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*Bi Chan Xu Zhi* (Necessities for Safe Childbirth) states: Do not take medicines indiscriminately, do not drink alcohol excessively, do not undergo acupuncture and moxibustion arbitrarily, do not give birth in abnormal places, do not lift heavy objects, climb high, or venture into danger, and do not indulge in sexual intercourse.

If the mind suffers from great fright, violating these taboos will lead to difficult labor, and the child will inevitably suffer from epilepsy. Do not sleep or lie down too much; walk frequently. Do not overexert yourself, as this may deplete Kidney Qi, resulting in a child born with craniolaminar separation (Jie Lu). Clothing should not be too warm, and food intake should not be excessive. If the Spleen and Stomach are disharmonious, and Ying (Nutrient) and Wei (Defensive) Qi are deficient and weak, the child will inevitably be emaciated and prone to illness.

If one violates construction or earth-moving activities, offending the Earth Qi, it may cause fetal deformity or death. Offending by knives results in physical injury to the fetus; offending by mud causes blockage of the orifices; being struck results in dark blue complexion; being bound leads to limb contracture.

If such violations occur, verification is as immediate as an echo or shadow. One must strictly avoid these taboos. The *Classic* (Neijing) says: "How do we know that a pregnant woman is about to give birth?" The answer is: "The body has symptoms of disease, but there is no pathogenic pulse." By "body has symptoms," it refers to amenorrhea. The pulse of amenorrhea shows interruption at the Chi (Cun Kou) position. If there is no pathogenic pulse, the Chi pulse is harmonious and even without signs of disease, indicating the fetal Qi has not yet transformed. By the second month, Jing (Essence) and Qi undergo positive transformation; the Qi of the Chong vessel steams upward to invade the Stomach, causing morning sickness (E Zu). By the third and fourth months, morning sickness subsides, and the pulse becomes very slippery and rapid, as the male and female fetuses are forming their physical structures, and their Qi is not yet stable. After the fifth and sixth months, the physical structure is established, and sexes are distinguished. By the eighth and ninth months, Blood and Qi flow smoothly, so the pulse appears peaceful, resembling that of a non-pregnant state. Unless a physician deeply understands pulse theory, and the patient understands the rationale, it is difficult to diagnose pregnancy solely through pulse taking. The *Mai Jue* (Pulse Classic) states: A slippery and rapid pulse that does not scatter indicates three months of pregnancy; a rapid pulse that does not scatter indicates five months; after six months, this rapid quality disappears. However, some cases show consistently surging and rapid pulses due to abundant Qi and Blood, which cannot be generalized rigidly.

The *Classic* states: "When the Foot Shaoyin pulse beats strongly, it indicates pregnancy." It also says: "Yin pulses beat distinctly different from Yang, called having a child." Here, Yin refers to the Foot Shaoyin Kidney pulse. "Beating strongly" means trembling like a bean. Yin refers to the Chi position. "Bo" means beating against the fingers; the Chi pulse beats distinctly differently from the Cun pulse, which is a sign of pregnancy.

Women take Blood as their root; abundant Blood indicates sufficient root. If Qi is too abundant, Blood may反而 decline, so women benefit more when Blood prevails over Qi. Strong beating of the Shaoyin pulse here refers to the Hand Shaoyin Heart pulse. The Heart governs Blood; strong beating indicates abundant Blood, which facilitates conception, hence "having a child." This aligns with the *Neijing*: "Strong beating of the Hand Shaoyin pulse in women indicates pregnancy." The Chi pulse refers to the Left Foot Shaoyin Kidney pulse. The Kidney is the Water of Tian Yi (Heavenly One), governing the uterus and connecting to the Bao (Womb), serving as the root of the fetus. A slippery and smooth pulse indicates moisture without dryness, resembling fullness containing potential life, thus indicating pregnancy. This matches the *Classic*'s "Yin beats distinctly from Yang, called having a child," and Wang Shuhe's description of the Chi pulse feeling unceasing upon pressure, conveying the same meaning. Regarding this slippery pulse, responding rapidly without scattering, slipperiness represents Blood, and rapidity without scattering represents the gathering and condensing of Blood, indicating three months of pregnancy. If only rapid without scattering, it signifies a transition from deficiency to excess, with Blood solidifying and forming the body, losing slipperiness, indicating five months of pregnancy.

