夫妊娠日月未足，胎气未全而产者，谓之半产。盖由妊妇冲任气虚，不能滋养于胎，胎
气不固，或颠扑闪坠，致气血损动，或因热病温疟之类，皆令半产。仲景谓寒虚相搏，此名
为革，妇人则半产漏下是也。
又云∶半产俗呼小产，或三四月，或五六月，皆为半产，以男女成形故也。或因忧恐悲
哀暴怒，或因劳力打扑损动，或触冒暑热，忌黑神散，恐犯热药，转生他疾，宜玉烛散、和经
汤之类。《便产须知》云∶小产不可轻视，将养十倍于正产可也。又云∶半产即肌肉腐烂，补
其虚损，生其肌肉，益其气血，去其风邪，养其
脏气，将养过于正产十倍，无不平复，宜审之。
薛氏曰∶小产重于大产，盖大产如栗熟自脱，小产有如生采，破其皮壳，伤其根蒂也。但
人轻忽致死者多，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；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；若血出过多而发热者，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；如昼
夜俱发热者，是重阳无阴也，当峻补其阴。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。若阳气自旺者，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。
一妊妇五月服剪红丸堕胎，腹中胀痛，服破血药益甚，手按之愈痛。余曰∶此峻药重伤，
脾胃受患，用八珍倍参、 ，加半夏、乳、没，二剂痛止，数剂痊愈。（倍法加法，俱有独见）
史仲子室年甫二十，困疫胎堕，时咳，服清肺解表，喘急不寐，请视。余曰∶脾土虚，不
能生肺金，药重损之，与补中益气加茯苓、半夏、五味、炮姜四剂渐愈，往视，又与八珍加五
味及十全大补汤而痊愈。
东垣云∶妇人分娩及半产漏下，昏冒不省，瞑目无所知觉，盖因血暴亡，有形血去，则
心神无所养。心与包络者，君火相火也，得血则安，亡血则危，火上炽，故令人昏冒；火胜其
肺，瞑目不省人事，是阴血暴去，不能镇抚也。血已亏损，往往用滑石、甘草、石膏之类，乃甘
辛大寒之药，能泻气中之热，是血亏泻气，乃阴亏泻阳，使二者俱伤（所谓有两死，而无两
生也），反为不足。虚劳之病，昏迷不省者，上焦心肺之热也，此无形之热，用寒凉之药，驱
令下行，岂不知上焦之病，悉属于表，乃阴证也，汗之则愈，今反下之，幸而不死，暴亏气
血，必夭天年。又不知内经有说，病气不足，宜补不宜泻。但瞑目之病，悉属于阴，宜汗不宜
下，又不知伤寒郁冒，得汗则愈，是禁用寒凉药也，分娩半产，本气不病，是暴去其血，亡血
补血，又何疑焉？补其血则神昌，常时血下降亡，今当补而升举之（妙在升阳），心得血养而
神不昏矣。血若暴下，是秋冬之令太旺，令举而升之，助其阳，则目张神不昏矣。今立一方，
补血养血，生血益阳，以补手足厥阴之不足也，名全生活血汤。（生产后诸证，更于产后方论中参
用之。）
人参汤 治半产后，血下过多，心惊体颤，头目运转，或寒或热，脐腹虚胀疼痛。
人参（《别录》谓人参能治心腹鼓痛，此用之，盖虚痛也，若实痛则不宜矣） 麦门冬
（去心） 生干地黄 当归（洗） 芍药（炒） 黄 白茯苓 甘草（炙各一两）
上 咀，每服三钱，水一盏煎七分，食前温服。
人参黄 汤 治小产气虚，血下不止。（脾统血，气载血，此方最妙）
人参 黄 （炒） 白术（炒） 当归 白芍药 艾叶（各一钱） 阿胶（炒二钱）
上作一剂，水煎服。
龙骨散 治因损娠下，恶血不止。（此重在恶血不止，故姜艾之用也）
龙骨 当归 地黄（各二两） 芍药 地榆 干姜 阿胶（各一两半） 艾叶（一两，炒） 蒲黄（一
两二钱半） 牛角鳃（炙焦，二两半）
上为细末，食前用米饮调下二钱。
全生活血汤 治妇人分娩，及半产漏下，昏冒不省，瞑目无所知觉，此因血暴亡，心神
无所养也，用此补血升阳。（阴从阳升，故用药如此）
升麻（三阴三阳之气俱升） 白芍药（各三钱） 当归（酒洗） 葛根 柴胡（去苗） 羌活 独活
防风 甘草（炙，各二钱） 川芎 本（各一钱五分） 生地黄（夏月加） 熟地黄（各一钱） 蔓荆子
细辛（各五分） 红花（三分）
上 咀，每服五钱，水二盏煎至一盏，去滓，食前稍热服。
以上治血下过多之剂。
生地黄汤 治妊娠胎气损动，气血不调，或跌扑闪坠，以致胎堕，堕后恶滞不尽，腹中绞痛。
生干地黄（一两） 大黄（暴煨） 芍药 白茯苓 当归 细辛 黄芩 甘草（炙） 桂（去粗皮，
各半两）（妙在桂与大黄同用，然须认病真切方可）
上 咀，每服五钱，水一盏半，入生姜、大枣拍碎同煎，至一盏，去滓，不拘时温服。
