients: Sheng Gan Dihuang (baked, 1 liang), Dahuang (sun-dried, roasted), Shaoyao, Baifuling (de-black skin), Danggui (cut, fried), Xixin (de-seeds), Gancao (roasted), Huangqin (de-black skin), Guizhi (de-bark. 0.5 liang each).
Usage: Coarsely powdered. Take 5 qian bi per dose, decoct with 1.5 sheng water, ginger, and smashed dates to 1 sheng. Strain and take warm anytime.
Renshen Tang: Treats excessive bleeding post-semi-abortion, palpitations, tremors, vertigo, alternating chills/fever, and vacuous distending pain in umbilical/abdominal region.
Ingredients: Renshen, Maidong (de-heart, baked), Sheng Gan Dihuang (baked), Danggui (washed, baked), Shaoyao, Huangqi, Baifuling (de-skin), Gancao (roasted. 1 liang each).
Usage: Coarsely cut. Take 3 qian per dose, decoct with 1 sheng water to 0.7 sheng. Strain and take warm before meals.
[Dai Yuanli] Post-miscarriage damage to meridians causing incessant bleeding, potentially fatal with stifling sensation, primarily focuses on regulating and tonifying Stomach Qi.
[Xue Ji] For the above syndromes: If Liver Meridian Blood-Heat, use Siwu Tang, Renshen, Baizhu, Zhizi. If Liver Meridian Wind-Heat, use Fangfeng Huangqin Wan. If Liver Meridian Anger-Fire, use Jia Wei Xiaoyao San. If Spleen Meridian Qi-Deficiency, use Sijunzi Tang, Danggui, Dihuang. If Spleen Meridian Stagnation, use Jia Wei Guipi Tang. If Qi-Stagnation disharmony, use Zisu Yin. If Bone Qi sinking, use Buzhong Yiqi Tang.
Renshen Huangqi Tang: Treats Qi-deficiency post-small production with incessant bleeding.
Ingredients: Renshen, Huangqi (stir-fried), Danggui, Baizhu (stir-fried), Baishao (stir-fried), Aiyè (1 qian each), Ejiao (fried, 2 qian).
Usage: One dose, decocted in water.
For pregnancy damage causing incessant bleeding and abdominal pain.
Ingredients: Ejiao (1 liang, fried), Aiyè (0.5 liang).
Usage: Decoct 1 sheng water to 0.6 sheng. Strain and take on empty stomach.
For pregnancy damage causing incessant bleeding.
Ingredients: Gancao (1 liang, roasted), Ejiao (2 liang), Ji Zi (egg yolk, 1).
Usage: Boil Gancao in 2 large sheng water to 1.3 sheng. Strain, add egg yolk and Ejiao, melt, mix well, divide into three doses.
Longgu San: Treats incessant evil blood discharge due to pregnancy damage.
Ingredients: Longgu, Danggui, Dihuang (2 liang each), Aiyè (1 liang, fried), Diyü, Ejiao, Shaoyao, Ganjiang (1.5 liang each), Puhuang (1.25 liang), Niujiao Pian (burnt to ash, 2.5 liang). All finely powdered.
Usage: Take 2 qian with rice drink before meals.
*Qianjin Fang*: For incessant bleeding after fetal loss.
Usage: Mix 1 small sheng fresh Dihuang juice with 1 qian Daizhe Shi powder. Take three times daily.
For pregnancy with incessant bleeding and pain. Also treats urinary incontinence.
Ingredients: Jialing (chicken feathers, burnt to ash).
Usage: Finely ground, taken with warm wine (2 qian). Repeat after walking five li, until effective.
*Qianjin Fang*: For incessant bleeding after fetal abortion.
Ingredients: Danshen (12 liang).
Usage: Finely cut, boil in 5 sheng wine to obtain 3 sheng. Divide into three doses.
*Buyi*: Cui Sheng Ru Shen San, excellent.
Another method: Xiangfu Zi powder, taken with rice drink.
Danggui Jiu: Treats retained blood after pregnancy miscarriage.
