产后恶露流于腰臂足关节之处，或漫肿、或结块，久则肿起作痛，肢体倦怠，急宜用葱熨法以治外肿；内服参
归生化汤以消血滞，无缓也。未成者消，已成者溃。
葱熨法
用葱一握，炙热，捣烂作饼，敷痛处，用浓布二、三层，以熨斗，火熨之。
参归生化汤
川芎（一钱半） 当归（二钱） 炙草（五分） 人参（二钱） 黄 （一钱半） 肉桂（五分） 马蹄香（二钱）
此症若不补气血，节饮食，慎起居，未有得生者。如肿起作痛，起居饮食如常，是病气未深，形气未损，易治；若
漫肿微痛，起居倦怠，饮食不足，最难治。或未成脓，未溃，气血虚也，宜服八珍汤；憎寒恶寒，阳气虚也，宜服十全
人补汤；补后大热，阴血虚也，宜服四物汤，加参、术、丹皮；呕逆，胃气虚也，宜服六君子汤，加炮姜、干姜；食少
体倦，脾气虚也，宜服补中益气汤；四肢冷逆，小便频数，肾气虚也，补中益气汤加益智仁一钱。神仙回洞散治产后流
注恶露，日久成肿，用此宜导其脓，若未补气血旺，不可服此方。
歌括∶产后恶露流关节，漫肿结块痛切切。
急宜葱熨治外肿，参归生化消瘀血。
参归生化桂黄 ，川芎炙草香马蹄。
此症当须补气血，饮食起居要适宜。
其人素弱，临产又劳，中气不足，胸膈不利，而转运稽迟，若产后即服生化汤以消块止痛，又眼加参生化汤以
健脾胃，自无中满之症。其膨胀，因伤食而误消，因气郁而误散，多食冷物而停留恶露；又因血虚大便燥结，误下
而愈胀；殊不知气血两虚，血块消后，当大补气血，以补中虚。治者若但知伤食宜消，气郁宜散，恶露当攻，便结
可下，则胃气反损，满闷益增，气不升降，湿热积久，遂成膨胀。岂知消导坐于补中，则脾胃强，而所伤食气消
散；助血兼行，大便自通，恶露自行。
如产后中风，气不足，微满，误服耗气药而胀者，服补中益气汤。
人参（五分） 当归（五分） 白术（五分） 白茯苓（一钱） 川芎（四分） 白芍（四分） 萝卜子（四
分） 木香（三分）
眉批∶一本人参、白术俱作一钱，当归作二钱，有姜一片。
歌括∶产后中风气血弱，医者误投耗散药。
气不升降生膨胀，补中益气是妙着。
补中益气用归芎，人参白术与茯苓。
木香白芍萝卜子，膨胀消除气血行。
如伤食，误服导药成胀；或胁下积块，宜服健脾汤。
人参 白术 当归（各三钱） 白茯苓 白芍 神曲 吴萸（各一钱） 大腹皮 陈皮（各四分） 砂仁 麦芽（各
五分）
眉批∶一本人参、白术作二钱。
歌括∶伤食消导反生胀，病家宜服健脾汤。
参苓归芍陈曲麦，大腹萸砂共煎尝。
如大便不通，误服下药成胀，及腹中作痛，宜服养荣生化汤。
当归（四钱） 白芍（一钱） 白茯苓（一钱） 人参（一钱） 白术（二钱） 陈皮（五分） 大腹皮（五分）
香附（五分） 苁蓉（一钱） 桃仁（十粒，制）
块痛，将药送四消丸。屡误下，须用参、归半斤。
眉批∶一本无桃仁。
歌括∶便秘误下反生胀，宜服养荣生化汤。
归芍参苓陈腹皮，白芍苁蓉桃仁香。
Postpartum lochia flows into the joints of the waist, arms, and feet, causing diffuse swelling or the formation of lumps. Over time, these swellings rise and become painful, accompanied by fatigue in the limbs. It is urgent to treat the external swelling with the Scallion Moxibustion Method (Cong Yi Fa) and internally administer Shenghua Tang with Ginseng and Angelica (Shen Gui Shenghua Tang) to resolve blood stasis without delay. If the pathogen has not yet formed a mass, it will dissipate; if it has already formed, it will suppurate and ulcerate.
