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 generally call this condition "pregnancy malaise" (Qiren Ezu). Little do they know that it is actually caused by excessive dryness of Liver Blood! The conception of a woman originates from the prosperity of Kidney Qi. Because Kidney Qi is prosperous, it can grasp essence. However, once the Kidney receives essence and forms an embryo, Kidney Water is used to nourish the fetus and has no spare capacity to moisten the five Zang organs. Since the Liver is the "child" organ of the Kidney (Water generates Wood), it relies daily on the maternal organ's (Kidney) Qi to expand and relax. If it lacks fluid nourishment for even one day, Liver Qi becomes urgent and contracted, while Kidney Water fails to respond in time, causing Liver Qi to become increasingly irritable. When Liver Qi is irritable, internal fire arises and rebels upward. Once Liver Qi rebels, symptoms such as vomiting and nausea arise. Even if vomiting is not severe, the damage to Qi is the same. Once Qi is damaged, Liver Blood is further depleted. The reason why people use Siwu Tang (Four Substance Decoction) to treat various conditions during pregnancy is precisely because it can generate Liver Blood. However, merely nourishing the Liver through blood generation, although not bad, is insufficient if one does not understand how to generate Qi; otherwise, the Spleen and Stomach will weaken and fail to withstand frequent vomiting. Moreover, it is feared that if Qi is deficient, Blood will be difficult to generate. Therefore, within the framework of soothing the Liver and nourishing Blood, herbs that strengthen the Spleen and stimulate appetite are added to generate Yang Qi. In this way, Qi can generate Blood, which is particularly beneficial to fetal Qi. Some may doubt: "If Qi is rebelling, using Qi-tonifying herbs will only exacerbate the rebellion!" They do not realize that in pregnancy malaise, the rebellion is not severe, and the rebellion is due to deficiency rather than pathogenic factors. For rebellions caused by pathogens, tonifying Qi increases rebellion; for rebellions caused by deficiency, tonifying Qi reverses the trend towards normalcy. Furthermore, when Qi is tonified amidst Blood-nourishing herbs, Yin is sufficient to control Yang, so there is no need to worry about increasing rebellion!

The appropriate prescription is Shun Gan Yi Qi Tang (Liver-Soothing and Qi-Boosting Decoction).
Ren Shen (Ginseng Radix et Rhizoma, 1 liang), Dang Gui (Angelicae Sinensis Radix, 1 liang, washed with wine), Su Zi (Perilla Fructus, 1 liang, stir-fried and crushed), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 3 qian, stir-fried with soil), Fu Ling (Poria, 2 qian), Shu Di Huang (Rehmanniae Radix Praeparata, 5 qian, steamed nine times), Bai Shao (Paeoniae Radix Alba, 3 qian, stir-fried with wine), Mai Dong (Ophiopogonis Radix, 3 qian, heart removed), Shu Chen Pi (Citri Reticulatae Pericarpium Praeparatum, 3 fen), Sha Ren (Amomi Fructus Rotundus, 1 grain, stir-fried and crushed), Shen Qu (Massa Medicata Fermentata, 1 qian, stir-fried).
Decoct in water and take orally. After one dose, symptoms lighten; after two doses, stability is achieved; after three doses, complete recovery occurs. This formula soothes the Liver to eliminate rebellion, tonifies the Kidney to extinguish Liver dryness, and tonifies Qi to facilitate Blood generation. For any fetal disorders accompanied by mild pregnancy malaise, administering this formula ensures safety and peace. It is most beneficial to pregnant women, surpassing the efficacy of Siwu Tang (Four Substance Decoction).

Marginal Note: The formula is extremely effective, but the use of 1 liang of Su Zi (Perilla Fructus) seems like a typo for 1 qian. However, individuals born in the early Qing Dynasty had robust constitutions, so perhaps 1 liang was necessary for efficacy. Now, in the late Qing period, constitutions are weaker, so 1 qian is sufficient. One must absolutely avoid using 1 liang.

There are also cases of Liver Qi stagnation and Qi mechanism obstruction, leading to chest and diaphragm distension and fullness, without aversion to food, but with an inability to eat large amounts. Although this occurs during pregnancy, it is not pregnancy malaise. These conditions should be treated differently; see the subsequent formula.

Shu Gan Hua Zhi Tang (Liver-Soothing and Stasis-Resolving Decoction)
Quan Dang Gui (Angelicae Sinensis Radix, washed with wine, 6 qian), Hang Shao Yao (Paeoniae Radix Alba, stir-fried with wine, 3 qian), Dang Shen (Codonopsis Radix, radix removed, 3 qian), Bai Bian Dou (Dolichos Lablab Semen Album, peel removed, 4 qian), Yun Ling Shen (Poria, 2 qian), Xiang Fu (Cyperi Rhizoma, stir-fried until scorched, 2 qian), Sha Ren (Amomi Fructus Rotundus, stir-fried and crushed, 1.5 qian), Tiao Qin (Scutellariae Radix, stir-fried until scorched, 8 fen), Shen Qu (Massa Medicata Fermentata, stir-fried until scorched, 1.5 qian), Guang Pi (Citri Reticulatae Pericarpium, 8 fen), Bo He (Menthae Haplocalycis Herba, 6 fen), Gan Cao (Glycyrrhizae Radix et Rhizoma, 5 fen).
Decoct in water and take orally.

Rhyme Formula:
After pregnancy begins, malaise appears,
Nausea, vomiting, thirst, craving sour flavors.
Aversion to food, often desiring rest,
Blood deficiency and dryness, the disease belongs to the Liver.
Use Shun Gan Yi Qi Tang with Ginseng and Angelica,
Perilla, Atractylodes, Poria, and Prepared Rehmannia.
Stir-fried Peony, Ophiopogon, Tangerine Peel, Amomum, and Fermented Dough,
Three consecutive doses lower the rebellious Qi.