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During pregnancy, menstrual blood is retained to nourish the fetus and accumulated to transform into milk. If the Qi of the Chong (Penetrating Vessel) and Ren (Conception Vessel) [Chong Mai (Penetrating Vessel), Ren Mai (Conception Vessel)] is deficient and cannot restrain it, causing slight vaginal bleeding monthly, it is called Bao Lou (Uterine Bleeding during Pregnancy). If the blood is exhausted, the fetus dies. However, there are also pregnant women with abundant blood whose menstruation continues normally without fetal movement, commonly known as "Gou'er Tai" (Dog Fetus). If treated as Bao Lou, the fetus will certainly abort; if not treated as Bao Lou, the fetus may not abort. There are also cases where the pulse is slippery and rapid but there are no wind-heat symptoms, and menstruation is normal but slightly less than before. This is due to a small fetus and surplus maternal blood. By the third or fourth month, when the fetus grows larger and requires more nourishment, menstruation will naturally stop. It is common now to see births at seven or eight months of pregnancy. People consider full term only after menstruation stops, calling earlier births premature. However, conception occurred before menstruation stopped, so by this time it is actually full term, though people do not realize this.

There are also robust pregnant women who have slight spotting monthly. If there is no lower back soreness or fetal restlessness, medication is unnecessary because their Qi and Blood are strong, and menstruation will naturally cease by the fourth or fifth month. If a pregnant woman is weak and emaciated, with frequent lower back soreness, fetal restlessness, and monthly spotting or continuous bleeding, this is not excess blood but Bao Lou. Jiawei Buzhong Antai Yin (Modified Cinnamon Twig and Atractylodes Decoction for Calming the Fetus) is suitable. It is also said that Bao Lou is often caused by Blood Heat, but there are cases of Qi deficiency and Blood deficiency where taking cooling herbs worsens the bleeding, accompanied by poor appetite and fatigue. This is Spleen Qi deficiency failing to control the blood. Guipi Tang (Restore the Spleen Decoction) and other formulas should be modified accordingly, and diagnosis should rely on pulse examination.

Abortion diseases mostly occur in the third, fifth, and seventh months. If an abortion occurred in the third month previously, it will likely recur in the corresponding month due to weakness. One must premedicate with Zunsheng Antai Yin (Venerable Life Fetal-Calming Decoction), or modify Taiyuan Yin (Fetal Origin Decoction), or use Taishan Panshi San (Mount Tai Porphyry Powder), Antai Wanquan Shenyingsan (Fetal-Calming Perfect Response Powder), etc., choosing according to symptoms to prevent recurrence. Continuous use until past the seventh month ensures safety. One must abstain from sexual intercourse, anger, overwork, and fried/spicy foods. Some abort within one month of conception; people are unaware, thinking it is just a regular period, not knowing the fetus was lost internally. After conception following the end of menstruation, one must rest and abstain from sex. Repeated intercourse disturbs the uterus, leading to abortion within one month or three to five months. Consider donkeys and horses: when pregnant, stallions kick away approaching males to protect the fetus, thus avoiding miscarriage. Should humans not be equally cautious? Labor, anger, lifting heavy objects, and washing the lower body (opening the orifices) can also cause abortion. Many infertile couples suffer from early abortions, not necessarily due to failure to conceive. For sudden falls damaging fetal Qi, Jiao Ai Antai San (Collage Moxa Fetal-Calming Powder) is suitable.

Before the third or fourth month, the fetus is unformed, called Duotai (Dropping Fetus). After the fifth or sixth month, the fetus is formed, called Banchan (Half Birth), commonly known as Xiaochan (Miscarriage). This generally belongs to maternal Qi and Blood deficiency and unstable fetal origin. Qi deficiency fails to hold firm; Blood deficiency fails to irrigate thoroughly, often leading to miscarriage. The Kidneys connect to the uterus, and the waist is the exterior of the Kidneys; lower back pain indicates risk of abortion, so prevention is essential. To treat Bao Lou, one must pre-nourish the root. Qianjin Baoyun Wan (Thousand Gold Pregnancy-Preserving Pill) is suitable. Zhilou Jueshen Dan (Stop Leakage Divine Spirit Elixir) is also very effective for Bao Lou. If a pregnant woman suddenly flows large amounts of water-like fluid, the fetus will abort. If the flow is gradual, Tonifying Qi and Calming the Fetus medicines can be used. Yellow discharge like bean juice with fetal restlessness and abdominal pain indicates Liver and Spleen Damp-Heat. Shengyang Chushi Tang (Raise Yang Expel Dampness Decoction) is used: Huangqi (Astragali Radix) 1 liang, Chuanxiong (Ligustici Chuanxiong Rhizoma) 1 qian, Nuomi (Oryza Sativa Glutinous Rice) 1 he, decocted and taken. Note that miscarriage differs greatly from term birth: term birth is like ripe fruit falling or nuts opening naturally; miscarriage is like picking green melons or peeling raw nuts, far more severe! People often neglect this, viewing it lightly, leading to illness and many deaths. This condition starts with blood consolidation to form the fetus, continues with essence and blood nourishing it, and ends with insufficiency causing abortion, so stasis is minimal. If there is abdominal pain with palpable masses, it is mostly Blood deficiency with rebellious Qi. Using Shenghua Tang (Generate New Decoction) first to remove stasis and generate new blood is wise, followed by strong warming tonification. If one only knows how to break stasis and stagnation, rebellious Qi will rise further, often leading to untreatable conditions. Beware! After the third month, if the Chi (Cun-Cord-Guan-Knee-Ankle) pulse is choppy or weak/faint, the fetus is unstable. Only a surging pulse indicates the fetus will not abort. Thus, *Maijue* (Pulse Classic) states: "String-taut-slippery-smooth pulses ensure safety; deep-thin-faint pulses lead to the underworld." Although miscarriage involves Qi and Blood deficiency, constitutional differences exist (Yin/Yang bias, Cold/Heat), so treatment must follow the pulse. If Yin deficiency with internal heat uses warming agents like Aijia (Moxae Folium, Aconiti Lateralis Radix Praeparata, Atractylodis Macrocephalae Rhizoma, Amomi Fructus), Yin blood will consume further, like plants without rain, naturally withering. If Yang deficiency with internal cold uses cooling agents like Huangqin (Scutellariae Radix), Baishao (Paeoniae Radix Alba), Spleen-Stomach cold and Qi-Blood weakness result, like fruits failing to bear in autumn/winter. In summary, before three months, nourish Spleen and Stomach; after four months, strengthen Waist and Kidneys, tonify Blood, smooth Qi, and assist with clearing Heat. This is the general principle.

