【歌】妇人小产可寒心，或用芎归或用参，去血过多宜大补，停痰昏闷服乌金。
【论】《产宝》曰∶凡驴马有孕，牡者近身则蹄之，名曰护胎，所以绝无小产之患。人之胎，系胞中气血
养之，静则神藏，躁则消亡，欲火一动则精神走泄，火扰于中则胎坠矣。齐仲甫曰∶小产有下血不止、血凝不出
二症，盖血得寒则凝，得热则行，若坠胎损经，其血不止，必烦闷而死。或因风冷坠胎，血冷相搏，气虚血逆，甚
则血结不出，抢上攻心，闷绝而死。当温经逐寒，其血自行。若血淋沥不止，是冲任气虚，不能约束，宜胶艾汤。
大抵腹痛者为实，按之更痛，手不可近者，宜逐瘀生新，芎归汤、失笑散之类是也。不腹痛者为虚，按之痛减者
亦为虚，宜用温补，四神汤、炮姜、肉桂之类。
【方】
乌金散
好墨（二两烧赤醋淬七次，又烧赤放冷研） 没药 血竭（各五钱） 麝（一分）
为末每服温酒调一钱，如血迷，童便调服二钱立醒。
当归散
当归（一两五钱） 阿胶（三两） 艾叶（一两） 川芎（一两）
每用四钱水煎入姜汁一匙，生地汁五合煎五六沸，温服。
【歌】风雷晦冥合阴阳，恶气乘胎产异常，更有异中还异者，相期博学漫推详。
【论】李时珍曰∶胎十月而生常理也。而有七月、八月生者，十二、三月生者，十四、五月生者，或云气虚也。
《医学正传》言∶有十七、八月至二十四、五月生者。刘敬叔异死言太源温盘古，孕三年乃生，岂亦气虚耶。今孕七
月生者多育，八月生者多夭，是七变而八不变也。《晋书》符坚母孕十三月而生，《汉书》尧及昭帝皆孕十四月生，
刘聪母孕十五月而生，搜神记云黄帝孕二十五月而生，皆常中之异者也。胞门子脏为奇恒之府，所以为生人之户，
常理也。而有自胁产，自额产，自背产，自髀产者何也。岂子脏受气驳离，而其系有不同。如宋史所记，男阴生于脊，
女阴生于头之类耶。《史记》云∶陆终氏娶鬼方之女，孕而左胁出三人，右胁出三人。如修已背坼而生禹，简狄胸
坼而生契也。魏黄初六年，孔羡表言汝南屈壅妻王氏生男，从右胁下小腹上出，子母全安。异死曰∶晋时李宣妻樊氏
义熙中怀孕不生，而额上有疮，儿从疮出。又赵宣母妊，股髀作痒，搔之成疮，儿从疮出。嵩山记阳翟有妇人妊三十
月，儿从母背出，五岁便入山学道去。琅琊钞云成化中宿州，妇孕胁肿如痈，及期儿从痈出，疮 随合，其子名佛
记儿。隆庆五年二月唐山县民妇有孕，左胁肿起，儿胁生，子母俱无恙，此皆产理异中之异者也。女子二七天癸至，
任脉通，故有子。七七天癸绝，无子常理也。乃有十二岁而生子者，如褚记室所载，平江苏达卿之女类是也。有妇人五
十、六十而生子者，如辽史所载，亟普妻年六十生二男一女，此则异中之常者也。《玄珠密语》曰∶人生三子主太平，
人生三女主淫失，政人生十子，诸侯竞位。人生肉块，天下饥荒，此就人事而论，气化所感，别有所关也。如西樵
野记载，嘉靖己酉横泾佣农孔方忽患膨胀，愦愦几数月，自胁产一肉块，剖视之，一儿肢体，毛发悉具也。又有
人生于卵，生于马之类，徐偃王之母产卵，弃之，孤独老母取伏之，出一儿。汉末有马生人，名曰马异，此皆造化
无穷之变异也。
【歌诀】妇女小产（早期流产）令人惊心，治疗可用川芎、当归，或者用人参；若失血过多应当大补气血，若有痰饮停滞导致昏闷则服用乌金散。
【论述】《产宝》说：凡是驴马怀孕，公畜靠近时母畜会用蹄子踢它，名叫“护胎”，所以完全没有小产的祸患。人类的胎儿，依靠胞宫中的气血来滋养，安静则神气内藏，躁动则精气消亡，欲火一动则精神外泄，火热扰动于中焦则胎元坠落。齐仲甫说：小产有下血不止、血液凝滞排不出两种症状，大概血液遇寒则凝结，遇热则运行，如果坠胎损伤经脉，血液不止，必然烦闷而死。或者因为风冷导致坠胎，血与冷相搏结，气虚血逆，甚至血液结聚排不出，冲上攻心，闷绝而死。此时应当温经逐寒，血液自然运行。如果血液淋沥不止，这是冲任二脉气虚，不能约束血液，适宜用胶艾汤。大体上腹痛属于实证，按压时疼痛加剧，手不可触碰的，适宜逐瘀生新，如芎归汤、失笑散之类的方剂。不腹痛属于虚证，按压时疼痛减轻的也属于虚证，适宜使用温补法，如四神汤、炮姜、肉桂之类的药物。
【方剂】
乌金散
好墨（二两烧红后用醋淬炼七次，再烧红放冷后研磨） 没药 血竭（各五钱） 麝香（一分）
研为细末，每次服用一钱，用温酒调服；如果血迷心神，用童便调服二钱，立刻清醒。
当归散
当归（一两五钱） 阿胶（三两） 艾叶（一两） 川芎（一两）
每次取四钱，用水煎煮，加入姜汁一匙，生地汁五合，煎煮五六沸，温服。
