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1. A woman suffered from metrorrhagia (non-menstrual heavy vaginal bleeding), caused by depression and anger in middle age, to which various medicines were ineffective. Zhang Zhongchun used a large dose of Ginseng Radix et Rhizoma (Renshen) [Atractylodis Macrocephalae Rhizoma (Baizhu)], mixed with fetal hair ash [powder prepared by calcining until carbonized but retaining properties], administered with the decoction. After a long period of treatment, she gradually recovered.

There are three prohibitions during pregnancy: prohibit diaphoresis (sweating therapy), prohibit purgation, and prohibit promoting urination. Zhang Zhongchun stated: The general principle for calming the fetus involves tonifying the Spleen and Stomach, [Ginseng Radix et Rhizoma (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu), Dolichos Lablab Semen (Baidou)]; strengthening the lower back and Kidneys, [Eucommiae Cortex (Duzhong), Dipsaci Radix (Xuduan)]; nourishing Yin, [Rehmanniae Radix Preparata (Shengdi), Asparagi Radix (Tian Dong), Ophiopogonis Radix (Mai Dong)]; nourishing Blood, [Lycii Fructus (Gouqi), Paeoniae Radix Alba (Baishao), Ziziphi Spinosae Semen (Suanzaoren)]; regulating Qi, [Citri Reticulatae Pericarpium (Juhong), Amomi Fructus (Sharen)]; generally focusing on clearing heat, [Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), Lycii Cortex (Gupi), Lonicerae Japonicae Flos (Yinhua)]. One must avoid herbs that break Qi and Blood, or those that are ascending, dispersing, acrid, hot, and drying. However, conditions during pregnancy vary. One condition is called "E Zu" (nausea and vomiting in early pregnancy), caused by weak Stomach Qi, leading to nausea and hindering food intake. Another is called "Zi Fan" (restlessness during pregnancy), due to Heat in the Heart and Lungs, causing irritability and discomfort in the chest and diaphragm. If fetal movement rushes upward, causing abdominal distension and pain, it is called "Zi Xuan" (fetal qi rebellion), attributed to rebellious Qi. If both feet swell and enlarge, even extending to the face and limbs, it is called "Zi Zhong" (pregnancy edema), attributed to Spleen deficiency. [Earth failing to control Water]. If there is painful, dribbling dysuria, it is called "Zi Lin" (pregnancy strangury), attributed to deficient Heat in the Lower Jiao. If there is urinary retention, sometimes caused by the full fetus compressing the bladder, lifting methods should be used; if due to other causes, treat according to symptoms. If there is involuntary urination or frequency, this belongs to Liver Fire and Blood Heat. It may also be due to Yin deficiency with hyperactive Fire, or compression of the bladder by the fetus, differing in cause. If there is spotting during pregnancy, or monthly bleeding resembling menstruation, or sudden heavy bleeding, all are caused by Yin deficiency failing to balance Fire, and Qi deficiency failing to secure Blood. It may also be due to Spleen deficiency failing to control Blood, or reckless flow due to Liver Fire and Blood Heat. If bleeding ceases completely, death ensues. Commonly, infants born from threatened miscarriage often do not survive, due to lack of Blood nourishing the fetus. Those with habitual abortion are so because of Qi and Blood deficiency, unable to nourish the fetal origin. Xue Lizhai said: Abortion is mostly due to internal Heat combined with deficiency; one should frequently take An Tai Yin. Any pregnant woman with lower back pain risks abortion, which must be known. If a pregnant woman suddenly loses her voice and cannot speak, as the classics say: "A person with a heavy body becomes aphasic at nine months," this is because the collaterals of the uterus are blocked. The uterine collaterals connect to the Shaoyin meridian of the Kidney, passing through the Kidney to tie to the root of the tongue, hence the inability to speak. No treatment is needed; speech will return after ten months. Once delivered, the uterine collaterals open, and speech returns. Regarding dystocia (difficult labor), it is mostly due to internal Heat scorching uterine fluids, causing dryness and difficulty at delivery. Or, Spleen and Stomach weakness fails to transform and transport essences, leading to insufficient uterine fluids, also causing difficult labor. One should frequently take formulas that tonify Qi and nourish Yin, nourish Blood and clear Heat, and resolve stagnation between the seventh and eighth months, such as An Tai Yin or Da Sheng San, modified as needed. For women in middle age who have given birth too many times and have weak Qi and Blood, preventive administration is especially appropriate. Or, if the pregnant woman has a robust physique and strong Qi, lives comfortably, prefers rich and sweet foods, leading to a thick and firm placenta/fetus, causing difficult labor, one should take Shou Tai Yin preventively. This is the general outline for managing pregnancy. However, obstetrics has its own specialty, and comprehensive reference is necessary.

