（子满证，即俗呼胎水证也。）
妊娠子肿，与子气相类，但子气在下体，子肿在头面。若子满证，又名为胎水，则在五六月以后，比
子气、子肿不同。盖胎大则腹满，遍身浮肿。凡子气、子肿、子满，由脏气本弱，或因泄泻下利，耗伤脾胃，
或寒热疟疾，烦渴加饮，湿渍脾胃，使头面手足浮肿也。然水渍于胞，儿未成形，则胎多损坏。故初妊
即肿，急宜调治，水去胀消，仍用六君子调补。
所谓子肿者，妊娠面目虚浮，多因脾胃气虚或久泻所致，宜健脾利水，全生白
术散主之，或用健脾利水汤。如未应，用六君子汤，或加腹皮、车前。又专治肢体
如水气之证。亦有用加味五皮汤治子肿之甚者。
所谓子气者，妊娠自三月成胎之后，两足面渐肿至腿膝，或腰以下肿，行步艰难，以致喘闷不宁，
饮食不美，似水气状，甚至脚趾间有黄水出者。盖脾主四肢，脾气虚弱不能制水而发肿，肺金少母气滋
养而气促满闷，诸书名曰子气，即水气，俗名皱脚。治此病者，先服加味天仙藤散，如不效，则服
茯苓汤，再不效，服补中益气汤加茯苓。若饮食失节，呕吐泄泻，六君子汤，或加炮姜、木香、香
附。若脾肺气滞，加味归脾汤，佐以加味逍遥散或紫苏饮。至孕妇八九个月，胫腿俱肿，非水气比，不
可以水气治之，反伤正气。凡有此者，必易产，因胞脏中水血俱多，不致胎燥也。
所谓子满者，妊娠至五六个月，胸腹急胀，腹大异常，或遍身浮肿，胸胁不分，气逆不安，小便艰
涩，名曰子满，又为胎水不利。若不早治，生子手足软短有疾，甚至胎死腹中，宜服千金鲤鱼汤
治其水。如脾虚不运，清浊不分，佐以四君、五皮，亦有用束胎饮以治子满证，甚效。曾有妊娠腹胀，
服鲤鱼汤三五剂，大小便皆下恶
水，肿消胀去，遂下死胎。此证每因怀孕腹大，终不知胎水之患，即水渍损胎也。
全生白术散 治妊娠面目虚浮，如水肿胀。
白术（一两，土炒） 生姜皮 大腹皮（豆汁制净） 茯苓皮 陈皮（各五钱）
共为细末，每服二钱，不拘时，米饮调下。此方较澹寮五皮散稍善，中间惟白术易桑皮，
而功用悬殊，诚点铁成金手也。《全书》云∶如未应，佐以人参、甘草。
健脾利水汤 治孕妇面目虚浮，多因脾胃气虚或久泻所致。
人参 茯苓（各一钱。一方用皮） 白术（土炒） 当归（酒洗。各二钱） 川芎 大腹皮（黑
豆水制净） 紫苏 陈皮（各八分） 炙草（三分）
姜皮一片，水煎服。
加味五皮汤 治孕妇面目、身体、四肢浮肿者。此胎水泛溢，谓之子肿。（澹寮五皮散无
白术，有陈皮。治病后浮肿，小便不利。）
大腹皮（黑豆水制净） 桑白皮（炒） 生姜皮 茯苓皮（用赤） 白术（土炒） 加紫苏（
连茎叶。各一钱）
枣二枚，去核，水煎服。服时以木香磨浓汁三匙入药内。
加味天仙藤散 治孕妇腰脚肿，虚人多有此证。
天仙藤（即青木香藤，洗，略炒） 制香附 紫苏（各六分） 陈皮（四分） 乌药（五分） 木香（二分）
姜皮三片，虚人加人参一钱，土炒白术二钱，酒洗当归二钱，或兼服补中益气汤。
茯苓汤 治孕妇六七个月以来两足肿大，行步艰难，脚趾间有黄水出，此名子气，
人多有之，生子之后其肿自消。甚者此汤主之。
白茯苓 白术（土炒） 陈皮 制香附 乌药（各一钱） 紫苏（连茎叶） 炙草（各五分） 木
瓜（三片）
生姜皮引，水煎空心服。