Cui Zixu said: "Yin pulses beat below, Yang pulses differ above; Blood and Qi are harmonious, a sign of pregnancy. The Hand Shaoyin pulse beats strongly, Chi pulse is unceasing, indicating pregnancy. Shaoyin belongs to the Heart, which governs Blood vessels. The Kidney is the Bao Gate, pulses reflect at the Chi position. If the Cun pulse is faint, Guan is slippery, Chi is rapid, flowing freely like a sparrow pecking, or if all three positions show floating/sinking with pauses, or are flat and empty, one must ask about menstruation. Women with symptoms but no pathogenic pulses are pregnant, not ill, hence amenorrhea. 'Symptoms' refers to amenorrhea. 'No pathogenic pulse' means the Chi pulse is harmonious. Wang Shuhe said: To determine gender at four months of pregnancy, a rapid Left pulse indicates a boy, a rapid Right pulse indicates a girl, and rapid pulses in both hands indicate twins. Also, a larger Left Chi pulse indicates a boy, a larger Right Chi pulse indicates a girl, and large pulses in both indicate twins. 'Large' resembles an Excess pattern, meaning Yin beats distinctly from Yang. The Chi pulse is substantial and large, differing from the Cun pulse, distinguishing boys on the left and girls on the right. Also, a deep and solid Left pulse indicates a boy, a floating and large Right pulse indicates a girl. Zhang Jingyue said: Distinguishing Yin and Yang by left/right, Left is Yang, Right is Yin. By Cun/Chi, Cun is Yang, Chi is Yin. By pulse body, surging/deep/solid is Yang, weak/floating/astringent is Yin. All Yang-excess patterns indicate boys, all Yin-deficiency patterns indicate girls, which is a fixed principle. Yang Qi gathers in the face; men have heavier faces, so the fetus lies prone (back to mother). Yin Qi gathers in the back; women have heavier backs, so the fetus lies supine (face to mother). Thus, drowning victims exhibit similar postures.

The *Nan Jing* states: "There are two kidneys; the left is the Kidney, the right is the Ming Men (Gate of Life). In men, Ming Men stores Essence; in women, it connects to the Bao. Thus, Ming Men is the Bao Gate, belonging to the uterus. However, while Kidneys have left/right distinctions, the uterus does not. Zhu Danxi now claims: Male conception occurs in the left uterus, female conception in the right uterus, implying women have two uteri. This seems groundless. Rather, one should say Qi and Blood protect the fetus, flourishing on the left, so Left-large/Left-rapid pulses indicate boys; Qi and Blood flourish on the right, so Right-large/Right-rapid pulses indicate girls. If one claims flourishing in the left uterus yields boys and right uterus yields girls, what about twins or conjoined fetuses? Would there be multiple uteri?

The *Ju Yao* states: Gender is determined by left/right. Left-rapid is boy, Right-rapid is girl. Deep-solid on Left, Floating-large on Right. Left-boy, Right-girl can be predicted. Generally, Left-rapid surpassing Right indicates male pregnancy, as males belong to Yang residing on the left, and fetal Qi concentrates on Yang, making Left superior. Right-rapid surpassing Left indicates female pregnancy, as females belong to Yin residing on the right, and fetal Qi concentrates on Yin, making Right superior. One may also observe the abdomen: basket-shaped indicates female fetus, pot-shaped indicates male fetus. Females face the mother's abdomen, knees pressing the belly, lower part large, upper small, resembling a basket. Males face the mother's back, spine pressing the belly, round shape, resembling a pot. Fetal movement timing varies: males move at three months (Yang is early); females move at five months (Yin is late). Another view: Movement at 3rd/5th months suggests boys; 4th/6th months suggests girls, based on odd/even numbers.

