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Pregnancy begins with conception, changing every seven days. Currently, spontaneous abortions in women occur mostly during the third, fifth, and seventh months of pregnancy; those occurring in the second, fourth, and sixth months are less common. This is because the meridians nourish the fetus, with Zang organs being Yin and Fu organs being Yang. The third month belongs to the Heart Meridian, the fifth month to the Spleen Meridian, and the seventh month to the Lung Meridian; all these are within the pulses of the Five Zang organs. Yin Qi is prone to deficiency, hence spontaneous abortion occurs frequently. If a spontaneous abortion occurred in the third month previously, upon subsequent pregnancies reaching this period, it will likely happen again due to the weakness of that specific organ, as the Heart pulse has been injured. Therefore, one must pre-condition the Heart starting from the second month. The same applies to the fifth and seventh months; one must take more herbs that strengthen the Spleen, benefit Qi, and nourish Ying blood. Once pregnant, daily administration without interruption is ideal. Only the spontaneous abortion in the first month is unknown to people. The first month belongs to the Liver Meridian; anger can cause abortion, and washing the lower body causing the orifices to open can also lead to abortion. Once an abortion occurs, the Liver pulse is injured, leading to abortion in the next pregnancy. Most people who are infertile have suffered from first-month spontaneous abortions, not because they fail to conceive. Therefore, after initial intercourse, it is best to rest and recuperate, avoid further sexual activity to disturb the Uterus, avoid labor and anger, avoid lifting heavy objects, avoid bathing, and take more herbs to nourish the Liver and calm Qi, so that there will be no repeated abortions and the fetus will remain secure. If there are multiple consecutive abortions and the Yuan of Fetus is severely damaged, more medication is required, as the Yuan of Fetus can recover over time. The medications should focus on nourishing Ying blood, regulating Qi, tonifying the Kidney, and benefiting the Spleen, such as Siwu Tang removing Chuanxiong and Raw Rehmannia Root, replacing them with Prepared Rehmannia Root, and adding Ginseng, Atractylodes Macrocephala Rhizome, Tangerine Peel, Scutellaria Root, Donkey-hide Gelatin, Dipsacus Root, and Eucommia Bark. In case of falls or trauma, the main treatment should be to expel stasis and generate new blood; Foshou San is most excellent; for abdominal pain, add Motherwort Herb, and once the pain stops after ingestion, both mother and child will be safe. If the fetus is already damaged, the foul matter will be expelled together; add Child's Urine, Processed Cyperus Rhizome, Motherwort Herb, and Tangerine Peel, decoct into a thick juice and drink. If falling from a height causes abdominal pain, bleeding, and irritability, add Raw Rehmannia Root and Phellodendron Bark (or Astragalus Root depending on interpretation of "Huang", here interpreted as Phellodendron for heat/blood cooling context or Astragalus for tonification, given "tonify to calm", Astragalus is plausible, but standard texts often pair Shengdi with Huangqi or Huangbai. Based on "tonify", we assume Astragalus), to tonify and calm; if caused by intercourse leading to abdominal pain and bleeding, add Ginseng, Atractylodes Macrocephala Rhizome, Tangerine Peel, Poria, Roasted Licorice Root, and Amomum Fruit powder to protect; if the fetus is expelled with excessive bleeding, leading to fainting and a large, weak pulse, use a strong Decoction of Single Ginseng Root mixed with Child's Urine. Abortion (Xiao Chan) originates from severe deficiency of Qi and Blood; now in the postpartum state, the deficiency is compounded, so it requires even more conditioning and tonification than normal delivery.

Chao Yuanfang discussed how each meridian nourishes the fetus for thirty days, yet among the Twelve Meridians, only the Heart and Small Intestine do not nourish the fetus. Why? The Heart is a Yang Zang organ, and the Small Intestine is a Fu organ, governing blood generation and connecting with the vessels. The Classics state: Zang Qi connects directly to the Heart; the Heart stores Blood, and the Vessel represents Qi. During pregnancy, the menstrual flow stops, which is called "amenorrhea to nourish the fetus." Thus, we know the fetus is based on Blood, and throughout its development, it relates to the Heart, so it should not follow the sequential order of acupoint distribution. In the third month, the Pericardium Meridian nourishes the fetus. The Ling Shu states: The Pericardium governs the vessels. If Qi and the fetus are distributed, the pulse will likely show deficiency or intermittent characteristics. The Classics say: The Heart harmonizes with the vessels. Although the Heart and Pericardium are two separate meridians, they essentially belong to one Zang organ. If the meridian responsible for nourishment at a specific time is imbalanced in terms of excess or deficiency, the fetus will be unstable, potentially leading to bleeding and abortion.

