妊娠出痘势最难，母子相连掌握间，审其所因随证治，如圣安胎效通仙。
【注】孕妇最忌出痘，盖热能动胎，胎落则气血因之而伤，又安望其起胀、灌浆、结
痂耶？故遇孕妇出痘，始终以安胎为上。用如圣散随证加减治之，不可轻用犯胎之药，致
有触动。
如圣散
当归身 陈皮 白术（土炒） 大腹皮 黄芩 缩砂仁（连壳炒） 甘草（生）
黑豆（酒洗） 桑上 羊儿藤
水煎服。
初发热，加升麻、葛根、连翘。出而稠密者，加酒炒黄连、牛蒡子、连翘、南山楂。
不起发者，加牛蒡子、赤芍药。渴，加麦门冬、知母、花粉。血动者，四物汤加芩、连。
脾虚食少，毒发不出者，《千金》内托汤去肉桂，倍加参、 。身热有外邪者，参苏饮加
木香。
【方歌】安胎如圣散最宜，归陈白术大腹皮，黄芩砂仁共甘草，黑豆羊藤服莫疑。
痘出正盛逢临产，束手无策势最险，无羌十全大补治，恶露未尽黑神散。
【注】孕妇当痘正出之际，忽然欲产，俟产育后无他恙者，只宜大补气血，十全大补
汤主之。若腹中微痛，此恶露未尽也，黑神散主之。
十全大补汤（方见结痂落痂证治）
黑神散
当归 川芎 熟地黄 青皮（醋炙） 香附（醋炙） 蒲黄 桂心 干姜
水煎，温服。
【方歌】恶露未净黑神良，当归川芎熟地黄，青皮香附俱醋炙，蒲黄桂心合干姜。
孕妇感染痘疹，病情最为棘手，因为母子气血相连，安危掌握在医者手中。必须审察致病原因，根据具体证候进行治疗，使用如圣散来安胎，疗效如同神仙般灵验。
【注释】孕妇最忌讳出痘，因为热邪容易扰动胎气，一旦胎落，气血就会随之受损，又怎能期望痘疹能够起胀、灌浆、结痂呢？因此，遇到孕妇出痘，始终应以安胎为第一要务。使用如圣散并根据证候加减治疗，不可轻易使用可能伤胎的药物，以免触动胎气。
如圣散
当归身 陈皮 白术（土炒） 大腹皮 黄芩 缩砂仁（连壳炒） 甘草（生）
黑豆（酒洗） 桑上羊儿藤
水煎服。
初起发热时，加升麻、葛根、连翘。痘疹发出后稠密者，加酒炒黄连、牛蒡子、连翘、南山楂。
痘疹不起发者，加牛蒡子、赤芍药。口渴者，加麦门冬、知母、花粉。血动不安者，用四物汤加黄芩、黄连。
脾虚食少，毒邪无法透发者，用《千金》内托汤去掉肉桂，加倍加入人参、[此处原文缺失，推测为黄芪或类似补气药，但依规则不增添]。身体发热且有外邪者，用参苏饮加木香。
【方歌】安胎如圣散最为适宜，包含当归、陈皮、白术、大腹皮，黄芩、砂仁与甘草同用，黑豆、羊儿藤服用不必怀疑。
痘疹正旺盛时恰逢临产，束手无策形势最为危险，若无羌活则用十全大补汤治疗，若恶露未尽则用黑神散。
【注释】孕妇在痘疹正发出的时候，忽然想要生产，待分娩后没有其他病症的，只宜大补气血，以十全大补汤为主治。如果腹部微痛，这是恶露未尽的表现，以黑神散为主治。
十全大补汤（方剂见结痂落痂证治章节）
黑神散
当归 川芎 熟地黄 青皮（醋炙） 香附（醋炙） 蒲黄 桂心 干姜
水煎，温服。
When a pregnant woman contracts smallpox (or chickenpox), the condition is extremely difficult to manage, as the mother and fetus are connected by Qi and Blood, and their safety lies in the hands of the practitioner. One must examine the etiology and treat according to the syndrome; using Rusheng San (Like-Sage Decoction) to calm the fetus yields efficacy comparable to that of an immortal.
