王叔和曰∶妇人月经下，但少，师脉之，反言有娠。其后审然，其脉何类？曰∶寸口脉阴阳俱平，营
卫调和，（沈注∶寸口脉阴阳俱平，自然营卫调和也。）按之则滑，浮之则轻。（沈注∶重按之以候阴分，
则滑是有余之象；浮取之以候阳分，则轻是不足之象。窃谓此即阴搏阳别之义。）阳明少阴，各如经法。（沈
注∶冲隶阳明主血，任隶少阴主精。各如经法，精血无损，是有妊而不堕之象。）身反洒淅不欲食，头痛，
心乱，呕吐，（沈注∶诸证经所谓身有病而无邪脉，妊子也。）呼之则微，吸之不惊。阳多气溢，阴滑气盛，
滑则多实，六经养成，所以月见。（沈注∶呼出之气微数，吸入之气舒徐不惊，是阳气多溢于外。令阳气不足
于内，阴脉滑则阴血内盛，所以月见经来。六经养成句无解，尚须查详。）阴见阳精，汁凝胞散，散者损胎。
（沈注∶若阴分虚而阳精乘之，胞中必散，方是胎堕。然胞中若散，脉必散而不滑，今脉滑无虞也。）设复阳
盛，双妊二胎，今阳不足，是故令激经也。（沈注∶设阴阳俱盛必双胎。今气不足而血有余，非双胎，乃激经也。）
考异∶“月经下”，周本作“经月下”。“但少”，周本作“但为微少”。“娠，作呕，何类？”周本下
有“何以别之？”四字。“按之则滑”，周无“则”字。“不欲食”，周本下有“饮”字。“呕吐”，周本作
“呕哕欲吐”。“呼之则微”，周作“呼则微数”。“吸之不惊”，周作“吸则不惊”。“散者损胎”，周作
“散者损堕”。
《产乳集》曰∶妊妇月信不绝，而胎不损，问产科熊宗古。答云∶此妇血盛气衰，其人必肥。既妊后，月
信常来，而胎不动。若便以漏胎治之，则胎必堕；若不作漏胎治，则胎未必堕。宗古之言，诚为有见。然亦
有未必因血盛者，荣经有风，则经血喜动，以风胜故也。则所下者，非养胎之血，若作漏胎治，投以滋补，是
实实也，胎岂有不堕？若知是风，专以一味风药投之，经信可止，即不服药，胎亦无恙。亦有胎本不固，
因房室不节，先漏而后堕胎者，须作漏胎治，又不可不审！
沈尧封曰∶妊娠经来，与漏胎不同。经来是按期而至，来亦必少，其人血盛气衰，体必肥壮。漏胎或因邪风
所迫，或因房室不节，血来未必按期，体亦不必肥壮。且漏胎之因，不尽风邪、房室，更有血热肝火诸证，不可
不察脉辨证。风入脉中，其脉乍大乍小，有时隆起。所云一味治风药，是举卿古拜散。（沈注∶即华佗愈风散。
荆芥略炒为末，每服三钱，黑豆淬酒调服。）血热证必五心烦热，治以黄芩、阿胶凉血之药。肝火内动，脉必
弦数，并见气胀腹痛，治以加味逍遥散。房劳证脉必虚，宜人参；或虚而带数，宜六味汤。
虞天民曰∶或问妊妇有按月行经而胎自长者；有三五个月，其血大下而胎不堕者；或及期而娩；或逾月而
生。其理何欤？曰∶按月行经而胎自长者，名曰盛胎。其妇气血充盛，养胎之外，其血有余故也；有数月之胎而
血大下，谓之漏胎∶因事触胎，动其冲脉，故血下而不伤子宫也。然孕中失血，胎虽不堕，气血亦亏，多致逾月
不产。曾见有十二三月、十七八月或二十四五个月生者，往往有之，俱是气血不足，胚胎难长故耳！凡十月之后
未产者，当大补气血以培养之，庶无分娩之患。
李氏曰∶胎漏自人门下血，尿血自尿门下血。
萧赓六云∶胎漏下血，频出无时；尿血溺时方下，不溺则不下。
沈尧封曰∶尿血，小蓟饮子妙。
王孟英按∶怀孕屡漏之后，气血耗伤，有迟至三四十月而生者。或谓妊娠带下，多主生女，亦大不然
也。吴酝香大令五令媳，素患带，婚后带益盛，继渐汛愆，医皆以为带所致，久投温涩无效。余诊之，脉
甚滑数，以怀麟断，清其胎火而愈。及期果诞一子。
王叔和说：妇女月经来潮，但量少，医生诊脉时，反而判断为怀孕。后来证实确实如此，这种脉象是什么样的呢？回答说：寸口脉的阴部和阳部都平和，营气与卫气调和。（沈注：寸口脉阴阳两部都平和，自然就是营卫调和的状态。）重按脉搏感觉滑利，轻取脉搏感觉浮轻。（沈注：重按以候察阴分，滑利是有余的表现；轻取以候察阳分，浮轻是不足的表现。我认为这就是“阴搏阳别”的含义。）阳明经和少阴经的脉象符合常规法则。（沈注：冲脉隶属于阳明胃，主司血液；任脉隶属于少阴肾，主司精气。各经脉象如常法所示，说明精血没有损伤，这是怀孕且不会流产的迹象。）身体反而出现恶寒战栗、不想吃东西、头痛、心烦意乱、呕吐等症状，（沈注：这些症状正是《内经》所说的“身有病而无邪脉”，是怀孕的表现。）呼气微弱而短促，吸气从容不迫不受惊扰。阳气偏盛则气机外溢，阴血滑利则气机旺盛，滑脉多主实证，六经气血养成，所以会出现月经来潮的现象。（沈注：呼出的气息微数，吸入的气息舒缓不惊，说明阳气多溢于体表。如果体内阳气不足，阴脉滑利则阴血内盛，所以会出现月经来潮。“六经养成”这一句难以解释，还需要详细查证。）阴分见到阳精，汁液凝结在胞宫散开，散开就会损伤胎元。（沈注：如果阴分虚弱而阳精乘虚而入，胞宫必然散乱，这才是胎堕的情况。然而如果胞宫散乱，脉象必定散乱而不滑，现在脉象滑利，无需担忧。）如果再遇到阳气过盛，可能是双胎妊娠，现在阳气不足，所以称为激经。（沈注：假设阴阳俱盛必然是双胎。现在气不足而血有余，不是双胎，而是激经。）
考异：“月经下”，周本作“经月下”。“但少”，周本作“但为微少”。“娠，作呕，何类？”周本下有“何以别之？”四个字。“按之则滑”，周本无“则”字。“不欲食”，周本下有“饮”字。“呕吐”，周本作“呕哕欲吐”。“呼之则微”，周本作“呼则微数”。“吸之不惊”，周本作“吸则不惊”。“散者损胎”，周本作“散者损堕”。
