5th Month: The Tai Yin of the Foot/the Spleen
“In the 5th month of pregnancy, the fetus begins to receive the essences of fire to form the Qi. The woman should rest and get up late, wash the clothes well, live in the most interior part of the house, put on thick clothes, go out in the morning to breathe in the rays of heaven to avoid the harmful cold. It is appropriate to eat rice and wheat and to make beef and lamb broths, which she mixes with Zanthoxyllum ailanthoides and seasons with the five flavors. It is also called supporting the Qi to stabilize the five zang. It is also said to be appropriate to eat fish and freshwater turtle. It is the tai yin of the foot that supports it. The tai yin of the foot, the circulation of the spleen, governs the four seasons. In the fifth month, the four limbs of the child are completely formed, and this is why the tai yin of the foot supports it.
When one takes the pulse of the pregnant woman, if on strong palpation it is not dispersed, but is lively without being slippery, she is in the fifth month. If the pulse is fast, she is heading for complications/deterioration. If the pulse is tight, there are severe abdominal pains. If the pulse is slow, the abdomen is congested with dyspnoea. If the pulse is floating, the deterioration of the water produces edema.” Mawongdui
These ancient words say a lot. The element of Fire is introduced, which is an element that is necessary for Qi,/i> and for moving forward. Fire and Qi express Yang, and Yang expresses movement and transformation. In the earlier months of pregnancy, there is a deep need to sustain stillness in order for the blood to build, nourish, and circulate throughout the embryo–fetus, but now there is mention of “fire to form Qi”. This Qi not only sustains the mother’s strength, but it is a pattern that is set for the fetus as well.
For the first time, the mother perceives fetal movement (quickening). This is a time that the fetus speaks “I am” and allows its mother to perceive its Qi and its individuality. It is no longer a silent little seed germinating, growing, and developing in the mystery of the dark feminine. Now it speaks of itself as a life force, palpable under one’s own hands. Now this being is very present.
The element of Fire complements the Water of early gestation and the first mention of the element Water in the 4th month. These two elements lead to a wholeness of this individual who has yet to express itself as a person, until now. Even though the Pericardium in month 3 and the Triple Warmer in month 4 are Fire meridians, in the 5th month, it is said that “Fire (is) forming Qi”.
Is it that the 3rd and 4th month were in preparation for this palpable Fire, this Qi, which for the first time speaks up as an individual? This is the Qi that is required for the fetal movements that the mother will continue to perceive abdominally as the fetus moves, sleeps, and wakes.
Spleen as Center
Typically in ancient China, the Spleen was seen in the center of a square or the center of a circle.
Character of Spleen
When we look at the shape of a circle or a square, we see that there are four sides to them. When we look at the character of “spleen”, we see that part of the character is written with a square. This square represents earth, which is the center of life and represents its continuity.
These four equal walls represent the number 4 as seen in 4 directions. The square or the circle can be seen as itself, its own entity, that is, it is the accumulation of the four separate directions. However, it is beyond the 4 separate aspects, it is a 5th aspect, and as such, it represents itself and can be seen as a fulcrum or a hub. Each of these words (fulcrum, hub) is seen as the center - or the most important part - of something bigger. Each of these words plays an essential role to something beyond itself. A hub or a kernel is the center of something that emanates outward, as well as the center to which things return. This movement between the center and the 4 walls represents the Spleen being the center of the other zang organs, communicating directly to each of them through its abilities of nourishment, transforming, transporting, receiving and giving. The Spleen, in this central position, is a place where exchange takes place; if the spleen is well, all the zang are well. Likewise, when all the zang are well, the Spleen is well. Thus, this central hub, this matrix, influences the entire body and, as such, can produce harmony, balance, and the sustenance of life.
The Spleen is seen as the center, both in the old diagram of five elements, and as the central organ for ongoing life.
Likewise, the 5th month is the middle of the pregnancy, where the mother is in the “center” of her gestation. During this month the mother’s health, both mental and physical, etches the pattern of Fire and Qi for her fetus. Her health communicates directly to the baby and the baby now responds directly to the mother, very much like the Spleen communicating directly to all the zang, as they in turn communicate directly to the Spleen.
