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In cases of cold damage (Shanghan, a disease caused by external pathogenic factors) during pregnancy, treatment should primarily focus on clearing heat and calming the fetus. External methods such as applying medicaments to the navel can be used to protect the fetus. Regarding sweating or purging therapies, they should be administered according to the pulse and symptoms indicating exterior or interior patterns. If there are exterior signs suitable for sweating, Qianghuo Chonghe Tang (Qianghuo Harmonizing Decoction) can be used with added Chai Hu (Bupleuri Radix), Dang Gui (Angelicae Sinensis Radix), Shao Yao (Paeoniae Radix), Zi Su Ye (Perillae Folium), and Cong Bai (Allii Fistulosi Bulbus). If there is an interior excess-heat pattern manifesting as constipation, restlessness, and thirst, Da Huang (Rhei Radix et Rhizoma) prepared as a purgative may be used, but it must be processed with wine. Diseases have their specific pathologies; if the patient presents with true cold patterns, such as a deep, hidden pulse and cold extremities, then Gan Jiang (Zingiberis Rhizoma), Rou Gui (Cinnamomi Cortex), and Fu Zi (Aconiti Lateralis Radix Praeparata) should be used. Although Gan Jiang and Rou Gui are hot in nature, their harshness can be neutralized by using Huang Lian (Coptidis Rhizoma) and Gan Cao (Glycyrrhizae Radix et Rhizoma), thus causing no harm. Moreover, failing to use necessary treatments when indicated is inappropriate; if extreme cold or heat pathogens are not promptly removed through regulation, the fetus will be trapped by the disease and difficult to preserve. Why do people fear medicines that eliminate pathogenic cold and heat, yet remain complacent about diseases that cause harm to life?

Chills and fever during pregnancy are generally due to deficiency and damage of Qi and Blood, allowing Wind-Cold pathogens to invade. Wind is a Yang pathogen that transforms into Qi and manifests as heat; Cold is a Yin pathogen that transforms into Qi and manifests as cold. When Yin and Yang pathogens combine, chills and fever appear alternately. The classics state: "When Yang is weak, there is aversion to cold; when Yin is weak, there is fever." These conditions result from deficiency, not from summer-heat. Treatment should involve resolving exterior pathogens while simultaneously greatly tonifying Qi and Blood, without being constrained by the false appearances of cold or heat. If chills and fever persist, steaming and damaging the fetus, the fetus will surely be injured. Furthermore, some women suffer from pregnancy malaria; once pregnant, the malarial disease immediately manifests. These individuals typically have Liver Fire. During pregnancy, Yin blood nourishes the fetal origin, leading to Liver deficiency and dry Blood, resulting in alternating chills and fever, resembling malaria but not being true malaria. Treatment should employ Xiaoyao San (Free and Easy Wanderer Powder) to clear Liver Fire and nourish Liver Blood, combined with Liuwei Wan (Six-Ingredient Pill with Rehmannia) to nourish the source of transformation (Kidney Yin).

Consumption of raw and cold foods during pregnancy impairs the Spleen and Stomach's ability to transform and transport, leading to pain in the heart and abdomen. Injury to Blood results in red dysentery; injury to Qi results in white dysentery; injury to both Qi and Blood results in mixed red and white discharge. In cases where there is a sensation of heaviness and bearing down in the abdomen with unstable fetal Qi, this is due to the downward sinking of Yuan Qi (Original Qi) because of its deficiency and inability to ascend, causing Zhen Qi (True Qi) to sink. Large doses of Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) should be used to stabilize the fetus. One must strictly avoid using Qi-regulating or Qi-moving herbs, as this would exacerbate the bearing-down condition. The fetus is anchored by the Kidneys, like a bell suspended from a beam; if the beams and pillars are not solid, they will bend and break, and how could the bell remain intact alone? Moreover, symptoms resembling dysentery but not being true dysentery are often caused by deficiency of Middle Qi preventing ascent, deficiency of Spleen Qi preventing the seepage of dampness, and deficiency of Kidney Qi preventing closure. Do not injure the formless Yuan Qi due to the apparent stagnation of formed substances. Once Yuan Qi is damaged, myriad complications will arise, and how can the fetus be preserved?