妊妇经血不固者，谓之胎漏。而胎漏之由，有因胎气者；有因病气者。而胎气之由，亦有二焉。余尝诊一
妇人，脉见滑数，而别无风热等病。问其经脉，则如常不断，而但较前略少耳。余曰∶“此必受妊者也。因胎
小，血盛有余而然。”后于三月之外，经脉方止，果产一男。故胎妊之妇，多有此类。今常见怀胎七、八个月
而生子者，人但以血止为度，谓之不足月。然其受胎于未止之前，至此而足而实，人所不知也。第此等胎气，
亦有阴阳盛衰之辨。如母气壮盛，荫胎有余，而血之溢者，其血虽漏，而生子仍不弱，此阴之强也，不必治
之。若父气薄弱，胎有不能全受，而血之漏者，乃以精血俱亏，而生子必萎小，此阳之衰也，而亦有人所不知
也。凡此皆先天之由，若无可以为力者。然栽培根本，岂果无斡旋之道乎？第见有于无之目，及转强于弱之
手，为不易得，是乌可以寻常语也？至若因病而漏者，亦不过因病治之而已耳。
妊娠血热而漏者，保阴煎、清化饮，择而用之。怒动肝火漏血者，保阴煎，甚者化肝煎主之。
保阴煎（见血热经早）
清化饮（见血热经早）
化肝煎（见崩淋经漏不止）
脾虚不能摄血者，寿脾煎、四君子之类主之。脾虚血热气滞者，四圣散主之。脾肾兼虚者，五阴煎主之。
寿脾煎（见血虚经乱）
四君子汤（见血虚经乱）
四圣散（见《妇人规》古方）治漏胎下血。
条芩 白术 砂仁 阿胶（各等分）
上为细末，每服二钱，艾汤调下。一方有芍药无阿胶。按此方若改为汤，砂仁用当减半。
五阴煎（见血虚经乱）
三焦气血俱虚者，五福饮、七福饮之类主之。
五福饮（见血热经早）
七福饮（见血虚经乱）
劳倦伤而动血者，寿脾煎、归脾汤主之。偶因伤触动血者，五福饮、安胎散主之。
归脾汤（见经不调）
安胎散（见《妇人规古方》）治妊娠卒然腰痛下血。
熟地 艾叶 白芍（炒） 川芎 黄 （炒） 阿胶（炒） 当归 甘草（炙） 地榆（各一钱）
上加姜、枣，水煎服。
冲任气虚不能制约，血滑易动者，固阴煎、秘元煎主之。
固阴煎（见肾虚经乱）
秘元煎（见血虚经乱）
立斋曰∶前证若因气热，用防风黄芩丸；若因血热，用加味逍遥散。若因血虚，用二黄散；若因去血太
多，用八珍汤。未应，补中益气汤。若因肝火，用柴胡清肝散；若因脾火，用加味归脾汤。若因事下血作痛，
用八珍汤加阿胶、熟艾。若因脾胃虚弱，用补中益气汤加五味子；若因脾胃虚陷，用前汤倍用升麻、柴胡。若
晡热内热，宜用逍遥散。
防风黄芩丸（见崩漏论外方）
加味逍遥散（见经不调）
二黄散（见血热论外方）
八珍汤（见经不调）
补中益气汤（见经不调）
薛氏 柴胡清肝散（见《古方八阵·寒阵》）治肝胆三焦风热疮疡，或怒火憎寒发热，或疮毒结于两
耳、两胁前后或胸乳小腹，下及股足等证。
柴胡 黄芩（炒各钱半） 山栀（炒） 川芎 人参（各一钱） 甘草（五分） 连翘 桔梗（各八分）
水一钟半，煎服。
加味归脾汤（见《古方八阵·补阵》）治脾经血虚发热等证。
即归脾汤加柴胡、山栀各一钱。
逍遥散（见经期腹痛）
妊娠期间经血不固者，称为胎漏。而胎漏的原因，有因胎气引起的；有因病气引起的。而胎气引起的原因，也有两种。我曾经诊治一位妇人，脉象滑数，但没有其他风热等病症。询问她的月经情况，则像往常一样没有中断，只是比以前略少而已。我说：“这一定是怀孕了的。因为胎儿小，血液旺盛有余所致。”后来在三个月之后，月经才停止，果然生下一个男孩。所以怀孕的妇女，多有这种情况。现在常见怀孕七、八个月就分娩的，人们只以月经停止为期限，称为不足月。然而她在月经停止之前受孕，到此时足月且充实，这是人们所不知道的。只是这类胎气，也有阴阳盛衰的区别。如果母体气壮盛，荫护胎儿有余，而血液溢出，虽然出血，但生下孩子仍然不虚弱，这是阴强，不必治疗。如果父体气薄弱，胎儿不能全受滋养，而血液溢出，乃是精血俱亏，生下孩子必然瘦小，这是阳衰，这也是人们所不知道的。凡此皆属先天原因，如果没有办法干预的话。然而栽培根本，难道真的没有扭转之道吗？只是见到从无到有、转弱为强的手段，是不容易得到的，这怎么可以用常理来谈论呢？至于因病而漏的，也不过是因病治疗罢了。
妊娠血热而漏血的，保阴煎（Bao Yin Decoction）、清化饮（Qing Hua Yin），选择使用。因愤怒触动肝火导致漏血的，用保阴煎，严重的用化肝煎（Hua Gan Decoction）主治。
脾虚不能摄血的，寿脾煎（Shou Pi Decoction）、四君子汤（Si Jun Zi Tang）之类主治。脾虚兼血热气滞的，用四圣散（Si Sheng San）主治。脾肾两虚的，用五阴煎（Wu Yin Decoction）主治。
三焦气血都虚的，用五福饮（Wu Fu Yin）、七福饮（Qi Fu Yin）之类主治。
劳倦损伤而动血的，用寿脾煎、归脾汤（Gui Pi Decoction）主治。偶然因伤触动动血的，用五福饮、安胎散（An Tai San）主治。
冲任二脉气虚不能制约，血液滑利易动的，用固阴煎（Gu Yin Decoction）、秘元煎（Mi Yuan Decoction）主治。
薛己说：上述证候如果因气热，用防风黄芩丸（Fang Feng Huang Qin Wan）；如果因血热，用加味逍遥散（Jia Wei Xiao Yao San）。如果因血虚，用二黄散（Er Huang San）；如果因失血太多，用八珍汤（Ba Zhen Tang）。无效时，用补中益气汤（Bu Zhong Yi Qi Tang）。如果因肝火，用柴胡清肝散（Chai Hu Qing Gan San）；如果因脾火，用加味归脾汤（Jia Wei Gui Pi Tang）。如果因事下血作痛，用八珍汤加阿胶、熟艾。如果因脾胃虚弱，用补中益气汤加五味子；如果因脾胃虚陷，用前方倍用升麻、柴胡。如果午后潮热内热，宜用逍遥散（Xiao Yao San）。
When a pregnant woman experiences uncontrolled vaginal bleeding, it is termed "Tai Lou" (Fetal Leakage). The causes of Tai Lou include those due to fetal qi and those due to pathological factors. Among the causes related to fetal qi, there are two types. I once treated a woman whose pulse was slippery and rapid, with no other signs of wind-heat or similar diseases. Upon inquiry regarding her menstruation, she reported that her periods had continued as usual without interruption, though they were slightly lighter than before. I said, "This must be pregnancy. Because the fetus is small, the blood is abundant and in excess." Later, after three months, her menstruation ceased, and indeed, she gave birth to a son. Therefore, many pregnant women present with such cases. It is common nowadays to see women delivering at seven or eight months of gestation; people consider this as "premature" only by measuring from the cessation of menstruation. However, conception occurred before menstruation stopped, and by this