陈良甫曰∶胎气壅塞成湿，致身体、胁腹浮肿，喘急气促，小便涩。法当疏壅气，行水湿，泽泻散主之。
《济阴纲目》按∶子满在五六月以后，比子气与子肿不同。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。
《金匮要略》曰∶妊娠有水气，身重，小便不利，洒淅恶寒，起即头眩，葵子茯苓散主之。
徐忠可曰∶有水气者，虽未大肿胀，经脉中之水道已不利，卫气挟水，不能条畅，则周身之气为水滞，故
身重。水已通调而顺行，逆则小便不利矣。恶寒者，卫气不行也。头眩者，内有水气，厥阳之火逆阴气而上蒸，
则所见皆眩矣。
薛立斋曰∶前证若胸满腹胀，小便不通，遍身浮肿，《千金》鲤鱼汤。脾胃虚弱，佐以四君子。若面目
虚浮，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，补中汤加茯苓。若饮食失节，呕
吐泄泻，六君子汤。若腿足发肿，喘闷不宁，或指缝出水，天仙藤散。若脾肺气滞，加味归脾汤，佐加味逍
遥散。
慎斋按∶以上八条，序胎前肿胀有子满之证也。子满有水血相抟，有停水受湿，有经血壅闭，有清浊不分。
总因脾土虚，不能制水所致。故立斋治法，不外健脾渗湿，顺气安胎为主。若《济阴》云，但一泻气利水
则愈，此谬论也。必兼立斋用药，乃为求本之要。至良甫以下三条，虽有胎水之名，其证实与子满异名同证也。
陈良甫说：胎气壅塞导致湿气内生，致使身体、胁肋和腹部浮肿，气喘急促，小便涩滞不畅。治疗法则应当疏通壅滞之气，行利水湿，以泽泻散为主方。
《济阴纲目》按语：子满（妊娠五六月后出现腹大异常、遍身浮肿的病证）发生在怀孕五个月以后，与子气（妊娠期间因气机阻滞引起的肢体肿胀）和子肿（妊娠期间肢体面目浮肿的病证）不同。因为胎儿长大则腹部胀满，腹满则气机浮越，导致遍身浮肿，邪气没有依附之处，只要通过泻气利水的方法就能痊愈。
《金匮要略》说：妊娠期间有水气停留，身体沉重，小便不利，怕冷如洒冷水般战栗，起身时即感到头晕目眩，以葵子茯苓散为主方。
徐忠可说：所谓有水气，虽然尚未出现严重肿胀，但经脉中的水道已经不通利，卫气挟带水湿，不能条达通畅，因此周身的气机被水湿停滞所困，所以身体沉重。如果水液能够通调并顺行，若逆乱则导致小便不利。恶寒是因为卫气运行不畅。头晕目眩是因为体内有水气，厥阳之火逆乱阴气而上蒸，所以看到的景象都显得眩晕。
薛立斋说：上述症状如果伴有胸满腹胀，小便不通，遍身浮肿，用《千金方》的鲤鱼汤。如果是脾胃虚弱，配合使用四君子汤。如果是面目虚浮，肢体像有水气一样，用全生白术散；如果无效，用六君子汤。如果是脾虚湿热，下部浮肿，用补中益气汤加茯苓。如果是饮食不节制，呕吐泄泻，用六君子汤。如果是腿足发肿，喘闷不安，或者指缝间渗出水液，用天仙藤散。如果是脾肺气滞，用加味归脾汤，配合加味逍遥散。
慎斋按语：以上八条，叙述了胎前肿胀中有子满这一证型。子满有水血相搏结，有停水受湿，有经血壅闭，有清浊不分。总的原因是脾土虚弱，不能制约水湿所致。所以薛立斋的治疗方法，不外乎健脾渗湿，顺气安胎为主。如果像《济阴纲目》所说，只要泻气利水就能痊愈，这是错误的言论。必须结合薛立斋的用药方法，才是治本的关键。至于陈良甫以下的三条，虽然有胎水的名称，但其病证实质是与子满异名同证。
Chen Liangfu stated: Fetal qi stagnation leads to dampness accumulation, resulting in edema of the body, hypochondrium, and abdomen, panting with shortness of breath, and astringent, difficult urination. The treatment principle should be to unblock stagnant qi and promote water metabolism, primarily using Zexie San (Alisma Powder).
The *Ji Yin Gang Mu* commentary notes: Zi Man (a condition characterized by excessive abdominal distension and generalized edema occurring after the fifth month of pregnancy) occurs after the fifth or sixth month of pregnancy, differing from Zi Qi (pregnancy-related edema due to qi stagnation) and Zi Zhong (pregnancy-related swelling of limbs and face). This is because as the fetus grows, the abdomen becomes full; fullness causes qi to float upward, leading to generalized edema where pathogenic factors have no specific locus. Simply resolving qi stagnation and promoting diuresis will lead to recovery.
The *Jin Gui Yao Lue* states: In pregnancy, when there is water qi retention, symptoms include heaviness of the body, difficult urination, chills resembling cold water being splashed on the skin, and dizziness upon rising. The primary formula is Kuizi Fuling San (Abelmoschus Seed and Poria Powder).
Xu Zhongke explained: When there is water qi, although severe swelling may not yet be present, the water pathways within the meridians are already obstructed. Wei qi (defensive qi) carries water dampness and cannot flow smoothly, causing the qi of the entire body to be stagnant due to water retention, hence the heaviness of the body. If water flows freely and smoothly, but if it regurgitates, it leads to difficult urination. Chills occur because Wei qi does not circulate properly. Dizziness occurs because internal water qi causes Jue Yang fire to rebel against Yin qi and steam upwards, causing visual disturbances and dizziness.
Xue Lizhai stated: For the aforementioned symptoms, if accompanied by chest fullness and abdominal distension, inability to urinate, and generalized edema, use Likou Tang (Carp Decoction) from the *Qian Jin Fang*. If there is Spleen-Stomach deficiency, combine with Sijunzi Tang (Four Gentlemen Decoction). If there is puffy edema of the face and eyes, and limbs feeling like they hold water, use Quansheng Baizhu San (Quansheng Atractylodes Macrocephala Powder); 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) with added Fuling (Poria). If caused by irregular diet leading to vomiting and diarrhea, use Liujunzi Tang. If legs and feet swell, accompanied by panting, oppression, restlessness, or fluid oozing from between fingers/toes, use Tianxianteng San (Aristolochia Vine Powder). If there is Spleen-Lung qi stagnation, use Jiawei Guipi Tang (Modified Restore the Spleen Decoction), assisted by Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder).
Shen Zhai commented: The above eight points describe the syndrome of Zi Man within the context of pre-partum swelling. Zi Man involves entanglement of water and blood, retained water due to dampness, closure of menstrual blood, and confusion of clear and turbid qi. The root cause is always Spleen Earth deficiency, failing to control water. Therefore, Xue Lizhai’s treatment methods focus primarily on invigorating the Spleen, leaching out dampness, smoothing qi, and calming the fetus. To claim, as the *Ji Yin Gang Mu* does, that simply purging qi and promoting diuresis cures the condition, is a fallacy. One must incorporate Xue Lizhai’s medication strategies to address the root cause. As for the following three points by Chen Liangfu, although named "fetal water," their clinical reality is identical to Zi Man under different names.