凡受孕二三月。必呕吐恶心。此月水不通。阳明壅盛。故不安食。但此是始膏始凝始 之时。骤
然壅盛故耳。迨四五月。则血渐荫胎儿形体成。便具五行生克循环之理。则血有所归。而不壅盛
矣。或曰血壅盛。何独于胃有病。曰。胃为多气多血之海。五脏之母也。女子应有是生。应有是
化。今不行而成孕。骤然不化。阳明气血俱盛。遂有是上僭之势。久之自平。不足虑也。然有微
甚。微者饮食调理。甚者六君子汤加砂仁生姜以和之。或曰。半夏损胎可信乎。曰。独食半夏一味。
虽非胎亦能损人。若与参术同用。但着开胃健脾之功耳。（正所谓当论方不当论药。当就方以论
药。不当执药以论方也。论药只好就一味单方而论耳。）曰。思食何为。曰。胃气盛则思食。血
壅则气逆。气逆则食入反出也。或女子性气褊急者。于六君子汤中。佐黄芩以清火。消息用之。
调治胎前呕吐。不出此方主之。如原有胃脘痛。而此时夹发。加丹皮山栀。如发热。不必加退热
药。只以此方调之。胎前下血。名曰漏胎。气不摄血也。多服补中益气汤。其恼怒伤肝。肝木贼
土。血不能藏。而成漏者。加味逍遥散加生地。（此症有风热血热血虚脾火。及脾胃虚弱虚陷之
别。当随症施治。其年壮人六脉平和。饮食如故。无所苦而经时下。是气血旺。养胎之余血也。然
亦不可使之多去。须和血凉血健脾为主。
胎动不安。血不养胎也。四物汤去川芎。即用亦不过五
分。加白术杜仲。有肝旺而动者。必痛无定处。归芍生地加黄芩白术甘草。如气虚者。必怠
惰嗜卧。脉必豁大而缓。补中益气汤加酒炒白芍。（此症须合邯郸遗稿辨别参治。其法乃全。）
堕胎。即俗所谓小产也。总属气虚血虚。及纵欲嗜酒而来。医家动云热则流动。胎火逼迫。不知
气血调和。胎火何由而生。岂胎不属母身。别有一动耶。寒凉杂投。利气行血。卒至堕胎。岂非
医害之耶。既堕之后。犹不禁忌。前以是月堕。后复期而来矣。不伸救补。止作火治。以致三胎
四胎。逢期必堕。乌能有济。予每于未堕之前。大料黄 丸预补之。将堕之际。大料补中益气汤
加酒炒白芍。勿论其脉。勿论其时。一概峻补中宫母气。万无一失。即先贤有一经配一月以补其
经者。亦皆昧于阴阳之理。不足信也。（此症由两肾亏损者尤多）子肿。子悬。子嗽。子泻。小
便不通。俱当用补中益气汤。有胎火盛而致此数种病者。用四物汤去川芎。加黄芩白术茯苓甘草
以和之。独子泻挟火。宜四君子汤加黄芩砂仁。胎前伤寒疟痢。悉以固胎为主。伤寒根据平时伤寒
治。自不损胎。但当倍用归芍。或当用参。须平时预先料理。独前胡汤与半夏白芷不可用。若小
柴胡有人参。半夏亦不妨矣。疟疾亦与平时不甚异。但清中驱疟饮。去苍楂枳实。余俱如法。大
抵黄芩为胎前疟中要药。总当视病患之盛衰而消息之。（或问。白术黄芩。安胎之圣药也。二味胎
前必不可缺乎。赵氏曰。未必皆然也。胎茎之系于脾。犹钟之系于梁也。若栋柱不固。栋梁必桡。
所以安胎先固两肾。使肾中和暖。始脾有生气。何必定以白术黄芩为安胎之药也。腹中有热胎不
安。固用凉药。腹中有寒胎不安。必用温药。此常法也。殊不知两肾之中。具有水火。系冲任之
根。胎元之所系甚要。非白术黄芩之可安也。如肾中无水胎不安者。用六味地黄汤壮水。肾中无火
用八味地黄汤壮火。故当以杜仲川断阿胶艾叶当归五味等药。出入于六味八味汤中为快捷方式。总之
一以贯之也。此论为诸书所未及。今特表而出之。）
凡是受孕两三个月时，必然出现呕吐恶心的症状。这是因为此时经血停止流通，阳明经气壅盛，所以导致饮食不安。但这正是胚胎开始形成、精血开始凝结的时期，骤然出现气血壅盛的情况罢了。等到四五月时，血液逐渐滋养胎儿，形体长成，便具备了五行生克循环的道理，那么血液就有了归属，不再壅盛了。有人问：既然血气壅盛，为什么唯独在胃上产生病症？回答说：胃是容纳多气多血的海洋，也是五脏的母亲。女子怀孕本应有这样的生理变化，也应有这样的转化过程。现在因为不行经而怀孕，骤然没有正常的经血转化，导致阳明经的气血都旺盛，于是产生了向上冲逆的趋势。时间久了自然会平复，不必担忧。然而病情有轻重之分，轻的用饮食调理；重的用六君子汤加入砂仁、生姜来调和它。有人问：半夏损伤胎气，这可信吗？回答说：单独食用半夏一味药，即使不是孕妇也能损害人体健康。但如果与人参、白术同用，只起到开胃健脾的功效罢了。（这正是所说的应当讨论方剂而不是单纯讨论药物，应当结合方剂来分析药物，而不应当执着于药物去否定方剂。讨论药物最好仅限于单味单方而言。）问：为什么会想吃东西？答：胃气旺盛就会想吃东西。血气壅滞则导致气机逆乱，气机逆乱则食物吃进去后反而吐出来。如果女子性情急躁偏激的，在六君子汤中辅助加入黄芩以清泻火邪，根据情况斟酌使用。调理胎前呕吐，不出这个方子作为主方。如果原本就有胃脘痛，而此时夹杂发作，加入牡丹皮、山栀。如果有发热，不必加退热药，只用这个方子调理即可。
胎前下血，名叫漏胎，这是气不能统摄血液的缘故。多服用补中益气汤。如果是恼怒伤肝，肝木克制脾土，导致血液不能藏守而成漏血的，用加味逍遥散加入生地。（这种病症有风热、血热、血虚、脾火以及脾胃虚弱下陷的区别，应当根据症状施治。那些年轻力壮的人，六脉平和，饮食如常，没有什么痛苦而月经按时来潮的，这是气血旺盛，是养胎后多余的血液。然而也不可使它们流失过多，必须以和血、凉血、健脾为主。）
胎动不安，是血不能滋养胎元。用四物汤去掉川芎。即使用了川芎，也不过五分量，加入白术、杜仲。如果有肝旺导致胎动的，必定疼痛位置不定，用当归、白芍、生地加入黄芩、白术、甘草。如果是气虚的，必定倦怠懒惰嗜睡，脉象必定豁大而缓，用补中益气汤加入酒炒白芍。（这种病症必须结合《邯郸遗稿》的方法来辨别参治，其方法才是完整的。）
