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Chen Liangfu stated: During pregnancy, the sensation of vexation and stuffiness arises because in the fourth month, Shaoyin Junhuo (Ministerial Fire of Shaoyin) nourishes the essence, and in the sixth month, Shaoyang Xianghuo (Ministerial Fire of Shaoyang) nourishes the qi. If the mother suffers from fright and gallbladder deficiency, this syndrome often occurs.

Li Taisu stated: "Vexation" refers to a state of mental restlessness and unease within the heart. This is caused by blood heat affecting the heart after conception, leading to a lack of clarity in heart qi, resulting in depression, agitation, and inability to find peace. Because this vexation occurs during pregnancy, it is termed "Zifan" (Pregnancy Vexation), not implying that the fetus itself is vexed in the womb. The ancients said: In the fourth month, Shaoyin Junhuo nourishes the essence; in the sixth month, Shaoyang Xianghuo nourishes the qi, thus causing vexation. Generally, vexation belongs to fire. Since the fetus receives the nourishment of both Junhuo and Xianghuo, how could the mother feel vexed? Moreover, since the mother uses these two fires to nourish the fetus, the fire energy would be dissipated through this process, so why would there be vexation? If one argues that the mother's deficiency causes vexation, then it should occur every month. Why specifically in the fourth and sixth months does the mother become deficient and vexed? Furthermore, it is not limited to only these two months. Thus, this explanation seems logically inconsistent.

Qi Zhongfu stated: There are four types of vexation and stuffiness during pregnancy: vexation in the heart, vexation in the chest, and Zifan (Pregnancy Vexation); all belong to heat syndromes. If organ deficiency allows heat pathogens to invade the heart, causing vexation, it is named "Xu Fan" (Deficiency Vexation). If there is accumulated phlegm-fluid retention with vomiting of phlegm-saliva, it is named "Xiongzhong Fan" (Chest Vexation). If blood stasis and fluid retention interact with cold and heat, disturbing fetal qi and causing instability, it is called "Zifan," treated with formulas such as Xijiao San (Rhinoceros Horn Powder) or Zhuli Tang (Bamboo Juice Decoction).

Shan Yangxian stated: This involves deficiency-heat of the heart and lungs, or phlegm accumulation in the chest. If vexation occurs in the third month of pregnancy, it is merely due to heat. If vexation is caused by phlegm-fluids, symptoms include spitting saliva, aversion to food, and restless agitation. Generally, during pregnancy, the presence of accumulated phlegm and fluids, combined with the struggle between cold and heat, leads to stagnant and unsmooth qi mechanism. Symptoms may include vexation or vomiting of saliva-phlegm; in severe cases, fetal movement becomes unstable. All these conditions are collectively referred to as "Zifan."

Zhu Danxi stated: Zifan results from the obstruction and stagnation of the fetal origin, with heat qi rushing upward, leading to vexation and stuffiness. The treatment method should focus on clearing heat and resolving stagnation to calm the fetus, primarily using Xijiao San (Rhinoceros Horn Powder).

Xue Lizhai stated: For the aforementioned syndromes, if caused by internal heat, use Zhuye Tang (Bamboo Leaf Decoction). If caused by qi stagnation, use Zisu Yin (Perilla Infusion). If caused by phlegm stagnation, use Erchen Tang (Two-Aged Phlegm Decoction) added with Huangqin (Scutellaria Root) and Zhike (Aurantium Fructus). If caused by qi depression, use Fenqi Yin (Qi-Dispelling Infusion) added with Chuanxiong (Ligusticum Rhizome). If caused by spleen and stomach weakness, use Liujunzi Tang (Six Gentlemen Decoction) added with Zisu (Perilla Leaf) and Shanzhi (Gardenia Fruit).