当归酒 治妊娠堕胎后，血不出。
当归（炙令香） 芍药（炒，各二两）
上 咀，每服三钱，无灰酒一盏，入生地黄汁一合，银器内慢火煎至七分，去滓温服，
以恶血下为度。（产后忌芍药，而此以血不出者用之，要知与当归同用，以无灰酒、生地汁
同煮，则不收敛，而入肝行血矣）
乌金散 治妊娠堕胎后，血不下，兼治诸疾血病。
好墨（二两，折二寸挺子，烧通赤，用好醋一升，蘸七遍，又再烧通赤放冷，另研为末） 没药（研）
麒麟竭（各二钱半） 麝香（一钱）
上为细末，每服温酒调下一钱匕。如血迷心，用童便加酒调下二钱匕。
红蓝花散 治堕胎后血不出，奔心闷绝，不识人。（二方俱宜合之，以备缓急）
红蓝花（微炒） 男子发（烧存性） 京墨（烧红） 血竭（研） 蒲黄（隔纸炒，各等分）
上为细末，以童便小半盏调二钱，服之立效。
白蜜酒 治堕胎后，恶血不出。（妙在缓
肝行血）
白蜜（二两） 生地黄（取汁一盏） 酒（半盏）
上汁与酒，共入铜器中煎五七沸，入蜜搅匀，分两服，服三剂，百病可愈。
以上治恶血不出之剂。（以上诸方，攻补不同，所谓寒热温凉，各从其事也，用者审之）
当归汤 治妊娠堕胎，胞衣不出。（此方活血滑利，催生下胞俱可用）
当归（切炒） 牛膝（酒浸，各一两半） 木通 滑石（研，各二两） 冬葵子（炒，三合）
瞿麦穗（一两）
上 咀，每服三钱，水煎服，未下再服，以下为度。
地黄汤 治胞衣不出。（方法俱妙，宜详之）
蒲黄（炒） 生姜（切炒，各二钱半） 生地黄（半两，以铜竹刀切炒）
上以无灰酒三盏，于银器内同煎至二盏，去滓，分三服，未下，再作服。
泽兰汤 治胞衣不出。
泽兰叶（切研） 滑石末（各半两） 生麻油（少许）
上以水三盏先煎泽兰至一盏半，去滓，入滑石末并油更煎三沸，顿服之，未下更服。
蒲黄酒 治胞衣不下。（一方一变，切似化工）
蒲黄（炒，一合） 槐子（十四枚，为末）
上以酒三盏煎至二盏，去滓，分温二服，未下更作服。
以上治胎衣不下之剂。
当归川芎汤 治小产后瘀血，心腹痛，或发热恶寒。（平正之方，可法可法，尤妙）
当归 川芎 熟地黄 白芍药 玄胡索（炒） 红花 香附 青皮 泽兰 牡丹皮 桃
仁（各等分）
上水煎，入童便、酒各小半盏服。
若以手按腹愈痛，此瘀血为患，宜此药，或失笑散消之；若按之不痛，此是血虚，宜四
物、参、芩、白术。
芎 汤 治堕胎，心腹冷痛。
川芎 芍药 白术 阿胶（炒令燥） 甘草（炙，各一两）（既曰冷痛，则不宜芍药；又曰腹痛，
则不宜白术，用者详之）
一方无白术，有人参。
上 咀，每服三钱，入艾叶、糯米、生姜同煎，食前服。
当归散 治产后气血虚弱，恶露内停，憎寒发热。
当归 白芍药（炒） 川芎 黄芩（炒，各二两） 白术（五钱）
上为细末，温童便调下二钱。（此方以气血虚弱而用则可，以恶露内停而用芩、芍、白
术，恐不宜）
当归补血汤 治肌热躁热，目赤面红，烦渴引饮，昼夜不息，脉洪大而虚，重按全无，此
脉虚血虚也，若误服白虎汤必死。（病似阳明，症象白虎，故云然）
当归（三钱） 黄 （一两）
上作一服，水煎服。（此东垣神方也，病真药当，一服如神）
四物二连汤 治血虚发热，或口舌生疮，或昼安夜热。（此河间方，后二味，非实热心火不用）
当归 川芎 芍药 熟地黄 胡黄连 宣黄连（各一钱）
上作一服，水煎服。
妊娠月份未满，胎气未成熟而分娩的，称为半产。这大多是因为孕妇冲任二脉气虚，不能滋养胎儿，导致胎气不固；或者是因跌倒、撞击、闪挫坠落，致使气血受损动荡；又或是因为热病、温疟等疾病，都会导致半产。张仲景说：“寒邪与虚损相互搏结，这种脉象称为革脉，妇女出现这种情况就会发生半产和漏下。”
又说：半产俗称小产，无论是怀孕三四月还是五六月，只要胎儿已经成形，都称为半产。原因可能是由于忧恐、悲伤或突然暴怒；也可能是因为过度劳累、被打扑损伤；或者触犯暑热之气。此时应忌用黑神散，担心它含有热性药物会引发其他疾病，适宜使用玉烛散、和经汤之类的方剂。《便产须知》说：“小产不可轻视，调养护理的程度应是正常分娩的十倍。”又说：“半产后容易出现肌肉腐烂，应当补益其虚损，促进肌肉生长，补充气血，祛除风邪，养护脏腑之气，调养护理超过正常分娩的十倍，没有不能痊愈的，务必仔细审察。”
