(又名子气、子满、胎水)
妊娠妇人,常有面目腿足肿胀,故有各肿之名,其实皆由脾土不足以传化水谷之湿,而胞胎壅遏,膀胱不
化,水泛横流,致肺气不降而喘息,小便淋漓不利,古方用鲤鱼汤、葵茯汤、白术散,皆有妙处。予每用五皮饮,
如水肿之治,亦多验。盖一体水症也,此方简而易,不已再用鲤鱼汤,惟参术不宜早补,补则填塞不通,总宜
利湿为先。如体浓者,或轻而小便利者,亦可不必治,待生子后而自消矣。此皆以体而言,不致胀满难过。
鲤鱼汤
白术(四两) 生姜(一两) 茯苓(四两) 当归(二两) 白芍(二两) 鲤鱼(一尾重斤)
先以水煮鲤鱼取汁,澄清,以汁煎药,分五次服。
葵茯汤
冬葵子(半斤,炒) 茯苓(三两)
共为末,每米饮汤,服三钱。
白术散
土炒白术(一钱五分) 茯苓(一钱五分) 泽泻(八分) 陈皮(五分) 姜皮(五分) 大腹皮(一钱
二分) 木香(三分)
原方无分两。
加味五皮饮
桑白皮(一钱五分) 大腹皮(一钱五分,此味只可治胎肿,常见治水肿者,服之愈大,须慎用) 茯苓
皮(一钱五分) 新会皮(一钱五分) 紫苏梗(一钱五分) 车前子(一钱五分) 老姜皮(八分) 五加
皮(一钱五分)
二三剂后再加白术、茯苓,消去大半,然后再用六君子汤,补其脾气,亦宜食淡,淡以渗利也。
(子肿又名子气、子满、胎水)
妊娠期的妇女,常常出现面部、眼部以及腿部、足部的肿胀,因此有多种关于肿胀的名称。其实这些症状都是由脾土虚弱,不足以运化水谷产生的湿气,导致胞胎壅滞阻碍气机,膀胱气化功能失常,水分泛滥横流所致。这会导致肺气不能肃降而出现喘息,小便淋漓不尽且排尿不畅。古代方书使用鲤鱼汤、葵茯汤、白术散,都有很好的疗效。我平时常用五皮饮,按照治疗水肿的方法来施治,也大多有效。因为本质上都是水液代谢异常的病症,这个方剂简单而容易操作,所以不再重复使用鲤鱼汤。只是参类和白术类药物不宜过早进补,因为补益药会填塞气机导致不通畅,总体原则应当以利湿为先。如果孕妇体质肥胖,或者肿胀轻微且小便通畅的,也可以不必治疗,等待分娩后自然会消退。这些都是针对身体没有胀满难受感觉的情况而言。
鲤鱼汤
白术(四两) 生姜(一两) 茯苓(四两) 当归(二两) 白芍(二两) 鲤鱼(一条,重一斤)
先用清水煮鲤鱼取汁,澄清后,用鱼汁来煎煮药物,分五次服用。
葵茯汤
冬葵子(半斤,炒制) 茯苓(三两)
共同研磨成粉末,每次用米汤送服三钱。
白术散
土炒白术(一钱五分) 茯苓(一钱五分) 泽泻(八分) 陈皮(五分) 姜皮(五分) 大腹皮(一钱二分) 木香(三分)
原方中没有标注分量。
加味五皮饮
桑白皮(一钱五分) 大腹皮(一钱五分,此药只适用于治疗胎肿,常见治疗水肿者服用后反而加重,必须谨慎使用) 茯苓皮(一钱五分) 新会皮(一钱五分) 紫苏梗(一钱五分) 车前子(一钱五分) 老姜皮(八分) 五加皮(一钱五分)
服用二三剂后,再加入白术、茯苓,待肿胀消除大半后,然后再使用六君子汤,来补益脾气,饮食上也宜清淡,因为淡味具有渗湿利水的作用。
(Sub-swelling, also known as Zi Qi, Zi Man, or Tai Shui)
Pregnant women often experience swelling of the face, eyes, legs, and feet, hence various names for such swellings. In essence, all these conditions arise from the insufficiency of Spleen Earth (the digestive system's transformative function) to transport and transform the dampness generated from food and fluids. This leads to obstruction within the fetus sac, impaired transformation in the Bladder, and rampant flooding of water. Consequently, Lung Qi fails to descend, resulting in panting, and urination becomes dribbling and difficult. Ancient prescriptions utilize Liyu Tang (Carp Decoction), Kuifu Tang (Abelmoschus Seeds and Poria Decoction), and Baizhu San (Atractylodes Macrocephala Powder), all of which have excellent effects. I frequently use Wupi Yin (Five Peel Decoction), treating it similarly to edema, and it is often effective. Since this is fundamentally a disorder of water metabolism, this formula is simple and easy to apply; thus, Liyu Tang is no longer repeatedly used. However, tonics like Ginseng and Atractylodes should not be