Scallion Moxibustion Method:
Take a handful of scallions, heat them, pound them into a paste to form a cake, apply it to the painful area, cover with two to three layers of thick cloth, and iron it with a heated moxibustion iron.
Shen Gui Shenghua Tang (Ginseng and Angelica Decoction for Generating New Blood):
Chuanxiong Rhizome (Chuanxiong Radix et Rhizoma) - 1.5 qian, Dang Gui Root (Angelicae Sinensis Radix) - 2 qian, Honey-fried Licorice Root (Zhi Gancao) - 5 fen, Ginseng Root (Renshen) - 2 qian, Astragalus Root (Huangqi) - 1.5 qian, Cinnamon Twig (Rougui) - 5 fen, Machi Xiang (Dichroa Radix) - 2 qian.
If this condition is not treated by tonifying Qi and Blood, regulating diet, and being cautious in daily life, recovery is unlikely. If swelling rises with pain but daily activities and diet remain normal, the pathogenic factor is not deep, and the healthy Qi is not damaged, making it easy to treat. If there is diffuse swelling with slight pain, fatigue in daily activities, and poor appetite, it is the most difficult to treat. If pus has not yet formed and no ulceration has occurred, it indicates deficiency of Qi and Blood, and Bazhen Tang should be taken. If aversion to cold and chills are present, it indicates Yang Qi deficiency, and Shiquan Dabu Tang should be taken. If high fever occurs after tonification, it indicates Yin and Blood deficiency, and Siwu Tang added with Ginseng, Atractylodes Macrocephala Rhizome (Baizhu), and Moutan Cortex (Danpi) should be taken. If vomiting and regurgitation occur, it indicates Stomach Qi deficiency, and Liujunzi Tang added with Fried Ginger (Paojiang) and Dried Ginger (Ganjiang) should be taken. If poor appetite and limb fatigue are present, it indicates Spleen Qi deficiency, and Buzhong Yiqi Tang should be taken. If the four limbs are cold and urination is frequent, it indicates Kidney Qi deficiency, and Yi Zhi Ren (Alpinia Oxyphylla Fruit) - 1 qian should be added to Buzhong Yiqi Tang. Shenxian Huidong San is used to treat postpartum liuzhu (flowing accumulation) of lochia that forms swelling over a long period; this formula is used to guide the discharge of pus. However, if Qi and Blood are not yet robust, this formula should not be taken.
Verse:
Postpartum lochia flows into the joints,
Diffuse swelling and lumps cause severe pain.
Urgently use Scallion Moxibustion to treat external swelling,
Shen Gui Shenghua Tang eliminates blood stasis.
Shen Gui Shenghua Tang contains Cinnamon Twig and Astragalus,
Chuanxiong, Honey-fried Licorice, and Machi Xiang.
This condition requires tonifying Qi and Blood,
Diet and daily life must be appropriate.
The patient was constitutionally weak and exhausted during labor, leading to insufficiency of Middle Jiao Qi, stagnation in the chest and diaphragm, and delayed transportation. If Shenghua Tang were administered immediately postpartum to dissipate masses and relieve pain, followed by Shenghua Tang with Ginseng to strengthen the Spleen and Stomach, middle-jiao fullness would naturally be avoided. Regarding postpartum distension (expansion), it often results from food stagnation treated incorrectly with draining methods, from Qi stagnation treated incorrectly with dispersing methods, or from excessive consumption of cold foods causing lochia retention. It may also result from dry stool due to Blood deficiency being incorrectly purged, leading to increased distension. One fails to realize that this is a dual deficiency of Qi and Blood; after the blood mass dissipates, one must greatly tonify Qi and Blood to fill the Middle Jiao deficiency. If practitioners only know that food stagnation requires draining, Qi stagnation requires dispersing, lochia requires attacking, and constipation requires purging, they will damage Stomach Qi further, increase fullness and oppression, hinder the ascending and descending of Qi, and allow damp-heat to accumulate over time, resulting in distension. Does one not know that using draining methods within tonification strengthens the Spleen and Stomach, allowing damaged food Qi to dissipate? Assisting Blood circulation allows stool to pass naturally and lochia to discharge spontaneously.
