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Pregnant women who suddenly lose the ability to speak are diagnosed with "mute pregnancy" (Ya Tai). Medication is not required; speech will be restored after delivery. This is because voice originates from the Kidney, and the uterine collateral connects to the Kidney, leading to the inability to speak.

The Classics state: "At nine months of pregnancy, loss of voice occurs; by the tenth month, it should recover." For delirium during pregnancy, use Siwu Tang (Four Substances Decoction) with doubled doses of Baishao (White Peony Root) and Danggui (Angelicae Sinensis Radix), removing Shengdihuang (Rehmanniae Radix), combined with Erchen Tang (Two Aged Things Decoction), plus Shan Zha (Crataegi Fructus), Bohe (Menthae Haplocalycis Herba), and Jiangzhi (Ginger Juice) for treatment.

If a pregnant woman's tongue appears cyanotic, it indicates fetal death in utero. Use 5 fen of Shexiang (Moschus) and 3 fen of Rougui (Cinnamomi Cortex), powdered, mixed with boiled wine for oral administration. If twins are present, one alive and one dead, this formula is also appropriate. This condition arises when maternal pathogenic factors, such as malaria, fume and scorch the fetus, causing fetal death due to heat. The dead fetus becomes cold and adheres, unable to expel itself spontaneously. Alternatively, formulas like Heishen San (Black Divine Powder) can be used to warm the uterus, allowing the dead fetus to pass naturally.

Frequent urination during pregnancy is called "Zi Lin" (Submersion Strangury); Neibu Tang (Internal Tonifying Decoction) yields immediate results. Urinary retention is caused by the descending fetus compressing the bladder, termed "Zhuan Bao" (Turning Uterus); Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Cheqianzi (Plantaginis Semen) is indicated. If there is an internal injury component, it involves stagnant blood that fails to resolve, manifesting as painful or difficult urination.

Constipation during pregnancy results from blood deficiency and qi stagnation; treat with Siwu Tang (Four Substances Decoction) plus Zhike (Aurantii Fructus) and Taoren (Persicae Semen). Watery diarrhea in pregnant women requires differentiated treatment. Li Zhong Wan (Regulate the Middle Pill) and Wuji San (Five Accumulations Powder) are contraindicated due to their warming ingredients like Ganjiang (Zingiberis Rhizoma) and Rongui (Cinnamomi Cortex). For diarrhea due to food stagnation, Yangwei Tang (Nourish Stomach Decoction) with digestive aids is used. For diarrhea caused by consuming raw/cold foods, Yangwei Tang (Nourish Stomach Decoction) plus Muxiang (Aucklandiae Radix) is applied. For fire-type diarrhea (heat diarrhea), Xiangru Yin (Elsholtzia Decoction) is used, which addresses sudden severe watery diarrhea in summer. For summerheat diarrhea, Weiling Tang (Stomach and Pinellia Decoction) plus Xiangru (Elsholtziae Herba) is prescribed. For diarrhea due to qi deficiency, characterized by borborygmus without pain and undigested food in stool, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) or Sijunzi Tang (Four Gentlemen Decoction) is suitable. For bloody diarrhea before delivery, Weiling Tang (Stomach and Pinellia Decoction) plus Muxiang (Aucklandiae Radix) and Sharen (Amomi Fructus), or Zisu Yin (Perilla Decoction) plus Shenqu (Massa Fermentata Medica), ZeXie (Alismatis Rhizoma), and Huanglian (Coptidis Rhizoma) may be used. For fullness in the stomach accompanied by phlegm-induced vomiting, Renshen (Ginseng Radix) and Huanglian (Coptidis Rhizoma) are contraindicated. Dysentery before and after delivery is detailed in *Li Zheng Hui Can* (Compendium of Dysentery Patterns), so it is not repeated here.

At five or six months, or seven or eight months of pregnancy, if fetal movement becomes chaotic, accompanied by intermittent pain over two to three days, or leakage of amniotic fluid, but without significant lower back pain, the fetus has not yet detached from its meridian connection. This is called "Nong Tai" (Playing Fetus) or "Shi Tai" (Testing Fetus). Whether amniotic fluid is present or not is not detrimental. The mother should maintain an upright posture while sitting, lying, walking, or standing, avoiding fear, anxiety, or pressure to prevent complications. Neither constitutes true labor; they are usually caused by physical strain or transgression. During the third to sixth months of pregnancy, the body should be securely bound to prevent excessive fetal movement, and frequent bathing and alcohol consumption should be avoided.

