【歌】子肿脾虚面目浮，风行水泛湿停留，关门不利从其类，散表分消疾自瘳。
【论】脾主肌肉，土气安和则能制水，水自传化无有停积。
若脾胃气虚，经血壅闭则水饮不化，湿气泛溢，外攻形体，内注胞胎，始娠肿满，儿未成实，必伤胎气。若临月
而肿，利小便自愈。
薛立斋曰∶子肿，胸腹胀满，小便不利，通身浮肿者，鲤鱼汤。脾胃虚弱，四君子汤。面目浮肿，肢体如水
气，全生白术散，未应，六君子汤。若脾虚湿热，下部作肿，补中益气汤加茯苓。若饮食失节，呕吐泄泻，香砂
六君子汤。若脾虚血少，气滞，加味归脾汤。脚肿，陈景初天仙藤散。
【方】
白术散
白术 茯苓 陈皮 大腹皮 桑白皮 姜皮
一方去白术加木香米汤服三钱。
木通散
木通 香茹 苏叶（各二钱） 枳壳 黄芩（各一钱） 大腹皮（一钱） 木香 诃子皮（各五分）
生姜皮 砂仁
水煎服。
单 方
山栀一合，炒为末，米饮调下，治妊娠通身浮肿。
【歌】胀满心胸气不舒，要分虚实漫踌躇，风邪水搏多因实，病后而成又属虚。
【论】《产宝》曰∶妊娠经血壅闭养胎，或挟水气，水血相搏致令肿满，皆由脾胃虚弱，不能制水，名曰
子满。若水停不去，浸渍入胎，则令胎坏。诊其脉浮、腹胀、喘息者，胎必坏也。泽泻散。妊娠心静气和则胎自
安稳，若中风寒，邪气或有触犯，则随邪生病。如经血壅闭养胎，忽然胸腹虚肿胀闷，是胎中挟水，脾主肌肉，
肌肉空虚，水气泛滥，故令身肿。然其由或因泄泻下利，虚损脾胃，或因内热烦渴，引饮太过，或因关门不利，
小便涩少，湿渍脾胃，皆致肿满，大抵生于五六月之间。盖胎大则腹满而气浮矣。
【方】
泽泻散
泽泻 枳壳 茯苓 木通 大腹皮 桑白皮 姜皮
加砂仁水煎服。
防己汤
桑白皮 防己 茯苓 紫苏 木香 砂仁
姜水煎。
白术散
白术（一两炒焦） 陈皮 姜皮 大腹皮（各五钱）
为末，米饮调二钱。
【歌诀】子肿（妊娠肿胀）因脾虚导致面目浮肿，风邪行水泛溢、湿气停留所致；若肾之关门不利，病势随其同类发展，通过发散表邪、分消水湿，疾病自然痊愈。
【论述】脾主肌肉，土气安和则能制约水液，水液自然传化而无停积。
如果脾胃气虚，经血壅闭则水饮不化，湿气泛溢，外攻形体，内注胞胎，怀孕后即出现肿满，胎儿尚未成熟，必然损伤胎气。若在临产前才出现肿胀，通利小便即可自愈。
薛立斋说：子肿，表现为胸腹胀满，小便不利，全身浮肿者，用鲤鱼汤。脾胃虚弱者，用四君子汤。面目浮肿，肢体如水肿状，用全生白术散，无效时，用六君子汤。若是脾虚湿热，下部作肿，用补中益气汤加茯苓。若是饮食失节，呕吐泄泻，用香砂六君子汤。若是脾虚血少，气滞，用加味归脾汤。脚肿，用陈景初的天仙藤散。
【方剂】
白术散
白术 茯苓 陈皮 大腹皮 桑白皮 姜皮
另一法去掉白术加木香，米汤送服三钱。
木通散
木通 香茹 苏叶（各二钱） 枳壳 黄芩（各一钱） 大腹皮（一钱） 木香 诃子皮（各五分）
生姜皮 砂仁
水煎服。
单方
山栀一合，炒为末，米饮调下，治妊娠通身浮肿。
【歌诀】胀满心胸气机不畅，要分辨虚实犹豫不决，风邪与水搏结多因实证，病后而成又属虚证。
【论述】《产宝》说：妊娠期间经血壅闭以养胎，或挟带水气，水血相搏导致肿满，皆由脾胃虚弱，不能制约水液，名为子满（妊娠腹大异常）。如果水液停聚不去，浸渍入胎，则会导致胎坏。诊察其脉浮、腹胀、喘息者，胎儿必然死亡。用泽泻散。妊娠期间心静气和则胎儿自安稳，若中风寒，邪气或有触犯，则随邪气生病。如经血壅闭养胎，忽然胸腹虚肿胀闷，是胎中挟水，脾主肌肉，肌肉空虚，水气泛滥，所以令身体肿胀。然而其原因或因泄泻下利，虚损脾胃，或因内热烦渴，饮水过多，或因关门不利，小便涩少，湿渍脾胃，都导致肿满，大多发生在五六月之间。大概因为胎儿长大则腹满而气浮了。
【方剂】
泽泻散
泽泻 枳壳 茯苓 木通 大腹皮 桑白皮 姜皮
加砂仁水煎服。
防己汤
桑白皮 防己 茯苓 紫苏 木香 砂仁
姜水煎。
白术散
白术（一两炒焦） 陈皮 姜皮 大腹皮（各五钱）
研为末，米饮调二钱。
[Song] Zi Zhong (pregnancy edema) is caused by Spleen deficiency leading to facial and ocular swelling; it results from Wind pathogen moving water, flooding and retention of Dampness. If the "gate" of the Kidney fails to function properly, the disease follows its similar nature; by releasing the exterior and dispersing/consuming water-dampness, the illness will naturally heal.
