妇人半产，多在三个月及五月、七月，除跌扑损伤不拘外，若前次三个月而堕，则下次必如期复然。
盖先于此时受伤，故后至期必应，乘其虚也。遇有半产者，产后须多服养气血、固胎元之药，以补其虚
损。下次有胎，先于两个半月后，即用固胎药十数服，以防三月之堕∶至四个半月后，再服八、九服
防过五月；又至六个半月后，再服以防七月；及至九个月内，服丹溪达生散十数服，可保无虞。其有连堕
数次，胎元损甚者，服药须多，久则可以留。方用四物
汤加白术、人参、陈皮、茯苓、甘草、阿胶、艾叶、条芩，多气加香附、缩砂，有痰加姜制半夏。调理妊
娠，在于清热养血。条实黄芩为安胎圣药，清热故也，暑月宜加用之。养胎全在脾胃，譬如钟悬于梁，
梁软则钟下坠，折则堕矣。故白术补脾，为安胎君药。若因气恼致胎不安者，宜用川芎、陈皮、茯苓、
甘草，多加缩砂，少佐木香以行气。
愚按半产重于大产，大产如瓜熟自落，栗熟自脱，半产如生采其皮壳，断其根蒂，岂不重于大产？
但人轻忽致死者多矣。治法宜补形气、生新血、去瘀血，若未足月，痛而产，芎归补中汤，倍加知母止
之；若产而血不止，人参黄 汤补之；若产而心腹痛，当归川芎汤主之；胎气弱而小产者，八珍汤固
之；若下血过多而发热，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，四君子、姜、附。
一妇人，胎已六月，每怒气便见血，甚至寒热、头疼、胁胀、腹痛、少食、作呕。余谓寒热、头疼，
肝火上冲也；胁胀、腹痛，肝气不行也；少食、作呕，肝侮脾胃也；小便见血，肝火下流也。用小柴胡
加芍药、炒黑山栀、茯苓、白术而愈。
一妇人，胎及六月，形体倦怠，饮食少思，劳役
便血，胎动不安。用六君、生熟地、升麻、柴胡而愈。
一妇人，每胎三、四月，作痛欲堕。余以为痛胎，用当归二钱，熟地黄三钱，而愈。
妇女发生半产（妊娠12-28周间的流产），多发生在怀孕三个月、五个月及七个月时。除了因跌打损伤导致的情况外，如果上一次在三个月时发生堕胎，那么下一次也必定会如期再次发生。
这是因为先前在此时已经受损，所以到了那个时期必然会出现反应，这是趁着身体虚弱之时发生的。遇到有半产情况的妇女，产后必须多服用补养气血、固护胎元的药物，以弥补其虚损。下次怀孕后，先在两个半月左右，就连续服用十几剂固胎药，以防止三个月时堕胎；到了四个半月后，再服用八、九剂，以防止五个月时堕胎；又过了六个半月后，再服药以防止七个月时堕胎；直到九个月内，服用丹溪达生散（朱丹溪所创的安胎方剂）十几剂，就可以保证没有危险。那些连续多次堕胎，胎元损伤严重的，服药次数需要更多，长期调理则可以保住胎儿。方剂用四物汤（补血调血基础方）加白术、人参、陈皮、茯苓、甘草、阿胶、艾叶、黄芩，气虚明显的加香附、砂仁，有痰湿的加姜制半夏。调理妊娠，关键在于清热养血。条实黄芩是安胎的圣药，因为它能清热，所以在暑天适宜多加使用。养胎完全依赖脾胃，就像钟悬挂在梁上，梁软则钟下坠，梁折则钟坠落。所以白术补脾，是安胎的主药。如果是因生气恼怒导致胎不安宁的，宜用川芎、陈皮、茯苓、甘草，多加砂仁，少佐木香以行气。
我按语：半产比足月生产（大产）更严重，足月生产如同瓜熟自然脱落，栗子成熟自然脱离枝头，而半产如同强行采摘未熟的果实，切断其根蒂，这难道不比足月生产更严重吗？但人们往往轻视疏忽而导致死亡的情况很多。治疗方法应当补益形体元气、生成新血、去除瘀血。如果未满月就腹痛欲产，用芎归补中汤，加倍加入知母以制止早产；如果生产后出血不止，用人参黄芪汤来补益；如果生产后心腹疼痛，用当归川芎汤主治；胎气虚弱导致小产的，用八珍汤固摄；如果下血过多而发热，用圣愈汤；汗出不止，急用独参汤；发热烦躁，肌肉跳动筋脉抽搐，用八珍汤；极度口渴面红，脉象洪大而虚，用当归补血汤；身热面红，脉沉细微弱，用四君子汤加生姜、附子。
有一位妇人，怀孕六个月，每次发怒就会见血，甚至出现寒热往来、头痛、胁肋胀满、腹痛、食欲减退、恶心呕吐。我认为寒热、头痛，是肝火上冲所致；胁肋胀满、腹痛，是肝气郁滞不通所致；食欲减退、恶心呕吐，是肝气犯胃侮脾所致；小便见血，是肝火下流所致。用小柴胡汤加芍药、炒黑山栀、茯苓、白术而治愈。
另一位妇人，怀孕六个月，身体倦怠，饮食减少思虑，劳累后便血，胎动不安。用六君子汤加生地黄、熟地黄、升麻、柴胡而治愈。
还有一位妇人，每次怀孕到三、四个月时，腹部作痛欲堕胎。我认为是“痛胎”（因痛致胎动不安），用当归二钱，熟地黄三钱，而治愈。
In women, spontaneous abortion (miscarriage occurring between 12 and 28 weeks of gestation) often happens at three, five, or seven months of pregnancy. Excluding cases caused by falls or physical trauma, if a miscarriage occurred at the third month previously, it is likely to recur at the same time in the next pregnancy.
