薛立斋曰∶妊娠若元气不实，发热倦怠，或胎动不安，用当归散。因气恼，加枳壳。胸膈痞闷，再加苏
梗。或作痛、加柴胡。
若饮食不甘，或欲呕吐，用六君加紫苏、枳壳。
若恶阻呕逆，头晕体倦，用参橘散。未应，用六君子汤。
若恶阻呕吐，不食烦闷，亦用参橘散之类。
若顿仆胎动，腹痛下血，用胶艾汤。未应，用八珍汤加胶、艾。
若顿仆毒药，腰痛短气，用阿胶散，未应，煎送知母丸。
若顿仆胎伤，下血腹疼，用佛手散。未应，用八珍送知母丸。
若心惊胆怯，烦闷不安，名子烦，用竹叶汤。未应，血虚佐以四物，气虚佐以四君。
若下血不止，名胎漏，血虚用二黄散，血去多用八珍汤。未应，用补中益气汤。
若因事而动下血，用枳壳汤加生熟地黄。未应，或作痛。
更加当归。血不止，八珍汤加胶。艾。
若不时作痛，小腹重坠，名胎痛，用地黄当归汤。未应，
加参、术，陈皮。或因脾气虚，用四君加归、地；中气虚，用补中益气汤。
若面目虚浮，肢体如水气，名子肿，用全生白术散。未应，用六君子汤。下部肿甚，用补中益气倍
加茯苓。
或因饮食失宜，吐呕泄泻，此是脾胃亏损，用六君子汤。
若足指发肿，渐至腿膝，喘闷不安，或足指缝出水，名水气，用天仙藤散，脾胃虚弱，兼以四君子。
未应，用补中益气汤，兼以逍遥散。
若胎气上攻心腹，胀满作痛，名子悬，用紫苏饮。饮食不甘，兼以四君子汤。内热晡热，兼逍遥散。
若小便涩少，或成淋沥，名子淋，用安营散，不应，兼八珍汤。腿足转筋而小便不利，急用八味丸，缓
则不救。
若项强筋挛，语涩痰盛，名子痫，用羚羊角散。
或饮食停滞，腹胀呕吐，此是脾胃虚弱而不能消化，用六君子汤。不应，用平胃散加茯苓。
或胎作胀，或腹作痛，此是脾气虚而不能承载，用安胎饮加升麻、白术。不应，用补中益气。
或脐腹作胀，或小便淋闭，此是脾胃气虚，胎压尿胞，用四物加二陈、参、术，空心服后探吐，药出
气定，又吐数次必安。
或因劳役所伤，或食煎炒，小便带血，此是血得热而流于脬中，宜清膀胱，用逍遥散。
或遗尿不禁，或为频数，此是肝火血热，用加味逍遥散。
若胸满腹胀，小便不通，遍身浮肿，名胎水不利，用鲤鱼汤。脾胃虚，佐以四君子。病名同而形症异，
形症异而病
名同，聊见本方。
医案
一妊娠六月，每怒气便见血，甚至寒热头痛，胁胀腹痛，作呕少食。余谓∶寒热头痛，肝火上冲也；胁
胀腹痛，肝气不行也；作呕少食，肝侮脾胃也；小便见血，肝火血热也。用小柴胡加芍药，炒黑山栀、茯苓、
白术而愈。
一妊娠六月，体倦食少，劳役见血，用六君子加当归、熟地、升麻、柴胡而愈。
一妊娠三月，饮食后因怒患疟，连吐三次，用藿香正气散二剂，随用安胎饮一剂而愈。后因怒气，痰
盛狂言，发热胸胀，手揉少得，此肝脾气滞，用加味逍遥散加川芎，二剂顿退，四剂而安。
一妊娠饮食后恼怒，寒热呕吐，头痛恶寒，胸胁胀痛，大便不实而色青，小便频数而有血。余曰∶当清
肝健脾为主，不信，乃主安胎止血，益甚。问余曰，何也？曰∶大便不实而色青，此是饮食所伤而兼木侮；小
便频数而有血，是肝火血流于胞而兼挺痿。遂用六君子加枳壳、紫苏、山栀，二剂脾胃顿醒。又用加味逍遥散
加紫苏、枳壳，二剂小便顿清。更节饮食，调理而安。
一妊娠每至五月，肢体困倦，饮食无味，先两足肿，渐至遍身，后又头面。此是脾肺气虚，朝用补中
益气，夕用六君子加苏梗而安。
一妊娠因怒吐血块，四月不止，两胁胀痛，小便淋涩。此怒而血蓄于上部，火炎而随出也。胁胀腹痛，
小便淋涩、肝经本病也。用小柴胡加四物，四剂而止。却用六君子、安胎饮，调理而安。
恶阻
若中脘停痰，用二陈加枳壳。若饮食停滞，用六君子加枳壳。若脾胃虚弱，用异功散。若胃气不足，用人
参橘皮汤；兼气恼，加枳壳；胸胁胀闷，再加苏梗；胁痛，再加柴胡。若饮食少思，用六君子加紫苏，枳壳。
头晕体倦，用六君子汤。若脾胃虚弱，呕吐不食，用半夏茯苓汤。盖半夏乃健脾气、化痰滞之主药也。脾胃虚
弱而呕吐，或痰涎壅滞，饮食少思，胎不安，必用茯苓、半夏倍加白术。陈皮、砂仁能安胎气、健脾胃，予常
用之，验矣。
胎动不安
胎气郁滞者，用紫苏饮。脾气虚弱者，用六君子汤加苏、壳。郁结伤脾，归脾汤加柴、栀。郁怒伤肝
脾者，四七汤加芎、归。怒动肝火者，加味小柴胡汤。若胎已死，急用平胃散加朴硝腐化之。
