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Ziman (Excessive Abdominal Distension in Pregnancy) refers to the condition where a woman, at five or six months of pregnancy, experiences abnormal abdominal enlargement, distension and fullness in the chest and abdomen, edema of the hands, feet, face, and eyes, rebellious Qi causing mental restlessness, and difficulty in urination. This is caused by water accumulation in the Baozhong (uterus), named Taishui (Fetal Water). If not treated promptly, the newborn may suffer from weak and short limbs with deformities, or the fetus may die in utero. Qianjin Liyu Tang (Thousand Golden Carp Decoction) is used to treat this water retention. If spleen deficiency leads to impaired transportation and transformation, resulting in the failure to distinguish clear from turbid, it can be assisted with Sijunzi Tang (Four Gentlemen Decoction); if there is puffy swelling of the face and eyes, and limbs resembling water qi, Quansheng Baizhu San (Quansheng Atractylodes Macrocephala Powder) is used; if there is spleen dampness with deficient heat causing swelling in the lower body, Buzhong Tang (Middle-Boosting Decoction) with added Fuling (Poria) is prescribed; if irregular diet causes vomiting and diarrhea, Liujunzi Tang (Six Gentlemen Decoction) is used; if leg and foot swelling occur with panting, chest stuffiness, and restlessness, or fluid oozing from between fingers, Tianxianteng San (Akebia Vine Powder) is applied; if there is stagnation of Qi in the spleen and lungs, Jiawei Guipi Tang (Modified Restore the Spleen Decoction) is used, assisted by Jiawei Xiaoyao San (Modified Free Wanderer Powder). However, only when generalized edema and severe distension are present is it termed Ziman. If only the dorsum of the foot is swollen, making walking difficult, or yellow fluid exudes from between toes, it is called Zi Qi (Fetal Qi), which resolves only after delivery. Therefore, for ankle swelling in pregnancy, especially when extending to the calves and legs at eight or nine months, it is not comparable to water disease and should not be treated as such, lest it damage the True Qi. Such cases usually result in easier childbirth because the uterus contains abundant water and blood, preventing the fetus from drying out. However, if swelling occurs immediately upon conception, it indicates excessive water qi while the fetus is not yet formed, leading to inevitable miscarriage.

Zizhong (Fetal Edema) is similar to Zi Qi, but Zi Qi occurs in the lower body, whereas Zizhong affects the head and face. If Ziman appears after five or six months of pregnancy, it differs from Zi Qi and Zizhong. As the fetus grows, abdominal distension increases, leading to severe Qi stagnation and generalized edema.

The *Jinkui Yaolue* states: "In women pregnant for six or seven months, if the pulse is wiry and accompanied by fever, the fetal distension worsens, abdominal pain and aversion to cold occur, and the lower abdomen feels like being fanned, this is due to the opening of the Zizang (uterus). It should be treated with Fuzi Tang (Aconite Decoction) to warm the uterus." Xu Zhongke stated: "At six or seven months, the Stomach and Lung nourish the fetus. If Qi is stagnant due to cold, the fetal distension worsens; internal cold causes abdominal pain and aversion to cold. Although aversion to cold can be exterior-related, here it is accompanied by abdominal pain, indicating internal cold injury. The sensation of the lower abdomen being fanned implies paroxysmal coldness, distinct from general aversion to cold, occurring specifically in the lower abdomen because the Zizang, affected by cold, fails to close, leaving the lower abdomen open and unconsolidated. Zizang refers to the uterus. Fuzi enters the Kidney meridian to warm the Lower Jiao, hence Fuzi Tang is suitable to warm the meridians. If a pregnant woman suffers accidental trauma causing restless fetus and unbearable pain, use Suisha Ren (Amomi Fructus Rotundus) with shell, any amount, stir-fried with peel until black, powdered, and taken with hot wine (2 qian). Non-drinkers may take it with rice gruel. When warmth is felt in the abdomen, the fetus will settle naturally."

Abdominal and cardiac pain during pregnancy, whether pre-existing cold pain or newly contracted wind-cold, arises from visceral deficiency. Pathogenic and healthy Qi clash and converge in the Qi mechanism, moving up and down. Rising to the Heart causes cardiac pain; descending to the abdomen causes abdominal pain. Prolonged internal conflict without resolution may cause pain to impact the Chongbao (fetus), inevitably disturbing the fetus. Jiegu's Dihuang Danggui Tang (Rehmannia and Angelica Decoction) treats fetal pain in pregnancy. Danxi attributed this to Blood deficiency, thus prescribing Siwu Tang (Four Substances Decoction) minus Chuanxiong, with doubled Shudi (Prepared Rehmannia Root), which is the core method.

Intermittent abdominal pain or heavy bearing sensation in the lower abdomen during pregnancy is termed Taitong (Fetal Pain). It is primarily treated with a decoction of 3 qian Dihuang (Rehmannia Root) and 1 qian Danggui (Angelica Sinensis). If ineffective, add Renshen (Ginseng), Baizhu (Atractylodes Macrocephala), and Chenpi (Tangerine Peel). For pain caused by sinking due to Middle Qi deficiency, Buzhong Yiqi Tang (Middle-Boosting and Qi-Invigorating Decoction) is used.