*Da Sheng Bian* (Guide to Childbirth) states: Miscarriage must be handled with caution. Abortion occurring between the third and fifth months is termed "miscarriage." This results from damage to the zang-fu organs and rotting of the uterine ligaments, leading to fetal expulsion. This is more severe than term delivery. Term delivery is like a ripe melon falling from the vine, inherently safe despite some difficulties; how much more dangerous is abortion due to damaged uterine ligaments? Underestimating miscarriage often leads to fatal consequences. Extra care and rest are essential, and herbs that tonify blood and qi while resolving stasis and generating new tissue should be taken. Those who take abortifacient drugs cause great harm; this practice belongs to beggars and midwives, never physicians.

The concept of inducing labor has been passed down since ancient times, but if the melon is ripe, why induce it? Induction is not only useless but potentially harmful. Methods include using Rabbit Brain Pills, Qiannianjian (Codonopsis Root), Labor-Inducing Stones, Jixingzi (Cardiospermi Semen), Bitouhui (Ink Stick Ash), or applying crushed Castor Bean seeds to the soles of the feet. These are often ineffective and merely create disturbance. Alas, neglecting proper care and engaging in unrestricted sexual activity leads to dystocia; frequently resorting to induction is futile. This is the behavior of the ignorant.

Male and female fetuses differ in position within the womb. Males carry yang on the front and yin on the back; females carry yin on the front and yang on the back. Similarly, male fetuses face inward, hands cupping the mother's heart area; female fetuses face outward, positioned below the mother's heart, hands holding their own head/face, with their back and feet downward. At birth, they rotate to emerge smoothly. If the mother lies on her side, the fetus may fail to rotate, leading to malpresentation. Therefore, preparing for labor ("sitting grass") should not be done too early. The mother should be assisted to move gently to avoid these hazards. Ignoring this principle and attributing difficulties solely to qi and blood deficiency is erroneous. However, some women do deliver while lying down; they must lie supine and straight to keep the birth canal open. Only those with sufficient qi and blood can deliver comfortably while lying down. If unable to sit or lie properly and labor stalls due to weakness, it is indeed due to qi and blood deficiency. Physicians should bear this in mind.

In the month of delivery, if bleeding occurs before the rupture of membranes, it indicates fetal injury, not labor. Treat with Bayi Tang (Eight Ingredients Decoction) and Antai Yin (Fetus-Securing Decoction). If membranes have ruptured, labor is imminent; use Zisu Yin (Perilla Decoction) to generate blood. Abortifacient or labor-inducing herbs should only be used when membranes are ruptured, contractions are urgent, and the full ten months are complete. If membranes are intact and abdominal pain is mild, even at term, wait until active labor begins. In such cases, use Antai Yin (Fetus-Securing Decoction) or Zisu Yin (Perilla Decoction), substitining Baishao (White Peony Root) with Chishao (Red Peony Root), using Danggui Wei (Angelicae Sinensis Radix tail), removing Renshen (Ginseng Radix), adding ginger and scallion decocted in water, and mixing with one cup of child's urine. Avoid Huoxue (blood-invigorating) herbs like Taoren (Persicae Semen). Once membranes rupture and the fetus descends quickly, it is called "Pu Ru" (Spreading Matting), indicating rapid delivery. If membranes rupture but the fetus does not descend, it is called "Shi Shui" (Testing Water), resulting in delayed labor. Some deliver after one or two days; others may experience relief from pain and fluid leakage after taking Antai Yin (Fetus-Securing Decoction), delivering after five or six days. Do not allow midwives to intervene manually immediately upon membrane rupture, as this exhausts and pains the mother, causing further complications. For prolonged retention, first tonify qi and blood to promote amniotic fluid production, using Foshou San (Buddha's Hand Powder) or Zisu Yin (Perilla Decoction). If red fluid leaks before labor, causing the fetus to dry out (like a boat without water), use Zisu Yin (Perilla Decoction) to nourish qi and blood. If lower back and abdomen hurt severely at onset, do not let midwives probe easily. Even with ruptured membranes and severe back pain, instruct the mother to walk with support for natural, smooth delivery. Malpresentations are often caused by premature manual intervention. The umbilical cord attaches to Mingmen (Gate of Life); as the fetus prepares to be born, it moves its hands, detaching the cord, which causes pain—this is the phenomenon of "ripe melon falling from the vine."