千金鲤鱼汤 治孕妇胸腹胀满，或遍身浮肿，小便艰涩，名曰子满。又为胎水不利，
或胞中渍水，以致胎死腹中。
白术（五钱，土炒） 白茯苓（四钱） 当归身（三钱，酒洗） 白芍（二钱） 鲤鱼（一尾，重二斤，要活的）
将鱼去鳞、肠，加橘皮少许或五分，姜七片，用水扣汤煮，取汁一盏半，去鱼，入药四味鱼汁
内，煎七分，空心温服。渣再制如前。如脾胃气虚，当佐以四君、五皮二汤，合煎服之。
局方五皮汤 治风湿客脾，面目四肢浮肿。兼治胎水。
五加皮 地骨皮 大腹皮（黑豆水制净） 茯苓皮 生姜皮（各等分）
水煎服，每服三钱。
束胎饮 治孕妇至七八个月，其胎长大，腹大胀满，逼迫子户，坐卧不安，谓之子满。
白术（土炒） 黄芩（酒炒） 苏叶（各一钱五分） 枳壳（麸炒） 大腹皮（黑豆水制
净。各一钱） 砂仁（五分，连壳略炒） 炙草（三分）
姜三片，水煎空心服。予谓苏叶，当易茎妙。
六君子汤 补中益气汤（俱见本卷诸痛门。） 加味归脾汤（见本卷胞漏小产门，附归
脾汤下。） 加味逍遥散（见本卷子悬门，附逍遥散下。） 紫苏饮（见本卷安胎门。）
四君子汤（见本卷子悬门。）
妊娠期间出现子肿，与子气症状相似，但子气主要发生在身体下部，而子肿主要发生在头面部。至于子满证，又被称为胎水，通常出现在怀孕五到六个月之后，这与子气、子肿有所不同。因为胎儿长大导致腹部胀满，全身浮肿。凡是子气、子肿、子满，都是由于脏腑之气原本虚弱，或者因为腹泻下利，耗伤了脾胃之气；或者是寒热疟疾，烦渴时大量饮水，湿气浸渍脾胃，从而导致头面手足浮肿。然而，如果水湿浸渍于胞宫，胎儿尚未成形，则胎儿大多会受损。所以如果在刚怀孕时就出现浮肿，应当紧急调理治疗，待水湿去除、肿胀消退后，仍需用六君子汤进行调补。
所谓的子肿，是指妊娠期间面目虚浮，多因脾胃气虚或长期腹泻所致，适宜健脾利水，主方用全生白术散，或者使用健脾利水汤。如果效果不明显，可用六君子汤，或者加入大腹皮、车前子。这也是专门治疗肢体像水气病一样的证候。也有用加味五皮汤来治疗严重的子肿。
所谓的子气，是指妊娠在三个月成胎之后，双脚脚背逐渐肿胀直到腿膝，或者腰部以下肿胀，行走困难，以致气喘胸闷不安，饮食不佳，症状像水气病一样，甚至脚趾间有黄水流出。这是因为脾主四肢，脾气虚弱不能制约水湿而引发肿胀；肺金缺乏母气（脾土）的滋养而导致气促胸闷，各医书称之为子气，即水气，民间俗称皱脚。治疗此病，先服用加味天仙藤散，如果无效，则服用茯苓汤，再无效，服用补中益气汤加茯苓。如果因饮食不节导致呕吐泄泻，用六君子汤，或者加入炮姜、木香、香附。如果是脾肺气滞，用加味归脾汤，配合加味逍遥散或紫苏饮。到了孕妇八九个月时，小腿和腿部都肿胀，这不是水气病，不可以按水气病治疗，否则会反伤正气。凡是有这种情况的，必定容易生产，因为胞宫中水和血都多，不会导致胎儿干燥。
所谓的子满，是指妊娠到五六个月时，胸腹部急迫胀满，腹部异常增大，或者全身浮肿，胸胁部位界限不清，气逆不安，小便艰涩，称为子满，也称为胎水不利。如果不尽早治疗，生下的孩子可能手足软弱短小且有疾病，甚至胎死腹中，适宜服用千金鲤鱼汤来治水湿。如果因脾虚运化无力，清浊不分，可配合四君子汤、五皮散，也有用束胎饮来治疗子满证的，效果很好。曾经有孕妇腹胀，服用鲤鱼汤三五剂后，大小便都排出恶臭的水液，肿胀消退，随后排出了死胎。这个病症往往因为怀孕后腹部变大，最终不知道是胎水为患，也就是水湿浸渍损伤了胎儿。