Jiawei Buzhong Antai Yin: For robust pregnant women with slight bleeding after conception due to abundant Qi and Blood. If no back pain or fetal soreness, no medicine is needed. For weak/emaciated women with continuous bleeding or monthly spotting (Bao Lou), often caused by labor-induced Qi-Blood deficiency or excessive consumption of fried/spicy hot foods. Abstain from sex and take tonics to preserve the fetus. Renshen (Ginseng Radix) 1 qian, Baizhu (Atractylodis Macrocephalae Rhizoma, earth-fried), Danggui (Angelicae Sinensis Radix, wine-washed), Huangqi (Astragali Radix, honey-roasted), Chenpi (Citri Reticulatae Pericarpium), Shengma ( Cimicifugae Rhizoma), Chaihu (Bupleuri Radix), Gancao (Glycyrrhizae Radix et Rhizoma, roasted) in appropriate amounts, Shengjiang (Zingiberis Rhizoma Recens), Dazao (Jujubae Fructus) as guides, decocted in water and taken.

Guipi Tang (Appendix: Jiawei Guipi Tang, Jisheng Guipi Tang): Treats Heart-Spleen constraint, amenorrhea with fever, and Spleen deficiency failing to control blood causing hemorrhage. Also treats menstrual disorders, leukorrhea, and Bao Lou due to Heart-Spleen injury from labor, fever, fatigue, poor appetite, insomnia, palpitations, and fright. Renshen, Baizhu (earth-fried), Fushen (Poria with Hostwood), Zaoren (Ziziphi Spinosae Semen, roasted), Longyanrou (Longan Aril) each 2 qian, Huangqi 1.5 qian (roasted), Dangguishen (Angelicae Sinensis Radix), Yuanzhi (Polygalae Radix, soaked in Licorice water), Muxiang (Aucklandiae Radix) each 0.5 qian, Shengjiang, Dazao as guides, decocted in water and taken.

Zunsheng Antai Yin: Treats Blood deficiency with Fire, history of third-month abortion. Suitable for preventing fifth/seventh-month abortions and treating fetal restlessness/Bao Lou. Dangguishen (wine-washed), Baishao (wine-fried), Shudihuang (Rehmanniae Radix Preparata), Shengdihuang (Rehmanniae Radix), Sharen (Amomi Fructus), Ejiao (Asini Corii Colla, fried into beads) each 1 qian, Duzhong (Eucommiae Cortex, salt-water fried to break fibers), Xuduan (Dipsaci Radix, salt-water fried), Huangqin (Scutellariae Radix, wine-fried) each 0.5 qian, Renshen, Baizhu each 1 qian, decocted in water and taken.

Jingyue Taiyuan Yin: Treats loss of Chong-Ren control, unstable fetal origin. Modify according to symptoms, take every other day or every two-three days. Renshen (as needed), Danggui (wine-washed), Duzhong (salt-water fried to break fibers), Baishao (wine-fried) each 2 qian, Shudihuang 2-3 qian, Baizhu 1 qian, Chenpi 0.5 qian, Zhigancao 0.5 qian, decocted in water and taken. Indicated for Kidney deficiency with unstable lower origin, or abdominal pain. Add Zhixuduan (Prepared Dipsacus Root) 0.8 qian, or Wuweizi (Schisandrae Chinensis Fructus) 0.8 qian.

Taishan Panshi San: See Volume 9. Treats women with Qi-Blood deficiency, obesity without solidity, thinness with Blood heat, or inherent Liver-Spleen deficiency with fatigue and poor appetite, prone to repeated abortions. This formula is mild, nourishing Spleen-Stomach and Qi-Blood. If heat is felt, double Huangqin and reduce Sharen. If stomach weakness is felt, increase Sharen and reduce Huangqin. Abstain from sexual anger and avoid alcohol, vinegar, and spicy-hot foods to permanently prevent abortion.

Jingyan Yichan Wan: Jiuxu duan (Wine-processed Dipsacus Root) 1 liang, Tuchaohuaishanyao (Earth-fried Dioscoreae Hypoglaucae Rhizoma) 1 liang, Zhichuanxiong (Processed Ligustici Chuanxiong Rhizoma) 5 qian, Jiuxuan danggui (Wine-processed Angelicae Sinensis Radix) 2 liang, Chuanduzhong (Sichuan Eucommia Cortex 1 liang, mixed with glutinous rice porridge, dried, fried to remove fibers). Grind into fine powder. Use 50 Guiyuanrou (Longan Arils), decoct in thick juice, mix with honey to form pills. Divide into three doses.