administered too early, as tonification can cause blockage and stagnation. The general principle should prioritize promoting diuresis and resolving dampness. If the patient has a robust physique, or if the swelling is mild with normal urination, treatment may not be necessary, as it will resolve spontaneously after childbirth. These remarks apply to cases where there is no sensation of distension or discomfort.
Liyu Tang (Carp Decoction)
Baizhu (Atractylodis Macrocephalae Rhizoma) (4 liang)
Shengjiang (Zingiberis Recens Rhizoma) (1 liang)
Fuling (Poria) (4 liang)
Danggui (Angelicae Sinensis Radix) (2 liang)
Baishao (Paeoniae Radix Alba) (2 liang)
Li Yu (Cyprini Carpio) (one carp weighing 1 jin)
First, boil the carp in water to extract the broth, clarify it, and then decoct the herbs in this broth. Divide into five doses for administration.
Kuifu Tang (Abelmoschus Seeds and Poria Decoction)
Dongkuizi (Abelmoschi Semen) (0.5 jin, stir-fried)
Fuling (Poria) (3 liang)
Grind together into powder. Take 3 qian each time, washed down with rice soup.
Baizhu San (Atractylodes Macrocephala Powder)
Tu Chao Baizhu (Soil-stir-fried Atractylodis Macrocephalae Rhizoma) (1.5 qian)
Fuling (Poria) (1.5 qian)
Zexie (Alismatis Rhizoma) (0.8 qian)
Chenpi (Citri Reticulatae Pericarpium) (0.5 qian)
Jiang Pi (Zingiberis Pericarpium) (0.5 qian)
Dafupi (Arecae Pericarpium) (1.2 qian)
Muxiang (Aucklandiae Radix) (0.3 qian)
The original prescription does not specify dosages.
Jiawei Wupi Yin (Modified Five Peel Decoction)
Sangbaipi (Mori Cortex) (1.5 qian)
Dafupi (Arecae Pericarpium) (1.5 qian; this herb is only suitable for treating fetal swelling. It is commonly observed that patients with edema taking this herb experience worsening symptoms, so it must be used with caution.)
Fuling Pi (Poria Cum Ligno Bark) (1.5 qian)
Xinhui Pi (Citri Reticulatae Pericarpium Rubrum) (1.5 qian)
Zisugeng (Perillae Caulis) (1.5 qian)
Cheqianzi (Plantaginis Semen) (1.5 qian)
Lao Jiang Pi (Old Zingiberis Pericarpium) (0.8 qian)
Wujia Pi (Acanthopanacis Cortex) (1.5 qian)
After two or three doses, add Baizhu (Atractylodis Macrocephalae Rhizoma) and Fuling (Poria). Once the swelling has reduced by more than half, subsequently administer Liu Junzi Tang (Six Gentlemen Decoction) to tonify Spleen Qi. The diet should also be bland, as a bland flavor promotes leaching out dampness.