薛己说：“小产比大产更严重，因为大产就像栗子成熟后自然脱落，而小产如同生摘，破坏了皮壳，损伤了根蒂。”只是人们往往轻视而导致死亡的很多，治疗方法应当补益形体元气，生成新血，祛除瘀血。如果未满月，腹痛欲产，可用芎归补中汤加倍知母以制止；如果生产后出血不止，用人参黄芪汤补益；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，用八珍汤巩固；如果出血过多导致发热，用圣愈汤；汗出不止，急用独参汤；发热烦躁，肌肉跳动筋惕，用八珍汤；极度口渴面赤，脉象洪大而虚，用当归补血汤；身体发热面赤，脉象沉而微弱，用四君子汤加生姜、附子。李东垣说：“白天发热而夜间安静，是阳气在阳分旺盛；白天安静而夜间发热，是阳气下陷于阴分；如果昼夜都发热，是重阳无阴，应当峻补其阴。”王太仆说：“如果极寒且严重，加热后仍不暖，是无火（肾阳虚）；热来复去，白天显现夜间潜伏，夜间发作白天停止，随季节而动，也是无火。如果极热且严重，冷却后仍不凉，是无水（肾阴虚）；热动复止，忽来忽往，时动时止，也是无水。如果是阳气自旺者，用四物二连汤；阳气陷于阴者，用补中益气汤；重阳无阴者，用四物汤；无火者，用八味丸；无水者，用六味丸。”
有一位孕妇怀孕五月时服用剪红丸堕胎，腹部胀痛，服用破血药后更加严重，用手按压疼痛加剧。我说：“这是峻猛药物重伤脾胃所致，用八珍汤加倍人参、白术，加半夏、乳香、没药，两剂后疼痛停止，数剂后痊愈。（加倍和加法都有独到见解）”
史仲子的妻子刚二十岁，因患疫病导致胎堕，当时咳嗽，服用清肺解表药后，出现喘急失眠，请我诊治。我说：“脾土虚弱，不能生肺金，药物过重损伤了正气，给予补中益气汤加茯苓、半夏、五味子、炮姜，四剂后逐渐好转，再去诊视，又给予八珍汤加五味子及十全大补汤而痊愈。”
李东垣说：“妇女分娩及半产漏下，出现昏晕不省人事，闭目无知觉，这是因为血液突然大量流失，有形的血液离去，心神就失去了滋养。心和心包络属于君火和相火，得到血液则安宁，失去血液则危险，火上炽盛，所以令人昏晕；火胜克肺，闭目不省人事，是因为阴血突然丧失，不能镇抚阳气。血液已经亏损，往往有人使用滑石、甘草、石膏等甘辛大寒的药物，这些药能泻气分之热，这是血亏却泻气，即阴亏却泻阳，使两者都受伤（所谓‘有两死，而无两生’），反而加重不足。虚劳病昏迷不省人事的，是上焦心肺的热证，这是无形之热，如果用寒凉药驱使其下行，岂不知上焦的病都属于表证，乃是阴证，发汗则可痊愈，现在反而用攻下法，幸好不死，但会暴亏气血，必然折损寿命。又不知道《内经》有说，病气不足，宜补不宜泻。凡是闭目之病，都属于阴，宜汗不宜下，又不知道伤寒郁冒，得汗则愈，因此禁用寒凉药。分娩半产，本气未病，只是暴失其血，亡血当补血，这有什么可怀疑的呢？补其血则精神昌明，平时血下降亡失，现在应当补而升举之（妙在升阳），心得血养则神志不昏。如果血暴下，是秋冬之令太旺，应当举而升之，助其阳气，则眼睛睁开神志不昏。现在立一方，补血养血，生血益阳，以补手足厥阴经的不足，名为全生活血汤。（生产后的各种证候，可参考产后方论中的内容。）”
人参汤：治疗半产后，血下过多，心惊体颤，头目眩晕，或寒或热，脐腹虚胀疼痛。
人参（《别录》称人参能治心腹鼓痛，此处使用，因为是虚痛，若是实痛则不宜）、麦门冬（去心）、生干地黄、当归（洗）、芍药（炒）、黄芪、白茯苓、甘草（炙，各一两）。
以上切碎，每次服三钱，用水一盏煎至七分，饭前温服。
人参黄芪汤：治疗小产气虚，血下不止。（脾统血，气载血，此方最妙）
人参、黄芪（炒）、白术（炒）、当归、白芍药、艾叶（各一钱）、阿胶（炒二钱）。
以上作一剂，水煎服。
龙骨散：治疗因损伤妊娠而下血，恶血不止。（此方重在恶血不止，故用姜、艾）
龙骨、当归、地黄（各二两）、芍药、地榆、干姜、阿胶（各一两半）、艾叶（一两，炒）、蒲黄（一两二钱半）、牛角鳃（炙焦，二两半）。
以上为细末，饭前用米饮调下二钱。
全生活血汤：治疗妇人分娩及半产漏下，昏晕不省人事，闭目无知觉，此因血暴亡，心神无所养也，用此补血升阳。（阴从阳升，故用药如此）
升麻（三阴三阳之气俱升）、白芍药（各三钱）、当归（酒洗）、葛根、柴胡（去苗）、羌活、独活、防风、甘草（炙，各二钱）、川芎、藁本（各一钱五分）、生地黄（夏季加）、熟地黄（各一钱）、蔓荆子、细辛（各五分）、红花（三分）。
以上切碎，每次服五钱，用水二盏煎至一盏，去渣，饭前稍热服。
以上是治疗血下过多的方剂。
生地黄汤：治疗妊娠胎气受损动荡，气血不调，或因跌扑闪坠，以致胎堕，堕后恶滞不尽，腹中绞痛。
生干地黄（一两）、大黄（暴煨）、芍药、白茯苓、当归、细辛、黄芩、甘草（炙）、桂（去粗皮，各半两）。（妙在桂与大黄同用，但必须辨证准确方可）
以上切碎，每次服五钱，用水一盏半，入生姜、大枣拍碎同煎，至一盏，去渣，不拘时候温服。
当归酒：治疗妊娠堕胎后，血不出。
当归（炙令香）、芍药（炒，各二两）。
以上切碎，每次服三钱，用无灰酒一盏，入生地黄汁一合，银器内慢火煎至七分，去渣温服，以恶血排出为度。（产后忌芍药，但此处因血不出而用之，要知道与当归同用，并以无灰酒、生地汁同煮，则不收敛，而入肝行血矣）
