Synopsis of the Golden Chamber, Volume II: Pattern and Treatment of Pregnancy Diseases in women, Chapter Twenty
Holistic Paraphrase
The "Synopsis of the Golden Chamber — Patterns and Treatment of Pregnancy Diseases in Women, Chapter Twenty" primarily discusses the principles and methods for assessing pregnancy-related pulse patterns and common disorders. All formulas, dosages, and acupuncture methods recorded in this chapter are derived from classical texts and are intended solely for academic study; they do not constitute modern medication or treatment recommendations.
- The Master said: When a woman's pulse is harmonious and even, the yin pulse (chi pulse) is slightly small and weak, accompanied by thirst, inability to eat, and absence of chills or fever — this condition is termed pregnancy. The ancients treated it primarily with Cinnamon Twig Decoction (formula found in the diarrhea chapter). According to general principles, these reactions typically appear around sixty days of gestation; if mistreated, and one month later vomiting and diarrhea are added, this indicates injury to fetal qi — the erroneous treatment should be stopped and careful nurturing should be undertaken.
- A woman who ordinarily suffers from a mass disease (abdominal mass-type conditions) may experience continuous flooding and spotting (non-menstrual vaginal bleeding) before three months of amenorrhea, with a sensation of fetal movement above the navel — this is harm caused by the accumulated mass.
- Fetal movement in the sixth month of pregnancy: if menstruation remained unobstructed during the first three months and fetal movement was accompanied by bleeding, and bleeding continues after the menses cease in the latter three months, the reason for unabating bleeding lies in the mass not having been eliminated. The mass should be removed, with Cinnamon Twig and Poria Pill as the primary treatment.
- 🌿 Cinnamon Twig and Poria Pill Formula: Cinnamon twig, Poria, Moutan bark (heart removed), Peach kernel (peeled and tip removed, stir-fried), White peony root — equal parts of each. According to ancient method, grind into powder, form with refined honey into pills the size of rabbit droppings. Take one pill before meals daily; if no obvious effect, increase to three pills.
- A woman in the sixth or seventh month of pregnancy presenting with string-like pulse, fever, increasing abdominal distension, abdominal pain with chills, and a feeling of cold in the lower abdomen as if fanned (referred to as "lower abdomen like a fan") — this indicates the uterus being open and insecure. The Aconite Decoction should be used to warm and nourish the uterine cavity (original formula not extant).
- The Master said: When a woman experiences vaginal bleeding, there are cases of non-menstrual spotting, persistent bleeding following incomplete miscarriage, and pregnancy-related bleeding. If in pregnancy there is abdominal pain, this is termed uterine blockade (pregnancy abdominal pain with bleeding), treated primarily with Donkey-hide Gelatin and Mugwort Decoction.
- 🌿 Chuanxiong, Donkey-hide Gelatin and Mugwort Decoction Formula: Chuanxiong 2 liang, Donkey-hide gelatin 2 liang, Licorice 2 liang, Mugwort leaf 3 liang, Chinese angelica 3 liang, White peony root 4 liang, Rehmannia root (amount not specified in the original formula). Ancient method: boil with 5 sheng of water and 3 sheng of clear wine, reduce to 3 sheng, remove dregs, then dissolve the donkey-hide gelatin into the warm liquid. Take 1 sheng warm, three times daily; if ineffective, may repeat.
- A woman in pregnancy with persistent, nagging abdominal pain is treated primarily with Chinese Angelica and Peony Powder. 🌿 Formula: Chinese angelica 3 liang, White peony root 1 jin, Poria 4 liang, Atractylodes 4 liang, Oriental water plantain 8 liang (half a jin), Chuanxiong 8 liang (some versions state 3 liang). Ancient method: grind to powder, take one square-inch spoon with wine, three times daily.
- For unremitting vomiting during pregnancy, treat primarily with Dried Ginger, Ginseng, and Pinellia Pill. 🌿 Formula: Dried ginger 1 liang, Ginseng 1 liang, Pinellia 2 liang. Ancient method: form into pills the size of parasol seeds using fresh ginger juice as binder, take ten pills (the original text reads "nineteen," likely a scribal error for "ten") with water, three times daily.
