Library

The *Daquan* (Compendium) states: Ingesting raw or cold foods during pregnancy may impair the Spleen and Stomach's ability to transform and transport, leading to pain in the heart and abdomen. If the pathology is in the Blood aspect, the stool will be red; if it is in the Qi aspect, the stool will be white; if both Qi and Blood are affected, red and white will be mixed. If heat invades the Large Intestine combined with Blood deficiency, bloody dysentery (Xue Li) will result.

Xue Ji (Xue Shi) stated: The treatment of dysentery should refer to the previous chapter. Discharging yellow watery stool indicates a deficiency of Spleen Earth and sinking of True Qi; one should raise and tonify Middle Qi. If yellow is accompanied by green, it indicates Liver Wood overacting on Spleen Earth; one should soothe the Liver and tonify the Spleen. If yellow is accompanied by white, it indicates the child affecting the mother (referring to the generative cycle where Spleen Earth generates Lung Metal, implying a deficiency pattern); the focus should be on tonifying the Spleen and Stomach. If yellow is accompanied by black, it indicates Water counter-acting Earth (Kidney Water insulting Spleen Earth); one must warm the Spleen and Stomach. If yellow is accompanied by red, it involves the Heart Mother benefiting the Child (Heart Fire generating Spleen Earth); using Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) suffices. If the Intestines and Stomach are weak and Wind Evil lodges within, use Wei Feng Tang (Stomach Wind Decoction). If the Fetal Qi is unstable, urgently tonify the Spleen and Stomach, and the Fetus will naturally stabilize. All fetal-calming herbs should be adapted to the specific condition; one should not rigidly adhere to herbs like E Jiao (Donkey-hide Gelatin) or Ai Ye (Mugwort Leaf).

(Attached: Zi Lin [Fetal Dysuria], Zhuan Bao [Displaced Bladder], Yi Niao [Urinary Incontinence])

The *Daquan* states: Urinary retention during pregnancy occurs because Heat in the Small Intestine transmits to the Bladder (Bao), causing obstruction. If accompanied by Qi stagnation in the Heart and Lungs, it leads to panting and urgency.

Chen Wuze (Chen Yan) stated: In pregnant women, a full fetus pressing against the bladder often causes difficult urination. If Heart and Kidney Qi are deficient, causing turbid and clear energies to interfere with each other, various forms of Lin Syndrome (Dysuria) arise. If the ligaments of the bladder are twisted and disordered, resulting in urinary retention, it is called Zhuan Bao (Displaced Bladder). If the full fetus causes urine leakage, it is called Yi Niao (Urinary Incontinence).

Zhu Danxi stated: Zhuan Bao disease generally affects pregnant women who are constitutionally weak, prone to worry and depression, have irritable temperaments, or consume rich and heavy flavors. Ancient formulas all used slippery and unblocking herbs, but few were effective. I reasoned that the bladder is compressed by the fetus, shifting to one side, causing the bladder ligaments to twist and obstruct flow. If the fetus is lifted and suspended in the center, the bladder ligaments relax, and the water pathway flows freely.

Xue Li Zhai (Xue Ji) stated: The aforementioned symptoms can also result from Spleen and Lung Qi deficiency failing to transmit downward to the Bladder; or from Qi and Heat knotting in the Bladder, making Jin Ye (Body Fluids) difficult to distribute; or from Metal being scorched by Fire, with severe Damp-Heat in Spleen Earth causing obstruction. Treatment must be detailed and precise.

The *Daquan* states: Pregnancy-related Lin syndrome (Zi Lin) arises from Deficient-Heat in the Kidney and Bladder failing to control water. Since the bladder ligaments connect to the Kidney during pregnancy, Deficient-Heat in the Kidney interstice creates this symptom. Severe cases involve mental restlessness and confusion, termed Zi Lin (Fetal Dysuria).

Wan Muzhai stated: Zi Lin must be differentiated into two conditions: one where the mother is ill herself, and one where the fetus is affected by the mother. However, maternal illness itself divides into two etiologies: either internal Heat generated by consuming pungent and hot foods, or dryness of Jin Ye due to spontaneous sweating or diarrhea. Fetal illness caused by the mother also divides into two patterns: either excess Heat from congested Fetal Qi, or physical obstruction caused by the fetal form. Since the syndromes differ, treatments differ. Generally, Heat is cleared, Dryness is moistened, Congestion is unblocked, and Obstruction is moved; this is the method of treatment.

Xue Li Zhai stated: For the aforementioned symptoms, if there is scanty, dribbling urination, use An Rong San (Peace and Prosperity Powder). If leg cramps occur with difficult urination, urgently use Ba Wei Wan (Eight-Ingredient Pill); delay will be incurable.

If frequent or difficult urination follows the use of drying agents, use Sheng Di Huang (Rehmanniae Radix), Fu Ling (Poria), Niu Xi (Achyranthis Bidentatae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Zhi Mu (Anemarrhenae Rhizoma), Huang Bo (Phellodendri Cortex), Chuan Xiong (Ligustici Chuanxiong Rhizoma), and Dang Gui (Angelicae Sinensis Radix). If frequency is accompanied by yellow color, use Si Wu Tang (Four Substances Decoction) plus Huang Bo, Zhi Mu, Wu Wei Zi (Schisandrae Fructus), Mai Dong (Ophiopogonis Tuber), and Xuan Shen (Scrophulariae Radix). If Lung Qi deficiency causes shortness of urine volume, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus Shan Yao (Dioscoreae Rhizoma) and Mai Dong. If vaginal prolapse and numbness accompany frequency, use Di Huang Wan (Rehmannia Pill). If Heat knots in the Bladder causing obstruction, use Wu Ling San (Five-Ingredient Powder with Poria). If Spleen and Lung dryness prevents the generation and transformation of fluids, use Huang Qin Qing Fei Yin (Scutellaria Lung-Clearing Decoction). If Bladder Yang deficiency leaves Yin without source, use Zi Shen Wan (Nourish the Kidney Pill). If Bladder Yin deficiency leaves Yang without transformation, use Shen Qi Wan (Kidney Qi Pill).