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Vaginal bleeding occurs resembling the onset of menstruation. Severe leakage dries up the uterus, primarily endangering the fetus. It also damages the pregnant mother, requiring great concern. One must strive to use divine elixirs for rescue to potentially save her life.

Tongzhenzi stated: This only discusses the pulse manifestation of fetal leakage. Fetal leakage may result from consuming food that agitates the fetus, invasion by heat-toxic qi, or damage due to sexual intercourse. Mild damage leads to mild leakage; severe damage leads to severe leakage. However, if the blood is exhausted, death ensues. There are two methods for stabilizing the fetus: if the mother’s illness disturbs the fetus, treating the mother’s disease will naturally stabilize the fetus. If the fetus is unstable causing disturbance, and the mother becomes ill as a result, treating the fetus (stabilizing the fetus) will naturally stabilize the mother. Tongzhenzi’s statement is thus. However, this has not been considered repeatedly. The fetus in the maternal abdomen relies on maternal qi for nourishment with every breath. Even if the fetus is unstable, it is because the mother’s qi and blood are insufficient. Treating the mother’s illness will naturally stabilize the fetus; this principle is indeed correct. As for saying “treating the fetus stabilizes the mother,” one must ask: if there is a method for treating the mother, what is the method for treating the fetus? If treating the fetus is essentially treating the mother, then why distinguish between fetus and mother? Tongzhenzi’s remarks are somewhat forced. Chao Yuanfang said: “Fetal leakage” refers to vaginal bleeding occurring during pregnancy after several months. This is due to deficiency of the Chong Mai (Penetrating Vessel) and Ren Mai (Conception Vessel), which fail to restrain the blood of the Taiyang (Greater Yang) and Shaoyin (Lesser Yin) meridians. The Chong and Ren meridians are the sea of the meridians, originating within the uterus. The Hand-Taiyang Small Intestine Meridian and Hand-Shaoyin Heart Meridian are exteriorly-interiorly related; their qi ascends to form milk and descends to form menstruation. In pregnant women, menstruation ceases because blood is congested to nourish the fetus and stored to form milk. When Qi of the Chong and Ren is deficient, the uterine tissue leaks and fails to control menstrual blood, hence menstruation flows down periodically. This is also called Bao Zu (Uterine Obstruction). If leakage blood is exhausted, the person dies. Chao Yuanfang’s words are correct. However, when leakage is extreme, not only does the fetus die from dryness, but the mother is also at risk. One should promptly investigate the cause of the leakage and treat it, so that both mother and child may be preserved. Therefore, Xue Lizhai said: If the aforementioned syndrome is caused by wind-heat, use Fangfeng Huangqin Wan (Saposhnikovia and Scutellaria Pill); if caused by blood-heat, use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder); if caused by blood deficiency, use Erhuang San (Two Huangs Powder); if caused by excessive blood loss, use Bazhen Tang (Eight Treasure Decoction); if ineffective, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction); if caused by liver fire, use Chaihu Shanzhi San (Bupleurum and Gardenia Powder); if caused by spleen fire, use Jia Wei Guipi Tang (Modified Restore the Spleen Decoction); if caused by menstrual bleeding with pain, use Bazhen Tang plus Ejiao (Donkey-Hide Gelatin) and Shu Ai Ye (Prepared Mugwort Leaf); if caused by spleen-stomach weakness, use Buzhong Yiqi Tang plus Wuweizi (Schisandra Berry); if caused by spleen-stomach sinking, use the previous formula with increased doses of Shengma (Cimicifuga Rhizome) and Chaihu (Bupleurum Root); if afternoon fever and internal heat occur, Xiaoyao San (Free and Easy Wanderer Powder) is suitable.