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Translation:

Q: How to determine if conception has occurred?

Regarding the differentiation of male and female fetuses, it is not constrained by the sequence of essence and blood union, nor by the number of days after menstruation ends when intercourse occurs, nor by whether it happens before or after midnight, nor by whether the father is strong and the mother weak, or vice versa. It solely depends on which one—essence or blood—gains superiority when both arrive simultaneously through the hundred vessels (Bai Mai). Therefore, if the essence arriving via the hundred vessels outweighs the blood, a male fetus is formed; if the blood outweighs the essence, a female fetus is formed. As for those who experience miscarriage after pregnancy, those whose children are born but do not survive, those who survive but do not live long, and those who live long with boundless blessings, this is also due to the firmness or fragility of the received essence and blood determining the length of life. People in the world fail to observe that the firmness or fragility of essence and blood is determined at the beginning of endowment, yet they blame mothers exclusively for miscarriage, attribute failure to raise children exclusively to the infants, and dismiss longevity or premature death exclusively to fate. Is this not absurd?

[Diagnosis]
If a pregnant woman at seven months shows no obvious signs of pregnancy, frequently suffers from epistaxis (nosebleed) accompanied by tendon spasms, this indicates abnormal fetal qi. If she sneezes and her body trembles during the nosebleed, it is not pregnancy. The *Su Wen* states: "When the pulse of the Foot Shaoyin kidney meridian in women moves vigorously, it indicates pregnancy." (*Ping Ren Qi Xiang Lun* refers to the pulse at Taixi acupoint. Quan Yuanqi's version writes Foot Shaoyin, while Wang Bing's version writes Hand Taiyin; the former should be followed. Wang Bing's commentary says: A moving pulse feels like a bean trembling vigorously. Another interpretation says "vigorous movement" refers to an extremely large amplitude of pulsation.) When the Yin pulse (Chi pulse) beats forcefully and differs distinctly from the Yang pulse (Cun pulse), it is called having a child. (Wang Bing's commentary on *Yin Yang Bie Lun* states: Yin refers to the Chi position, Bo refers to the pulse touching the fingers. If the Chi pulse beats differently from the Cun pulse, it is a sign of pregnancy.)

[Pulse Diagnosis]
At the beginning of pregnancy, the Cun pulse is minute, and the pulse rate is five beats per breath (rapid). By three months, the Chi pulse becomes rapid. If the pulse is slippery and rapid, and feels scattered when pressed heavily, it indicates a three-month pregnancy. If the pulse does not scatter under heavy pressure but is rapid without being slippery, it indicates a five-month pregnancy. (This embodies the meaning of "Yin Bo Yang Bie," meaning the Chi pulse is slippery and rapid, the Cun pulse is minute, and the distinction between Chi and Cun pulses characterizes the pregnancy pulse.) If the Chi pulse is larger on the left side, it is a male; if larger on the right, it is a female; if both sides are large, twins will be born. The pulse feels solid and substantial. (This also reflects "Yin Bo Yang Bie," meaning the Chi pulse is solid and large, distinct from the Cun pulse, distinguishing gender by left for male and right for female.) For women four months pregnant, to determine the gender: a rapid pulse on the left indicates a male, on the right a female, and rapid on both indicates twins. (Wang Ziheng says: If all three positions of the pregnancy pulse are slippery and rapid, left indicates male, upper indicates female.) Have the pregnant woman walk facing south, then call her back. If she turns her head to the left, it is a boy; to the right, a girl. When she is using the toilet, have her husband call her urgently from behind. Turning left indicates a boy; turning right indicates a girl.

Lou Quanshan said: According to Zhu Danxi, male fetuses conceive in the left uterus, and female fetuses in the right uterus. This statement aligns well with the above theory. Presumably, because the male fetus is on the left, the left side feels heavier, so when turning her head, she instinctively protects the heavier side and leans left. Because the female fetus is on the right, the right side feels heavier, so she leans right. Applying this to pulse diagnosis, the principle is the same. If the fetus is on the left, blood and qi protect the fetus and become abundant on the left, so the pulse follows suit: left rapid indicates male, left large indicates male. If the fetus is on the right, blood and qi protect the fetus and become abundant on the right, so the pulse follows: right rapid indicates female, right large indicates female. This is similar to the classic saying: "Yin Bo Yang Bie, Wei Zhi You Zi." It means the conception site is below the navel, where blood and qi protect the fetus and become abundant in the lower part, causing the Yin Chi pulse to beat vigorously and differ from the Yang Cun pulse. Similarly, if an abscess occurs above, blood and qi rise, and the Cun pulse becomes strong; if below, blood and qi descend, and the Chi pulse becomes strong; if on the left, blood and qi flow left, and the left pulse becomes strong; if on the right, blood and qi flow right, and the right pulse becomes strong. Zhu Danxi believed that left large favors males and right large favors females, referring to the doctor's left and right hands, which was a mistake by a wise man.

