妊妇至三四个月，自觉口干舌燥，咽喉微痛，无津以润，以至胎动不安，甚则血流如经水，人以为火动之极
也，谁知是水亏之甚乎！夫胎也者，本精与血之相结而成，逐月养胎，古人每分经络，其实均不离肾水之养，故
肾水足而胎安，肾水亏而胎动。虽然肾水亏又何能动胎，必肾经之火动，而胎始不安耳。然而火之有余，仍是水之
不足，所以火炎而胎必动，补水则胎自安，亦既济之义也。惟是肾水不能遽生，必须滋补肺金，金润则能生水，而水有
逢源之乐矣。水既有本，则源泉混混矣，而火又何难制乎。再少加以清热之品，则胎自无不安矣。
方用润燥安胎汤。
熟地（一两，九蒸） 生地（三钱，酒炒） 山萸肉（五钱，蒸） 麦冬（五钱，去心） 五味（三钱，炒） 阿
胶（二钱，蛤粉炒） 黄芩（二钱，酒炒） 益母（二钱）
水煎服。二剂而燥息，再二剂而胎安。连服十剂，而胎不再动矣。此方专填肾中之精，而兼补肺。然补肺仍是
补肾之意，故肾经不干燥，则火不能灼，胎焉有不安之理乎！
眉批∶方极妙，用之立应。万不可因咽痛而加豆根、射干等药；亦不可因过润而加云苓。
歌括∶妊娠三月四月间，口干咽痛胎不坚。
甚则血流如经水，火动之极水亏焉。
润燥安胎二地先，山萸五味麦冬添。
黄芩阿胶益母草，肾经滋润胎自安。
孕妇到了怀孕三四个月的时候，自觉口干舌燥，咽喉轻微疼痛，体内缺乏津液滋润，导致胎动不安，严重时甚至出现阴道流血，状如月经来潮。人们通常认为这是火邪亢盛至极的表现，但谁能想到这其实是肾水亏损严重的结果呢？
胎儿的形成，本是精与血相结合而成的。古人按月养胎的理论中，虽然常按经络划分，但其实质都离不开肾水的滋养。因此，肾水充足则胎儿安稳，肾水亏虚则胎儿躁动。
虽然说是肾水亏虚，但仅仅水亏为何会扰动胎儿？必定是肾经之火妄动，胎儿才会不安。然而，火的有余，本质上仍是水的不足。所以火势炎上则胎必动，通过补水则胎自安，这也符合“水火既济”的道理。
只是肾水不能迅速生成，必须通过滋补肺金（肺属金），肺金滋润则能生水（金生水），这样水源就有了源头，如同泉水涌流一般。既然水源有了根本，那么火势又怎能难以制约呢？再稍加一些清热的药物，胎儿自然就不会不安了。
方剂使用润燥安胎汤。
熟地黄（一两，经过九次蒸制）、生地黄（三钱，用酒炒）、山茱萸肉（五钱，蒸制）、麦冬（五钱，去心）、五味子（三钱，炒制）、阿胶（二钱，用蛤粉炒）、黄芩（二钱，用酒炒）、益母草（二钱）。
用水煎服。服用两剂后燥热症状平息，再服两剂后胎儿安稳。连续服用十剂，胎儿就不再躁动了。这个方子专门填补肾中的精气，同时兼补肺气。然而补肺仍然是为了补肾的意思，所以如果肾经不干燥，火邪就不能灼伤胎儿，胎儿怎么会有不安的道理呢！
眉批：此方极为巧妙，使用后立即见效。千万不要因为咽喉痛就加入豆根、射干等药物；也不要因为担心药性过于滋腻而加入茯苓。
歌诀：妊娠三月四月间，口干咽痛胎不坚。
甚则血流如经水，火动之极水亏焉。
润燥安胎二地先，山萸五味麦冬添。
黄芩阿胶益母草，肾经滋润胎自安。
When a pregnant woman reaches the third or fourth month of gestation, she may feel dry mouth and tongue, with slight pain in the throat, lacking body fluids to moisten the area. This leads to fetal restlessness, and in severe cases, vaginal bleeding resembling menstruation. People often attribute this to extreme hyperactivity of Fire (excessive heat), but who would realize it is actually due to severe deficiency of Kidney Water (Kidney Yin)?
The fetus is formed by the union of Essence (Jing) and Blood. Although ancient texts on monthly fetal nourishment often divide the process by meridians, the essence remains unchanged: it relies entirely on the nourishment of Kidney Water. Therefore, when Kidney Water is sufficient, the fetus is stable; when Kidney Water is deficient, the fetus becomes restless.
However, why does mere deficiency of Kidney Water disturb the fetus? It must be that Fire within the Kidney Meridian becomes hyperactive, causing fetal instability. Yet, the excess of Fire is essentially due to the insufficiency of Water. Thus, when Fire flares up, the fetus moves; replenishing Water ensures fetal stability, which aligns with the principle of "Water and Fire in Mutual Balance" (Ji Ji).
Nevertheless, Kidney Water cannot be generated abruptly. One must first tonify Lung Metal (the Lungs belong to Metal in Five Elements theory). When Lung Metal is moistened, it generates Water (Metal generates Water), providing a source like a spring. Once the water has its root, the flow continues endlessly, making it easy to control the Fire. Adding a few herbs for clearing Heat will further ensure fetal stability.
The formula used is Run Zao An Tai Tang (Moistening Dryness and Calming Fetus Decoction).
Prepared Rehmannia Root (Shu Di Huang, 1 liang, steamed nine times), Raw Rehmannia Root (Sheng Di Huang, 3 qian, stir-fried with wine), Cornus Fruit (Shan Yu Rou, 5 qian, steamed), Ophiopogon Tuber (Mai Dong, 5 qian, heart removed), Schisandra Berry (Wu Wei Zi, 3 qian, stir-fried), Donkey-hide Gelatin (E Jiao, 2 qian, stir-fried with clam powder), Scutellaria Root (Huang Qin, 2 qian, stir-fried with wine), Motherwort Herb (Yi Mu Cao, 2 qian).
Decoct in water and take orally. After two doses, the dryness subsides; after another two doses, the fetus stabilizes. Continuous administration for ten doses prevents further fetal restlessness. This formula specifically fills the Essence in the Kidneys while simultaneously tonifying the Lungs. However, tonifying the Lungs is ultimately intended to benefit the Kidneys. If the Kidney Meridian is not dry, Fire cannot scorch the fetus, so there is no reason for the fetus to be unstable.
Marginal Note: The formula is excellent and works immediately. Do not add Dou Gen (Scrophularia Root) or She Gan (Belamcanda Rhizome) simply because of sore throat; nor should you add Fu Ling (Poria) out of fear that the formula is too cloying/moistening.
Verse:
Between the third and fourth months of pregnancy,
Dry mouth and sore throat make the fetus insecure.
In severe cases, blood flows like menstruation,
Extreme Fire activity stems from Water deficiency.
Start with Sheng Di and Shu Di for moistening and calming the fetus,
Add Shan Yu, Wu Wei, and Mai Dong.
Huang Qin, E Jiao, and Yi Mu Cao,
Moisten the Kidney Meridian, and the fetus naturally stabilizes.