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Medusa's relationship with Xiao Yan is somewhat complicated. In their initial encounter, they fought when she was in her adult form. However, after she merges with Xiao Cai, she remains dormant until Xiao Cai asks for her help to save Xiao Yan. Initially, Medusa only kept Xiao Yan alive so he could create the Spirit Fusion pill to seperate her spirit from Xiao Cai's. Their relationship begins to grow slowly as Medusa was unable to harm Xiao Yan due to Xiao Cai's spirit remaining inside her. Her affection towards him also shows when he saves her twice: once against a raging beast and the other during a battle. Later on in the story, Xiao Yan unintentionally rapes her during process of consuming the Essence flame as the aphrodisiac affects his mind. This leads to her pregnancy with Xiao Xiao(Xiao Can reincarnated). Her pregnancy eventually leads her to accept Xiao Yan as her husband and she begins to care for him even more. Xiao Yan loves her as well because she is the mother of his first child. They eventually marry once Xiao Yan meets his daughter for the first time.

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