小产元气虚损。不能荣养乎胎而自堕。昔人譬之以枝枯则果落。藤萎则花坠是也。然或劳怒伤情。内火发动。亦能
堕胎。则犹风撼其木。人折其枝也。夫火能消物。造化自然。说者乃谓风冷伤其子脏。此未得病情者也。大抵属虚属热。
当视其轻重而治之耳。是知正产者。正如果中栗熟。其壳自开。两无所损。半产者。则犹之采斫新栗。碎其肤壳。损其
皮膜。然后取得其实。以其胎脏伤损。胞系断坏。而后胎至堕落。故小产后须十倍调治。总以补血生肌养脏。生新去瘀
为主。世有一种恣情妄为。偷生不正。或多男女。厌于养育。往往以草药毒之。每至败血不下。冲心闷乱。喘汗交作而
死者。急须以解毒行血药救之。宜白扁豆散。或有受孕至三五七阳月。胎必堕者。宜未至应堕之期。先清其热。宜芩术
汤、安胎丸。若气不足。预行补助。宜八珍汤。明医杂着云。凡小产多在三五七月。若前次三个月堕。则下胎必如期复
然。故须于前次小产后。多服养气血固胎元之药。以补其虚。下次有胎。必于两个月半后。即服清热安胎药数帖。以防
三月之堕。至四个半月。再服数帖。防过五月至六个半月。再服数帖。以防七月之堕。至九个月。服达生散数帖。则可
保无虞矣。宜千金保胎丸、金匮当归散、芎归补中汤、五味安胎丸、安荣汤、和痛汤。孰谓小产而可忽视哉。凡小产后
诸病。与产后参看。
脉法 脉诀曰。半产漏下。革脉主之。弱则血耗。立见倾危。脉经曰。阴脉浮而紧。紧则疝瘕。腹中痛。半产
而胎堕。
鳌按。脉诀脉经所言。皆由内因而堕胎者。若由跌扑挫犯及误服毒药。则不得拘此。
堕胎 陈自明曰。凡妊妇腰痛。多堕胎。又妊未足月而痛如欲产。或应产而难。或为子烦。用知母一味蜜丸米
汤下。或蒲黄末水调钱许亦效。朱震亨曰。有贾氏妇。但孕三月左右。必堕。诊其脉。左手大而无力。重取则涩。知其
少血也。以其妙年。只补中气。使血自荣。时正初夏。教以浓煎白术汤下黄芩未一钱。三四十帖。遂得保全而愈。王纶
曰。有数堕胎。胎元损甚者。服药须多且久。则可以留。方用四物加人参、白术、陈皮、茯苓、甘草、艾叶、阿胶、条
芩。多气。加砂仁、香附。有痰。少加半夏曲。黄芩为安胎圣药。清热故也。暑月尤宜加用。养胎全在脾胃。故白术补
脾。为安胎君药。若因气恼致胎不安。宜川芎、陈皮、甘草、茯苓。多加砂仁。少佐木香以行气。王肯堂曰。袁了凡先
生云。受胎在腹。七日一变。展转相成。各有相生。今妇人堕胎。在三五七月者多。在二四六月者少。脏阴而腑阳。三
月属心。五月属脾。七月属肺。当在五脏之脉。阴常易亏。故多堕耳。唯一月堕胎。人皆不知有胎。但谓不孕。不知其
受而堕也。一月属肝。怒则堕。多洗下体。则窍开亦堕。既堕一次。则肝脉受伤。他次亦堕。今之无子者。大半是一月
即堕。非尽不孕也。故凡初交之后。最宜将息。切勿交接以扰子宫。勿怒。勿劳。勿举动。勿洗浴。而又服养肝平气之
药。胎可固矣。万全曰。孕而多堕者。男子贪淫纵情。女子好欲性偏。又好食辛热。暴损冲任故也。其膏粱藜藿不同。
欲之多寡故也。有等妇人。有胎似无胎。痰气疼痛发热。医者不明医理。不知胎宜养。病宜攻。妄施攻耗。岂不误欤。
故养胎者血也。护胎者气也。或有妇人小产太多。至中年欲保全。设法服药。但欲心不绝。又百凡上气。逆损冲任。因
而殒命者有之。又曰。脾胃伤则胎易堕。寒热交杂。子亦多痰。况多食酸伤肝。多食苦伤心。多食甘伤脾。多食辛伤肺。
多食咸伤肾。随其食物。伤其脏气。不但胎易堕。即不堕子病亦多。又曰。喜伤心。气散。怒伤肝。气上。思伤脾。气
郁。忧伤肺。气结。恐伤肾。气下。母气既伤。子气应之。母伤则胎易堕。子伤则脏气不和。多盲聋喑 痴呆癫痫。又
曰。孕后行立坐卧若太久。则筋骨肌肤受伤。子在腹中。气通于母。必有伤者。睡卧处要人护从。恐邪气侵也。虚险处
毋往来。恐堕跌也。张介宾曰。凡堕胎者。或气虚而提摄不固。或血虚而灌溉不周。故善保胎者专顾血。虚以胎元饮为
主。次则芍药芎归汤。次则泰山磐石散、千金保孕丸。皆有夺天之功。又胎热者血易动。血动者胎不安。故堕于内热。
而虚者正多。如脾气虚而血热者。四圣散。肝肾虚而血热者。凉胎饮。肝脾虚而血热者。固胎煎。此外凡有他症而胎不
安者。当于安胎条中酌治。陈士择曰。小产非正产之症。亦可作产前治。盖小产之气血亦大伤。宜急补之。则日后坐胎
不致再有崩漏。用人参、当归、白术、各五钱。茯苓三钱。熟地一两。杜仲二钱。炮姜五分。此方乃补气补血之圣方。
胎动而下。必损带脉。补其气血。则带脉损处可以重生。他日受孕。不致有再损之虞。武之望曰。日月未足。胎气未全
而产者。谓之半产。俗呼小产。由妊妇冲任气虚。不能滋养于胎。胎气不固。或颠扑闪堕。致气血损动。或因热病温疟
之类。皆令半产。忌黑神散。恐犯热药。转生他疾。宜玉烛散、和经汤之类。薛氏云。小产重于大产。但人轻忽致血者
多。治法宜补形气。生新血。去瘀血。若未足月痛而欲产。芎归补中汤倍加知母止之。产而血不止。人参黄 汤。产而
心腹痛。当归川芎汤。胎气弱而小产。八珍汤。血出过多而发热。圣愈汤。汗不止。急用独参汤。发热烦躁。肉 筋惕。
八珍汤。大渴面赤。脉洪而虚。当归补血汤。身热面赤。脉沉而微。四君加姜附。东垣云。昼发热而夜安静。是阳气自
旺于阳分也。昼安静而夜发热。是阳气下陷于阴分也。昼夜俱发热。重阳无阴也。峻补其阴。王太仆云。如大寒而甚。
热之不热。是无火也。热来复去。昼见夜伏。夜发昼止。时节而动。是无火也。如大热而甚。寒之不寒。是无水也。热
动复止。倏忽往来。时动时止。是无水也。阳气自旺者。四物二连汤。阳气陷于阴者。补中益气汤。重阳无阴者。四物
汤。无火者。八味丸。无水者。六味丸。
小产是因为元气虚损，不能滋养胎儿而导致自然流产。古人将其比喻为树枝干枯果实就会掉落，藤蔓枯萎花朵就会坠落。然而，有时因为劳累和愤怒导致情志受伤，引发内火，也能造成堕胎，这就像风吹摇撼树木、人折断树枝一样。火热之性能消蚀万物，这是造化的自然规律。那些解说者却认为是风冷损伤了子宫（子脏），这是没有掌握病情实质的人的说法。大抵小产的病因属于虚证或热证，应当根据病情的轻重来进行治疗。由此可知，足月正产，就像栗子成熟后果壳自然裂开，母体与胎儿都未受损伤；而半产（小产），则如同采摘砍伐新栗，破碎了其外壳，损伤了皮膜，然后才取得里面的果实。这是因为胎脏受到损伤，胞系断裂毁坏，之后胎儿才会堕落。所以小产后需要十倍于正常生产的调治，总以补血、生肌、养脏、生新血、去瘀血为主。世间有一种人恣意妄为，行为不端，或者生育子女过多，厌倦养育，往往用草药毒害胎儿。常常导致败血不下，瘀血上冲心脏引起闷乱，气喘出汗交替发作而死亡。此时急需使用解毒行血的药物来抢救，适宜用白扁豆散。如果有孕妇怀孕到三、五、七等阳月，胎儿必定会堕落的，应当在未到应堕之期前，先清除体内的热邪，适宜用芩术汤、安胎丸。如果气不足，预先进行补助，适宜用八珍汤。《明医杂著》说：凡是小产多发生在三、五、七月。如果前三个月流产，那么下一次怀孕必定会在同样的月份再次流产。所以需要在上次小产后，多服用补养气血、固护胎元的药物，以补充其虚弱。下次怀孕后，必须在两个半月时，就服用清热安胎的药物数帖，以防三月时流产。到了四个半月，再服用数帖，以防过五月时流产。到了六个半月，再服用数帖，以防七月时流产。到了九个月，服用达生散数帖，就可以保证没有忧患了。适宜用的方剂有千金保胎丸、金匮当归散、芎归补中汤、五味安胎丸、安荣汤、和痛汤。谁说小产可以忽视呢？凡是小产后的各种病症，参考产后病的治法。
