10.头面四肢肿子肿, 自膝至足子气名, 肿胀喘满曰子满, 但脚肿者
脆皱称.
【注】头面遍身浮肿, 小水短少者, 属水气为病, 故名曰子肿. 自膝
至足肿, 小水长者, 属湿气为病, 故名曰子气. 遍身俱肿, 腹胀而喘
,在六, 七个月时者, 名曰子满. 但两脚肿而肤厚者, 属湿, 名曰皱
脚.皮薄者, 属水, 名曰脆脚. 大凡水之为病多喘促, 气之为病多胀
满.喘促属肺, 胀满属脾也. 以其人素有水气湿邪, 故受孕有肿满之
证. 儿未成形, 被水浸渍, 其胎每致损坏. 成形尚可调治, 故在五,
六月后有是证者, 多有生育者也.
茯苓导水汤
11.妊娠肿满与子气, 水气湿邪脾肺间, 水气浸胎喘难卧, 湿气伤胎
胀难堪. 均宜茯苓导水治, 香瓜槟腹四苓攒, 桑砂苏陈胀加枳, 腿脚
防己喘葶添.
【注】妊娠水肿胀满, 子气, 皱脚, 脆脚等证, 皆由水气湿邪, 伤于
脾肺为病也. 若水气盛而浸胎, 则必喘而难卧; 若湿气盛而伤胎, 则
胀满难堪. 皆宜用茯苓导水汤治之, 方用木香, 木瓜, 槟榔, 大腹皮
,白术, 茯苓, 猪苓, 泽泻, 桑皮, 砂仁, 苏叶, 陈皮, 以和脾肺而
利水湿. 胀甚者, 加枳壳以破结; 腿脚肿者, 加防己以利下; 湿喘者
,加苦葶苈以泄上水也.
10. 头面和四肢肿胀称为“子肿”，从膝盖到足部肿胀称为“子气”，全身肿胀且伴有气喘、腹部胀满的称为“子满”，仅双脚肿胀的分别称为“脆脚”和“皱脚”。
【注】头面和全身浮肿，小便短少的，属于水气致病，所以名叫“子肿”。从膝盖到足部肿胀，小便通畅的，属于湿气致病，所以名叫“子气”。全身都肿，腹部胀满且气喘，发生在怀孕六、七个月时的，名叫“子满”。仅两脚肿胀且皮肤厚的，属于湿邪，名叫“皱脚”；皮肤薄的，属于水邪，名叫“脆脚”。大凡水邪致病多伴有气喘急促，气邪致病多伴有腹部胀满。气喘急促归属于肺，腹部胀满归属于脾。因为孕妇素来体内有水气和湿邪，所以受孕后出现肿胀满闷的症状。胎儿尚未成形时，被水气浸渍，往往会导致胎损。如果胎儿已经成形尚可调理治疗，所以在怀孕五、六个月后出现这些症状的，大多能够顺利生育。
茯苓导水汤（Poria Decoction for Guiding Water）
11. 妊娠期间的肿胀满闷与子气，是水气与湿邪阻滞于脾肺之间；水气浸淫胎儿导致气喘难以平卧，湿气损伤胎儿导致胀满难以忍受。均适宜用茯苓导水汤治疗，方剂由木香、木瓜、槟榔、大腹皮、白术、茯苓、猪苓、泽泻、桑白皮、砂仁、苏叶、陈皮组成，以调和脾肺并利水祛湿。若胀满严重的，加入枳壳以破气散结；腿脚肿胀的，加入防己以利水消肿；湿盛气喘的，加入苦葶苈以泻上焦之水。
【注】妊娠水肿胀满、子气、皱脚、脆脚等证候，皆因水气湿邪伤害脾肺所致。如果水气旺盛而浸淫胎儿，则必然气喘且难以平卧；如果湿气旺盛而损伤胎儿，则胀满难忍。都适宜使用茯苓导水汤治疗，方中用药包括木香、木瓜、槟榔、大腹皮、白术、茯苓、猪苓、泽泻、桑白皮、砂仁、苏叶、陈皮，用以调和脾肺功能并通利水湿。胀满严重者，加用枳壳以破除气结；腿脚肿胀者，加用防己以利水下行；湿邪重伴气喘者，加用苦葶苈以宣泄上部水饮。
10. Swelling of the head, face, and four limbs is termed *Zi Zhong* (Fetal Edema); swelling from the knees to the feet is termed *Zi Qi* (Fetal Qi Distension); generalized swelling accompanied by panting and abdominal fullness is termed *Zi Man* (Fetal Fullness); swelling limited to the feet is respectively termed *Cui Jiao* (Brittle Foot) or *Zhou Jiao* (Wrinkled Foot).
[Note] Generalized edema of the head, face, and body with scanty urine belongs to water qi pathology, hence named *Zi Zhong*. Swelling from the knees to the feet with normal urine flow belongs to dampness pathology, hence named *Zi Qi*. Generalized swelling, abdominal distension, and panting occurring at six or seven months of pregnancy are named *Zi Man*. Swelling confined to both feet with thick skin belongs to dampness, named *Zhou Jiao*; swelling with thin skin belongs to water, named *Cui Jiao*. Generally, water pathologies often present with panting and shortness of breath, while qi pathologies often present with abdominal distension and fullness. Panting and shortness of breath are associated with the Lung, while abdominal distension and fullness are associated with the Spleen. This occurs because the pregnant 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 qi may cause fetal damage. However, if the fetus has already formed, it can still be regulated and treated; thus, those presenting with these symptoms after five or six months of pregnancy often give birth successfully.
Fuling Dao Shui Tang (Poria Decoction for Guiding Water)
11. In pregnancy, edema, fullness, and *Zi Qi* arise from water qi and dampness pathogens obstructing the Spleen and Lung. When water qi soaks the fetus, it causes panting and difficulty lying down; when dampness damages the fetus, it causes unbearable abdominal distension. All such conditions are suitable for treatment with Fuling Dao Shui Tang. The formula consists of Muxiang (Aucklandiae Radix), Mugua (Chaenomelis Fructus), Binglang (Arecae Semen), Dafupi (Tangerine Peel of the Large Fruit), Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Zhuling (Polyporus), Zexie (Alismatis Rhizoma), Sangbai Pi (Mori Cortex), Sharen (Amomi Fructus), Ziye (Perillae Folium), and Chenpi (Citri Reticulatae Pericarpium), to harmonize the Spleen and Lung and promote diuresis to resolve dampness. For severe distension, add Zhike (Aurantii Fructus Immaturus) to break up stagnation; for leg and foot swelling, add Fangji (Stephaniae Tetrandrae Radix) to promote downward drainage of water; for dampness-induced panting, add Ku Tingli (Semen Lepidii seu Descurainiae) to drain upper jiao water.
[Note] Conditions such as pregnancy edema, abdominal 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 soaks the fetus, there will inevitably be panting and difficulty lying down; if dampness is excessive and damages the fetus, there will be unbearable abdominal distension. All should be treated with Fuling Dao Shui Tang. The prescription uses Muxiang, Mugua, Binglang, Dafupi, Baizhu, Fuling, Zhuling, Zexie, Sangbai Pi, Sharen, Ziye, and Chenpi to harmonize the Spleen and Lung and facilitate the discharge of water and dampness. For severe distension, add Zhike to dissipate nodules; for leg and foot swelling, add Fangji to promote lower urination; for heavy dampness with panting, add Ku Tingli to vent upper water.