堕胎，就是俗话所说的小产。总属于气虚血虚，以及纵欲、嗜酒引起的。医生动不动就说热则流动，胎火逼迫，不知道气血调和，胎火从哪里产生呢？难道胎儿不属于母体，另外有一个动力吗？胡乱投用寒凉药物，利气行血，最终导致堕胎，这难道是医生害的吗？既然已经堕胎之后，仍然不禁止房事等禁忌，以前在这个月份堕胎，后来又在同样的月份再次发生。不加以救补，只当作火证治疗，以致第三胎第四胎，到了那个时期必然堕胎，怎么能有救治呢？我每次在即将堕胎之前，大量使用地黄丸预先进补。在即将堕胎之际，大量使用补中益气汤加入酒炒白芍。不论脉象如何，不论时间早晚，一概峻补中焦脾胃之气，万无一失。即使是先贤有一经对应一个月来补益该经的说法，也都昧于阴阳的道理，不值得相信。（这种病症由两肾亏损导致的尤其多。）
子肿（妊娠肿胀）、子悬（妊娠胸腹胀满）、子嗽（妊娠咳嗽）、子泻（妊娠泄泻）、小便不通，都应当用补中益气汤。有因胎火旺盛而导致这几种病的，用四物汤去掉川芎，加入黄芩、白术、茯苓、甘草来调和它。唯独子泻夹带火邪的，宜用四君子汤加入黄芩、砂仁。胎前患伤寒、疟疾、痢疾，都以固护胎元为主。伤寒根据平时治疗伤寒的方法处理，自然不损伤胎元，但应当加倍使用当归、白芍，或者应当用人参，必须在平时预先料理。唯独前胡汤与半夏白芷不可用。如果小柴胡汤里有人参，半夏也无妨了。疟疾也与平时不太不同，只是清中驱疟饮要去掉苍术、山楂、枳实，其余都照法处理。大抵黄芩是胎前疟疾中的要药，总要根据病人的虚实盛衰来斟酌使用。（有人问：白术和黄芩，是安胎的圣药，这两味药在胎前必不可缺吗？赵氏说：未必都是这样。胎茎系于脾，就像钟悬挂在梁上一样。如果栋梁不坚固，梁一定会弯曲。所以安胎首先要巩固两肾，使肾中温暖中和，然后脾才有生气，何必一定把白术和黄芩当作安胎的药呢？腹中有热胎不安，固然用凉药；腹中有寒胎不安，必用温药，这是常法。却不知道两肾之中，具有水火，是冲任二脉的根本，胎元所系非常重要，不是白术和黄芩所能安定的。如果肾中无水导致胎不安的，用六味地黄汤壮水；肾中无火用八味地黄汤壮火。所以应当以杜仲、川断、阿胶、艾叶、当归、五味子等药，出入于六味地黄汤和八味地黄汤中使用为快捷方式。总之是一理贯通的。这个论述是其他书籍所未涉及的，现在特别提出并阐明它。）
When conception occurs for two or three months, vomiting and nausea are inevitable. This is because the menstrual blood ceases to flow at this time, causing an excess and stagnation of the Yangming channel qi, leading to discomfort with food intake. However, this is precisely the time when the embryo begins to form and the essence and blood begin to coagulate; thus, the sudden excess of qi and blood is merely a temporary state. By the fourth or fifth month, the blood gradually nourishes the fetus, its physical form matures, and it embodies the principles of the cyclical generation and restriction of the Five Elements. At this point, the blood has its proper destination and no longer stagnates excessively. One might ask: If the blood and qi are stagnant and excessive, why does pathology manifest specifically in the Stomach? The answer is that the Stomach is the sea of abundant qi and blood, and the mother of the five Zang organs. It is natural for women to undergo such physiological changes and transformations during pregnancy. Since menstruation stops due to pregnancy, the normal transformation of menstrual blood is abruptly halted, causing both qi and blood of the Yangming channel to become vigorous, resulting in a tendency to rebel upwards. Over time, this will naturally subside and need not be a cause for concern. Nevertheless, there are mild and severe cases. Mild cases can be managed with