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When conception occurs for two or three months, vomiting and nausea are inevitable. This is because the menstrual blood ceases to flow at this time, causing an excess and stagnation of the Yangming channel qi, leading to discomfort with food intake. However, this is precisely the time when the embryo begins to form and the essence and blood begin to coagulate; thus, the sudden excess of qi and blood is merely a temporary state. By the fourth or fifth month, the blood gradually nourishes the fetus, its physical form matures, and it embodies the principles of the cyclical generation and restriction of the Five Elements. At this point, the blood has its proper destination and no longer stagnates excessively. One might ask: If the blood and qi are stagnant and excessive, why does pathology manifest specifically in the Stomach? The answer is that the Stomach is the sea of abundant qi and blood, and the mother of the five Zang organs. It is natural for women to undergo such physiological changes and transformations during pregnancy. Since menstruation stops due to pregnancy, the normal transformation of menstrual blood is abruptly halted, causing both qi and blood of the Yangming channel to become vigorous, resulting in a tendency to rebel upwards. Over time, this will naturally subside and need not be a cause for concern. Nevertheless, there are mild and severe cases. Mild cases can be managed with dietary regulation; severe cases require Liu Junzi Tang (Six Gentlemen Decoction) with added Amomum fruit (Sha Ren) and fresh ginger to harmonize the condition. One may ask: Is it true that Pinellia ternata (Ban Xia) damages the fetus? I reply: Consuming Pinellia ternata alone, even in non-pregnant individuals, can harm the body. However, when used together with Ginseng root (Ren Shen) and Atractylodes macrocephala rhizome (Bai Zhu), it only serves the function of opening the stomach and strengthening the spleen. (This illustrates the principle that one should evaluate formulas rather than isolated herbs; herbs should be analyzed within the context of the formula, not vice versa. Discussion of herbs is best limited to single-herb prescriptions.) Why is there a craving for food? The response is: When Stomach qi is vigorous, there is an appetite. Blood stagnation leads to rebellious qi; rebellious qi causes ingested food to be vomited back up. For women with irritable or aggressive temperaments, Huang Qin (Scutellaria baicalensis radix) can be added to Liu Junzi Tang to clear heat, dosed according to circumstances. The treatment of vomiting during pregnancy generally centers on this formula. If there was pre-existing epigastric pain that flares up during pregnancy, add Moutan cortex (Dan Pi) and Gardenia jasminoides seed (Shan Zhi). If fever is present, antipyretics are unnecessary; simply regulate with this formula.

Vaginal bleeding during pregnancy is called "Lou Tai" (Leaking Fetus), caused by Qi failing to contain the blood. Frequent use of Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) is indicated. If anger injures the Liver, causing Liver Wood to overact on Spleen Earth, leading to blood failure to be stored and resulting in leakage, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) with Rehmannia glutinosa root (Sheng Di) is used. (This condition varies by wind-heat, blood-heat, blood deficiency, Spleen fire, and Spleen Qi sinking; treatment must be tailored to symptoms. In young, robust women with smooth pulses and normal diet who experience regular menstruation without distress, this represents abundant Qi and blood, leaving surplus blood after fetal nourishment. However, excessive loss should be prevented, focusing primarily on harmonizing, cooling, and strengthening the blood and Spleen.)

Restless fetus is caused by blood's inability to nourish the fetus. Siwu Tang (Four Substance Decoction) is used, removing Chuanxiong rhizome (Chuan Xiong). Even if Chuan Xiong is retained, the dose should not exceed 1.5 grams (five fen), adding Atractylodes macrocephala rhizome (Bai Zhu) and Eucommia bark (Du Zhong). If Liver hyperactivity causes restlessness, characterized by wandering pain, use Dang Gui (Angelica sinensis radix), Bai Shao (White Peony root), Sheng Di, Huang Qin, Bai Zhu, and Gan Cao. If Qi deficiency is present, manifested by lethargy and drowsiness with a large, slow, and empty pulse, use Buzhong Yiqi Tang with wine-fried Bai Shao. (This condition requires differentiation based on methods from *Handan Yigao*; following those methods comprehensively is essential.)

