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Xu Wenbo accompanied Emperor Houfei of Song out of the gate of Leyou Garden. They encountered a pregnant woman. The emperor, skilled in diagnosis, examined her and said, "There is a female fetus in the abdomen." He then asked Xu Wenbo. Xu Wenbo replied, "There are two fetuses in the abdomen, one male and one female. The male is on the left, with a bluish-black complexion, and smaller in size than the female. The emperor had an impatient temperament and immediately wanted to剖视 (surgically inspect). Xu Wenbo, feeling pity, said, "If using knives or axes, there may be complications. Please allow me to use acupuncture, and the fetuses will fall immediately." Thus, he reduced (Xie) the Yinbai acupoint (SP-1, White Pearl) of the Foot-Taiyin Spleen Meridian and supplemented (Bu) the Hegu acupoint (LI-4, Union Valley) of the Hand-Yangming Large Intestine Meridian. The fetuses fell as expected by the needle. The two infants were born successively, exactly as he predicted.

Wei commented: This shows that for conditions of abortion, the Spleen is primary. Therefore, it can be known that methods for securing pregnancy also prioritize the Spleen.

Yu Zhen's note: Master Xu's skills were exquisite, and his responses were particularly clever. It seems Emperor Houfei was decadent and tyrannical. If he advised against killing the pregnant woman by verifying the fetal gender, the emperor would certainly not have listened. By saying, "If using knives or axes, there may be complications," he provided an excuse the emperor hoped would prove false, thus avoiding any cover-up. Consequently, the emperor allowed the use of acupuncture. The words of a benevolent person bring immense benefit.

Chen Douyan treated the wife of Ye Nanzhou. Her menstruation had ceased for five months, with white or red vaginal discharge, afternoon fever, cough, and vomiting. Physicians considered it Laozhai (Consumption/Tuberculosis). Chen examined her and said, "Both Chi pulses are excess; this must be pregnancy. It is caused by external Wind pathogen agitating the interior." She took a Qinghe (Clearing and Harmonizing) formula and stabilized. Within half a year, she gave birth to a son.

Xue Lizhai treated a patient at three months of pregnancy who experienced menstrual-like bleeding three to five times a month, but in small amounts. Her diet and spirit remained normal. This was due to Excess Blood, which the growing fetus could absorb, hence no further bleeding occurred. This proved correct.

Yu Zhen's note: These two cases resemble pregnancy yet appear pathological, which is common nowadays. One must be skilled in diagnosis to avoid confusion.

A certain pregnant woman, upon reaching five months, suffered from limb fatigue and loss of taste. Swelling began in both feet, gradually spreading to the whole body, and later involving the head and face. This was Qi and Yang deficiency of the Spleen and Lung. In the morning, she took Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction); in the evening, Liujunzi Tang (Six Gentlemen Decoction) with Zi Su Geng (Perilla Stem), and she recovered.

Cheng Wenbin treated a pregnant woman at seven months who complained of chest fullness and distension, and shortness of breath. Suddenly, she expectorated an object resembling a segment of small intestine, about one cun long. The family was terrified, suspecting uterine rot. Cheng arrived, palpated the Cun Kou pulse as Hong Hua (Surging and Slippery), determined that Qi was excessive while Blood was deficient, causing Fetal Qi to rush upward. Damp-Heat accumulated in the Middle Jiao generated Phlegm. The expectorated object was congealed Phlegm. The disease name was Zi Xuan (Fetal Distension). He used Zi Su Yin (Perilla Decoction) added with Huang Qin (Scutellaria Root), Huang Lian (Coptis Rhizome), and Bei Mu (Fritillaria Bulb). After ten doses, she fully recovered.

Yu Zhen's note: These two medical records outline the general treatment principles for Zi Zhong (Fetal Edema) and Zi Xuan.

Sun Dongsu treated a craftsman's wife who suffered from Heart pain at five months of pregnancy. Investigating the cause, he learned it resulted from falling from a building. Initially, he taught her to drink a cup of Le Jiu Zhi (Leek Juice), after which the pain stopped. Her husband then obtained medicine from a neighbor physician to decoct and administer. After taking it, the Heart pain returned, accompanied by vomiting copious fresh blood, a sensation of rushing upward in the chest, and unbearable pain. Sun diagnosed six pulses as Hong Da (Surging and Large), with profuse sweating like rain and continuous panting. Since the woman lived in a low, small upper-story room, he ordered her to move downstairs immediately. He then prescribed Yi Yuan San (Benefit the Origin Powder), five qian, mixed and taken with Zi Su Tang (Perilla Decoction). She slept soundly until dawn, the sweat ceased, breathing stabilized, and pain stopped. Another dose of Gu Tai Yin (Secure the Fetus Decoction) ensured complete safety. A neighbor physician privately asked, "The pulse for hematemesis should not be Hong Da. Combined with panting and sweating, the condition is critically dangerous. Moreover, pregnant women are contraindicated for diaphoresis, purgation, and promoting urination. Your prescriptions violate all these prohibitions, yet you achieved efficacy. Why?" Sun replied, "Medicine values syndrome differentiation. This woman's sweating was due to living in a low, small room during intense summer heat. Profuse sweating depleted Blood, causing the Fetus to lose nourishment, leading to palpitations and upward rushing, and interrupted breathing. Moving to the lower floor avoided the summer heat. Yi Yuan San is a sacred remedy for clearing summerheat, and Zi Su is an excellent product for calming the Fetus and directing Qi downward. When Qi descends, Blood returns to its origin, and the illness resolves. This is a syndrome-specific prescription. The method derives from modifications of Si Wu Tang in *Hai Zang Yi Lei Yuan Rong*. It is merely that you have not reviewed extensively, or even if you did, you would not recognize it as a treatment for pregnancy and childbirth. I merely integrated previous masters' methods and applied them without error."