- For difficult urination during pregnancy with normal appetite, treat primarily with Chinese Angelica, Fritillaria, and Sophora Pill (for males, add half a liang of talc). 🌿 Formula: Chinese angelica, Fritillaria, Sophora root — 4 liang each. Ancient method: form with refined honey into pills the size of small beans, take three pills with water, gradually increasing to ten pills.
- For water qi during pregnancy — heavy body, difficult urination, chills with shivering, and dizziness upon standing — treat primarily with Malva Seed and Poria Powder. 🌿 Formula: Cluster mallow seed 1 jin, Poria 3 liang. Ancient method: grind to powder, take one square-inch spoon with water, three times daily; resolution occurs once urination becomes free-flowing.
- For women in pregnancy, the ancients advocated regular administration of Chinese Angelica Powder. 🌿 Formula: Chinese angelica, Scutellaria, White peony root, Chuanxiong — 1 jin each, Atractylodes 8 liang (half a jin). Ancient method: grind to powder, take one square-inch spoon with wine or water, twice daily. The ancient belief held that regular use during pregnancy facilitated easy delivery, kept the fetus free from suffering, and addressed all hundred postpartum diseases — this is an archaic generalization and must not be applied literally in modern practice.
- For nurturing the fetus during pregnancy, treat primarily with Atractylodes Powder. 🌿 Formula: Atractylodes, Chuanxiong, Sichuan pepper 3 fen (sweated to remove pungency), Oyster shell. Ancient method: grind to powder, take one qian spoon with wine, three times daily plus once at night. If there is severe pain, add white peony; for acute pain below the heart, double the Chuanxiong; for vexation, vomiting, and pain with inability to eat or drink, add Asarum 1 liang and twenty large Pinellia pieces. After administration, regulate with vinegar-water mixture; if vomiting occurs, take the powder with vinegar-water; if vomiting persists, take wheat juice; if thirst develops afterward, take barley porridge. The ancients believed that even after resolution of illness, one may continue taking it and should not discontinue.
- 🩺 When a woman's fetus is injured — during pregnancy she has abdominal fullness, inability to urinate, and heaviness from the waist downward resembling water qi — in the seventh month of pregnancy, the Taiyin (spleen) channel should nourish the fetus but fails to do so. This is due to heart qi excess. Ancient records state that one should needle to drain the Pericardium-8 (Laogong) and Conception Vessel-4 (Guanyuan) points. Slight improvement in urination indicates recovery (per the Jade Hall. This acupuncture method must not be self-performed in modern times.
🧠 Deep Comprehension
Core Principles 💡
- Pregnancy diseases are organized by qi-blood, cold-heat, dampness-water, and mass-accumulation categories. This chapter covers both physiological pregnancy responses and pathological states — masses, uterine blockade, water qi — reflecting the combination of "disease differentiation with pattern differentiation."
- “With illness, no harm; expel pathogenic factors to calm pregnancy”: When a pre-existing abdominal mass coexists with pregnancy, if the mass is not eliminated, bleeding continues unabated. Zhong-jing's Cinnamon Twig and Poria Pill works slowly to disperse the mass. Within the formula, cinnamon twig warms and unblocks the blood vessels, Poria promotes downward percolation, Moutan bark and peach kernel invigorate blood and break stasis, white peony harmonizes the nutrient level, and honey pills provide gradual, sustained action — embodying the academic principle of "attacking hardness without harming fetal qi." However, this must be clearly understood: this is by no means a routine pregnancy-stabilizing formula, and modern application requires rigorous evaluation by a specialist physician.
- Pregnancy bleeding is differentiated by vacuity vs. excess: Though spotting, post-miscarriage bleeding, and uterine blockade all involve bleeding, the mechanisms differ. Donkey-hide Gelatin and Mugwort Decoction uses donkey-hide gelatin, mugwort, rehmannia, angelica, and peony to nourish the blood and staunch bleeding; chuanxiong to regulate the blood; and licorice to harmonize the center — reflecting the strategy of "staunching bleeding without leaving stasis; nourishing the blood to calm the fetus."