Song for Diagnosing Pregnancy in Women:
The Liver governs Blood, the Lung governs Qi.
Blood forms Ying (Nutritive), Qi forms Wei (Defensive).
Yin and Yang match without discrepancy;
The two organs harmonize, following the same pattern.
If Blood is deficient and Qi is vigorous, pregnancy is impossible;
If Blood is vigorous and Qi is deficient, pregnancy will occur.
(The Liver stores Blood as Ying, belonging to Yin; the Lung governs Qi as Wei, belonging to Yang. Yin-Yang matching refers to the union of husband and wife, combining essence to conceive. If Blood is scant and Qi is excessive, there is no pregnancy. If Blood is abundant and Qi is scarce, there is pregnancy.)
The Cun pulse is minute, Guan is slippery, Chi carries rapidity;
Flowing smoothly, coming and going like a sparrow pecking.
The infant's pulse already shows its form,
Yet for several months of gestation, it remains unnoticed.
(Cun minute, Guan slippery, Chi rapid and flowing/sparrow-pecking indicate closed meridians forming the fetus. These pulses reflect abundant Blood and scarce Qi, showing the form of a pregnancy.)
Left rapid indicates male, upper indicates female;
Flowing and connected, coming and going swiftly.
If both hands' Guan pulses are large and corresponding,
The form is already present, as previously discussed.
Left pulse with "Zong" (Vertical) indicates two sons;
(Zong means Husband conquers Wife, Water conquers Fire, Metal conquers Wood, i.e., Ghost-Thief Pulse. Named Zong. Seen on the left, it indicates two male children.)
Right pulse with "Heng" (Horizontal) indicates two daughters.
(Heng means Wife conquers Husband, Fire conquers Water, Wood conquers Metal, i.e., Overcoming Pulse. Named Heng. Seen on the right, it indicates two female children.)
Left pulse with "Ni" (Reverse) generates three sons;
(Ni means Child conquers Mother, Water conquers Metal, Fire conquers Wood, i.e., Already-Generated Pulse. Named Ni. Seen on the right [Note: Text says Right here but context implies Left for sons, likely a textual variation or error in source, but translating literally], it indicates three male children.)
Right pulse with "Shun" (Smooth) returns three daughters.
(Shun means Mother conquers Child, Metal conquers Water, Wood conquers Fire, i.e., Generated-Already Pulse. Named Shun. Seen on the right, it indicates three female children.)
If Cun, Guan, and Chi positions all correspond,
One son and one daughter show their distinct forms.
(Pulses of Cun, Guan, Chi corresponding in size, slowness/rapidity indicate one son and one daughter. Guan front is Yang, rear is Yin; Yin-Yang correspondence yields one son and one daughter.)
Sometimes the child dies while the mother survives,
Or the mother perishes while the child lives.
(These two lines lack a method to distinguish survival of child vs. mother.)
Coming and going, all three positions flow smoothly;
Slippery and rapid intermixed, all robust and steady.
Yang Excess and Yin Deficiency make the pulse clear;
Full chest filled with rebellious Qi.
(If Cun, Guan, Chi all flow smoothly, robust, slippery, and rapid, it indicates Yang Excess and Yin Deficiency, leading to rebellious Qi filling the chest in pregnant women.)
Left hand Taiyang floating and large indicates male;
(Left Cun is Taiyang; floating and large pulse indicates male pregnancy.)
Right hand Taiyin deep and fine indicates female.
(Right Cun is Taiyin; deep and fine pulse indicates female pregnancy.)
All Yang pulses indicate male, all Yin pulses indicate female;
Keep this clear under your fingers always.
(All Yang pulses, such as floating, large, rapid, slippery, excess, indicate males. All Yin pulses, such as deep and fine, indicate females.)
If Cun, Guan, Chi are deep, upright, equal, and unbroken,
And Chi pulse continues upon lifting and pressing, it is a true pregnant woman.
(Husband conquering Wife creates Zong Qi mist;
(Mist/Fog implies upward/downward movement. Husband's Yang Qi conquers Wife's Yin Qi, chasing each other up and down like mist nourishing the seed.)
Wife conquering Husband creates Heng Qi assistance.
(Heng means Wife conquers Husband, assisted by lateral Qi.)
Child conquering Mother creates Ni Qi participation;
(Child's Qi invades Mother's Qi, reverse-flowing Qi participates.)
Mother conquering Child creates Shun Qi protection.
(Mother's Qi conquers Child's Qi, smooth Qi protects. All fetuses gather Zong, Heng, Ni, Shun four Qi to nourish and form.)
When the infant's days are full, the fetus gathers and forms;
Body heat and chaotic pulse bring no distress.
(Five months of gestation complete, the fetus forms and gathers. The mother may have high fever and chaotic pulse, which is not a pathological distress. At five months, the fetus is formed, receiving Fire Essence to create Qi, so body heat and chaotic pulse are normal.)
Sweating, loss of appetite, vomiting and reflux occur;
Spirit and essence gather and reside within.
(Gestation receives Five Elements' essence to form shape, relying on two meridians to nourish the mother. At five months, though the fetus forms, its Qi is not yet complete, so fetal Qi is unstable, rushing up to the heart/chest causing sweating, anorexia, and vomiting, named E Zu (Morning Sickness), commonly called Xuan Fan, craving sour/spicy flavors to regulate fetal Qi.)
Slippery and rapid without scattering indicates three-month fetus;
(Slippery/rapid flowing indicates little Qi and much Blood; non-scattering indicates abundant Qi and Blood, starting the formation of the fetus.)
Only rapid without scattering indicates five-month mother.
(Pulse only rapid and numerous without scattering indicates a five-month pregnant mother.)
String-tight, firm-strong, slippery-smooth indicates peace;
Deep-fine and minute leads to the springs of death.
(Pregnant women's pulses should be string-tight, firm, strong, slippery, and smooth, indicating auspiciousness. If deep, fine, and minute, the pulse does not match the condition, indicating death. Although earlier texts mention Taiyin deep/fine and all Yin for females, this refers to the entire three-position pulse not being deep/fine/minute, hence different.)

