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Crab Claws (Shuangzhua, 1 sheng) Donkey-hide Gelatin (Ejiao, 3 liang) Licorice Root (Gancao, 2 liang)

When a woman's pulse is vigorous at both the yin and yang positions (superficial and deep, or upper and lower), it is called "Shuangqu" (indicating twin pregnancy). If the Shaoyin pulse is slightly tight, the blood becomes coagulated and turbid, leading to insufficient nourishment of the fetus. Consequently, one fetus may die prematurely while the other survives. If the dead fetus is not expelled, it will harm the mother and endanger the living fetus; this formula is indicated for such cases. Crab claws can break the uterus and induce abortion because they possess a sharp and hard nature, so they are not suitable for pregnant women. This formula uses crab claws to attack the dead fetus, Ejiao to stabilize the living fetus, and Gancao to moderate toxicity. One might ask: since crab claws are toxic and injurious to the hands, how can we ensure they do not harm the surviving fetus? I reply: without a dead fetus, there would be injury to the living one; with a dead fetus present, the toxicity follows its kind (acting only on the dead tissue). By attacking only the dead, we do not violate the living. This aligns with the principle in the *Book of Changes* (*I Ching*) that "forms gather according to their kinds, things group by their categories; water flows to wetness, fire moves toward dryness."

Ginseng Root (Renshen, 2 liang)

Add one sheng of water, decoct until half remains, and take warm.

This formula is indicated for postpartum blood syncope characterized by loss of consciousness.

"Blood syncope" refers to dizziness caused by excessive bleeding after childbirth. "Loss of consciousness" results from the massive depletion of Qi and Blood, rendering the Shen (Spirit) unable to function. Therefore, Renshen, a sweet and warm herb that tonifies primal Qi, is used as the principal agent. This herb can consolidate Qi, generate Blood, and benefit Yuan Qi. If the patient presents with body heat and rapid breathing, add one cup of child's urine (Tongbian). If the patient presents with cold limbs and weakness, add three qian of Aconite Root (Fuzi).

In cases of postpartum blood syncope with loss of consciousness, urgently burn charcoal and pour strong vinegar onto it. The fumes of the vinegar should be inhaled to astringe the Shen, naturally restoring mental clarity.

Safflower Flower (Honghua, 1 liang, stir-fried)

Soak in five cups of clear wine and take warm.

This formula is indicated for retained placenta (Baoyi bu xia).

Retained placenta occurs due to Qi deficiency and stagnant blood filling the uterus. Therefore, clear wine is used to strengthen Qi, and Honghua is used to resolve stasis.

Pig Kidney (Zhushen, one piece) White Glutinous Rice (Bainuomi, 3 he) Light Fermented Soybeans (Danchi, 5 he) Scallion White (Congbai, 1 sheng) Ginseng Root (Renshen) and Angelica Sinensis Root (Danggui) (each 2 liang)

This formula is indicated for postpartum "Rulao" (childbed consumption).

"Ru" refers to the period of childbirth. Weakness, emaciation, panting, and fatigue during childbirth, accompanied by alternating chills and fever resembling malaria, are termed "Rulao." This condition arises from severe deficiency of Qi and Blood failing to connect smoothly. Deficiency causes alternating chills, while stagnation causes alternating fevers. The chills and fever persist without respite; although symptoms resemble malaria, it is not actually malaria. Treatment requires substantial tonification of Qi and Blood to restore their smooth connection, thereby curing the disease. Thus, Renshen is used to tonify Qi, Danggui to tonify Blood, glutinous rice to benefit the Stomach, and scallions and fermented soybeans to awaken the Spleen. Pig kidney is included based on the principle of "similars attract," as it can tonify the area where the uterus is suspended.