安胎寄生汤（妇十九 下血腰痛） 当归芍药汤（妇十六 急痛去血）
妊娠忽然下血，其证有四∶或因火热迫血则妄行；或因郁怒气逆则动血；或因损触胎气
，胞宫受伤而下血；或因脾肾气陷，命门不固而脱血。凡此皆动血之最者也。不速为调理，
则必致堕胎矣。然治此者，必先察其血去之多少，及于血去之后，尤当察其邪之微甚。如火
犹未清，仍当清火；气犹未顺，仍当顺气。若因邪而动血，血去而营虚，则速当专顾元气以
防脱陷。此中或当治标，或当救本，或当兼标本而调理之。倘不知先后缓急，将恐治标未已
，而救本无暇也。当详察之。
若火盛迫血妄行者，当察其火之微甚。火之微者，凉胎饮；稍甚者，徙薪饮；再甚者，
保阴煎、子芩散。若肝经有风热而血下者，宜防风黄芩丸。若怒气伤肝，气逆血动而暴至者
，宜保阴煎。若气有未顺而胀满者，四七汤、二陈汤，或加芎、归之类。若兼肝火者，宜化
肝煎。若触损胎气，胞宫受伤而血下者，宜安胎散、胶艾汤。去血多者，倍加人参。若从高
坠下，伤动胎气而下血者，宜益母地黄汤、安胎散。若因惊气虚而陷者，仍加人参。若脾胃
素弱，或偶因伤脾下血者，宜寿脾煎、归脾汤。或中气下陷者，补中益气汤。若血虚微热，
漏血尿血者，续断汤。以上诸动血证，若去血未多，血无所积，胎未至伤而不止者，宜凉则
凉，宜补则补，惟以安之固之为主治。若血已离位，蓄积胞宫，为胀为痛，而余血未出者，
欲与留之，有不可得，欲去其血而不伤营气，则惟四物汤大加当归为最宜也。若察其胎气已
动，势有难留，则五物煎、决津煎皆切要之药。
一方∶治顿仆胎动，用川芎末二钱，酒下二三服，胎生即安，胎死即下。
又方∶治同前，用砂仁和皮炒为末，每服二钱，米饮下，腹热即安。
安胎寄生汤（出自《妇人科》卷十九，主治下血伴腰痛） 当归芍药汤（出自《妇人科》卷十六，主治急痛伴出血）
妊娠期间突然阴道出血，其病因主要有四种：一是因火热之邪逼迫血液妄行；二是因郁怒导致气机上逆而扰动血液；三是因外力损伤胎气，致使胞宫受伤而出血；四是因脾肾之气下陷，命门不固而导致失血。以上这些情况都是导致动血的严重证候。如果不迅速进行调理，必然会导致流产。然而治疗此类病症，必须先观察出血量的多少，以及在出血之后，更要仔细辨别病邪的轻重。如果火热之邪尚未清除，仍应当清热泻火；如果气机尚未调顺，仍应当理气顺气。如果是因邪气扰动导致出血，且出血后营血虚弱，则应当迅速专注于扶持元气，以防发生虚脱或下陷。这其中有的需要治标，有的需要救本，有的则需要标本兼治。倘若不懂得治疗的先后缓急，恐怕在治标的过程中，就没有时间顾及救本了。因此必须详细审察。
如果是火盛逼迫血液妄行的，应当观察火势的轻重。火势轻微的，用凉胎饮；稍严重的，用徙薪饮；更严重的，用保阴煎、子芩散。如果是肝经有风热导致出血的，宜用防风黄芩丸。如果是怒气伤肝，气逆血动而突然大量出血的，宜用保阴煎。如果气机不畅伴有胀满的，用四七汤、二陈汤，或者加入川芎、当归之类的药物。如果兼有肝火的，宜用化肝煎。如果是触损胎气，胞宫受伤而出血的，宜用安胎散、胶艾汤。如果出血量多，应加倍使用人参。如果是从高处坠落，伤动胎气而出血的，宜用益母地黄汤、安胎散。如果是因惊恐导致气虚下陷的，仍应加入人参。如果脾胃素来虚弱，或者偶尔因伤脾而出血的，宜用寿脾煎、归脾汤。如果是中气下陷的，用补中益气汤。如果是血虚伴有微热，出现漏血或尿血的，用续断汤。以上各种动血证候，如果出血不多，血液没有积聚，胎元未受严重损伤但出血不止的，该清热的就清热，该补益的就补益，主要以安胎固摄作为主要治疗原则。如果血液已经离经妄行，蓄积在胞宫，引起胀满疼痛，而余血尚未排出的，想要让它留存是不可能的，想要去除瘀血而不损伤营气，那么只有四物汤大剂量加入当归最为适宜。如果审察发现胎气已动，形势难以挽留，那么五物煎、决津煎都是关键有效的药物。
一方：治疗突然跌倒导致的胎动不安，用川芎末二钱，酒送服二三剂，胎儿存活则安，胎儿死亡则排出。
又一方：治疗方法同上，用砂仁连皮炒研为末，每次服用二钱，米汤送服，腹部感到温热即安。
An Tai Ji Sheng Tang (Cushioning the Fetus and Nourishing Life Decoction, from *Fu Ren Ke* Vol. 19, for bleeding with lower back pain) Dang Gui Shao Yao Tang (Angelica Sinensis and Peony Decoction, from *Fu Ren Co* Vol. 16, for acute pain with bleeding)
Sudden vaginal bleeding during pregnancy has four main etiologies: first, it may be caused by fire-heat forcing blood to move recklessly; second, by emotional depression and anger causing qi rebellion that disturbs blood; third, by physical trauma injuring fetal qi and damaging the uterus (Baogong), leading to bleeding; fourth, by sinking of spleen and kidney qi, with failure of the Mingmen (Gate of Vitality) to secure blood, resulting in hemorrhage. These are all severe conditions involving the disturbance of blood. If not regulated promptly, miscarriage will inevitably occur. However, in treating this, one must first observe the amount of blood lost, and after the bleeding, particularly scrutinize the severity of the pathogenic factors. If fire is not yet cleared, one should still clear fire; if qi is not yet smooth, one should still regulate qi. If bleeding was triggered by pathogens, and blood deficiency follows the loss, one must rapidly focus on supporting primordial qi to prevent collapse or sinking. In these cases, some require treating the branch (symptoms), some require saving the root (constitution), and some require addressing both simultaneously. If the sequence and urgency are not understood, one may find no time to save the root while attempting to treat the branch. Therefore, careful observation is essential.