Yang acts and Yin transforms, allowing conception to form. Cold in the fetus causes pain; Heat in the fetus causes fright. If Qi and Blood are deficient and insufficient to nourish the fetus, it will naturally abort. It is like a branch drying up causing fruit to fall, or a vine withering causing flowers to drop. Some abortions are caused by excessive Seven Emotions triggering internal Fire, which consumes substances; some by physical strain or sprains injuring the fetus; some by anger stirring Liver Fire and disrupting free flow; some by excessive sexual activity leaking the Yuan of Fetus. It is like wind shaking a tree, disturbing its roots. However, abortion is more serious than normal delivery because the fetal viscera are damaged and the placental ties rot. Treatment should heavily tonify Ying and Wei, promote flesh growth, and nourish Zang Qi, with slight assistance in resolving stasis. For patients with a history of recurrent abortion, early treatment according to symptoms is necessary; waiting until the time of delivery to tonify is too late.

Spontaneous abortion (Ban Chan) in pregnancy, unless caused by Seven Emotions, Six Evils, fatigue, or sexual excess, does not occur. Thus, medication is similar to normal delivery, primarily focusing on Danxi's principle of heavily tonifying Qi and Blood. If expulsion occurs before the third or fourth month when the fetus is unformed, it is called "Duo Tai" (Abortion). If expulsion occurs after the fifth or sixth month when the fetus is formed, it is called "Ban Chan" (Miscarriage). Both belong to the deficiency of Qi and Blood in the pregnant woman and emptiness of the Chong and Ren meridians, leading to insecurity of the fetal origin. The longer the delay, the more deficient the Qi and Blood become. Therefore, Qianjin Bao Tai Wan is an excellent formula, and Zhao Yangkui's modification of Liuwei Dihuang Wan with added Eucommia Bark, Schisandra Berry, and Donkey-hide Gelatin is particularly good, truly a sacred medicine for calming the fetus.

Abortion should not be taken lightly; its care requires ten times the attention of normal delivery. Normal delivery is like a ripe chestnut falling naturally; abortion is like picking it raw, breaking the shell and severing the stem. Many suffer illness from neglecting this, and many die because of it. This condition starts with collecting blood to form the fetus, continues with nourishing via essence and blood, and ends with withering and abortion due to insufficiency of essence and blood, so there is little stasis. If there is abdominal pain forming a palpable mass, it mostly belongs to Blood deficiency and Qi rebellion. Only by increasing warm tonification can new blood be generated and stasis removed. If one adds herbs to break stasis and move stagnation, the rebellious Qi will attack and rise further, often leading to untreatable conditions. Beware! Moreover, some have abdominal pain due to Blood deficiency, while others have True Yin deficiency failing to grasp Qi, resulting in hernia-like masses. Often, Bawei Wan (Eight-Ingredient Pill) added with Achyranthes Root and Schisandra Berry, taken morning and night, brings peace.

Donkeys and horses in gestation: the male approaches and stamps with hooves, named "protecting the fetus," thus never experiencing abortion. Human fetuses reside in the Bao Zhong (Uterus), nourished by Qi and Blood. When quiet, the Spirit is stored; when desire moves, spirit and essence leak, fire disturbs internally, and the fetus naturally aborts. Those seeking conception (Zhong Yu) should know that pursuing desire without knowing taboos leads to this.

Danxi said: If a woman's menses stop for three months, and the Chi pulse is choppy or weak, yet she has no other disease, it indicates incomplete true Qi in the Uterus. Thus, Yang does not act, Yin does not transform essence; although blood coagulates, it fails to form properly, eventually producing blood clots or blood membranes. Only if the pulse is full and vigorous will the fetus not abort.

Ban Chan (Miscarriage) is due to discontinuity of Qi and Blood, unable to nourish the fetal origin. Within Qi and Blood deficiency, there are variations in constitutional Yin/Yang bias or Cold/Heat. One must treat based on the pulse. For Yin deficiency with internal Heat, using warming agents like Moxa, Aconite, Atractylodes, and Amomum will consume Yin further, like plants without rain, naturally withering. For Yang deficiency with internal Cold, using cooling blood agents like Scutellaria and Peony will damage Spleen and Stomach coldness, weakening Qi and Blood further, like fruits growing in spring/summer but failing to set in autumn/winter. Therefore, appropriate syndrome differentiation allows even extreme Cold or Heat to benefit the person. As the Classics say: Violating principles when one should violate them seems like not violating them (referring to treating contrary symptoms with contrary methods appropriately).