妊妇有口渴烦躁，舌上生疮，两唇肿裂，大便干结，数日不得通，以致腹疼小产者，人皆曰大肠之火热也 谁知是
血
热铄胎乎！夫血所以养胎也，温和则胎受其益，太热则胎受其损。如其热久铄之，则儿在胞胎之中，若有探汤之苦，难
以存活，则必外越下奔，以避炎气之逼迫，欲其胎之不坠也得乎！然则血荫乎胎，则血必虚耗。血者阴也，虚则阳亢，
亢则害矣。且血乃阴水所化，血日荫胎，取给刻不容缓而火炽，阴水不能速生以化血，所以阴虚火动。阴中无非火气，
血中亦无非火气矣，两火相合，焚逼儿胎，此胎之所以下坠也。治法宜清胞中之火，补肾中之精，则可已矣。或疑儿已
下坠，何故再顾其胞？血不荫胎，何必大补其水？殊不知火动之极，以致胎坠，则胞中纯是一团火气，此火乃虚火也。
实火可泄，而虚火宜于补中清之，则虚火易散，而真火可生。倘一味清凉以降火，全罔顾胞胎之虚实，势必至寒气逼人，
胃中生气萧索矣。胃乃二阳，资养五脏者也。胃阳不生，何以化精微以生阴水乎！有不变为劳瘵者几希矣。
方用加减四物汤。
熟地（五钱，九蒸） 白芍（三钱，生用） 当归（一两，酒洗） 川芎（一钱） 山栀子（一钱，炒） 山萸
（二钱，蒸，去核） 山药（三钱，炒） 丹皮（三钱，炒）
水煎服。四、五剂而愈矣。丹皮性急凉血，产后用之，最防阴凝之害，慎之！
眉批∶此方加条芩二钱尤妙。
歌括∶妊妇口渴干躁烦，舌上生疮两唇翻。
便结腹疼致小产，血热灼胎是病源。
清胞中火补肾元，加减四物效不凡。
丹栀山药山萸肉，补中清之虚火散。
孕妇出现口渴、烦躁不安，舌面生疮，双唇肿胀破裂，大便干结，多日无法通畅排便，进而导致腹痛并发生小产。人们都认为是大肠的火热之邪所致，却不知这是血热煎熬胎儿的缘故！血液是用来滋养胎儿的，温度温和则胎儿受益，过于炎热则胎儿受损。如果热邪长久煎熬，胎儿在胞胎之中，就像遭受沸水烫煮的痛苦，难以存活，于是必然向外逃逸、向下奔坠，以躲避炎气的逼迫，想要胎儿不坠落，怎么可能呢？然而，血液荫护胎儿，自身必然会被虚耗。血属于阴，阴虚则阳气亢盛，阳亢就会产生危害。况且血是由阴精（阴水）化生的，血每日滋养胎儿，取用供给刻不容缓，此时火势炽盛，阴精不能迅速生成以化生血液，所以导致阴虚火动。阴分中无非是火气，血中也无非是火气，两股火气相合，焚烧逼迫胎儿，这就是胎儿下坠的原因。治疗方法应当清泄胞宫中的火气，补肾中的精气，就可以痊愈了。有人怀疑：胎儿已经下坠，为何还要顾及胞宫？血液不再荫护胎儿，何必大补阴水？殊不知火气动极导致胎坠后，胞宫中纯粹是一团火气，这火气属于虚火。实火可以泻除，而虚火应当在补益中清泄，这样虚火容易消散，真火（肾阳/元气）才能生发。如果一味使用清凉药物来降火，完全不顾及胞胎的虚实状况，势必导致寒气逼人，胃中的生气萧条索然。胃属于二阳经，是资养五脏的根本。如果胃阳不生发，又怎能化生精微物质来产生阴水呢！如果不转变为劳损痨病的情况就太少了。方剂选用加减四物汤。熟地黄（五钱，九次蒸制）、白芍（三钱，生用）、当归（一两，酒洗）、川芎（一钱）、山栀子（一钱，炒制）、山茱萸（二钱，蒸制，去核）、山药（三钱，炒制）、牡丹皮（三钱，炒制）。用水煎服。服用四到五剂即可痊愈。牡丹皮性急凉血，产后使用它，最能防止阴凝停滞的危害，务必谨慎！眉批：此方加入黄芩二钱尤其妙处。歌诀：孕妇口渴干燥烦躁，舌上生疮双唇翻卷。大便干结腹痛致小产，血热灼伤胎儿是病源。清泄胞中火气补肾元，加减四物汤效果不凡。丹皮、栀子、山药、山茱萸肉，补中清之使虚火消散。
Pregnant women presenting with thirst, irritability, sores on the tongue, swelling and cracking of both lips, dry stool, inability to defecate for several days, leading to abdominal pain and miscarriage, are often said by people to be caused by excessive heat-fire in the Large Intestine. However, who would know that this is actually fetal damage due to Blood Heat (Xue Re)? Blood serves to nourish the fetus; when mild and warm, the fetus benefits from it, but when too hot, the fetus suffers damage. If the heat persists and scorches for a long time, the fetus within the gestational sac will suffer as if immersed in boiling water, making survival difficult. Consequently, it must escape outward and descend downward to avoid the oppression of the inflammatory qi. How could one expect the fetus not to fall? Since blood nourishes the fetus, it inevitably becomes depleted. Blood belongs to Yin; when deficient, Yang becomes hyperactive, and hyperactivity brings harm. Moreover, blood is transformed from Yin fluids (Yin Shui). As blood daily nourishes the fetus, the supply is urgent and cannot wait. When fire blazes fiercely, Yin fluids cannot generate quickly enough to transform into