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(From *Suwen: Fuzhong Lun*. Appendix: *Qibing Lun* - Methods for Infant Protection)

The Yellow Emperor asked, "How can one know that a pregnant woman is about to give birth?" Qibo replied, "The body may have symptoms of illness, but the pulse will not show pathological signs." (By "body has illness," it refers to conditions such as amenorrhea and morning sickness. When the body is ill, the pulse should also be abnormal, such as being intermittent or irregular, or presenting wiry, choppy, fine, or rapid qualities; these are all pathological pulses indicating true disease. If the six pulses are harmonious and slippery while the body feels uneasy, this is undoubtedly due to fetal qi. For detailed meanings regarding fetal pulses, see Chapter 23 on Pulse and Color.)

The Yellow Emperor asked, "Some people become aphonic (unable to speak) in the ninth month of pregnancy. What causes this?" Pregnancy involves carrying another life within the body, hence termed "double body" (Chongshen). Aphonia refers to hoarseness or inability to speak. (Aphonia, pronounced 'yin'.) Qibo answered, "This is because the collaterals of the uterus are obstructed." (In the ninth month of pregnancy, the fetus has grown large, thereby obstructing the collaterals within the uterus.) The Yellow Emperor asked, "Why do you say so?" Qibo said, "The uterine collaterals are connected to the Kidney. The Foot-Shaoyin Kidney Meridian passes through the Kidney and connects to the root of the tongue; thus, speech becomes impaired." (The collaterals within the uterus refer to those of the Chong and Ren meridians. The uterine collaterals connect to the Kidney and ascend to meet at the throat. Therefore, obstruction of these collaterals leads to aphonia.) The Yellow Emperor asked, "How should it be treated?" Qibo said, "No treatment is needed; speech will return naturally in the tenth month." (When the fetus is born in the tenth month, the uterine collaterals reopen, and speech returns, so no intervention is necessary.)

The acupuncture principles state: "Do not damage what is deficient, nor tonify what is excessive, lest you create pathology; only then should regulation occur." (Zhen refers to disease. Treating when treatment is inappropriate either damages the deficient healthy qi or augments the excessive pathogenic factors. Originally without disease, one inadvertently creates illness. Thus, one must observe the physical signs and symptoms before regulating accordingly.) "Do not damage what is deficient" means that for emaciated individuals, one should not use bian stones (acupuncture needles/lancets). (In the ninth month of pregnancy, the body is heavy and fatigued, expending effort to nourish the fetus; this is a time of healthy qi deficiency and weakness. It is absolutely forbidden to use needles or stones to further injure the qi. Bian, pronounced 'chan'.) "Do not augment what is excessive" means that if there is a formed fetus in the abdomen and one mistakenly applies purgation, essence will leak out, leaving the pathogen to dominate the interior, thus stating that pathology is created. (If the fetus in the uterus is pierced, essence will inevitably leak. Leakage of essence injures fetal qi, allowing the pathogen to prevail in the center. This augments the excess, resulting in pathology.)

My commentary states: Regarding the principles of conception and gestation, Wu Fangshi of the middle antiquity wrote in the *Luxin Jing*: In the first month, it is called Tai Bao (fetal sac), formed by the congealing of essence and blood; in the second month, it is called Tai Xing (fetal form), where the embryo begins to take shape; in the third month, the Yang Spirit transforms into three Hun souls; in the fourth month, the Yin Spirit transforms into seven Po souls; in the fifth month, the Five Elements govern the five Zang organs; in the sixth month, the Six Laws determine the six Fu organs; in the seventh month, the eyes open, connecting to light; in the eighth month, the Yuan Shen is complete, descending with true spirit; in the ninth month, the palace structure is fully arranged to establish human life; in the tenth month, Qi reception is sufficient, and all phenomena are formed.

Additionally, in the *Wu Zang Lun*, Qipo is quoted saying: In the first month, like a dewdrop; in the second month, like peach blossoms; in the third month, male and female distinguish; in the fourth month, features are complete; in the fifth month, sinews and bones form; in the sixth month, hair grows; in the seventh month, the Hun wanders, and the infant moves the left hand; in the eighth month, the Po wanders, and the infant moves the right hand; in the ninth month, turns three times; in the tenth month, Qi reception is sufficient.

Sun Simiao stated: Generally, while in the womb, an infant is in the stage of Pei (germ) in the first month, Tai (embryo) in the second month, develops blood vessels in the third month, forms its shape in the fourth month, can move in the fifth month, has complete bones in the sixth month, grows hair in the seventh month, has complete internal organs in the eighth month, ingests food into the stomach in the ninth month, and is born with all spirits prepared in the tenth month. After birth, at sixty days, the pupils form, and the child can cough, laugh, and respond to others; at one hundred fifty days, the Ren Mai forms, and the child can roll over independently; at one hundred eighty days, the hip bones form, and the child can sit alone; at two hundred ten days, the palm bones form, and the child can crawl; at three hundred days, the patella forms, and the child can walk. Failure to develop according to schedule indicates abnormalities.

Furthermore, Chao Yuanfang in the *Bingyuan Lun* stated: The first month of pregnancy is named Taipei, nourished by the Foot-Jueyin Liver Meridian; the second month is named Shigao, nourished by the Foot-Shaoyang Gallbladder Meridian; the third month is named Shitai, nourished by the Hand-Jueyin Pericardium Meridian. At this time, blood does not flow freely, the image begins to transform, and there is no fixed pattern, changing due to influences. To ensure the child is upright and solemn, one should speak righteous words and perform righteous deeds; to ensure beauty, one should wear white jade; to ensure virtue and ability, one should read poetry and books. This is called external images affecting internal sensations. In the fourth month, blood vessels begin to form, nourished by the Hand-Shaoyang Sanjiao Meridian; in the fifth month, Qi begins to form, nourished by the Foot-Taiyin Spleen Meridian; in the sixth month, sinews begin to form, nourished by the Foot-Yangming Stomach Meridian; in the seventh month, bones begin to form, nourished by the Hand-Taiyin Lung Meridian; in the eighth month, skin begins to form, nourished by the Hand-Yangming Large Intestine Meridian; in the ninth month, hair begins to form, nourished by the Foot-Shaoyin Kidney Meridian; in the tenth month, the five Zang organs, six Fu organs, joints, and human spirits are all complete. This is the general outline.

Chen from Linchuan explained this: Attempting to deduce the principle of meridian nourishment in pregnancy discussed by Chao, the Foot-Jueyin is the Liver Meridian, and the Foot-Shaoyang is the Gallbladder Meridian; this is one Zang and one Fu meridian, and the rest follow suit. The commands of the four seasons always begin with Spring Wood; therefore, the nourishment of the twelve meridians begins with the Liver and Gallbladder, which is why nourishment occurs in the first and second months. The Hand-Jueyin is the Pericardium, and the Hand-Shaoyang is the Sanjiao, belonging to Fire and flourishing in Summer; thus, nourishment occurs in the third and fourth months. The Foot-Taiyin is the Spleen, and the Foot-Yangming is the Stomach, belonging to Earth and flourishing in Late Summer; thus, nourishment occurs in the fifth and sixth months. The Hand-Taiyin is the Lung, and the Hand-Yangming is the Large Intestine, belonging to Metal and flourishing in Autumn; thus, nourishment occurs in the seventh and eighth months. The Foot-Shaoyin is the Kidney, belonging to Water and flourishing in Winter; thus, nourishment occurs in the ninth month. By the tenth month, the fetus in the mother's womb has received Qi from all organs and waits for the proper time to be born. Both theories are reasonable. However, among the twelve meridians, only the Hand-Shaoyin Heart Meridian, Hand-Taiyang Small Intestine Meridian, and Foot-Taiyang Bladder Meridian are not mentioned as nourishing the fetus. This is likely because nourishment in the ninth month is in the Kidney, so the Bladder is included. Only the Heart and Small Intestine are exterior-interior pairs. The Heart is the master of the five Zang and six Fu organs; although noble and non-action-oriented, wherever Zang Qi reaches, Shen (Spirit) arrives. The Small Intestine is close to the fetal sac, transformed by Bing Fire, so Qi reaches everywhere. Therefore, they do not govern specific months but are present in every month. The way of conception and gestation lies herein. However, male and female fetuses differ in the speed of formation; Yin and Yang constitutions differ in orientation. Male movement occurs in the third month due to early Yang nature; female movement occurs in the fifth month due to late Yin nature. Female fetuses resemble the mother in orientation, making the mother's abdomen soft; male fetuses face the mother, making the abdomen hard. These are differences between male and female fetuses.

Regarding longevity after birth, there are two causes: constitution (Binfu) and upbringing (Fuyang). Constitution is the root of the fetal origin, receiving essence and Qi from parents. Upbringing is the root of longevity, involving housing temperature and dietary gains/losses. Children of young parents are often weak due to frequent desires and thin essence; children of older parents are often strong due to fewer desires and preserved essence. Those who drink much alcohol often have infertile offspring because alcohol confuses essence, making it impure and dominated by damp-heat. Those indulging in lust often have infertile offspring because lack of restraint during pregnancy drains maternal Yin and steals Qi used to nourish the fetus. Hunger, fullness, labor, rest, five emotions, and six climatic factors all relate to constitution. Regarding upbringing methods, folklore says: "To keep a child safe, keep them slightly hungry and cold." This is highly inappropriate. The suggestion of slight hunger aims to prevent overeating, which damages the Spleen and generates accumulations. One should merely prevent uncontrolled eating and sudden large meals that the Spleen cannot digest. With balanced diet and moderation of raw/cold foods, what illness would arise? Suggesting intentional hunger is incorrect. This advice merely aims at prevention, preferring slight hunger over overfeeding. However, the aspect of "cold" is crucial. Classics state sages avoid wind like arrows; the harm of wind-cold is significant. Infants have undeveloped blood/Qi and tender skin, differing from adults by hundreds of times. How can they endure cold? I see many newborns suffering from convulsions and spasms because they were tightly protected in the womb and are easily attacked by pathogens upon birth. If midwives are slow or careless, wind-cold attacks, often leading to death. As they grow, they often develop fever; mild cases cause nasal congestion and cough, severe cases cause pediatric Shanghan. Pediatricians misdiagnose these as "bianzheng" (physiological fever), leading to fatal medication errors. Cold damaging organs causes vomiting and diarrhea; cold generating heat causes fright and malnutrition (Gan syndrome). Many variations stem from external pathogens. Even strong infants fearing neither wind nor cold exist, but the strong are one-third, the weak two-thirds; thirty percent suffer heat injury, seventy percent cold injury. Nobility and poverty imply different constitutions. Physicians failing to examine the root and simply attacking heat when fever appears, while infants cannot speak and families cannot discern, leave matters to fate, which is lamentable.

The theory that infants are "pure Yang" bodies requiring cooling treatments is particularly misleading. According to *Shanggu Tianzhen Lun*: Females reach menarche at fourteen, males at sixteen, when Tian Gui arrives. Tian Gui is Yin Qi. Since infants' Yin Qi has not arrived, they are called pure Yang, meaning not that Yang is excessive, but that it is immature (Zhi Yang). How much Yang is in immature Yang? If Yang is not solid but mistaken for Fire, cold-cooling herbs will be used to attack heat. With insufficient Yin and destroyed Yang, both Yin and Yang fail, and Spleen and Kidney are damaged. How can survival be expected? Wang Jiezhai stated: There is no method to tonify the Kidney in infants. He claimed males' Kidneys fill only at sixteen; only after filling and subsequent depletion can herbs tonify. If conception receives insufficient endowment, nothing can be added; if originally sufficient, no tonification is needed. Alas! What logic is this? Immature Yin Qi in infants constitutes Kidney deficiency; parental lust causing water deficiency also constitutes Kidney deficiency. If Yin is insufficient and not tonified, Yin extinction leads to the demise of solitary Yang. How can one say it cannot be tonified? Only Xue Lizhai truly understood this. Because I had children late and successfully treated my own children's illnesses, pitying others' misunderstandings, I record this here to assist those struggling with infertility.