[Note] Pregnant women are most susceptible to complications from eruptive diseases, as heat pathogens can disturb the fetus. If the fetus is lost, Qi and Blood will be damaged, making it impossible to expect the eruption to swell, fill with pus, or form scabs. Therefore, when a pregnant woman suffers from an eruption, calming the fetus should always be the primary objective. Treat with Rusheng San (Like-Sage Decoction) modified according to the syndrome. Do not lightly use herbs that may harm the fetus, lest they disturb the pregnancy.
Rusheng San (Like-Sage Decoction)
Danggui Shen (Radix Angelicae Sinensis Root Body)
Chenpi (Pericarpium Citri Reticulatae)
Baizhu (Rhizoma Atractylodis Macrocephalae, stir-fried with soil)
Dafupi (Pericarpium Arecae)
Huangqin (Radix Scutellariae)
Suosharen (Fructus Amomi Rotundus, stir-fried with shell)
Gancao (Radix Glycyrrhizae, raw)
Heidou (Semen Sojae Nigrum, washed with wine)
Sangshang Yangerteng (Caulis Toxocarpus on Mulberry)
Decoct in water and take orally.
If fever is present at the onset, add Shengma (Rhizoma Cimicifugae), Gegen (Radix Puerariae), and Lianqiao (Fructus Forsythiae).
If the eruption is dense after appearing, add Huanglian (Rhizoma Coptidis, stir-fried with wine), Niubangzi (Fructus Arctii), Lianqiao (Fructus Forsythiae), and Nanshan Zha (Fructus Crataegi).
If the eruption fails to rise, add Niubangzi (Fructus Arctii) and Chishao Yao (Radix Paeoniae Rubra).
If there is thirst, add Maimendong (Radix Ophiopogonis), Zhimu (Rhizoma Anemarrhenae), and Huafen (Radix Bupleuri).
If there is blood disturbance, use Siwu Tang (Four Substances Decoction) plus Huangqin (Radix Scutellariae) and Lian (Rhizoma Coptidis).
If there is Spleen deficiency with poor appetite and the toxin fails to emerge, use Qianjin Neituo Tang (Inner-Supporting Decoction from Essential Prescriptions of a Thousand Gold Pieces) minus Rougui (Cortex Cinnamomi), with doubled doses of Renshen (Radix Ginseng) and [text missing in original].
If there is body heat due to external pathogens, use Shensu Yin (Ginseng and Perilla Drink) plus Muxiang (Radix Aucklandiae).
[Formula Song] Rusheng San for calming the fetus is most suitable,
Containing Danggui, Chenpi, Baizhu, and Dafupi.
Huangqin, Sharen, and Gancao together,
With Heidou and Yangteng, no need to doubt its efficacy.
When the eruption is at its peak and labor coincides, the situation is most perilous if one feels helpless. If there is no Qianghuo (Radix Notopterygii), use Shiquan Dabu Tang (Perfect Golden Great Tonifying Decoction); if lochia has not cleared, use Heishen San (Black Divine Powder).
[Note] When a pregnant woman is in the midst of an eruption and suddenly goes into labor, if she recovers without other complications after delivery, only a great tonification of Qi and Blood is appropriate, primarily using Shiquan Dubu Tang (Perfect Golden Great Tonifying Decoction). If there is slight abdominal pain, this indicates that lochia has not yet cleared; treat primarily with Heishen San (Black Divine Powder).
Shiquan Dabu Tang (Perfect Golden Great Tonifying Decoction) (See formula in the section on Scabbing and Falling Scabs)
Heishen San (Black Divine Powder)
Danggui (Radix Angelicae Sinensis)
Chuanxiong (Rhizoma Chuanxiong)
Shudihuang (Radix Rehmanniae Preparata)
Qingpi (Pericarpium Citri Reticulatae Viride, stir-fried with vinegar)
Xiangfu (Rhizoma Cyperi, stir-fried with vinegar)
Puhuang (Pollinis Typhae)
Guixin (Cortex Cinnamomi)
Ganjiang (Rhizoma Zingiberis)
Decoct in water and take warm.
[Formula Song] For uncleaned lochia, Heishen San is excellent,
Comprising Danggui, Chuanxiong, and Shudihuang.
Qingpi and Xiangfu are both stir-fried with vinegar,
Combined with Puhuang, Guixin, and Ganjiang.