全生白术散：治疗妊娠面目虚浮，像水肿胀满。
白术（一两，土炒） 生姜皮 大腹皮（豆汁制净） 茯苓皮 陈皮（各五钱）
共研为细末，每次服用二钱，不限时间，用米汤调服。此方比澹寮五皮散稍好，其中只是将白术替换了桑白皮，但功效相差悬殊，真是点铁成金的妙手。《全书》说：如果效果不明显，配合人参、甘草。
健脾利水汤：治疗孕妇面目虚浮，多因脾胃气虚或长期腹泻所致。
人参 茯苓（各一钱。一方用茯苓皮） 白术（土炒） 当归（酒洗。各二钱） 川芎 大腹皮（黑豆水制净） 紫苏 陈皮（各八分） 炙甘草（三分）
加生姜皮一片，水煎服。
加味五皮汤：治疗孕妇面目、身体、四肢浮肿者。这是胎水泛溢，称为子肿。（澹寮五皮散没有白术，有陈皮。治疗病后浮肿，小便不利。）
大腹皮（黑豆水制净） 桑白皮（炒） 生姜皮 茯苓皮（用赤茯苓皮） 白术（土炒） 加紫苏（连茎叶。各一钱）
大枣二枚，去核，水煎服。服药时将木香磨成浓汁三匙加入药液中。
加味天仙藤散：治疗孕妇腰脚肿，体虚的人多有此证。
天仙藤（即青木香藤，洗净，略炒） 制香附 紫苏（各六分） 陈皮（四分） 乌药（五分） 木香（二分）
加生姜皮三片，体虚者加人参一钱，土炒白术二钱，酒洗当归二钱，或者兼服补中益气汤。
茯苓汤：治疗孕妇六七个月以来两足肿大，行走困难，脚趾间有黄水流出，这名叫子气，很多人都有，生孩子后其肿自消。严重的用此汤主治。
白茯苓 白术（土炒） 陈皮 制香附 乌药（各一钱） 紫苏（连茎叶） 炙甘草（各五分） 木瓜（三片）
以生姜皮为引，水煎空腹服。
千金鲤鱼汤：治疗孕妇胸腹胀满，或全身浮肿，小便艰涩，名叫子满。也是胎水不利，或者胞中积水，导致胎死腹中。
白术（五钱，土炒） 白茯苓（四钱） 当归身（三钱，酒洗） 白芍（二钱） 鲤鱼（一条，重二斤，要活的）
将鱼去鳞、肠，加少许橘皮或五分，姜七片，用水炖煮，取汁一盏半，去掉鱼，将四味药放入鱼汁中，煎至七分，空腹温服。药渣再按前法制作。如果脾胃气虚，应当配合四君子汤、五皮散两方，合煎服用。
局方五皮汤：治疗风湿客犯脾脏，面目四肢浮肿。兼治胎水。
五加皮 地骨皮 大腹皮（黑豆水制净） 茯苓皮 生姜皮（各等分）
水煎服，每次服用三钱。
束胎饮：治疗孕妇到七八个月时，胎儿长大，腹部胀满，逼迫子宫，坐卧不安，这叫子满。
白术（土炒） 黄芩（酒炒） 苏叶（各一钱五分） 枳壳（麸炒） 大腹皮（黑豆水制净。各一钱） 砂仁（五分，连壳略炒） 炙甘草（三分）
加姜三片，水煎空腹服。我认为苏叶，改用苏梗更好。
六君子汤 补中益气汤（均见本卷诸痛门。） 加味归脾汤（见本卷胞漏小产门，附归脾汤下。） 加味逍遥散（见本卷子悬门，附逍遥散下。） 紫苏饮（见本卷安胎门。） 四君子汤（见本卷子悬门。）
(Ziman man syndrome, also commonly known as fetal water syndrome.)
