Ms. Hu, a twenty nine year old teacher came for her first visit on October 10, 1973. She was four and a half months pregnant. Her abdomen increased in size relatively quickly and is not consistent with her month of pregnancy. An ultrasound examination showed that she had "excessive amniotic fluid". Ms. Hu's subjective experience was that her abdomen felt distended and oppressed, her appetite was poor and her urination was scanty. Her pulse was thin and slippery and her tongue body was red and moist. In this case, the Spleen, being vacuous, lost its movement which caused the Qi to stagnate and for the water to pool up. In this way, the fetal water became over abundant. For treatment I used a modified version of Wu Pi Yin Five Peel Drink. I gave her five packages of the following perscription. (Note that in these cases, these dosages are for one day's worth of herbs)

Tian Xian Teng Caulis Aristolochiae 9 gm.
Da Fu Pi Pericarpium Arecae Catechu 9 gm.
Chen Pi Pericarpium Citri Reticulatae 4 gm.
Su Geng Caulis Perillae 2.4 gm.
Chao Bai Zhu Rhizoma Atractylodis Macrodephalae(Dry-fried) 9 gm.
Sang Bai Pi Cortex Mori Albae Radicis 9 gm.
Ze Xie Rhizoma Alixmatis Orientalis 9 gm.
Hai Er Shen Radix Pseudostellariea Heterophyllae 30 gm.
Fu Ling Pi Cortex Poria Cocos 30 gm.
Di Gu Pi Cortex Lycii Radicis 15 gm.
Huang Qin Radix Scutellariae Baicalensis 9 gm.
Zhu Ma Gen Radix Boehmeriae 15 gm.

Second Visit: October 15, 1973. After the herbs, Ms. Hu's urination became clear and more profuse. Her abdomen was slightly smaller. Her pulse was wirey and slippery and her tongue was red. I continued along the same lines with some additions and subtractions, giving her seven packages of the following perscription:

Hai Er Shen Radix Pseudostellariea Heterophyllae 30 gm.
Sang Bai Pi Cortex Mori Albae Radicis 9 gm.
Huang Qin Radix Scutellariae Baicalensis 9 gm.
Zhu Ma Gen Radix Boehmeriae 15 gm.
Da Fu Pi Pericarpium Arecae Catechu 9 gm.
Tian Xian Teng Caulis Aristolochiae 9 gm.
Chao Bai Zhu Rhiaoma Atractylodis Macrodephalae (Dry-fried) 9 gm.
Chen Pi Pericarpium Citri Reticulatae 4 gm.
Di Gu Pi Cortex Lycii Radicis 12 gm.
Su Geng Caulis Perillae 2.4 gm.
Hong Zao Fructus Zizyphi Jujubae 15 gm.

Third Visit: November 3, 1973. Ms. Hu's urination was still profuse and without discomfort. Her pulse and tongue were as before. For treatment I used Three Bean Drink San Dou Yin and Carp Soup Li Yu Tang. I gave her ten packages of the following perscription:

Chi Xiao Dou Semen Phaseoli Calcarati 30 gm.
Lu Dou Semen Phaseoli Radiati 15 gm.
Hei Dou Semen Glycines Atrum 15 gm.
Gan Cao Radix Glycyrrhizae Uralensis 3 gm.
Hong Zao Fructus Zizyphi Jujubae 30 gm.

As for the Carp Soup Li Yu Tang I instructed her to cook one fish, weighing one Jin, cutting of the head and tail, in a soup with Luo Bo Radix Raphani and to drink it in place of her daily tea.

Forth Visit: December 22, 1973. A check up revealed that Ms. Hu's abdomen had increased appropriately to her month in pregnancy. I discontinued the herbs though kept her under observation. After a full term, she gave birth and the baby was without irregularity.

Ms. Shan, a twenty four year old woman, came for her first visit on March 12, 1948. She was seven months pregnant. Her abdomen was especially large and her urination was scanty. She also felt chest oppression, panting upon movement and low back soreness. Her pulse was slippery and her tongue moss was thin white. This was a case of fetal water swelling and fullness due to Spleen movement loosing its fortification resulting in water pooling in the uterus. For treatment I used San Yin Li Yu Tang Three Reason Carp Soup with added flavors. I gave her five packages of the following prescription:

Chao Bai Zhu Rhiaoma Atractylodis Macrodephalae (Dry-fried) 9 gm.
Fu Ling Sclerotium Poriae Cocos Pararadicis 15 gm
Chao Dang Gui Radix Angelica Sinensis (Dry-fried) 9 gm.
Chao Bai Shao Radix Paeoniae Lactiflorae (Dry-fried) 9 gm.
Chen Pi Pericarpium Citri Reticulatae 4.5 gm.
Sheng Jiang Rhizoma Zingiberis Officinallis 3 pieces

As for the Carp Soup Li Yu Tang I instructed her to boil one fish, weighing one Jin, making a clear broth. I had her drink a cup and a half with her herbs on an empty stomach.

