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[Song] Women's miscarriage (early abortion) is heart-rending; treatment may involve Chuanxiong Rhizome and Angelica Sinensis Decoction, or Ginseng Root; if excessive blood loss occurs, major tonification is indicated; if phlegm stagnation causes dizziness and oppression, Wu Jin San should be administered.

[Discussion] *Chanbao* states: When donkeys or horses are pregnant, the male approaches, and the female kicks him with her hooves, a behavior called "protecting the fetus," thus avoiding miscarriage entirely. In humans, the fetus is nourished by the Qi and Blood in the Bao Gong (uterus). Stillness allows the Shen (spirit) to remain stored; agitation causes essence and Qi to dissipate. If desire-fire arises, spirit leaks outward; fire disturbs the interior, causing the fetus to fall. Qi Zhongfu stated: Miscarriage presents with two symptoms: continuous bleeding or retained clotted blood. Generally, blood coagulates when cold and flows when hot. If the fetus falls and meridians are damaged, leading to unceasing bleeding, death from vexation and oppression will follow. Alternatively, wind-cold may cause fetal expulsion; cold blood clashes, Qi deficiency leads to rebellious Blood, and severe cases result in blood coagulation failing to exit, rushing upward to attack the Heart, causing sudden unconsciousness and death. At this time, warming the meridians and expelling cold is required so that blood flows naturally. If blood drips continuously without stopping, it indicates Qi deficiency of the Chong and Ren vessels, failing to constrain blood; Jiao Ai Tang is appropriate. Generally, abdominal pain indicates an Excess pattern; tenderness upon pressure, where the abdomen cannot be touched, suggests expelling stasis and generating new blood, using formulas such as Xiong Gui Tang or Shi Xiao San. Lack of abdominal pain indicates a Deficiency pattern; reduced pain upon pressure also indicates Deficiency, requiring warm tonification, using substances like Si Shen Tang, Pao Jiang (Processed Ginger), or Rou Gui (Cinnamon Bark).

[Formula]
Wu Jin San (Black Ink Powder)
Good Ink (2 liang, burned red, quenched in vinegar seven times, burned red again, cooled, and ground) Myrrh Hematite (each 5 qian) Musk (1 fen)
Grind into fine powder. Take 1 qian per dose, mixed with warm wine. If blood confusion affects the mind, take 2 qian mixed with child's urine for immediate awakening.

Dang Gui San (Angelica Sinensis Powder)
Dang Gui (1.5 liang) Ejiao (3 liang) Ai Ye (1 liang) Chuan Xiong (1 liang)
Take 4 qian each time, decoct in water, add 1 spoonful of fresh ginger juice and 5 he of Sheng Di Huang juice, boil for five to six boils, and take warm.

[Song] When wind and thunder darken the sky and Yin-Yang unite, evil qi attacks the fetus and birth becomes abnormal. There are even more bizarre anomalies among these oddities; scholars are urged not to speculate rashly.

[Discussion] Li Shizhen stated: Ten months of gestation is the normal rule. However, births occur at seven or eight months, twelve or thirteen months, fourteen or fifteen months; some attribute this to Qi deficiency. *Yixue Zhengchuan* mentions births at seventeen or eighteen months up to twenty-four or twenty-five months. Liu Jingshu's *Yi Yuan* records Wangu Pan of Taiyuan, who was pregnant for three years before giving birth; could this also be due to Qi deficiency? Currently, fetuses born at seven months often survive, while those at eight months often die early; this reflects the principle that seven transforms but eight does not stabilize. *Jin Shu* records that Fu Jian's mother was pregnant for thirteen months. *Han Shu* records that Emperor Yao and Emperor Zhao of Han were both pregnant for fourteen months. Liu Cong's mother was pregnant for fifteen months. *Soushen Ji* states the Yellow Emperor was pregnant for twenty-five months. These are all anomalies within the norm. The Bao Men Zi Zang (uterus) is a Qi Heng Zhi Fu (extraordinary fu organ), serving as the gateway for human generation, which is the norm. Yet, births occur from the hypochondrium, forehead, back, or thighs. Why? Is it because the Zi Zang receives scattered Qi, and its ligaments differ? For instance, as recorded in *Song Shi*, a male infant had genitals on his spine, and a female infant had them on her head. *Shiji* states: Lu Zhong married a woman from Guifang; she gave birth to three sons from her left hypochondrium and three from her right. Similarly, Xiuci gave birth to Yu after her back split, and Jiedi gave birth to Xie after her chest split. In the sixth year of Huangchu of Wei, Kong Xian memorialized that Qu Yong's wife Wang gave birth to a boy emerging from the upper part of her lower abdomen near the right hypochondrium, with both mother and child safe. *Yi Yuan* records that Fan Shi, wife of Li Xuan during the Yixi era, was pregnant but did not deliver; she developed a sore on her forehead, and the baby emerged from it. Another case involves the mother of Zhao Xuan, whose thighs itched until sores formed, from which the baby emerged. *Songshan Ji* records a woman in Yangdi who was pregnant for thirty months and gave birth through her back; the child went to study the Dao in the mountains at age five. *Langya Chao* records that during the Chenghua era in Suzhou, a pregnant woman had a tumor-like swelling on her hypochondrium; at term, the baby emerged from the tumor, which healed immediately. Her son was named Foji'er. In February of the fifth year of Longqing, a woman in Tangshan County had a swelling on her left hypochondrium and gave birth via the side; both mother and child were unharmed. These are anomalies among anomalies in obstetrics. Women typically conceive when Tian Gui arrives at age fourteen and the Ren Mai is unblocked. Infertility usually begins when Tian Gui ceases at age forty-nine, which is the norm. Yet, some give birth at age twelve, such as the daughter of Su Daqing of Pingjiang recorded by Chu Jishi. Some give birth at fifty or sixty, such as the wife of Ji Pu in *Liao Shi*, who bore two sons and one daughter at sixty; this is the norm within the anomaly. *Xuanzhu Miyu* states: Three children born presage peace; three daughters presage licentiousness; ten children presage warlords competing for power. Birth of a flesh mass presages famine. This interpretation is based on human affairs and Qi transformation influences. *Xiqiao Yezai* records that in the Jiyou year of Jiajing, Kong Fang, a hired farmer from Hengjing, suffered from distension for several months and vomited/birthed a piece of flesh from his hypochondrium. Upon dissection, it resembled an infant with complete limbs and hair. Others are born from eggs or horses. Xu Yawan's mother laid an egg which was discarded; a lonely old woman incubated it, and a boy hatched. At the end of the Han Dynasty, a horse gave birth to a human named Ma Yi. These are all infinite variations of creation.