乌金散：治疗妊娠堕胎后，血不下，兼治诸疾血病。
好墨（二两，折断成二寸长的段，烧至通红，用好醋一升，蘸七遍，再烧至通红放冷，另研为末）、没药（研）、麒麟竭（各二钱半）、麝香（一钱）。
以上为细末，每次服温酒调下一钱匕。如血迷心，用童便加酒调下二钱匕。
红蓝花散：治疗堕胎后血不出，奔心闷绝，不识人。（二方俱宜合之，以备缓急）
红蓝花（微炒）、男子发（烧存性）、京墨（烧红）、血竭（研）、蒲黄（隔纸炒，各等分）。
以上为细末，用童便小半盏调二钱，服之立效。
白蜜酒：治疗堕胎后，恶血不出。（妙在缓肝行血）
白蜜（二两）、生地黄（取汁一盏）、酒（半盏）。
以上汁与酒，共入铜器中煎五七沸，入蜜搅匀，分两次服，服三剂，百病可愈。
以上是治疗恶血不出的方剂。（以上诸方，攻补不同，所谓寒热温凉，各从其病情也，使用者须审察）
当归汤：治疗妊娠堕胎，胞衣不出。（此方活血滑利，催生下胞俱可用）
当归（切炒）、牛膝（酒浸，各一两半）、木通、滑石（研，各二两）、冬葵子（炒，三合）、瞿麦穗（一两）。
以上切碎，每次服三钱，水煎服，未下再服，以下为度。
地黄汤：治疗胞衣不出。（方法俱妙，宜详之）
蒲黄（炒）、生姜（切炒，各二钱半）、生地黄（半两，以铜竹刀切炒）。
以上用无灰酒三盏，于银器内同煎至二盏，去渣，分三次服，未下，再作服。
泽兰汤：治疗胞衣不出。
泽兰叶（切研）、滑石末（各半两）、生麻油（少许）。
以上用水三盏先煎泽兰至一盏半，去渣，入滑石末并油更煎三沸，顿服之，未下更服。
蒲黄酒：治疗胞衣不下。（一方一变，切似化工）
蒲黄（炒，一合）、槐子（十四枚，为末）。
以上用酒三盏煎至二盏，去渣，分温二服，未下更作服。
以上是治疗胎衣不下的方剂。
当归川芎汤：治疗小产后瘀血，心腹痛，或发热恶寒。（平正之方，可法可法，尤妙）
当归、川芎、熟地黄、白芍药、玄胡索（炒）、红花、香附、青皮、泽兰、牡丹皮、桃仁（各等分）。
以上水煎，入童便、酒各小半盏服。
若以手按腹愈痛，此为瘀血为患，宜此药，或失笑散消之；若按之不痛，此为血虚，宜四物、参、芩、白术。
芎 汤：治疗堕胎，心腹冷痛。
川芎、芍药、白术、阿胶（炒令燥）、甘草（炙，各一两）。（既曰冷痛，则不宜芍药；又曰腹痛，则不宜白术，用者详之）
一方无白术，有人参。
以上切碎，每次服三钱，入艾叶、糯米、生姜同煎，食前服。
当归散：治疗产后气血虚弱，恶露内停，憎寒发热。
当归、白芍药（炒）、川芎、黄芩（炒，各二两）、白术（五钱）。
以上为细末，温童便调下二钱。（此方以气血虚弱而用则可，以恶露内停而用芩、芍、白术，恐不宜）
当归补血汤：治疗肌热躁热，目赤面红，烦渴引饮，昼夜不息，脉洪大而虚，重按全无，此脉虚血虚也，若误服白虎汤必死。（病似阳明，症象白虎，故云然）
当归（三钱）、黄芪（一两）。
以上作一服，水煎服。（此东垣神方也，病真药当，一服如神）
四物二连汤：治疗血虚发热，或口舌生疮，或昼安夜热。（此河间方，后二味，非实热心火不用）
当归、川芎、芍药、熟地黄、胡黄连、宣黄连（各一钱）。
以上作一服，水煎服。
If delivery occurs before the full term of pregnancy and the fetal qi is not yet fully formed, it is called *ban chan* (semiflu abortion). This is generally due to deficiency of qi in the Chong and Ren meridians in the pregnant woman, which fails to nourish the fetus, leading to instability of fetal qi. It may also result from falls, bumps, or sudden jolts that damage and disturb blood and qi, or from febrile diseases such as warm malaria, all of which can cause semiflu abortion. Zhang Zhongjing stated: "Cold and deficiency interact, this pulse pattern is named Ge (Leather Pulse); in women, it manifests as semiflu abortion and dripping bleeding."