漏胎下血
若因风热，用防风黄芩丸。若因血热，用加味逍遥散。若因血虚，用二黄散。若因血去太多，用八珍汤；
未应，补中益气汤。若因肝火，用柴胡山栀散。若因脾火，用加味归脾汤。若因事下血作痛，用八珍汤加阿
胶、熟艾。若因脾胃虚弱，用补中益气汤加五味子。若因脾胃虚陷，用前汤倍用升麻、柴胡。若潮晡热内热，
用逍遥散。
咳嗽
若秋间风邪伤肺，用人参败毒散。春间风邪伤肺，用参苏饮。若脾肺气虚，用六君子、芎、归、桔梗。若
血虚，四物、桑皮、杏仁、桔梗。肾火上炎，用六味丸加五味子服。脾胃气虚，风寒所伤，用补中益气加桑皮、
杏仁、桔梗，盖肺属辛金，生于己土，嗽久不愈者，多因脾土不能生肺气，腠理不密，以致外邪复感；或以
肺气虚不能生水，以致阴火上
炎而然，治法当壮土金、生肾水为善。
疟
因脾胃虚弱，饮食停滞；或外邪所感，郁怒伤脾；或暑邪所伏。审系饮食停滞，用六君子加桔梗、苍术、
藿香。外邪多而饮食少，用藿香正气散。外邪少而饮食多，用人参养胃汤。劳伤元气，用补中益气汤。若郁
怒所伤，用小柴胡兼归脾汤。若木侮土而不愈，用六君子为主，佐以安胎药。仍参三阴三阳而治之。
小产
重于大产。盖大产如栗熟自脱，小产如生采，破其皮壳，断其根蒂，岂不重于大产？治法宜补形气，生
新血，去淤血。若未足月，痛而欲产，芎归补中汤倍知母止之。若产而血不止，人参黄 汤补之。若产而心腹
痛，当归川芎汤主之。胎气弱而小产者，八珍汤固之。若出血过多而发热，圣愈汤。汗不止，急用独参汤。发
热烦躁，肉 筋惕，八珍汤。大渴面赤，脉洪而虚，当归补血汤。身热面赤，脉沉而微，四君、姜、
附。若阳气自旺者，补中益气汤。阳气陷于阴中者，四物二连汤。重阳无阴者，四物汤。无火者，八味丸。
无水者，六味丸。
一妊娠，停食腹满，呕吐吞酸，作泻不食。余以为饮食停滞，兼肝木伤脾土，用六君子汤以健脾胃，
加苍术、浓朴以消饮食，吴茱萸、黄连以清肝火，诸症悉愈。又以六君子加砂仁调，而脾土乃安。
一妊娠，胸腹膨胀，吐痰不食。此脾胃虚而饮食为痰，用半夏茯苓汤渐愈，又用六君子加枳壳、苏梗，
而饮食如常。后因恚怒，胁胀不食，吐痰恶心，用半夏茯苓汤加柴胡、山栀而愈。
一妊妇，内热晡热，或兼寒热，饮食少思，其胎或下坠，或上攻。此肝经血虚而火动耳，先用加味逍遥
散数剂，次用六君子加柴胡、枳壳，各数剂而安。
一妊妇下血，服凉血之剂，下血益甚，食少体倦。此脾气虚而不能摄血，余用补中益气汤而愈。后因怒而
寒热，其血仍下，此肝火旺而血沸腾，用加味逍遥散血止，用补中益气汤而安。
一妊妇，每因恚怒，其胎上逼，左关脉弦洪，乃肝火内动，用小柴胡加茯苓、枳壳、山栀而愈。但体倦
不食，用六君子调养脾土，加柴胡、枳壳调和肝气而瘥。
一妊妇下血，发热作渴，食少体倦，属脾气虚而肝火所侮，用四君子加柴胡、山栀血止。因怒复作，用
六君加柴胡、山栀、升麻而安。
一妊妇，胎上逼，胸满嗳气，饮食少思。此脾气郁滞，用紫苏饮顿安，又用四君子加枳壳、柴胡、山栀
而瘥。
一妊妇，因怒胸膈不利，饮食少思，服消导顺气之剂，脾胃愈弱，饮食愈少，大便不实且无度，久而便
黄水，或带白，视其面色，黄中隐白。余曰∶黄色脾虚也，白色肺虚也，朝以补中益气汤升补胃气，夕以六君
子培补脾气而愈。
一妊妇，心腹作痛，胸胁作胀，吞酸不食。此肝脾气滞，用二陈、山楂、山栀、青皮、木香而愈。又因
怒仍痛，胎动不食，面色青黄，肝脉弦紧，脾脉弦长，此肝乘其土，用六君子汤加升麻、柴胡、木香而安。
一妊妇，心痛，烦热作渴，用白术散即愈，后因停食，其痛仍作，胸腹膨胀，按之则痛。此因饮食停滞
，用人参养胃汤。按之不痛，乃脾胃受伤，以六君子补之而愈。
一妊妇，小腹作痛，其胎不安，气攻左右，或时逆上，小
便不利，用小柴胡加青皮、山栀清肝火而愈。后因怒小腹胀满，小便不利，水道重坠，胎仍不安，此亦肝火
炽盛所致，用龙胆泻肝汤，一剂诸证顿愈，乃以四君子加升、柴以培脾土而安。
一妊妇，饮食停滞，心腹胀满，或用人参养胃汤加青皮、山楂、枳壳，其胀益甚，其胎上攻，恶心不食，
右关脉浮大，按之则弦。此脾土不足，肝木所侮，余用六君子加柴胡、升麻而愈。后小腹痞闷，用补中益气
升举脾气乃瘥。