time, the fetus has reached full term and vitality, which is unknown to most. Nevertheless, among these cases involving fetal qi, there is a distinction between the prosperity and decline of Yin and Yang. If the mother's constitution is robust, providing ample nourishment to the fetus, leading to overflow of blood, although bleeding occurs, the newborn remains strong; this indicates strong Yin, and no treatment is necessary. If the father's essence is weak, failing to fully nourish the fetus, resulting in blood leakage, this signifies deficiency of both essence and blood, leading to a frail and small newborn; this indicates weak Yang, which is also often overlooked. All these stem from congenital factors. If nothing can be done, then so be it. Yet, nurturing the root—surely there must be ways to intervene? However, methods that transform absence into presence, or weakness into strength, are rare and difficult to attain; thus, they cannot be explained by ordinary discourse. As for leakage caused by disease, it is simply treated according to the underlying disease.
For Tai Lou caused by Blood Heat during pregnancy, choose between Bao Yin Decoction (Nourishing Yin Decoction) or Qing Hua Yin (Clearing Transformation Drink). For leakage due to Liver Fire stirred by anger, use Bao Yin Decoction; for severe cases, Hua Gan Decoction (Transforming Liver Decoction) is indicated.
For Spleen Deficiency failing to control blood, use Shou Pi Decoction (Longevity Spleen Decoction) or Si Jun Zi Decoction (Four Gentlemen Decoction). For Spleen Deficiency accompanied by Blood Heat and Qi Stagnation, use Si Sheng San (Four Saints Powder). For concurrent Spleen and Kidney Deficiency, use Wu Yin Decoction (Five Yins Decoction).
For simultaneous deficiency of Qi and Blood in the Triple Burner, use Wu Fu Yin (Five Blessings Drink) or Qi Fu Yin (Seven Blessings Drink).
For bleeding triggered by fatigue and overexertion, use Shou Pi Decoction or Gui Pi Decoction (Restore the Spleen Decoction). For accidental bleeding due to trauma or agitation, use Wu Fu Yin or An Tai San (Calming the Fetus Powder).
For Qi Deficiency of the Chong and Ren vessels failing to restrain blood, causing blood to slip and move easily, use Gu Yin Decoction (Consolidating Yin Decoction) or Mi Yuan Decoction (Secret Origin Decoction).
Xue Ji stated: For the aforementioned conditions, if due to Qi Heat, use Fang Feng Huang Qin Wan (Saposhnikovia and Scutellaria Pill); if due to Blood Heat, use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder). If due to Blood Deficiency, use Er Huang San (Two Yellows Powder); if due to excessive blood loss, use Ba Zhen Tang (Eight Treasures Decoction). If ineffective, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). If due to Liver Fire, use Chai Hu Qing Gan San (Bupleurum Clearing Liver Powder); if due to Spleen Fire, use Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction). If bleeding and pain occur due to emotional distress, use Ba Zhen Tang added with E Jiao (Donkey-Hide Gelatin) and Shu Ai Ye (Prepared Mugwort Leaf). If due to Spleen-Stomach Weakness, use Bu Zhong Yi Qi Tang added with Wu Wei Zi (Schisandra Berry); if due to Spleen-Stomach sinking, increase the dosage of Sheng Ma (Cimicifuga Rhizome) and Chai Hu (Bupleurum Root) in the previous formula. If afternoon tidal fever or internal heat occurs, Xiao Yao San (Free and Easy Wanderer Powder) is appropriate.