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(Chen Nianzu) stated: The discussions on pulse diagnosis in the *Neijing* (Inner Canon of the Yellow Emperor) and by later experts are complex and difficult to learn, whereas the teachings of Pu Mingzi are concise and easy to follow. Pu Mingzi said: The *Jing* (Canon) states, "In pregnant women, there may be symptoms of illness, but the pulse will not show signs of pathogenic factors." "Symptoms of illness" refers to amenorrhea; "no signs of pathogenic factors" means the pulse rhythm is normal and uninterrupted. The *Jing* also states, "When the pulse of the Hand-Shaoyin meridian beats vigorously, it indicates pregnancy." Shaoyin corresponds to the Heart, which governs blood vessels. When the Heart pulse is vigorous, blood is abundant, signaling pregnancy. The *Jing* further states, "When the Yin pulse at the cun position beats strongly, distinct from the Yang pulse, it is called having a child." This means that when the pulses at both chi positions (distal radial artery) are vigorous and significantly different from those at both cun positions (proximal radial artery), it also indicates pregnancy. Among these three indicators, possessing any one constitutes a pregnancy pulse. By analyzing them separately and synthesizing them comprehensively, the signs of pregnancy become unmistakable. Alternatively, a pulse that flows smoothly like a sparrow pecking at food is also a sign of pregnancy. Why?

I reply: A smooth flowing pulse indicates that blood and qi are flourishing; a sparrow-pecking pulse indicates obstruction of the menstrual channels. Thus, the pulse comes rapidly with intermittent pauses, indicating a fetus of several months' gestation. Those who do not understand this may mistakenly diagnose it as a pathological pulse, which would be laughable.

Someone asked: How can one determine the gender of the fetus through pulse diagnosis?

I reply: The left cun position corresponds to Taiyang; if the pulse is floating and large, it indicates a male fetus. The right cun position corresponds to Taiyin; if the pulse is deep and solid, it indicates a female fetus. If both cun positions are floating and large, it suggests twins boys; if both chi positions are deep and solid, it suggests twin girls. Generally, for pregnancy, a string-tight (Xian), tight (Jin), slippery (Hua), or free-flowing pulse is considered favorable (Shun), whereas a deep (Chen), fine (Xi), minute (Wei), or weak (Ruo) pulse is considered unfavorable (Ni).

A disciple asked: Regarding dietary and medicinal taboos during pregnancy, whose authority should be primarily followed?

I say: This is a fixed standard. Books such as *Dasheng Pian*, *Furen Liangfang*, *Nuke Dacheng*, and *Jiyin Gangmu* all follow similar traditions. However, I shall take the regulations established by Pu Mingzi as the primary guide. Pu Mingzi said: "After conception, one must strictly avoid consuming prohibited foods."

First, eating chicken eggs and glutinous rice may cause the child to develop tapeworms (Cunbai Chong) after birth. Second, eating lamb liver may make the child prone to illnesses. Third, eating carp may lead to infantile malnutrition syndrome (Gan Ji). Fourth, eating dog meat may cause the child to lose their voice. Fifth, eating rabbit meat may result in a cleft lip. Sixth, eating soft-shelled turtle meat may cause a short neck. Seventh, eating duck may induce heart coldness in the child. Eighth, eating crab often leads to dystocia or breech presentation. Ninth, eating sparrow meat may predispose the child to excessive lust. Tenth, eating bean paste may trigger asthma in the child. Eleventh, eating wild beast meat may cause rare diseases. Twelfth, eating ginger may result in polydactyly. Thirteenth, eating frogs and eels may cause leprosy-like skin conditions. Fourteenth, eating mule or horse meat may prolong labor beyond the due date. Such prohibitions are all effective and should be deeply observed.

Pu Mingzi also added: There are dozens of songs detailing medicinal taboos during pregnancy, and the list extends even further. However, substances such as Mylabris (Banmao), Leech (Shuizhi), Snake Slough (Shetui), Centipede (Wugong), Mercury (Shuiyin), and Arsenic (Xinpi) are rarely used in daily practice and need not be discussed here. I have selected only those commonly encountered to compile a few verses, so that physicians may remain vigilant and avoid errors. Other bizarre or highly toxic substances should naturally be avoided during pregnancy without needing explicit mention.

The verse reads: Avoid Aconitum (Wutou), Prepared Aconite Root (Fuzi), and Lateral Root of Aconite (Tianxiong); Realgar (Niuhuang), Croton Seed (Badou), and Peach Kernel (Taoren); Mirabilite (Mangxiao), Rhubarb (Dahuang), Peony Root (Mudanpi), and Cinnamon Twig (Guizhi); Achyranthes Root (Niuxi), Veratrum (Lilu), Imperata Rhizome (Maogen), and Madder Root (Qiancaogen); Sophora Fruit (Huaijiao), Safflower (Honghua), and Gleditsia Sinensis (Zaojiao); Burreed Tuber (Sanleng), Curcuma Zedoaria (Ezhu), and Coix Seed (Yiyiren); Dried Lacquer (Ganqi), Ginger (Ru), and Lygodium Spore (Qumai Sui); Pinellia Tuber (Banxia), Star Fennel (Nanxing), and Thoroughwort Stem (Tongcao); Dried Ginger (Ganjiang), Garlic (Dasuan), and Horse Bean (Madoudou); Corydalis Rhizome (Yanhusu), Oldenlandia (Changshan), and Musk (She) should never be heard of. These are the taboos for women before childbirth; keep them constantly in mind.