吴江庠史万湖子室，年二十余，疫疾堕胎时咳，服清肺解表之药，喘急不寐。予以为脾土虚，不能生肺
金，药复损而益甚也。先与补中益气汤加茯苓，半夏、五味、炮姜，四剂渐愈。后往视之，用八珍加五味，
及十全大补而愈。
一妊妇，胎六月，体倦懒食，面黄晡热，而胎不长，因劳欲坠，此脾气不足也，用八珍汤倍加参、术、
茯苓，三十余剂，脾胃渐健，而胎安且长矣。
一妊妇，因怒寒热往来，内热晡热，胁痛呕吐，胎至八月而不长。此因肝脾郁怒所致，用六君子加柴胡、
山栀、枳壳、紫苏、桔梗，痛愈而胎亦长矣。
一妊妇，堕胎昏愦，不时吐痰，自用养血化痰之剂，昏愦不省，自汗发搐，痰涎涌出。彼以为中风，欲
用祛风化痰。余曰∶此属脾气虚寒所致。用十全大补加炮姜，二十余剂而愈。
一妊妇，八月胎欲堕如产，卧久少安，日晡益甚。此气血虚弱，朝用补中益气加茯苓、半夏、随愈。更以八
珍汤调理而安。
一妊妇，嗽则便自出。此肺气不足，肾气亏损，不能司摄，用补中益气以培土金，六味丸加五味以生肾
气而愈。
一妊妇，咳嗽，其痰上涌，日五六碗许，诸药不应。余以为，此水泛为痰，用六味丸及四君子汤，各一
剂，稍愈，数剂而安。
一妊妇，因怒吐血，两胁胀痛，小便淋漓。此怒而血蓄于上，随火出也，用小柴胡合四物，四剂而血止；
用六君子，安胎饮，调理而安。
一妊妇，烦热吐痰，恶心头晕，恶食。此脾虚风痰为患，用半夏白术天麻汤，以补元气、祛风邪，渐愈。
惟头晕未痊，乃用补中益气汤加蔓荆子，以升补阳气而愈。
一妊妇，出汗口噤，腰背反张，时作时止。此怒动肝火也，用加味逍遥散渐愈，又用钩膝散而止，更以
四君加钩藤、山栀、柴胡而安。
一妊妇，四肢不能伸，服祛风燥血之剂，遗尿痰甚，四肢抽搐。余谓肝火血燥，用八珍汤加炒黑黄芩为
主，佐以钩藤汤而安，后因怒，前证复作，小便下血，寒热少寐，饮食少思，用钩藤散加山栀、柴胡而血止。
用加味逍遥散，寒热退而得寐；用六君子汤加芍药、钩藤，饮食进而渐愈。
一妇人，经闭八月，肚腹渐大，面色或青或黄，用治胎之药不应。余曰∶面青脉涩，寒热往来，肝经
血病也。面黄腹大，少食体倦，脾经血病。此郁怒伤脾肝之证，非胎也。不信，仍用治胎之类，不验。余用加
味归脾、逍遥二药，各二十余剂，诸证稍愈。彼欲速效，别服通经丸一服，下血昏愦，自汗恶寒，手足俱冷，
呕吐不食。余用人参、炮姜二剂，渐愈。又用十全大补汤，五十余剂而安。
一妊妇，患疟已愈，但寒热少食，头痛，晡热内热。此脾虚血弱也，用补中益气加蔓荆子，头痛顿止；
又用六君子加芎、归，饮食顿进。再用逍遥加参、术，而寒热愈。
一妊妇，霍乱已止，但不进饮食，口内味酸，泛行消导宽中。余曰∶此胃气伤而虚热也，当用四君子汤。
彼不信，乃服人参养胃汤，呕吐酸水，其胎不安。是胎复伤也，仍与四君子汤，俾煎熟，令患者先嗅药气，
不作呕，则呷少许，恐复呕则胎为钩动也。如是旬余而愈。
边太常侧室，妊娠泄泻，自用枳实、黄连之类，腹闷吐痰，发热恶寒，饮食到口即欲作呕，强匙许
即吞酸不快，欲用祛痰理气。余曰∶此因脾胃伤，而痰滞中脘，若治痰气，复伤脾胃矣。遂以参、术、炮姜为
末，丸如黍粒，不时含咽三五丸，渐加二三十丸，三日后进六君子，而寻愈。
地官胡成之内，妊娠久痢，自用消导理气之剂，腹内重坠，胎气不安、又用阿胶、艾叶之类，不应。余曰∶
Xue Lizhai stated: If a pregnant woman has insufficient Yuan Qi (Original Qi), presenting with fever, fatigue, or restless fetus, use Danggui San (Angelica Powder). If caused by anger and irritation, add Zhike (Bitter Orange Fruit). If there is chest and diaphragm fullness and oppression, add Sugeng (Perilla Stem). If accompanied by pain, add Chaihu (Bupleurum Root).
