【脉】 平而虚者，乳子。阴搏阳别者，妊子。搏者近于下，别者出于上，血气
和调，阳施阴化也。
少阴脉动甚者妊。少阴，心脉也。尺中按之不绝者妊；三部脉浮沉正等，按之无绝者妊
。妊
娠初时寸微小，呼吸五至；三月而尺脉数。脉滑疾，重以手按之散者，盖三月也；脉重手按
之不散，但疾不滑者，五月也。寸微关滑尺带数，流利往来并雀啄，是妊。左沉实疾大，皆
为男，纵者主双；右沉实疾大，皆为女，横者主双。脉浮腹痛，痛引腰脊，为欲生也；脉一
呼三至曰离经，沉细而滑亦同；尺脉转急如切绳者，皆便生也。妊三月而渴，脉反迟，欲为
水分；复腹痛者，必堕。妊五月六月脉数，必坏；脉紧，必胞满；脉迟，必水坏为肿。妊六
七月脉弦，发热恶寒，其胎愈腹，腹痛，小腹如扇，子脏开故也。当温之以附子。妊六七月
，暴下斗余水，必倚而堕。妊七八月，脉实大牢强，弦者生，沉细者死。妊十月，足身热脉
乱者吉。少阴脉浮而紧，紧则疝瘕，腹中痛，半产而堕伤，浮则亡血，绝产恶寒。脉微涩为
无子，脉弦大为无子，血气虚不足之故也。新产脉沉小滑者生，实大强急者死；沉细附骨者
生，数疾不调死。新产因得热病，脉悬小，四肢温者生，寒清者死。新产因伤寒、中风，脉
实大浮缓者生，小急者死。脉得浮紧，当身痛；不痛，腹鸣者，当阴吹。寸口浮而弱，浮为
虚，弱无血；浮短气弱有热。趺阳浮而涩，浮气喘，涩有寒。少阴微而弱，微少血，弱生风
，微弱相搏，阴中恶寒。胃气不泄，吹而正喧，此谷气之寒也，膏发导之。少阴滑而数，阴
中必疮；少阴脉弦，白肠必挺核；少阴浮而动，浮虚，动痛、脱下。
【因证治】 胎坠因虚而热；转胞乃血虚有痰；胎漏逼胞，致小便不利；溺出不
知时因痰，胎避而下，因血气不能升，四物加贝母、滑石；痰加二陈。恶阻因痰血相搏，半
夏汤主之。
妊娠腹胀，乃气不利而虚有热。炒枳壳、黄芩、白术。妊娠寒热，小柴胡去半夏。胎痛
乃血少，四物、香附紫苏汤安胎大妙。
胎衣不下，或子死胎中，或血冲上昏闷，或暴下血，胞干不生。
半夏（一两半） 肉桂（七钱半） 大黄（五钱） 桃仁（三十，去皮尖）
先服四物三两，次服煎汤，姜煎。不效，再服。又半夏、白蔹丸之。
下死胎 肉桂（二钱） 麝香（五分，同下）
又方，朴硝半两，童便下。
欲堕方 肉桂（一两） 栝蒌（一两二钱） 牛膝（一两） 瞿麦（半两）
绝产方 蚕种纸一尺，烧灰，醋汤调服，永不孕产。
难产，乃败血裹其子。麝香（一钱）、盐豉（一两），青布裹，烧令红，捶为末。秤锤烧红
，淬酒下一钱。
又 百草霜 香白芷 伏龙肝（单用）
童便、醋调下，未下再服。
贝母、白蒺藜、活石、葵子，并治之。
产后阴脱，乃气血下溜。四物、 皮（各，半两）、牡蛎（ ）、黄芩（二两）或加升麻饮下
；蛇床子布裹熨妙；乌贼骨、硫黄、五味子，共末，糁患处。
产后血晕因暴虚，素有痰饮，瘀血随气上攻。
芎归汤 治暴虚，童便下；治瘀血，荆芥下。
清魂散 治虚。
泽兰叶 人参（一两） 荆芥（一两） 川芎 当归（半两）
温酒灌下。
五灵脂、荆芥，童便下；鹿角灰，酒下。
半夏茯苓汤 治痰饮。
牡丹散 牡丹皮 大黄（蒸） 芒硝（一两） 冬瓜子（半合） 桃仁（二十个）
水煎服。
浮肿，是胎前宿有寒湿。茯苓 白术 白芍 当归 陈鲤鱼。如法。
又名胎水，俗名子肿，如肿满状。产后因败血化水，或血虚气滞。
喘急。因营血暴竭，卫气无主，独聚于肺，此名孤阳绝阴，必死。因败血上熏于肺，夺
命丹主之；因伤风寒者，旋复花汤主之。
