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During pregnancy, "Zi Zhong" (fetal edema) is similar to "Zi Qi" (fetal qi stagnation with edema), but "Zi Qi" manifests as swelling in the lower body, whereas "Zi Zhong" manifests as swelling in the head and face. If the condition is "Zi Man" (fetal fullness), also known as "Tai Shui" (fetal water), it typically occurs after five or six months of gestation, which differs from "Zi Qi" and "Zi Zhong". This is because the enlarging fetus causes abdominal distension and generalized edema. All conditions of "Zi Qi", "Zi Zhong", and "Zi Man" arise from inherent weakness of the Zang-Fu organs, or from diarrhea and dysentery that damage the Spleen and Stomach Qi, or from alternating chills and fever with malaria, where excessive thirst leads to over-drinking, causing dampness to infiltrate the Spleen and Stomach, resulting in edema of the head, face, hands, and feet. However, if water-dampness infiltrates the Bao Organ (uterus) before the fetus has fully formed, the fetus is often damaged; thus, if swelling occurs immediately upon conception, urgent regulation and treatment are required. Once the water-dampness is eliminated and the swelling subsides, Liu Jun Zi Tang (Six Gentlemen Decoction) should still be used for tonification.

"Zi Zhong" refers to puffy swelling of the face and eyes during pregnancy, often caused by deficiency of Spleen-Stomach Qi or chronic diarrhea. The appropriate treatment is to invigorate the Spleen and promote urination to resolve dampness, primarily using Quan Sheng Bai Zhu San (All-Generating Atractylodes Macrocephala Powder), or alternatively Jian Pi Li Shui Tang (Spleen-Strengthening Water-Draining Decoction).

"Zi Qi" refers to the gradual swelling of the dorsum of both feet extending to the knees and thighs, or swelling below the waist, occurring after three months of gestation when the fetus is formed. It may cause difficulty walking, panting, chest oppression, restlessness, poor appetite, and symptoms resembling water-gas disease; in severe cases, yellow fluid may exude from between the toes. This is because the Spleen governs the four limbs; when Spleen Qi is weak, it fails to control water metabolism, leading to edema. Additionally, Lung Metal lacks nourishment from its mother element (Earth/Spleen), resulting in shortness of breath and chest fullness. Various medical texts call this condition "Zi Qi," which is equivalent to water-gas disease. To treat this, first administer Jia Wei Tian Xian Teng San (Modified Aristolochia Vine Powder). If ineffective, then use Fu Ling Tang (Poria Cocos Decoction); if still ineffective, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) added with Fu Ling (Poria Cocos). When a pregnant woman reaches eight or nine months and her calves and legs swell, this is not comparable to water-gas disease and should not be treated as such, as doing so would damage healthy Qi. Those with this condition will likely have easier childbirth because there is abundant water and blood in the Bao Organ, preventing fetal dryness.

"Zi Man" refers to urgent abdominal distension and abnormal abdominal enlargement, or generalized edema with indistinct boundaries between the chest and hypochondrium, accompanied by rebellious Qi and restlessness, and difficult urination, occurring at five or six months of pregnancy. It is called "Zi Man" or unfavorable fetal water. If not treated early, the newborn may suffer from soft, short, and deformed limbs, or even intrauterine fetal death. The appropriate treatment is to use Qian Jin Li Yu Tang (Thousand Gold Carp Decoction) from *Qian Jin Fang* to treat the water-dampness.

Quan Sheng Bai Zhu San: Treats puffy swelling of the face and eyes during pregnancy, resembling edematous distension.
Ingredients: Bai Zhu (Atractylodis Macrocephalae Rhizoma, 1 liang, stir-fried with soil), Sheng Jiang Pi (Zingiberis Officinalis Pericarpium), Da Fu Pi (Arecae Pericarpium, processed with bean juice until clean), Fu Ling (Poria Cocos), Chen Pi (Citri Reticulatae Pericarpium) (each 5 qian).
Grind into powder. Take 2 qian each time, mixed with rice water.

Jia Wei Tian Xian Teng San: Treats swelling of the waist and feet in pregnant women; this condition is common in individuals with deficient constitutions.
Ingredients: Tian Xian Teng (Aristolochiae Manshuriensis Caulis, i.e., Qing Mu Xiang Teng, washed and slightly stir-fried), Zhi Xiang Fu (Cyperi Rhizoma preparatum), Zi Su (Perillae Fructus) (each 6 fen), Chen Pi (4 fen), Wu Yao (Linderae Radix) (5 fen), Mu Xiang (Aucklandiae Radix) (2 fen), Jiang Pi (3 slices).
For deficient constitutions, add Ren Shen (Ginseng Radix et Rhizoma, 1 qian), Tu Chao Bai Zhu (2 qian), and Jiu Xi Dang Gui (Angelicae Sinensis Radix, wine-washed, 2 qian), or concurrently take Bu Zhong Yi Qi Tang.

Fu Ling Tang: Treats swollen feet and difficulty walking starting from the sixth or seventh month of pregnancy, with yellow fluid exuding from between the toes. This is named "Zi Qi" and is common among many people. The swelling usually resolves spontaneously after delivery. For severe cases, this decoction is indicated.
Ingredients: Bai Fu Ling (Poria Cocos), Tu Chao Bai Zhu (Atractylodis Macrocephalae Rhizoma, stir-fried with soil), Chen Pi, Zhi Xiang Fu, Wu Yao (each 1 qian), Zi Su (Perillae Fructus, including stems and leaves), Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma preparatum) (each 5 fen), Mu Gua (Chaenomelis Fructus) (3 slices).

Qian Jin Li Yu Tang: Treats chest and abdominal distension or generalized edema with difficult urination during pregnancy, named "Zi Man." It addresses unfavorable fetal water or accumulation of water in the Bao Organ, which can lead to fetal death in utero.
Ingredients: Bai Zhu (5 qian, stir-fried with soil), Bai Fu Ling (Poria Cocos, 4 qian), Dang Gui Shen (Angelicae Sinensis Radix, wine-washed, 3 qian), Bai Shao (Paeoniae Radix Alba, 2 qian), one live carp weighing 2 jin.
Remove scales and entrails from the carp. Add a small amount of Ju Pi (Citri Reticulatae Pericarpium) or 5 fen, and 7 slices of Sheng Jiang. Simmer in water to obtain 1.5 zhan of broth. Remove the fish. Add the four medicinal ingredients to the fish broth and decoct until reduced to 0.7 zhan. Take warm on an empty stomach. Prepare the dregs again as previously described.