产宝论曰∶妊娠肿满，由脏气本弱，因妊重虚，土不克水，血散于四肢，遂致腹胀，手足
面目皆浮肿，小便秘涩。陈无择云∶凡妇人宿有风寒冷湿，妊娠喜脚肿，俗呼为皱脚。亦有
通身肿满，心腹急胀，名曰胎水。
论曰∶凡妊娠之人，无使气极，若心静气和，则胎气安稳，若中风寒邪气，及有所触犯，
则随邪而生病也。凡妊娠经血壅闭以养胎，若忽然虚肿，乃胎中挟水，水血相搏，脾胃恶湿，
身之肌肉温渍，气弱则肌肉虚，水气流溢，故令身肿满也。然其由有自，或因泄泻下痢，脏
腑虚滑，耗损脾胃，或因寒热疟疾，烦渴引饮太过，湿渍脾胃，皆能使头面或手足浮肿也。
然水渍于胞，儿未成形，则胎多损坏，及临产日，脚微痛者，乃胞脏水少血多，水出于外，故
现微肿，则易生也，宿有寒气，因寒冷所触，故能令腹胀满肿也。
产乳集论曰∶妊娠自三月成胎之后，两足自脚面渐肿腿膝以来，行步艰辛，以至喘闷，
饮食不美，似水气状，至于脚趾间有黄水出者，谓之子气，直至分娩方消。此由妇人素有
风气，或冲任经有血风，未可妄投汤药，亦恐大段甚者，虑将产之际费力，有不测之忧，故
不可不治于未产之前也，古方论中少有言者。元丰中，淮南陈景初，名医也，独有论治此证，
方名初谓之香附散，李伯时名曰天仙藤散也。（子气者，因子而肝脾气阻，土遂不能制水，故
一香附散足以疗之，然不服药亦无害）
薛氏曰∶前证若胸满腹胀，小便不通，遍身浮肿，用鲤鱼汤；脾胃虚弱，佐以四君子；若
面目虚浮，肢体如水气，用全生白术散，如未应，用六君子汤；脾虚湿热，下部作肿，用补中
益气加茯苓，若饮食失宜，呕吐泄泻，用六君子汤；若腿足发肿，喘闷不安，或趾缝出水，用
天仙藤散，脾胃虚弱，兼四君子汤，如未应，用补中益气汤；若脾肺气滞，用加味归脾汤，佐
以加味逍遥散。
白术散 治妊娠面目虚浮，四肢肿如水气，名曰子肿。（子肿与子气相类，然子气在下
体，子肿在头面，须识之）
白术（二钱半） 茯苓皮（一钱半） 陈皮 生姜皮 大腹皮 桑白皮（各一钱）
上锉，水煎服，或为细末，每服三钱，米饮调下。本方去白术名五皮散，或加木香。
木通散 治妊娠身体浮肿，四肢胀急，小便不利。
木通 香薷 紫苏茎叶（各一钱） 枳壳（面炒） 槟榔 条芩（各五分） 木香 诃子皮（各三分）
上锉，加生姜三片，水煎，食前服。
葶苈散 治妊娠遍身洪肿。（补胆泻肺，利大肠）
葶苈子（一两） 白术（五两） 茯苓 桑白皮 郁李仁（各二两）
上为粗末，水六升，煎取二升，分三服，小便利即瘥。
千金鲤鱼汤 治妊娠腹胀满，或浑身浮肿，小便赤涩。
当归 白芍药（各一钱） 白茯苓（一钱半） 白术（二钱） 橘红（五分） 鲤鱼（一尾）
上作一服，将鲤鱼（鲤鱼治怀妊身肿，及胎气不安，煮食又下水气，利小便）去鳞肠，白
水煮熟，去鱼，用汁一盏半，入生姜三片，煎至一盏，空心服，胎水即下。如未尽，腹闷未除，
再合一剂服之。
一方
泽泻 葶苈（各二两） 茯苓 枳壳 白术（各六两）
上锉，以水六升煮取二升半，分温二服。
防己汤 治妊娠脾虚，遍身浮肿，腹胀喘促，小便不利。
防己（一钱半） 桑白皮（炒） 紫苏茎叶 赤茯苓（各二钱） 木香（五分）
上锉一服，加生姜四片，水煎服，如大便不通，加枳壳、槟榔。
泽泻散 治妊娠遍身浮肿，上气喘急，大便不通，小便赤涩，谓之子满。（子满，大都在
五六月以后，病此气与肿不同，盖胎大则腹满，满则气浮，遍身肿，邪无所挟，但一泻气利
水则愈）
泽泻 桑白皮（炒） 木通 枳壳（面炒） 槟榔 赤茯苓（各一钱半）
上锉一服，加生姜五片，水煎服。
天仙藤散 治妊娠自三月成胎之后，两足自脚面渐肿至腿膝，行步艰难，喘闷妨食，
状似水气，甚至足趾间有黄水出者，谓之子气。
天仙藤（洗，略炒，即青木香藤） 香附子（炒） 陈皮 甘草 乌药 木香（各等分，一方作木瓜）
上锉，每服五钱，加生姜三片，紫苏五叶，水煎，日三服，肿消止药。
产宝方 疗妊娠身肿有水气，心腹胀满，小便少。（以下三方，不甚相远，但郁李与白术
补泻不同，黄芩与干姜冷热不同，而旋覆散结痰，杏仁泻肺气，亦略相似，惟在用者审之）
茯苓（四两） 杏仁 槟榔（各三两） 旋复花 郁李仁（各一两）
上为粗末，以水六升煮取二升，去滓，分温三服，小便通即瘥。
崔氏方 疗妊娠体肿有水气，心腹急满。
茯苓 白术（各四两） 旋复花（二两） 杏仁 黄芩（各三两）
上细切，以水七升煮取二升半，分温三服。忌桃、李、雀肉、酢物。
肾着汤 治妊娠腰脚肿。
茯苓 白术（各二钱） 干姜（炮） 甘草（各一钱） 杏仁（一钱半）
上 咀，水煎服。
子和方 治妊娠从脚上至腹肿，小便不
利，微渴。
猪芩五两为末，以热水调服方寸匕，日三服。（即仲景猪芩汤法，而服法更巧）
The *Chanbao Lun* (Treatise on Childbirth and Treasures) states: Swelling and fullness during pregnancy arise from the inherent weakness of the Zang-Fu Qi. Pregnancy exacerbates this deficiency, causing Spleen Earth to fail to control Kidney Water. Blood scatters into the four limbs, leading to abdominal distension, edema of the hands, feet, face, and eyes, along with scanty and difficult urination. Chen Wuyue stated: Whenever women have a history of Wind, Cold, or Damp-Cold pathogens, they often experience swelling in the legs during pregnancy, commonly known as "Zhoujiao" (Wrinkled Feet). There are also cases of generalized swelling and fullness with urgent abdominal distension, termed "Taishui" (Fetal Water).
