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Swelling of pregnancy

子肿 〔子腫〕zǐ zhǒng

Mentioned in The Gateway to Medicine (医学入门 yī xué rù mén). Water swelling in pregnancy. Swelling of pregnancy tends to affect women suffering from constitutional spleen-kidney yáng vacuity and usually occurs in the fifth or sixth month of pregnancy when, as the fetus becomes larger, the spleen’s movement and transformation function breaks down and allow water to flood into the limbs. It affects the instep first, spreading up the low extremities and eventually to the whole body including the head and face. This is attended by short voidings of scant urine. It is caused by spleen vacuity, kidney vacuity, or qì stagnation.

Patterns

Spleen vacuity (脾虚 pí xū) gives rise to swelling with fatigue and lack of strength, and distension and oppression in the stomach duct and abdomen.

Medicinal therapy: Fortify the spleen, promote qì transformation, and move water. Use Life-for-All White Atractylodes Powder (全生白朮散 quán shēng bái zhú sǎn).

Acumoxatherapy: Base treatment mainly on SP, ST, KI and back transport points. Main points: CV-9 (Water Divide, 水分 shuǐ fēn), ST-36 (Leg Three Lǐ, 足三里 zú sān lǐ), SP-9 (Yīn Mound Spring, 阴陵泉 yīn líng quán), SP-6 (Three Yīn Intersection, 三阴交 sān yīn jiāo), and KI-7 (Recover Flow, 复溜 fù liū). For spleen vacuity, add BL-20 (Spleen Transport, 脾俞 pí shù), BL-21 (Stomach Transport, 胃俞 wèi shù), and LR-13 (Camphorwood Gate, 章门 zhāng mén); needle with supplementation and, if appropriate, moxa.

Kidney vacuity (肾虚 shèn xū) patterns are characterized by aching limp lumbus and knees, and lack of warmth in the extremities.

Medicinal therapy: Warm yáng, promote qì transformation, and move water using Poria Five Powder (五苓散 wǔ líng sǎn).

Acumoxatherapy: To the above main points, add BL-23 (Kidney Transport, 肾俞 shèn shù), KI-3 (Great Ravine, 太溪 tài xī), and CV-4 (Pass Head, 关元 guān yuán); needle with supplementation and, if appropriate, moxa.

Qì stagnation (气滞 qì zhì) is marked by pronounced swelling of the head and face, and oppression in the chest and rib-side distension.

Medicinal therapy: Rectify qì, move stagnation, and disinhibit water using Aristolochia Stem Powder (天仙藤散 tiān xiān téng sǎn).

Acumoxatherapy: To the above main points add CV-6 (Sea of Qì, 气海 qì hǎi), LR-3 (Supreme Surge, 太冲 tài chōng), and BL-22 (Triple Burner Transport, 三焦俞 sān jiāo shù); needle with even supplementation and drainage. Warning: strong stimulus should be avoided in pregnant women.

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