妇人正产。犹瓜粟之熟脱。乃候至而气足。半产。如草木之催残。乃枝萎则
实落。盖一顺而一逆也。顺则不计月之足否。总无碍于经络。逆则无问月
之多寡。均有伤于经络。何以言之。如妊娠一二月。足厥阴少阳脉养之。三
四月。手少阴太阳脉养之。五六月。足太阴阳明脉养之。七八月。手太阴阳
明脉养之。九月。足少阴脉养之。十月。则受气足而生矣。苟女子性不善调。
动静违和。既不遵乎胎教。乃轻率而躁妄。以致半产漏下。或三四月而堕
者。则伤手少阴太阳。后至二经而必复堕。五六月而堕者。则伤足太阴阳
明。后至二经而必复坠。甚且三四次。五六次。而终不成孕者有之。故凡遇
半产者。必需兼补气血。加阿胶香附。调养于被伤之余。预固于复孕之日。
使至其所伤之经而不堕。则不患复堕矣。且当其欲堕时。有因暴怒而伤。
有因闪挫而损。或先见红而胎未移。尚可固而安者。或腹疼甚而小腹坠。
不可挽而留者。有小产后去血过多。元气虚脱。而肢冷脉微。用大温补而
愈者。有小产后去之不尽。腹尚疼痛而琳沥未止。兼破恶血而痊者。种种
不一。或补或泻。尤宜斟酌而不可忽耳。
一小产有一二月而堕者。俗以为过期。腹痛凝结而下。殊不知足厥阴少
阳。受伤而孕不固也。治者宜胶艾八珍之类补之。不可误认为凝经也。
一小产年壮气盛。跌扑而伤。宜先去瘀而后补之。质弱经伤。屡堕而下。即
当大补气血。而兼以去瘀可也。
一小产下血不止。用补气养血汤。心腹疼痛。用补血定痛汤。
一胎气不固。时常小产。宜预服安荣汤。加人参以固胎元。
治验
一儒者内室。初秋小产。去血过多。大汗如雨。肢泠脉微。以人参理中汤倍
参。加黄 归芍。连进二三剂。四肢渐暖。汗止脉出。继以人参调理而安。
一女子小产。腹中大痛。治者误行温补而愈甚。用补血定痛汤。复下瘀滞。腹痛遂减。
胶艾汤
阿胶（一两蛤粉炒成珠） 艾叶（半两）
水煎服。
补气养血汤
人参 黄 （蜜炙） 白术（土炒） 当归 白芍药（酒炒） 阿胶珠 香附（各一钱酒炒） 艾叶 川芎 炙甘
草（各五分） 青皮 砂仁（各七分）
水煎。
补血定痛汤
白芍药 当归 熟地 川芎（各一钱） 玄胡索（七分） 桃仁泥 红花（各三分） 香附 青皮 泽兰 牡丹皮
（各五分）
水煎。
安荣汤
当归 白芍 熟地 川芎 阿胶 香附 白术 黄芩 缩砂 糯米 桑寄生
各等分。水煎。
妇女正常分娩，就像瓜果和谷粒成熟后自然脱落一样，是时机已到、气血充足的表现。小产（妊娠12-28周内胎儿自然殒堕），则像草木遭受摧残一样，是因为枝干枯萎导致果实坠落。这是一顺一逆的区别。顺产则不论月份是否足月，总不会损伤经络；小产则无论怀孕多少个月，都会损伤经络。为什么这样说呢？例如怀孕一至两个月，由足厥阴肝经和足少阳胆经滋养胎儿；三至四个月，由手少阴心经和手太阳小肠经滋养；五至六个月，由足太阴脾经和足阳明胃经滋养；七至八个月，由手太阴肺经和手阳明大肠经滋养；九个月，由足少阴肾经滋养；到十个月时，胎儿受气充足便出生了。如果女子性情不善调摄，动静违背和谐，不遵循胎教，轻率躁妄，以致导致小产或漏下出血。若在怀孕三四月时流产，则损伤了手少阴心和手太阳小肠二经，到了这两个经脉当令的后续月份必然再次流产；若在五六月时流产，则损伤了足太阴脾和足阳明胃二经，到了这两个经脉当令的后续月份必然再次坠胎。甚至有三四次、五六次流产最终无法成孕的情况。所以凡是遇到小产的，必须兼补气血，加入阿胶、香附，在被损伤之后进行调养，在准备再次怀孕之前预先固护，使胎儿到达其所伤之经时不再流产，就不必担心再次流产了。而且在小产即将发生之时，有的因暴怒而受伤，有的因闪挫而受损。有的先见红但胎元未动，尚可固摄安胎；有的腹痛剧烈且小腹下坠，不可挽回挽留；有的小产后出血过多，元气虚脱，出现四肢冰冷、脉象微弱，用大温补法治愈的；有的小产后恶露不尽，腹部仍然疼痛且淋漓不止，兼用破血祛瘀法痊愈的。情况种种不一，或用补法或用泻法，尤其应当斟酌考虑，不可疏忽。
有一种小产是在怀孕一两个月时流产的，世俗之人认为是过期流产，腹痛凝结而下，殊不知这是足厥阴肝经和足少阳胆经受伤导致胎元不固。治疗者宜用胶艾汤、八珍汤之类补益，不可误认为是凝滞经血。
有一种小产是年轻体壮、气血旺盛者，因跌扑外伤所致，宜先去瘀血而后补益。如果是体质虚弱、经脉受损、屡次流产者，就应当大补气血，同时兼以祛除瘀血即可。
有一种小产下血不止，用补气养血汤治疗。心腹疼痛，用补血定痛汤治疗。
有一种胎气不固，时常小产，宜预先服用安荣汤，加入人参以固护胎元。
治验案例：
一位儒生的妻子，初秋时节小产，出血过多，大汗如雨，四肢冰冷，脉象微弱。用人参理中汤加倍人参用量，加入黄芪、当归、白芍药，连续服用二三剂后，四肢逐渐回暖，汗止脉出。随后用人参调理而安定。
一位女子小产，腹部剧痛。治疗者误用温补法反而加重病情。改用补血定痛汤，排出瘀滞后，腹痛随即减轻。
补气养血汤
人参 黄芪（蜜炙） 白术（土炒） 当归 白芍药（酒炒） 阿胶珠 香附（各一钱，酒炒） 艾叶 川芎 炙甘草（各五分） 青皮 砂仁（各七分）
水煎。
补血定痛汤
白芍药 当归 熟地黄 川芎（各一钱） 玄胡索（七分） 桃仁泥 红花（各三分） 香附 青皮 泽兰 牡丹皮（各五分）
水煎。
Normal childbirth in women is like the natural shedding of ripe melons or grains; it occurs when the time is right and qi and blood are sufficient. Spontaneous abortion (miscarriage occurring between the 12th and 28th week of pregnancy) is like plants being withered and destroyed, where the fruit falls because the branch has withered. One follows the natural order, while the other goes against it. In normal delivery, regardless of whether the gestational months are full, the meridians are generally not