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The formation of the fetus relies on the generation of Yang Qi and the nourishment of Yin Blood. When Qi moves, Blood follows, and Ying (Nutritive) and Wei (Defensive) harmonize, delivery occurs at term. If nourishment is in any way inadequate, it will be like branches withering and fruit falling, or vines shrinking and flowers dropping, leading to miscarriage.

Therefore, *Suwen: Wuchang Zheng Da Lun* states: "Those rooted within are called Shen Ji (Spirit Mechanism); when Shen departs, the mechanism ceases. Those rooted outside are called Qi Li (Qi Establishment); when Qi stops, transformation ends." This precisely refers to this principle. In cases of recurrent spontaneous abortion during pregnancy, it must be due to the deficiency and damage of Qi and Mai (Vessels). The causes of this deficiency include: innate constitutional weakness; decline in age and physical strength; exhaustion of Jing (Essence) and vitality due to worry, anger, labor, and hardship; secret loss of Sheng Qi (Vital Qi) due to imprudent sexual activity; as well as external factors such as falls/trauma and improper diet, all of which can injure Qi and Mai. For Qi and Mai to be injured yet the fetus remain unharmed requires the most solid congenital endowment; for ordinary people, this does not happen. Moreover, throughout the ten months of gestation, the nurturing by different meridians has its specific dominance. Therefore, recurrent early miscarriages or abortions often occur between the third, fifth, and seventh months. Subsequent abortions tend to recur at these same stages. This is because once a specific meridian's Qi/Blood is damaged, when that meridian's time arrives again, the deficiency prevents passage, leading to abortion. Furthermore, the Kidney connects to the Bao Gong (Uterus), and the Waist is the Mansion of the Kidney. Thus, pregnant women should be most wary of lower back pain; severe pain leads to fetal descent, so prevention is essential. Therefore, those fearing abortion must investigate the cause of injury and exercise utmost caution. In treating abortion, one must examine the source of fetal nourishment and preemptively tonify the deficiency. The method of preserving the fetus lies herein. If treatment is delayed until term, it may be too late. Unstable pregnancy is invariably a disease of Qi and Blood injury. Qi deficiency leads to failure in lifting and securing; Blood deficiency leads to insufficient irrigation and moistening, thus often causing miscarriage. Hence, experts in preserving the fetus must focus on Blood deficiency, primarily using Tai Yuan Yin (Fetal Origin Decoction) with modifications; secondly, Shaoyao Xiong Gui Tang (Peony, Ligusticum, and Angelica Decoction); and thirdly, Taishan Panshi San (Mount Tai Porphyry Powder) or Qianjin Baoyun Wan (Thousand Gold Pregnancy Preservation Pill). These possess the merit of rivaling creation and should be used judiciously.

Tai Yuan Yin (See Section on An Tai / Preserving Fetus)

Shaoyao Xiong Gui Tang (See *Fu Ren Gui Ancient Formulas*), also known as Xiong Gui Bu Zhong Tang. Treats miscarriage due to Qi and Blood deficiency.
Ingredients: Chuanxiong Radix (Ligusticum Chuanxiong), Danggui Radix (Angelica Sinensis), Huangqi Radix (Astragalus Membranaceus, honey-fried), Baizhu Rhizoma (Atractylodes Macrocephala, stir-fried), Renshen Radix Ginseng (Panax Ginseng), Shaoyao Radix Alba (Paeonia Lactiflora, stir-fried), Duzhong Cortex Eucommiae (Eucommia Ulmoides, stir-fried), Yeye Folium Artemisiae Argyi (Mugwort Leaf), Ejiao Colla Asini (Donkey-hide Gelatin, stir-fried), Wuweizi Fructus Schisandrae (Schisandra Chinensis, pounded and stir-fried, 1 qian each), Gancao Radix Glycyrrhizae (Licorice Root, honey-fried, 0.5 qian).
Usage: Take 5 qian per dose, decoct in water and drink. If Spleen Qi is deficient, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). If Qi deficiency is accompanied by Heat, use Antai Yin (Preserve Fetus Decoction).

Taishan Panshi San (See External Formulas in Section on An Tai / Preserving Fetus Theory)

Qianjin Baoyun Wan (See External Formulas in Section on An Tai / Preserving Fetus Theory)

Additionally, in cases of Fetal Heat, Blood is prone to agitation; agitated Blood makes the fetus unstable. Thus, abortion due to internal heat and deficiency is common. For Spleen Qi deficiency with Blood Heat, Six Holy Powder (Sisheng San) is suitable. For Liver-Kidney deficiency with Blood Heat, Cool Fetus Decoction (Liangtai Yin) is suitable. For Liver-Spleen deficiency with Blood Heat, Secure Fetus Decoction (Gutai Jian) is suitable.

Sisheng San (See Section on Tailou / Fetal Bleeding)

Liangtai Yin (Cool Fetus Decoction) (See Section on An Tai / Preserving Fetus)

Gutai Jian (Secure Fetus Decoction) (See *Xin Fang Ba Zhen · Yin Zhen*), treats recurrent abortion due to Liver-Spleen Fire excess and Qi stagnation.
Ingredients: Huangqin Cortex Scutellariae (Scutellaria Baicalensis, 2 qian), Baizhu Rhizoma Atractylodis Macrocephalae (Atractylodes Macrocephala, 1-2 qian), Danggui Radix Angelicae Sinensis (Angelica Sinensis), Shaoyao Radix Alba (Paeonia Lactiflora), Ejiao Colla Asini (Donkey-hide Gelatin, 1.5 qian each), Chenpi Pericarpium Citri Reticulatae (Citrus Reticulata, 1 qian), Sharen Fructus Amomi Rotundus (Amomum Villosum, 0.5 qian).
Usage: Decoct in 1.5 zhong of water and drink.

Furthermore, Master Lizhai's method: For treating recurrent abortion due to Blood deficiency and Blood Heat, in addition to regulating and tonifying, during early summer, instruct the patient to decoct Baizhu Tang (Atractylodes Decoction) strongly and administer 2 qian of Huangqin powder (Scutellaria Powder) with it. After taking dozens of doses, the pregnancy can be preserved and birth achieved. This is also a method worth emulating.

In other cases where other syndromes cause fetal instability, treatment should be judged according to the "An Tai" (Preserving Fetus) section.