It is also said: Semiflu abortion is commonly referred to as *xiao chan* (minor abortion), whether occurring at three or four months, or five or six months, it is considered a minor abortion because the male or female form has already taken shape. Causes may include sudden worry, fear, grief, or anger; excessive physical labor or trauma from blows; or exposure to summer heat. At this time, Hei Shen San (Black Spirit Powder) should be avoided for fear that its hot-natured herbs will induce other ailments; instead, formulas such as Yu Zhu San (Jade Candle Powder) or He Jing Tang (Harmonizing Meridian Decoction) are appropriate. *Bian Chan Xu Zhi* states: "Minor abortion must not be taken lightly; nursing care should be ten times more intensive than that for normal delivery." It further states: "After semiflu abortion, muscle tissue may rot; one must tonify deficiencies, promote muscle regeneration, replenish blood and qi, dispel wind pathogens, and nourish organ qi. Nursing care exceeding that of normal delivery by tenfold ensures recovery without exception; this must be carefully examined."
Xue Ji said: "Minor abortion is more severe than major abortion. Major delivery is like a ripe chestnut falling naturally, whereas minor abortion is like picking it raw, breaking the shell and damaging the root." However, many deaths occur due to negligence. The treatment method should focus on tonifying body qi, generating new blood, and removing stasis. If delivery is threatened before full term with pain, Xiong Gui Bu Zhong Tang (Ligusticum and Angelica Tonifying Middle Decoction) with added Zhi Mu (Anemarrhena Rhizome) should be used to arrest it; if bleeding continues after delivery, Ren Shen Huang Qi Tang (Ginseng and Astragalus Decoction) should be used to tonify; if heart and abdominal pain occur post-delivery, Dang Gui Chuan Xiong Tang (Angelica and Ligusticum Decoction) is indicated; for weak fetal qi causing minor abortion, Ba Zhen Tang (Eight Treasure Decoction) is used to consolidate; if fever results from excessive blood loss, Sheng Yu Tang (Sage Salvation Decoction) is used; if sweating persists, Du Shen Tang (Single Ginseng Decoction) should be urgently administered; for fever, irritability, muscle twitching, and tendon tremors, Ba Zhen Tang is used; for extreme thirst, red face, and a large, empty pulse, Dang Gui Bu Xue Tang (Angelica Tonifying Blood Decoction) is used; for body heat, red face, and a deep, faint pulse, Si Jun Zi Tang (Four Gentlemen Decoction) with Sheng Jiang (Fresh Ginger) and Fu Zi (Aconite Lateral Root) is used. Li Dongyuan said: "Fever during the day and quietness at night indicates Yang qi flourishing in the Yang aspect; quietness during the day and fever at night indicates Yang qi sinking into the Yin aspect; fever both day and night indicates excess Yang and deficiency of Yin, requiring vigorous tonification of Yin." Wang Tai pu said: "Severe cold that does not respond to warming indicates absence of Fire (Kidney Yang deficiency); heat that comes and goes, appearing by day and hiding by night, or flaring at night and subsiding by day, moving with seasons, also indicates absence of Fire. Severe heat that does not respond to cooling indicates absence of Water (Kidney Yin deficiency); heat that moves and stops, coming suddenly and going suddenly, also indicates absence of Water. For self-flourishing Yang, use Si Wu Er Lian Tang (Four Substance and Two Coptis Decoction); for Yang sinking into Yin, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction); for excess Yang and deficient Yin, use Si Wu Tang (Four Substance Decoction); for absence of Fire, use Ba Wei Wan (Eight-Ingredient Pill); for absence of Water, use Liu Wei Wan (Six-Ingredient Pill)."
A pregnant woman who took Jian Hong Wan (Cut Red Pill) at five months to abort experienced abdominal distension and pain. Taking blood-breaking herbs worsened her condition, and pressure increased the pain. I said: "This is severe injury from harsh drugs affecting the Spleen and Stomach. Use Ba Zhen Tang with doubled Ren Shen (Ginseng) and Bai Zhu (Atractylodes Macrocephala Rhizome), plus Ban Xia (Pinellia Tuber), Ru Xiang (Frankincense), and Mo Yao (Myrrh). Two doses stopped the pain, and several doses led to recovery. (The doubling and addition methods show unique insight.)"
