《大全》云∶妊娠胎动不安，由冲任经虚、受胎不实也。亦有饮酒房室过度损动不安者
，有
误击触而胎动者，有喜怒气宇不舒，伤于心肝、触动血脉者，有信医宜服温暖而反为药所误
，
有因母病而胎动者，但治母病其胎自安。有胎不坚固，动及母疾，但当安胎，其母自愈。当
察母之形色，若面赤舌青，子死母活，面青舌赤，口中沫出，母死子活。若唇青，两边沫出
者，子母俱亡。
(即妊妇经来尿血，自尿门下血，漏胎自胞门下血)
《脉经》云∶妇人经月下，但为微少，师脉之，反言有躯。其后审状，其脉何类，何以
别之
?师曰∶寸口脉阴阳俱平，荣卫调和，按之则滑，举之则轻，阳明少阴，各知经法，身反洒
淅，不欲饮食，头痛心乱，呕哕欲吐，呼则微数，吸则不惊，阳多气溢，阴滑气盛，当作血
盛。滑则多实，六经养成，所以月见。阴见阳精，汁凝胞散。散者损堕，设或阳盛，双妊二
胎，今阳不足，故令激经也(滑脉主血有余，今经又少，故主有孕)。大抵妊娠经来不多，而
饮食精神如故，六脉和缓，滑大无病者，血盛有余也。儿大能饮，自不来也。
《大全》云∶夫漏胎者，谓娠孕数月而经水时下也。此由冲任脉虚，不能约制手太阳、
少阴
之经血故也。冲任之脉为经络之海，起于胞内，手太阳小肠脉也，手少阴心脉也。是二经为
表里，上为乳汁，下为月水。有娠之人经水所以断者，壅之养胎，蓄之为乳汁也。冲任气虚
则胞内泄，不能制其经血，故月水时下，亦名胞漏，血尽则人毙矣。又有因劳役喜怒哀乐不
节，饮食生冷，触冒风寒，遂致胎动。若母有宿疾，子脏为风冷所乘，气血失度，使胎不安
，故令下血也。夫有子之后，蓄以养胎矣，岂可复能散动耶?所以然者，因妇人营经有风，
则经血喜动，以此辨之，既营经为风所胜，则所来者非养胎之血。若作漏胎治之，必服补养
保胎之药，且胎不损强，以药滋之，乃所谓实实虚虚也。其胎总宜堕矣。若医者知营经有风
之理，端于一药，治风经信可止(漏胎用风药亦是升举肝气，使血不漏则胎自固，不但疏风
已也)。或不服药，胎亦无恙。然亦有胎本不固而因房室不节先漏而后堕者，须作漏胎治之
，不可不审也。《脉经》云∶妇人怀躯六七月，暴下斗余水，其胞必倚而堕，此非时孤浆预
下故也(孤浆预下必倚而堕，此气血两虚也)。
按薛氏曰∶胎漏黄汁下，或如豆汁，若因肝脾湿热，用升阳除湿汤。血崩肝脾风热，用
加味逍遥散。肝脾郁怒用加味归脾汤，脾胃气虚钱氏白术散，脾气下陷用补中益气汤，肝经风热
用防风黄芩丸，风入肠胃用胃气汤。
《女科大全》说：妊娠期间胎动不安，是由于冲脉和任脉虚弱、受孕不实造成的。也有因为饮酒或房事过度损伤导致胎动不安的；有因误被击打触碰而导致胎动的；有因喜怒情绪导致气机郁结不畅，损伤心肝二脏、触动血脉的；有轻信医生适宜服用温热药物反而被药误伤的；有因母亲患病而导致胎动的，只要治疗母亲的疾病，胎儿自然安固。有因胎儿不坚固，胎动引发母体疾病的，只应当安胎，母亲病自愈。应当观察母亲的形色，如果面色红赤、舌色青紫，是子死母活之象；如果面色青紫、舌色红赤、口中流出泡沫，是母死子活之象。如果嘴唇青紫、嘴角两边流沫，则是母子俱亡。
《脉经》说：妇人月经量少，只是稍微减少，医师诊脉后，反而说是有身孕。后来仔细审察症状，其脉象属于哪一类？如何辨别呢？医师说：寸口脉阴阳平和，营卫调和，重按则脉滑，轻取则脉浮轻，阳明经和少阴经的脉法都符合规律，身体反而恶寒战栗，不想饮食，头痛心烦，恶心欲吐，呼气微快，吸气不惊，阳气盛则气溢，阴气滑则气盛，这应当判断为血盛。滑脉主血有余，六经滋养成形，所以月经来潮。阴见阳精，汁液凝结于胞宫而散开。散开者会导致损伤堕胎，假如阳气过盛，可能是双胎妊娠，现在阳气不足，所以称为激经（滑脉主血有余，现在月经又少，所以主有孕）。大抵妊娠期间月经来量不多，而饮食精神如常，六脉和缓，滑大无病态的，是血盛有余的表现。胎儿长大能吸收营养，自然就不会再来月经了。
