【歌】三月七月数应奇，肝一心三五属脾，七肺九肾皆在脏，伤胃中冲恐坠之，十月养胎遵古法，千金保孕
独称奇，更宜爱护调神气，免使胎元不及期。
【论】大金曰∶阳施阴化，荣卫调和，经脉完固，十月而产。若气血虚损，不能养胎则坠也。凡腰痛者，
多有坠胎之患。王海藏曰∶坠胎之因有五，总由气血虚弱不能荣养胎元，或七情太甚，内火发动，火能消物而坠。
或遇伤劳役饥饱，动胎而坠，或遇于房事，触犯其胎而坠。或跌仆闪挫，伤动其胎而坠。或大怒悲哀，伤动心肝
之血而坠。然而小产甚于大产，由于胎脏损坏，胞系腐烂故也。
巢元方曰∶受胎在腹，七日一变，坠胎在三、五、七月多，二、四、六月少。脏阴而腑阳，三月属心，五月
属脾，七月属肺，皆属五脏，阴常易亏，故多坠耳。一月属肝，怒则多坠，洗下体窍开亦坠，一次既坠，肝脉受
伤，下次亦坠，今之无子者，大半是一月坠胎，非尽不受孕也。
泰山磐石丸
人参 黄 白术 当归 川芎 白芍 甘草 熟地 续断 黄芩 砂仁 糯米
为丸服。
【歌】跌仆双胎一死生，器中投鼠实难行，千金蟹爪胶甘桂，方出真人价不轻。
【论】阳施阴化，精血有余，则成双胎。若冷热失宜，气血亏损则胎萎而不育，或过期而不产。若双胎脉弱，
经养不周，故偏伤也。候其胎上冷，是胎已死，如抱鸡子，热者为生，冷者多浊物，理之自然者也。孙真人曰∶
妊娠僵仆失据，胎动转上抢心，甚者血从口出，逆不得息。或注下血一斗五升，胎不出，子死腹中，急如产状，
虚乏少气困顿欲死者。
【方】
蟹爪散
蟹爪（一升） 阿胶（二两，炒） 甘草（二尺） 桂（半尺）
东流水一斗，煮蟹爪、甘草，取三升去滓内阿胶烊尽，能为一服佳，不能者，食顷再服。若口噤不能饮者，
格口灌之，药下便活，与母俱生。若胎一死一生，则死者自下，而生者自安，若胎已死，独母活也。煎药宜用向
东灶，以茅苇薪火煎之。
【歌诀】怀孕第三个月和第七个月，胎元数目应为奇数（注：此处指易发生变动之期），肝、心各一，三与五归属于脾，七属肺、九属肾，这些脏腑都在体内。若损伤了胃气及冲脉，恐怕会导致胎儿坠落。第十个月养胎应遵循古法，《千金方》中的保胎方法独显奇妙，更应当爱护并调理神气，以免使胎元不能足月而产。
【论述】金代医家戴原礼说：阳气施布，阴气化生，营卫之气调和，经脉坚固完整，经过十个月便分娩。如果气血虚损，不能滋养胎元，就会导致流产。凡是出现腰痛症状的，大多有流产的隐患。王海藏说：导致流产的原因有五种，总归是因为气血虚弱，不能荣养胎元；或者是七情（喜、怒、忧、思、悲、恐、惊）过于强烈，引发内火，火性炎上能消蚀万物而导致流产；或者是遭遇劳累、过度役使、饥饿或过饱，扰动胎气而导致流产；或者是进行房事，触犯胎气而导致流产；或者是跌倒、扑打、扭挫，伤动胎气而导致流产；或者是大怒或悲哀，伤动心肝两脏的血分而导致流产。然而，小产的危害往往大于足月生产，这是因为胞宫受损，胞系腐烂的缘故。
巢元方说：受孕在腹中，每七天发生一次变化，流产多发生在第三、五、七个月，第二、四、六个月较少。脏属阴，腑属阳。第三个月属心，第五个月属脾，第七个月属肺，这些都归属于五脏，阴气容易亏损，所以容易发生流产。第一个月属肝，发怒容易导致流产，清洗下部窍穴导致孔窍张开也会导致流产。一旦有一次流产经历，肝脉就会受伤，下次也容易流产。现在没有子女的人，大半是在第一个月流产，并非完全不能受孕。
泰山磐石丸
人参、黄芪、白术、当归、川芎、白芍、甘草、熟地黄、续断、黄芩、砂仁、糯米。
将这些药材制成丸药服用。
【歌诀】因跌倒扑打导致双胎中一死一生，处理这种情况确实难以施行（如投鼠忌器）。《千金方》中的蟹爪胶甘桂汤，此方出自孙真人，价值不菲且疗效显著。
【论述】阳气施布，阴气化生，精血充足有余，就会形成双胎。如果冷热失调，气血亏损，就会导致胎儿发育不良而不育，或者过期不产。如果是双胎，脉象微弱，经血供养不周，所以会偏伤其中一个。观察胎儿上方感觉寒冷，说明胎儿已经死亡，就像抱鸡蛋一样；感觉温热的是活胎，寒冷的多为浊物，这是自然的道理。孙思邈说：妊娠期间跌倒失据，胎动不安向上冲击心脏，严重的会出现口出血，气息逆乱无法呼吸。或者阴道下血一斗五升，胎儿不出，子死腹中，情况紧急如同临产状，产妇虚弱乏力，气短困顿，几乎要死去。
【方剂】
蟹爪散
蟹爪（一升）、阿胶（二两，炒制）、甘草（二尺）、桂枝（半尺）。
用东流水一斗，煮蟹爪和甘草，取汁三升，去掉药渣，加入阿胶使其完全溶化。如果能一次服完最好，如果不能，过一顿饭的时间再服。如果牙关紧闭不能吞咽的，撬开嘴巴灌入，药下去后母子都能存活。如果是双胎一死一生，那么死的胎儿自然会排出，活的胎儿自然平安；如果胎儿已经死亡，只有母亲能存活。煎药宜使用向东的灶台，以茅草芦苇为燃料煎煮。
[Song] In the third and seventh months, the numbers should be odd; the Liver and Heart correspond to one, Three and Five belong to the Spleen, Seven corresponds to the Lungs, and Nine to the Kidneys, all residing within the Zang organs. Injury to the Stomach Qi and the Chong Mai (Penetrating Vessel) may fear causing fetal expulsion. For nourishing the fetus in the tenth month, follow ancient methods; the pregnancy-preserving prescriptions in *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold) are uniquely remarkable. One should further cherish and regulate Shen Qi (Spiritual Energy) to prevent the Tai Yuan (Fetal Origin) from failing to reach term.