harmed. In miscarriage, regardless of the number of months pregnant, the meridians are inevitably injured. Why is this so? For instance, during the first and second months of pregnancy, the Foot Jueyin Liver Meridian and Foot Shaoyang Gallbladder Meridian nourish the fetus. During the third and fourth months, the Hand Shaoyin Heart Meridian and Hand Taiyang Small Intestine Meridian nourish it. During the fifth and sixth months, the Foot Taiyin Spleen Meridian and Foot Yangming Stomach Meridian nourish it. During the seventh and eighth months, the Hand Taiyin Lung Meridian and Hand Yangming Large Intestine Meridian nourish it. In the ninth month, the Foot Shaoyin Kidney Meridian nourishes it. By the tenth month, the fetus receives sufficient qi and is born. If a woman fails to regulate her temperament, acts in discord with harmony, ignores prenatal care, and behaves rashly or irrationally, leading to miscarriage or uterine bleeding: if miscarriage occurs at three or four months, the Hand Shaoyin Heart Meridian and Hand Taiyang Small Intestine Meridian are injured, and recurrence is inevitable when these meridians govern their respective periods later; if miscarriage occurs at five or six months, the Foot Taiyin Spleen Meridian and Foot Yangming Stomach Meridian are injured, and recurrence is inevitable when these meridians govern their respective periods later. There are cases of three, four, five, or six consecutive miscarriages resulting in infertility. Therefore, whenever encountering miscarriage, one must simultaneously tonify qi and blood, adding Ejiao (Donkey-hide Gelatin) and Xiangfu (Cyperus Rhizome), to regulate after injury and preventively secure before the next conception, ensuring that when the fetus reaches the previously injured meridian, it does not miscarry, thus avoiding recurrence. Furthermore, at the time of impending miscarriage, some are injured by sudden anger, others damaged by physical trauma. Some present with vaginal bleeding but the fetus remains in place, allowing for stabilization and preservation; some suffer severe abdominal pain and lower abdominal bearing-down sensation, making preservation impossible; some experience excessive blood loss after miscarriage, leading to collapse of yuan qi (original qi) with cold limbs and faint pulse, cured by strong warming and tonification; some have incomplete expulsion of lochia, persistent abdominal pain, and continuous dripping discharge, cured by invigorating blood and resolving stasis. The situations vary greatly, requiring careful consideration of whether to use tonification or purgation methods, which should not be neglected.
