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Pregnant women presenting with thirst, irritability, sores on the tongue, swelling and cracking of both lips, dry stool, inability to defecate for several days, leading to abdominal pain and miscarriage, are often said by people to be caused by excessive heat-fire in the Large Intestine. However, who would know that this is actually fetal damage due to Blood Heat (Xue Re)? Blood serves to nourish the fetus; when mild and warm, the fetus benefits from it, but when too hot, the fetus suffers damage. If the heat persists and scorches for a long time, the fetus within the gestational sac will suffer as if immersed in boiling water, making survival difficult. Consequently, it must escape outward and descend downward to avoid the oppression of the inflammatory qi. How could one expect the fetus not to fall? Since blood nourishes the fetus, it inevitably becomes depleted. Blood belongs to Yin; when deficient, Yang becomes hyperactive, and hyperactivity brings harm. Moreover, blood is transformed from Yin fluids (Yin Shui). As blood daily nourishes the fetus, the supply is urgent and cannot wait. When fire blazes fiercely, Yin fluids cannot generate quickly enough to transform into blood, resulting in Yin deficiency with stirring fire. The Yin aspect contains nothing but fire qi, and the blood contains nothing but fire qi. The combination of two fires burns and oppresses the fetus, which is why the fetus descends. The treatment method should clear the fire in the Uterus (Bao Gong) and tonify the essence in the Kidneys, which can cure the condition. Some may doubt: since the fetus has already fallen, why attend to the uterus? Since blood no longer nourishes the fetus, why greatly tonify the Yin fluids? One does not realize that when extreme fire movement causes fetal expulsion, the uterus becomes purely filled with a mass of fire qi. This fire is Deficient Fire (Xu Huo). Excess fire can be purged, but deficient fire should be cleared amidst tonification, allowing the deficient fire to dissipate easily and the True Fire (Zhen Huo) to arise. If one solely uses cooling herbs to reduce fire, completely disregarding the excess or deficiency of the gestational sac, cold qi will inevitably become oppressive, and the vital Qi in the Stomach will become desolate. The Stomach belongs to the Two Yang meridians and is the source that nourishes the Five Zang organs. If Stomach Yang does not arise, how can it transform fine essences to generate Yin fluids? It would hardly fail to develop into Consumption Disease (Lao Zhai). Use the Modified Si Wu Tang (Four Substance Decoction). Prepared Rehmannia Root (Shu Di Huang, 5 qian, steamed nine times), Raw White Peony Root (Bai Shao, 3 qian, used raw), Angelica Sinensis Root (Dang Gui, 1 liang, washed with wine), Szechwan Lovage Rhizome (Chuan Xiong, 1 qian), Gardenia Fruit (Shan Zhi Zi, 1 qian, stir-fried), Cornus Officinalis Fruit (Shan Yu Rou, 2 qian, steamed, pips removed), Chinese Yam (Shan Yao, 3 qian, stir-fried), Moutan Cortex (Dan Pi, 3 qian, stir-fried). Decoct in water and take orally. Cure after four or five doses. Moutan Cortex has an urgent nature and cools the blood; using it postpartum best prevents the harm of Yin stagnation/coagulation, so be cautious! Marginal note: Adding Scutellaria Baicalensis Root (Tiao Qin, 2 qian) to this formula is particularly excellent. Song verse: Pregnant woman with thirst, dryness, restlessness, and irritability; sores on the tongue and turning/cracking of both lips. Dry stool and abdominal pain lead to miscarriage; blood heat scorching the fetus is the disease source. Clear the fire in the middle of the womb and tonify the Kidney Yuan; Modified Si Wu Tang shows extraordinary efficacy. Moutan Cortex, Gardenia, Chinese Yam, and Cornus fruit; tonifying while clearing disperses the deficient fire.