In cases of postpartum wind-stroke with Qi insufficiency and slight fullness, where distension is caused by mistakenly taking Qi-consuming drugs, Buzhong Yiqi Tang should be taken.
Formula: Ginseng Root (Renshen) - 5 fen, Dang Gui Root (Angelicae Sinensis Radix) - 5 fen, Atractylodes Macrocephala Rhizome (Baizhu) - 5 fen, Poria (Baifuling) - 1 qian, Chuanxiong Rhizome (Chuanxiong Radix et Rhizoma) - 4 fen, White Peony Root (Baishao) - 4 fen, Radish Seed (Luobozǐ) - 4 fen, Costus Root (Muxiang) - 3 fen.
Commentary: In another version, Ginseng and Atractylodes are each 1 qian, Angelica is 2 qian, plus one slice of ginger.
Verse:
Postpartum wind-stroke leaves Qi and Blood weak,
Doctors mistakenly administer dispersing drugs.
Qi fails to ascend and descend, causing distension,
Buzhong Yiqi Tang is the excellent remedy.
Buzhong Yiqi Tang uses Angelica and Chuanxiong,
Ginseng, Atractylodes, and Poria.
Costus, White Peony, and Radish Seed,
Distension is eliminated as Qi and Blood circulate.
In cases of food stagnation where mistakenly taking draining drugs causes distension, or masses under the hypochondrium, Jianpi Tang should be taken.
Formula: Ginseng Root (Renshen), Atractylodes Macrocephala Rhizome (Baizhu), Dang Gui Root (Angelicae Sinensis Radix) (each 3 qian), Poria (Baifuling), White Peony Root (Baishao), Medicated Leaven (Shenqu), Evodia Fruit (Wuyu) (each 1 qian), Areca Peel (Dafupi), Tangerine Peel (Chenpi) (each 4 fen), Amomum Fruit (Sharen), Malt (Maiya) (each 5 fen).
Commentary: In another version, Ginseng and Atractylodes are 2 qian.
Verse:
Food stagnation drained wrongly causes distension,
Patients should take Jianpi Tang.
Ginseng, Poria, Angelica, Peony, Chenpi, Shenqu, and Malt,
Areca peel, Evodia, and Amomum decocted together.
In cases of constipation where mistakenly taking purgative drugs causes distension, along with abdominal pain, Yangrong Shenghua Tang should be taken.
Formula: Dang Gui Root (Angelicae Sinensis Radix) - 4 qian, White Peony Root (Baishao) - 1 qian, Poria (Baifuling) - 1 qian, Ginseng Root (Renshen) - 1 qian, Atractylodes Macrocephala Rhizome (Baizhu) - 2 qian, Tangerine Peel (Chenpi) - 5 fen, Areca Peel (Dafupi) - 5 fen, Cyperus Rhizome (Xiangfu) - 5 fen, Cistanche Stem (Rongshu) - 1 qian, Peach Kernel (Taoren) (10 grains, processed).
For mass-related pain, take with Six Elimination Pills (Six Xiao Wan). For repeated incorrect purging, half a jin of Ginseng and Angelica is required.
Commentary: Another version lacks Peach Kernel.
Verse:
Constipation purged wrongly causes distension,
Yangrong Shenghua Tang should be taken.
Angelica, Peony, Ginseng, Poria, Chenpi, Dafupi,
Peony, Cistanche, Taoren, and Xiangfu.