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Xue Lizhai stated: Li Dongyuan said, "When the Qi of the Spleen and Stomach is robust, one will not feel hungry past mealtime, and excessive eating will not cause injury." This is because the Stomach governs reception (accepting food), and the Spleen governs digestion; they are the root of the Five Zang organs. Injury from excessive food intake occurs due to deficiency of Spleen Qi and failure of transformation. If harsh medicines are administered, it will further injure the Spleen and Stomach, thereby damaging the fetus. One must examine the etiology for treatment. For food stagnation or abdominal pain, use Pingwei San (Pingwei Powder). For vomiting and nausea, add Zhike (Aurantii Fructus) and Sharen (Amomi Fructus). For acid regurgitation and belching with a putrid odor, add Huanglian (Coptidis Rhizoma) and Wuzhuyu (Evodiae Fructus). For abdominal distension and diarrhea, use Liujunzi Tang (Six Gentlemen Decoction). For meat stagnation, add Shanzha (Crataegi Fructus); for flour-based food stagnation, add Maiya (Hordei Fructus Germinatus) and Boluozhi (Raphani Semen); for glutinous rice stagnation, add Baijiuqu (Levisticum Officinale Fermented Dough); for rice stagnation, add Guya (Oryzae Fructus Germinatus); for injury caused by fishy odors, double the dosage of Chenpi (Citri Reticulatae Pericarpium); for injury from spicy and hot substances, add Huanglian (Coptidis Rhizoma); for injury from cold and raw substances, add Sharen (Amomi Fructus) and Muxiang (Aucklandiae Radix). Generally, for weak Spleen and Stomach where food is difficult to digest, grinding Baizhu (Atractylodis Macrocephalae Rhizoma) and Chenpi (Citri Reticulatae Pericarpium) into powder and forming Shenqu Wan (Shenqi Pill) is the most stable method. Zhike Wan (Zhike Pill) can be used temporarily. Zhishi (Aurantii Fructus Immaturus) is harsh and consumes true Qi; practitioners must exercise caution.

Shenzhen commented: The above two sections describe the syndrome of food injury during pregnancy. Food injury in pregnancy is mostly due to weakness of the Spleen and Stomach and inability to transport and transform. Moreover, the fetus relies on the Spleen and Stomach; when the Spleen and Stomach are strong, the fetus hangs securely like a suspended bell without falling. If food injury leads to indigestion, the Spleen becomes encumbered, and the fetus cannot be secured. Therefore, for resolving food stagnation, one should primarily tonify the Spleen and strengthen the Stomach, so that food digests naturally. All harsh and attacking medicines should not be recklessly administered to avoid damaging fetal Qi. Reviewing Xue Lizhai's statement reveals the fundamental principle.

The *Daquan* (Great Compendium) stated: Hematemesis during pregnancy is always caused by injury to the Zang organs. Worry, overthinking, fright, and anger all injure the Zang organs, causing Qi to rebel upward, with blood following and overflowing. This results in chest oppression, fullness, and irritability. If prolonged and unceasing, it often leads to miscarriage.

Xue Lizhai stated: For hematemesis during pregnancy, if it is due to Fire-Flare from the Liver Channel, first use Xiaochaihu Tang (Minor Bupleurum Decoction), Zhizi (Gardeniae Fructus), and Shengdi (Rehmanniae Radix), followed by Siwu Tang (Four Substances Decoction) and Jiawei Xiaoyao San (Modified Free Wanderer Powder); if due to Wind-Heat in the Liver Channel, use Fangfeng Ziqin Wan (Saposhnikoviae and Scutellaria Pill); if there is Heat in the Heart Channel, use Zhusha Anshen Wan (Cinnabar Calming Spirit Pill); if Heart Qi is deficient, use Buxin Tang (Tonify Heart Decoction); if overthinking injures the Heart, use Miaoxiang San (Wonderful Fragrance Powder); if there is Fire in the Stomach Channel, use Xijiao Dihuang Tang (Rhino Horn and Rehmannia Decoction); if there is accumulated heat from rich and greasy foods, use Jiawei Qingwei San (Modified Clear Stomach Powder); if there is Fire in the Lung Channel, use Huangqin Qingfei Yin (Scutellaria Lung-Clearing Infusion); if Qi fails to control blood, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction); if there is Deficiency-Fire in the Kidney Channel, use Jiawei Liuwei Wan (Modified Six-Ingredient Pill with Rehmannia).

Shenzhen commented: The above two sections describe the syndrome of hematemesis during pregnancy. Hematemesis may result from internal injury by the Seven Emotions or external contraction of the Six Excesses, both sufficient to cause hemorrhage. However, hematemesis in pregnancy is primarily attributed to Fire-Heat, precisely because Qi and Blood are abundant to nourish the Fetal Origin; if disturbed, Qi rebels and Fire ascends. This is why Xue Lizhai’s differentiation focuses solely on Fire. Nevertheless, Fire has Deficiency and Excess distinctions. Excess Fire should be cleared to nourish Blood, while Deficiency Fire should be treated by yin-nourishing to replenish Water, thereby stabilizing and securing the fetus. If one adheres to ordinary methods for treating blood disorders using blood-invigorating and blood-resolving agents, the fetus will inevitably miscarry, and disaster will follow immediately.