Zi zhong (pregnancy edema) during pregnancy is similar to Zi qi (pregnancy swelling of the lower limbs), but Zi qi occurs in the lower body, whereas Zi zhong occurs on the head and face. As for Ziman man syndrome, also called Tai shui (fetal water), it typically appears after the fifth or sixth month of pregnancy, differing from Zi qi and Zi zhong. This is because the enlarging fetus causes abdominal fullness and generalized edema. The etiologies of Zi qi, Zi zhong, and Ziman man are all rooted in inherent weakness of the zang-fu qi, or damage to the Spleen and Stomach due to diarrhea and dysentery; or dampness infiltrating the Spleen and Stomach caused by excessive drinking during febrile diseases with aversion to cold and heat, polyopia, and thirst. Consequently, this leads to edema of the head, face, hands, and feet. However, if fluid infiltrates the uterus before the fetus has formed, the fetus is often damaged. Therefore, if edema occurs immediately upon conception, urgent regulation and treatment are required. Once the fluid is eliminated and swelling subsides, Liu Jun Zi Tang (Six Gentlemen Decoction) should still be used for tonification.
The so-called Zi zhong refers to puffy swelling of the face and eyes during pregnancy, often caused by Qi deficiency of the Spleen and Stomach or chronic diarrhea. It is appropriate to invigorate the Spleen and promote urination to leach out dampness, primarily using Quan Sheng Bai Zhu San (Complete Life Atractylodes Powder) or Jian Pi Li Shui Tang (Spleen-Strengthening Water-Draining Decoction). If there is no response, use Liu Jun Zi Tang, or add Da Fu Pi (Areca Peel) and Che Qian Zi (Plantago Seed). This formula is specifically indicated for limb edema resembling water-dampness pathology. In severe cases of Zi zhong, Jia Wei Wu Pi Tang (Modified Five Barks Decoction) may also be used.
The so-called Zi qi refers to gradual swelling of the dorsum of both feet extending to the knees and legs, or swelling below the waist, occurring after the third month of pregnancy when the fetus is formed. It causes difficulty in walking, panting, chest oppression, restlessness, poor appetite, and symptoms resembling water-dampness disease. In severe cases, yellow fluid may exude from between the toes. Since the Spleen governs the four limbs, Spleen Qi deficiency fails to control water metabolism, leading to swelling. The Lung Metal lacks nourishment from its mother element (Earth/Spleen), resulting in shortness of breath and chest fullness. Medical texts call this Zi qi, which is equivalent to water-dampness disease, commonly known as Zhou jiao (wrinkled foot). Treatment begins with Jia Wei Tian Xian Teng San (Modified Aristolochia Vine Powder). If ineffective, use Fu Ling Tang (Poria Decoction); if still ineffective, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) added with Fu Ling (Poria). If irregular diet causes vomiting and diarrhea, use Liu Jun Zi Tang, possibly added with Pao Jiang (Prepared Ginger), Mu Xiang (Aucklandia Root), and Xiang Fu (Cyperus Rhizome). For Spleen and Lung Qi stagnation, use Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction), assisted by Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) or Zi Su Yin (Perilla Infusion). By the eighth or ninth month of pregnancy, if the calves and legs are swollen, this is not water-dampness disease and should not be treated as such, lest healthy Qi be injured. Such cases usually result in easy delivery because the abundance of water and blood in the uterus prevents fetal dryness.
The so-called Ziman man refers to urgent abdominal distension and abnormal abdominal enlargement, or generalized edema with indistinct boundaries between the chest and hypochondrium, accompanied by rebellious Qi, discomfort, and difficult urination, appearing at five or six months of pregnancy. It is named Ziman man or Tai shui bu li (ineffective fetal water). If not treated early, the newborn may have soft, short, or deformed limbs, or even intrauterine fetal death. One should administer Qian Jin Li Yu Tang (Thousand Gold Carp Decoction) to treat the water retention. If Spleen deficiency leads to failure of transportation and transformation, causing confusion of clear and turbid substances, assist with Si Jun Zi Tang (Four Gentlemen Decoction) and Wu Pi Tang (Five Barks Decoction). Shu Tai Yin (Fetus-Binding Infusion) is also effective for Ziman man. There was a case of a pregnant woman with abdominal distension who took three to five doses of Li Yu Tang, passing foul-smelling fluid through stool and urine, after which the swelling and distension subsided, followed by the expulsion of a dead fetus. This condition is often overlooked due to the enlarged abdomen of pregnancy, failing to recognize that fetal water infiltration damages the fetus.