Zhuru Tang [see Shanghan section] added with Ginseng Radix et Rhizoma (Renshen), Poria (Fuling), Paeoniae Radix Alba (Baishao), Citri Reticulatae Pericarpium (Juhong), Chaenomelis Fructus (Mugua), Perillae Fructus (Suzi), Amomi Fructus (Sharen).
This formula tonifies the Stomach and clears Heat, regulates Qi and descends rebellion, a miraculous agent for treating E Zu. For obese individuals with phlegm retention in the Middle Jiao, Er Chen Tang can be used with added Bupleuri Radix (Chaihu - *Note: Text says Zhi Qiao/Aurantium*, correcting to Aurantii Fructus (Zhike)) and Amomi Fructus (Sharen); add Ginseng Radix et Rhizoma (Renshen) for weak Stomach. Pinelliae Rhizoma (Banxia) damages Body Fluids and is taboo in pregnancy, yet "when there is the disease, use the medicine." Thus Sun Simiao, the Sage of Prescriptions, used it in pregnancy formulas. If not damp-phlegm, do not administer blindly.

Xijiao San
Rhinocerotis Cornu (Xijiao) [cools the Heart]; Triticum Aestivum (Xiaomai - *Text says Dong Mai/Ophiopogon context but Xiaomai is Wheat, text likely implies Ophiopogonis Radix (Maidong) or Triticum Aestivum (Xiaomai) for Lung Heat. Given "Qing Fei", Xiaomai fits, but text says Dong Mai. I will translate as written but note standard term* -> Ophiopogonis Radix (Maidong) [clears the Lung]; Lycii Cortex (Gupi) [removes Heat]; Scutellariae Radix (Huangqin) [drains Fire]; Poria (Fuling) [guides out Heart Fire]. This is a formula for treating Zi Fan.

Zisu Yin [Revised]
Perillae Folium (Zisu), Citri Reticulatae Pericarpium (Juhong) [regulates Qi and resolves stagnation], Arecae Pericarpium (Dafupi) [descends rebellious Qi], Paeoniae Radix Alba (Baishao) [astringes rebellious Qi], Angelicae Sinensis Radix (Danggui) [Qi herb in Blood], Ginseng Radix et Rhizoma (Renshen) [for deficiency]. Add Agarwood (Chenxiang) and Amomi Fructus (Sharen).
This is a formula for treating Zi Xuan [i.e., fetal movement rushing upward]. Zhang Zhongchun's prescription uses Perillae Folium (Zisu), Citri Reticulatae Pericarpium (Juhong), Ophiopogonis Radix (Maidong), Bamboo Shavings (Zhuru), Loquat Leaf (Pipaye) for patients with Yin deficiency, which is very suitable and effective.

Fuling Daoshui Tang [see Swelling section]
The original formula should remove Alisma Rhizoma (Zexie) [disliked for its diuretic strength], Areca Seed (Binglang) [disliked for breaking Blood], and add Ginseng Radix et Rhizoma (Renshen) for deficiency.
This formula regulates the Spleen to control Water, clears the Lungs and benefits Qi, suitable for treating Zi Zhong. Remove any ingredients in the original modifications that harm fetal Qi. Xue Shi recorded Liyu Tang, using Atractylodis Macrocephalae Rhizoma (Baizhu), Poria (Fuling), Citri Reticulatae Pericarpium (Juhong), Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Baishao) decocted with one carp, cleaned and boiled to extract the broth for cooking the herbs.

Wulin Tang [see Strangury section]
The original formula should remove Achyranthis Bidentatae Radix (Niuxi) [disliked for opening meridians/moving blood], and use less Plantaginis Semen (Cheqian).
This formula nourishes Yin, clears Heat, and separates turbidity to promote urination, suitable for treating Zi Lin.

Buzhong Yiqi Tang [see Diarrhea section]
This is a lifting method. If the full fetus compresses the bladder causing urinary retention, one may follow this formula with modifications, decoct and induce vomiting. Must review contraindications for vomiting; if applicable, it is safe. If due to other causes, refer to treatments for urinary retention. Alternatively, have the midwife insert a hand into the vagina to lift the fetus, allowing urine to flow like a stream.