(Changsun Xindian) noted: The above prohibitions seem correct. However, Banxia is sometimes used to calm the fetus and stop vomiting; Dahuang is used for febrile diseases during pregnancy; Ganjiang, Guizhi, and Fuzi are used for cold syndromes during pregnancy. What is the explanation for this? In ancient times, the Yellow Emperor asked Qibo: "If toxic medicines are used on a pregnant woman, what happens?" Qibo replied: "If there is an existing pathology, the medicine will not harm [the mother or fetus]. Large accumulations and masses may be attacked, but stop when half has subsided." "Existing pathology" means disease is present; "not harming" means the fetus is not injured; "also not harming" means the mother is not injured. Essentially, because the disease bears the brunt of the medication, toxic drugs do not damage fetal qi. However, this applies only when large accumulations and strong pathological forces exist. One must stop treatment once the condition improves by half and avoid overdosing, exercising extreme caution! Physicians must adhere to the great principles of Qibo and Huangdi.

A disciple asked: What are the methods for care and emergency treatment during labor?

I say: The book *Dasheng Pian* covers this topic in detail, with every word being valuable, so no further elaboration is needed. Any husband whose wife is pregnant should hold this book and discuss three to four pages with her daily. Within half a month, she can memorize the entire text. Is this not better than gambling or idle chatter to pass the time? Please reflect on this repeatedly. I will supplement what *Dasheng Pian* omitted: To verify impending labor, lower back pain without abdominal pain indicates labor has not started; abdominal pain without lower back pain also indicates labor has not started. Only when both lower back and abdomen hurt intensely and tightly is true labor beginning. If labor stalls, administering appropriate medication will facilitate delivery. Nature's creation of humans possesses miraculous spontaneity; human intervention should not force the process but merely follow its natural course.

(Chen Yuanxi, second son) noted: For women who have just given birth, their organ qi is robust, and the placental sac is firm. Before delivery, taking Baosheng Wuyou San (Baosheng Wuyou Powder) for two to three doses helps open the birth canal, making delivery easier. This formula should be taken before the rupture of membranes. If membranes have ruptured but labor is delayed, accompanied by fatigue and mental exhaustion, Shiquan Dabu Tang (Ten Significant Tonifying Decoction) should be used to boost strength. Furthermore, to prevent excessive amniotic fluid leading to blood deficiency and lack of fetal mobility, Danggui Buxue Tang (Angelica Tonifying Blood Decoction) should be administered urgently, optionally adding Cinnamon Bark (Rougui) or Prepared Aconite Root (Fuzi) as indicated. This is the clinical method of Gao Gufeng, which I have used successfully many times. For cases where the pubic symphysis does not separate (Jiaogu Bukai), or the vulva remains open, or the uterus fails to contract, these are all due to insufficiency of Yuan Qi (Original Qi). For non-separation of the pubic symphysis, predecessors recommended Jiawei Xiongui Tang (Modified Ligusticum and Angelica Decoction), but Zhang Shiwen criticized it, arguing that it causes blood stasis and worsens the condition. He advocated using large doses of Ginseng (Renshen) and Child's Urine (Tongbian) combined with Ligusticum (Xiong) and Angelica (Gui) to boost qi and blood, yielding immediate results. For the vulva remaining open, use Shiquan Dabu Tang with increased Ginseng and Cinnamon to tonify and astringe. For uterine inversion/prolapse, use Buzhong Yiqi Tang (Middle-Boosting Qi-Supplementing Decoction) with 1 qian of Wine-fried White Peony Root (Jiu Shaoyao) and 0.5 qian of Cinnamon Bark to tonify and lift. Actually, Zhang Shiwen's critique was somewhat overcorrecting. While it may be true that Jiawei Xiongui Tang lacks sufficient potency, claiming it causes blood stasis and worsens disease is incorrect. As for traditional pills tested over time, Huatuo's Shunsheng Dan (Smooth Birth Pill) and Rushen San (Miraculous Powder) for inducing labor, and Shixiao San (Laughing Off Powder) and Huarui Shi San (Flower and Pyrite Powder) for retained placenta, are essential preparations for any practitioner. Additionally, for dystocia, moxibustion on the tip of the right little toe of the parturient woman, using moxa cones the size of a small bean, three to five cones, can induce immediate delivery. This technique must be taught in advance.