Quan Sheng Bai Zhu San: Treats puffy swelling of the face and eyes in pregnancy, resembling edema.
Bai Zhu (Atractylodis Macrocephalae Rhizoma, 1 liang, stir-baked with soil), Sheng Jiang Pi (Zingiberis Recens Cortex), Da Fu Pi (Arecae Pericarpium, cleaned with bean juice), Fu Ling Pi (Poriae Cortex), Chen Pi (Citri Reticulatae Pericarpium, each 5 qian).
Grind into fine powder. Take 2 qian each time, at any time, mixed with rice water. This formula is slightly superior to Dan Liao Wu Pi San (Dan Liao Five Barks Powder); the key difference is replacing Sang Bai Pi (Mori Cortex) with Bai Zhu, resulting in vastly different efficacy—a true touch of gold. *Quan Shu* states: If ineffective, assist with Ren Shen (Ginseng Radix) and Gan Cao (Licorice Radix).
Jian Pi Li Shui Tang: Treats puffy swelling of the face and eyes in pregnant women, often caused by Spleen-Stomach Qi deficiency or chronic diarrhea.
Ren Shen (Ginseng Radix), Fu Ling (Poria, each 1 qian; one prescription uses Fu Ling Pi), Bai Zhu (Atractylodis Macrocephalae Rhizoma, stir-baked with soil), Dang Gui (Angelicae Sinensis Radix, wine-washed, each 2 qian), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Da Fu Pi (Arecae Pericarpium, cleaned with black bean water), Zi Su (Perillae Folium), Chen Pi (Citri Reticulatae Pericarpium, each 8 fen), Zhi Cao (Prepared Glycyrrhizae Radix et Rhizoma, 3 fen).
Add one slice of Sheng Jiang Pi (Zingiberis Recens Cortex), decoct in water, and take orally.
Jia Wei Wu Pi Tang: Treats edema of the face, body, and limbs in pregnant women. This is fetal water overflowing, termed Zi zhong. (Dan Liao Wu Pi San lacks Bai Zhu but contains Chen Pi; it treats post-illness edema with difficult urination.)
Da Fu Pi (Arecae Pericarpium, cleaned with black bean water), Sang Bai Pi (Mori Cortex, stir-fried), Sheng Jiang Pi (Zingiberis Recens Cortex), Fu Ling Pi (Poriae Cortex, use red Poria), Bai Zhu (Atractylodis Macrocephalae Rhizoma, stir-baked with soil), plus Zi Su (Perillae Folium with stems and leaves, each 1 qian).
Add two Jujubae Fructus (Ziziphi Jujubae Fructus), pitted. Decoct in water and take orally. When taking, mix in 3 spoons of thick Mu Xiang (Aucklandiae Radix) paste.
Jia Wei Tian Xian Teng San: Treats swelling of the waist and feet in pregnant women; common in deficient individuals.
Tian Xian Teng (Aristolochiae Vine Stem, washed, lightly stir-fried), Zhi Xiang Fu (Cyperi Rhizoma prepared), Zi Su (Perillae Folium, each 6 fen), Chen Pi (Citri Reticulatae Pericarpium, 4 fen), Wu Yao (Linderae Radix, 5 fen), Mu Xiang (Aucklandiae Radix, 2 fen).
Add three slices of Sheng Jiang Pi (Zingiberis Recens Cortex). For deficient persons, add Ren Shen (Ginseng Radix, 1 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma, stir-baked with soil, 2 qian), Dang Gui (Angelicae Sinensis Radix, wine-washed, 2 qian), or concurrently take Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction).