脉法方面，《脉诀》说：半产漏下（流产伴阴道出血不止），革脉主此病。若脉弱则是血耗竭，立刻可见危重局面。《脉经》说：阴脉浮而紧，紧脉主疝瘕，腹中疼痛，半产而胎儿堕落。
沈金鳌按语：《脉诀》和《脉经》所说的情况，都是由内因而导致堕胎的。如果是由于跌打损伤挫犯以及误服毒药导致的，则不能拘泥于此。
堕胎：陈自明说：凡是孕妇腰痛，容易堕胎。又有孕妇未满月而腹痛如临产，或者该生产时难产，或者出现子烦（妊娠心烦），只用知母一味药制成蜜丸，米汤送服。或者用蒲黄末用水调服一钱许也有效。朱震亨说：有位贾姓妇人，每次怀孕到三个月左右，必定流产。诊察她的脉象，左手脉大而无力，重取则涩，知道她是血少。因为她正值青春年少，只补益中气，使血液自然充盈荣养。当时正是初夏，教导她用浓煎的白术汤送服黄芩末一钱，服用三四十帖，最终得以保全并痊愈。王纶说：有多次流产，胎元损伤严重的，服药必须多且久，才可以留住胎儿。方剂用四物汤加人参、白术、陈皮、茯苓、甘草、艾叶、阿胶、条芩。气虚多加砂仁、香附。有痰症，少加半夏曲。黄芩是安胎的圣药，因为它能清热。暑天尤其适宜加用。养胎全赖脾胃，所以白术补脾，是安胎的主药。如果因气恼导致胎不安，适宜用川芎、陈皮、甘草、茯苓，多加砂仁，少佐木香以行气。王肯堂说：袁了凡先生讲，受孕在腹中，七天一变，辗转相成，各有相生关系。现在妇女堕胎，在三、五、七月多的，在二、四、六月少的。脏属阴而腑属阳，三月属心，五月属脾，七月属肺，应当对应五脏的脉象，阴气常易亏损，所以容易流产。唯独一个月流产，人们都不知道已经有胎，只说是不孕，不知道是受孕后即流产。一月属肝，发怒会导致流产，多洗下身，则窍孔张开也会流产。一旦流产一次，肝脉就会受伤，以后也会流产。现在的无子者，大半是一个月即流产，并非完全是不孕。所以凡是初次同房之后，最宜将息调养，切勿性交以扰动子宫，不要发怒，不要劳累，不要剧烈举动，不要洗浴，又服用养肝平气的药物，胎元就可以稳固了。万全说：怀孕后多次流产的，是男子贪淫纵欲，女子喜好性欲偏激，又好食辛辣热性食物，暴损冲任二脉的缘故。饮食的膏粱厚味与藜藿粗食不同，欲望的多寡也不同。有些妇人，有胎却像没胎一样，出现痰气疼痛发热，医生不明白医理，不知道胎宜养，病宜攻，妄施攻伐消耗之法，难道不是错误吗？所以养胎靠的是血，护胎靠的是气。有的妇人小产太多，到了中年想保全，设法服药，但只要欲望不断绝，加上百凡上气逆乱，损伤冲任，因而丧命的也有。又说：脾胃受伤则胎易堕，寒热交杂，胎儿也多痰。况且多吃酸伤肝，多吃苦伤心，多吃甘伤脾，多吃辛伤肺，多吃咸伤肾。随着食物的不同，损伤相应的脏气，不但胎易堕，即使不堕，胎儿生病也很多。又说：喜伤心，气散；怒伤肝，气上；思伤脾，气郁；忧伤肺，气结；恐伤肾，气下。母气既已受伤，子气相应受到影响。母伤则胎易堕，子伤则脏气不和，容易出现盲聋喑哑、痴呆癫痫等症状。又说：孕后行立坐卧如果太久，则筋骨肌肤受伤，子在腹中，气通于母，必然会有所损伤。睡卧之处要有人护卫跟随，恐怕邪气侵袭。危险险峻的地方不要往来，恐怕跌倒。张介宾说：凡是堕胎的，或是气虚而提摄不固，或是血虚而灌溉不周。所以善于保胎的人专门顾护血，虚证以胎元饮为主，其次是芍药芎归汤，再次是泰山磐石散、千金保孕丸，都有夺天之功。另外胎热者血易动，血动者胎不安，所以因内热而流产的，虚证占多数。如脾气虚而血热的，用四圣散；肝肾虚而血热的，用凉胎饮；肝脾虚而血热的，用固胎煎。此外凡有其他症状而胎不安的，应当在安胎条中酌情治疗。陈士铎说：小产不是正产的病症，也可以按产前病治疗。因为小产的气血也大大受损，宜急补之，则日后坐胎不会再有崩漏。用人参、当归、白术各五钱，茯苓三钱，熟地一两，杜仲二钱，炮姜五分。此方是补气补血的圣方。胎动而下，必损带脉，补其气血，则带脉受损处可以重生，他日受孕，不会有再损的忧虑。武之望说：日月未足，胎气未全而生产的，叫做半产，俗称小产。由孕妇冲任气虚，不能滋养胎儿，胎气不固，或颠扑闪落，致气血损伤动荡，或因热病温疟之类，都导致半产。忌用黑神散，恐怕触犯热药，转生其他疾病。适宜用玉烛散、和经汤之类。薛氏说：小产重于大产，但人轻忽导致死亡的很多。治法宜补形气，生新血，去瘀血。如果未满月痛而欲产，用芎归补中汤倍加知母以制止。生产后血不止，用人参黄芪汤。生产后心腹痛，用当归川芎汤。胎气弱而小产，用八珍汤。血出过多而发热，用圣愈汤。汗不止，急用独参汤。发热烦躁，肌肉跳动筋惕，用八珍汤。大渴面赤，脉洪而虚，用当归补血汤。身热面赤，脉沉而微，用四君子汤加姜附。东垣说：白天发热而夜间安静，是阳气自旺于阳分；白天安静而夜间发热，是阳气下陷于阴分；昼夜都发热，是重阳无阴，应峻补其阴。王太仆说：如大寒而甚，用热药治而不热，是无火；热来复去，昼见夜伏，夜发昼止，时节而动，是无火；如大热而甚，用寒药治而不寒，是无水；热动复止，倏忽往来，时动时止，是无水。阳气自旺的，用四物二连汤；阳气陷于阴的，用补中益气汤；重阳无阴的，用四物汤；无火的，用八味丸；无水的，用六味丸。