If appetite is poor or there is a desire to vomit, use Liujunzi Tang (Six Gentlemen Decoction) plus Zisu (Perilla Leaf) and Zhike.
If morning sickness causes vomiting and retrograde qi, dizziness, and body fatigue, use Shenju San (Ginseng and Tangerine Peel Powder). If ineffective, use Liujunzi Tang.
If morning sickness involves vomiting, anorexia, and mental restlessness, also use Shenju San or similar formulas.
If trauma from falling or striking causes fetal movement, abdominal pain, and bleeding, use Jiao'ai Tang (Colla Corii Asini and Artemisia Argyi Decoction). If ineffective, use Bazhen Tang (Eight Treasure Decoction) plus Ejiao (Donkey-hide Gelatin) and Aiyi (Mugwort Leaf).
If injury from falling or accidental ingestion of toxic substances causes lower back pain and shortness of breath, use Ejiao San (Donkey-hide Gelatin Powder). If ineffective, administer Zhimu Wan (Anemarrhena Pill) with decoction.
If trauma damages the fetus causing bleeding and abdominal pain, use Foshou San (Buddha's Hand Powder). If ineffective, use Bazhen Tang to deliver Zhimu Wan.
If there is heart palpitations, fearfulness, mental restlessness, and unease, termed "Zi Fan" (Fetal Agitation), use Zhuye Tang (Bamboo Leaf Decoction). If ineffective, for Blood deficiency, assist with Siwu Tang (Four Substance Decoction); for Qi deficiency, assist with Sijunzi Tang (Four Gentlemen Decoction).
If bleeding continues without stopping, termed "Tai Lou" (Fetal Leakage), for Blood deficiency use Erhuang San (Two Yellow Powders); for excessive blood loss, use Bazhen Tang. If ineffective, use Buzhong Yiqi Tang (Center-Boosting and Qi-Supplementing Decoction).
If bleeding occurs due to physical agitation, use Zhike Tang (Bitter Orange Decoction) plus Sheng Dihuang (Rehmannia Root) and Shu Dihuang (Prepared Rehmannia Root). If ineffective, or if pain arises, add Danggui (Angelica Sinensis Root). If bleeding persists, use Bazhen Tang plus Ejiao and Aiyi.
If intermittent pain occurs with a heavy, bearing-down sensation in the lower abdomen, termed "Tai Tong" (Fetal Pain), use Dihuang Danggui Tang (Rehmannia and Angelica Decoction). If ineffective, add Renshen (Ginseng), Baizhu (Atractylodes Macrocephala Rhizome), and Chenpi (Tangerine Peel). If Spleen Qi is deficient, use Sijunzi Tang plus Danggui and Dihuang; if Middle Qi is deficient, use Buzhong Yiqi Tang.
If facial puffiness and limb edema resembling water accumulation occur, termed "Zi Zhong" (Fetal Edema), use Quansheng Baizhu San (Quansheng Atractylodes Powder). If ineffective, use Liujunzi Tang. If swelling is severe in the lower part, use Buzhong Yiqi Tang with increased Fuling (Poria).
Or, if improper diet leads to vomiting and diarrhea, this indicates Spleen and Stomach damage; use Liujunzi Tang.
If toe swelling gradually extends to the legs and knees, accompanied by wheezing, chest oppression, and unease, or fluid oozing from between toes, termed "Shui Qi" (Water Qi/Edema), use Tianxian Teng San (Akebia Vine Powder). For weak Spleen and Stomach, combine with Sijunzi Tang. If ineffective, use Buzhong Yiqi Tang combined with Xiaoyao San (Free and Easy Wanderer Powder).
If fetal Qi attacks the heart and abdomen causing distension and pain, termed "Zi Xuan" (Fetal Suspension), use Zisu Yin (Perilla Infusion). For poor appetite, combine with Sijunzi Tang. For internal heat or afternoon fever, combine with Xiaoyao San.
If urination is difficult and scanty, or becomes dribbling, termed "Zi Lin" (Fetal Strangury), use Anying San (Peace Camp Powder). If ineffective, combine with Bazhen Tang. If leg cramps occur with difficulty in urination, urgently use Bawei Wan (Eight Flavor Pill); delay may be incurable.
If neck stiffness, muscle spasms, slurred speech, and profuse phlegm occur, termed "Zi Xian" (Fetal Eclampsia), use Lingyangjiao San (Antelope Horn Powder).
Or, if food stagnation causes abdominal distension and vomiting, this is due to weak Spleen and Stomach failing to digest; use Liujunzi Tang. If ineffective, use Pingwei San (Calm the Stomach Powder) plus Fuling.
Or, if fetal distension or abdominal pain occurs, this is due to weak Spleen Qi failing to support the fetus; use Antai Yin (Fetus-Supporting Infusion) plus Shengma (Cimicifuga Rhizome) and Baizhu. If ineffective, use Buzhong Yiqi Tang.
Or, if umbilical and abdominal distension or urinary retention occurs, this is due to weak Spleen and Stomach Qi, with fetal pressure on the bladder; use Siwu Tang combined with Erchen Tang (Two Aged Substances Decoction), Renshen, and Baizhu. Take on an empty stomach, then induce vomiting. After the medicine is expelled and breathing stabilizes, repeat vomiting several times until peace is restored.
Or, if labor injury or consumption of fried foods causes blood in urine, this is because Heat causes blood to flow into the bladder; clear the Bladder using Xiaoyao San.
