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Translation:

The treatise states: What is the reason for postpartum heat oppression and qi rushing upward, transforming into Hong Kong gout (a disease characterized by swelling and heaviness of the lower legs and weakness)? The answer is: After childbirth, lying in bed leads to blood deficiency generating internal heat. Furthermore, due to excessive exposure to coolness during spring and summer, combined with the steaming dampness from the ground entering through the feet, the pathogen lodges and forms Hong Kong gout. Its manifestations include heat oppression, muscle twitching and pulling pain, fright palpitations, vexation, vomiting, and qi rushing upward; these are all its signs. One may take Xiao Xuming Tang (Decoction of Minor Continuation of Life) (see Formula 8 in this volume). Two or three doses will surely cure it. If a physician mistakenly uses drugs that purge stasis to attack it, the blood will be depleted and the disease will increase.

Chen Wuyue commented: Hong Kong gout is indeed a common disease, but I have never heard of it transforming from postpartum conditions. Often, reading *Qianjin Fang* (Essential Prescriptions Worth a Thousand Gold), one sees statements that many women after childbirth suffer from this disease, and thus deduces this syndrome. This shows how textual descriptions can harm the understanding of medical principles. If there is heat oppression and qi rushing upward, how can one simply administer Xuming Tang? This medicine originally treats wind-stroke of the Shaoyang channel, not all channels of Hong Kong gout indiscriminately. One must rely on the treatises on Hong Kong gout and regulate according to Yin and Yang channels. This involves specialized knowledge and is not easy to discuss lightly. Since it is not a critical disease of the postpartum period, further citation is unnecessary.

Although Chen Wuyue has this comment, modifying Xiao Xuming Tang and using it yields effective results without exception. Thus, *Baiwen* (Hundred Questions) states: When cold invades the Three Yang channels, the illness must be cold in nature, treated with Xiao Xuming Tang. (Adding ginger juice is fastest). When summer-heat invades the Three Yin channels, the illness must be hot in nature, treated with Xiao Xuming Tang. (Remove Fuzi [Prepared Aconite Root], reduce Rougui [Cinnamon Bark] by half). For those with extreme restlessness, Zixue Powder (Purple Snow Powder) is best. (I selected the modification methods from *Baiwen* so that later generations may receive treatment). If Zixue Powder is unavailable, decoct fresh Bohe (Menthae Haplocalycis Herba), chew it, and swallow with cold water.

The treatise states: What is the reason for generalized body pain after childbirth? The answer is: After childbirth, the joints open up, and blood vessels disperse. When qi is weak, blood stagnates in the meridians and between muscles. If this stagnation persists for days, joint movement becomes difficult, and sinews and vessels become tense and pulling. Therefore, one cannot turn or side over in bed, hands and feet cannot move freely, and there is body fever and headache. If a physician treats it as Shanghan (Cold Damage), sweating will occur, causing sinews and vessels to tremble, leading to cold extremities and the generation of other diseases. One should only use Chentong San (Powder for Hastening Pain Relief) to eliminate it.