dietary regulation; severe cases require Liu Junzi Tang (Six Gentlemen Decoction) with added Amomum fruit (Sha Ren) and fresh ginger to harmonize the condition. One may ask: Is it true that Pinellia ternata (Ban Xia) damages the fetus? I reply: Consuming Pinellia ternata alone, even in non-pregnant individuals, can harm the body. However, when used together with Ginseng root (Ren Shen) and Atractylodes macrocephala rhizome (Bai Zhu), it only serves the function of opening the stomach and strengthening the spleen. (This illustrates the principle that one should evaluate formulas rather than isolated herbs; herbs should be analyzed within the context of the formula, not vice versa. Discussion of herbs is best limited to single-herb prescriptions.) Why is there a craving for food? The response is: When Stomach qi is vigorous, there is an appetite. Blood stagnation leads to rebellious qi; rebellious qi causes ingested food to be vomited back up. For women with irritable or aggressive temperaments, Huang Qin (Scutellaria baicalensis radix) can be added to Liu Junzi Tang to clear heat, dosed according to circumstances. The treatment of vomiting during pregnancy generally centers on this formula. If there was pre-existing epigastric pain that flares up during pregnancy, add Moutan cortex (Dan Pi) and Gardenia jasminoides seed (Shan Zhi). If fever is present, antipyretics are unnecessary; simply regulate with this formula.
Vaginal bleeding during pregnancy is called "Lou Tai" (Leaking Fetus), caused by Qi failing to contain the blood. Frequent use of Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) is indicated. If anger injures the Liver, causing Liver Wood to overact on Spleen Earth, leading to blood failure to be stored and resulting in leakage, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) with Rehmannia glutinosa root (Sheng Di) is used. (This condition varies by wind-heat, blood-heat, blood deficiency, Spleen fire, and Spleen Qi sinking; treatment must be tailored to symptoms. In young, robust women with smooth pulses and normal diet who experience regular menstruation without distress, this represents abundant Qi and blood, leaving surplus blood after fetal nourishment. However, excessive loss should be prevented, focusing primarily on harmonizing, cooling, and strengthening the blood and Spleen.)