Or, if involuntary urination or frequency occurs, this is due to Liver Fire and Blood Heat; use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder).
If chest fullness, abdominal distension, urinary obstruction, and generalized edema occur, termed "Taishui Buli" (Fetal Water Obstruction), use Liyu Tang (Carp Decoction). For weak Spleen and Stomach, assist with Sijunzi Tang. Although disease names are the same, symptoms differ; although symptoms differ, disease names are the same; briefly seen in the source formula explanation.
Medical Cases
A pregnant woman at six months presented with bleeding upon every outburst of anger, even experiencing chills, fever, headache, hypochondriac distension, abdominal pain, vomiting, and reduced intake. I reasoned: Chills, fever, and headache indicate Liver Fire rushing upward; hypochondriac and abdominal distension/pain indicate stagnant Liver Qi; vomiting and reduced intake indicate Liver overacting on Spleen and Stomach; blood in urine indicates Liver Fire and Blood Heat. She was cured using Xiao Chaihu Tang (Minor Bupleurum Decoction) plus Shaoyao (Peony Root), Chao Hei Shan Zhi (Charred Gardenia Fruit), Fuling, and Baizhu.
A pregnant woman at six months presented with body fatigue and reduced appetite, with bleeding triggered by exertion. She was cured using Liujunzi Tang plus Danggui, Shu Dihuang, Shengma, and Chaihu.
A pregnant woman at three months developed malaria after anger following meals, vomiting three times consecutively. She was treated with two doses of Huoxiang Zhengqi San (Patchouli Corrective Qi Powder), followed by one dose of Antai Yin, resulting in recovery. Later, due to anger, she experienced profuse phlegm, delirium, fever, and chest distension, relieved slightly by rubbing. This indicated Liver and Spleen Qi stagnation. She was treated with Jiawei Xiaoyao San plus Chuanxiong (Sichuan Lovage Rhizome); symptoms subsided significantly after two doses and stabilized after four doses.
A pregnant woman, after anger post-meal, presented with chills, fever, vomiting, headache, aversion to cold, chest/hypochondriac distension/pain, loose green stools, and frequent bloody urine. I advised clearing Liver fire and strengthening Spleen as primary treatment. Disbelieving, she sought fetal support and hemostasis, worsening her condition. When asked why, I explained: Loose green stools indicate dietary injury combined with Wood insulting Earth; frequent bloody urine indicates Liver Fire disturbing blood flow into the uterus. I prescribed Liujunzi Tang plus Zhike, Zisu, and Shan Zhi (Gardenia Fruit); Spleen and Stomach function recovered after two doses. Then, Jiawei Xiaoyao San plus Zisu and Zhike cleared the urine after two doses. Dietary regulation led to stability.
A pregnant woman at five months presented with limb fatigue, tasteless appetite, starting with bilateral foot edema spreading to the whole body, then face/head. This indicated Spleen and Lung Qi deficiency. Morning administration of Buzhong Yiqi Tang and evening administration of Liujunzi Tang plus Sugeng brought relief.
A pregnant woman who coughed up blood clots due to anger for four months, with hypochondriac distension/pain and dysuria. Anger caused blood to accumulate upper body, rising with Fire. Hypochondriac/abdominal pain and dysuria are Liver Meridian diseases. Xiao Chaihu Tang combined with Siwu Tang stopped bleeding in four doses. Subsequent management with Liujunzi Tang and Antai Yin ensured stability.
Morning Sickness (E Zu)
If Phlegm stagnates in the Middle Jiao (Epigastrium), use Erchen Tang plus Zhike. If food stagnation exists, use Liujunzi Tang plus Zhike. If Spleen/Stomach is weak, use Yigong San (Extraordinary Merit Powder). If Stomach Qi is insufficient, use Renshen Jupi Tang (Ginseng and Tangerine Peel Decoction); for anger, add Zhike; for chest/hypochondriac oppression, add Sugeng; for hypochondriac pain, add Chaihu. For reduced appetite/thought of eating, use Liujunzi Tang plus Zisu and Zhike. For dizziness/fatigue, use Liujunzi Tang. For weak Spleen/Stomach with vomiting/anorexia, use Banxia Fuling Tang (Pinellia and Poria Decoction). Banxia (Pinellia Tuber) is the chief herb for strengthening Spleen Qi and resolving Phlegm. For weak Spleen/Stomach vomiting, Phlegm-fluid retention, reduced appetite, and fetal unrest, Fuling, Banxia, increased Baizhu, Chenpi, and Sharen (Amomum Fruit) are essential to calm the fetus and strengthen Spleen/Stomach. I frequently use these with verified results.
Restless Fetus (Tai Dong Bu An)
For stagnant Fetal Qi, use Zisu Yin. For weak Spleen Qi, use Liujunzi Tang plus Zisu and Zhike. For constraint injuring Spleen, use Guipi Tang (Restore the Spleen Decoction) plus Chaihu and Shan Zhi. For constraint/anger injuring Liver/Spleen, use Siqi Tang (Four Emotions Decoction) plus Chuanxiong and Danggui. For angered Liver Fire, use Jiawei Xiao Chaihu Tang. If the fetus is dead, urgently use Pingwei San plus Pomiao (Mirabilite) to rot and expel it.
