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Abdominal and epigastric pain during pregnancy may arise from pre-existing cold stagnation, phlegm-fluid retention, or recent exposure to wind-cold, where pathogenic factors clash with healthy qi. If the chest and abdomen are distended and painful upon palpation, it indicates food stagnation; treat with Renshen Yangwei Tang (Ginseng Stomach-Nourishing Decoction). If there is no pain upon palpation, it indicates spleen-stomach injury; tonify with Liujunzi San (Six-Gentlemen Powder). Abdominal fullness and pain radiating to the heart, accompanied by inability to eat, is treated with Qinshu Shaoyao Tang (Scutellaria, Atractylodes, and Peony Decoction) from *Qianjin Fang*. Irregular abdominal pain is termed "Tai Tong" (Fetal Pain). It has two causes: blood deficiency and qi stagnation, with blood deficiency being more common. Use Shudi (Rehmanniae Radix Preparata) 3 qian and Danggui (Angelicae Sinensis Radix) 1 qian, decocted in water. If ineffective, add Renshen (Ginseng), Baizhu (Atractylodis Macrocephalae Rhizoma), and Chenpi (Citri Reticulatae Pericarpium). Danxi used Siwu Tang (Four-Substance Decoction) removing Chuanxiong (Ligustici Chuanxiong Rhizoma) and doubling Shudi. For qi stagnation, use Zisu Yin (Perilla Infusion). If pain is accompanied by a heavy, bearing-down sensation due to middle qi deficiency and sinking, use Buzhong Yiqi Tang (Decoction for Reinforcing the Middle and Augmenting Qi).

Epigastric pain is often due to spleen deficiency and indigestion of retained food; nourish the stomach and digest food. *Bencao Gangmu* suggests Pingwei San (Peaceful Stomach Powder) with Zhike (Aurantii Fructus) and Shanzha (Crataegi Fructus). I argue that Pingwei San may damage the fetus and is not suitable; instead, use modified Yangwei Tang.

Hypochondriac pain during pregnancy may result from weeping, internal injury, or anger. Breaking qi methods should be avoided. Use urine from a healthy child (Tongbian) mixed with wine, or modify Zisu Yin by removing Renshen, using Shaoyao (Paeoniae Radix Alba), Danggui, adding Renchen (Amomi Fructus Rotundus), and Tongbian.

Cold pain below the umbilicus, abdominal distension with empty pain, frequent urination, and loose stools are caused by consuming raw and cold foods. Treat with Xiaojianzhong Tang (Minor Construct the Middle Decoction) plus Paojiang (Zingiberis Rhizoma Preparatum) and Muxiang (Aucklandiae Radix). If ineffective, add Huixiang (Foeniculi Fructus) and Liangjiang (Alpiniae Officinarum Rhizoma).

Lower abdominal pain during pregnancy: if due to empty heat, use Zisu Yin; if due to empty cold, use Jiaoai Tang (Donkey-Hide Gelatin and Mugwort Decoction). Swelling near the lower abdomen with thin, shiny skin indicates "Yun Yong" (Pregnancy Abscess); treat with Tuoli San (Support the Interior Powder) from *Qianjin Fang*, or drink decoction of Yiyiren (Coicis Semen). If there is acute epigastric pain, irritability, cyanotic face, cold sweat, syncope, continuous vaginal bleeding, and fetal gas rushing upward, it is incurable.

Lower back pain during pregnancy: if due to kidney deficiency, the pulse is large and pain persists; urgently administer Bazhen Tang (Eight-Treasure Decoction) plus Ejiao (Asini Corii Colla), Aiyè (Artemisiae Argyi Folium), and Huangqin (Scutellariae Radix), or modified Zisu Yin. If caused by overexertion and heavy lifting damaging the uterine ligaments threatening miscarriage, use Antai Yin (Fetus-Securing Infusion) plus Duzhong (Eucommiae Cortex) and Xuduan (Dipsaci Radix). If caused by excessive sexual activity damaging uterine ligaments, use Shudi, Danggui, Ejiao, Renchen, Zhuru (Bambusae Caulis in Taenia), and Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata), mixed with 1 qian of ash from men's underwear crotch; strictly avoid sexual intercourse for 100 days. If damp-heat presents with a slow pulse, pain worsens on cloudy days or after prolonged sitting, with leukorrhea, use Ermiao San (Two-Marvels Powder) plus Chaihu (Bupleuri Radix), Fangfeng (Saposhnikoviae Radix), Fuling (Poria), and Banxia (Pinelliae Rhizoma). If cold-damp causes heaviness like wearing a weight and coldness, modify Zisu Yin with spleen-fortifying and warming-drying herbs. If qi-blood stagnation presents with choppy pulse, pain worse at night than day, insomnia, whole-body stiffness and pain, and visual spots, use Zisu Yin plus Zhike and Jiegeng (Platycodonis Radix). If dull pain with a forceful pulse, use Jiaoai Xiong Gui Tang (Donkey-Hide Gelatin, Ligusticum, and Angelica Decoction), or Foshou San (Buddha's Hand Powder), or burnt brown sugar mixed with Tongbian and wine. For migratory pain indicating stagnant blood entering meridians, use Siwu Tang (Note: Text says Siwu but lists ingredients for Siwu Tang variant? Text says "Si Wu Tang" but context implies a specific formula named "Si Wu Tang" here which might be a typo for something else or a specific local name, sticking to text "Si Wu Tang") plus Bohe (Menthae Haplocalycis Herba), Rougui (Cinnamomi Cortex), Duzhong, and Xuduan.