产后不语，因败血迷心窍。产后口鼻黑气起及衄，因胃气绝肺败，气消血散，乱入诸经
，却还不得，死矣。
子烦，二火为之。病则苦烦闷。麦门冬、茯苓、黄芩、防风、竹叶。
心痛，因宿寒搏血，血凝其气。五灵脂、蒲黄。醋下。
子痫（佚）
漏阻。因事下血，胎干不动，奔上抢心，腹中急迫。返魂丹、达生散、天仙方。
产妇临月未涎者，凡有病先以黄芩、白术安胎，然后用治病药。肌热者，黄芩、黄连、
黄、人参；腹痛者，白芍药、甘草。感冒根据解利。
产后诸病，忌用白芍，以黄芩、柴胡主之。内恶物，上冲胸胁痛者，大黄、桃仁；血刺
痛者，当归。内伤发热者，黄连；渴者，茯苓。一切诸病，皆根据前法。唯渴者，去半夏；喘
咳去参；腹胀忌甘草。产后身热血证，一同伤寒。若伤寒内有痛处，脉弦而健，宜解伤寒，
血虚无疼，脉弱而涩，宜补其血。
【脉象】
脉象平和而虚弱的，是正在哺乳期的妇女。阴脉搏动有力且与阳脉有所区别的，是怀孕的妇女。“搏”指脉气聚集于下部，“别”指上部脉气不同，这是血气调和、阳气施布、阴气化生的表现。
少阴脉（心脉）跳动明显的，是怀孕。尺部脉按之不绝的，是怀孕；寸、关、尺三部脉浮沉力度相当，按之不绝的，也是怀孕。妊娠初期，寸口脉微细，呼吸五次脉跳一次；到了三个月，尺脉变数。脉象滑利疾速，重按之下感觉散漫的，大约是怀孕三个月；脉象重按不散，只是快而不滑的，是怀孕五个月。寸口脉微，关脉滑，尺脉带数，流利往来如雀啄米状，这是怀孕。左手脉沉实疾大，多为怀男孩，若脉势纵长则主双胞胎；右手脉沉实疾大，多为怀女孩，若脉势横宽则主双胞胎。脉象浮而腹痛，疼痛牵引腰脊，是即将分娩的表现；一呼三至的脉象称为“离经”，沉细而滑的脉象也属于此类；尺脉转急如切绳状，都是即将分娩的表现。怀孕三个月出现口渴，脉象反而迟，可能是水饮为患；如果又出现腹痛，必然流产。怀孕五六月脉数，胎儿必坏；脉紧，必然胞宫胀满；脉迟，必然水液代谢失常导致水肿。怀孕六七月脉弦，发热恶寒，胎气上逆入腹，腹痛，小腹像扇子一样冷，这是因为子脏开泄所致。应当用附子温补。怀孕六七月，突然腹泻如水一斗多，必然倚靠身体而流产。怀孕七八月，脉象实大牢强，脉弦者能生，脉沉细者死。怀孕十月，足身发热，脉象紊乱的，预后良好。少阴脉浮而紧，紧主疝瘕，腹中痛，半产及堕胎损伤；浮主亡血，绝产及恶寒。脉微涩是无子的表现，脉弦大也是无子的表现，这是血气虚弱不足的缘故。新产后脉象沉小滑的，预后良好；脉象实大强急的，预后不良；脉象沉细附骨的，预后良好；脉象数疾不调的，预后不良。新产后因感受热病，脉象悬小，四肢温暖的，预后良好；四肢寒冷的，预后不良。新产后因伤寒或中风，脉象实大浮缓的，预后良好；脉象小急的，预后不良。脉象得浮紧，应当身体疼痛；如果不痛，腹鸣的，应当发生阴吹（阴道排气有声）。寸口脉浮而弱，浮主虚，弱主无血；浮短气弱主有热。趺阳脉浮而涩，浮主气喘，涩主有寒。少阴脉微而弱，微主少血，弱主生风，微弱相搏，阴中恶寒。胃气不泄，吹而正喧，这是谷气之寒，可用膏发导法治疗。少阴脉滑而数，阴中必有疮疡；少阴脉弦，白肠（直肠）必脱出成核；少阴脉浮而动，浮主虚，动主痛、脱下。
【病因证治】
胎坠是因为虚而有热；转胞（小便不通）是因为血虚有痰；胎漏逼胞，导致小便不利；溺出不自觉是因为痰，胎避而下，因为血气不能升提，用四物汤加贝母、滑石；痰多加二陈汤。恶阻（妊娠呕吐）是因为痰血相搏，用半夏汤主治。
妊娠腹胀，是因为气机不利而虚有热。用炒枳壳、黄芩、白术。妊娠寒热，用小柴胡汤去半夏。胎痛是因为血少，用四物汤、香附紫苏汤安胎效果极佳。