《产乳集》说：孕妇月经不断，但胎儿未受损，问产科医生熊宗古。他回答说：这位妇女血盛气衰，其人一定肥胖。怀孕后，月经经常来潮，但胎儿不动。如果当作漏胎治疗，那么胎儿一定会流产；如果不当作漏胎治疗，那么胎儿未必会流产。宗古的话，确实很有见解。但也并非都是因为血盛，如果是荣经有风邪，那么经血喜欢妄动，这是因为风邪胜的缘故。那么流下的血，就不是养胎的血，如果当作漏胎治疗，投用滋补药物，这就变成了实实之误（实证用补法），胎儿岂有不流产的道理？如果知道是风邪，专门用一味祛风药投治，月经可以停止，即使不服药，胎儿也没有危险。也有胎儿本来不稳固，因为房事不节制，先见红然后流产的情况，必须当作漏胎治疗，这又不可不仔细审察！
沈尧封说：妊娠期间月经来潮，与漏胎不同。月经来潮是按周期而至，量也必然少，这种人血盛气衰，体质一定肥壮。漏胎可能是因为邪风逼迫，或者因为房事不节制，流血未必按期，体质也不一定肥壮。而且漏胎的原因，不仅仅是风邪、房事，还有血热、肝火等各种证候，不可不通过诊脉辨证来区分。风邪入脉，脉象忽大忽小，有时隆起。所谓的一味治风药，是指举卿古拜散。（沈注：即华佗愈风散。荆芥略炒成末，每次服用三钱，用黑豆浸泡的酒调服。）血热证必然五心烦热，治疗用黄芩、阿胶等凉血药物。肝火内动，脉象必然弦数，并伴有气胀腹痛，治疗用加味逍遥散。房劳证脉象必然虚弱，宜用人参；或者虚而兼数脉，宜用六味地黄汤。
虞天民说：有人问孕妇有按月行经而胎儿自然长大的；有三五个月，大量出血而胎儿不流产的；或者到预产期分娩；或者超过一个月才生产。这是什么道理呢？回答说：按月行经而胎儿自然长大，名叫盛胎。这个妇女气血充盛，除了供养胎儿之外，她的血还有多余；有几月的胎儿而大量出血，叫做漏胎：因为事情触动胎元，动摇了冲脉，所以血下行但不伤及子宫。然而在怀孕期间失血，胎儿虽然不流产，气血也会亏损，大多导致超过预产期不生产。曾见过十二三个月、十七八个月或二十四五个月才生产的，往往都有这种情况，都是气血不足，胚胎难以生长的缘故！凡是十个月后未生产的，应当大补气血以培养身体，这样才不会有分娩的祸患。
萧赓六说：胎漏下血，频繁流出没有定时；尿血只有在排尿时才流出，不排尿就不流出。
王孟英按语：怀孕后多次漏血之后，气血耗伤，有的迟至三四十月才生产。有人说妊娠带下多主生女孩，这也完全不对。吴酝香大令的五位儿媳，素来患有白带，婚后白带更加严重，接着逐渐月经失调，医生们都认为是白带所致，长期投用温涩药物无效。我诊察她，脉象非常滑数，判断为怀孕，清其胎火而痊愈。到了预产期果然生了一个儿子。
Wang Shuhe said: When a woman's menstruation flows but is scanty, and the physician palpates the pulse yet incorrectly diagnoses pregnancy, which later proves true, what does this pulse resemble? It is described as follows: The cunkou (inch position) pulse shows both yin and yang aspects as peaceful, with Ying (Nutrient) and Wei (Defensive) qi harmonized. (Shen's note: When the yin and yang aspects of the cunkou pulse are peaceful, it naturally indicates harmony between Ying and Wei.) Pressing deeply reveals a slippery quality, while light palpation feels floating and light. (Shen's note: Deep pressing examines the yin aspect; slipperiness indicates excess. Light palpation examines the yang aspect; lightness indicates deficiency. I consider this to be the meaning of "yin pulsating distinct from yang".) The Maiyang (Yangming) and Shaoyin meridians follow their regular methods. (Shen's note: The Chong vessel belongs to Yangming and governs blood; the Ren vessel belongs to Shaoyin and governs essence. Following regular methods implies no damage to essence or blood, indicating