Yang Renzhai said: Wang Shuhe considered Left Taiyang floating-large as female, Right Taiyin deep-fine as male. Yuan Shi considered Right floating-large as female, Left deep-solid as male. These two views contradict. However, examining the original intent of the *Mai Jing*, they appear different but are essentially the same. The *Classic* says: Left deep-solid is boy, Right floating-large is female. Both hands floating-large yield two girls; both deep-solid yield two boys. This supports Yuan Shi. The *Classic* also says: Left Chi floating-large is boy, Right Chi deep-fine is female. Both Chi pulses floating yield two boys; both Chi pulses deep yield two girls. This supports Wang Shuhe. Why does "deep-fine" differ from "deep-solid"? Why does "Right Chi floating-large" differ from "Right hand floating-large"? Generally, deep-solid indicates boy, deep-fine indicates female. Right Chi floating-large indicates female; Left Chi floating-large generally indicates boy. Deep-fine is female, deep-solid is male, corresponding to "All Yang is boy, All Yin is girl." Left Chi floating-large is boy, Right Chi floating-large is female, corresponding to "Left-rapid is boy, Right-rapid is girl." Yuan Shi detailed combining both hands for Yin/Yang; Wang Shuhe was concise, focusing on Chi pulse theory in the *Mai Jing*. Is there any real difference? For women, if all three positions are equal in floating/sinking, with no other illness but amenorrhea, it is pregnancy. Large and vigorous Chi pulse also indicates pregnancy. Left Chi surging-large-slippery-solid indicates boy; Right Chi surging-large-slippery-solid indicates girl. In frail women, an unceasing Chi pulse upon pressure indicates pregnancy. Amenorrhea with frequent illness but healthy Six Pulses also indicates pregnancy, because frail bodies make pulses hard to manifest. The *Mai Jing* states: "Three positions equal in floating/sinking, unceasing upon pressure, is pregnancy." Why restrict to surging/slippy?

Women must ensure sufficient Blood and Qi, harmonious Yin and Yang, regular menstruation, and unobstructed uterus. Consolidate congenital Qi, strengthen Stomach Qi. Do not blindly assume women have excess Qi and use herbs like Xiang Fu (Cyperi Rhizoma) to damage Blood, or Su Sha (Amomi Fructus Rotundus) to harm Qi. Harmonize temperament, nourish Shen (Spirit), and manifest gentle virtue; conception is certain. Such a condition is called "having the place."

Men's essence depletion often stems from emotional imbalance and failure of the Five Zang to generate each other. The *Su Wen* states: "The Kidney governs Water, receiving and storing Essence from all Five Zang and Six Fu organs. Only when Five Zang are abundant can Essence be discharged." The *Ling Shu* states: "Five Zang store Essence. Stored Essence must not be injured. Each Zang has its own Essence, infused into the Kidney as needed. The Kidney is merely a hub, not the sole owner of Essence." Why does the world fail to discern excess/deficiency in Zang organs and balance them, instead focusing only on tonifying the Kidney? Heat harms Water, Cold destroys Fire. Even if Kidney Qi is tonified, if the Four Zang are unbalanced, generation cannot occur, and conception fails. One must regulate the Five Zang, ensuring all Essence is full, and Heart and Kidney are robust. Such a condition is called "having the seed."

Heaven and Earth have moments of yinyun (intermingling Qi) for creation. When menstruating once, there is one day of yinyun. Within one shichen (two hours), Qi steams and heats, consciousness dims, and there is an irresistible urge. This is the precise moment. Reversing this creates Elixir (internal alchemy); following it creates Fetus. Knowing this timing is crucial. Intentional seeking with anxiety makes conception difficult; casual action without awareness makes it easy. After conception, avoid intercourse to disturb the uterus, avoid labor, cold food, running, falling, excessive bathing, drunkenness, anger, and fright. Take herbs to strengthen Stomach, harmonize Middle, calm Liver, and nourish Qi. Adjust care according to time to prevent miscarriage. Miscarriage after several months is known; miscarriage within one month is often unnoticed. Once the fetus is secured, follow prenatal education. Chao Yuanfang said: At three months, the fetus begins to form and transform, lacking fixed features, changing due to influences. To have a dignified child, speak rightly, act rightly. To have a boy, wear strings/bow/arrows; to have a girl, wear leather/rings. To have a beautiful child, wear white jade; to have a virtuous child, read poetry/books. Ancient methods to change gender include wearing Realgar in a red silk bag on the left, placing husband's hair/nails under the mattress, placing a cauldron under the bed with blade down, or placing three long rooster tail feathers under the mattress, hidden from the wife. These rely on external images affecting internal sensations. Testing with chickens shows entire clutches become male. Fetal transformation follows natural principles. Eating male chicken takes Yang Essence from nature; wearing Realgar takes Yang Essence from earth; using bows/arrows/axes takes firmness from human affairs. Qi resonates secretly, Creation shifts subtly. Physical laws apply; thus, pregnant women seeing divine statues or strange objects often give birth to children with abnormalities, which is evidence. Ivory and rhino horn patterns follow elephant shapes; yam and cockscomb shapes follow human changes. Using eggs to hatch chickens or brooms to conceive shows matter has sensitivity, let alone humans. Nature has barren lands, but responds to humans; women may lack uteri, but Heaven provides rain/dew to all. Men can propagate but often lose the way, cutting off generations. Those seeking heirs should awaken suddenly!