Abortion, commonly known as miscarriage, generally stems from Qi and Blood deficiency, or from excessive sexual activity and alcohol consumption. Physicians often attribute it to heat causing fluidity or fetal fire forcing expulsion, failing to realize that when Qi and Blood are harmonious, where would fetal fire originate? Does the fetus not belong to the mother's body, possessing its own independent motion? Indiscriminate use of cold-natured drugs promotes Qi movement and blood circulation, ultimately leading to abortion. Is this not medical harm? After abortion, if taboos are not observed, recurrence in subsequent pregnancies at the same gestational age is likely. Failing to rescue and tonify, instead treating solely as fire syndromes, leads to recurrent abortions in third or fourth pregnancies. How can this be helped? I typically prescribe Dihuang Wan (Rehmannia Pill) in substantial doses beforehand to prevent impending abortion. At the critical moment, I prescribe Buzhong Yiqi Tang with wine-fried Bai Shao in substantial doses. Regardless of pulse or timing, I vigorously tonify the Middle Jiao and Mother Qi, ensuring safety. Even the ancient theory of tonifying specific meridians corresponding to specific months is ignorant of Yin-Yang principles and unreliable. (This condition is particularly common due to Kidney Essence deficiency.)

Zi Zhong (pregnancy edema), Zi Xuan (pregnancy chest/abdominal distension), Zi Sou (pregnancy cough), Zi Xie (pregnancy diarrhea), and urinary retention should all be treated with Buzhong Yiqi Tang. If these conditions are caused by excessive fetal fire, use Siwu Tang minus Chuan Xiong, plus Huang Qin, Bai Zhu, Fu Ling, and Gan Cao to harmonize. Specifically for Zi Xie with fire, use Sijunzi Tang (Four Gentlemen Decoction) plus Huang Qin and Sha Ren. For cold damage, malaria, or dysentery during pregnancy, the primary goal is securing the fetus. Cold damage is treated according to standard protocols without harming the fetus, but Dang Gui and Bai Shao should be doubled, or Ren Shen used, with preparation made in advance. Qian Hu Tang (Peucedanum Root Decoction) and Ban Xia Baizhi (Pinellia and Angelica Dahurica) are contraindicated. However, if Xiao Chaihu Tang contains Ren Shen, Ban Xia is permissible. Malaria treatment is similar to standard practice, except Qingzhong Qumei Yin (Clear Middle and Expel Malaria Decoction) should exclude Cang Zhu, Shan Zha, and Zhi Shi. Generally, Huang Qin is a key herb for malaria in pregnancy; dosage must be adjusted based on the patient's strength and weakness. (One asks: Are Bai Zhu and Huang Qin indispensable holy medicines for securing the fetus? Zhao states: Not necessarily. The fetus is attached to the Spleen like a bell hangs from a beam; if the beam is weak, it bends. Thus, securing the fetus first requires consolidating the two Kidneys, warming and neutralizing the Kidney area, so the Spleen gains vital energy. Why insist on Bai Zhu and Huang Qin? If heat in the abdomen causes restlessness, coolants are used; if cold causes restlessness, warmers are used—this is the standard method. However, the two Kidneys contain Water and Fire, serving as the root of the Chong and Ren vessels and the foundation of the fetal origin, which Bai Zhu and Huang Qin cannot secure alone. For fetal restlessness due to Kidney Water deficiency, use Liuwei Dihuang Tang (Six-Ingredient Pill with Rehmannia) to nourish water; for Kidney Fire deficiency, use Shenwei Dihuang Tang (Eight-Ingredient Pill with Rehmannia) to strengthen fire. Therefore, using Du Zhong, Xu Duan, Ejiao, Ai Ye, Dang Gui, and Wu Wei Zi within Liuwei or Shenwei Dihuang Tang is the most efficient approach. Ultimately, one principle runs through all. This discussion is unique and not found in other texts, so it is hereby highlighted.)