(又名子气、子满、胎水)
妊娠妇人,常有面目腿足肿胀,故有各肿之名,其实皆由脾土不足以传化水谷之湿,而胞胎壅遏,膀胱不
化,水泛横流,致肺气不降而喘息,小便淋漓不利,古方用鲤鱼汤、葵茯汤、白术散,皆有妙处。予每用五皮饮,
如水肿之治,亦多验。盖一体水症也,此方简而易,不已再用鲤鱼汤,惟参术不宜早补,补则填塞不通,总宜
利湿为先。如体浓者,或轻而小便利者,亦可不必治,待生子后而自消矣。此皆以体而言,不致胀满难过。
鲤鱼汤
白术(四两) 生姜(一两) 茯苓(四两) 当归(二两) 白芍(二两) 鲤鱼(一尾重斤)
先以水煮鲤鱼取汁,澄清,以汁煎药,分五次服。
葵茯汤
冬葵子(半斤,炒) 茯苓(三两)
共为末,每米饮汤,服三钱。
白术散
土炒白术(一钱五分) 茯苓(一钱五分) 泽泻(八分) 陈皮(五分) 姜皮(五分) 大腹皮(一钱
二分) 木香(三分)
原方无分两。
加味五皮饮
桑白皮(一钱五分) 大腹皮(一钱五分,此味只可治胎肿,常见治水肿者,服之愈大,须慎用) 茯苓
皮(一钱五分) 新会皮(一钱五分) 紫苏梗(一钱五分) 车前子(一钱五分) 老姜皮(八分) 五加
皮(一钱五分)
二三剂后再加白术、茯苓,消去大半,然后再用六君子汤,补其脾气,亦宜食淡,淡以渗利也。
(Sub-swelling, also known as Zi Qi, Zi Man, or Tai Shui)
Pregnant women often experience swelling of the face, eyes, legs, and feet, hence various names for such swellings. In essence, all these conditions arise from the insufficiency of Spleen Earth (the digestive system's transformative function) to transport and transform the dampness generated from food and fluids. This leads to obstruction within the fetus sac, impaired transformation in the Bladder, and rampant flooding of water. Consequently, Lung Qi fails to descend, resulting in panting, and urination becomes dribbling and difficult. Ancient prescriptions utilize Liyu Tang (Carp Decoction), Kuifu Tang (Abelmoschus Seeds and Poria Decoction), and Baizhu San (Atractylodes Macrocephala Powder), all of which have excellent effects. I frequently use Wupi Yin (Five Peel Decoction), treating it similarly to edema, and it is often effective. Since this is fundamentally a disorder of water metabolism, this formula is simple and easy to apply; thus, Liyu Tang is no longer repeatedly used. However, tonics like Ginseng and Atractylodes should not be administered too early, as tonification can cause blockage and stagnation. The general principle should prioritize promoting diuresis and resolving dampness. If the patient has a robust physique, or if the swelling is mild with normal urination, treatment may not be necessary, as it will resolve spontaneously after childbirth. These remarks apply to cases where there is no sensation of distension or discomfort.
Liyu Tang (Carp Decoction)
Baizhu (Atractylodis Macrocephalae Rhizoma) (4 liang)
Shengjiang (Zingiberis Recens Rhizoma) (1 liang)
Fuling (Poria) (4 liang)
Danggui (Angelicae Sinensis Radix) (2 liang)
Baishao (Paeoniae Radix Alba) (2 liang)
Li Yu (Cyprini Carpio) (one carp weighing 1 jin)
First, boil the carp in water to extract the broth, clarify it, and then decoct the herbs in this broth. Divide into five doses for administration.
Kuifu Tang (Abelmoschus Seeds and Poria Decoction)
Dongkuizi (Abelmoschi Semen) (0.5 jin, stir-fried)
Fuling (Poria) (3 liang)
Grind together into powder. Take 3 qian each time, washed down with rice soup.
Baizhu San (Atractylodes Macrocephala Powder)
Tu Chao Baizhu (Soil-stir-fried Atractylodis Macrocephalae Rhizoma) (1.5 qian)
Fuling (Poria) (1.5 qian)
Zexie (Alismatis Rhizoma) (0.8 qian)
Chenpi (Citri Reticulatae Pericarpium) (0.5 qian)
Jiang Pi (Zingiberis Pericarpium) (0.5 qian)
Dafupi (Arecae Pericarpium) (1.2 qian)
Muxiang (Aucklandiae Radix) (0.3 qian)
The original prescription does not specify dosages.
Jiawei Wupi Yin (Modified Five Peel Decoction)
Sangbaipi (Mori Cortex) (1.5 qian)
Dafupi (Arecae Pericarpium) (1.5 qian; this herb is only suitable for treating fetal swelling. It is commonly observed that patients with edema taking this herb experience worsening symptoms, so it must be used with caution.)
Fuling Pi (Poria Cum Ligno Bark) (1.5 qian)
Xinhui Pi (Citri Reticulatae Pericarpium Rubrum) (1.5 qian)
Zisugeng (Perillae Caulis) (1.5 qian)
Cheqianzi (Plantaginis Semen) (1.5 qian)
Lao Jiang Pi (Old Zingiberis Pericarpium) (0.8 qian)
Wujia Pi (Acanthopanacis Cortex) (1.5 qian)
After two or three doses, add Baizhu (Atractylodis Macrocephalae Rhizoma) and Fuling (Poria). Once the swelling has reduced by more than half, subsequently administer Liu Junzi Tang (Six Gentlemen Decoction) to tonify Spleen Qi. The diet should also be bland, as a bland flavor promotes leaching out dampness.