- Pregnancy abdominal pain differentiates cold-heat, vacuity-excess: Vacuous cold presents with lower abdomen as if fanned, treated by warming the uterus. Blood vacuity with dampness obstruction manifests as persistent dull abdominal pain, treated with Chinese Angelica and Peony Powder to nourish the blood, soothe the liver, fortify the spleen, and disinhibit dampness. This demonstrates the ancients' attention to "same disease, different treatments."
- Pregnancy complications: Unremitting vomiting addressed by descending rebellious stomach qi; difficult urination addressed by supplementing the blood, clearing dryness-heat, and restoring bladder qi transformation; generalized water swelling addressed by promoting urination and eliminating dampness — with Dried Ginger, Ginseng, and Pinellia Pill, Chinese Angelica, Fritillaria, and Sophora Pill, and Malva Seed and Poria Powder established respectively.
- Acupuncture principles: Laogong (Pericardium-8) is the fire point of the pericardium channel; Guanyuan (Conception Vessel-4) is a Ren channel point. The ancients believed that "heart qi excess" can be drained via Laogong and Guanyuan to promote urination; however, Guanyuan lies close to the uterine cavity, making acupuncture extremely risky in pregnant women — modern non-professionals must never attempt this.
Modern Understanding 🌟
- This chapter constitutes one of the earliest systematic documents on gynecology and obstetrics in Chinese medicine, recording pregnancy vomiting, bleeding, abdominal pain, edema, and difficulty urinating among common issues, and holds significant value in medical history.
- "Fixated disease causing harm" may be understood as the ancient description of organic disease conjoined with pregnancy — such as uterine fibroids or ovarian masses; "uterine blockade" resembles threatened miscarriage or ectopic pregnancy, but ancient and modern concepts cannot be simply equated.
- Modern obstetrics employs ultrasound, hormonal testing, and genetic screening to evaluate fetal development and maternal status with far greater precision. Statements in this chapter — such as "regular intake of Chinese Angelica Powder facilitates easy delivery" or "treats all hundred postpartum diseases" — are products of their historical context and cannot be transported into modern practice.
- Some contemporary research on the formulas in this chapter suggests anti-inflammatory, blood-invigorating, and smooth-muscle- modulating effects, but evidence for medication safety during pregnancy remains limited. Any use must be evaluated under a physician's guidance — one cannot self-administer according to ancient formulas.
Wellness In Sight ⚡
- Pregnancy should be maintained with emotional balance, avoiding overexertion and fright — consistent with the ancient concept of "nurturing fetal peace."
- Diet should favor lightness and temperance; when vomiting is prominent, small frequent meals are appropriate, but antiemetic formulas must not be self-administered.
- Keep the lower abdomen warm and avoid cold stimulation; for any abnormal bleeding, abdominal pain, edema, or difficulty urinating, seek timely care at a regular medical institution.
- The ancients emphasized "with illness, no harm" — but modern individuals cannot use this to justify aggressive or arbitrary treatment. Any ancient "fetal-nourishing" or "ease-of-delivery" methods must be examined through the lens of modern medicine.
📚 Related Knowledge
- Associated concepts: Thoroughfare and Conception vessels, uterine cavity, abdominal masses, spotting, uterine blockade, the "uterus room," Taiyin fetal-nourishment, "with illness no harm."
- Further reading: Requirements of the Golden Chamber — Postpartum Diseases of Women and Mixed Diseases of Women; Yellow Emperor's Inner Classic — Plain Questions, Ancient Heavenly Truth and Spiritual Pivot, Five Sounds and Five Flavors; Treatise on the Origins and Symptoms — various pregnancy conditions; Chen Zi-ming's Complete Good Formulas for Women, chapter on pregnancy.
Bu-gua Note: This content is based on classic Chinese medical texts and is provided solely for the study of traditional culture. It does not constitute any form of medical diagnosis, medication, or treatment recommendation. Please consult a qualified healthcare provider promptly if you are unwell.