[Methods to Verify Pregnancy]
[Hai] Divine Formula Yan Tai San:
For women two to three months past menstruation, with amenorrhea, suspecting pregnancy but confused by blood stasis, irritability, alternating chills and fever, this medicine can verify internal pregnancy. External signs of pregnancy combined with absence of pathogenic pulses, deduced by *Su Wen* pulse methods, yield 80-90% accuracy.
Zhen Que Nao Xiong (True Sparrow Brain Xiongqiong / Ligusticum Chuanxiong) (1 liang)
Dang Gui (Angelica Sinensis, whole root, weighing 1 liang, use only 7 qian)
Grind into fine powder, divide into two doses. Take with a cup of thickly decocted good Ai Ye (Mugwort) soup, or mixed with good wine. After two to three shichen (4-6 hours), if slight frequent movements are felt in the abdomen and umbilicus, pregnancy is confirmed. Movements cease and health is restored, safe and secure. If not pregnant, there will be no movement, and stagnant evil matter will pass naturally, leaving the mother safe. If no effect is felt, take again with Hong Hua (Carthamus tinctorius) soup decoction; miraculous effects will surely appear.
[Ling Yuan] Method to verify pregnancy after three months of amenorrhea:
Use Zhen Chuan Xiong (Chuanxiong Rhizome) ground into fine powder. Take one bi (measure) with thick Ai Ye soup. Gradual movement in the abdomen indicates pregnancy.
Tan Tai San (Probe Fetus Powder):
To resolve doubts about the presence of fetal Qi, use this to probe. If pregnant, vomiting occurs; if not, no vomiting.
Zao Jiao (Gleditsia Sinensis Fruit, peeled)
Gan Cao (Licorice Root, roasted), each 1 qian
Huang Lian (Coptis Rhizome), 0.5 qian
Grind into fine powder, take as one dose, mixed with warm wine.

Hao Weng, a divine physician from Boling, treated the wife of scholar Chen Yaozun, who was ill. Other doctors attributed it to labor injury. Hao said: Stop medication immediately; this is a pregnancy syndrome. I congratulate you on having a son. It proved true.
Two other pregnant women presented; one lost her voice and could not speak. Hao said: The fetus is large, blocking the meridians. She will speak once the child is born and meridians open. Do not poison her with medicine.
Another extremely robust woman: Hao diagnosed her pulse and said: The mother's Qi is dead; she survives only by relying on the fetal Qi. The child will be born on schedule, and the mother will die.
(A pregnant woman losing her voice is not a disease. Upon hearing this, no medication is needed. On the day of delivery, take Bao Sheng Wan or Si Wu Tang. Speech returns naturally after birth; this is natural law, not the power of medicine.)
A woman suffered sudden thirst, drinking only Wu Wei Zhi (Five Flavor Juice). Famous doctor Geng Yu diagnosed her pulse: "Blood is about to coagulate; this is not a disease." She subsequently became pregnant. Ancient formulas mention symptoms of thirst from drinking five-flavor juice due to blood about to coagulate; this must be known.
Pan Wensou diagnosed the wife of Yu Bu Yuan Wai Lang Zhang Xian, pregnant for five years without childbirth; Fu Changling, Vice Magistrate of Nanling, pregnant for two years without childbirth; Liu Yisun, Military Commissioner, pregnant for fourteen months without childbirth. Wensou examined them and said: These are diseases; ordinary doctors mistakenly assumed pregnancy. He administered large doses of blood-breaking and toxin-attacking medicines.
The Yu Bu wife expelled over a hundred flesh lumps resembling eyebrows and eyes.
Changling wife dreamed of two pitch-black boys who fled in terror.
Liu's relative expelled a large snake, still wriggling and alive.
All three women recovered safely.
Chen Douyan treated the wife of Ye Nanzhou, who had amenorrhea for five months, discharged white or red fluid, had afternoon fever, cough, and vomiting. Doctors diagnosed it as Lao Zhai (Consumption/Tuberculosis). Chen examined and said: Both Chi pulses are solid; this must be pregnancy, complicated by external wind pathogen agitation. He prescribed a Qing He (Clearing and Harmonizing) formula, and she stabilized. Half a year later, she gave birth to a son.