The wife of Shi Zhongzi, aged twenty, suffered abortion due to an epidemic disease. She had coughing; after taking Lung-clearing and exterior-releasing herbs, she developed wheezing, urgency, and insomnia. Upon examination, I said: "Spleen Earth is deficient and cannot generate Lung Metal. The heavy medication damaged her further. Prescribe Bu Zhong Yi Qi Tang with Fu Ling (Poria), Ban Xia, Wu Wei Zi (Schisandra Fruit), and Pao Jiang (Roasted Ginger). Four doses gradually improved her condition. On follow-up, Ba Zhen Tang with Wu Wei Zi and Shi Quan Da Bu Tang (Ten Complete Great Tonifying Decoction) were given until she recovered."
Li Dongyuan said: "Women suffering from delivery or semiflu abortion with dripping bleeding may experience fainting, unconsciousness, closed eyes, and lack of sensation. This is because blood is lost suddenly; when有形 (substantial) blood departs, the Heart Spirit loses its nourishment. The Heart and Pericardium belong to Ministerial and Sovereign Fire; they are calm when nourished by blood but endangered when blood is lost. With fire blazing upward, one becomes faint; fire overcoming the Lung leads to closed eyes and unconsciousness, caused by sudden loss of Yin blood failing to anchor the Yang. When blood is already deficient, some use Hua Shi (Talcum), Gan Cao (Licorice Root), and Shi Gao (Gypsum), which are sweet, pungent, and greatly cold herbs that drain heat from the Qi level. This drains Qi while Blood is deficient, draining Yang while Yin is deficient, injuring both (the saying 'two deaths, no two lives'), worsening the insufficiency. In consumptive diseases with coma and unconsciousness, the heat is in the Upper Jiao (Heart and Lung). This is formless heat; using cold herbs to drive it downward ignores that Upper Jiao diseases belong to the Exterior and are Yin patterns, cured by sweating. Now, purging them instead causes, fortunately, survival but violent depletion of Qi and Blood, shortening life. One must know the *Neijing* states: for deficiency of pathogenic Qi, tonification is preferred over purgation. Fainting belongs to Yin; sweating is preferred over purgation. One must know that in Cold Damage with depression and dizziness, sweating cures it; thus, cold herbs are contraindicated. Delivery and semiflu abortion do not inherently injure the Original Qi; only sudden blood loss occurs. Losing blood requires tonifying blood—what doubt remains? Tonifying blood makes the Spirit prosperous. Normally, blood descends and is lost; now it must be tonified and lifted (the subtlety lies in lifting Yang). The Heart receives blood nourishment, and the Spirit remains clear. If blood flows violently downward, it is like the command of Autumn and Winter being too strong; it must be lifted and raised, assisting Yang, so the eyes open and the Spirit remains clear. I now establish a formula to tonify, nourish, and generate blood and augment Yang, addressing the deficiency of the Hand and Foot Jueyin meridians, named Quan Sheng Huo Xue Tang (Complete Life Blood-Activating Decoction). (For various postpartum conditions, refer to the Postpartum Formula Treatise.)"
**Ren Shen Tang (Ginseng Decoction)**: Treats semiflu abortion with excessive bleeding, palpitations, body trembling, vertigo, alternating chills and fever, and empty, distending, painful umbilical/abdominal pain.
Ren Shen (Ginseng Root; *Ben Cao Jing Bie Lu* says it treats heart/abdominal drum-like pain; used here for deficiency pain, not suitable for excess pain), Mai Men Dong (Ophiopogon Tuber, heart removed), Sheng Gan Di Huang (Dried Rehmannia Root), Dang Gui (Angelica Sinensis Root, washed), Shao Yao (Peony Root, stir-fried), Huang Qi (Astragalus Root), Bai Fu Ling (Poria, white part), Gan Cao (Licorice Root, honey-fried; each 1 liang).
All cut into small pieces. Take 3 qian per dose, decoct in 1 sheng water to 0.7 sheng, take warm before meals.
**Ren Shen Huang Qi Tang (Ginseng and Astragalus Decoction)**: Treats minor abortion with Qi deficiency and continuous bleeding. (The Spleen controls blood, Qi carries blood; this formula is excellent.)
Ren Shen, Huang Qi (stir-fried), Bai Zhu (Atractylodes Macrocephala Rhizome, stir-fried), Dang Gui, Bai Shao Yao (White Peony Root), Ai Ye (Mugwort Leaf, each 1 qian), E Jiao (Donkey-hide Gelatin, stir-fried 2 qian).
Make one dose, decoct in water, and take.
**Long Gu San (Dragon Bone Powder)**: Treats bleeding from damaged pregnancy with persistent lochia. (Focuses on persistent lochia, hence use of Ginger and Mugwort.)
