当归 人参 芍药 川芎 干姜(炮，各一两） 甘草(炙，四钱)
上锉散。每服四钱，水一盏，姜三片，煎六分，去滓热服，不以时候。
评曰∶乍寒乍热，荣卫不和，难以轻议。若其败血不散，岂止入脾肺二脏耶?大抵一阴
闭一阳，即作寒热，阴胜故寒，阳胜故热，只可云败血循经流入，闭诸阴则寒，闭诸阳则热
，血气与卫气解则休，遇再会而复作，大调经散、五积散入醋煎。
治产后血虚，恶露未消，气为败浊凝滞，荣卫不调，阴阳相乘，憎寒发热，
或自汗，或肿满，皆气血未平之所为也。
大豆(炒去皮，一两半) 茯神（一两） 真琥珀（一钱）
上为末。浓煎乌豆紫苏汤调下。
五积散 方见伤寒太阴经。入醋煎妙
第七论曰∶产后四肢浮肿者何?答曰∶产后败血乘虚停积于五脏，循经流入四肢，留淫
日深，却还不得，腐坏如水，故令四肢面目浮肿。医人不识，便作水气治之。凡治水气，
多用导水药，极虚人。夫产后既虚，又以药虚之，是谓重虚，往往因致夭枉，但服调经散
，血行肿消即愈。
没药(别研) 琥珀(别研) 桂心 赤芍药 当归（各一钱） 细辛 麝香（各半钱，别研)
上为末。每取半钱匕，生姜汁、温酒各少许，调匀服。
评曰∶产后浮肿多端，有自怀妊肿至产后不退者，亦有产后失于将理，外感寒暑风湿，
内作喜怒忧惊，血与气搏，留滞经络。气分血分，不可不辨。要当随所因脉证治之，宜得其
情。调经散治血分固效，但力浅难凭，不若吴茱萸汤，枳术汤、夺魂散、大调经散，皆要药也。
Danggui (Radix Angelicae Sinensis), Renshen (Radix Ginseng), Shaoyao (Radix Paeoniae Rubra/Radix Paeoniae Alba), Chuanxiong (Rhizoma Chuanxiong), Ganjiang (Rhizoma Zingiberis Recens, processed), each one liang; Gancao (Radix Glycyrrhizae Preparata, honey-fried), four qian.
The above herbs are cut into pieces and made into a powder. Each dose is four qian, decocted with one zhan of water and three slices of fresh ginger until reduced to six-tenths. Strain the dregs and take it hot, without restriction on time.
Comment: Sudden chills and fever indicate disharmony between Ying (Nutrient Qi) and Wei (Defensive Qi), which cannot be lightly addressed. If stagnant blood fails to dissipate, does it not affect more than just the Spleen and Lung organs? Generally, when one Yin channel is obstructed by Yang, or vice versa, chills and fever occur. Excess Yin causes chills, excess Yang causes fever. It can only be said that stagnant blood flows along the meridians; obstruction of various Yin channels leads to chills, while obstruction of various Yang channels leads to fever. Symptoms cease when Blood-Qi harmonizes with Defensive Qi, but recur upon their next convergence. Dajiaojing San (Great Menstruation Regulating Powder) and Wuji San (Five Accumulations Powder) are effective when decocted with vinegar.
Treating postpartum blood deficiency, where lochia has not cleared, Qi stagnates due to turbid remnants, leading to disharmony of Ying and Wei, mutual invasion of Yin and Yang, resulting in aversion to cold with fever, spontaneous sweating, or swelling and fullness. These are all manifestations of unbalanced Blood and Qi.
Dadou (Soybean, stir-fried and peeled), one liang half; Fushen (Poria with Hostwood), one liang; Zhen Hupo (Genuine Amber), one qian.
The above are ground into fine powder. Take with thick decoction of black soybean and Perilla leaf soup.
Wuji San (Five Accumulations Powder) formula is seen in the Taiyin Meridian chapter of Shanghan Lun. Decocting with vinegar is excellent.
Question Seven states: What causes edema of the four limbs after childbirth? Answer: After childbirth, stagnant blood enters the five Zang organs due to deficiency, flows along the meridians into the four limbs, stays and infiltrates for a long time, yet cannot return. It rots and becomes like water, thus causing edema of the four limbs and face. Physicians who do not recognize this condition treat it as fluid retention disease. Usually, treating fluid retention involves using diuretic drugs, which further deplete extremely deficient patients. Since the postpartum state is already deficient, using drugs to cause further deficiency is called "double deficiency," often leading to premature death. Simply taking Tiaojing San (Menstruation Regulating Powder) will resolve the issue once blood circulation resumes and swelling subsides.
Moyao (Myrrha), separately ground; Hupo (Amber), separately ground; Guixin (Cortex Cinnamomi), Chi Shaoyao (Radix Paeoniae Rubra), Danggui (Radix Angelicae Sinensis), each one qian; Xixin (Herba Asari), Shexiang (Moschus), each half qian, separately ground.
The above are ground into fine powder. Each dose is half a qian bi (spoonful), mixed evenly with a small amount of fresh ginger juice and warm wine, then taken orally.
Comment: Postpartum edema has diverse causes. Some women swell during pregnancy and remain swollen postpartum. Others suffer from poor postpartum care, external contraction of cold, heat, wind, and dampness, or internal emotional disturbances such as anger, joy, worry, and fright. Blood and Qi contend and stagnate in the collaterals. One must distinguish between Qi-level and Blood-level pathologies. Treatment should follow the specific etiology, pulse, and symptoms to ascertain the true nature of the disease. While Tiaojing San is effective for Blood-level disorders, its action is mild and may not suffice. Better alternatives include Wuzhuyu Tang (Evodia Decoction), Zhizhu Tang (Aurantium and Atractylodes Macrocephala Decoction), Duohun San (Soul-Rescuing Powder), and Dajiaojing San (Great Menstruation Regulating Powder), all of which are essential remedies.