If excessive fire forces blood to move recklessly, observe the intensity of the fire. For mild fire, use Liang Tai Yin (Cool the Fetus Decoction); for slightly more severe cases, use Xi Xin Yin (Remove Firewood Decoction); for even more severe cases, use Bao Yin Jian (Protect the Yin Decoction) or Zi Qin San (Scutellaria Powder). If wind-heat in the Liver channel causes bleeding, use Fang Feng Huang Qin Wan (Saposhnikovia and Scutellaria Pill). If anger injures the Liver, causing qi rebellion and sudden violent bleeding, use Bao Yin Jian. If qi stagnation causes distension and fullness, use Si Qi Tang (Four Seven Decoction) or Er Chen Tang (Two Aged Things Decoction), possibly adding Xiong (Chuanxiong Rhizome) and Gui (Dang Gui Radix Angelicae Sinensis). If accompanied by Liver fire, use Hua Gan Jian (Transform the Liver Decoction). If trauma to fetal qi damages the uterus causing bleeding, use An Tai San (Stabilize the Fetus Powder) or Jiao Ai Tang (Colla Corii Asini and Mugwort Decoction). If blood loss is heavy, double the dose of Ren Shen (Ginseng Radix et Rhizoma). If falling from a height injures fetal qi causing bleeding, use Yi Mu Di Huang Tang (Motherwort and Rehmannia Decoction) or An Tai San. If fright causes qi deficiency and sinking, add Ren Shen. If the Spleen and Stomach are inherently weak, or if injury to the Spleen causes bleeding, use Shou Pi Jian (Nourish the Spleen Decoction) or Gui Pi Tang (Restore the Spleen Decoction). If Middle Qi sinks, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). If blood deficiency with slight heat causes spotting or hematuria, use Xu Duan Tang (Drynaria Decoction). Regarding the above various conditions of blood disturbance, if blood loss is not heavy, there is no accumulation of blood, and the fetus is not severely damaged but bleeding persists, apply cooling where appropriate, tonification where appropriate, with the primary treatment principle being to stabilize and secure the fetus. If blood has left its vessels and accumulated in the uterus, causing distension and pain, with residual blood remaining, it is impossible to retain it; to expel the blood without damaging Ying (Nutritive) qi, the most suitable method is Si Wu Tang (Four Substance Decoction) with a significantly increased dose of Dang Gui. If examination reveals that fetal qi is disturbed and retention is difficult, Wu Wu Jian (Five Material Decoction) and Jue Jin Jian (Crossing the River Decoction) are crucial remedies.
One formula: For treating sudden falls causing fetal movement, use Chuan Xiong powder (2 qian), taken with wine in two or three doses. If the fetus lives, it stabilizes; if dead, it is expelled.
Another formula: Same indication as above. Use Sha Ren (Amomi Fructus) fried with peel, ground into powder. Take 2 qian per dose, washed down with rice water. Relief occurs when abdominal warmth is felt.