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[Verse]
Internal burning and vexation is termed "Zi Fan" (Fetal Vexation), with its root cause lying in the Lung Metal being scorched by Heart Fire. Heart vexation accompanied by Lung Heat often manifests as Xiao Ke (Wasting-Thirst); if chest vexation is accompanied by vomiting and retching, it indicates stagnant depression causing heat in the fetal Qi. Vexation alone without other disease signs constitutes Xu Fan (Deficiency Vexation); if accompanied by mental confusion, fright, palpitations, Zhu Ye (Bamboo Leaf) and Mai Dong (Ophiopogon Tuber) should not be used indiscriminately.

[Discussion]
Pregnant women suffering from vexation and stuffiness do so because, at the fourth month of gestation, they receive the influence of Shaoyin Junhuo (Ministerial Fire of the Hand-Shaoyin) to nourish the fetus's essence, and at the sixth month, they receive the influence of Shaoyang Xianghuo (Ministerial Fire of the Hand-Shaoyang/San-Jiao) to nourish the fetus's Qi. If the mother experiences heart fright, gallbladder coldness, and emotional depression, this is named Zi Fan.
The *Chanbao* states: "There are four types of Zi Fan: Xin Fan (Heart Vexation), Xiong Zhong Fan (Chest Vexation), Chan Fan (Labor Vexation), and Zi Fan (Fetal Vexation); all belong to Heat." When Lung Qi is deficient and Fire attacks it, Heart Vexation occurs; when phlegm-fluids stagnate and accumulate, leading to vomiting of saliva and foam, and aversion to food odors, this is Chest Vexation; when there is only heat and vexation with no apparent illness, this is Deficiency Vexation; when Qi and Blood stagnate and accumulate, fighting with Deficient Heat, causing Qi stagnation and discomfort, resulting in vexation and foamy vomiting, which in severe cases leads to fetal movement and insecurity—all are categorized under Zi Fan. Treatments include Zhuye Tang (Bamboo Leaf Decoction), Maimendong Yin (Ophiopogon Drink), Qizhi Zisu Yin (Qi-Stagnation Perilla Drink), and Tan Zhuli Tang (Phlegm Bamboo Juice Decoction).

[Pulse Diagnosis]
Zi Fan belongs to Heat; the pulse must be Hong (Surging) and Shuo (Rapid). A Chen (Deep) pulse suggests Qi stagnation or Phlegm; a Wu Li (Powerless) pulse indicates Deficiency.

[Formulas]
Zhuye Tang (Bamboo Leaf Decoction)
Fangfeng (Saposhnikovia Root), Huangqin (Scutellaria Root), Maidong (Ophiopogon Tuber), Fuling (Poria), Zhuye (Bamboo Leaf), Shanzhi (Gardenia Fruit), Danggui (Angelica Sinensis).
*Waitai Miyao* includes Zhuli (Bamboo Juice) instead of Zhuye; another version includes Zhimu (Anemarrhena Rhizome) instead of Shanzhi, Huangqin, and Danggui.

Maimendong Yin (Ophiopogon Drink)
Maidong (Ophiopogon Tuber), Renshen (Ginseng Root), Fushen (Poria with Hostwood), Shengdi (Rehmannia Root), Huangqin (Scutellaria Root), Xijiao (Rhinoceros Horn - *Note: Substitute with Buffalo Horn in modern practice*), Gancao (Licorice Root), Lianxin (Lotus Plumule).

Zhuli Tang (Bamboo Juice Decoction)
Zhuli (Bamboo Juice, 1 Sheng), Fuling (Poria, 4 Liang), Maidong (Ophiopogon Tuber), Fangfeng (Saposhnikovia Root), Huangqin (Scutellaria Root) (each 3 Liang).
Boil with 4 Sheng of water until reduced to 2 Sheng, add Zhuli, and divide into three doses.
Zhimu Wan (Anemarrhena Pill): Grind Zhimu into powder, mix with jujube paste to form pills. This treats deficiency vexation and restlessness caused by taking incorrect medications.

[Verse]
Dry mouth, vexation, heat, and deficiency arise from Yin-Yang imbalance and Qi stagnation. Heat affecting the Heart and Spleen is a common pattern, scorching fluids so they are not as abundant as before. Ancient formulas use Zhimu to eliminate fetal thirst; Liu Yi San (Six-to-One Powder) with Huangbo treats Qi deficiency; there is also the case of thirst due to blood coagulation requiring skilled intervention. (From *Geng Yu Zai Fang Shu*)

[Discussion]
Chen Liangfu stated: In pregnancy, vexation and thirst occur because the Foot-Taiyin Spleen Meridian connects to the mouth, and the Hand-Shaoyin Heart Meridian connects to the tongue. If the Zang-Fu organs are weak, and Ying-Wei (Nutritive and Defensive Qi) are disharmonious, leading to an imbalance of Yin and Yang, Heat attacks the Heart and Spleen, consuming fluids, thus causing vexation and thirst. This is largely similar but slightly different from Zi Fan; Zhimu San (Anemarrhena Powder) is suitable. For Deficient Heat, Ren Shen Huang Qi San (Ginseng and Astragalus Powder) or Huang Qi Liu Yi Tang (Astragalus Six-to-One Decoction) may be used. Geng Yu treated a pregnant woman with sudden extreme thirst by having her drink only juice from Wu Wei Zi (Schisandra Berry), saying, "This is blood attempting to coagulate, not a disease," and she subsequently became pregnant. Ancient texts mention the syndrome of thirst due to blood desiring to coagulate, cured by drinking Schisandra juice; this must be known.

[Formulas]
Zhimu San (Anemarrhena Powder)
Zhimu (Anemarrhena Rhizome), Maidong (Ophiopogon Tuber), Huangqi (Astragalus Root), Fuling (Poria), Huangqin (Scutellaria Root), Gancao (Licorice Root), Zhuli (Bamboo Juice).
Decoct with 2 cups of water until 0.8 cup remains, strain, and take with Zhuli.

Ren Shen Huang Qi San (Ginseng and Astragalus Powder)
Renshen (Ginseng Root), Huangqi (Astragalus Root), Zhimu (Anemarrhena Rhizome), Maidong (Ophiopogon Tuber), Gegen (Kudzu Root), Fuling (Poria), Qinjiao (Gentiana Macrophylla Root), Gancao (Licorice Root), Zhuye (Bamboo Leaf).
Decoct in water and take.

Huang Qi Liu Yi Tang (Astragalus Six-to-One Decoction)
Huangqi (Astragalus Root, 6 Qian), Gancao (Licorice Root, 1 Qian).
Decoct in water and take.