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After a woman becomes pregnant, she experiences nausea and vomiting, a craving for sour foods to quench thirst, aversion to food, fatigue, and a desire to lie down. People consider this to be *Ezu* (morning sickness/nausea of pregnancy),
but who would know that it is due to excessive dryness of Liver Blood? Once the Kidney receives the essence, it generates Kidney Water to nourish the fetus, leaving no fluid to moisten other organs. The Liver is the "son" of the Kidney; it consumes Qi from its "mother," the Kidney, daily. Once deprived of the nourishment of body fluids, the Liver Qi becomes dry and increasingly irritable, Fire stirs, and Qi rebels upward, thereby generating symptoms of nausea and vomiting. Although the vomiting may not be severe, the damage to Qi is the same. When Qi is damaged, Liver Blood is further depleted. The world uses *Siwu Tang* (Four Substances Decoction) to treat various conditions during pregnancy precisely because it can generate Liver Blood.
However, tonifying the Liver to generate blood is not bad, but one must fear that generating blood without generating Qi will lead to the decline of the Spleen and Stomach, which cannot withstand frequent vomiting. I fear that if Qi is deficient, Blood will not easily be generated. Therefore, in the treatment method, while soothing the Liver and nourishing Blood, one should use herbs that strengthen the Spleen and open the appetite to generate Yang Qi. In this way, Qi can generate Blood, which is especially beneficial to the fetal Qi. Although Qi rebels, using Qi-tonifying herbs might seem to exacerbate the rebellion. However, one does not realize that in pregnancy-related *Ezu*, the rebellion is not severe, and the rebellion is due to deficiency rather than pathogenic factors. When rebellion is caused by pathogens, boosting Qi increases the rebellion; when rebellion is caused by deficiency, tonifying Qi reverses the rebellion. Moreover, adding Qi-tonifying herbs among Blood-nourishing herbs ensures that Yin sufficiently controls Yang, so why worry about rebellion? The prescription used is *Shun Gan Yi Qi Tang* (Liver-Soothing and Qi-Boosting Decoction):
*Bai Shao* (White Peony Root, 3 qian) *Dang Gui* (Chinese Angelica Root, 1 qian) *Bai Zhu* (Atractylodes Macrocephala Rhizome, 3 qian) *Ren Shen* (Ginseng Root, 1 qian) *Fu Ling* (Poria, 2 qian) *Shu Di Huang* (Prepared Rehmannia Root, 5 qian) *Su Zi* (Perilla Fruit, 1 qian) *Mai Dong* (Ophiopogon Tuber, 3 qian) *Sha Ren* (Amomum Fruit, 1 grain) *Shen Qu* (Medicated Leaven, 1 qian) *Chen Pi* (Citrus Reticulata Peel, 3 fen) Decoct in water and take orally.
After one dose, *Ezu* symptoms lighten; after two doses, it stabilizes; after three doses, it is completely cured.
This formula harmonizes the meridians of the Liver, Kidney, Spleen, Stomach, and Lung, with its intent primarily focusing on the Liver and Kidney. When the Liver is peaceful, Qi does not rebel; when the Kidney is robust, Blood is easily generated. For any case where the fetus is stable with mild *Ezu*, administering this formula invariably restores calmness as before, benefiting the pregnant woman significantly, truly surpassing *Siwu Tang*. This is because *Siwu Tang* specifically treats the Liver, whereas this formula treats more than just the Liver, hence its miraculous efficacy.
Using *Run Gan An Zhen Tang* (Liver-Moistening and Fetus-Calming Decoction) is also excellent.
*Ren Shen* *Fu Ling* *Bian Dou* *Shan Yao* (each 3 qian) *Ban Xia* *Shu Di Huang* *Bai Zhu* (each 5 qian) *Chuan Xiong* *Mai Dong* *Dan Pi* *Su Zi* *Shen Qu* (each 2 qian) *Bai Dou Kou* (1 grain) *Chen Pi* (3 fen) Decoct in water and take orally. After four consecutive doses, *Ezu* ceases.
During the fifth month of pregnancy, limbs become fatigued, food lacks flavor, swelling starts in both feet, gradually spreading to the whole body, and eventually involving the head and face. People assume this is due to dampness, but who knows it is actually deficiency of Spleen and Lung Qi? Although pregnancy involves monthly fetal nourishment, one should not rigidly adhere to months; the main principle is always strengthening the Spleen and tonifying the Lung. The Spleen governs Blood, and the Lung governs Qi. The fetus is not nourished without Blood, and the child is not born without Qi. If the Spleen is healthy, Blood is abundant and nourishes the fetus; if the Lung is clear, Qi is strong and sustains the child. If the Lung declines, Qi fails, and it cannot transport Qi to the skin. If the Spleen is deficient, Blood is scarce, and it cannot transport nutrients to the limbs. With dual deficiency of Qi and Blood, and dysfunction of the Spleen and Lung, food is difficult to digest, and essences fail to transform. Consequently, Qi and Blood sink and cannot ascend. Dampness then takes advantage of these deficient areas, accumulating moisture and causing edema. The treatment method should tonify the deficiency of the Spleen and Lung, rather than focusing on dispelling dampness. The prescription is *Bu Zhong Yi Qi Tang* (Tonify the Middle and Augment the Qi Decoction) with modifications:
*Ren Shen* (5 qian) *Bai Zhu* (5 qian) *Dang Gui* (3 qian) *Huang Qi* (Astragalus Root, 3 qian) *Chen Pi* (3 fen) *Gan Cao* (Licorice Root, 1 fen) *Chai Hu* (Bupleurum Root, 1 qian) *Sheng Ma* (Cimicifuga Rhizome, 3 fen) *Fu Ling* (1 liang) Decoct in water and take orally. After one dose, bloating decreases slightly; after two doses, comfort returns; after three doses, swelling gradually subsides; after four doses, recovery occurs. After ten doses, recurrence is prevented.
*Bu Zhong Yi Qi Tang* originally lifts Spleen and Lung Qi, seemingly tonifying Qi but not Blood. One does not realize that Blood is not generated without Qi. Moreover, with dampness invading, it is inappropriate to tonify Blood directly. Thus, tonifying Qi and assisting with damp-dispelling herbs allows Qi to ascend and water to disperse more easily. Then, why use only small amounts of diuretics? Why heavily use *Fu Ling* up to 1 liang, making it the chief herb for draining water? Using heavy *Fu Ling* within a Qi-tonifying context, although it drains water, still strengthens the Spleen and clears the Lung. Most water-draining herbs consume Qi and Blood, but *Fu Ling* and *Bai Zhu* have more tonifying than draining effects. Therefore, using them heavily to share the burden of dampness is essentially tonifying Qi and Blood.
Using *Tu Jin Shuang Pei Tang* (Earth and Metal Dual-Nourishing Decoction) is also very effective.
*Ren Shen* *Su Zi* *Fu Ling* *Gu Ya* *Ba Ji Tian* *Tu Si Zi* *Bai Shao* (each 3 qian) *Bai Zhu* *Yi Yi Ren* (each 5 qian) *Shan Yao* (5 qian) *Shen Qu* (2 qian) *Sha Ren* (1 grain) *Gan Cao* (2 fen) *Chai Hu* (5 fen) Decoct in water and take orally. After four doses, swelling completely disappears.