胎衣不下，或者胎儿死于胎中，或者血冲上导致昏闷，或者暴下血，胞干不生。
半夏（一两半） 肉桂（七钱半） 大黄（五钱） 桃仁（三十个，去皮尖）
先服四物汤三两，再服煎汤，姜汁煎煮。无效，再服。另外可用半夏、白蔹丸剂。
下死胎：肉桂（二钱） 麝香（五分，同下）
又一方，朴硝半两，童便送服。
欲堕方：肉桂（一两） 栝蒌（一两二钱） 牛膝（一两） 瞿麦（半两）
绝产方：蚕种纸一尺，烧灰，醋汤调服，永久不孕。
难产，是因为败血包裹胎儿。麝香（一钱）、盐豉（一两），青布包裹，烧红，捣为末。秤锤烧红，淬酒送下一钱。
又方：百草霜 香白芷 伏龙肝（单用）
童便、醋调下，未下再服。
贝母、白蒺藜、活石、葵子，一并治疗。
产后阴脱，是因为气血下溜。四物汤、[缺字]皮（各半两）、牡蛎（[缺字]）、黄芩（二两）或加升麻饮下；蛇床子布裹熨烫妙用；乌贼骨、硫黄、五味子，共为末，撒敷患处。
产后血晕是因为暴虚，素有痰饮，瘀血随气上攻。
芎归汤：治暴虚，童便送服；治瘀血，荆芥送服。
清魂散：治虚。
泽兰叶 人参（一两） 荆芥（一两） 川芎 当归（半两）
温酒灌下。
五灵脂、荆芥，童便送服；鹿角灰，酒送服。
半夏茯苓汤：治痰饮。
牡丹散：牡丹皮 大黄（蒸） 芒硝（一两） 冬瓜子（半合） 桃仁（二十个）
水煎服。
浮肿，是胎前宿有寒湿。茯苓 白术 白芍 当归 陈鲤鱼。依法炮制服用。
又名胎水，俗名子肿，如肿满状。产后因败血化水，或血虚气滞。
喘急。因为营血暴竭，卫气无主，独聚于肺，此名孤阳绝阴，必死。因为败血上熏于肺，用夺命丹主治；因为伤风寒者，用旋复花汤主治。
产后不语，因为败血迷心窍。产后口鼻黑气起及衄血，因为胃气绝肺败，气消血散，乱入诸经，却还不得，死矣。
子烦，由二火引起。病则苦烦闷。麦门冬、茯苓、黄芩、防风、竹叶。
心痛，因为宿寒搏血，血凝其气。五灵脂、蒲黄。醋下。
子痫（原文佚失）
漏阻。因为事下血，胎干不动，奔上抢心，腹中急迫。返魂丹、达生散、天仙方。
产妇临月未涎者，凡有病先以黄芩、白术安胎，然后用治病药。肌热者，黄芩、黄连、黄[缺字]、人参；腹痛者，白芍药、甘草。感冒根据解利。
产后诸病，忌用白芍，以黄芩、柴胡主治。内恶物，上冲胸胁痛者，大黄、桃仁；血刺痛者，当归。内伤发热者，黄连；渴者，茯苓。一切诸病，皆根据前法。唯渴者，去半夏；喘咳去参；腹胀忌甘草。产后身热血证，一同伤寒。若伤寒内有痛处，脉弦而健，宜解伤寒，血虚无疼，脉弱而涩，宜补其血。
[Pulse Diagnosis]
A pulse that is level and deficient indicates a woman who is nursing. A Yin pulse that is vigorous and distinct from the Yang pulse indicates pregnancy. "Vigorous" refers to the pulse qi gathering in the lower part, while "distinct" refers to the difference in pulse qi in the upper part; this signifies harmonious blood and qi, with Yang distributing and Yin transforming.