It is discussed that pregnant women should avoid extreme emotional agitation or Qi stagnation. If the mind is calm and Qi and Blood are harmonious, the Fetal Qi will be stable. However, if one contracts Wind-Cold pathogens or violates dietary/lifestyle taboos, illness will ensue following the pathogen. During pregnancy, menstrual blood is retained to nourish the fetus. If sudden generalized edema occurs, it indicates that water-dampness is harbored within the fetus, where Water and Blood contend. The Spleen-Stomach dislikes dampness; when muscle tissue is soaked by dampness and Qi is weak, the muscles become deficient, allowing water fluids to overflow, resulting in whole-body swelling and fullness. However, the etiology varies. Some cases result from diarrhea or dysentery, causing visceral deficiency and slipping, which depletes the Spleen-Stomach. Others result from cold-heat malaria or excessive drinking due to irritability and thirst, where dampness soaks the Spleen-Stomach. Both can cause edema of the face, head, hands, or feet. Furthermore, if water-dampness soaks the Bao (Uterus) before the fetus has formed, the fetus is likely to be damaged. On the day of delivery, slight pain in the feet indicates that there is less water and more blood in the Bao-Zang; water exits outward, presenting as slight swelling, which facilitates easy delivery. If one has a history of Cold Qi triggered by cold exposure, it causes abdominal distension and swelling.
The *Chanru Ji Lun* (Treatise on Childbirth and Lactation Collection) states: After conception at three months, both feet gradually swell from the dorsum of the foot up to the calves and knees, making walking difficult, accompanied by panting, chest oppression, and poor appetite, resembling Edema Disease. If yellow fluid oozes from between the toes, it is called "Ziqi" (Fetal Qi), which persists until delivery. This condition arises because the woman has a prior history of Wind pathogens or Blood-Wind in the Chong and Ren meridians. One should not recklessly administer decoctions, nor should one ignore severe cases, fearing exhaustion during labor and unforeseen dangers. Therefore, treatment is necessary before delivery, although ancient formulas rarely discuss this. During the Yuanfeng era, Chen Jingchu of Huainan, a renowned physician, specifically discussed treating this syndrome. The formula was initially named "Xiangfu San" (Cyperi Rhizoma Powder) by him, and Li Boshi named it "Tianxianteng San" (Akebiae Caulis Powder). (Ziqi refers to Liver and Spleen Qi obstruction caused by the fetus, preventing Earth from controlling Water; thus, Xiangfu San alone is sufficient for treatment, though abstaining from medication is also harmless.)
