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Zhang Zhongjing stated: For abdominal pain during pregnancy, Danggui Shaoyao San (Angelica and Peony Powder) is used for treatment. This aims to tonify Qi and Blood. However, if there is retained phlegm, or invasion by wind-cold, or it is caused by Qi stagnation or food retention, using the four herbs Xiangfu (Cyperi Rhizoma), Sharen (Amomi Fructus), Suggeng (Perillae Caulis), and Shengjiang (Zingiberis Rhizoma Recens) uniformly is extremely stable and effective.

Danggui Shaoyao San (Angelica and Peony Powder)
Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma), Zexie (Alismatis Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma).
Decoct in water and take orally. Alternatively, grind into powder, taking two qian per dose.

Generally speaking, lower back pain belongs to Kidney deficiency, which requires urgent treatment during pregnancy. This is because the fetus is tied to the Dai Mai (Girdle Vessel); if the Dai Mai becomes lax, the uterus will prolapse. Ancient formulas use Qing'e San (Blue Young Man Powder) for treatment; I often use Shudi (Rehmanniae Radix Praeparata) and Duzhong (Eucommiae Cortex) combined with Baotai Wan (Fetus-Securing Pill) with good results.

Qing'e Wan (Blue Young Man Pill)
Duzhong (Eucommiae Cortex, 4 liang, stir-fried with ginger juice), Buguzhi (Psoraleae Fructus, 1 liang, fried with salt), Hetaorou (Semen Juglandis).
Grind into powder, make pills with honey, and swallow with wine.

In the past, during the Gengchen year, in Wanjia Du, Haining, a man surnamed Jin had been married for ten years without conceiving. Suddenly, his wife's menstruation was overdue. A physician from Chang'an diagnosed it as pregnancy and prescribed tonifying and calming herbs such as Shudi (Rehmanniae Radix Praeparata), Ejiao (Asini Corii Colla), Fuling (Poria), and Baizhu (Atractylodis Macrocephalae Rhizoma). The condition dragged on until the tenth month, yet no delivery occurred. Her abdomen enlarged daily, and she became increasingly ill. By the fifteenth month, she could not get out of bed or eat; food barely passed her throat, and her abdomen was abnormally distended. Occasionally, when abdominal pain occurred, bowel sounds were heard like the noise of treading a water wheel, audible even outside the door. The situation was critically dangerous. At that time, due to the invitation of brothers Zhu Fuwen and Wu Dacheng, I was invited to diagnose. The patient was on her deathbed, and other physicians stood by waiting for her to die. Some suggested "Ghost Fetus," others suggested "Obstructed Menses." Upon diagnosis, I found the six pulses slippery and excessively large, firm upon pressure. I said, "This is not pregnancy; this is Tan Gu (Phlegm Distension)." It resulted from excessive worry damaging the Spleen, causing the Spleen to fail to transport fluids for the Stomach, thereby generating phlegm. Initially misdiagnosed as pregnancy, the administration of cloying and cold-cooling medicines caused the phlegm to stagnate, accumulating over time to form this syndrome. If the pathogenic factor is not attacked, there is no hope for survival. I immediately used Erchen Tang (Two-Cured Decoction) added with Nanxing (Arisaematis Rhizoma Preparatum), Houpo (Magnoliae Officinalis Cortex), Binglang (Arecae Semen), Sanleng (Sparganii Rhizoma), Ezhu (Curcumae Rhizoma), Guizhi (Cinnamomi Ramulus), and Shengjiang (Zingiberis Rhizoma Recens). After two or three doses, the turbid matter moved downward. The family feared it would cause dysentery and urgently requested a follow-up. Checking the pulse, it had slightly harmonized. The discharged material was dark red and clotted; upon picking it open, the interior was white. I said, "This is blood wrapping phlegm." I then added Dahuang (Rhei Radix et Rhizoma) and Mengshi (Melanitis Leucopsis Squama) to the previous formula. After several more doses, she defecated twenty to thirty times daily. Her abdomen gradually subsided, and she began consuming congee. Ten days later, we switched to Jianggui Liujunzi Tang (Six-Gentlemen Decoction with Ginger and Cinnamon) and Zhishi Lizhong Wan (Immature Bitter Orange and Middle-Warming Pills), administering both decoctions and pills simultaneously, and the patient recovered. Everyone respected and accepted this. If we had hesitated and failed to attack at that time, would she not have died from distension? Therefore, medication must be appropriate; one should not hesitate to use unconventional methods to save a critical patient. Thus, I preserved this case for future reference.
Reading Mr. Wu Lingshan's book *Bianyi Shu* (Book of Clarifying Doubts), he treated a woman with Phlegm-Fluid and Blood stasis syndrome, misdiagnosed by previous physicians as a fetal condition, which is similar to this case.
Slippery pulses are indeed typical of pregnancy; however, if they are excessively slippery and large, and firm upon pressure, it is clearly not a fetal pulse. Why did the physicians fail to realize this? Seeing the discharged dark-red material, and recognizing the phlegm wrapped inside, adding Dahuang (Rhei Radix et Rhizoma) to attack blood stasis and Mengshi (Melanitis Leucopsis Squama) to attack phlegm in the previous formula exemplifies adapting to circumstances without being rigidly bound to fixed formulas.