Second Visit: After taking the Three Reason Carp Soup San Yin Li Yu Tang Ms. Shan's urination increased and the amniotic fluid decreased. The size of her abdomen was slightly contracted. The rebellious Qi was also less. Her pulse and tongue were as before. I gave her three packages of the original prescription and instructed her to take one package on intermittent days.

Third Visit: All of Ms. Shan's symptoms had been eliminated. I urged her to boil a Carp, weighing one Jin, with Luo Bo Radix Raphani and drink the broth every day, not on a fixed schedule, for four days. After a normal delivery of a single child, the baby was without abnormalities.

Ms. Yang was thirty-one years old when she came for her first visit on May 10, 1979. She was early in her pregnancy, just two months along and had suffered from relatively acute vomiting, dizziness, chest oppression, poor appetite and back soreness as if her back was broken. She had been pregnant two times in the past and both times suffered from excessive amniotic fluid. The first child died at seven months of pregnancy and the second child died at five months of pregnancy. Her pulse was thin and relaxed and her tongue moss was thin white. Both the Spleen and Kidneys were vacuous and the fetal Qi was not harmonized. It was essential, in this case to guard against the water Qi not transforming and then having the disorder of over abundant amniotic fluid. For treatment it was appropriate to supplement and boost the Spleen and Kidneys, rectify the Qi and calm the fetus. This approach was assisted by harmonizing the Stomach and stopping vomiting. I gave her five packages of the following prescription:

Hai Er Shen Radix Pseudostellariea Heterophyllae 30 gm.
Lu E Mei Fructus Mume 4.5 gm.
Chao Bai Shao Radix Paeoniae Lactiflorae (Dry-fried) 9 gm.
Huai Shan Yao Radix Dioscoreae Oppositae 12 gm.
Bian Dou Semen Dolichoris Lablab 9 gm.
Shu Di Huang Radix Rehmanniae Glutinosae Conquitae (Prepared) 15 gm.
Fu Ling Sclerotium Poriae Cocos Pararadicis 9 gm.
Chao Bai Zhu Rhizoma Atractylodis Macrodephalae (Dry-fried) 9 gm.
Ju Hong Pars Rubra Epicarpii Citri Erythrocarpae 4.5 gm.
Chen Shan Yu Rou Fructus Corni Officinalis 9 gm.
Dan Zhu Ru Caulis Bambusae in Taeniis 9 gm.
Zhi Ji Nei Jin Endothelium Corneum Gigeriae Galli (Honey-fried) 9 gm.
Hong Zao Fructus Zizyphi Jujubae 12 gm.

Second Visit: May 29, 1979. Ms. Yang's back soreness had decreased and the vomiting had stopped. She still had an aversion to food. Her pulse was thin and slippery and her tongue moss was thin white. My treatment plan was to fortify her Spleen and harmonize her Stomach, rectify her Qi and calm the fetus. I have her seven packages of the following prescription:

Chao Dang Shen Radi x Codonopsitis Pilosulae 9 gm.
Chao Bai Zhu Rhizoma Atractylodis Macrodephalae (Dry-fried) 9 gm.
Hong Zao Fructus Zizyphi Jujubae 4.5 gm.
Fu Ling Sclerotium Poriae Cocos Pararadicis 9 gm.
Ze Xie Rhizoma Alixmatis Orientalis 9 gm.
Lu E Mei Fructus Mume 4.5 gm.
Chao Bai Shao Radix Paeoniae Lactiflorae (Dry-fried) 9 gm.
Zhi Ji Nei Jin Endothelium Corneum Gigeriae Galli (Honey-fried) 9 gm.
Huang Qin Radix Scutellariae Baicalensis 9 gm.
Su Geng Caulis Perillae 9 gm.

