胎间水气,子满体肿者,此由脾胃虚弱,脏腑之间有停水,而挟以妊娠故也。妊娠之人
,经血壅闭,以养于胎。若挟有水气,则水血相搏,水渍于胎,兼伤腑脏。脾胃主身之肌肉
,故气虚弱,肌肉则虚,水气流溢于肌,故令体肿;水渍于胞,则令胎坏。
然妊娠临将产之月而脚微肿者,其产易。所以尔者,胞藏水血俱多,故令易产,而水乘
于外,故微肿,但须将产之月耳。若初任而肿者,是水气过多,儿未成具,故坏胎也。
怀胎脉浮者,必腹满而喘,怀娠为水肿。
漏胞者,谓妊娠数月而经水时下。此由冲脉、任脉虚,不能约制太阳、少阴之经血故也
。冲任之脉,为经脉之海,皆起于胞内。手太阳,小肠脉也;手少阴,心脉也,是二经为表
里,上为乳汁,下为月水。有娠之人,经水所以断者,壅之以养胎,而蓄之为乳汁。冲任气
虚,则胞内泄漏,不能制其经血,故月水时下,京名胞阻。漏血尽,则人毙也。
胎动不安者,多因劳役气力,或触冒冷热,或饮食不适,或居处失宜。轻者止转动不安
,重者便致伤堕。若其母有疾以动胎,治母则胎安;若其胎有不牢固,致动以病母者,治胎
则母瘥。若伤动甚者,候其母,面赤舌青者,儿死母活;母唇口青,口两边沫出者,母子俱
死;母面青舌赤,口中沫出,母死子活。
妊娠期间出现水气停滞,导致腹部胀大、全身浮肿的病症,称为“子满体肿”。这是由于脾胃虚弱,脏腑之间有水液停聚,又兼有妊娠的缘故。怀孕后,经血闭止以滋养胎儿。如果体内兼有水气,则水与血相互搏结,水湿浸渍于胎,同时损伤脏腑。脾主肌肉,胃亦参与肌肉的运化,因此脾气虚弱,肌肉就会松弛无力,水气流溢于肌肤,所以导致身体浮肿;水湿浸渍胞宫,就会导致胎坏。
然而,孕妇临近分娩月份时,脚部轻微浮肿,说明生产容易。之所以这样,是因为此时胞宫内水血俱多,所以易于生产,水气外溢于体表,故见轻微浮肿,但这只需发生在即将分娩的月份即可。如果在怀孕初期就出现浮肿,则是水气过多,胎儿尚未发育成熟,会导致胎坏。
妊娠期间脉象浮的,必定伴有腹部胀满和喘息,这是妊娠水肿的表现。
所谓“漏胞”,是指怀孕数月后,阴道仍有少量出血,如同月经来潮。这是由于冲脉和任脉虚弱,不能制约太阳经和少阴经的经血所致。冲脉和任脉是十二经脉的海,都起于胞宫内部。手太阳小肠经和手少阴心经互为表里,上行化为乳汁,下行化为月经。怀孕后,经血之所以停止,是因为血液被壅滞以滋养胎儿,并蓄积化为乳汁。如果冲任之气虚弱,胞宫内部就会泄漏,无法控制经血,因此月经样出血时下不止,京兆地区称之为“胞阻”。如果漏血不止流尽,人就会死亡。
胎动不安,多因过度劳累耗气,或触犯冷热邪气,或饮食不当,或居住环境不适所致。轻者仅表现为胎动不安,重者则会导致流产堕胎。如果是母亲有病而扰动胎儿,治疗母亲的疾病则胎儿安定;如果是胎儿不牢固,进而导致母亲生病,治疗胎儿则母亲痊愈。如果伤动严重,观察母亲的面色和舌象:若面赤舌青,是儿死母活;若母亲嘴唇和口角发青,口边流出涎沫,是母子双亡;若母亲面色青、舌赤,口中流出涎沫,是母死子活。
Fetal edema with abdominal distension and generalized swelling (Zi Man Ti Zhong) arises from deficiency of the Spleen and Stomach, with fluid retention among the Zang-Fu organs, compounded by pregnancy. During pregnancy, menstrual blood is retained to nourish the fetus. If accompanied by pathogenic water-qi, water and blood contend with each other; water infiltrates the fetus and damages the Zang-Fu organs. The Spleen governs the muscles of the body; thus, when Qi is deficient, the muscles become flaccid, and water flows into the muscle layer, causing generalized swelling. If water infiltrates the uterus (Bao), it leads to fetal demise.
However, if a pregnant woman exhibits slight swelling of the feet in the month approaching delivery, labor will be easy. This is because the uterus contains abundant water and blood, facilitating easy delivery, and the excess water manifests externally as slight swelling. This condition is only considered favorable if it occurs in the final month before delivery. If swelling appears early in pregnancy, it indicates excessive water-qi while the fetus is not yet fully formed, leading to fetal damage.
A floating pulse during pregnancy indicates abdominal fullness and wheezing, signifying pregnancy-related edema.
"Leaking Bao" (Lou Bao) refers to vaginal bleeding occurring months into pregnancy, resembling menstruation. This results from deficiency of the Chong and Ren vessels, which fail to restrain the blood of the Taiyang and Shaoyin meridians. The Chong and Ren vessels are the seas of the twelve meridians and originate within the uterus. The Hand-Taiyang (Small Intestine) and Hand-Shaoyin (Heart) meridians are exterior-interior pairs; their Qi transforms upward into milk and downward into menstrual blood. During pregnancy, menstrual blood ceases because it is retained to nourish the fetus and stored to form milk. When Qi of the Chong and Ren is deficient, leakage occurs in the uterus, failing to control menstrual blood, resulting in intermittent bleeding. In Jingzhao, this is called "Bao Zu." If bleeding continues until exhaustion, death ensues.
Restless fetus (Tai Dong Bu An) is often caused by overexertion, exposure to cold or heat, improper diet, or unsuitable living conditions. Mild cases present only with fetal restlessness, while severe cases result in miscarriage. If maternal illness disturbs the fetus, treating the mother stabilizes the fetus. If fetal instability causes maternal illness, treating the fetus alleviates the mother. In severe trauma, prognosis depends on signs: red face and blue tongue indicate dead fetus and living mother; blue lips and mouth corners with froth at the mouth indicate death of both mother and fetus; blue face and red tongue with froth in the mouth indicate dead mother and living fetus.