Spontaneous abortion (Xiao Chan) is caused by deficiency and damage to Yuan Qi (Original Qi), which fails to nourish the fetus, leading to natural miscarriage. Ancients compared it to: when branches wither, fruits fall; when vines shrivel, flowers drop. However, sometimes labor and anger cause emotional injury, triggering internal fire, which can also induce miscarriage. This is like wind shaking trees or people breaking branches. Fire has the nature to consume things, which is the natural law of creation. Those who explain it as cold wind damaging the Zi Zang (uterus) have not grasped the essence of the disease. Generally, spontaneous abortion belongs to deficiency or heat patterns. Treatment should be based on the severity of the condition. Thus, full-term delivery is like a mature chestnut where the shell opens naturally, causing no harm to either mother or fetus. Half-term delivery (spontaneous abortion) is like harvesting new chestnuts by chopping, shattering the shell, damaging the membrane, before obtaining the kernel. This is because the fetal organs are damaged, and the placental connections are broken, after which the fetus falls. Therefore, post-spontaneous abortion requires ten times the care of normal delivery. The general principle is to tonify blood, generate flesh, nourish organs, generate fresh blood, and remove stasis. There are some people who act recklessly, behave immorally, or have too many children and grow weary of raising them, often using herbal poisons to abort. This often leads to retained dead blood failing to discharge, rushing up to the heart causing oppression and confusion, alternating wheezing and sweating, resulting in death. Urgent rescue with detoxifying and blood-moving herbs is required. Bai Bian Dou San (White Hyacinth Bean Powder) is suitable. If a pregnant woman conceives and inevitably miscarries during the 3rd, 5th, or 7th lunar months (Yang months), one should clear internal heat before the expected time of miscarriage. Qin Shu Tang (Scutellaria and Atractylodes Decoction) and An Tai Wan (Fetus-Stabilizing Pills) are suitable. If Qi is insufficient, preventive supplementation is suitable, such as Ba Zhen Tang (Eight Treasure Decoction). *Ming Yi Za Zhu* states: Spontaneous abortions mostly occur in the 3rd, 5th, and 7th months. If a miscarriage occurs in the first three months, the next pregnancy will likely miscarry at the same time. Therefore, after a previous spontaneous abortion, one should take more medicine to nourish Qi and Blood and secure the fetal origin to replenish deficiency. In the next pregnancy, starting from two and a half months, take several doses of heat-clearing and fetus-stabilizing medicine to prevent miscarriage at three months. At four and a half months, take several more doses to prevent miscarriage past five months. At six and a half months, take several more doses to prevent miscarriage at seven months. At nine