Fetal Leakage Bleeding (Lou Tai Xia Xue)
Due to Wind-Heat, use Fangfeng Huangqin Wan (Saposhnikovia and Scutellaria Pill). Due to Blood Heat, use Jiawei Xiaoyao San. Due to Blood Deficiency, use Erhuang San. Due to excessive blood loss, use Bazhen Tang; if ineffective, use Buzhong Yiqi Tang. Due to Liver Fire, use Chaihu Shan Zhi San. Due to Spleen Fire, use Jiawei Guipi Tang. Due to trauma causing bleeding/pain, use Bazhen Tang plus Ejiao and Shu Aiye (Prepared Mugwort Leaf). Due to weak Spleen/Stomach, use Buzhong Yiqi Tang plus Wuweizi (Schisandra Berry). Due to Spleen/Stomach sinking, use the previous formula with increased Shengma and Chaihu. For tidal or afternoon fever, use Xiaoyao San.
Cough (Ke Sou)
Autumn Wind attacking Lungs: Renshen Baidu San (Ginseng Rescue the Extremities Powder). Spring Wind attacking Lungs: Rensu Yin (Ginseng and Perilla Infusion). Weak Spleen/Lung Qi: Liujunzi Tang plus Chuanxiong, Danggui, Jiegeng (Platycodon Root). Blood Deficiency: Siwu Tang plus Sangbai Pi (Mulberry Root Bark), Xingren (Apricot Seed), Jiegeng. Kidney Fire flaming upward: Liuwei Wan (Six Flavor Pill) plus Wuweizi. Weak Spleen/Stomach Qi attacked by Wind-Cold: Buzhong Yiqi Tang plus Sangbai Pi, Xingren, Jiegeng. The Lung belongs to Metal, born from Earth. Chronic cough often stems from Spleen Earth failing to generate Lung Metal, leading to insecure interstices and external pathogen recurrence; or Lung Metal failing to generate Water, leading to Yin Fire flaming upward. Treatment should strengthen Earth and Metal, and generate Kidney Water.
Malaria (Nüe)
Due to weak Spleen/Stomach and food stagnation; or external pathogens with constraint/anger injuring Spleen; or latent Summerheat. If food stagnation: Liujunzi Tang plus Jiegeng, Cangzhu (Atractylodes Lancea Rhizome), Huoxiang (Patchouli). More external pathogen than food: Huoxiang Zhengqi San. Less external pathogen than food: Renshen Yangwei Tang (Ginseng Nourish Stomach Decoction). Labor/Qi injury: Buzhong Yiqi Tang. Constraint/anger injury: Xiao Chaihu Tang combined with Guipi Tang. If Wood insults Earth without improvement: Liujunzi Tang as main, assisted by fetal-calming herbs. Refer to Three Yin and Three Yang differentiation for treatment.
Miscarriage (Xiao Chan)
More serious than term birth. Term birth is like a ripe nut falling naturally; miscarriage is like picking unripe fruit, breaking the shell and severing the root. Treatment should tonify Form/Qi, generate new Blood, and remove stasis. Pre-term pain/labor: Xiong Gui Bu Zhong Tang (Ligusticum and Angelica Center-Boosting Decoction) with increased Zhimu to stop labor. Post-partum bleeding: Renshen Huangqi Tang (Ginseng and Astragalus Decoction). Post-partum heart/abdominal pain: Danggui Chuanxiong Tang (Angelica and Ligusticum Decoction). Weak fetal Qi causing miscarriage: Bazhen Tang to secure. Excessive bleeding with fever: Shengyu Tang (Holy Salvation Decoction). Uncontrollable sweating: Dushen Tang (Single Ginseng Decoction). Fever/restlessness/muscle twitching: Bazhen Tang. Thirst/red face/Hollow-large pulse: Danggui Buxue Tang (Angelica Tonifying Blood Decoction). Body heat/red face/Deep-micro pulse: Sijunzi Tang plus Ginger and Fu Zi (Aconite). Self-warming Yang: Buzhong Yiqi Tang. Yang trapped in Yin: Siwu Erlian Tang (Four Substance and Two Lotus Decoction). Extreme Yang without Yin: Siwu Tang. No Fire: Bawei Wan (Eight Flavor Pill). No Water: Liuwei Wan (Six Flavor Pill).
Case 1: Pregnant woman with food stagnation, abdominal fullness, sour regurgitation, diarrhea, anorexia. Diagnosis: Food stagnation with Liver Wood injuring Spleen Earth. Treated with Liujunzi Tang to strengthen Spleen/Stomach, Cangzhu and Houpo (Magnolia Bark) to resolve food, Wuzhuyu (Evodia Fruit) and Huanglian (Coptis Rhizome) to clear Liver Fire. All symptoms resolved. Followed by Liujunzi Tang plus Sharen to stabilize Spleen Earth.
Case 2: Pregnant woman with chest/abdominal distension, phlegm vomiting, anorexia. Diagnosis: Weak Spleen/Stomach transforming food into Phlegm. Gradually improved with Banxia Fuling Tang. Stabilized with Liujunzi Tang plus Zhike and Sugeng. Later, anger caused hypochondriac distension, anorexia, phlegm vomiting, nausea. Cured with Banxia Fuling Tang plus Chaihu and Shan Zhi.
Case 3: Pregnant woman with internal heat, afternoon fever, chills, reduced appetite, fetal bearing down or rising. Diagnosis: Liver Blood deficiency with Fire stirring. Initially treated with Jiawei Xiaoyao San for several doses, then Liujunzi Tang plus Chaihu and Zhike for several doses each, resulting in stability.
