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The *Da Quan* states: Hematemesis during pregnancy is caused by injury to the zang-fu organs. All emotions such as worry, overthinking, fright, and anger injure the zang-fu organs. Qi rebels upward, and blood follows it to overflow, causing mental oppression and chest fullness. If prolonged and unhealed, severe mental oppression leads to death. Pregnant women suffering from this condition often miscarry.

Li Zhai (Xue Ji) stated: For the aforementioned symptoms due to fire from liver channel stagnation, first use Xiao Chai Hu Tang (Minor Bupleurum Decoction) with Shanzhi (Gardeniae Fructus) and Shengdi (Rehmanniae Radix), then combine the previous prescription with Si Wu Tang (Four Substances Decoction), and finally use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder).

For wind-heat in the liver channel, use Fang Feng Zi Qin Wan (Saposhnikoviae and Scutellariae Pill). For heat in the heart channel, use Zhu Sha An Shen Wan (Cinnabar Calming the Spirit Pill). For deficiency of heart qi, use Bu Xin Tang (Tonify Heart Decoction). For overthinking injuring the heart, use Miao Xiang San (Miraculous Fragrance Powder). For fire in the stomach channel, use Xi Jiao Di Huang Tang (Rhinoceros Horn and Rehmannia Decoction). For accumulation of heat from rich food, use Jia Wei Qing Wei San (Modified Stomach-Clearing Powder). For constraint injuring the spleen, use Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction). For fire in the lung channel, use Huang Qin Qing Fei Yin (Scutellaria Lung-Clearing Infusion).

The *Da Quan* states: When a pregnant woman is emaciated or complicated by disease, leading to deficiency and damage of the zang-fu organs, depletion of qi and blood, she cannot nourish the fetus, resulting in fetal movement that is not firm. If the fetus remains unstable, abortion may be induced to avoid harming the mother.

Mr. Xue stated: The aforementioned symptoms should be treated according to the formulas and discussions in the section on "Lower Abdominal and Back Pain." Only when the fetus is truly untenable should one consider inducing abortion; exercise utmost caution.

Danxi stated: Yang exerts its influence and yin transforms it, thus conception occurs. If qi and blood are deficient and fail to nourish, the fetus will naturally abort. Alternatively, labor or anger may injure the emotions, stirring internal fire, which can also cause spontaneous abortion. Tracing to the root, all cases involve hot fire consuming substances, following the natural course of creation. The *Bing Yuan* attributes miscarriage to wind-cold injuring the uterus, which fails to grasp the true nature of the pathology. In the past, a woman would invariably miscarry around the third month of pregnancy. Her left hand pulse was large but weak, and rough upon heavy pressure, indicating blood deficiency. Being young, only middle qi was tonified to allow blood to naturally flourish. It was early summer, so she was instructed to take one qian of Huang Qin (Scutellariae Radix) powder with thickly decocted Bai Zhu (Atractodylae Rhizoma) decoction. After taking 30-40 doses, she successfully preserved the pregnancy (Using Bai Zhu alone to tonify middle qi, allowing nourishment to arise from the middle jiao, as earth generates all things). Reflecting on this, miscarriage due to internal heat is common, as is deficiency. One must distinguish the severity of heat versus deficiency. Generally, at three months of pregnancy, the ministerial fire is dominant, making miscarriage more likely. Otherwise, why are Huang Qin (Scutellariae Radix), Shu Ai Ye (Artemisiae Argyi Folium Preparatum), and E Jiao (Colla Corii Asini) considered sacred herbs for calming the fetus? (Physicians who cherish life should not underestimate these principles).