[Discussion] Dai Yuanli of the Jin Dynasty stated: When Yang Qi is distributed and Yin Qi transforms, Ying Wei (Nutritive and Defensive Qi) harmonize, and the meridians become complete and solid, childbirth occurs after ten months. If Qi and Blood are deficient and unable to nourish the fetus, miscarriage will occur. Those who suffer from lower back pain often face the risk of miscarriage. Wang Haizang stated: There are five causes for miscarriage, all stemming from deficiency of Qi and Blood failing to nourish the Tai Yuan. Alternatively, excessive emotional stimulation triggers internal Fire, which can consume substances and cause miscarriage. Or, encountering fatigue, overwork, hunger, or overeating disturbs the fetus leading to miscarriage. Or engaging in sexual intercourse, offending the fetus leads to miscarriage. Or falling, striking, or twisting injures the fetus leading to miscarriage. Or extreme anger or sorrow injures the Blood of the Heart and Liver leading to miscarriage. However, spontaneous abortion (Xiao Chan) is more detrimental than full-term delivery because it damages the Tai Zang (Fetal Organ) and causes the Bao Xi (Uterine Ligaments) to rot.
Chao Yuanfang stated: After conception in the abdomen, changes occur every seven days. Miscarriage occurs mostly in the third, fifth, and seventh months, and less frequently in the second, fourth, and sixth months. Zang organs are Yin, and Fu organs are Yang. The third month belongs to the Heart, the fifth to the Spleen, and the seventh to the Lungs; all belong to the Five Zang organs. Since Yin is prone to deficiency, miscarriage is common. The first month belongs to the Liver; anger often causes miscarriage, and washing the lower orifices opening them also causes miscarriage. Once a miscarriage has occurred, the Liver Meridian is injured, making subsequent miscarriages likely. Most people today who are infertile actually suffered miscarriage in the first month; it is not that they never conceived.
Taishan Panshi Wan (Mount Tai Porphyry Pill)
Ren Shen (Ginseng Root), Huang Qi (Astragalus Root), Bai Zhu (Atractylodes Rhizome), Dang Gui (Angelica Sinensis Root), Chuan Xiong (Ligusticum Rhizome), Bai Shao (White Peony Root), Gan Cao (Licorice Root), Shu Di Huang (Prepared Rehmannia Root), Xu Duan (Dipsacus Root), Huang Qin (Scutellaria Root), Sha Ren (Amomum Fruit), Nu Mi (Glutinous Rice).
Grind these herbs into powder and make pills. Take orally.
[Song] Due to falling or striking, if twins result in one death and one life, handling the situation is as difficult as throwing stones at rats in a precious vessel (caution is needed). The Xie Zhua Jiao Gan Gui Decoction (Crab Claw, Gelatin, Licorice, and Cinnamon Decoction) from *Qianjin Fang*, originating from Master Sun, is highly valued.
[Discussion] When Yang distributes and Yin transforms, and Essence and Blood are abundant, twins form. If cold and heat are imbalanced, and Qi and Blood are depleted, the fetus withers and fails to develop, or delivery is delayed. In cases of twins, if the pulse is weak and nourishment via the meridians is insufficient, one fetus may be injured. If the area above the fetus feels cold, the fetus is dead, like holding an egg; if warm, it is alive; coldness usually indicates turbid matter, which is natural. Sun Simiao stated: During pregnancy, if one falls and loses balance, fetal movement rises and rushes to the heart. Severe cases involve bleeding from the mouth, counter-flowing Qi preventing breathing. Or vaginal bleeding of one dou and five sheng occurs, the fetus does not deliver, the child dies in the womb, and the condition is urgent like labor. The patient is weak, lacking Qi, exhausted, and near death.
[Formula]
Xie Zhua San (Crab Claw Powder)
Xie Zhua (Claws of Pot-bellied Pig Crab, 1 sheng), E Jiao (Donkey-hide Gelatin, 2 liang, stir-fried), Gan Cao (Licorice Root, 2 chi), Gui Zhi (Cinnamon Twig, 0.5 chi).
Use one dou of flowing water from the east to boil the crab claws and licorice root. Reduce to three sheng, remove the dregs, add the gelatin until fully dissolved. It is best to take this as a single dose; if not possible, take another dose after a meal interval. If the patient has trismus (lockjaw) and cannot swallow, pry open the mouth and pour the medicine in. Once the medicine enters, both mother and child will survive. If one twin is dead and one is alive, the dead one will naturally pass, and the living one will remain safe. If the fetus is already dead, only the mother survives. The decoction should be prepared using a stove facing east, burning reeds and straw as fuel.