《易·系》曰∶男女媾精，万物化生。是五类昆虫，咸感阴阳精气而成孕育。肾主藏精，为生气之原，
故胎之根本在肾，假血以成形。冲任之血，肝所主也，故始于肝脏主养，肝气暴虚，故多思酸作呕。夫
人生于寅，故始于厥阴木，脏腑之精气，次序资养，至十月而五行之阴阳已周，十干之气已化，归于壬癸
而生。（戊癸化火，丁壬化木。）此天地生成之道也。一月肝木，二月胆木，三月君火，四月相火，五月脾土，六
月胃土，七月肺金，八月大肠金，九月肾水，十月壬水，脏腑阴阳之气，循序相生，如主养之气不足，则
胎亦不长矣。（胎长如瓜，若不长，则有陨落之虞。）《金匮要略》
云∶怀身七月，太阳当养不养，此心气实，当刺泻劳宫，盖因火制其金也。故如土气主养，当培其土而
抑其木；金气主养，当泻其火而资其金。以逐月主养之脏腑，审其虚实而调之，此养胎之大要也。又火能
速物，是以三月、四月，多有半产之虞；火能克金，故七月亦有不足之虑，如胎气热者，当预防之。胎以
肾为本，故养胎以地黄、杜仲为君，坤德浓而资生万物，故白术、大枣为安胎之圣药；胎从血长，是以四
物汤乃胎产之要方。胎寄而生，故桑上寄生、川续断，力能系胞；火能速物，故芩、连、益母，皆为要
药；气化则血行而胎长，故砂仁、橘皮、紫苏、枳壳，宜兼用以疏气。夫天地交而万物生，水火济而阴
阳平，是以阿胶、艾叶、香附、茯苓，得交感之妙用者也。至于胎前百病，以治病、养胎之法，兼而行之，
此胎前之大纲领也。（妇人小儿，总是阴阳气血，止多胎产、痘疹耳！其
余百病皆归一法，是以《灵》、《素》诸经，不过分别数条，学人当明白此理。）
开之曰∶肺属天，七月而生者，得干金之气，故能育而且寿；九月感天癸之气，十月得化运之全，若
八月则不育矣。
The *Yijing* (Book of Changes) · *Xici* (Great Commentary) states: "When male and female interact, their essence blends, and all things are transformed." Thus, insects of the five categories all conceive and gestate by sensing the essence of Yin and Yang. The Kidney stores essence and is the source of vital Qi; therefore, the root of the fetus lies in the Kidney, taking form through blood. The blood of the Chong and Ren vessels is governed by the Liver; thus, gestation begins with the Liver providing nourishment. If Liver Qi becomes suddenly deficient, one may experience excessive thinking, craving for sour flavors, and nausea. Humans are born under the influence of Yin (associated with Wood/East), so development begins with the Jueyin Liver channel. The essence and Qi of the Zang-Fu organs nourish each other in sequence; by the tenth month, the Yin and Yang of the Five Elements are complete, and the transformation of the Ten Heavenly Stems is finished, returning to Ren and Gui (Water) for birth. (Wu and Gui transform into Fire; Ding and Ren transform into Wood.) This is the way of Heaven and Earth's generation. In the first month, Liver Wood governs; in the second, Gallbladder Wood; in the third, Ministerial Fire; in the fourth, Sovereign Fire; in the fifth, Spleen Earth; in the sixth, Stomach Earth; in the seventh, Lung Metal; in the eighth, Large Intestine Metal; in the ninth, Kidney Water; and in the tenth, Ren Water. The Yin and Yang Qi of the Zang-Fu organs generate each other in order. If the governing Qi is insufficient, the fetus will not grow properly. (Fetal growth is like that of a melon; if it does not grow, there is a risk of miscarriage.) The *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) states: "In the seventh month of pregnancy, if the Taiyang [Bladder] fails to provide its due nourishment, this indicates excess Heart Qi, and Laogong (PC 8) should be needled and drained, because Fire controls Metal." Therefore, when Earth Qi is governing, one should tonify Earth and suppress Wood; when Metal Qi is governing, one should drain Fire and support Metal. By examining the deficiency or excess of the organ governing each month and regulating accordingly, one grasps the main principle of fetal nourishment. Furthermore, Fire accelerates processes; thus, in the third and fourth months, there is often a risk of premature birth. Because Fire overcomes Metal, there is also concern about insufficiency in the seventh month. If fetal Qi is hot, preventive measures should be taken. Since the Kidney is the root of the fetus, Di Huang (Rehmanniae Radix) and Du Zhong (Eucommiae Cortex) are used as sovereign herbs for fetal nourishment, reflecting the thick virtue of Kun (Earth) which generates all things. Bai Zhu (Atractylodis Macrocephalae Rhizoma) and Da Zao (Ziziphi Jujubae Fructus) are considered holy medicines for calming the fetus. As the fetus grows from blood, Si Wu Tang (Four Substances Decoction) is a crucial formula for obstetrics. Since the fetus resides within the mother, Sang Shen Jian Sheng (Taxilli Herba) and Chuan Xu Duan (Dipsaci Radix) have the power to anchor the uterus. Because Fire accelerates processes, Huang Qin (Scutellariae Radix), Lian Zi (Nelumbinis Nuciferae Semen - *Note: Context implies Huang Lian Coptidis Rhizoma based on 'Qin, Lian' pairing for heat*, but text says 'Qin, Lian', usually Huang Qin & Huang Lian. I will use Huang Lian for Lian*), and Yi Mu Cao (Leonuri Herba) are important drugs. When Qi transforms, Blood moves, and the fetus grows; thus, Sha Ren (Amomi Fructus Rotundus), Ju Pi (Citri Reticulatae Pericarpium), Zi Su Ye (Perillae Folium), and Zhi Qiao (Aurantii Fructus Immaturus) are suitable for jointly regulating Qi. When Heaven and Earth interact, all things are born; when Water and Fire assist each other, Yin and Yang are balanced. Therefore, E Jiao (Colla Corii Asini), Ai Ye (Artemisiae Argyi Folium), Xiang Fu (Cyperi Rhizoma), and Fu Ling (Poria) possess the miraculous function of mutual interaction. Regarding various diseases during pregnancy, treating the disease while nourishing the fetus simultaneously is the general outline for prenatal care. (Diseases in women and children generally pertain to Yin, Yang, Qi, and Blood, with the addition of gestation/childbirth and smallpox/measles. All other hundred diseases fall under one method. Thus, the *Ling Shu* and *Su Wen* merely list several categories; students must understand this principle.) Zhang Zhicong explains: The Lung belongs to Heaven. Those born in the seventh month receive the Qi of the Metal Heavenly Stem, enabling them to be nurtured and long-lived. Those born in the ninth month sense the Qi of Tian Gui (Heavenly Purity/Menstrual Essence), and those born in the tenth month achieve the fullness of Qi transformation. However, those conceived/born in the eighth month would not survive.