[Discussion] The Spleen governs muscles. When Earth Qi is harmonious, it can control Water, allowing Water fluids to transform and circulate without stagnation.
If Spleen and Stomach Qi are deficient, menstrual blood becomes stagnant and closed, causing fluid retention not to transform. Dampness overflows, attacking the exterior body and infiltrating the fetal sac internally. Swelling and fullness occur immediately after conception. Since the fetus is not yet mature, this inevitably damages the fetal Qi. If swelling occurs only near term, promoting urination will lead to self-healing.
Xue Lizhai stated: For Zi Zhong presenting with chest and abdominal distension, difficulty in urination, and generalized edema, use Liyu Tang (Carp Decoction). For Spleen and Stomach weakness, use Sijunzi Tang (Four Gentlemen Decoction). For facial and ocular swelling, with limbs resembling edema, use Quansheng Baizhu San (Baizhu Powder for Pregnancy); if ineffective, use Liujunzi Tang (Six Gentlemen Decoction). If there is 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 irregular diet causes vomiting and diarrhea, use Xiangsha Liujunzi Tang (Aucklandia and Amomum Six Gentlemen Decoction). If Spleen deficiency leads to Blood insufficiency and Qi stagnation, use Jiawei Guipi Tang (Modified Guipi Decoction). For foot swelling, use Chen Jingchu's Tianxian Teng San (Tianxian Teng Powder).
[Formulas]
Baizhu San (Baizhu Powder)
Baizhu (Atractylodis Rhizoma), Fuling (Poria), Chenpi (Citri Reticulatae Pericarpium), Dafupi (Arecae Pericarpium), Sangbaipi (Mori Cortex), Jiangpi (Zingiberis Pericarpium).
Alternative prescription: Remove Baizhu, add Muxiang (Aucklandiae Radix), take three qian with rice broth.
Mutong San (Mutong Powder)
Mutong (Akebiae Caulis), Xiangru (Agastaches Herba), Ziyè (Perillae Folium) (each 2 qian), Zhike (Aurantii Fructus Immaturus), Huangqin (Scutellariae Radix) (each 1 qian), Dafupi (Arecae Pericarpium) (1 qian), Muxiang (Aucklandiae Radix), Hezizi Pi (Terminaliae Chebulae Pericarpium) (each 5 fen), Shengjiangpi (Zingiberis Pericarpium), Sharen (Amomi Fructus Rotundus).
Decoct in water and take orally.
Single Prescription
Zhizi (Gardeniae Fructus) one he, stir-fried and powdered, taken with rice drink, treats generalized edema during pregnancy.
[Song] Distension and fullness in the chest and heart with constrained Qi require distinguishing between Excess and Deficiency patterns. Wind pathogen combing with Water often indicates an Excess pattern, while conditions arising post-illness indicate a Deficiency pattern.
[Discussion] *Chanbao* states: During pregnancy, menstrual blood is retained to nourish the fetus. If accompanied by Water Qi, Water and Blood interact causing swelling and fullness. This is due to Spleen and Stomach weakness failing to control Water, named Zi Man (abdominal distension in pregnancy). If Water stagnates and penetrates into the fetus, it causes fetal demise. If the pulse is floating, with abdominal distension and panting, the fetus will certainly die. Use Zexie San (Alisma Powder). When the pregnant woman’s mind is calm and Qi is harmonious, the fetus remains stable. If struck by Wind-Cold, pathogens may invade, causing illness following the pathogen. If menstrual blood is retained to nourish the fetus, and suddenly there is empty distension and stuffiness in the chest and abdomen, it indicates Water retained within the fetus. The Spleen governs muscles; when muscles are empty, Water Qi floods, causing body swelling. Causes include diarrhea or dysentery damaging Spleen and Stomach, internal heat and thirst leading to excessive drinking, or failure of the "gate" resulting in scanty, difficult urination, where Dampness impregnates the Spleen and Stomach. All lead to swelling and fullness, mostly occurring between the fifth and sixth months. Generally, as the fetus grows large, the abdomen becomes full and Qi floats upward.
[Formulas]
Zexie San (Alisma Powder)
Zexie (Alismatis Rhizoma), Zhike (Aurantii Fructus Immaturus), Fuling (Poria), Mutong (Akebiae Caulis), Dafupi (Arecae Pericarpium), Sangbaipi (Mori Cortex), Jiangpi (Zingiberis Pericarpium).
Add Sharen (Amomi Fructus Rotundus), decoct in water and take orally.
Fangji Tang (Stephania Decoction)
Sangbaipi (Mori Cortex), Fangji (Stephaniae Tetrandrae Radix), Fuling (Poria), Zisu (Perillae Folium), Muxiang (Aucklandiae Radix), Sharen (Amomi Fructus Rotundus).
Decoct with ginger water.
Baizhu San (Baizhu Powder)
Baizhu (Atractylodis Rhizoma) (one liang, stir-fried until scorched), Chenpi (Citri Reticulatae Pericarpium), Jiangpi (Zingiberis Pericarpium), Dafupi (Arecae Pericarpium) (each five qian).
Grind into powder, take two qian mixed with rice drink.