**Qigong Wan (Open the Palace Pill)**
Treats obese women with fatty, obstructed uteri unable to conceive.
Chuanxiong (1 liang), Baizhu (1 liang), Banxia Qu (1 liang), Xiangfu (1 liang), Fuling (5 qian), Shenqu (5 qian), Juhong (2 qian), Gancao (2 qian).
Make pills with rice porridge, take 3 qian with warm water.
Juhong, Banxia, and Baizhu dry dampness and resolve phlegm; Xiangfu and Shenqu regulate Qi and eliminate stagnation; Chuanxiong disperses depression and invigorates Blood; Fuling and Gancao remove dampness and harmonize the Middle, boosting vital Qi. Thus, obstruction is cleared. Obesity-related infertility is often due to Phlegm abundance, so Er Chen Tang is the sovereign formula, augmented with Blood and Qi herbs.

**Shenshen Wan**
Treats women with Deficient-Cold of Chong and Ren vessels, failing to maintain pregnancy or frequent miscarriages.
Danggui (wine-washed, dried), Chuanxiong, Shihu (wine-soaked, fried), Baishaoyao, Mudanpi, Yanhusuo (each 1 liang), Rougui (peeled, 5 qian), Zelan Ye (1.5 liang), Baizhu (1.5 liang), Ganjiang (processed, 5 qian), Shudihuang (washed, dried, 2 liang).
Grind to powder, make pills with vinegar paste, size of tung seeds. Take 50 pills on an empty stomach with warm wine.

**Danggui Jianzhong Tang**
Treats all conditions of insufficient Blood and Qi in women, wasting and emaciation.
Danggui (4 liang), Rougui (peeled), Gancao (roasted, each 2 liang), Baishaoyao (6 liang).
Take 5 qian per dose, decoct with Ginger and Jujube, drink warm.

**Buzhong Wan**
Treats various deficiency syndromes in women; suitable for regular use.
Chuanxiong (5 qian), Baishaoyao (5 qian), Huangqi (5 qian), Danggui (5 qian), Renshen (5 qian), Chenpi (5 qian), Baizhu (1 liang), Dihuang (1 liang).
Grind to powder, make honey pills. Take 50 pills with warm water.

**Bazhen San**
Harmonizes Ying and Wei, nourishes Blood and Qi, improves appetite.
Siwu Tang and Sijunzi Tang in equal parts.
Decoct with Ginger and Jujube, take warm before meals.

**Dihuang Wan**
Treats Kidney Jing deficiency, fever with thirst, dysuria, Qi stagnation with phlegm-cough, dizziness, blurred vision, deafness, dry throat/tongue pain, loose teeth, weak waist/knees, spontaneous/night sweats, blood-loss aphonia, edema-phlegm, Blood-deficiency irritability, lower body sores, heel pain.
Shudihuang (8 liang, wine-boiled to paste), Shanzhuyu (wine-moistened, branch-fried), Ganshanyao (fried yellow, each 4 liang), Mudanpi (wine-washed, lightly fried), BaiFuling (human milk-processed, dried), Zexie (light salt-wine stir-fried, each 3 liang).
Grind to powder, make honey pills, size of tung seeds. Take 4 qian on an empty stomach with light salt water.

**Zixue Tang**
Treats women with withered skin and dull complexion, Heart-Lung injury, weak Blood vessels, delayed menstruation. Tonifies Qi and nourishes Blood.
Renshen, BaiFuling, Chuanxiong, Danggui, Baishao, Shanyao, Huangqi, Shudihuang.
Decoct in water, take warm before meals.