Jiawei Xiaoyao Tang [see Involuntary Urination, follow modification rules], Liuwei Dihuang Wan remove Alisma Rhizoma (Zexie), add Anemarrhenae Rhizoma (Zhimu), Phellodendri Cortex (Huangbai), Asparagi Radix (Tian Dong), Ophiopogonis Radix (Mai Dong). Both formulas add Codonopsis Root? No, text says Baiwei. Add Cimicifugae Rhizoma? No, text says Baiwei. Baiwei [treats hematuria and postpartum urinary incontinence].
Both formulas treat urinary incontinence. For Liver Fire and Blood Heat, use Jiawei Xiaoyao Tang; for Yin deficiency with hyperactive Fire, use Zhimu/Huangbai combined with Liuwei Dihuang Wan, use separately.

Baxian Changshou Wan, Renshen Guben Wan [both see Consumption/Deficiency. Suitable as decoctions.]
Add Paeoniae Radix Alba (Baishao), Ziziphi Spinosae Semen (Suanzaoren), Eucommiae Cortex (Duzhong), Dipsaci Radix (Xuduan).
Both formulas treat leakage of blood. Baxian Wan only treats Yin deficiency failing to balance Fire, while Guben Wan also treats Qi deficiency failing to secure Blood. If due to Spleen deficiency failing to control Blood, use Jiawei Guipi Tang. If due to reckless flow from Liver Fire and Blood Heat, use Jiawei Xiaoyao San, modify as needed.

Antai Yin [Can also be made into pills for long-term use.]
Atractylodis Macrocephalae Rhizoma (Baizhu) [tonifies Spleen, generates nutritious Blood to nourish the fetus]; Scutellariae Radix (Huangqin) [drains Fire, clears Uterine Heat to calm the fetus; these two are called the sacred medicines for calming the fetus]; Eucommiae Cortex (Duzhong) & Dipsaci Radix (Xuduan) [tonify Kidney, ensure sufficient Kidney Qi to support the fetus and prevent abortion. Eucommiae Cortex 8 liang, Dipsaci Radix 2 liang, powdered, pillified with Yam paste, named Baotai Wan]; Rehmanniae Radix Preparata (Shengdi), Asparagi Radix (Tian Dong) & Ophiopogonis Radix (Mai Dong) [nourish Yin]; Lycii Fructus (Gouqi), Paeoniae Radix Alba (Baishao) [nourish Blood]; Ginseng Radix et Rhizoma (Renshen), Glycyrrhizae Radix et Rhizoma (Gancao) [tonify Qi]; Amomi Fructus (Sharen) [resolves stagnation]. Add Lonicerae Japonicae Flos (Yinhua), Coptidis Rhizoma (Huanglian), Forsythiae Fructus (Lianqiao). [Can preemptively resolve all fetal toxins; taking up to 100 doses yields miraculous effects. Huanglian alone decocted treats maternal abdominal rumbling and fetal crying].
This formula tonifies Spleen and Stomach, strengthens waist and Kidneys, nourishes Yin and Blood, clears Heat and regulates Qi. All methods are complete. From early pregnancy to delivery, this should be the main approach, modified as appropriate. Especially for those with habitual abortion, preventive use is recommended. Zhang Zhongchun said: I read the Materia Medica, seeing a treatment for impending severe miscarriage: use 2 liang of Rehmanniae Radix Preparata (Shengdi), 1 liang of wine-fried Amomi Fructus powder, 2 bowls of water and 2 bowls of wine, taken in two doses. Passed to a student, tested with miraculous results.

Dasheng San
Ginseng Radix et Rhizoma (Renshen) [or Astragali Radix (Huangqi)], Glycyrrhizae Radix et Rhizoma (Gancao) [tonifies Qi], Atractylodis Macrocephalae Rhizoma (Baizhu) [tonifies Spleen], Paeoniae Radix Alba (Baishao) & Angelicae Sinensis Radix (Danggui) [nourishes Blood], Perillae Folium (Zisu), Citri Reticulatae Pericarpium (Chenpi) [regulates Qi and resolves stagnation], Arecae Pericarpium (Fupi) [descends Qi, reduces swelling]. If taken near delivery, add White Honey (Baimi) and Sesame Oil (Mayou) [one cup each]. If membranes rupture early and amniotic fluid/blood dries up, administer frequently to assist.
The name Dasheng derives from the poem: "When the month of birth arrives, the firstborn is like a lamb." 'Da' refers to a small lamb; 'Xiansheng' means born head-first. Lamb lambs are born head-first without obstruction. Taking this formula beforehand ensures Qi and Blood are neither deficient nor stagnant, plus it provides lubrication, making delivery smooth like a lamb.

