Library

In cases of cold damage (Shanghan, a disease caused by external pathogenic cold) during pregnancy, treatment should primarily focus on clearing heat and calming the fetus. External methods such as applying medicaments to the navel can be used to protect the fetus. Regarding diaphoresis (inducing sweating) or purgation (inducing bowel movement), treatment should be guided by the pulse and symptoms indicating exterior or interior patterns. If an exterior pattern is present requiring diaphoresis, Qianghuo Chonghe Tang (Notopterygium Decoction for Harmonizing the Middle) may be used with added Chai Hu (Bupleuri Radix), Dang Gui (Angelicae Sinensis Radix), Shao Yao (Paeoniae Radix Alba), Zi Su Ye (Perillae Folium), and Cong Bai (Allii Fistulosi Bulbus). If there is an interior excess-heat pattern manifesting as constipation, restlessness, and thirst, Da Huang (Rhei Radix et Rhizoma) prepared as a purgative may also be used, but it must be processed with wine. Diseases have specific pathological correspondences; if the patient presents with true cold patterns characterized by deep, imperceptible pulses and cold extremities, Gan Jiang (Zingiberis Rhizoma), Rou Gui (Cinnamomi Cortex), and Fu Zi (Aconiti Lateralis Radix Praeparata) should be employed. Although Gan Jiang and Rou Gui are hot in nature, their harmful effects are neutralized when constrained by Huang Lian (Coptidis Rhizoma) and Gan Cao (Glycyrrhizae Radix et Rhizoma). Moreover, using medication when indicated may seem like violating conventional caution, yet it does not truly go against medical principles; if one fails to promptly regulate and treat the condition to eliminate extreme cold and heat pathogens, the fetus will be besieged by the disease and difficult to preserve. Why do people fear medications that remove pathogenic cold and heat, while accepting the cold and heat diseases that harm life?

Cold and heat sensations during pregnancy are all due to deficiency and damage of Qi and Blood, allowing Wind-Cold pathogens to invade. Wind is a Yang pathogen that transforms into heat; Cold is a Yin pathogen that transforms into cold. When Yin and Yang pathogens combine, cold and heat symptoms appear alternately. The Classics state: "When Yang is weak, there is aversion to cold; when Yin is weak, there is fever." These are all caused by deficiency, not by summer-heat. Treatment should involve clearing and resolving exterior pathogens while simultaneously greatly tonifying Qi and Blood. One should not be confused by the false appearance of cold and heat. If the cold and heat persist, steaming and damaging the fetus, the fetus will surely be injured. Furthermore, some patients suffer from "Fetal Malaria" (Tai Nue), where malaria-like symptoms occur immediately upon conception. These individuals typically have pre-existing Liver Fire. During pregnancy, Yin blood nourishes the fetal origin, leading to Liver Blood deficiency and dryness, resulting in alternating chills and fever. This resembles malaria but is not malaria. It should be treated with Xiaoyao San (Free and Easy Wanderer Powder) to clear Liver Fire and nourish Liver Blood, combined with Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) to nourish the source of transformation.

Consumption of raw and cold foods during pregnancy impairs the Spleen and Stomach's ability to transform and transport, causing pain in the heart and abdomen. Injury to the Blood aspect results in bloody stools (red dysentery); injury to the Qi aspect results in white mucus discharge (white dysentery); injury to both results in mixed red and white discharge. In cases of abdominal heaviness and downward bearing sensation with unstable fetal Qi, this is due to the downward sinking of Yuan Qi (Original Qi) which is too weak to ascend, causing Zhen Qi (True Qi) to sink. Large doses of Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) should be used to stabilize the fetus. One must strictly avoid using Qi-regulating or Qi-moving herbs, as this will exacerbate the downward bearing pathology. The fetus is anchored by the Kidney, much like a bell hung from a beam. If the beam is not sturdy, it will bend and break, and how can the bell remain intact? Moreover, symptoms resembling dysentery but not being true dysentery are often due to Middle Qi deficiency failing to ascend, Spleen Qi deficiency failing to separate turbid fluids, and Kidney Qi deficiency failing to secure and store. Do not injure the formless Yuan Qi because of the apparent stagnation of formed substances. Once the Yuan Qi is damaged, myriad pathological changes will emerge, and how can the fetus be preserved?