小儿通身肿者，头面手足皆肿也，病由内停湿饮，外感风邪，风湿相搏，水道不利，外攻肌表，因而作肿，
重者，古法主疏凿饮（如商陆、秦艽、羌活、椒目、木通、赤小豆、茯苓皮、大腹皮、泽泻、槟榔，引用姜皮）。
轻者，古法主茯苓导水汤（如紫苏、陈皮、炒白术、木香、炒桑白皮、去心麦冬、赤茯苓、泽泻、木瓜、大腹
皮、缩砂仁、槟榔，引用灯芯）。
若水停上攻于肺，喘急不得卧者，古法主苏葶丸泻之（方见痰饮喘急）。
水停中州胀满者，古法主舟车神佑丸攻之〔如甘遂、芫
花、大戟各一个（俱醋炒），大黄二两，黑牵牛（头末）四两，炒青皮、正陈皮、木香、槟榔各五钱，轻粉一钱，
共为细末，水丸，如椒目大，小儿二三丸，大儿五七丸，量服之，滚白水送下〕。
〔真按〕小儿身尽肿者，或因胎禀不足，卒冒风寒，或因疟痢脾虚，皆能作肿，古方除茯苓导水汤外，如疏
凿饮等剂，以治壮实之儿，犹虞陨越，怯弱之儿，更所难胜。但用生于术一钱，炒浓朴一钱，广陈皮一钱，制于术
一钱，云茯苓二钱，结猪苓二钱，宣泽泻二钱，炙甘草五分，上肉桂三分，引用生姜三片。
重者头面肿起，加蜜炙麻黄二分；作喘，加炒桑白皮一钱，苦杏仁二钱；小便黄赤，加木通八分；身肿，加五
加皮一钱；腹胀，加砂仁五分，白蔻仁五分，丁香五分，枳壳八分；脚冷不温，加熟附子五分，上肉桂三分，防
己五分。
When a child suffers from generalized edema, it refers to swelling of the head, face, hands, and feet. This condition arises from internal retention of damp-fluids combined with external contraction of wind-pathogen. The wind and dampness interact and obstruct, causing dysfunction of the water passages. The pathological fluids attack the muscle and skin surface externally, resulting in swelling.
In severe cases, ancient methods primarily prescribe Shuozao Yin (Draining and Scouring Decoction), which contains Phytolaccae Radix (Shanglu), Gentianae Macrophyllae Radix (Qinjiao), Notopterygii Rhizoma et Radix (Qianghuo), Zanthoxyli Fructus (Jiaomu), Akebiae Caulis (Mutong), Phaseoli Semen Rubrum (Chixiaodou), Poriae Cortex (Fulingpi), Arecae Pericarpium (Dafupi), Alismatis Rhizoma (Zexie), and Arecae Semen (Binglang), using Zingiberis Recensis Cortex (Jiangpi) as an guiding herb.
In mild cases, ancient methods primarily prescribe Fuling Daoshui Tang (Poria Water-Directing Decoction), which contains Perillae Folium (Zisu), Citri Reticulatae Pericarpium (Chenpi), Atractylodis Macrocephalae Rhizoma stir-fried with bran (Chao Baizhu), Aucklandiae Radix (Muxiang), Mori Cortex (Chao Sangbaipi), Ophiopogonis Radix without heart (Quxin Maidong), Poria with red wood (Chi Fuling), Alismatis Rhizoma (Zexie), Chaenomelis Fructus (Mugua), Arecae Pericarpium (Dafupi), Amomi Fructus Rotundus (Suosharen), and Arecae Semen (Binglang), using Juncus effusus (Dengxin) as a guiding herb.
If fluid retention attacks upward to the Lung, causing wheezing, urgency, and inability to lie flat, ancient methods primarily use Sut Ting Wan (Perilla and Lepidium Pill) to drain the pathogen (see "Phlegm-Fluid Wheezing and Urgency" for the formula).
If fluid retention stagnates in the Middle Jiao (Central Region), causing abdominal distension and fullness, ancient methods primarily use Zhouche Shenyou Wan (Boat Vehicle Divine Blessing Pill) to attack and purge the fluid [Formula: Kansui Radix (Gansui), Genkwa Flos (Yanhua), and Euphorbiae Pekinensis Radix (Daji), each one piece, all stir-fried with vinegar; Rheum Palmatum Radix (Dahuang) two liang; Black Sesame Seed (Hei Qianniu, first powder) four liang; Stir-fried Citri Reticulatae Viride (Chao Qingpi), Authentic Citri Reticulatae Pericarpium (Zheng Chenpi), Aucklandiae Radix (Muxiang), and Arecae Semen (Binglang), each five qian; Calomelas (Qingfen) one qian. Grind all into fine powder, make pills with water, size similar to Zanthoxyli Fructus (Jiaomu). Children take 2-3 pills, older children take 5-7 pills, adjust dosage accordingly, swallow with boiling water].
[Commentary by Chen Shouzhen] Generalized edema in children may result from insufficient congenital endowment followed by sudden exposure to wind-cold, or from Spleen deficiency due to malaria or dysentery, both of which can cause swelling. Apart from Fuling Daoshui Tang, ancient formulas such as Shuozao Yin are intended for robust children; even then, there is concern that they might cause harm or death. For frail or weak children, these harsh purgatives are even more difficult to tolerate. Therefore, it is recommended to use only Raw Atractylodis Macrocephalae Rhizoma (Sheng Baizhu) one qian, Stir-fried Magnoliae Officinalis Cortex (Chao Houpo) one qian, Guang Citri Reticulatae Pericarpium (Guang Chenpi) one qian, Processed Atractylodis Macrocephalae Rhizoma (Zhi Baizhu) one qian, Yun Poria (Yun Fuling) two qian, Polyporus (Zhu Ling) two qian, Prepared Alismatis Rhizoma (Xuan Zexie) two qian, Honey-fried Glycyrrhizae Radix et Rhizoma (Zhi Gancao) five fen, Cinnamomi Ramulus (Shang Rougui) three fen, with Zingiberis Recensis (Shengjiang) three slices as a guiding herb.
If the head and face swell severely, add Honey-fried Ephedrae Herba (Mi Zhi Mahuang) two fen; if wheezing occurs, add Stir-fried Mori Cortex (Chao Sangbaipi) one qian and Bitter Apricot Kernel (Ku Xingren) two qian; if urine is yellow and red, add Akebiae Caulis (Mutong) eight fen; if body swelling persists, add Acanthopanacis Cortex (Wujia Pi) one qian; if abdominal distension occurs, add Amomi Fructus (Sharen) five fen, White Cardamom Seed (Baokou Ren) five fen, Eugeniae Flos (Dingxiang) five fen, and Aurantii Fructus Immaturus (Zhiqiao) eight fen; if feet are cold and not warm, add Prepared Aconiti Lateralis Radix Prepara (Shu Fuzi) five fen, Cinnamomi Ramulus (Shang Rougui) three fen, and Stephaniae Tetrandrae Radix (Fangji) five fen.