Library

After the third month of pregnancy, if both feet become edematous, walking is difficult, food tastes bland, and there is panting resembling water qi (fluid retention), it is named Ziqi (Fetal Qi). Ancient prescriptions primarily focus on resolving dampness. Generally, edema is mostly caused by Spleen deficiency. If panting occurs, it involves the Lung and Kidney. This is because the Spleen governs the four limbs; when Spleen Qi is weak, it cannot control water, leading to swelling. When the Lung and Kidney lack nourishment from the Mother Qi (Spleen Earth generating Metal and Water), shortness of breath and chest fullness occur. Treatment should involve tonification combined with separating and draining fluids, which can be cross-referenced with Zitong (Fetal Edema). If the swelling subsides at night but returns during the day, and is due to Blood deficiency, one should strengthen the Spleen and nourish the Blood using Chuanxiong Rhizome (Chuanxiong Radix), Angelicae Sinensis Radix (Danggui), Poria (Fuling), Atractylodis Macrocephalae Rhizoma (Baizhu), White Peony Root (Baishao), Tangerine Peel (Chenpi), and Gentianae Macrophyllae Radix (Qinjiao). If there is distension in the epigastrium (heart below), this indicates turbid Qi obstructing the Upper Jiao; add Magnoliae Officinalis Cortex (Houpo), Fritillariae Bulbus (Beimu), Cyperi Rhizoma (Xiangfu), Peucedani Radix (Qianhu), Arecae Pericarpium (Dafupi), and Perilla Leaf (Ziyu) in quantities of one or two herbs. If panting is severe, add Apricot Seed (Xingren); if extreme, add stir-fried Perilla Seed (Su Zi).

Note: This condition starts in the feet and gradually progresses to panting and chest oppression resembling water, with fluid oozing from the toe webs, termed Ziqi. It arises because the woman has pre-existing Wind pathogens or Blood-Wind in the Chong and Ren vessels. It should not be treated as ordinary water retention, nor should decoctions be administered recklessly. The primary treatment should be Tianshen Teng San (Immortals Vine Powder).

Tianshen Teng (i.e., Qingmuxiang/Aristolochiae Manshuriensis Radix, washed and lightly stir-fried), Xiangfu (stir-fried), Chenpi, Gancao, Wuyao (all in equal parts), mixed evenly and ground into powder. Take three qian per dose. Add three slices of Ginger, three leaves of Perilla, and three slices of Papaya Fruit (Mugua). Decoct together and take on an empty stomach. After three doses, the edema will subside. In Shan Shi's version, this formula is made into a decoction with the addition of four fen of Perilla Leaf. If deficiency is present, add Ginseng Radix et Rhizoma (Renshen), Atractylodis Macrocephalae Rhizoma (Baizhu), and Angelicae Sinensis Radix (Danggui). If ineffective, concurrently administer medicines that tonify the Middle and strengthen the Spleen.
([Wu's Comment] For the last three ingredients mentioned above, decoct them separately in water to deliver the aforementioned powder.)

When fetal Qi is disharmonious, turbid Qi lifts the fetus upward, causing chest and abdominal distension and fullness, known as Zixuan (Fetal Suspension). However, this diagnosis applies only if the face is not red and the eyes are not blue; otherwise, it may indicate fetal death.

Perilla Leaf (Ziyu, 8 fen), Ginseng Radix et Rhizoma (Renshen), Arecae Pericarpium (Dafupi), Chuanxiong Rhizome (Chuanxiong), White Peony Root (Baishao), Tangerine Peel (Chenpi, pith removed), Licorice Root (Gancao, 1 qian each), Angelicae Sinensis Radix (Danggui, soaked in wine, 2 qian), Ginger (3 slices), Scallion White (Congbai, 1 stalk). Take on an empty stomach. This condition often involves Qi stagnation; without Perilla Leaf, Arecae Pericarpium, Tangerine Peel, and Chuanxiong Rhizome, the Qi cannot be dispersed. Without Angelicae Sinensis Radix and White Peony Root, the Blood cannot be unblocked. Once Qi flows smoothly and Blood circulates freely, the fetus will naturally descend. Where evil pathogens gather, Qi must be deficient; therefore, Ginseng Radix et Rhizoma and Licorice Root are used to tonify. One tonifies, one drains, pushing out the old and bringing forth the new.