Xue stated: For the aforementioned symptoms, if there is chest fullness, abdominal distension, urinary retention, and generalized edema, use Likui Tang (Carp Decoction). If the Spleen-Stomach is weak, combine with Sijunzi Tang (Four Gentlemen Decoction). If the face and eyes are puffy and limbs resemble Edema Disease, use Quansheng Baizhu San (Quansheng Atractylodes Macrocephala Powder); if ineffective, use Liujunzi Tang (Six Gentlemen Decoction). For Spleen deficiency with Damp-Heat causing lower body swelling, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Fuling (Poria). If improper diet leads to vomiting and diarrhea, use Liujunzi Tang. If legs and feet swell with panting, chest oppression, or oozing between toes, use Tianxianteng San; if Spleen-Stomach is weak, combine with Sijunzi Tang; if ineffective, use Buzhong Yiqi Tang. For Spleen-Lung Qi stagnation, use Jiaweigui Pi Tang (Modified Guipi Decoction) combined with Jiawei Xiaoyao San (Modified Free Wanderer Powder).
Baizhu San (Atractylodes Macrocephala Powder): Treats pregnancy with puffy face/eyes and limb edema resembling water, termed "Zizhong" (Fetal Swelling). (Zizhong is similar to Ziqi, but Ziqi affects the lower body while Zizhong affects the head and face; distinguish them carefully.)
Baizhu (Atractylodis Macrocephalae Rhizoma) (2.5 qian), Fulingpi (Poria Cocos Peridium) (1.5 qian), Chenpi (Citri Reticulatae Pericarpium), Shengjiangpi (Zingiberis Officinalis Rhizoma Exsiccatum Peridium), Dafupi (Arecae Coccae Pericarpium), Sangbaipi (Mori Cortex) (each 1 qian).
Chop the herbs, decoct in water, and take orally. Alternatively, grind into fine powder, take 3 qian per dose, mixed with rice water. Removing Baizhu from this formula yields Wupi San (Five Peel Powder); Muguxiang (Aquilariae Lignum Resinatum) may be added.
Mutong San (Akebiae Caulis Powder): Treats pregnancy with whole-body edema, swollen/tight limbs, and difficult urination.
Mutong (Akebiae Caulis), Xiangru (Elsholtziae Herba), Zisujingye (Perillae Caulis et Folium) (each 1 qian), Zhike (Aurantii Fructus Immaturus, stir-fried with flour), Binglang (Arecae Semen), Tiaohuang (Scutellariae Radix) (each 0.5 qian), Muxiang (Aucklandiae Radix), Hezipi (Terminaliae Chebulae Pericarpium) (each 0.3 qian).
Chop the herbs, add 3 slices of fresh ginger, decoct in water, and take before meals.
Tingli San (Descurainiae Semen Powder): Treats pregnancy with massive generalized edema. (Tonifies Gallbladder, purges Lung, benefits Large Intestine.)
Tinglizi (Descurainiae Semen seu Lepidii Semen) (1 liang), Baizhu (Atractylodis Macrocephalae Rhizoma) (5 liang), Fuling (Poria), Sangbaipi (Mori Cortex), Yuliren (Pruni Armeniaci Semium Amarum) (each 2 liang).
Grind into coarse powder, decoct in 6 sheng of water to obtain 2 sheng, divide into three doses. Recovery occurs when urination becomes smooth.
Qianjin Likui Tang (Thousand Golden Carp Decoction): Treats pregnancy with abdominal distension/fullness, generalized edema, and red/scanty urine.
Danggui (Angelicae Sinensis Radix), Baishaoyao (Paeoniae Radix Alba) (each 1 qian), Bai Fuling (Poria Cocos with White Wood) (1.5 qian), Baizhu (Atractylodis Macrocephalae Rhizoma) (2 qian), Juhong (Citri Reticulatae Pericarpium Rubrum) (0.5 qian), Licui (Cyprinus Carpio) (one fish).
Prepare as one dose. Clean the carp (Carp treats pregnancy edema and unstable fetal Qi; cooking and eating it reduces water-dampness and promotes diuresis), remove scales and entrails, boil in plain water until cooked. Remove the fish, retain 1.5 liang of broth. Add 3 slices of fresh ginger, decoct until 1 liang remains. Take on an empty stomach to expel fetal water. If symptoms persist, prepare another dose.
Another Formula:
Zexie (Alismatis Rhizoma), Tingli (Descurainiae Semen seu Lepidii Semen) (each 2 liang), Fuling (Poria), Zhike (Aurantii Fructus Immaturus), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 6 liang).