《女科大全》说：所谓漏胎，是指怀孕数月而月经时下。这是由于冲脉和任脉虚弱，不能约束手太阳小肠经和手少阴心经的经血缘故。冲脉和任脉是经络之海，起于胞宫内部，手太阳是小肠脉，手少阴是心脉。这两经互为表里，上行化为乳汁，下行化为月水。怀孕的人月经之所以停止，是因为气血壅滞以养胎，蓄积化为乳汁。冲任之气虚弱则胞内泄，不能制约经血，所以月水时下，也称为胞漏，如果血尽则人会死亡。又有因劳累、喜怒哀乐不节制，饮食生冷，触犯风寒，导致胎动。如果母亲有宿疾，子宫被风冷所乘，气血失调，使胎不安稳，所以令下血。有了孩子之后，气血蓄积以养胎，怎么还能再散动呢？之所以这样，是因为妇女的营经有风，则经血喜欢妄动，以此辨别，既然营经被风邪所胜，那么流出来的就不是养胎的血。如果当作漏胎治疗，必然服用补养保胎的药物，而且胎儿不损且强，用药物滋腻之，这就是所谓的“实实虚虚”（使实证更实，虚证更虚）。胎儿最终总会流产。如果医生知道营经有风的道理，专门使用一味治风药，月经可以止住（治疗漏胎使用风药也是升举肝气，使血不漏则胎自固，不仅仅是疏风而已）。或者不服药，胎儿也无恙。然而也有胎儿本来不坚固，因房事不节先出现漏胎而后流产的，必须当作漏胎治疗，不可不审慎。《脉经》说：妇人怀胎六七个月，突然大量下泄如水一斗多，其胞宫必倾斜而堕胎，这是非时孤浆预先下泄的缘故（孤浆预下必致胎堕，这是气血两虚的表现）。
薛己按语说：胎漏流出黄汁，或像豆汁，如果是肝脾湿热，用升阳除湿汤。血崩属肝脾风热，用加味逍遥散。肝脾郁怒用加味归脾汤，脾胃气虚用钱氏白术散，脾气下陷用补中益气汤，肝经风热用防风黄芩丸，风入肠胃用胃气汤。
The *Daquan* (Complete Collection) states: Fetal restlessness during pregnancy is caused by deficiency of the Chong and Ren meridians and unstable conception. There are also cases caused by excessive drinking or sexual intercourse damaging the fetus; cases caused by accidental blows or touches disturbing the fetus; cases caused by anger or joy leading to stagnant Qi, injuring the Heart and Liver, and stirring the blood vessels; cases where trusting a doctor's advice to take warming herbs results in medical error; and cases where the mother's illness disturbs the fetus, in which treating the mother's illness will naturally stabilize the fetus. In cases where the fetus is insecure, causing maternal illness, stabilizing the fetus will cure the mother. One must observe the mother's complexion and tongue: if the face is red and the tongue is cyan, it indicates death of the fetus and survival of the mother; if the face is cyan, the tongue is red, and foam issues from the mouth, it indicates death of the mother and survival of the fetus. If the lips are cyan and foam issues from both corners of the mouth, both mother and fetus will die.
(Referring to pregnant women experiencing hematuria during menstruation, bleeding from the urethra, whereas Lou Tai [Leaking Fetus] involves bleeding from the Bao Men [uterine gate].)
