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Translation:
The discussion states: What is the cause of edema in the four limbs after childbirth? The answer is: After childbirth, retained blood (stasis) takes advantage of deficiency to stagnate and accumulate in the five zang organs, flowing along the meridians into the four limbs. Remaining and infiltrating for a long time, it fails to return and dissipate, rotting and transforming like water, thus causing yellowish complexion and edema in the four limbs. If physicians do not recognize this condition, they may treat it as fluid retention disease. Generally, treatments for fluid retention mostly use diuretic drugs, which severely weaken already deficient patients. Since the postpartum state is already deficient, using drugs to further deplete qi constitutes "double deficiency," often leading to premature death. One should simply administer Xiao Tiaojing San (Small Regulating Menses Powder); once blood circulation resumes and swelling subsides, recovery occurs.

Myrrh, Amber, Cinnamon Twig, White Peony Root, Angelica Sinensis (each 1 qian), Asarum, Musk (each 0.5 qian).
Grind the above ingredients into fine powder. Take 0.5 qian per dose, mixed with a small amount of ginger juice and warm wine.

Commentary: Postpartum edema has various causes. Some cases involve swelling starting during pregnancy that persists after childbirth. Others result from improper postpartum care, external contraction of cold or heat pathogens, internal generation of wind-dampness, and emotional disturbances such as anger, joy, worry, or fright, causing qi and blood to clash and stagnate in the meridians. It is crucial to distinguish between Qi-pattern and Blood-pattern. Treatment must be tailored to the specific etiology, pulse, and symptoms to ascertain the true nature of the disease. While Xiao Tiaojing San is effective for Blood-pattern edema, its action is mild and may not suffice. Better alternatives include Wuzhuyu Tang (Evodia Decoction), Zhizhu Tang (Immature Bitter Orange and Atractylodes Macrocephala Decoction), Duohun San (Soul-Rescuing Powder), and Da Tiaojing San (Great Regulating Menses Powder), all of which are essential formulas. The classics state: For postpartum skin edema, consume tangerine peel with wine.

This formula treats women with originally weak zang qi and chronic wind-cold pathogenic factors, resulting in chest and diaphragm fullness and pain, twisting and stabbing pain in the abdomen and hypochondrium, vomiting and nausea, reduced appetite, facial and bodily edema, aversion to cold, and shivering. It also addresses persistent diarrhea, shortness of breath, emaciation, and weakness; or sudden zang qi deficiency due to childbirth, where cold pathogens prevail internally, exacerbating chronic conditions.
Evodia Fruit (1.5 liang), Platycodon Root, Dried Ginger, Licorice, Ophiopogon Tuber, Saposhnikovia Root, Pinellia Tuber, Asarum, Angelica Sinensis, Red Poria, Moutan Cortex, Cinnamon Twig (each 0.5 liang).
Grind the above ingredients into coarse powder. Take 4 qian per dose. Add 1.5 bowls of water, decoct until 0.7 bowl remains, strain, and take hot before meals.

This formula treats hardness and distension of the heart and abdomen resembling a plate, with edges like a rotating disk, caused by fluid retention, known as Qi-pattern.
Immature Bitter Orange (1.5 liang), Atractylodes Macrocephala Rhizome (3 liang).
Cut the above ingredients. Take 4 qian per dose. Add 1.5 bowls of water, decoct until 0.7 bowl remains, strain, and take warm. When the abdomen becomes soft, the pathogen will disperse.