When the fetal qi is injured and agitated during pregnancy, causes such as falls or blows, anger, physical weakness, fatigue, improper medication or diet, violation of taboos, and imprudent sexual intercourse can all lead to this condition. If the fetal agitation is caused by the mother's illness, treat only the mother; if the mother's illness is caused by fetal agitation, stabilize only the fetus. In mild cases characterized by restlessness or slight bleeding, observe that the condition is not severe and promptly apply stabilization methods, such as those for stabilizing the fetus and sudden bleeding mentioned previously. If there is abdominal pain with heavy bleeding, soreness and weakness in the lower back with a bearing-down sensation, indicating that the fetus cannot be retained, Juejin Decoction (Juejin Jian) and Wuwu Decoction (Wuwu Jian) are most appropriate to assist blood flow and induce expulsion.

Juejin Decoction (See section on Abdominal Pain during Menstruation)
Wuwu Decoction (See External Formulas in the Discussion on Blood-Cold)

If the condition is severe, presenting with a bluish tongue, red face, abdominal distension and fullness, vomiting, nausea, or upward rushing of cold qi, the fetus has died. If the face is blue, there is foaming at the mouth, and the tongue is red, the mother has died. If the face, tongue, lips, and corners of the mouth are all blue, and foam issues from the mouth, both mother and fetus have died. If the fetus has died, it must be expelled quickly to save the mother. For those with deficiency of Qi and Blood, using Juejin Decoction is best. If ineffective, and distension/pain rushes upward requiring urgent intervention, administer Pingwei San (Pingwei Powder) 1 liang, mixed with half wine and half water, adding Puxiao (Natrii Sulfas, 朴硝) 5 qian, taken hot. Alternatively, use Puxiao 1 liang, mixed with urine from an uncircumcised boy (Tongbian, 童便), which will expel the contents downward. After expulsion, tonify according to the syndrome. If there is no urgency or distension, simply use Juejin Decoction added with Puxiao, and the dead fetus will pass naturally.

Pingwei San (See Stabilizing the Fetus section)

In cases where Qi and Blood are weak and unable to nourish the fetus, or where the mother suffers from chronic weakness such that conception cannot ultimately succeed, it is better to induce abortion to avoid further complications. Guixin San (Guixin Powder) or Xia Tai Duanju Fang (Xia Tai Duanju Formula) should be used.

*Liufang* Guixin San (See *Furen Gui Ancient Formulas*) treats cases where the fetus cannot be stabilized due to illness during pregnancy; inducing abortion is appropriate.

Guixin (Cinnamomi Cortex, 桂心), Gualou (Trichosanthis Fructus, 栝蒌), Niuxi (Achyranthis Bidentatae Radix, 牛膝), Qumai (Dianthi Herba, 瞿麦) (each 5 fen or 1 qian), Danggui (Angelicae Sinensis Radix, 当归) (1 qian or 2-3 qian).
Decoct with water.

Xia Tai Duanju Fang (See *Furen Gui Ancient Formulas*)
Use Maiya (Hordei Fructus Germinatus, 麦芽) 1 sheng, crushed, boiled in 2 sheng of water until reduced to 1 sheng. Taking this will cause expulsion immediately, with miraculous effect. Note: Maiya damages Qi and breaks Blood so severely that it is clearly unsuitable for those with weak Spleen-Stomach or indigestion. Another formula: Use Niuxi 1 liang, boil in one zhong of wine until reduced to seven-tenths, divide into two doses, which will cause expulsion.