Back pain during pregnancy is due to qi stagnation; treat with Zisu Yin.

Pain involving the lower back, abdomen, and back: The kidneys govern the lower back. Fatigue depletes meridians, allowing wind-cold to invade causing back pain; invading the abdomen causes abdominal pain, leading to mutual pulling pain. Persistent pain risks miscarriage. For fatigue-induced back/abdominal pain, use Buzhong Yiqi Tang plus Duzhong. However, pain may also stem from strangury; examine carefully. Treat strangury with Jiawei Daochi Tang (Modified Guide-Out Red Decoction); once strangury resolves, pain ceases.

Pain at the Huantiao acupoint during pregnancy belongs to kidney deficiency; use Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill) plus Duzhong and Xuduan, or Baoyun Wan (Pregnancy-Preserving Pills) from *Qianjin Fang*.

Red eyes, sore throat, and sores in mouth, nose, lips, and tongue during pregnancy are all treated with modified Liangge San (Cool the Diaphragm Powder).

Trauma from carrying heavy loads causing blood stasis pain: Using blood-invigorating herbs risks harming the fetus; not using them leaves injured blood. First determine fetal viability. If no other symptoms, use burnt brown sugar mixed with aged wine and Tongbian. Chew peeled walnuts thoroughly; if the fetus is dead, it will be expelled; if alive, pain stops immediately. If trauma resulted from anger or convulsions, use Zisu Yin plus Gouteng (Uncariae Ramulus cum Uncis). If excessive blood loss occurs, use Bazhen Tang removing Fuling, adding Ejiao, Aiyè, and Huangqin.

Renshen Yangwei Tang treats food stagnation and fullness.
Ingredients: Renshen, Cangzhu (soaked in rice water, peeled, stir-fried with sesame oil until yellow), Chenpi (peeled), Huoxiang, Zhi Banxia, Houpo (peeled, stir-fried with ginger juice), Fuling, Caoguo, Zhigancao, Shengjiang, Dazao, Wumei.
Decoct with water as guide.

Qinshu Shaoyao Tang (*Qianjin Fang*) treats abdominal fullness and pain, guarding the chest with hands, inability to eat.
Ingredients: Baizhu (6 qian, stir-fried with soil), Huangqin (2 qian), Shaoyao (4 qian).
Decoct three ingredients in water, divide into three doses. Finish within half a day.

Zisu Yin treats edema and wheezing near term, Zi Xuan syndrome (floating fetus), fetal restlessness, upper chest pain, or stuck labor qi.
Ingredients: Danggui (wine-washed), Zisu, Chuanxiong, Shaoyao (wine-fried), Chenpi, Dafupi (boiled in black bean water, processed, each 1 qian), Renshen, Zhigancao (each 5 fen).
Add 3-5 slices of Shengjiang and 7 cun of Congbai (scallion white), decoct in water. For wind-cold, remove Dafupi, add Chidou Chi (Fermented Soybean). For restless fetus, add fried Huangqin and soil-fried Baizhu. For non-moving fetus, add Muxiang and Renchen.

Jiaoai Tang treats metrorrhagia, post-miscarriage bleeding, or pregnancy bleeding with abdominal pain. Also treats damage to Chong and Ren vessels with menorrhagia.
Ingredients: Shengdihuang (2 qian), Shaoyao (1.5 qian), Ejiao (fried with Puhuang until granular), Aiyè, Danggui (each 1 qian), Chuanxiong, Gancao (each 5 fen).

Tuoli San (*Qianjin Fang*) treats damp-heat pain, heaviness, and swelling in the lower half of the body.
Ingredients: Huangbai (processed multiple times with ginger juice), Cangzhu (from Maoshan preferred, peeled, sliced, stir-fried with sesame oil until yellow).
Grind into powder, mix with ginger juice, take 2 qian with warm wine on an empty stomach.

Jiaoai Xiong Gui Tang treats trauma between 2-3 months and 8-9 months of pregnancy causing fetal restlessness, severe lower back and abdominal pain, and bleeding.
Ingredients: Ejiao (fried with Ge Fen or Puhuang), Chuanxiong, Danggui, Shengdihuang, Aiyè.

Siwu Tang treats qi stagnation in blood with acute lower abdominal pain.
Ingredients: Shudi, Danggui (each 2 qian, wine-washed), Chuanxiong (8 fen), Shaoyao (1.5 qian, wine-fried), Wuyao (6 fen), Xiangfu (7 fen, processed), Zhigancao (5 fen).

Jiawei Daochi Tang treats oliguria and dysuria in pregnant women, known as Zi Lin (Fetal Strangury), and hematuria.
Ingredients: Renshen, Shengdi, Tiaoqin, Mutong, Gancao Shao, Maidong (heart removed), Chishao (each 1 qian), Danzhuye (15 leaves).

Dongyuan Liangge San treats heat syndromes in pregnant women, such as red eyes and oral ulcers, modified according to symptoms.
Ingredients: Huangqin (wine-fried), Huanglian (wine-fried), Shanzhiren (wine-fried), Lianqiao (heart removed), Jiegeng, Sheng Gancao (equal parts), Boheye (small amount).