Yu Zhen's note: Using Shi Huak (Talcum) before delivery and Zi Su (Perilla Leaf) when sweating excessively exemplifies "You Gu Wu Yun, Yi Wu Yun" (When there is a pathogenic factor, there is no injury; thus no injury occurs). Citing Si Wu Tang to prove this is actually forced association. This formula contains only Zi Su, Dan Shen (Salvia Root), Pu Huang (Typha Pollen), and Shi Huak. Thus, it can be falsely attributed.

A woman, seven months pregnant, dreamed of her deceased grandmother striking her back once. Upon waking, she felt fetal restlessness, vaginal bleeding, urgency in urination and defecation, and lower abdominal and lumbar distending pain for five days. This was also a strange event. Sun palpated her pulses; both Cun pulses were Duan Ruo (Short and Weak), indicating severe deficiency of Upper Jiao Yuan Qi. Immediate tonification was required. He used Ren Shen (Ginseng Root), Bai Zhu (Atractylodes Rhizome), and E Jiao (Donkey-Hide Gelatin) each 2 qian; Dang Gui (Angelica Root), Shao Yao (Peony Root), Huang Qin (Scutellaria Root), and Du Zhong (Eucommia Bark) each 1 qian; Sha Ren (Amomum Fruit) and Xiang Fu (Cyperus Rhizome) each 0.5 qian; Zhu Gen N Pi (Bamboo Shoot Skin/Phragmites Root Bark) 3 qian; and Cong Bai (Scallion White) 6 qian. After one dose, bleeding stopped; after two doses, all symptoms resolved. After four doses, Zhu Gen and Cong Bai were removed. After ten days of regulation, she delivered a healthy daughter at term.

Dongsu said: Mrs. Zhang, aged twenty-one, had her husband invite me to diagnose. The Left Cun and Guan were Duan Ruo (Short and Weak), Chi was Hua (Slippery); Right Cun was also Hua, Guan was Ru Ruo (Soft and Weak), Chi was Chen Wei (Deep and Minute). After diagnosis, I asked my assistant, "How is the pulse?" The assistant said, "Heart Spirit and Spleen Will are significantly deficient. There is Phlegm in the Lung Meridian." The husband said, "No, she is pregnant." The assistant said, "With such Short and Weak Left Cun, how can there be pregnancy?" The husband said, "It has been seventy days." The assistant pondered deeply, then asked, "Have you been pregnant before?" The husband said, "Twice already; this is the third time." The assistant asked if both previous births were at term, and whether they were male or female. The husband said, "I dare not hide it. The first was nearly nine months; limbs, face, and eyes were complete, but water and fire were indistinguishable, covered by a piece of flesh; died immediately after birth. The second was also nine months; no cry upon birth; mouth lacked a tongue; died shortly after. I do not know the cause of the abnormalities in the second and third pregnancies. I hope you examine carefully." The assistant then realized that the incompleteness of the previous two fetuses was caused by deficiency in the Heart and Spleen meridians, evident in the Left Cun and Right Guan pulses. He formulated a prescription focusing primarily on tonifying Heart Blood, advising frequent intake, up to one hundred doses. He used Suan Zao Ren (Zizyphus Seed), Yuan Zhi (Polygala Root), Fu Shen (Poria with Hostwood) each 1 qian; Bai Zhu 2 qian; Dang Gui, Bai Shao (White Peony Root), Gou Qi Zi (Goji Berry) each 1.5 qian; Gan Cao (Licorice Root) 0.5 qian; Sheng Di Huang (Rehmannia Root) 0.8 fen; Ai Xu (Mugwort Floss) 0.2 fen; and Long Yan Rou (Longan Aril) five pieces. Decocted in water. At term, she delivered a son. The following year, she became pregnant again, disregarding past events. At nine months, she delivered; the infant was fully formed, with a layer of fatty membrane covering the face, though eyes, ears, nose, and mouth were visible, but the membrane could not be removed. Reflecting on the previous child, he concluded it was due to the power of the medication.

Yu Zhen's note: Short and Weak pulses in both Cun indicate severe deficiency of Upper Jiao Yuan Qi; Short and Weak Left Cun indicates absence of pregnancy. These are insights from experienced practice. It is also evident that pulse diagnosis requires careful examination of each position. However, in this case, since it stated deficiency in both Heart and Spleen meridians, why only tonify the Heart and not the Spleen?