This is because damage was sustained at that specific time previously, so the reaction inevitably occurs when that period arrives, taking advantage of the body's deficiency. For women who have experienced spontaneous abortion, it is necessary to take numerous doses of herbs that nourish Qi and Blood and secure the fetal root after delivery, to replenish their deficiency and loss. In subsequent pregnancies, starting from two and a half months, administer more than ten doses of fetal-securing prescriptions to prevent miscarriage at three months; at four and a half months, take another eight or nine doses to prevent miscarriage at five months; at six and a half months, take more doses to prevent miscarriage at seven months; and within the ninth month, take more than ten doses of Danxi Dasheng San (a fetal-securing formula by Zhu Danxi) to ensure safety. For those who have suffered multiple consecutive miscarriages with severe damage to the fetal root, medication should be taken for a longer duration and in greater quantity, which can help retain the fetus. The prescription uses Siwu Tang (Four Substances Decoction) added with Baizhu (Atractylodis Macrocephalae Rhizoma), Renshen (Ginseng Radix et Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Fuling (Poria), Gancao (Glycyrrhizae Radix et Rhizoma), Ejiao (Colla Corii Asini), Aye (Folium Artemisiae Argyi), and Huangqin (Scutellariae Radix). If there is significant Qi deficiency, add Xiangfu (Cyperi Rhizoma) and Suosha (Amomi Fructus Rotundus); if there is phlegm-dampness, add Jiangzhi Banxia (Pinelliae Rhizoma Preparatum with Ginger). Regulating pregnancy lies in clearing heat and nourishing blood. Tiaoshi Huangqin (high-quality Scutellariae Radix) is the sacred herb for securing the fetus because it clears heat, making it suitable for increased use during summer months. Nourishing the fetus relies entirely on the Spleen and Stomach, similar to a bell suspended from a beam; if the beam is soft, the bell sinks, and if it breaks, the bell falls. Therefore, Baizhu tonifies the Spleen and serves as the chief herb for securing the fetus. If emotional anger causes fetal unrest, use Chuanxiong (Ligustici Chuanxiong Rhizoma), Chenpi, Fuling, Gancao, with increased Suosha and a small amount of Muxiang (Aucklandiae Radix) to move Qi.
My commentary: Spontaneous abortion is more severe than term delivery. Term delivery is like a ripe melon falling naturally or a ripe chestnut detaching from its shell, whereas spontaneous abortion is like picking an unripe fruit forcibly and severing its stem; is this not more severe than term delivery? However, many people die due to negligence and overlooking this condition. The treatment method should involve tonifying the form and Qi, generating new blood, and removing stasis. If labor pains occur before full term, use Xionggui Buzhong Tang (Chuanxiong and Danggui Tonify Middle Decoction) with doubled Zhimu (Anemarrhenae Rhizoma) to stop premature labor; if bleeding continues after delivery, use Renshen Huangqi Tang (Ginseng and Astragalus Decoction) to tonify; if heart and abdominal pain occur after delivery, use Danggui Chuanxiong Tang (Danggui and Chuanxiong Decoction) as the primary treatment; for spontaneous abortion due to weak fetal Qi, use Bazhen Tang (Eight Treasures Decoction) to secure it; if fever occurs due to excessive bleeding, use Shengyu Tang (Sage Renewal Decoction); if sweating does not stop, urgently use Dushen Tang (Single Ginseng Decoction); for fever with restlessness, muscle twitching, and tendon tremors, use Bazhen Tang; for extreme thirst and red face with a flooding yet empty pulse, use Danggui Buxue Tang (Danggui Tonify Blood Decoction); for body heat and red face with a deep, thin, and faint pulse, use Sijunzi Tang (Four Gentlemen Decoction) added with Shengjiang (Zingiberis Rhizoma Recens) and Fuzi (Aconiti Lateralis Radix Preparata).
One woman, at six months of pregnancy, would bleed every time she became angry, accompanied by alternating chills and fever, headache, distension in the hypochondrium, abdominal pain, poor appetite, and vomiting. I reasoned that the alternating chills and fever and headache were due to Liver Fire rushing upward; the hypochondriac distension and abdominal pain were due to stagnant Liver Qi; the poor appetite and vomiting were due to Liver Qi invading and insulting the Spleen and Stomach; and the blood in urine was due to Liver Fire flowing downward. She was cured using Xiaochaihu Tang (Minor Bupleurum Decoction) added with Shaoyao (Paeoniae Radix), Chaohei Zhizi (Gardeniae Fructus Preparated with Stir-frying until Black), Fuling, and Baizhu.
Another woman, at six months of pregnancy, presented with physical fatigue, reduced appetite and desire for food, hematochezia after exertion, and restless fetus. She was cured using Liujunzi Tang (Six Gentlemen Decoction) added with Shengdihuang (Rehmanniae Radix), Shudihuang (Rehmanniae Radix Preparata), Shengma (Cimicifugae Rhizoma), and Chaihu (Bupleuri Radix).
Yet another woman, whenever she reached three or four months of pregnancy, experienced abdominal pain threatening miscarriage. I diagnosed this as "painful fetus" (fetal unrest caused by pain) and treated her with Danggui (Angelicae Sinensis Radix) 2 qian and Shudihuang 3 qian, resulting in a cure.