Case 4: Pregnant woman with bleeding, worsened by cooling-blood herbs, reduced appetite/fatigue. Diagnosis: Spleen Qi deficiency failing to control Blood. Cured with Buzhong Yiqi Tang. Later, anger caused chills/fever and recurring bleeding due to旺盛 Liver Fire boiling Blood. Hemostasis achieved with Jiawei Xiaoyao San; stability with Buzhong Yiqi Tang.
Case 5: Pregnant woman whose fetus pressed upward upon anger, wiry-hyperactive left Guan pulse indicating internal Liver Fire. Cured with Xiao Chaihu Tang plus Fuling, Zhike, and Shan Zhi. Fatigue/anorexia managed with Liujunzi Tang to nourish Spleen Earth, plus Chaihu and Zhike to harmonize Liver Qi.
Case 6: Pregnant woman with bleeding, fever/thirst, reduced appetite/fatigue. Diagnosis: Spleen Qi deficiency insulted by Liver Fire. Hemostasis with Sijunzi Tang plus Chaihu and Shan Zhi. Recurrence due to anger managed with Liujunzi Tang plus Chaihu, Shan Zhi, and Shengma.
Case 7: Pregnant woman with fetal pressing upward, chest fullness, belching, reduced appetite. Diagnosis: Spleen Qi stagnation. Immediate relief with Zisu Yin; recovery with Sijunzi Tang plus Zhike, Chaihu, and Shan Zhi.
Case 8: Pregnant woman with chest/diaphragm discomfort due to anger, reduced appetite. Digestive/promoting agents weakened Spleen/Stomach further, causing loose/uncontrolled stools, yellow/white watery discharge, yellow complexion with white hints. Diagnosis: Yellow indicates Spleen deficiency; White indicates Lung deficiency. Morning: Buzhong Yiqi Tang to raise Stomach Qi; Evening: Liujunzi Tang to tonify Spleen Qi. Cured.
Case 9: Pregnant woman with heart/abdominal pain, chest/hypochondriac distension, sour regurgitation, anorexia. Diagnosis: Liver/Spleen Qi stagnation. Cured with Erchen Tang, Shanzha (Hawthorn Fruit), Shan Zhi, Qingpi (Green Tangerine Peel), Muxiang (Aucklandia Root). Recurrence due to anger, fetal unrest, green-yellow complexion, wiry-tight Liver pulse, wiry-long Spleen pulse indicated Liver overacting on Earth. Managed with Liujunzi Tang plus Shengma, Chaihu, and Muxiang.
Case 10: Pregnant woman with heart pain, irritability/thirst. Cured with Baizhu San (Atractylodes Powder). Pain recurred after food stagnation with abdominal distension/tenderness. Diagnosis: Food stagnation. Treated with Renshen Yangwei Tang. Non-tender abdomen indicated Spleen/Stomach injury; cured with Liujunzi Tang.
Case 11: Pregnant woman with lower abdominal pain, fetal unrest, Qi attacking sides/upward, dysuria. Cured with Xiao Chaihu Tang plus Qingpi and Shan Zhi to clear Liver Fire. Later, anger caused lower abdominal distension, dysuria, heavy sensation, fetal unrest due to blazing Liver Fire. Cured with Longdan Xiegan Tang (Gentian Liver-Draining Decoction) in one dose; stabilized with Sijunzi Tang plus Shengma and Chaihu to nourish Spleen Earth.
Case 12: Pregnant woman with food stagnation, heart/abdominal distension. Use of Renshen Yangwei Tang plus Qingpi, Shanzha, Zhike worsened distension, fetal pressing, nausea/anorexia. Right Guan pulse floating-large, wiry on pressure. Diagnosis: Insufficient Spleen Earth insulted by Liver Wood. Cured with Liujunzi Tang plus Chaihu and Shengma. Lower abdominal stuffiness resolved with Buzhong Yiqi Tang to raise Spleen Qi.
Case 13: Wife of Wanhu from Wujiang, age 20+, miscarried due to epidemic disease, coughing, took Lung-clearing/exterior-releasing herbs, leading to wheezing/insomnia. Diagnosis: Weak Spleen Earth failing to generate Lung Metal, worsened by drugs. Initial treatment: Buzhong Yiqi Tang plus Fuling, Banxia, Wuweizi, Pao Jiang (Prepared Ginger); improved after four doses. Follow-up: Bazhen Tang plus Wuweizi, then Shiquan Dabu Tang (Ten Thousand Complete Great Tonifying Decoction); cured.
Case 14: Pregnant woman at six months, fatigue, reluctance to eat, yellow face, afternoon fever, fetal growth retardation, threatened miscarriage due to labor. Diagnosis: Spleen Qi insufficiency. Treated with Bazhen Tang increased with Renshen, Baizhu, Fuling for over thirty doses; Spleen/Stomach strengthened, fetus stabilized and grew.
Case 15: Pregnant woman with alternating chills/fever, internal/afternoon fever, hypochondriac pain/vomiting, fetal growth retardation at eight months due to Liver/Spleen constraint/anger. Treated with Liujunzi Tang plus Chaihu, Shan Zhi, Zhike, Zisu, Jiegeng; pain resolved, fetus grew.
Case 16: Pregnant woman with faintness after miscarriage, intermittent phlegm vomiting. Self-medicated with Blood-nourishing/Phlegm-resolving herbs, leading to unconsciousness, spontaneous sweating, convulsions, profuse phlegm. Misdiagnosed as Wind-stroke. Diagnosis: Spleen Qi deficiency and Cold. Cured with Shiquan Dabu Tang plus Pao Jiang for over twenty doses.