A vigorous movement of the Shaoyin pulse (Heart pulse) indicates pregnancy. If the Chi position pulse cannot be obliterated by pressure, it indicates pregnancy; if the Cun, Guan, and Chi positions have equal floating and sinking depths and cannot be obliterated by pressure, it also indicates pregnancy. At the beginning of pregnancy, the Cun position pulse is minute and fine, with five breaths per pulse beat; at three months, the Chi pulse becomes rapid. A slippery and rapid pulse, which feels scattered when pressed heavily, indicates approximately three months of pregnancy; a pulse that does not feel scattered under heavy pressure but is merely rapid without being slippery indicates five months of pregnancy. A minute Cun, slippery Guan, and rapid Chi pulse, flowing smoothly and coming and going like a sparrow pecking rice, indicates pregnancy. A left-hand pulse that is deep, solid, rapid, and large generally indicates a male fetus; if the pulse shape is longitudinal, it indicates twins. A right-hand pulse that is deep, solid, rapid, and large generally indicates a female fetus; if the pulse shape is transverse, it indicates twins. A floating pulse accompanied by abdominal pain radiating to the waist and spine indicates imminent labor. A pulse rate of three beats per exhalation is called "Li Jing" (departing from the standard), and a deep, fine, and slippery pulse is similar. A Chi pulse that becomes urgent like cutting a rope indicates imminent birth. Thirst during the third month of pregnancy with a contrary slow pulse suggests water retention; if accompanied by abdominal pain, miscarriage is inevitable. A rapid pulse during the fifth or sixth month indicates fetal demise. A tight pulse indicates uterine fullness. A slow pulse indicates water metabolism disorder leading to edema. During the sixth or seventh month, a wiry pulse with fever and aversion to cold, with fetal Qi rushing into the abdomen causing abdominal pain and a cold sensation in the lower abdomen like a fan, occurs because the Zi Zang (uterus) is open. It should be treated with warming agents such as Fuzi (Prepared Aconite Root). Sudden diarrhea of more than one dou of watery stool during the sixth or seventh month leads to miscarriage supported by leaning. During the seventh or eighth month, a solid, large, firm, and strong pulse that is wiry indicates survival, while a deep and fine pulse indicates death. In the tenth month, heat in the feet and body with a chaotic pulse is auspicious. A Shaoyin pulse that is floating and tight: tight indicates hernia and masses, abdominal pain, premature birth, and miscarriage injury; floating indicates blood loss, sterility, and aversion to cold. A minute and choppy pulse indicates infertility; a wiry and large pulse also indicates infertility, due to deficiency of blood and qi. After childbirth, a deep, small, and slippery pulse indicates survival; a solid, large, strong, and urgent pulse indicates death; a deep, fine pulse adhering to the bone indicates survival; a rapid and irregular pulse indicates death. For postpartum women contracting febrile diseases, a suspended small pulse with warm limbs indicates survival, while cold limbs indicate death. For postpartum women contracting Cold Damage or Wind Strike, a solid, large, floating, and moderate pulse indicates survival, while a small and urgent pulse indicates death. A floating and tight pulse should present with body pain; if there is no pain but borborygmus, it indicates Yin Chuī (noisy vaginal flatulence). A Cun position pulse that is floating and weak: floating indicates deficiency, weak indicates lack of blood; floating, shortness of breath, and weakness indicate heat. A Duyang pulse that is floating and choppy: floating indicates asthma/wheezing, choppy indicates cold. A Shaoyin pulse that is minute and weak: minute indicates less blood, weak indicates wind generation; minute and weak struggling together causes cold in the Yin region. Stomach Qi failing to vent leads to noisy blowing, caused by cold in grain Qi, treatable with Gao Fa Dao method. A Shaoyin pulse that is slippery and rapid indicates sores in the Yin region. A Shaoyin pulse that is wiry indicates prolapse of the Bai Chang (large intestine) forming a mass. A Shaoyin pulse that is floating and moving: floating indicates deficiency, moving indicates pain and prolapse.
