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Shen Yaofeng stated: When a pregnant woman's abdomen is excessively distended, or the entire body, hands, feet, face, and eyes are edematous, the disease is named "Zi Man" (Fetal Fullness), or alternatively "Zi Zhong" (Fetal Edema), "Zi Qi" (Fetal Qi), "Tai Shui" (Fetal Water), or "Liuli Tai" (Glazed Fetus). If only the two feet are swollen, it may be called "Zhou Jiao" (Wrinkled Feet) or "Cui Jiao" (Brittle Feet). Although there are many names, they essentially fall into two categories: tangible "Water Disease" (Shui Bing, pathogenic water accumulation) and intangible "Qi Disease" (Qi Bing, qi stagnation). Why? Because the fetus obstructs the zang-fu organs, causing the mechanism of movement to become unresponsive. The Kidney serves as the gatekeeper for the Stomach; if this gate fails to function properly, water accumulates; or if the Spleen cannot distribute essence to the Lung; or if the Lung cannot distribute fluid essence throughout the body—these constitute tangible Water Diseases. Furthermore, with an additional entity in the abdomen, the pathway for the ascending and descending of Great Qi becomes blocked, which constitutes an intangible Qi Disease. In diseases involving tangible water, symptoms must include thin, white, and shiny skin; in diseases involving intangible qi, symptoms must include thick skin with unchanged color. This explanation is found in the *Neijing·Zhang Lun* (Treatise on Distension), and careful study will clarify it. There is also a syndrome of Phlegm Stagnation; although phlegm belongs to the category of water, it condenses into a dense substance that does not spread throughout the skin but rather obstructs the airway, preventing qi from circulating smoothly, thereby causing swelling. Since the skin color remains unchanged, qi-regulating herbs are ineffective, but adding phlegm-resolving agents naturally yields efficacy.

Xu Aihui stated: The *Lingshu·Shui Zhang Lun* (Treatise on Water Distension in the Spirit Pivot) states: When water retention begins, the eye sockets swell slightly, resembling the appearance after just waking up; the neck pulse beats visibly; there is occasional coughing; the inner thighs feel cold; the calves swell; and the abdomen enlarges, indicating that water pathology has already formed. Pressing the abdomen with the hand causes it to rise immediately, resembling a bag wrapped around water; this is its sign. For "Fu Zhang" (Skin Distension), cold pathogen lodges between the skin layers; pressing it feels soft and non-rigid, the abdomen is large and the whole body swells, the skin is thick, pressing the abdomen leaves an indentation that does not rebound, and the abdominal color remains unchanged; this is its sign. My commentary notes that since Fu Zhang is described as having "thick skin and unchanged color," it can be inferred that Water Distension involves "thin skin and changed color." For reference.

*Qianjin* Carp Decoction (Liyu Tang): Treats pregnancy abdominal distension and fullness, or generalized edema, with red and scanty urination.

Shen Yaofeng stated: This formula treats tangible Water Disease, focusing primarily on abdominal distension and fullness. The addition of "or" before "body edema and difficult urination" indicates these symptoms may or may not be present, and do not need to coexist completely.

Chen Liangfu stated: By the fifth or sixth month of pregnancy, the abdomen becomes abnormally large due to water accumulation in the uterus, named "Tai Shui" (Fetal Water). If not treated early, fetal death is feared. Alternatively, the child may be born with soft and short limbs. *Qianjin* Carp Decoction is suitable. Carp enters the Kidney channel and is a living, active creature; it acts as a minister herb alongside Poria (Fuling), Atractylodes (Baizhu), Ginger (Shengjiang), and Tangerine Peel (Jupi) to directly reach the uterus and remove water; fearing that removing water might weaken the fetus, Angelica (Danggui) and White Peony Root (Baishao) are added as assistants to nourish the fetus. It is truly a miraculous formula.

Herbs: Dang Gui (Angelica Sinensis Root), Bai Shao (White Peony Root) (each 1 qian), Fu Ling (Poria), Bai Zhu (Atractylodes Macrocephala Rhizome) (2 qian), Ju Pi Hong (Red Tangerine Peel) (0.5 qian), Carp (one fish, scales and entrails removed).
Preparation: As one dose, boil in plain water until cooked, remove the fish, take 1.5 liang of the broth, add three slices of fresh ginger, decoct until reduced to one liang, and take on an empty stomach. Fetal water will then discharge. If abdominal stuffiness is not fully resolved, prepare another dose.