Third Visit: June 27, 1979. Ms. Yang was more than three months along at the time of this visit. Her pulse was thin and slippery and her tongue moss was thin. It was essential to avoid swelling and fullness of the amniotic fluid so I again fortified her Spleen, harmonized her Stomach and disinhibited water. I gave her five packages of the following perscription:

Fu Ling Sclerotium Poriae Cocos Pararadicis 9 gm.
Di Gu Pi Cortex Lycii Radicis 9 gm.
Lu E Mei Fructus Mume 4.5 gm.
Chao Bai Shao Radix Paeoniae Lactiflorae (Dry-fried) 9 gm.
Chao Bai Zhu Rhizoma Atractylodis Macrodephalae (Dry-fried) 9 gm.
Chen Pi Pericarpium Citri Reticulatae 4.5 gm.
Su Geng Caulis Perillae 6 gm.
Sang Bai Pi Cortex Mori Albae Radicis 9 gm.
Huang Qin Radix Scutellariae Baicalensis 9 gm.
Hai Er Shen Radix Pseudostellariea Heterophyllae 15 gm.

Forth Visit: July 2, 1979. Ms. Yang's fetus was restless. Both of her pulses were wirey and slippery. The body of her tongue tended to red. For treatment I used Three Bean Drink San Dou Yin with added flavors.

Chao Bian Dou Semen Dolichoris Lablab (Dry-fried) 9 gm.
Lu Dou Semen Phaseoli Radiati 12 gm.
Hei Dou Semen Glycines Atrum 12 gm.
Bai Zhu Rhiaoma Atractylodis Macrodephalae 9 gm.
Sang Ji Sheng Ramulus Sangjisheng 9 gm.
Fu Ling Sclerotium Poriae Cocos Pararadicis 15 gm.
Bei Sha Shen Radix Adenophorae seu Glehniae 9 gm.
Chao Bai Shao Radix Paeoniae Lactiflorae (Dry-fried) 9 gm.
Huai Shan Yao Radix Dioscoreae Oppositae 12 gm.
Zhi Gan Cao Radix Glycyrrhizae Uralensis (Honey-fried) 3 gm.

Fifth Visit: September 17, 1979. By this visit, Ms. Yang was already more than six months pregnant. She could feel her baby move. Her pulse was thin and slippery and the moss on her tongue was thin. I continued to fortify her Spleen and calm the fetus and gave her seven packages of the following prescription:

Chao Bai Zhu Rhiaoma Atractylodis Macrodephalae (Dry-fried) 9 gm.
Hai Er Shen Radix Pseudostellariea Heterophyllae 15 gm.
Chen Pi Pericarpium Citri Reticulatae 4.5 gm.
Fu Ling Sclerotium Poriae Cocos Pararadicis 12 gm.
Chao Bai Shao Radix Paeoniae Lactiflorae (Dry-fried) 15 gm.
Su Geng Caulis Perillae 4.5 gm.
Chao Bian Dou Semen Dolichoris Lablab (Dry-fried) 12 gm.
Huai Shan Yao Radix Dioscoreae Oppositae 12 gm.
Zhi Gan Cao Radix Glycyrrhizae Uralensis (Honey-fried) 3 gm.
Hong Zao Fructus Zizyphi Jujubae 15 gm.

Ms. Yang was thirty two and three months pregnant when she came for her first visit on July 2, 1979. She had been pregnant two times before and suffered from excessive amniotic fluid. Both pregnancy resulted in fetal death. Both of her pulses were wire and slippery and her tongue was crimson. For treatment I used a modified version of San Dou Yin Three Bean Drink and gave her seven packages of the following perscription:

Chao Bian Dou Semen Dolichoris Lablab (Dry-fried) 12 gm.
Lu Dou Semen Phaseoli Radiati 12 gm.
Hei Dou Semen Glycines Atrum 12 gm.
Bai Zi Ren Semen Biotae 9 gm.
Huang Qin Radix Scutellariae Baicalensis 12 gm.
Fu Ling Sclerotium Poriae Cocos Pararadicis 12 gm.
Sheng Bai Zhu Rhiaoma Atractylodis Macrodephalae (Fresh) 9 gm.

Second Visit: July 30, 1979. Ms. Yang was more than four months pregnant at the time of this visit and her lower abdomen had a bearing down sensation. Both of her pulses were wirely and slippery and her tongue was crimson with thin moss. Wanting to avoid another pregnancy with excessive amniotic fluid I again gave her a modified version of San Dou Yin Three Bean Drink and gave her seven packages of the following perscription:

Lu Dou Semen Phaseoli Radiati 12 gm.
Hei Dou Semen Glycines Atrum 12 gm.
Huang Qin Radix Scutellariae Baicalensis 9 gm.
Chao Bai Shao Radix Paeoniae Lactiflorae (Dry-fried) 9 gm.
Chao Bai Zhu Rhiaoma Atractylodis Macrodephalae(Dry-fried) 9 gm.
Fu Ling Pi Cortex Poria Cocos 30 gm.
Chao Bian Dou Semen Dolichoris Lablab (Dry-fried) 12 gm.
Su Geng Caulis Perillae 2.4 gm.
Qing Pi Pericarpium Citri Reticulatae Viride 4.5 gm.