Restless fetus is caused by blood's inability to nourish the fetus. Siwu Tang (Four Substance Decoction) is used, removing Chuanxiong rhizome (Chuan Xiong). Even if Chuan Xiong is retained, the dose should not exceed 1.5 grams (five fen), adding Atractylodes macrocephala rhizome (Bai Zhu) and Eucommia bark (Du Zhong). If Liver hyperactivity causes restlessness, characterized by wandering pain, use Dang Gui (Angelica sinensis radix), Bai Shao (White Peony root), Sheng Di, Huang Qin, Bai Zhu, and Gan Cao. If Qi deficiency is present, manifested by lethargy and drowsiness with a large, slow, and empty pulse, use Buzhong Yiqi Tang with wine-fried Bai Shao. (This condition requires differentiation based on methods from *Handan Yigao*; following those methods comprehensively is essential.)
Abortion, commonly known as miscarriage, generally stems from Qi and Blood deficiency, or from excessive sexual activity and alcohol consumption. Physicians often attribute it to heat causing fluidity or fetal fire forcing expulsion, failing to realize that when Qi and Blood are harmonious, where would fetal fire originate? Does the fetus not belong to the mother's body, possessing its own independent motion? Indiscriminate use of cold-natured drugs promotes Qi movement and blood circulation, ultimately leading to abortion. Is this not medical harm? After abortion, if taboos are not observed, recurrence in subsequent pregnancies at the same gestational age is likely. Failing to rescue and tonify, instead treating solely as fire syndromes, leads to recurrent abortions in third or fourth pregnancies. How can this be helped? I typically prescribe Dihuang Wan (Rehmannia Pill) in substantial doses beforehand to prevent impending abortion. At the critical moment, I prescribe Buzhong Yiqi Tang with wine-fried Bai Shao in substantial doses. Regardless of pulse or timing, I vigorously tonify the Middle Jiao and Mother Qi, ensuring safety. Even the ancient theory of tonifying specific meridians corresponding to specific months is ignorant of Yin-Yang principles and unreliable. (This condition is particularly common due to Kidney Essence deficiency.)
Zi Zhong (pregnancy edema), Zi Xuan (pregnancy chest/abdominal distension), Zi Sou (pregnancy cough), Zi Xie (pregnancy diarrhea), and urinary retention should all be treated with Buzhong Yiqi Tang. If these conditions are caused by excessive fetal fire, use Siwu Tang minus Chuan Xiong, plus Huang Qin, Bai Zhu, Fu Ling, and Gan Cao to harmonize. Specifically for Zi Xie with fire, use Sijunzi Tang (Four Gentlemen Decoction) plus Huang Qin and Sha Ren. For cold damage, malaria, or dysentery during pregnancy, the primary goal is securing the fetus. Cold damage is treated according to standard protocols without harming the fetus, but Dang Gui and Bai Shao should be doubled, or Ren Shen used, with preparation made in advance. Qian Hu Tang (Peucedanum Root Decoction) and Ban Xia Baizhi (Pinellia and Angelica Dahurica) are contraindicated. However, if Xiao Chaihu Tang contains Ren Shen, Ban Xia is permissible. Malaria treatment is similar to standard practice, except Qingzhong Qumei Yin (Clear Middle and Expel Malaria Decoction) should exclude Cang Zhu, Shan Zha, and Zhi Shi. Generally, Huang Qin is a key herb for malaria in pregnancy; dosage must be adjusted based on the patient's strength and weakness. (One asks: Are Bai Zhu and Huang Qin indispensable holy medicines for securing the fetus? Zhao states: Not necessarily. The fetus is attached to the Spleen like a bell hangs from a beam; if the beam is weak, it bends. Thus, securing the fetus first requires consolidating the two Kidneys, warming and neutralizing the Kidney area, so the Spleen gains vital energy. Why insist on Bai Zhu and Huang Qin? If heat in the abdomen causes restlessness, coolants are used; if cold causes restlessness, warmers are used—this is the standard method. However, the two Kidneys contain Water and Fire, serving as the root of the Chong and Ren vessels and the foundation of the fetal origin, which Bai Zhu and Huang Qin cannot secure alone. For fetal restlessness due to Kidney Water deficiency, use Liuwei Dihuang Tang (Six-Ingredient Pill with Rehmannia) to nourish water; for Kidney Fire deficiency, use Shenwei Dihuang Tang (Eight-Ingredient Pill with Rehmannia) to strengthen fire. Therefore, using Du Zhong, Xu Duan, Ejiao, Ai Ye, Dang Gui, and Wu Wei Zi within Liuwei or Shenwei Dihuang Tang is the most efficient approach. Ultimately, one principle runs through all. This discussion is unique and not found in other texts, so it is hereby highlighted.)