陈良甫曰∶凡妊娠无使气极,若心静气和,则胎气安稳。若中风寒邪气,及有触犯,则随邪生病。如妊娠
经血壅闭养胎,忽然虚肿,是胎中挟水,水血相抟。脾胃恶湿,主身之肌肉,湿渍气弱,则肌肉虚,水气流溢,
故令身肿满。然其由,或因泄泻下痢,脏腑虚滑,耗损脾胃。或因寒热疟疾,烦渴引饮太过,湿渍脾胃,皆使
头面手足浮肿。然水清于胞,儿未成形,则胎多损坏。
齐仲甫曰∶妊娠以经血养胎,或挟水气,水血相抟,以致体肿。皆由脾胃虚,而脏腑之间,宿有停水所挟,
谓之子满。若水停不去,浸渍其胎,则令胎坏。如脉浮腹满兼喘者,胎未坏也。
《圣济总录》曰∶脾候肌肉,土气和则能制水,水自传化,无有停积。若妊娠脾胃气虚,经血壅闭,则水
饮不化,湿气淫溢,外攻形体,内注胞胎。怀妊之始,肿满必伤胎气,如临月而脚微肿,利其小便,病自愈。
何松庵曰∶妊娠三月后,肿满如水气者,俗呼为琉璃胎是也。古方一主于湿,大率脾虚者多。脾虚不运,
则清浊不分,须以补脾兼分利。若夜肿日消,是血虚,宜健脾兼养血主之。
陈良甫曰∶妇人胎孕至五六个月,腹大异常,胸腹胀满,手足面目浮肿,气逆不安,此由胞中蓄水,名曰胎水。
不早治,生子手
足软短有疾,或胎死腹中,用《千金》鲤鱼汤治其水。
陈良甫说:凡是妊娠期间,不要让情绪激动到极点。如果心境平静、气息平和,那么胎气就会安稳。如果感受了中风寒邪气,或者有触犯禁忌的情况,就会随着邪气而生病。比如妊娠期间经血闭阻以滋养胎儿,突然发生虚肿,这是胎中挟带水湿,水与血相互搏结。脾胃厌恶湿气,主管身体的肌肉,湿气浸渍导致气机虚弱,则肌肉变得松弛无力,水流之气外溢,所以导致身体浮肿胀满。然而其成因,可能是因为泄泻下痢,脏腑虚弱滑脱,耗损了脾胃;或者因为寒热疟疾,烦渴饮水过多,湿气浸渍脾胃,都会导致头面手足浮肿。如果水液清澈地停留在胞宫,胎儿尚未成形,那么胎儿大多会受损。
齐仲甫说:妊娠依靠经血来滋养胎儿,如果挟带水气,水与血相互搏结,导致身体浮肿。这都是由于脾胃虚弱,而在脏腑之间,素有停积的水湿所挟制,称为“子满”。如果水湿停留不去,浸渍胎儿,就会导致胎儿损坏。如果脉象浮、腹部胀满兼有气喘的,说明胎儿尚未损坏。
《圣济总录》说:脾脏候应肌肉,土气平和则能制约水湿,水液自然传输转化,不会有停积。如果妊娠期间脾胃气虚,经血闭阻,则水饮不能化生,湿气淫溢,向外攻冲形体,向内注入胞胎。怀孕之初,如果肿满严重必定损伤胎气,如果是临近分娩时脚部轻微浮肿,通利小便,病自然会痊愈。
何松庵说:妊娠三个月以后,肿满像有水气的情况,俗称为“琉璃胎”。古方主要侧重于祛湿,大率是脾虚者居多。脾虚不能运化,则清浊不分,需要用补脾兼分利水湿的方法治疗。如果是夜间肿胀白天消退,这是血虚,应当用健脾兼养血的方法为主治疗。
陈良甫说:妇人怀孕到五六个月,腹部异常增大,胸腹胀满,手足面目浮肿,气逆不安,这是由于胞中蓄水,名叫“胎水”。如果不早治疗,生下的孩子手脚软弱短小且有疾病,或者胎死腹中,使用《千金》鲤鱼汤来治疗水湿。
Chen Liangfu stated: During pregnancy, one should avoid extreme emotional agitation. If the mind is calm and the qi is harmonious, the fetal qi will be stable. If exposed to wind-cold pathogenic factors or if taboos are violated, illness will arise following the pathogen. For instance, during pregnancy, when menstrual blood is closed off to nourish the fetus, sudden flaccid swelling occurs; this indicates that water-dampness is carried within the fetus, with water and blood struggling against each other. The Spleen and Stomach dislike dampness and govern the muscles of the body. When dampness infiltrates and weakens the qi, the muscles become flaccid, and fluid qi overflows, causing general edema and distension. However, the causes may include diarrhea or dysentery leading to deficiency and slipping of the zang-fu organs, thereby depleting the Spleen and Stomach; or chills and fever from malaria, excessive thirst and drinking, which cause dampness to infiltrate the Spleen and Stomach. All these result in edema of the head, face, hands, and feet. If clear fluid accumulates in the uterus while the fetus has not yet formed, the fetus is likely to be damaged.
Qi Zhongfu stated: Pregnancy relies on menstrual blood to nourish the fetus. If it carries water-qi, with water and blood struggling, it leads to bodily swelling. This is all due to Spleen-Stomach deficiency, where stagnant water previously retained among the zang-fu organs is exacerbated, a condition termed "Zi Man" (Fetal Fullness). If the stagnant water remains and infiltrates the fetus, it causes fetal damage. If the pulse is floating, the abdomen is full, and there is accompanied panting, the fetus has not yet been damaged.
The *Shengji Zonglu* states: The spleen corresponds to the muscles. When earth qi is harmonious, it can control water, allowing water to circulate and transform without stagnation. If during pregnancy the qi of the Spleen and Stomach is deficient and menstrual blood is obstructed, then water-drinkings fail to transform, and dampness overflows. It attacks the exterior form and penetrates inward to the gestational sac. At the beginning of pregnancy, severe swelling and fullness will inevitably injure the fetal qi. However, if only slight swelling of the feet occurs near term, promoting urination will lead to spontaneous recovery.
He Song'an stated: After the third month of pregnancy, swelling and fullness resembling water accumulation is commonly known as "Liuli Tai" (Glazed Fetus). Ancient formulas primarily focus on resolving dampness, mostly occurring in cases of Spleen deficiency. When the Spleen is deficient and fails to transport, clear and turbid substances are not separated; treatment requires tonifying the Spleen combined with draining dampness. If swelling occurs at night and subsides during the day, it indicates Blood deficiency, and treatment should prioritize tonifying the Spleen and nourishing the Blood.
Chen Liangfu stated: When a woman reaches five or six months of pregnancy, the abdomen becomes abnormally large, with chest and abdominal distension, and edema of the hands, feet, face, and eyes, accompanied by rebellious qi and discomfort. This is caused by water accumulation in the uterus, named "Tai Shui" (Fetal Water). If not treated early, the child born may have soft, short limbs and diseases, or the fetus may die in the womb. Use the *Qianjin* Carp Decoction (*Liyu Tang*) to treat the water accumulation.