months, take several doses of Da Sheng San (Reaching Life Powder) to ensure safety. Suitable formulas include Qian Jin Bao Tai Wan (Thousand Gold Fetus-Preserving Pills), Jin Gui Dang Gui San (Golden Cabinet Angelica Powder), Xiong Gui Bu Zhong Tang (Ligusticum and Angelica Tonifying Middle Decoction), Wu Wei An Tai Wan (Five-Ingredient Fetus-Stabilizing Pills), An Rong Tang (Peaceful Nourishment Decoction), and He Tong Tang (Harmonizing Pain Decoction). Who says spontaneous abortion can be ignored? All diseases following spontaneous abortion should be referred to postpartum conditions.
Regarding pulse diagnosis: *Mai Jue* (Pulse Classic) states: For half-term miscarriage with dripping bleeding, Ge Mai (Leather Pulse) is indicated. Weakness indicates blood exhaustion, immediately showing danger. *Mai Jing* (Pulse Canon) states: Yin pulses floating and tight indicate Jian Jia (abdominal masses) and abdominal pain, leading to half-term miscarriage and fetal expulsion.
Shen Jin'ao's commentary: What *Mai Jue* and *Mai Jing* describe are all cases of miscarriage due to internal causes. If caused by falls, trauma, or accidental ingestion of toxic drugs, these rules do not apply.
Miscarriage: Chen Ziming said: Pregnant women with lower back pain are prone to miscarriage. Also, if pregnant women under term experience pain resembling labor, or difficulty delivering at term, or suffer from Zi Fan (pregnancy-related restlessness/irritability), using only Zhi Mu (Anemarrhena Rhizome) made into honey pills taken with rice soup is effective. Alternatively, Pu Huang (Pollen Typhae) powder mixed with water, taken in small amounts, is also effective. Zhu Zhenheng said: A Mrs. Jia always miscarried around the third month of pregnancy. Her pulse was large and powerless on the left hand, and choppy upon heavy pressure, indicating blood deficiency. Since she was young, he only tonified Middle Qi so that blood would naturally nourish. It was early summer, so he instructed her to take Huang Qin (Scutellaria Root) powder with strong decoction of Bai Zhu (Atractylodes Macrocephala Rhizome). After taking 30-40 doses, she was preserved and recovered. Wang Lun said: For those with multiple miscarriages and severe damage to the fetal origin, medication must be taken in large quantities and for a long time to retain the fetus. Use Si Wu Tang (Four Substances Decoction) plus Ren Shen (Ginseng Radix), Bai Zhu, Chen Pi (Citrus Reticulata Pericarpium), Fu Ling (Poria), Gan Cao (Licorice Root), Ai Ye (Artemisia Argyi Folium), E Jiao (Donkey-hide Gelatin), and Tiao Qin (Scutellaria Root). For Qi deficiency, add Sha Ren (Amomum Fruit) and Xiang Fu (Cyperus Rhizome). For phlegm, add