【歌诀】风雷昏暗之时阴阳交合，恶气乘袭胎产出现异常，更有奇异中的奇异者，期望博学之人不要随意推测详究。
【论述】李时珍说：胎儿十月分娩是常理。但有七月、八月出生的，十二个月、十三个月出生的，十四个月、十五个月出生的，有人说这是气虚所致。《医学正传》说：有十七、八个月到二十四、五个月出生的。刘敬叔《异苑》记载太原温盘古，怀孕三年才出生，难道也是气虚吗？现在怀孕七个月出生的大多能养育存活，八个月出生的大多夭折，这是七变而八不变的道理。《晋书》记载符坚的母亲怀孕十三个月才出生，《汉书》记载尧和汉昭帝都怀孕十四个月才出生，刘聪的母亲怀孕十五个月才出生，《搜神记》说黄帝怀孕二十五个月才出生，这些都是常理中的变异。胞门子脏（子宫）是奇恒之府，是生育人的门户，这是常理。但有从胁部产出、从额头产出、从背部产出、从大腿产出的，为什么呢？难道是子脏受气驳杂分离，且系带有所不同？比如《宋史》所记载，男婴阴部长在脊背上，女婴阴部长在头上之类的情形吗？《史记》说：陆终氏娶鬼方之女，怀孕后左胁生出三人，右胁生出三人。像修己背部裂开而生禹，简狄胸部裂开而生契一样。魏黄初六年，孔羡上表说汝南屈壅的妻子王氏生男孩，从右胁下小腹上方出来，母子全安。《异苑》说：晋朝李宣的妻子樊氏在义熙年间怀孕不生，额头上长疮，婴儿从疮口中生出。又有赵宣的母亲怀孕，大腿髀部发痒，抓挠成疮，婴儿从疮口中生出。《嵩山记》记载阳翟有一位妇人怀孕三十个月，婴儿从母亲背部生出，五岁便入山学道离去。《琅琊钞》记载成化年间宿州，一位妇人怀孕胁部肿胀如痈，到期时婴儿从痈肿处生出，疮口随即愈合，她的儿子名叫佛记儿。隆庆五年二月，唐山县民妇怀孕，左胁肿起，婴儿从胁部生出，母子都无恙，这些都是产理中奇异中的奇异现象。女子十四岁天癸至，任脉通畅，所以能怀孕生子。四十九岁天癸绝，不能生子是常理。却有十二岁就生子的，如褚记室所载，平江苏达卿的女儿就是这类情况。有妇人五十岁、六十岁还生子的，如《辽史》所载，亟普的妻子六十岁生了二男一女，这则是奇异中的常理。《玄珠密语》说：人生三子主太平，人生三女主淫乱，政人生十子，诸侯争位。人生肉块，天下饥荒，这是就人事而言，气化感应，另有关系。如《西樵野载》记载，嘉靖己酉年横泾佣农孔方忽然患膨胀病，昏昏沉沉几个月，从胁部产出一块肉，剖开看，是一个婴儿的肢体，毛发都具备。又有人生于卵，生于马之类，徐偃王的母亲产卵，被丢弃，孤独老母捡回来伏在上面孵化，生出一个婴儿。汉末有马生人，名叫马异，这些都是造化无穷的变化。
[Song] Women's miscarriage (early abortion) is heart-rending; treatment may involve Chuanxiong Rhizome and Angelica Sinensis Decoction, or Ginseng Root; if excessive blood loss occurs, major tonification is indicated; if phlegm stagnation causes dizziness and oppression, Wu Jin San should be administered.
[Discussion] *Chanbao* states: When donkeys or horses are pregnant, the male approaches, and the female kicks him with her hooves, a behavior called "protecting the fetus," thus avoiding miscarriage entirely. In humans, the fetus is nourished by the Qi and Blood in the Bao Gong (uterus). Stillness allows the Shen (spirit) to remain stored; agitation causes essence and Qi to dissipate. If desire-fire arises, spirit leaks outward; fire disturbs the interior, causing the fetus to fall. Qi Zhongfu stated: Miscarriage