The Mawangdui tells the mother
‘to rest and arise late, wash the clothes well, live in the most interior part of the house, put on thick clothes, go out in the morning to breathe in the rays of heaven to avoid the harmful cold.’
There is mention of rest, of cleanliness, and of caution not to go out in an unkind environment. Instead, the woman is advised to go out in the clear, fresh air and breathe in the rising yang of morning. Once again, there is need for the Yang. The morning light (or the rising of yang) will end the darkness of night (or the sinking of yin), and this rhythm will “set her (the woman’s) clock” so her system produces the sleep-inducing hormone, Melatonin. When the clock is properly set, the woman will tire in the evening and automatically awaken in the morning. This puts her on schedule with a healthy circadian rhythm, affecting behavior as well as physical and mental health.
The Spleen and its Ability to Digest, Assimilate, and Transport
The Spleen is responsible to distribute the essences of the 5 flavors to each of the 5 zang/solid organs.
“The mother’s spleen functions properly in order to give the fetus the right pattern for its own process of distribution”. Elisabeth p 71
The ancient book advises the mother to season her food with red pepper, circulating more warmth and Qi, and to eat certain foods of “5 flavors” (not surprising since we are seeing the influence of the Spleen).
Sun Simiao cautions the mother to eat a balanced diet, “enough but not too much” and cautions her to avoid too much dry food, and to balance the dry and damp.
Modern knowledge has learned that there is a metabolic imprinting for obesity for fetuses whose mothers have dietary problems such as diabetes, and that diet and exercise are of extreme importance for healthy fetal development as well as lifelong eating habits. These dietary recommendations, therefore, appear to be as important for the fetus as they are to the mother. In Western findings, fetal digestion begins early in the 18th week or during the 5th month. This fact compliments the Chinese perceptions that this is the time that recognizes the fetus's ability for its Spleen to function - digest, assimilate, and transport.
The caution of balancing foods so there is not too much dryness or dampness warns the mother not to introduce too much sweet in her body, which would cause a heaviness and dampness, and disturb the ascending movement of the Spleen Qi. Also, as each organ has a “flower” (meaning a connection to a sensory orifice) the “flower” to the Spleen is the mouth, which involves taste, appetite, eating, and digesting. (The “flowers” of the other organs are: Kidney/ear, Liver/eye, Heart/tongue, and Lung/nose.)
Pulses
The healthy pulse of the 5th month is mentioned in detail, describing it as “one that cannot be dispersed with strong palpation, and is lively but not slippery”. The woman is cautioned to keep a healthy pulse and to avoid heat, congestion, and cold, any one of which could be a negative influence; that is, “if the pulse is floating, there are problems in edema; if it is tight, there are pains; if it is slow, there is abdominal congestion and dyspnea; and, if it is fast, there are future complications.” Elisabeth p. 68
The Mawongdui speaks of the surface of the body (skin, hair, and nails) being nourished by the zang organs and transported to the surface by the Triple Heater. During the 19th and 20th weeks, science teaches us that lanugo forms. (Lanugo is the soft feathery hair that the fetus grows all over its body, and which falls off shortly after birth.)
Along with the ancients’ intellectual perception of fetal growth, lanugo would have been observed and known (because 2,000 or 5,000 years ago, there were miscarriages and, very likely, abortions), but their insight is reflected in the understanding of the developing zang reaching the body’s surface (skin).
The 5th month is called “supporting the Qi to stabilize the 5 zang”, which are beginning to be stable enough to support the expression of fetal Qi. This Qi lets us know that the fetus is growing and maturing. Clearly, there is not enough stability for the fetus to exist on its own yet, but it is a beautiful recognition of its evolving development. The mother is cautioned on how to dress, where to reside, when to be outdoors, and what to eat. She is specifically guided in the importance of self-care.
Balance
In the 5th month, the mother may embrace Fire, but not too much Fire. Caution is given against going out in too much sun causing heat and dryness. So once again, there is a message of balance. By perfect balance, the mother will create enough Qi for the fetus to nourish itself so that as it grows and gathers Qi, it will eventually be able to survive on its own.