Ban Xia Qu (Pinellia Fermented Paste) in small amounts. Huang Qin is the holy medicine for stabilizing the fetus because it clears heat. It is especially suitable in summer. Nourishing the fetus relies entirely on the Spleen and Stomach, so Bai Zhu tonifies the Spleen and is the chief herb for stabilizing the fetus. If fetal unrest is caused by Qi stagnation and anger, use Chuan Xiong (Ligusticum Chuanxiong Rhizome), Chen Pi, Gan Cao, Fu Ling, adding more Sha Ren, and a little Mu Xiang (Aucklandiae Radix) to move Qi. Wang Kentang said: Mr. Yuan Liaofan stated that conception changes every seven days in the womb, transforming mutually, each having generative relationships. Now, women miscarrying mostly do so in the 3rd, 5th, and 7th months, rarely in the 2nd, 4th, and 6th. Zang organs are Yin and Fu organs are Yang. The 3rd month belongs to the Heart, the 5th to the Spleen, and the 7th to the Lung, corresponding to the pulses of the Five Zang organs. Yin is easily deficient, hence frequent miscarriage. Only at one month do people not know there is a pregnancy, attributing it to infertility, not knowing it is conception followed by immediate miscarriage. The first month belongs to the Liver. Anger causes miscarriage; washing the lower body frequently opens the orifices and causes miscarriage. Once miscarried, the Liver pulse is injured, leading to future miscarriages. Most childless people actually miscarry at one month, they are not completely infertile. Therefore, after initial intercourse, one must rest carefully, avoid sexual intercourse to disturb the uterus, avoid anger, avoid fatigue, avoid vigorous movement, avoid bathing, and take medicine to nourish the Liver and calm Qi, then the fetus can be secured. Wan Quan said: Frequent miscarriages are due to men being lustful and indulgent, women having excessive sexual desire, and liking spicy and hot foods, violently damaging the Chong and Ren meridians. Diet differs between rich food and coarse food, and desires differ in quantity. Some women have a pregnancy but seem not to, experiencing phlegm-Qi pain and fever. Doctors ignorant of medical principles do not know that the fetus should be nourished and the disease attacked, but recklessly use attacking and consuming methods, which is wrong. Thus, nourishing the fetus relies on Blood, protecting the fetus relies on Qi. Some women have too many spontaneous abortions and want to preserve health in middle age, trying medicines, but if desires are not extinguished, combined with rebellious Qi damaging the Chong and Ren meridians, death may result. Also, if the Spleen and Stomach are damaged, the fetus easily miscarries. Cold and heat mixed lead