blood, resulting in Yin deficiency with stirring fire. The Yin aspect contains nothing but fire qi, and the blood contains nothing but fire qi. The combination of two fires burns and oppresses the fetus, which is why the fetus descends. The treatment method should clear the fire in the Uterus (Bao Gong) and tonify the essence in the Kidneys, which can cure the condition. Some may doubt: since the fetus has already fallen, why attend to the uterus? Since blood no longer nourishes the fetus, why greatly tonify the Yin fluids? One does not realize that when extreme fire movement causes fetal expulsion, the uterus becomes purely filled with a mass of fire qi. This fire is Deficient Fire (Xu Huo). Excess fire can be purged, but deficient fire should be cleared amidst tonification, allowing the deficient fire to dissipate easily and the True Fire (Zhen Huo) to arise. If one solely uses cooling herbs to reduce fire, completely disregarding the excess or deficiency of the gestational sac, cold qi will inevitably become oppressive, and the vital Qi in the Stomach will become desolate. The Stomach belongs to the Two Yang meridians and is the source that nourishes the Five Zang organs. If Stomach Yang does not arise, how can it transform fine essences to generate Yin fluids? It would hardly fail to develop into Consumption Disease (Lao Zhai). Use the Modified Si Wu Tang (Four Substance Decoction). Prepared Rehmannia Root (Shu Di Huang, 5 qian, steamed nine times), Raw White Peony Root (Bai Shao, 3 qian, used raw), Angelica Sinensis Root (Dang Gui, 1 liang, washed with wine), Szechwan Lovage Rhizome (Chuan Xiong, 1 qian), Gardenia Fruit (Shan Zhi Zi, 1 qian, stir-fried), Cornus Officinalis Fruit (Shan Yu Rou, 2 qian, steamed, pips removed), Chinese Yam (Shan Yao, 3 qian, stir-fried), Moutan Cortex (Dan Pi, 3 qian, stir-fried). Decoct in water and take orally. Cure after four or five doses. Moutan Cortex has an urgent nature and cools the blood; using it postpartum best prevents the harm of Yin stagnation/coagulation, so be cautious! Marginal note: Adding Scutellaria Baicalensis Root (Tiao Qin, 2 qian) to this formula is particularly excellent. Song verse: Pregnant woman with thirst, dryness, restlessness, and irritability; sores on the tongue and turning/cracking of both lips. Dry stool and abdominal pain lead to miscarriage; blood heat scorching the fetus is the disease source. Clear the fire in the middle of the womb and tonify the Kidney Yuan; Modified Si Wu Tang shows extraordinary efficacy. Moutan Cortex, Gardenia, Chinese Yam, and Cornus fruit; tonifying while clearing disperses the deficient fire.