Third Visit: August 20, 1979. Five months pregnant at this point, Ms. Yang felt that the fetus was restless. The fetal heart beat was relatively faint. My treatment was designed to fortify and move. I gave her three packages of the following perscription:
Bai Zhu Rhiaoma Atractylodis Macrodephalae 9 gm.
Bai Fu Ling Sclerotium Poriae Cocos Pararadicis 15 gm.
Huai Shan Yao Radix Dioscoreae Oppositae 12 gm.
Bai Bian Dou Semen Dolichoris Lablab 12 gm.
Hai Er Shen Radix Pseudostellariea Heterophyllae 9 gm.
Sang Ji Sheng Ramulus Sangjisheng 9 gm.
Chao Bai Shao Radix Paeoniae Lactiflorae (Dry-fried) 9 gm.
Zhi Gan Cao Radix Glycyrrhizae Uralensis (Honey-fried) 3 gm.
Bei Sha Shen Radix Adenophorae seu Glehniae 9 gm.

Example Five:

Ms. Zuo, a twenty eight year old teacher came for her first visit in September of 1950.
She was seven months pregnant and suffered from chest oppression which was worse with eating. Her urination was scanty. Her pulses were thin and slippery and the moss on her tongue was thin and the body of it was moist. Her gynecology exam showed that her uterus was the size of a full term pregnancy. The fetal heart beat and position were unclear. Her diagnosis was excessive amniotic fluid disorder in the seveth month ofpregnancy. I urged her to use my proven perscription Li Yu Luo Bo Yin Carp and Radish Drink .

Second Visit: She drank ten packages the above perscription which increased her urination and calmed the fetus. Her pulse and tongue were as before. I gave her Si Jun Zi Tang Four Gentleman Soup and urged her to take one package each day for a long period of time. After full term she gave birth to a daughter weighing 3500 grams.

Commentary:
Excessive amniotic fluid is a commonly seen disorder in the obstetric department and is a considerable risk for both the mother and the child. The category of the disorder in the traditional chinese medical texts is "fetal water swelling and distention". The cause and dynamic of this illness is most often Spleen and Kidney vacuity weakness with water Qi not transforming. This results in the water pooling in the uterus. In my experience it is appropriate to adopt the principle of fortifying the Spleen, supplementing the Kidneys, disinhibiting water and dissipating swelling. The perscriptions I commonly use as principle perscriptions are Quan Sheng Bai Zhu San Whole Life Atractyloes Powder, Bian Que San Dou San Hyacinth Magpie Three Bean Powder, or San Yin Li Yu Tang Three Reasons Carp Soup . For a lighter treatment, using Wu Pi Yin Five Peel Drink or Li Yu Luo Bo Yin Carp and Radish Drink in place of daily tea or beverage is also good.
In the first example, the size of the patient's belly was bigger than was appropriate for the number of months she was pregnant. She felt abdominal distention, poor appetite and scanty urination. Her differential diagnosis was Spleen vacuity and water pooling leading to over abundant amniotic fluid. The perscription used Hai Er Shen and Bai Zhu to fortify the Spleen and boost the Qi. The five peels, Tian Xian Teng and Ze Xie disinhibited the water and dissipated swelling. I also added Su Geng, Huang Qin and Zhu Ma Gen to rectify Qi and clear heat in order to calm the fetus. On the second visit I used a modified version of the original method and her symptoms had basicly dissappeared. On the third visit I gave her San Dou San Three Bean Powder, and Li Yu Luo Bo Yin Carp and Radish Drink to take as a food and drink treatment, in order to consolidate the effect.
In the second example the patient suffered from heavy fetal water disorder and I used San Yin Li Yu Tang Three Reasons Carp Soup and the effectiveness was especially good. According the the San Yin Fang Three Yin Formulary "Li Yu Tang Carp Soup treats large abdomen in pregnant women and water qi in the fetal residence". In my experience, this perscription is reliably effective for the treatment of excessive amniotic fluid.
In example three, the patient had lost her babys twice due to excessive amniotic fluid. Her visit to me related to her third baby. She was more than two months pregnant. Though there was no clear manifestation of excessive amniotic fluid, the malign obstruction was relatively extreme and she was heading toward illness. Treatment had to be given to guard against further pathology and so I fortified her Spleen, harmonized her Stomach, move water, rectify her Qi and calm the fetus. After the treatment she didn't tread in the same old rut.
In example five the patient benifited from my proven perscription Li Yu Luo Bo Yin Carp and Radish Drink and had a smooth delivery at full term.