to fetal phlegm. Moreover, eating too much sour damages the Liver, bitter damages the Heart, sweet damages the Spleen, pungent damages the Lung, salty damages the Kidney. Depending on food, the Zang Qi is damaged. Not only does the fetus easily miscarry, but even if it doesn't, the child suffers many illnesses. Joy damages the Heart, scattering Qi; anger damages the Liver, causing Qi to rise; worry damages the Spleen, causing Qi to stagnate; sorrow damages the Lung, causing Qi to knot; fear damages the Kidney, causing Qi to sink. When maternal Qi is damaged, fetal Qi responds. Maternal damage makes the fetus prone to miscarriage; fetal damage leads to disharmony of Zang Qi, resulting in blindness, deafness, muteness, dementia, epilepsy, etc. Also, if walking, standing, sitting, or lying down for too long during pregnancy, muscles, bones, and skin are damaged. The fetus in the womb connects Qi with the mother, so both are injured. Sleeping places need protection to prevent pathogenic invasion. Avoid dangerous places to prevent falls. Zhang Jiebin said: Miscarriage is due to Qi deficiency failing to hold firm, or Blood deficiency failing to irrigate properly. Those good at preserving the fetus focus on Blood. For deficiency, Tai Yuan Yin (Fetal Origin Decoction) is primary, followed by Shao Yao Xiong Gui Tang (Peony, Ligusticum, and Angelica Decoction), then Tai Shan Pan Shi San (Mount Tai Porphyry Powder), and Qian Jin Bao Yun Wan (Thousand Gold Pregnancy-Preserving Pills), all achieving miraculous results. Additionally, fetal heat moves Blood, and moved Blood unsettles the fetus, so miscarriage due to internal heat is often due to deficiency. For Spleen Qi deficiency with Blood heat, use Si Sheng San (Four Sacred Powders); for Liver-Kidney deficiency with Blood heat, use Liang Tai Yin (Cooling Fetus Decoction); for Liver-Spleen deficiency with Blood heat, use Gu Tai Jian (Fetus-Securing Decoction). For other symptoms causing fetal unrest, treat according to the Stabilizing Fetus section. Chen Shize said: Spontaneous abortion is not a normal delivery symptom but can be treated as a prenatal condition. Since Qi and Blood are greatly damaged in spontaneous abortion, urgent tonification prevents future metrorrhagia and metrostaxis during subsequent pregnancies. Use Ren Shen, Dang Gui (Angelica Sinensis Radix), Bai Zhu, each 5 qian; Fu Ling 3 qian; Shu Di Huang (Prepared Rehmannia Root) 1 liang; Du Zhong (Eucommia Bark) 2 qian; Pao Jiang (Roasted Ginger) 0.5 qian. This formula is a holy prescription for tonifying Qi and Blood. Fetal movement downward damages the Dai Mai (Girdle Vessel). Tonifying Qi and Blood allows the damaged Dai Mai to regenerate, preventing