Ingredients: Danggui (fried until fragrant), Shaoyao (stir-fried, 2 liang each).
Usage: Coarsely cut. Take 3 qian bi, decoct with 1 sheng clean wine and 1 he fresh Dihuang juice in silver vessel over slow fire to 0.7 sheng. Strain and take warm. Stop when evil blood is expelled.
Wujin San: Treats retained evil blood after miscarriage, also for various blood disorders.
Ingredients: Haomo (2 liang, broken into 2-cun sticks, burnt red, dipped in 1 sheng good vinegar seven times, burnt red again, cooled, separately powdered), Moyao (ground), Qilinjie (2.5 qian each), Shexiang (1 qian).
Usage: Fine powder. Take 1 qian bi with warm wine. If blood confuses the heart, use child’s urine with wine, take 2 qian bi.
For retained blood after miscarriage with lower abdominal fullness/pain.
Usage: Burn Lingyangjiao to ash, grind fine. Take 3 qian anytime with Doulin Jiu (soybean-leavened wine).
For incomplete expulsion of blood after miscarriage with severe stifling, alternating chills/fever, mania.
Ingredients: Lujiaoxie (Deer horn shavings, 1 liang, roasted).
Usage: Decoct 1 sheng water with 1 he fermented soybeans to get 0.6 sheng juice. Divide into three doses, mix with 2 qian Lujiaoxie powder. Take three times daily; blood will descend shortly.
Honglanhua San: Treats blood retention after miscarriage rushing to heart, causing suffocation and unconsciousness.
Ingredients: Honglanhua (lightly roasted), Nanrenfa (human hair, burnt retaining character), Jingmo (beacon ink, burnt red), Xuèjié (ground), Puhuang (stir-fried through paper, equal parts).
Usage: Fine powder. Take 2 qian mixed with half a small sheng of child’s urine. Immediate effect.
Baimi Tang: Treats retained evil blood after miscarriage.
Ingredients: Baimi (white honey, 2 liang), Sheng Dihuang juice (1 sheng), Wine (0.5 sheng).
Usage: Juice and wine boiled in copper vessel for 5-7 boils. Add honey, mix well. Divide into two doses. Three courses cure hundred diseases.
Zhigao Yin: Treats blood retention after miscarriage rushing to heart, causing painful distress.
Ingredients: Zhigao (pig fat, 7 he), Baimi (3 he), Sheng Dihuang (cut, 2 liang).
Usage: Mix pig fat and Dihuang, boil until red. Remove Dihuang, add honey, mix well. Divide into two warm doses, take sequentially.
Danggui Tang: Treats retained placenta after pregnancy miscarriage.
Ingredients: Danggui (cut, fried), Niuxi (wine-soaked, cut, baked, 1.5 liang each), Mutong (crushed), Huashi (ground, 2 liang each), Dongkuizi (fried, 2 he), Qumai Sui (1 liang).
Usage: Coarsely cut. Take 3 qian, decoct with 1.5 sheng water to 0.7 sheng. Strain and take warm. Repeat if not expelled.
Dihuang Tang
Ingredients: Puhuang (fried), Shengjiang (cut, fried, 2.5 qian each), Sheng Dihuang (0.5 liang, cut with copper/bamboo knife, fried).
Usage: Decoct with 3 sheng clean wine in silver vessel to 2 sheng. Strain, divide into three doses. Repeat if not expelled.
Zelan Tang
Ingredients: Zelan Ye (cut, ground), Huashi Mo (0.5 liang each), Sheng Mazhi (raw hemp oil, little).
Usage: Decoct Zelan Ye in 3 sheng water to 1.5 sheng. Strain, add Huashi Mo and oil, boil three times. Take at once. Repeat if not expelled.
Puhuang Jiu (Pill name: Huaizi Wan)
Ingredients: Puhuang (fried, 1 he), Huaizi (Sophorae Fructus, 14 pieces, powdered).
Usage: Decoct in 3 sheng wine to 2 sheng. Strain, divide into two warm doses. Repeat if not expelled. Also treats pre-term labor pain; powdered, made into honey pills taken with wine.