Long Gu (Dragon Bone), Dang Gui, Di Huang (Rehmannia Root; each 2 liang), Shao Yao, Di Yu (Sanguisorba Root), Gan Jiang (Dried Ginger), E Jiao (each 1.5 liang), Ai Ye (1 liang, stir-fried), Pu Huang (Typha Pollen, 1.25 liang), Niu Jiao Sai (Buffalo Horn Spicule, roasted to char, 2.5 liang).
Grind into fine powder. Take 2 qian mixed with rice water before meals.
**Quan Sheng Huo Xue Tang (Complete Life Blood-Activating Decoction)**: Treats women after delivery or semiflu abortion with dripping bleeding, fainting, unconsciousness, closed eyes, and lack of sensation, caused by sudden blood loss leaving the Heart Spirit un-nourished. Uses this to tonify blood and lift Yang. (Yin rises with Yang, hence these herbs.)
Sheng Ma (Cimicifuga Rhizome; lifts Qi of all three Yin and three Yang meridians), Bai Shao Yao (each 3 qian), Dang Gui (wine-washed), Ge Gen (Kudzu Root), Chai Hu (Bupleurum Root, tips removed), Qiang Huo (Notopterygium Rhizome), Du Huo (Angelica Pubescens Root), Fang Feng (Saposhnikovia Root), Gan Cao (honey-fried; each 2 qian), Chuan Xiong (Ligusticum Chuanxiong Rhizome), Ben Cao (Ligusticum Wallichii Rhizome; each 1.5 qian), Sheng Di Huang (Fresh/Dried Rehmannia Root, add in summer), Shu Di Huang (Prepared Rehmannia Root; each 1 qian), Man Jing Zi (Vernonia Fruit), Xi Xin (Asarum Root; each 0.5 qian), Hong Hua (Carthamus Flower, 0.3 qian).
Cut into pieces. Take 5 qian per dose, decoct in 2 sheng water to 1 sheng, strain, take slightly warm before meals.
*Above are formulas for excessive bleeding.*
**Sheng Di Huang Tang (Rehmannia Root Decoction)**: Treats pregnancy with disturbed fetal qi and disharmony of blood and qi, or abortion due to falls/bumps, resulting in incomplete expulsion of lochia and colicky abdominal pain.
Sheng Gan Di Huang (1 liang), Da Huang (Rhubarb Root, briefly roasted), Shao Yao, Bai Fu Ling, Dang Gui, Xi Xin, Huang Qin (Scutellaria Root), Gan Cao (honey-fried), Gui (Cinnamon Bark, bark removed; each 0.5 liang). (The妙 [wonder] lies in combining Gui and Da Huang, but accurate diagnosis is essential.)
Cut into pieces. Take 5 qian per dose, decoct in 1.5 sheng water with crushed Sheng Jiang (Fresh Ginger) and Da Zao (Jujube) to 1 sheng, strain, take warm anytime.
**Dang Gui Jiu (Angelica Wine)**: Treats post-abortion failure of blood to exit.
Dang Gui (roasted until fragrant), Shao Yao (stir-fried; each 2 liang).
Cut into pieces. Take 3 qian per dose, decoct in 1 sheng of non-intoxicating wine with 1 he of Sheng Di Huang Juice in a silver vessel over slow fire to 0.7 sheng, strain, take warm. Stop when lochia exits. (Shao Yao is contraindicated postpartum, but here used for retained blood; combined with Dang Gui, wine, and Rehmannia juice, it does not astringe but enters the Liver to move blood.)
**Wu Jin San (Black Gold Powder)**: Treats post-abortion failure of blood to descend, and various blood disorders.
Hao Mo (Good Ink Stick, 2 liang, broken into 2-cun segments, burned red-hot, dipped 7 times in 1 sheng good vinegar, burned red-hot again, cooled, and ground separately), Mo Yao (Myrrh, ground), Qi Lin Jie (Dragon's Blood, each 2.5 qian), She Xiang (Musk, 1 qian).
Grind into fine powder. Take 1 qian bi mixed with warm wine. If blood confuses the Heart, mix with Child's Urine and wine, take 2 qian bi.
**Hong Lan Hua San (Red Blue Flower Powder)**: Treats post-abortion retention of blood, rushing to the Heart causing suffocation and unconsciousness. (Combine both formulas for emergencies.)
Hong Lan Hua (Saflower, lightly stir-fried), Nan Zi Fa (Male Hair, burned to retain nature), Jing Mo (Beijing Ink, burned red), Xue Jie (Dragon's Blood, ground), Pu Huang (Typha Pollen, stir-fried between papers; equal parts).
Grind into fine powder. Mix 2 qian with a small half-sheng of Child's Urine. Take for immediate effect.
**Bai Mi Jiu (White Honey Wine)**: Treats post-abortion failure of lochia to exit. (The wonder lies in soothing the Liver and moving blood.)
Bai Mi (White Honey, 2 liang), Sheng Di Huang Juice (1 sheng), Jiu (Wine, 0.5 sheng).
Decoct juice and wine together in a copper vessel for 5-7 boils, mix in honey evenly. Divide into two doses. Take three courses to cure hundred diseases.
*Above are formulas for retained lochia. (These formulas vary in attacking and tonifying, reflecting cold, heat, warm, and cool properties according to the case; users must examine carefully.)*
**Dang Gui Tang (Angelica Decoction)**: Treats post-abortion failure of the placenta to expel. (This formula activates blood and promotes lubrication, useful for inducing labor and expelling placenta.)