Shoutai Yin
Aurantii Fructus (Zhike) [bran-fried, 2 liang], Glycyrrhizae Radix et Rhizoma (Gancao) [roasted, 1 liang. Powdered, take 2 qian per dose, mixed with warm water, three times daily. Wen Juju added Angelicae Sinensis Radix (Danggui) and Aquilariae Lignum Resinatum (Muxiang). Decoction or pills are fine].
Named Shoutai (Thin Fetus) to make the fetus smaller and easier to deliver. Formerly, Princess Huyang was obese and difficult to deliver for days. Daoist Nanshan presented this formula, which was effective. Only suitable for those with robust physique and strong Qi; otherwise, it consumes Qi and causes difficult labor. Medicine must be applied according to the individual.

Baochan Wuyu Fang Take several doses before the month of delivery, and one dose just before delivery, ensuring easy birth.
Angelicae Sinensis Radix (Danggui) [wine-washed, 1.5 qian], Paeoniae Radix Alba (Baishao), Ligusticum Chuanxiong Rhizoma (Chuanxiong) [benefits Blood. Each 1.2 qian], Astragali Radix (Huangqi) [1 qian], Glycyrrhizae Radix et Rhizoma (Gancao) [benefits Qi. 0.5 qian], Aurantii Fructus (Zhike) [fried], Magnoliae Officinalis Cortex (Houpo) [resolves stagnation. Ginger-juice fried, each 0.5 qian], Fritillariae Thunbergii Bulbus (Chuanbeimu) [powdered alone, taken with wine. Treats dystocia and retained placenta. Remove heart, grind 1 qian], Cuscutae Semen (Tusizi) [powdered alone, taken with wine. Treats transverse presentation. 1.5 qian], Schizonepetae Spica (Jingjiesui), Notopterygii Rhizoma et Radix (Qianghuo) [penetrates joints], Ai Ye [opens orifices, each 0.5 qian. Decoct in river water].
This is a miraculous formula for dystocia. However, for those with Yin deficiency and internal Heat, coughing and reversing Qi, focus on nourishing Yin and Blood, clearing Heat and regulating Qi.

Foshou San [Also known as Xiong Gui Tang]. Treats pregnant women with trauma/disruption, or dead fetus in the womb, bleeding and pain. Take this to test: if not damaged, pain stops; if damaged, expel immediately.
Angelicae Sinensis Radix (Danggui) [5 qian], Ligusticum Chuanxiong Rhizoma (Chuanxiong) [2.5 qian. Decoct half water, half wine].
This formula calms living fetuses and expels dead fetuses, a kingly method. Another prescription uses Achyranthis Bidentatae Radix (Niuxi) 1 liang, decocted in wine. Zhang Zhongchun used 3-4 raw eggs and 3 qian salt, mixed and taken. Others use Sesame Oil and White Honey, one cup each, taken in decoction. All can be adopted. To verify fetal death in the womb, check if the tip of the pregnant woman's tongue is blue-black. If lips and tongue are both blue, both mother and child die.

If the Shaoyin pulse of the woman's hand is vigorous, she is pregnant. [Heart pulse flowing and slippery indicates abundant Blood capable of conceiving, not merely rapid like beans]. "Yin pulses forcefully and differs from Yang" is called having a child. [Heart governs Blood, Kidney governs the uterus. Saying the two Shaoyin pulses beat against the fingers, distinct from Yang pathogens; because they are flowing, slippery, and harmonious]. If the pulses in the three positions are equal in floating and sinking, with no other illness, and menstruation has stopped, she is pregnant. Similarly if the Chi pulse is large and vigorous. Menstruation stopped, many illnesses present, but the six pulses are healthy, also indicates pregnancy. For weak women, although the pulse is faint and thin, if the Chi pulse does not cease upon pressure, it is pregnancy. [Because the body is weak, the pulse is hard to manifest]. If the Chi pulse is small but slippery upon pressure, it is pregnancy. [Chi reflects the Kidney externally, the root of life. Chong and Ren meridians originate in the uterus, the place of generation. Thus abundant Blood makes the pulse shape like water, gathered Qi makes the pulse image like pearls, all flowing smoothly, embodying the moving-slippery pulse]. Rapid left pulse indicates male, rapid right pulse indicates female. [Rapid means frequent].
If a pregnant woman has stopped menstruation and the pulse is wiry, she will later suffer heavy bleeding and fail to conceive. [Wiry indicates excessive Liver Wood; Liver governs dispersion and excretion, unable to store Blood]. During the seventh and eighth months of pregnancy, a solid, firm, large pulse is auspicious; a deep and fine pulse indicates difficult labor and death. When a woman is about to give birth, her pulse deviates from the regular pattern. If felt at midnight, she gives birth at noon. [Deviating from regular pulse. Fetal movement inside causes pulse disorder outside, inevitably so].