Case 17: Pregnant woman at eight months, threatened miscarriage resembling labor, slight relief lying down, worsening at dusk. Diagnosis: Qi and Blood deficiency. Morning: Buzhong Yiqi Tang plus Fuling, Banxia; improved. Stabilized with Bazhen Tang.
Case 18: Pregnant woman with fecal incontinence upon coughing. Diagnosis: Lung Qi insufficiency, Kidney Qi deficiency failing to control. Cured with Buzhong Yiqi Tang to nourish Earth/Metal, Liuwei Wan plus Wuweizi to generate Kidney Qi.
Case 19: Pregnant woman with cough, profuse phlegm (5-6 bowls daily), unresponsive to other meds. Diagnosis: Water flooding transforming into Phlegm. Treated with Liuwei Wan and Sijunzi Tang, one dose each; slightly improved, stable after several doses.
Case 20: Pregnant woman with hematemesis due to anger, hypochondriac distension/pain, dribbling urine. Anger caused blood accumulation upper body, rising with Fire. Hemostasis with Xiao Chaihu Tang combined with Siwu Tang in four doses; stabilization with Liujunzi Tang and Antai Yin.
Case 21: Pregnant woman with irritability, phlegm vomiting, nausea, dizziness, food aversion. Diagnosis: Spleen deficiency with Wind-Phlegm. Improved gradually with Banxia Baizhu Tianma Tang (Pinellia, Atractylodes, and Gastrodia Decoction) to tonify Yuan Qi and dispel Wind. Dizziness persisted; cured with Buzhong Yiqi Tang plus Manjingzi (Vitex Fruit) to raise Yang Qi.
Case 22: Pregnant woman with sweating, locked jaw, opisthotonos, intermittent. Diagnosis: Anger stirring Liver Fire. Improved with Jiawei Xiaoyao San; stopped with Gouteng San (Uncaria Decoction); stabilized with Sijunzi Tang plus Gouteng (Uncaria Ramulus with Hook), Shan Zhi, Chaihu.
Case 23: Pregnant woman unable to extend limbs, took Wind-dispelling/Blood-drying herbs, leading to enuresis, profuse phlegm, limb convulsions. Diagnosis: Liver Fire and Blood dryness. Main treatment: Bazhen Tang plus Chao Hei Huangqin (Charred Scutellaria Root); assisted by Gouteng Tang. Recurrence due to anger, bloody urine, chills/fever, insomnia, reduced appetite. Hemostasis with Gouteng San plus Shan Zhi and Chaihu. Chills/fever resolved and sleep restored with Jiawei Xiaoyao San; diet improved and gradual recovery with Liujunzi Tang plus Shaoyao and Gouteng.
Case 24: Woman with amenorrhea for eight months, increasing abdominal size, blue/yellow complexion. Fetal treatments failed. Diagnosis: Blue face/wiry-choppy pulse/chills-fever indicates Liver Blood disease; Yellow face/large abdomen/reduced appetite/fatigue indicates Spleen Blood disease. Constraint/anger injuring Liver/Spleen, not pregnancy. Disbelieving, continued fetal treatments unsuccessfully. Used Jiawei Guipi Tang and Xiaoyao San, 20+ doses each; symptoms slightly improved. Seeking quick effect, took Tongjing Wan (Menstruation-Unblocking Pill), causing bleeding, faintness, sweating, aversion to cold, cold extremities, vomiting/anorexia. Cured with Renshen and Pao Jiang in two doses; stabilized with Shiquan Dabu Tang for 50+ doses.
Case 25: Pregnant woman, malaria cured but residual chills/fever, reduced appetite, headache, afternoon/internal fever. Diagnosis: Spleen deficiency and Blood weakness. Headache stopped immediately with Buzhong Yiqi Tang plus Manjingzi; appetite improved with Liujunzi Tang plus Chuanxiong and Danggui. Chills/fever resolved with Xiaoyao Tang plus Renshen and Baizhu.
Case 26: Pregnant woman, cholera resolved but no appetite, sour taste. Tried digestive/broadening agents. Diagnosis: Stomach Qi injury with Empty Heat. Should use Sijunzi Tang. Disbelieving, took Renshen Yangwei Tang, causing sour vomiting and fetal unrest (re-injury). Prescribed Sijunzi Tang again, boiled well, instructed patient to smell first, sip only if no nausea to avoid triggering fetal movement via vomiting. Cured after ten days.
Case 27: Concubine of Grand Secretary Bian, pregnant with diarrhea, self-treated with Zhishi (Immature Bitter Orange) and Huanglian, leading to abdominal stuffiness, phlegm vomiting, chills/fever, immediate nausea upon eating, sour regurgitation. Wanted Phlegm-resolving/Qi-regulating herbs. Diagnosis: Spleen/Stomach injury with Phlegm stagnation in Middle Jiao; treating Phlegm/Qi would further injure Spleen/Stomach. Prescribed Renshen, Baizhu, Pao Jiang powder, pills size of millet seeds, sucked/swallowed occasionally (3-5 initially, increasing to 20-30). After three days, administered Liujunzi Tang; quickly cured.
Case 28: Wife of Official Hu Cheng, pregnant with chronic dysentery, self-treated with digestive/Qi-regulating herbs, leading to heavy abdominal sensation, fetal unrest. Tried Ejiao and Aiyi without success. I stated: