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In general, if a woman's pulse shows no obvious pathological signs, but only the Yin pulse (Chi pulse at the wrist) is small and weak, this indicates a deficiency of Ying Qi (Nutritive Qi). If external pathogens are contracted while Ying Qi is deficient, there will inevitably be aversion to cold and fever. Since there is currently neither aversion to cold nor fever, but rather difficulty with food intake (poor appetite), it can be known that she is pregnant. Menstruation ceases; by the sixtieth day, blood gathers and Qi struggles, beginning to condense into a fetus. Ying Qi converges on the fetal origin, leading to insufficient Stomach Qi and reduced distribution of body fluids; thus, the person experiences thirst and inability to eat. It is appropriate to use Guizhi Tang (Cinnamon Twig Decoction) to harmonize Ying and Wei (Defensive Qi) and benefit the Stomach Qi. If physicians treat this as other diseases, exacerbating vomiting and diarrhea, this condition is called Ezu (Morning Sickness/Pregnancy Vomiting); medical intervention should cease, waiting for self-recovery. (Guizhi harmonizes Ying and disperses pathogens; paired with Shaoyao to astringe Yin; Gancao moderates the action; guided by Shengjiang and Dazao, the pungent-sweet warm-natured herbs move Spleen fluids to harmonize Ying and Wei, stopping thirst.)

Whenever women encounter cold during menstruation, residual blood stagnates forming Blood Stasis. However, women with Blood Stasis are common; if the stasis does not obstruct the uterus, menstruation may continue and conception can occur. Although blood gathers to form a fetus, menstruation stops only after three months of fetal formation. Before three months have passed since cessation, if the Blood Stasis pathology reactivates, it leads to continuous spotting or bleeding. The stasis resides in the Lower Jiao, pressing on the fetus, hence termed "Guhai" (Chronic/Fixed Pathology). Therefore, movement felt above the umbilicus, confirmed upon inquiry, indicates a normal pregnancy. A "Ghost Fetus" (hydatidiform mole or abnormal gestation) belongs to Yin Qi aggregation and would absolutely not exhibit Yang activity in Yang positions (above the umbilicus). Current movement above the umbilicus indicates the fetus is six months old. It is inferred that although menstruation was regular for the first three months, the fetus had already formed; for the subsequent three months, menstruation ceased, but blood accumulated into stasis, causing continuous downward bleeding. The primary formula is Guixin Fuling Wan (Cinnamon Heart and Poria Pill). Herbs are equal parts made into pills, taken one pill before meals. If ineffective, increase to three pills. Uses Guixin (Cinnamon Heart), Fuling (Poria), Mudanpi (Moutan Cortex), and Taoren (Peach Seed, stir-fried) to dissipate stasis; Shaoyao protects Ying blood; thus bleeding stops and the fetus is secured. The version circulating in世的 as Guizhi Fuling Wan is a transcription error. Detailed analysis shows Guizhi has thin aroma and flavor, suitable only for releasing the exterior; one must use the heart of Rougui (Cinnamon Bark) to have the efficacy of removing stasis. An Chang stated that Cinnamon does not harm the fetus; do not doubt its safety in pregnancy. Referencing the next section where Fuzi Tang is used for an open Zang Zang (uterus) and Shenqi Wan for Zhuanbao (bladder compression/difficulty urinating), both utilize Guizhi and Fuzi; this aligns with the Nei Jing principle: "If there is a disease, the disease receives the treatment without injury [to the healthy qi]."

During the sixth or seventh month of pregnancy, a wiry pulse indicates deficiency-cold. Deficient Yang scatters outward, causing fever. Internal reversal of Yin-Cold causes abdominal distension and pain due to the fetus. Aversion to cold indicates the interior lacks Yang. The Zi Zang (Uterus) fails to execute its closing and storing function, so there is a sensation of cold air blowing from the vagina, and the lower abdomen feels like it is being fanned. Use Fuzi Tang to warm the Zang Zang, ensuring fetal security. Zhang Zhongjing’s use of Fuzi for calming the fetus requires divine understanding; few dare to try lightly. The original formula is missing, but can be inferred to likely contain Ganjiang (Dried Ginger) and Guixin/Rougui (Cinnamon).

Menstruation and conception both belong to the Chong and Ren Mai (Penetrating and Conception Vessels). Although Chong and Ren manage Yin-Yang intersection via Liver and Kidney functions, nourishing and forming the fetus relies on Kun Tu (Spleen/Stomach Earth). Because Yin and Yang embrace each other, leakage is prevented; Kun Tu acts as a dike, preventing seepage. If chronic turbid stasis lodges in Chong and Ren, Yin blood binds internally and cannot intersect with Yang, leading to occasional spotting, miscarriage, or continuous bleeding. Pregnancy Qi consists of Yang Essence formed internally and Yin Blood nourishing externally. Now, if Yin Blood binds internally, blocking the fetus and preventing harmony, solitary Yin remains inside, causing abdominal pain and bleeding. This results from Yin-Yang failing to embrace and Kun Tu failing to dike. The primary formula is Jiao Ai Tang (Donkey-Hide Gelatin and Mugwort Decoction). Composition: Xiong 2 liang, Gui 3 liang to circulate Yang blood; Shaoyao 4 liang, Dihuang 4 liang to circulate Yin blood; Ejiao 2 liang, a substance of flesh and blood, nourishes similarly, calms fetus, tonifies blood, and seals leakage; Gancao 2 liang, moderates urgency, harmonizes Yin-Yang, unblocks vessels; Aiye 2 liang, specifically treats dampness-stagnation with leukorrhea and spotting. This formula enters internally, opens Yin blood binding to connect with Yang, offering wonders of regulating menses, stopping spotting, calming fetus, and nourishing blood. Additions/subtractions must be appropriate: if pulse is slow/late indicating Yin excess over Yang, add Ganjiang; if pulse is rapid/large indicating Yang excess over Yin, add Huangqin.

Some pregnant women suffer because Spleen Earth is overcome by Liver Wood evil, grain Qi fails to rise, dampness floods downward stagnating Yin blood, causing abdominal cramping pain. Primary formula: Danggui Shaoyao San (Angelica and Peony Powder). This differs from pain caused by fetal obstruction. Thus, Shaoyao (1 jin) is the Sovereign herb to drain Liver and relieve stagnation; assisted by Xiong and Gui (3 liang each) to tonify blood and stop pain; Fuling (4 liang) and Zexie (8 liang) to leach dampness down via urine; Baizhu (4 liang) to benefit Spleen and dry dampness. Know that external and internal Six Evils can all damage the fetus causing pain, not just dampness.

Pregnant women previously suffering from Spleen-Stomach weakness retain body fluids, accumulating as Phlegm-Fluids. After two months of pregnancy, turbid Yin rushes upward; the Middle Jiao cannot withstand the rebellion, Phlegm-Fluids surge, Middle Cold arises, and vomiting persists. Primary formula: Ganjiang Renshen Banxia Wan (Dried Ginger, Ginseng, and Pinellia Pill). This is the secular "Ezu" (Morning Sickness). Uses Ganjiang (1 liang) to stop cold, Renshen (1 liang) to tonify deficiency, Banxia (2 liang, processed) to treat phlegm and scatter rebellion, formed into pills with Shengjiang juice, taken ten pills per dose, three times daily.

Difficulty in urination during pregnancy is due to Bladder Heat stagnation, Qi condensing into dryness. The disease is in the Lower Jiao, not Middle, so diet is normal. Primary formula: Guimu Kushen Wan (Danggui, Motherwort, and Sophora Pill). Each herb 4 liang, pills sized like beans, take 3 pills, increase to 10. Danggui harmonizes blood and moistens dryness; Beimu clears Lung and opens depression; Kushen excels at treating heat, benefiting orifices and driving out water; assisting Beimu entering the Bladder to remove heat knots; once knots clear, water flows.

Urinary difficulty/inability during pregnancy locates in the Bladder. Internally connected to the Bao Shi (Uterus), it stores fluids and excretes urine via Qi transformation. Externally connects to meridians, ascending to the head, serving as the exterior of all Yang meridians. Now Bladder Qi fails to transform, urine cannot exit, exterior meridians are not benefited, causing heavy body, chills/shivering, and dizziness upon rising. Only by promoting urination does water leave, meridian Qi moves, and exterior symptoms heal. Primary formula: Kuizi Fuling San (Malva Seed and Poria Powder). Kuizi (1 jin) enters Bladder directly to relieve retention; assisted by Fuling (3 liang) to leach water pathways; once urination is smooth, all diseases resolve.

For pregnant women, essence remains and blood wraps; the Chi pulse pulses visibly. Movement generates change/life. Stillness produces no change. Therefore, pregnancy blood must not be static; static blood coagulates, coagulated blood fails to generate/nourish, becoming deficient. Deficiency cannot combine with the Fire that transforms the fetus. Fetal generation requires pulsing arteries. Regulation involves first harmonizing Yin-Yang and benefiting Qi-Blood. Regularly taking fetal-nourishing herbs ensures easy delivery and prevents postpartum diseases. Recommended regular use of Danggui San (Angelica Powder), taken with wine. Xiong, Gui, Shaoyao (1 jin each) calm fetus and tonify blood. Baizhu (0.5 jin) removes old stasis around waist/navel, benefits Stomach and nourishes fetus, resolving external fetal blood stagnated by cold-damp. Huangqin (1 jin) transforms vigorous fire back to mild fire to generate Qi, making it suitable for regular use. However, additions/subtractions must follow pulse/symptoms (slow/fast, deficiency/excess). Take when diseased, not otherwise. Herbs are biased/unbalanced, unlike rice/grain; unsuitable for long-term use without disease. The Classic states: "Flavors enter and target their preferred organs; prolonged excessive Qi intake causes premature death."

After pregnancy blood gathers to form a fetus, slight pathogenic invasion causes stagnant blood to fail to circulate, resembling bad stasis. One must first eliminate old stasis to generate new blood before the fetus can be nourished. Nourishing the fetus depends not only on blood but also on the Kidneys (where the fetus is rooted) and the Stomach (which nurtures). Thus, tonify Kidneys to secure Essence, regulate Stomach to harmonize the Middle. Primary formula: Baizhu San (Atractylodes Powder). Why use herbs known to remove bad blood? Baizhu (3 fen) regulates Stomach; Shujiao (3 fen, induces sweating, some texts say Qinjiao) opens Bi (obstruction); once opened, Yang Essence arrives; Muli (4 fen) treats Bing (flooding); once stopped, Yin Essence secures; Chuanxiong (3 fen) descends to Blood Sea, moves fetal blood, eliminates old to generate new. If Yin blood is unfavorable and Liver Wood harms, causing internal suppression/pain, drain with Sour-Cold Shaoyao to unblock Yin. If direct rushing causes pain, disperse with Acrid-Warm Xiong to unblock Yang. If mixed with bad Qi rebels to Stomach causing vomiting/restlessness/anorexia, use Xixin to warm middle, descend Qi, resolve phlegm; Banxia treats epigastric urgency, harmonizes Stomach, promotes eating, stops vomiting. If vomiting persists due to reckless Liver Wood movement, use Xiaomai Yin (Wheat Drink) to nourish original Qi and calm it, simultaneously calming Stomach, descending Qi, and stopping restlessness—killing two birds with one stone. Damai (Barley) treats thirst, benefits Qi, harmonizes middle; used for middle Qi deficiency with thirst.