[Etiology, Syndrome Differentiation, and Treatment]
Fetal descent is due to deficiency and heat. Zhuan Bao (retention of urine due to bladder displacement) is due to blood deficiency with phlegm. Tai Lou (fetal leakage) pressing on the Bao (uterus) causes difficult urination. Involuntary urination is due to phlegm; fetal descent is due to failure of blood and Qi to ascend. Treat with Si Wu Tang plus Bei Mu (Fritillaria Bulb) and Hua Shi (Talc); add Er Chen Tang for phlegm. E Zu (morning sickness) is due to struggle between phlegm and blood; treat primarily with Ban Xia Tang (Pinellia Decoction).
Abdominal distension during pregnancy is due to unfavorable Qi mechanism with deficiency and heat. Use Chao Zhi Qiao (Stir-fried Bitter Orange Peel), Huang Qin (Scutellaria Root), and Bai Zhu (Atractylodes Rhizome). Chills and fever during pregnancy: use Xiao Chai Hu Tang (Minor Bupleurum Decoction) removing Ban Xia. Tai Tong (fetal pain) is due to blood deficiency; An Tai Da Miao (Great Efficacy for Calming the Fetus) using Si Wu Tang, Xiang Fu (Cyperus Rhizome), and Zi Su (Perilla Leaf) is excellent.
Failure to expel the placenta may be due to fetal death in utero, blood rushing upward causing fainting, sudden profuse bleeding, or dry uterus preventing expulsion.
Ban Xia (Pinellia Tuber, 1.5 liang), Rou Gui (Cinnamon Bark, 0.75 liang), Da Huang (Rhubarb Root, 0.5 liang), Tao Ren (Peach Seed, 30 pieces, skin and tip removed).
First take Si Wu Tang (Four Substances Decoction) 3 liang, then take the decoction cooked with ginger. If ineffective, take again. Alternatively, use Ban Xia and Bai Lian (Trichosanthes Sieboldii Root) pills.
Expelling Dead Fetus: Rou Gui (0.2 liang), She Xiang (Musk, 0.05 fen, taken together).
Another prescription: Po Xiao (Mirabilite, 0.5 liang), taken with Tong Bian (Child's Urine).
Formula for Inducing Miscarriage: Rou Gui (1 liang), Gua Lou (Trichosanthes Fruit, 1.2 liang), Niu Xi (Achyranthes Root, 1 liang), Qu Mai (Dianthus Herb, 0.5 liang).
Sterilization Formula: Can Zhong Zhi (Paper with Silkworm Eggs, 1 chi), burned to ash, mixed with vinegar water and taken orally, resulting in permanent sterility.
Dystocia is caused by敗血 (stagnant blood) wrapping the fetus. She Xiang (Musk, 1 qian), Yan Chi (Salted Soybean Paste, 1 liang), wrapped in Qing Bu (Blue Cloth), burned red, pounded into powder. Take 1 qian with wine quenched from a red-hot weight.
Another formula: Bai Cao Shuang (Soot from Chimney), Xiang Bai Zhi (Angelica Dahurica), Fu Long Gan (Burnt Clay).
Take with Tong Bian and vinegar; repeat if not expelled.
Bei Mu (Fritillaria Bulb), Bai Ji Li (Tribulus Fruit), Huo Shi (Live Stone), Kui Zi (Malva Seed) all treat this condition.
Postpartum vaginal prolapse is due to downward flow of blood and Qi. Si Wu Tang, [Missing Character] Pi (Bark, 0.5 liang each), Mu Li (Oyster Shell, [Missing Character]), Huang Qin (0.2 liang), or added with Sheng Ma (Cimicifuga Rhizome) taken as a drink. Soaking Snake Bed Seed (She Chuang Zi) in cloth for hot compress is effective. Ou Gu (Cuttlefish Bone), Liu Huang (Sulfur), Wu Wei Zi (Schisandra Berry) powdered and applied to the affected area.
Postpartum blood syncope is due to sudden deficiency; pre-existing phlegm-fluids and stagnant blood attack upward with Qi.