In some cases of miscarriage occurring at one or two months, laypeople mistakenly consider it overdue abortion with condensation causing abdominal pain and expulsion. In fact, this is due to injury to the Foot Jueyin Liver Meridian and Foot Shaoyang Gallbladder Meridian, leading to unstable pregnancy. Treatment should employ formulas such as Jiao'ai Tang (Ejiao and Mugwort Decoction) or Bazhen Tang (Eight Treasure Decoction) for tonification, and should not be mistaken for stagnant menstrual blood.
In cases where young individuals with robust constitution suffer miscarriage due to falls or blows, one should first resolve blood stasis and then tonify. For those with weak constitutions, damaged meridians, and recurrent miscarriages, one should strongly tonify qi and blood while simultaneously resolving stasis.
For miscarriage with continuous bleeding, use Buxue Yangxue Tang (Qi-Tonifying and Blood-Nourishing Decoction). For heart and abdominal pain, use Buxue Dingtong Tang (Blood-Nourishing and Pain-Stopping Decoction).
For unstable fetal qi with frequent miscarriages, one should pre-administer Anrong Tang (Anning Decoction) with added Renshen (Ginseng Root) to secure the fetal origin.
Clinical Cases:
A scholar's wife suffered miscarriage in early autumn with excessive blood loss, profuse sweating like rain, cold limbs, and faint pulse. She was treated with Renli Zhong Tang (Ginseng and Middle-Warming Decoction) with doubled Renshen dosage, plus Huangqi (Astragalus Root), Danggui (Angelica Sinensis Root), and Baishao (White Peony Root). After two or three doses, limbs warmed, sweating stopped, and pulse returned. Subsequent regulation with Renshen led to recovery.
A woman suffered miscarriage with severe abdominal pain. Previous treatment with warming and tonifying methods exacerbated the condition. Using Buxue Dingtong Tang (Blood-Nourishing and Pain-Stopping Decoction), blood stasis was expelled, and abdominal pain subsided.
Jiao'ai Tang (Ejiao and Mugwort Decoction)
Ejiao (50g, stir-fried with clam powder until bead-like) Aiye (Mugwort Leaf, 25g)
Decoct in water and take orally.
Buxue Yangxue Tang (Qi-Tonifying and Blood-Nourishing Decoction)
Renshen (Ginseng Root), Huangqi (Astragalus Root, honey-fried), Baizhu (Atractylodes Macrocephala Rhizome, earth-fried), Danggui (Angelica Sinensis Root), Baishaoyao (White Peony Root, wine-fried), Ejiaozhu (Ejiao beads), Xiangfu (Cyperus Rhizome, each 3g, wine-fried), Aiye (Mugwort Leaf), Chuanxiong (Ligusticum Chuanxiong Rhizome), Zhi Gancao (Prepared Licorice Root, each 1.5g), Qingpi (Citrus Reticulata Green Peel), Sharen (Amomum Fruit, each 2.1g)
Decoct in water.
Buxue Dingtong Tang (Blood-Nourishing and Pain-Stopping Decoction)
Baishaoyao (White Peony Root), Danggui (Angelica Sinensis Root), Shudihuang (Rehmannia Glutinosa Root, prepared), Chuanxiong (Ligusticum Chuanxiong Rhizome, each 3g), Yuanhusuo (Corydalis Rhizome, 2.1g), Taoren (Peach Seed paste), Honghua (Carthamus Flower, each 0.9g), Xiangfu (Cyperus Rhizome), Qingpi (Citrus Reticulata Green Peel), Zelan (Lycopus Lucidus Herb), Mudanpi (Moutan Cortex, each 1.5g)
Decoct in water.
Anrong Tang (Anning Decoction)
Danggui (Angelica Sinensis Root), Baishao (White Peony Root), Shudihuang (Rehmannia Glutinosa Root, prepared), Chuanxiong (Ligusticum Chuanxiong Rhizome), Ejiao (Donkey-hide Gelatin), Xiangfu (Cyperus Rhizome), Baizhu (Atractylodes Macrocephala Rhizome), Huangqin (Scutellaria Baicalensis Root), Suosha (Amomum Villosum Fruit), Nuomi (Glutinous Rice), Sangjisheng (Taxillus Chinensis Stem)
Equal parts. Decoct in water.