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(Wang Mengying's commentary: This is the syndrome of eclampsia.)

Shen Yaofeng said: The root causes of diseases in pregnant women can be summarized into three main categories: First, deficiency of Yin fluids. The essence and blood of the human body are limited; they gather to nourish the fetus, so the Yin aspect inevitably becomes deficient. Second, stagnation of Qi. With an obstacle (the fetus) added to the abdomen, the ascending and descending movement of Qi must become stagnant. Third, retention of phlegm and fluid. The organs and viscera of the human body are adjacent; with a sudden addition of an object in the abdomen, the functional mechanisms of the organs become inflexible, causing body fluids to condense into phlegm and fluid. Understanding these three points prevents one from being confused by erroneous theories. When a pregnant woman suddenly faints and cannot speak, or has deviation of the mouth and eyes, or convulsions of the limbs, it is all termed stroke (Zhong Feng); or when there is opisthotonos (backward arching of the back), alternating between coma and consciousness, it is termed spasm (Jing), also known as eclampsia (Zi Xian). Historically, it has always been treated as stroke, but one does not realize that sudden fainting and inability to speak is a disease named Jue (syncope/collapse), which refers to Yin deficiency failing to anchor the solitary Yang leading to upward rebellion. Deviation of the mouth and eyes and limb convulsions may be due to phlegm obstructing the meridians; or due to Yin deficiency failing to absorb/anchor, causing Liver Yang to move internally and generate internal wind. As for the symptom of opisthotonos, at the critical stage, upward staring of the eyes (Dai Yan) must appear. What is the reason? The meridian of Foot-Taiyang Bladder originates from the inner canthus, ascends to the forehead and intersects at the vertex, runs along the medial side of the shoulder blades, flanks the spine, and reaches the middle of the waist; the Foot-Taiyang governs body fluids. When deficient, the meridians contract intermittently; due to contraction, opisthotonos occurs. The Classics state: "High pupils indicate Taiyang insufficiency." This means insufficiency of the fluids of the Taiyang meridian. When the meridians contract and tighten, the pupils look upward; severely, Dai Yan occurs. Treatment should employ herbs such as Sheng Di Huang (Rehmanniae Radix) and Mai Dong (Ophiopogonis Tuber) to primarily nourish body fluids. In pregnancy-related diseases, Yang deficiency is extremely rare; one must strictly avoid using Xiao Xuming Tang (Minor Cinnamon Twig Decoction).

Wang Mengying's commentary: The aspects of Yin deficiency and Qi stagnation have been discussed by predecessors. The aspect of phlegm and fluid, however, elucidates issues previously unmentioned by predecessors, thereby leading to insights into conditions such as postpartum delirium. This is indeed Shen's unique insight. Repeatedly clarifying these principles benefits future students greatly, is it not valuable!

Shen Yaofeng said: Qian Hu's principal wife had normal diet and起居 (daily activities). One night, she experienced syncope dozens of times in succession. During attacks, her eyes rolled upward, and her body was rigid like a corpse. The next day, she had dozens more episodes. By evening, one episode did not resolve. Red-hot charcoal was thrown into vinegar, and the vapor was wafted near her nose, but she showed no awareness. Her pulse at the Cun, Guan, and Chi positions on both hands responded normally, neither rapid nor slow, showing no abnormal signs. After diagnosis, her father, Ni Fuzeng, asked: Can this be cured? I said: Use one jin (approx. 500g) of Qing Qian (Lead) to melt it, pour it into a basin, scoop it up, melt again, and pour again, repeating this three times. Take this water to decoct Sheng Di Huang (Rehmanniae Radix) 1 liang, Tian Dong (Asparagi Radix) 2 qian, Xi Shi Hu (Dendrobii Caulis) 3 qian, Gan Cao (Glycyrrhizae Radix et Rhizoma) 1 qian, and Shi Chang Pu (Acori Tatarinowii Rhizoma) 1 qian for administration. Mr. Ni invited me to stay overnight in his study. In the morning, seeing Mr. Ni reviewing the prescription, he said that after taking the medicine last night, she only had six episodes of syncope until now, and they were very mild. Therefore, the previous prescription was decocted and administered again. After taking it, syncope ceased. She later gave birth to a son. Calculating the time, this was during the first month of conception. Transferring this treatment to middle-aged non-pregnant patients also yielded frequent success.

Dr. Ye from Wu Men treated a case of opisthotonos. During attacks, the patient jumped like a worm, moving several inches away from the seat; after the attack, she returned to normal. Using Bai Shao (Paeoniae Radix Alba), Gan Cao (Glycyrrhizae Radix et Rhizoma), Zi Shi Ying (Hematitum), Chao Xiao Mai (Fritillariae Thunbergii Bulbus - stir-fried wheat), and Nan Zao (Jujubae Fructus), decocted and taken orally, she recovered. *Kuaijie Fang* (Quick Method Formulas) records a case of toxic drugs attacking the fetus. The drug toxicity rushed upward. External symptoms included locked jaw, inability to speak, rigid clenched fists, spontaneous sweating, and slight fever, resembling stroke. However, the pulse was floating and soft. The prognosis was ten deaths to one survival. Most physicians failed to recognize it; treating it as stroke would certainly lead to death. Use Bai Bian Dou (Dolichos Lablab Seed) 2 liang, raw, peeled, and powdered. Mix with fresh well water and administer. Immediate effect ensued.

Shen Yaofeng said: For phlegm obstructing the meridians, Er Chen Tang (Two-Cured Decoction) added with Dan Xing (Arisaematis Cum Bile) Zhu Li (Bambusae Succus) and Jiang Zhi (Zingiberis Recensis Juice) is appropriate.