Xiong Gui Tang (Ligusticum and Angelica Decoction): treats sudden deficiency taken with Tong Bian; treats stagnant blood taken with Jing Jie (Schizonepeta Spike).
Qing Hun San (Clear Soul Powder): treats deficiency.
Ze Lan Ye (Leonurus Leaf), Ren Shen (Ginseng Root, 1 liang), Jing Jie (1 liang), Chuan Xiong (Ligusticum Rhizome), Dang Gui (Angelica Sinensis Root, 0.5 liang).
Pour down with warm wine.
Wu Ling Zhi (Trogopterus Dung), Jing Jie, taken with Tong Bian; Lu Jiao Hui (Deer Horn Ash), taken with wine.
Ban Xia Fu Ling Tang (Pinellia and Poria Decoction): treats phlegm-fluids.
Mu Dan San (Moutan Powder): Mu Dan Pi (Moutan Cortex), Da Huang (Rhubarb Root, steamed), Mang Xiao (Mirabilite, 1 liang), Dong Gua Zi (Winter Melon Seed, 0.5 he), Tao Ren (Peach Seed, 20 pieces).
Decoct in water and take.
Edema is due to chronic cold-dampness before pregnancy. Fu Ling (Poria), Bai Zhu (Atractylodes Rhizome), Bai Shao (White Peony Root), Dang Gui (Angelica Sinensis Root), Chen Li Yu (Old Carp). Prepare according to method.
Also known as Tai Shui (Fetal Water), commonly called Zi Zhong (Fetal Swelling), resembling general edema. Postpartum, it is due to stagnant blood transforming into water, or blood deficiency with Qi stagnation.
Panting and urgency. Due to sudden exhaustion of Ying Blood, Wei Qi has no master, gathering solely in the Lung. This is named Gu Yang Jue Yin (Lonely Yang and Absolute Yin), which is fatal. Due to stagnant blood steaming upward to the Lung, treat with Duo Ming Dan (Life-Saving Pill); due to Cold Damage or Wind Strike, treat with Xuan Fu Hua Tang (Inula Flower Decoction).
Postpartum muteness is due to stagnant blood confusing the Heart orifices. Black Qi rising from the mouth and nose and epistaxis after childbirth indicates exhaustion of Stomach Qi and failure of the Lung; Qi dissipates, blood scatters, enters the meridians chaotically, cannot return, leading to death.
Zi Fan (Fetal Restlessness) is caused by two Fires. The patient suffers from vexation and oppression. Mai Men Dong (Ophiopogon Tuber), Fu Ling (Poria), Huang Qin (Scutellaria Root), Fang Feng (Saposhnikovia Root), Zhu Ye (Bamboo Leaf).
Heart pain is due to chronic cold clashing with blood, causing blood coagulation and Qi stagnation. Wu Ling Zhi (Trogopterus Dung), Pu Huang (Typha Pollen). Take with vinegar.
Zi Xian (Fetal Eclampsia) [Text Missing].
Lou Zu (Leakage and Obstruction). Bleeding after intercourse, dry fetus immobile, rushing up to seize the heart, abdominal urgency. Fan Hun Dan (Soul-Returning Pill), Da Sheng San (Generate Life Powder), Tian Xian Fang (Celestial Immortal Formula).
For pregnant women near term without saliva, if sick, first calm the fetus with Huang Qin and Bai Zhu, then use disease-treating medicines. For muscle heat, Huang Qin, Huang Lian (Coptis Rhizome), Huang [Missing Character], Ren Shen; for abdominal pain, Bai Shao Yao (White Peony Root), Gan Cao (Licorice Root). For colds, follow resolving methods.
For various postpartum diseases, avoid Bai Shao; primarily use Huang Qin and Chai Hu (Bupleurum Root). For internal foul matter rushing up causing chest and hypochondriac pain, use Da Huang and Tao Ren; for stabbing blood pain, use Dang Gui. For internal injury fever, use Huang Lian; for thirst, use Fu Ling. All diseases follow previous methods. For thirst only, remove Ban Xia; for panting and cough, remove Ren Shen; for abdominal distension, avoid Gan Cao. Postpartum body heat and blood syndromes are treated like Cold Damage. If Cold Damage has painful areas, pulse is wiry and robust, resolve Cold Damage; if blood deficiency with no pain, pulse is weak and choppy, tonify blood.