*Jingui* Hibiscus Seed and Poria Decoction (Kuizi Fuling Tang): Treats pregnancy with water qi, heavy body, difficult urination, aversion to cold with shivering, and dizziness upon rising.

Shen Yaofeng stated: This is a slippery and lubricating preparation, also treating tangible Water Disease.

Herbs: Kuizi (Abelmoschus esculentus Seeds/Hibiscus Seeds) (1 jin), Fu Ling (Poria) (3 qian).
Preparation: Grind into powder, take one fangcun bi (a square-inch measure) with warm water, three times daily. Recovery occurs when urination becomes smooth.

Tianxianteng San (Polygonum Vine Powder): Treats conditions occurring after conception at three months of pregnancy, where swelling gradually spreads from the dorsum of the feet to the knees, making walking difficult, accompanied by panting, chest oppression, and poor appetite, resembling water qi, or even yellow fluid oozing from between the toes, known as "Zi Qi" (Fetal Qi). This formula was created by Chen Jingchu, a famous physician in Huainan during the Yuanfeng era. Originally named Xiangfu San, it was renamed Tianxian Teng San by Li Boshi.

Shen Yaofeng stated: This is a qi-regulating formula. Swelling spreading from the foot dorsum to the knees, along with yellow fluid from the toes, indicates a syndrome involving both water and qi, and cannot be immediately classified solely as a Qi Disease. Only when the skin is thick and the color is unchanged is it a pure Qi Disease, for which this formula is appropriate.

Herbs: Tian Xian Teng (Polygonum Aviculare Herba, i.e., Aristolochia Manshuriensis Radix/Qingmuxiang, washed and lightly roasted), Xiang Fu (Cyperi Rhizoma, stir-fried), Chen Pi (Citrus Reticulatae Pericarpium), Gan Cao (Glycyrrhizae Radix et Rhizoma), Wu Yao (Linderae Radix), Mu Xiang (Aucklandiae Radix).
Preparation: Equal parts, grind into coarse powder. Take 5 qian per dose, add three slices of fresh ginger and five leaves of Perilla (Zisu), decoct in water, three times daily. Discontinue medication when swelling subsides.

Qi Zhongfu stated: Foot swelling appearing in the eighth or ninth month of pregnancy requires no treatment and indicates easier delivery, because there is abundant amniotic fluid, preventing the drying of the fetus. However, if swelling occurs immediately upon conception, it indicates excessive water qi while the fetus is not yet formed, risking fetal damage.

Foot swelling indicates a male fetus. The Young Prince of Song went incognito, accompanied by Xu Wenbo. They saw a pregnant woman unable to walk. The Prince palpated her pulse and said, "This is a female fetus." Wenbo diagnosed, "This is a male fetus; if located on the left, the fetal complexion will be black." The Prince was angered and wished to abort it. Wenbo pityingly said, "Allow me to treat it with acupuncture." He supplemented Hegu (LI4) and drained Sanyinjiao (SP6). The fetus was delivered immediately, revealing a male infant with dark complexion.

Case record of Xue Lizhai: A pregnant woman suffered from abdominal distension, difficult urination, and vomiting. Various physicians administered mixed prescriptions for warming the stomach and moving qi, but she vomited more severely, and the distension worsened, pressing against the heart. Examination revealed the fetus had been dead for a long time. Medications to expel the dead fetus failed to work, so *Qianjin* Carp Decoction was used. His discussion stated: Generalized edema and fullness in a pregnant woman, or urgent distension in the chest and heart, is named "Tai Shui" (Fetal Water). Observing that this patient's chest and abdomen were indistinguishable, he urgently prescribed three to five doses of Carp Decoction. Both urine and stool discharged foul water, the swelling subsided, and the distension cleared, allowing for the delivery of the dead fetus. This condition likely arose because the enlarged abdomen of pregnancy was disregarded, ultimately leading to fetal injury. How can one not be cautious!