pregnancy without miscarriage.) The body may experience chills (chattering teeth), anorexia, headache, mental confusion, and vomiting. (Shen's note: These symptoms correspond to the Classic's statement "disease in the body but no abnormal pulse," signifying pregnancy.) Exhalation is weak and rapid, while inhalation is calm and unstartled. Yang excess leads to qi overflowing outward; yin slipperiness leads to vigorous qi. Slippery pulses often indicate excess; the nourishment of the six meridians allows menstruation to appear. (Shen's note: Rapid exhalation and calm inhalation suggest yang qi overflowing externally. If internal yang is deficient and yin pulses are slippery, internal yin blood is abundant, causing menstruation. The phrase "nourishment of the six meridians" is unclear and requires further verification.) When yin encounters yang essence, fluids coagulate and disperse within the uterus; dispersion damages the fetus. (Shen's note: If yin is deficient and yang essence invades, the uterine cavity scatters, leading to miscarriage. However, if the uterus scatters, the pulse would be scattered rather than slippery. Since the pulse is slippery, there is no cause for alarm.) If yang is excessively strong, it may indicate twins; currently, due to insufficient yang, this condition is termed "Ji Jing" (provoked menstruation). (Shen's note: If both yin and yang were excessive, it would be twins. Now, qi is insufficient while blood is abundant, not twins, but provoked menstruation.)
Textual variants: "Menstruation flows" is written as "Menstruation comes monthly" in Zhou's edition. "But scanty" is written as "merely slightly scanty." "Pregnancy, vomiting, what resemblance?" has four additional characters "how to distinguish them?" in Zhou's edition. "Pressing then slippery" lacks the character "then" in Zhou's edition. "Does not desire food" has the character "drink" added in Zhou's edition. "Vomiting" is written as "vomiting, retching, desiring to vomit." "Exhaling then weak" is written as "exhaling is weak and rapid." "Inhaling without startle" is written as "inhaling without startle." "Dispersion damages fetus" is written as "dispersion causes miscarriage."