Fu Ling Tang: Treats significant swelling of both feet starting from the sixth or seventh month of pregnancy, difficulty walking, and yellow fluid exuding from toes. This is named Zi qi. Many experience this, and the swelling resolves spontaneously after childbirth. Severe cases are treated with this decoction.
Bai Fu Ling (Poria, white), Bai Zhu (Atractylodis Macrocephalae Rhizoma, stir-baked with soil), Chen Pi (Citri Reticulatae Pericarpium), Zhi Xiang Fu (Cyperi Rhizoma prepared), Wu Yao (Linderae Radix, each 1 qian), Zi Su (Perillae Folium with stems and leaves), Zhi Cao (Prepared Glycyrrhizae Radix et Rhizoma, each 5 fen), Mu Gua (Chaenomelis Fructus, 3 slices).
Use Sheng Jiang Pi (Zingiberis Recens Cortex) as a guide. Decoct in water and take on an empty stomach.
Qian Jin Li Yu Tang: Treats chest and abdominal fullness, or generalized edema, and difficult urination in pregnant women, named Ziman man. It addresses ineffective fetal water or water infiltration in the uterus leading to intrauterine fetal death.
Bai Zhu (Atractylodis Macrocephalae Rhizoma, 5 qian, stir-baked with soil), Bai Fu Ling (Poria, white, 4 qian), Dang Gui Shen (Angelicae Sinensis Radix root end, 3 qian, wine-washed), Bai Shao (Paeoniae Radix Alba, 2 qian), Li Yu (Cyprinus Carpio, one live fish weighing 2 jin).
Remove scales and entrails from the fish. Add a small amount of Ju Pi (Citri Reticulatae Pericarpium, approx. 5 fen) and seven slices of Jiang (Zingiberis Rhizoma). Simmer in water to obtain 1.5 cups of broth. Remove the fish. Add the four herbal medicines to the fish broth and decoct until reduced to 0.7 parts. Take warm on an empty stomach. Repeat the residue preparation as before. If Spleen-Stomach Qi is deficient, assist with Si Jun Zi Tang (Four Gentlemen Decoction) and Wu Pi Tang (Five Barks Decoction), decocted together.
Ju Fang Wu Pi Tang: Treats wind-dampness invading the Spleen, causing edema of the face and limbs. Also treats fetal water.
Wu Jia Pi (Acanthopanacis Cortex), Di Gu Pi (Lycii Cortex), Da Fu Pi (Arecae Pericarpium, cleaned with black bean water), Fu Ling Pi (Poriae Cortex), Sheng Jiang Pi (Zingiberis Recens Cortex, equal parts).
Decoct in water and take orally, 3 qian per dose.
Shu Tai Yin: Treats pregnant women at seven or eight months whose growing fetus causes abdominal distension, pressing on the uterus, leading to restlessness in sitting and lying down. This is called Ziman man.
Bai Zhu (Atractylodis Macrocephalae Rhizoma, stir-baked with soil), Huang Qin (Scutellariae Radix, wine-stir-fried), Su Ye (Perillae Folium, each 1.5 qian), Zhi Ke (Aurantii Fructus, bran-stir-fried), Da Fu Pi (Arecae Pericarpium, cleaned with black bean water, each 1 qian), Sha Ren (Amomi Fructus, 5 fen, lightly stir-fried with shell), Zhi Cao (Prepared Glycyrrhizae Radix et Rhizoma, 3 fen).
Add three slices of Jiang (Zingiberis Rhizoma). Decoct in water and take on an empty stomach. I suggest substituting Su Ye (Perillae Folium) with Su Geng (Perillae Caulis) for better effect.
Liu Jun Zi Tang (Six Gentlemen Decoction), Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) (both see "Various Pain Section" in this volume). Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction) (see "Uterine Bleeding and Miscarriage Section" in this volume, attached under Gui Pi Tang). Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) (see "Upper Abdominal Distension Section" in this volume, attached under Xiao Yao San). Zi Su Yin (Perilla Infusion) (see "Fetus-Calming Section" in this volume). Si Jun Zi Tang (Four Gentlemen Decoction) (see "Upper Abdominal Distension Section" in this volume).