presents with two symptoms: continuous bleeding or retained clotted blood. Generally, blood coagulates when cold and flows when hot. If the fetus falls and meridians are damaged, leading to unceasing bleeding, death from vexation and oppression will follow. Alternatively, wind-cold may cause fetal expulsion; cold blood clashes, Qi deficiency leads to rebellious Blood, and severe cases result in blood coagulation failing to exit, rushing upward to attack the Heart, causing sudden unconsciousness and death. At this time, warming the meridians and expelling cold is required so that blood flows naturally. If blood drips continuously without stopping, it indicates Qi deficiency of the Chong and Ren vessels, failing to constrain blood; Jiao Ai Tang is appropriate. Generally, abdominal pain indicates an Excess pattern; tenderness upon pressure, where the abdomen cannot be touched, suggests expelling stasis and generating new blood, using formulas such as Xiong Gui Tang or Shi Xiao San. Lack of abdominal pain indicates a Deficiency pattern; reduced pain upon pressure also indicates Deficiency, requiring warm tonification, using substances like Si Shen Tang, Pao Jiang (Processed Ginger), or Rou Gui (Cinnamon Bark).
[Formula]
Wu Jin San (Black Ink Powder)
Good Ink (2 liang, burned red, quenched in vinegar seven times, burned red again, cooled, and ground) Myrrh Hematite (each 5 qian) Musk (1 fen)
Grind into fine powder. Take 1 qian per dose, mixed with warm wine. If blood confusion affects the mind, take 2 qian mixed with child's urine for immediate awakening.
Dang Gui San (Angelica Sinensis Powder)
Dang Gui (1.5 liang) Ejiao (3 liang) Ai Ye (1 liang) Chuan Xiong (1 liang)
Take 4 qian each time, decoct in water, add 1 spoonful of fresh ginger juice and 5 he of Sheng Di Huang juice, boil for five to six boils, and take warm.