The *Chanru Ji* states: Pregnant women whose menstruation continues without damaging the fetus asked obstetrician Xiong Zonggu. He replied: This woman has abundant blood and deficient qi, and her physique must be fat. After pregnancy, menstruation frequently occurs, yet the fetus remains undisturbed. If treated as threatened abortion (Lou Tai), the fetus will surely miscarry; if not treated as threatened abortion, the fetus may not miscarry. Zonggu's words are indeed insightful. However, it is not always due to abundant blood. If wind pathogen affects the Ying meridian, menstrual blood tends to move recklessly due to wind dominance. The discharged blood is not that which nourishes the fetus; treating it as threatened abortion with tonifying herbs constitutes a double-evil error (tonifying excess), making miscarriage inevitable. Knowing it is wind, using a single wind-dispelling herb can stop menstruation, and even without medication, the fetus remains safe. There are cases where the fetus was inherently unstable due to sexual indiscretion, presenting spotting before miscarriage; these must be treated as threatened abortion and require careful examination!
Shen Yaofeng stated: Menstruation during pregnancy differs from threatened abortion. Menstruation arrives on schedule and is necessarily scanty; such individuals have abundant blood, deficient qi, and robust physiques. Threatened abortion may be caused by wind pathogen invasion or sexual indiscretion; bleeding may not be periodic, and the physique need not be robust. Furthermore, causes of threatened abortion extend beyond wind and sex, including blood heat and liver fire syndromes; one must not fail to differentiate via pulse and symptom analysis. Wind entering the vessels causes pulses that fluctuate between large and small, sometimes protruding. The aforementioned single wind-dispelling herb refers to Juqing Gubai San. (Shen's note: Also known as Huatuo Yufeng San. Scutellaria barbata [Jingjie] lightly stir-fried into powder, taken 3 qian per dose, mixed with wine infused with black soybeans.) Blood heat syndromes manifest as five-palm heat, treated with cooling blood herbs like Huangqin (Scutellariae Radix) and Ejiao (Donkey-hide Gelatin). Liver fire moving internally presents with wiry and rapid pulses, accompanied by abdominal distension and pain, treated with Jiawei Xiaoyao San. Sexual exhaustion syndromes present with deficient pulses, suitable for Renshen (Ginseng Radix); if deficient and rapid, Liuwei Dihuang Wan is appropriate.
Yu Tianmin said: Someone asked about pregnant women who menstruate monthly while the fetus grows normally; those who bleed heavily at three to five months without miscarriage; those delivering on time; or those delivering months late. What is the rationale? Monthly menstruation with normal fetal growth is called "Sheng Tai" (Abundant Fetus). The woman's qi and blood are abundant, leaving surplus blood after nourishing the fetus. Heavy bleeding several months into pregnancy is called "Lou Tai" (Leaking Fetus): external events disturb the fetus, agitating the Chong vessel, causing blood discharge without injuring the uterus. However, blood loss during pregnancy depletes qi and blood even if the fetus doesn't miscarry, often delaying delivery. I have seen deliveries at twelve to thirteen, seventeen to eighteen, or twenty-four to twenty-five months; these are all due to insufficient qi and blood, hindering embryo growth. For those past ten months without delivery, substantial tonification of qi and blood is necessary to prevent delivery complications.
Li Shi stated: Lou Tai bleeding exits from the lower vagina; Hematuria bleeding exits from the urethra.
Xiao Gengliu said: Lou Tai bleeding occurs frequently without fixed timing; hematuria occurs only during urination, not otherwise.
Shen Yaofeng said: For hematuria, Xiaoji Yinzi is excellent.
Wang Mengying commented: After repeated bleeding episodes during pregnancy, qi and blood are depleted, leading to delayed deliveries up to thirty to forty months. Some claim vaginal discharge during pregnancy predicts female birth, which is entirely incorrect. Wu Yunxiang's fifth daughter-in-law suffered from leukorrhea since youth, worsening after marriage, followed by irregular menstruation. Physicians attributed it to leukorrhea, prescribing warming and astringent herbs ineffectively. I diagnosed her pulse as very slippery and rapid, predicting pregnancy, and cured her by clearing fetal heat. She delivered a son on time.