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In pregnancy, contracting cold damage (Shanghan). The pathogenic factor enters the meridians. If mild, the mother is affected; if severe, the fetus is injured. When the branch is damaged, the fruit inevitably falls; this is a matter of course. Therefore, in treating such cases, one must first secure the fetal qi. If the fetus is stable, both mother and child are safe.
The face reflects the condition of the mother; the tongue reflects the condition of the fetus. A lustrous color indicates safety; a withered color indicates death. Red face and cyan tongue indicate fetal death with maternal survival. Cyan face and tongue with frothy saliva indicate death of both mother and fetus. There are also cases where both face and tongue are white, resulting in the death of both mother and fetus. This is due to the lack of luster in the color.

Pregnant woman with cold damage and white-coated tongue:
When a pregnant woman initially contracts cold, presenting with a red face and a slippery white coating on the tongue, one should induce slight sweating to release the exterior. If both face and tongue are white, it is caused by excessive intake of cold water during fever, leading to extreme yang transforming into yin. One should use warming middle-jiao herbs. If cold extremities and irritability appear, administering cooling agents by mistake will lead to death from cold reversal, vomiting, and diarrhea.

Pregnant woman with cold damage and yellow-coated tongue:
In pregnancy, with a red face and yellow tongue, after five or six days, interior syndromes appear. One should induce slight purgation to avoid the harm of heat pathogens injuring the fetus. If both face and tongue are yellow, this results from neglected sweating, causing damp-heat to enter the interior. One should use herbs that clear heat and promote urination.

Pregnant woman with cold damage and gray-black coated tongue:
In pregnancy, with both face and tongue black, water and fire are conflicting. Regardless of the month of gestation, both mother and fetus will die. If the face is red and the tongue slightly black, one should still attempt to preserve the fetus. If gray-black appears, it indicates the pathogen has entered the uterus, and the fetus cannot be sustained. If the face is red, the root is not yet damaged; one should urgently purge to save the mother.

Pregnant woman with cold damage and purely red tongue:
In pregnancy, contracting warm-cold damage, with both face and tongue red, one should follow the syndrome to apply sweating or purging methods; both mother and child will be safe. In cold damage, if the face is pale white but the tongue is red, the mother's qi has been deficient since long ago. One should use herbs like Shengjiang (Zingiberis Rhizoma Recens) and Guizhi (Cinnamomi Ramulus). Guizhi does not cause abortion, as stated by Pang Anchang. If the face is black and the tongue red, it is also an ill omen. If near term, the fetus may survive while the mother dies.

Pregnant woman with cold damage and purple-cyan tongue:
In pregnancy with cold damage, presenting with a red face and purple tongue, this is caused by alcohol toxin transmitting inward. If light purple with cyan edges, it indicates a yin syndrome with food stagnation. Formulas like Zhishi Lizhong Tang (Immature Bitter Orange and Poria Decoction) or Sini Tang (Frigid Extremities Decoction) may be used, though efficacy may be limited. If the face is red and the tongue cyan, although the mother may be unaffected, the fetus has died within the abdomen. One should urgently use Pingwei San (Stomach-Pacifying Powder) with Mangxiao (Natrii Sulfas) to purge.

Pregnant woman with cold damage and curled-short tongue:
In pregnancy, with a black face and dry, curled, short tongue, or yellow-black with prickles and cracks, this indicates an urgent interior syndrome. Failure to purge will allow heat pathogens to injure the fetus; purging carries immediate danger. Without symptoms like fixed gaze or grasping at empty air, one out of ten might be saved.