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Head and facial edema along with swelling of the four limbs is termed Zi Zhong (Fetal Edema). Swelling from the knees to the feet is named Zi Qi (Fetal Qi). Generalized swelling accompanied by panting and abdominal fullness is called Zi Man (Fetal Fullness). Swelling confined to the feet with thickened skin is referred to as Zhou Jiao (Wrinkled Feet), while swelling with thin skin is called Cui Jiao (Brittle Feet).

[Note] When the head, face, and entire body are edematous with scanty urine, it is attributed to Water Qi pathogenesis, hence named Zi Zhong. Swelling from the knees to the feet with normal urination is attributed to Dampness pathogenesis, hence named Zi Qi. Generalized swelling, abdominal distension, and panting occurring during the sixth or seventh month of pregnancy are termed Zi Man. Swelling limited to both feet with thickened skin is due to Dampness, named Zhou Jiao. Swelling with thin skin is due to Water, named Cui Jiao. Generally, diseases caused by Water often present with panting and shortness of breath, whereas diseases caused by Qi often present with abdominal distension and fullness. Panting is associated with the Lung, and abdominal distension is associated with the Spleen. This occurs because the woman previously harbored Water Qi and Dampness pathogens; upon conception, these manifest as swelling and fullness. If the fetus has not yet formed, immersion in water may damage the fetus. However, if the fetus has already formed, treatment can still be effective; thus, those presenting with these symptoms after the fifth or sixth month often have successful deliveries.

Fuling Daoshui Decoction (Poria Decoction for Guiding Out Water)
For pregnancy-related edema, fullness, and Zi Qi, the pathology involves Water Qi and Dampness pathogens residing between the Spleen and Lung. If Water Qi overwhelms and immerses the fetus, it causes panting and difficulty lying down; if Dampness overwhelms and damages the fetus, it causes unbearable abdominal distension. Both conditions are suitable for treatment with Fuling Daoshui Decoction. The formula comprises Xiangru (Elsholtziae Herba), Gualougen (Trichosanthis Radix), Binglang (Arecae Semen), Dafupi (Tangerine Fruit Pericarp - specifically Citri Reticulatae Pericarpium Viride or similar contextually used bark), and the Four Poria Powder (Siling San: Fuling, Zhuling, Zexie, Baizhu). For prominent abdominal distension, add Zhike (Aurantii Fructus); for leg and foot swelling, add Fangji (Stephaniae Tetrandrae Radix); for severe panting, add Tinglizi (Lepidii Semen).

[Note] Conditions such as pregnancy edema, fullness, Zi Qi, Zhou Jiao, and Cui Jiao are all caused by Water Qi and Dampness pathogens injuring the Spleen and Lung. If Water Qi is excessive and immerses the fetus, it inevitably leads to panting and inability to lie flat; if Dampness is excessive and damages the fetus, it results in unbearable abdominal distension. All these should be treated with Fuling Daoshui Decoction. The prescription consists of Muxiang (Aucklandiae Radix), Mugua (Chaenomelis Fructus), Binglang (Arecae Semen), Dafupi (Mature Tangerine Peel), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Zhuling (Polyporus), Zexie (Alismatis Rhizoma), Sangbai (Mori Cortex), Sharen (Amomi Fructus), Ziye (Perillae Folium), and Chenpi (Citri Reticulatae Pericarpium). It harmonizes the Spleen and Lung while promoting diuresis to resolve dampness. For severe distension, add Zhike to break stagnation; for leg and foot swelling, add Fangji to promote downward drainage of water; for panting caused by dampness, add Ku Tingli to drain upper-jiao water.

Zhimu Yin (Anemarrhenae Decoction)
When a pregnant woman experiences frequent irritability, it is termed Zi Fan (Fetal Irritability). This condition is caused by fetal heat assaulting the Heart and can be cured with Zhimu Yin. The base formula contains Huangqin (Scutellariae Radix), Zhimu (Anemarrhenae Rhizoma), Maidong (Ophiopogonis Tuber), Fuling (Poria), and Gancao (Glycyrrhizae Radix et Rhizoma). If heat is severe, add Xijiao (Rhinocerotis Cornu); if Qi is deficient, add Renshen (Ginseng Radix); if thirst is present, add Shigao (Gypsum Fibrosum) for decoction and administration.

[Note] If a pregnant woman has no other symptoms but experiences frequent mental restlessness, it is called Zi Fan. This arises from stagnant heat within the fetus ascending to the Heart. It is appropriate to use Zhimu Yin, composed of Huangqin, Zhimu, Maidong, Fuling, and Gancao. Add Xijiao for severe heat, Renshen for Qi deficiency, and Shigao for thirst when decocting and taking orally.