妊娠出疹，当以四物加减而加条芩、艾叶，以安胎清热为主，则胎不动而麻疹自出矣。
然热毒蒸胎，胎多受伤，但胎虽伤而母实无恙也。盖疹与痘不同，痘宜内实，以痘当从外解
，故胎落热毒瓦斯乘虚而内攻，其母亡。疹宜内虚，以疹当从内解，故胎落热毒随胎而下，其
母存。虽然，与其胎去而母存，孰若子母两全之为愈也？且古人徒知清热以安胎，不思疹未
出而即以清热为事，则疹难出而内热愈深，是欲保胎反足以伤胎也。宜轻扬表托，则疹出而
热自清，继以滋阴清解，则于疹于胎，两不相碍，不安胎而胎自安矣。如疹出不快，宜白虎
汤合用升麻葛根汤，倍加元参、牛蒡治之。胎气上冲，急用苎根、艾叶煎汤磨槟榔服之，再
以四物汤进之。热甚胎不安，服固胎饮数剂。如又不愈，腹疼腰酸，即知胎有必堕之机，如
胎堕，即以产法论治矣。
升麻葛根汤∶葛根、升麻、白芍、甘草各等分，水一盏，煎七分，温服。
此解表发散之方也。表热壮盛，邪之间于表，《经》曰∶轻可去实，故用升麻、葛根以
疏表。所以然者，升麻能解疫毒，升阳于至阴之下，以助发生之气。葛根能解热毒，兼疏荣
卫以导起发之机。二味之外，又加甘草佐之以和在表之气，芍药佐之以和在里之荣。去其实
邪，和其荣卫，风寒自解，麻疹自出。
固胎饮∶止痛安胎。地黄、川芎各五分，归身、人参、白芍、陈皮各一钱，白术（土炒）
、黄芩各一钱五分，甘草三分，黄连、黄柏各一分，桑上羊儿藤（七叶圆者），上细切，每
服
During pregnancy, if macules and papules (rash) appear, modifications of Siwu Tang (Four Substances Decoction) should be used, adding Huangqin (Scutellariae Radix, 黄芩) and Aye (Mugwort Leaf, 艾叶). The primary treatment principle is to calm the fetus and clear heat; thus, the fetus will remain undisturbed, and the rash will naturally erupt.
However, steaming by heat-toxin often injures the fetus. Although the fetus may be injured, the mother usually remains unharmed. This is because the nature of rash (macules and papules) differs from smallpox. For smallpox, it is suitable for the interior to be solid, as the pathogen of smallpox should resolve from the exterior. If the fetal qi descends, the heat-toxin qi attacks inward through the deficiency, leading to the death of the mother. For rash, it is suitable for the interior to be relatively empty, as the pathogen of rash should resolve from within. If the fetal qi descends, the heat-toxin exits along with the fetus, allowing the mother to survive. Nevertheless, rather than losing the fetus while saving the mother, it is better for both mother and child to survive. Moreover, ancients only knew to clear heat to calm the fetus. They did not consider that clearing heat before the rash has erupted makes it difficult for the rash to emerge, causing internal heat to deepen further. This desire to protect the fetus actually harms it. One should use light, ascending, and dispersing methods to support the eruption of the rash externally; once the rash emerges, the heat clears naturally. Subsequently, using yin-nourishing and heat-clearing methods ensures neither the rash nor the fetus is hindered. Without explicitly attempting to calm the fetus, the fetus calms itself. If the eruption of the rash is slow, Baihu Tang (White Tiger Decoction) should be combined with Shengma Gegen Tang (Cimicifugae et Puerariae Decoction), doubling the dosage of Xuanshen (Scrophulariae Radix, 玄参) and Niubangzi (Arctii Fructus, 牛蒡子). If fetal qi rushes upward, Zhugen (Bamboo Shoot Root / Ramie Root, 苎根) and Aye (Mugwort Leaf, 艾叶) should be decocted in water, mixed with ground Binglang (Areca Seed, 槟榔), and taken orally, followed by Siwu Tang (Four Substances Decoction). If the heat is severe and the fetus is unstable, several doses of Gutai Yin (Fetus-Calm Drink, 固胎饮) should be administered. If there is no improvement, accompanied by abdominal pain and soreness of the lower back, it indicates that abortion is inevitable. If the fetus is aborted, treat according to postpartum disease protocols.
Shengma Gegen Tang (Cimicifugae et Puerariae Decoction): Consists of Gegen (Puerariae Radix, 葛根), Shengma (Cimicifugae Rhizoma, 升麻), Baishao (Paeoniae Radix Alba, 白芍), and Gancao (Glycyrrhizae Radix et Rhizoma, 甘草) in equal parts. Decoct one cup of water until reduced to 70%, and take warm.
This is a formula for resolving the exterior and promoting dispersion. When exterior heat is vigorous and pathogens reside in the exterior, the *Classic* states: "Light substances can remove excess." Therefore, Shengma (Cimicifugae Rhizoma, 升麻) and Gegen (Puerariae Radix, 葛根) are used to vent the exterior. The reason is that Shengma (Cimicifugae Rhizoma, 升麻) can resolve epidemic toxins and raise yang qi from below the extreme yin, assisting the vitalizing qi. Gegen (Puerariae Radix, 葛根) can resolve heat toxins and simultaneously regulate Ying (Nutritive Qi) and Wei (Defensive Qi) to guide the mechanism of eruption. Besides these two herbs, Gancao (Glycyrrhizae Radix et Rhizoma, 甘草) is added to harmonize the qi at the exterior, and Baishao (Paeoniae Radix Alba, 白芍) is added to harmonize the nutritive blood at the interior. By removing excess pathogens and harmonizing Ying and Wei, wind-cold resolves naturally, and the rash erupts spontaneously.
Gutai Yin (Fetus-Calm Drink): Relieves pain and calms the fetus. Dihuang (Rehmanniae Radix, 地黄) and Chuanxiong (Ligustici Chuanxiong Rhizoma, 川芎) each 5 fen; Dangguishen (Angelicae Sinensis Radix, 当归身), Renshen (Ginseng Radix, 人参), Baishao (Paeoniae Radix Alba, 白芍), and Chenpi (Citri Reticulatae Pericarpium, 陈皮) each 1 qian; Baizhu (Atractylodis Macrocephalae Rhizoma, 白术) stir-fried with soil, Huangqin (Scutellariae Radix, 黄芩) each 1.5 qian; Gancao (Glycyrrhizae Radix et Rhizoma, 甘草) 3 fen; Huanglian (Coptidis Rhizoma, 黄连) and Huangbai (Phellodendri Cortex, 黄柏) each 1 fen; Sangshang Yangerteng (Vine of Mulberry-growing Goatweed, 桑上羊儿藤 - specifically those with seven round leaves). All herbs are finely cut. Each dose...