Library

*Daquan* states: If a pregnant woman experiences irritability and oppression, it is because in the fourth month of pregnancy, she receives the Qi of Shaoyin Junhuo (Ministerial Fire of the Hand-Shaoyin) to nourish the fetus's essence, and in the sixth month, she receives the Qi of Shaoyang Xianghuo (Ministerial Fire of the Foot-Shaoyang) to nourish the fetus's Qi. If the mother is frightened with a timid gallbladder, she often suffers from irritability, which is named "Zifan" (Pregnancy Irritability). *Chanbao* states: The cause of Zifan during pregnancy is that the Lung organ is deficient, allowing Heat to invade the Heart, causing mental restlessness (Lung deficiency allowing Heat to invade the Heart seems contrary to medical theory; the character "invade" should be interpreted as being affected due to deficiency). Phlegm-fluid retention stagnating between the heart and chest, or rushing up to the Heart, also causes irritability. If irritability is caused by Heat, there is merely fever. If irritability is caused by phlegm-fluids, there are symptoms such as vomiting saliva and froth, aversion to the smell of food, and restless agitation. Generally, pregnant women who have both phlegm-fluid retention and the struggle between Cold and Heat, leading to stagnant and unsmooth Qi mechanism, may experience irritability or vomiting of saliva and froth. In severe cases, this leads to fetal movement and insecurity. All these conditions belong to "Zifan".

According to Xue Ji: For the aforementioned symptoms, if caused by internal Heat, use Zhuye Tang (Bamboo Leaf Decoction); if caused by Qi stagnation, use Zisu Yin (Perilla Infusion); if caused by phlegm stagnation, use Erchen Tang (Two-Cured Decoction) added with Baizhu (Atractylodis Macrocephalae Rhizoma), Huangqin (Scutellariae Radix), and Zhike (Aurantii Fructus Immaturus); if caused by Qi depression, use Fenqi Yin (Qi-Dispersing Infusion) added with Chuanxiong (Chuanxiong Rhizoma); if caused by Spleen-Stomach deficiency, use Liujunzi Tang (Six-Gentlemen Decoction) added with Zisu (Perillae Folium) and Shanzhi (Gardeniae Fructus).

Irritability accompanied by dry mouth belongs to the Heart and Spleen meridians, which is largely similar but slightly different from Zifan; Zhimu Wan (Anemarrhenae Pill) is suitable.

*Daquan* states: Pregnancy-induced epigastric and abdominal fullness is due to pre-existing Cold Qi in the abdomen causing fluid retention, which is then triggered by consuming cold drinks, causing the fluids to contend with the body's Qi, resulting in epigastric and abdominal fullness.

According to Xue Ji: For the aforementioned symptoms, if caused by external contraction of Wind-Cold and internal injury from diet, use Huoxiang Zhengqi San (Agastache Powder for Rectifying Qi); if caused by dietary injury to the Spleen and Stomach, use Liujunzi Tang (Six-Gentlemen Decoction); if caused by Yang Qi obstruction and fetal Qi rushing up to press against the Heart, use Zisu Yin (Perilla Infusion). Mr. Li states: "Zixuan" (Fetal Suspension) refers to epigastric and abdominal fullness. Since the fourth or fifth month of pregnancy, when Xianghuo (Ministerial Fire) nourishes the fetus, fetal Heat and rebellious Qi rush up to the Heart, causing epigastric and abdominal fullness and pain; Zisu Yin (Perilla Infusion) is suitable. If depression causes severe epigastric fullness, add a small amount of Ezhu (Curcumae Rhizoma) and Dingxiang (Caryophylli Flos). If there is loss of appetite, use Qinshu Tang (Scutellaria and Atractylodes Decoction) with doubled Baizhu (Atractylodis Macrocephalae Rhizoma) and added Shaoyao (Paeoniae Radix). If Fire becomes extremely excessive at one time, causing Heart Qi blockage, suffocation, and even death, continuously administer Zisu Yin (Perilla Infusion) for rescue. If the two Chi pulses (Kidney pulses) are absent in this condition, it may be due to the mistaken ingestion of abortifacient drugs, leading to fetal death in the uterus. The patient will shiver with cold, and the fingers, lips, and nails will turn blue. Diagnosis relies entirely on tongue examination; Xionggui Tang (Ligusticum and Angelica Decoction) is used for rescue. Zhang Zhongjing states: When a woman is six or seven months pregnant, if the pulse is Wiry, accompanied by fever, increased fetal distension, abdominal pain, and aversion to cold, feeling as if the lower abdomen is fanned by wind, this is due to Cold in the Zi Zang (Uterus). It should be treated with Fuzi Tang (Aconite Decoction) to warm the Zang. If a woman injures her fetus while pregnant, experiencing abdominal fullness and inability to urinate, with heaviness above the waist resembling edema, and at seven months of pregnancy, when the Taiyin (Spleen) should be nourishing the fetus but fails to do so, this indicates Excess of Heart Qi. One should needle Laogong (PC 8) and Guanyuan (CV 4) using the reducing method; slight improvement in urination indicates recovery.