Dang Gui (cut and stir-fried), Niu Xi (Achyranthes Root, wine-soaked; each 1.5 liang), Mu Tong (Akebia Stem), Hua Shi (Talcum, ground; each 2 liang), Dong Kui Zi (Malva Seed, stir-fried, 3 he), Qu Mai Sui (Polygala Spike, 1 liang).
Cut into pieces. Take 3 qian per dose, decoct in water. If not expelled, take again. Stop when expelled.
**Di Huang Tang (Rehmannia Decoction)**: Treats failure of placenta to expel. (Methods are excellent, examine carefully.)
Pu Huang (stir-fried), Sheng Jiang (cut and stir-fried; each 2.5 qian), Sheng Di Huang (half liang, cut and stir-fried with copper/bamboo knife).
Decoct in 3 sheng non-intoxicating wine in a silver vessel to 2 sheng, strain, divide into three doses. If not expelled, prepare another dose.
**Ze Lan Tang (Lycopus Decoction)**: Treats failure of placenta to expel.
Ze Lan Ye (Lycopus Leaf, cut and ground), Hua Shi Mo (Talcum Powder; each half liang), Sheng Ma You (Raw Sesame Oil, a little).
Decoct Ze Lan in 3 sheng water to 1.5 sheng, strain, add Talcum Powder and oil, boil three more times, take in one dose. If not expelled, take again.
**Pu Huang Jiu (Typha Pollen Wine)**: Treats failure of placenta to descend. (One formula, one variation, resembling natural creation.)
Pu Huang (stir-fried, 1 he), Huai Zi (Sophora Seed, 14 pieces, ground).
Decoct in 3 sheng wine to 2 sheng, strain, divide into two warm doses. If not expelled, prepare another dose.
*Above are formulas for retained placenta.*
**Dang Gui Chuan Xiong Tang (Angelica and Ligusticum Decoction)**: Treats post-minor abortion blood stasis, heart/abdominal pain, or fever with chills. (A balanced formula, exemplary and excellent.)
Dang Gui, Chuan Xiong, Shu Di Huang, Bai Shao Yao, Yan Hu Suo (Corydalis Rhizome, stir-fried), Hong Hua, Xiang Fu (Cyperus Rhizome), Qing Pi (Citrus Peel, green), Ze Lan, Mu Dan Pi (Moutan Cortex), Tao Ren (Peach Seed; equal parts).
Decoct in water, add a small half-sheng each of Child's Urine and Wine, take.
If pressing the abdomen increases pain, this is blood stasis; use this medicine or Shi Xiao San (Laughing Dispersal Powder) to resolve it. If pressing does not increase pain, this is blood deficiency; use Si Wu Tang, Ren Shen, Huang Qin, and Bai Zhu.
**Xiong Tang (Ligusticum Decoction)**: Treats abortion with cold pain in the heart and abdomen.
Chuan Xiong, Shao Yao, Bai Zhu, E Jiao (stir-fried until dry), Gan Cao (honey-fried; each 1 liang). (Since it is cold pain, Shao Yao is unsuitable; since it is abdominal pain, Bai Zhu is unsuitable; users should examine carefully.)
One variant has no Bai Zhu but includes Ren Shen.
Cut into pieces. Take 3 qian per dose, decoct with Ai Ye, Nuomi (Glutinous Rice), and Sheng Jiang, take before meals.
**Dang Gui San (Angelica Powder)**: Treats postpartum Qi and Blood deficiency with retained lochia, aversion to cold, and fever.
Dang Gui, Bai Shao Yao (stir-fried), Chuan Xiong, Huang Qin (Stir-fried; each 2 liang), Bai Zhu (5 qian).
Grind into fine powder. Take 2 qian mixed with warm Child's Urine. (Suitable for Qi/Blood deficiency, but using Huang Qin, Shao Yao, and Bai Zhu for retained lochia may be inappropriate.)
**Dang Gui Bu Xue Tang (Angelica Tonifying Blood Decoction)**: Treats skin heat, restlessness, red eyes and face, irritability, thirst with desire to drink, constant day and night, large and empty pulse, completely empty upon heavy pressure. This indicates pulse and blood deficiency. Misusing Bai Hu Tang (White Tiger Decoction) would be fatal. (The disease resembles Yangming, symptoms resemble White Tiger, hence this warning.)
Dang Gui (3 qian), Huang Qi (1 liang).
Make one dose, decoct in water, and take. (This is Dongyuan's divine formula; correct disease and correct medicine, one dose works like a spirit.)
**Si Wu Er Lian Tang (Four Substance and Two Coptis Decoction)**: Treats blood deficiency fever, mouth/tongue ulcers, or quietness by day and fever by night. (This is Hejian's formula; the last two ingredients are not used unless there is excess heat and Heart Fire.)
Dang Gui, Chuan Xiong, Shao Yao, Shu Di Huang, Hu Huang Lian (Coptis Chinensis Rhizome), Xuan Huang Lian (Scutellaria Baicalensis Root; each 1 qian).
Make one dose, decoct in water, and take.