further damage in future conceptions. Wu Zhiwang said: Delivery before term with incomplete fetal Qi is called Ban Chan (half-term delivery), commonly known as Xiao Chan. It is caused by Chong and Ren Qi deficiency in the pregnant woman, failing to nourish the fetus, leading to insecure fetal Qi, or falls causing Qi and Blood damage and agitation, or febrile diseases like Wen Nue (warm malaria) causing half-term delivery. Black God Powder (Hei Shen San) is contraindicated to avoid aggravating heat and causing other diseases. Yu Zhu San (Jade Candle Powder) and He Jing Tang (Harmonizing Meridian Decoction) are suitable. Xue said: Spontaneous abortion is more serious than normal delivery, but many die due to negligence. Treatment should tonify Body Qi, generate fresh Blood, and remove stasis. If pain and labor urge appear before term, use Xiong Gui Bu Zhong Tang with doubled Zhi Mu to stop it. If bleeding continues after delivery, use Ren Shen Huang Qi Tang (Ginseng and Astragalus Decoction). If heart and abdominal pain occur after delivery, use Dang Gui Chuan Xiong Tang (Angelica and Ligusticum Decoction). For weak fetal Qi causing spontaneous abortion, use Ba Zhen Tang. For fever due to excessive blood loss, use Sheng Yu Tang (Sage Saving Decoction). For unceasing sweating, urgently use Du Shen Tang (Single Ginseng Decoction). For fever, irritability, muscle twitching, and tendon tremors, use Ba Zhen Tang. For extreme thirst, red face, and surging yet empty pulse, use Dang Gui Bu Xue Tang (Angelica Tonifying Blood Decoction). For body heat, red face, and deep yet faint pulse, use Si Jun Zi Tang (Four Gentlemen Decoction) plus Ginger and Aconite. Dong Yuan said: Fever during the day and quiet at night indicates Yang Qi flourishing in the Yang aspect. Quiet during the day and fever at night indicates Yang Qi sinking into the Yin aspect. Fever day and night indicates excess Yang without Yin, requiring vigorous tonification of Yin. Wang Taipu said: Severe cold unresponsive to heat therapy indicates lack of Fire. Heat coming and going, appearing by day and hiding by night, occurring seasonally, indicates lack of Fire. Severe heat unresponsive to cold therapy indicates lack of Water. Heat moving and stopping, suddenly coming and going, intermittently active and still, indicates lack of Water. For Yang Qi flourishing, use Si Wu Er Lian Tang (Four Substances and Two Coptis Decoction). For Yang Qi sinking into Yin, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment Qi Decoction). For excess Yang without Yin, use Si Wu Tang. For lack of Fire, use Ba Wei Wan (Eight-Ingredient Pill). For lack of Water, use Liu Wei Wan (Six-Ingredient Pill).