The *Mai Jing* (Pulse Classic) states: When a woman's menstrual flow is merely slightly reduced, but the physician diagnoses pregnancy upon palpation, how should this be distinguished? The physician says: If the Cun Kou pulse is balanced in Yin and Yang, with harmonious Ying and Wei, slippery upon deep pressure, and light upon superficial pressure, conforming to the methods of the Yangming and Shaoyin meridians, accompanied by aversion to cold, loss of appetite, headache, mental confusion, nausea, rapid exhalation, and calm inhalation, with abundant Yang Qi and slippery Yin Qi, this should be interpreted as excess Blood. A slippery pulse indicates excess Blood nourishing the six meridians, hence menstruation occurs. Yin encountering Yang essence causes fluid coagulation in the Bao Gong [uterus]; dispersion leads to damage or abortion. If Yang were excessive, it might indicate twins; since Yang is insufficient here, it is called "Ji Jing" [Stimulated Menses] (A slippery pulse governs Blood excess; combined with scanty menses, it governs pregnancy). Generally, if menstrual flow during pregnancy is scanty, while diet and spirit remain normal, and the six pulses are gentle, slippery, and large without pathology, it indicates Blood excess. Once the fetus grows and consumes nutrients, menstruation ceases naturally.
The *Daquan* states: "Lou Tai" [Leaking Fetus] refers to vaginal bleeding occurring monthly during pregnancy. This is due to deficiency of the Chong and Ren meridians, failing to control the blood of the Hand-Taiyang Small Intestine meridian and Hand-Shaoyin Heart meridian. The Chong and Ren meridians are the sea of the collaterals, originating within the Bao Gong. The Hand-Taiyang is the Small Intestine meridian, and the Hand-Shaoyin is the Heart meridian. These two meridians are exterior-interior pairs; upward they transform into milk, downward into menstruation. During pregnancy, menstruation stops because Qi and Blood are congested to nourish the fetus and stored as milk. Deficiency of Chong and Ren Qi leads to leakage within the Bao Gong, inability to control menstrual blood, hence monthly bleeding, also called "Bao Lou" [Uterine Leakage]; if blood exhausts, death ensues. Other cases arise from labor, unregulated emotions, consumption of raw/cold foods, or exposure to wind-cold, leading to fetal restlessness. If the mother has chronic disease, the Zi Zang [uterus] is invaded by wind-cold, disrupting Qi and Blood, unsettling the fetus, causing bleeding. After conception, Qi and Blood are stored to nourish the fetus; how can they disperse? This happens because Wind invades the Ying meridians, causing Blood to move recklessly. Thus, the flowing blood is not that which nourishes the fetus. Treating this as Lou Tai by administering tonic/fetal-stabilizing herbs would be "reinforcing excess and depleting deficiency," likely leading to miscarriage. If the physician understands the Wind in Ying meridians, using a single Wind-dispersing herb can stop menstruation (Wind herbs for Lou Tai also lift Liver Qi, securing the fetus by stopping leakage, not just dispersing Wind). Or, without medication, the fetus may remain safe. However, if the fetus was inherently insecure and miscarried after initial leakage due to immoderate intercourse, it must be treated as Lou Tai, requiring careful differentiation. The *Mai Jing* states: In the sixth or seventh month of pregnancy, sudden profuse discharge of water (over a dou) causes the uterus to tilt and abort; this is premature discharge of "Gu Jiang" [isolated amniotic fluid] (Premature Gu Jiang discharge inevitably leads to abortion, indicating dual deficiency of Qi and Blood).
Xue Ji notes: For Lou Tai with yellow discharge or bean-juice-like fluid, due to Damp-Heat in Liver and Spleen, use Sheng Yang Chu Shi Tang [Yang-Raising Damp-Draining Decoction]. For uterine hemorrhage due to Wind-Heat in Liver and Spleen, use Jia Wei Xiao Yao San [Modified Free Wanderer Powder]. For Liver-Spleen depression and anger, use Jia Wei Gui Pi Tang [Modified Restore the Spleen Decoction]; for Spleen-Stomach Qi deficiency, use Qian Shi Bai Zhu San [Child Master's Atractylodes Powder]; for Spleen Qi sinking, use Bu Zhong Yi Qi Tang [Tonify the Middle and Augment the Qi Decoction]; for Wind-Heat in the Liver channel, use Fang Feng Huang Qin Wan [Saposhnikovia and Scutellaria Pills]; for Wind invading the intestines and stomach, use Wei Qi Tang [Stomach-Qi Decoction].