Chop, decoct in 6 sheng of water to obtain 2.5 sheng, divide into two warm doses.
Fangji Tang (Stephaniae Tetrandrae Decoction): Treats pregnancy Spleen deficiency with generalized edema, abdominal distension, panting, and difficult urination.
Fangji (Stephaniae Tetrandrae Radix) (1.5 qian), Sangbaipi (Mori Cortex, stir-fried), Zisujingye (Perillae Caulis et Folium), Chi Fuling (Poria Cocos with Red Wood) (each 2 qian), Muxiang (Aucklandiae Radix) (0.5 qian).
Chop for one dose, add 4 slices of fresh ginger, decoct in water, and take orally. If constipation exists, add Zhike (Aurantii Fructus Immaturus) and Binglang (Arecae Semen).
Zexie San (Alismatis Rhizoma Powder): Treats pregnancy with generalized edema, upper body panting, constipation, and red/scanty urine, termed "Ziman" (Fetal Fullness). (Ziman usually occurs after the fifth or sixth month. The "Qi" sensation differs from swelling; as the fetus grows, the abdomen fills, causing Qi to float and general edema. With no pathogenic factor to cling to, purging Qi and promoting diuresis cures it.)
Zexie (Alismatis Rhizoma), Sangbaipi (Mori Cortex, stir-fried), Mutong (Akebiae Caulis), Zhike (Aurantii Fructus Immaturus, stir-fried with flour), Binglang (Arecae Semen), Chi Fuling (Poria Cocos with Red Wood) (each 1.5 qian).
Chop for one dose, add 5 slices of fresh ginger, decoct in water, and take orally.
Tianxianteng San (Akebiae Caulis Powder): Treats pregnancy starting from three months post-conception, where feet swell from the dorsum to the calves/knees, making walking difficult, accompanied by panting, chest oppression, poor appetite, resembling Edema Disease, even with yellow fluid oozing from toe webs, termed "Ziqi" (Fetal Qi).
Tianxianteng (Akebiae Caulis, washed and lightly stir-fried, i.e., Qingmuxiangteng), Xiangfuzi (Cyperi Rhizoma, stir-fried), Chenpi (Citri Reticulatae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma), Wuyao (Linderae Radix), Muxiang (Aucklandiae Radix) (equal parts; one version uses Mugua).
Chop, take 5 qian per dose, add 3 slices of fresh ginger and 5 leaves of Perilla, decoct in water, take three times daily. Stop medication once swelling subsides.
Chanbao Fang (Childbirth Treasure Formula): Treats pregnancy edema with water-dampness, heart/abdominal distension/fullness, and scanty urine. (The following three formulas are quite similar. Differences lie in Tonification/Purging of Yuliren vs. Baizhu, and Cold/Hot nature of Huangqin vs. Ganjiang. Xuanfuhua resolves phlegm nodules, Xingren purges Lung Qi; usage requires careful judgment.)
Fuling (Poria) (4 liang), Xingren (Armeniacae Semen Amarum), Binglang (Arecae Semen) (each 3 liang), Xuanfuhua (Inulae Flos), Yuliren (Pruni Armeniaci Semium Amarum) (each 1 liang).
Grind into coarse powder, decoct in 6 sheng of water to obtain 2 sheng, strain, divide into two warm doses. Recovery occurs when urination becomes smooth.
Cui Shi Fang (Master Cui's Formula): Treats pregnancy body edema with water-dampness, urgent heart/abdominal fullness.
Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 4 liang), Xuanfuhua (Inulae Flos) (2 liang), Xingren (Armeniacae Semen Amarum), Huangqin (Scutellariae Radix) (each 3 liang).
Cut finely, decoct in 7 sheng of water to obtain 2.5 sheng, divide into two warm doses. Avoid peaches, plums, sparrow meat, and vinegar.
Shenzhe Tang (Kidney Fixing Decoction): Treats pregnancy edema of waist and feet.
Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 2 qian), Ganjiang (Zingiberis Rhizoma Recens, processed), Gancao (Glycyrrhizae Radix et Rhizoma) (each 1 qian), Xingren (Armeniacae Semen Amarum) (1.5 qian).
Chop, decoct in water, and take orally.
Hezi Fang (Master Hezi's Formula): Treats pregnancy edema extending from feet to abdomen, difficult urination, and slight thirst.
Zhuling (Polyporus) 5 liang ground into powder, mix with hot water, take one fangcunbi (square-inch spoonful) per dose, three times daily. (This is based on Zhang Zhongjing's Zhuling Tang method, but the administration is more ingenious.)