[Song] When wind and thunder darken the sky and Yin-Yang unite, evil qi attacks the fetus and birth becomes abnormal. There are even more bizarre anomalies among these oddities; scholars are urged not to speculate rashly.
[Discussion] Li Shizhen stated: Ten months of gestation is the normal rule. However, births occur at seven or eight months, twelve or thirteen months, fourteen or fifteen months; some attribute this to Qi deficiency. *Yixue Zhengchuan* mentions births at seventeen or eighteen months up to twenty-four or twenty-five months. Liu Jingshu's *Yi Yuan* records Wangu Pan of Taiyuan, who was pregnant for three years before giving birth; could this also be due to Qi deficiency? Currently, fetuses born at seven months often survive, while those at eight months often die early; this reflects the principle that seven transforms but eight does not stabilize. *Jin Shu* records that Fu Jian's mother was pregnant for thirteen months. *Han Shu* records that Emperor Yao and Emperor Zhao of Han were both pregnant for fourteen months. Liu Cong's mother was pregnant for fifteen months. *Soushen Ji* states the Yellow Emperor was pregnant for twenty-five months. These are all anomalies within the norm. The Bao Men Zi Zang (uterus) is a Qi Heng Zhi Fu (extraordinary fu organ), serving as the gateway for human generation, which is the norm. Yet, births occur from the hypochondrium, forehead, back, or thighs. Why? Is it because the Zi Zang receives scattered Qi, and its ligaments differ? For instance, as recorded in *Song Shi*, a male infant had genitals on his spine, and a female infant had them on her head. *Shiji* states: Lu Zhong married a woman from Guifang; she gave birth to three sons from her left hypochondrium and three from her right. Similarly, Xiuci gave birth to Yu after her back split, and Jiedi gave birth to Xie after her chest split. In the sixth year of Huangchu of Wei, Kong Xian memorialized that Qu Yong's wife Wang gave birth to a boy emerging from the upper part of her lower abdomen near the right hypochondrium, with both mother and child safe. *Yi Yuan* records that Fan Shi, wife of Li Xuan during the Yixi era, was pregnant but did not deliver; she developed a sore on her forehead, and the baby emerged from it. Another case involves the mother of Zhao Xuan, whose thighs itched until sores formed, from which the baby emerged. *Songshan Ji* records a woman in Yangdi who was pregnant for thirty months and gave birth through her back; the child went to study the Dao in the mountains at age five. *Langya Chao* records that during the Chenghua era in Suzhou, a pregnant woman had a tumor-like swelling on her hypochondrium; at term, the baby emerged from the tumor, which healed immediately. Her son was named Foji'er. In February of the fifth year of Longqing, a woman in Tangshan County had a swelling on her left hypochondrium and gave birth via the side; both mother and child were unharmed. These are anomalies among anomalies in obstetrics. Women typically conceive when Tian Gui arrives at age fourteen and the Ren Mai is unblocked. Infertility usually begins when Tian Gui ceases at age forty-nine, which is the norm. Yet, some give birth at age twelve, such as the daughter of Su Daqing of Pingjiang recorded by Chu Jishi. Some give birth at fifty or sixty, such as the wife of Ji Pu in *Liao Shi*, who bore two sons and one daughter at sixty; this is the norm within the anomaly. *Xuanzhu Miyu* states: Three children born presage peace; three daughters presage licentiousness; ten children presage warlords competing for power. Birth of a flesh mass presages famine. This interpretation is based on human affairs and Qi transformation influences. *Xiqiao Yezai* records that in the Jiyou year of Jiajing, Kong Fang, a hired farmer from Hengjing, suffered from distension for several months and vomited/birthed a piece of flesh from his hypochondrium. Upon dissection, it resembled an infant with complete limbs and hair. Others are born from eggs or horses. Xu Yawan's mother laid an egg which was discarded; a lonely old woman incubated it, and a boy hatched. At the end of the Han Dynasty, a horse gave birth to a human named Ma Yi. These are all infinite variations of creation.