产后手足俱浮，皮肤间光莹色润，乃脾虚不能制水，肾虚不能行水也，宜大补为主，补中利水
汤治之。如因寒邪湿气，伤表无汗而肿，前汤加姜皮、半夏、苏叶，或五皮散亦可。又有由败血乘
虚停积，而循经流入四肢，留淫日深，腐坏如水，故令面目四肢浮肿，乍寒乍热，医人不识，误作水
气治之，多用导水。凡治水药，极能虚人，产后既虚，药又虚之，是谓重虚，多致夭枉。如产毕，随服生化汤，化瘀生
新，自无此败血如水之症。今既失治，宜服小调经散，则血行肿消。密斋用调经汤，又加味五皮汤，使气血流行，风湿
消散，肿自消矣。若水气系肺失降下之令，其人必发咳嗽，小便涩少，可立而辨也。如脚肿或肚肺，或成臌肿，宜
济生肾气丸。冯氏云∶产后浮肿，若寒水侮土，宜养脾肺；若气虚浮肿，宜盖脾胃；若水气浮肿，
宜补中汤；若兼喘咳而脉沉细无力，此命门火衰，脾土虚寒也，八味丸主之。腹满者，气虚而非
血也，补中汤送八味丸，一以升补清阳，一以敛纳浊气，升降既得，而胀满自消矣。
补中利水汤 治产后七日外，消肿利水。
人参 白术（土炒，各二钱） 茯苓 白芍（炒，各一钱） 木瓜（八分） 陈皮（五分）
紫苏 制苍术 木通 大腹皮（黑豆水净制） 浓朴（姜汁制，各四分）
如壅满，用制半夏、陈皮、制香附监之。
小调经散 治产后浮肿，因败血者。
归身（酒洗） 赤芍 桂心（各一钱） 没药 琥珀（各一分） 麝香 细辛（各五厘） 炙草（二分）
为末，每服五分，姜汁酒调下。
调经汤
归身（酒洗） 赤芍 丹皮 桂心 赤茯苓 陈皮 炙草（各一钱） 细辛 炮
姜（各五分）
加味五皮汤 治产后虚弱，腠理不密，调理失宜，外受风湿，面目四肢浮肿者。
桑白皮 陈皮 茯苓皮 大腹皮 生姜皮（各一钱） 汉防己 枳壳 猪苓（各八分） 炙草（五分）
Postpartum edema of the hands and feet, with skin that is smooth and lustrous, indicates Spleen deficiency failing to control water and Kidney deficiency failing to transform water. Treatment should primarily focus on substantial tonification, using Buzhong Lishui Tang (Tonify Middle and Promote Water Decoction) to treat it. If the edema is caused by cold pathogenic factors and dampness invading the exterior, resulting in anhidrosis and swelling, add Ginger Peel (Zi Jiang Pi), Pinellia Tuber (Ban Xia), and Perilla Leaf (Su Ye) to the aforementioned decoction, or Wupi San (Five-Peel Powder) may also be used. Another cause is residual blood (postpartum stasis) taking advantage of deficiency to stagnate and accumulate, flowing along the meridians into the four limbs. Over time, this stagnation infiltrates deeply, becoming corrupt and watery, causing edema of the face and limbs accompanied by alternating chills and fever. If physicians fail to recognize this pathology and mistakenly treat it as water qi disease, they often use diuretic drugs. All drugs for treating water qi are extremely damaging to healthy Qi. Since the postpartum state is already deficient, using such drugs further depletes it, a condition termed "double deficiency," which often leads to premature death. If Shenghua Tang (Generate New Decoction) were taken immediately after delivery to resolve stasis and generate new blood, such symptoms of residual blood turning watery would naturally not occur. Now that treatment has been delayed, Xiao Tiaojing San (Small Regulate Menses Powder) should be administered to promote blood circulation and eliminate swelling. Mi Zhai used Tiaojing Tang (Regulate Menses Decoction) combined with Jiawei Wupi Tang (Modified Five-Peel Decoction) to facilitate the flow of Qi and Blood and dissipate wind-dampness, thereby resolving the swelling. If the water qi disease is due to the Lung's failure to descend, the patient will inevitably suffer from coughing and scanty, difficult urination, allowing for immediate differentiation. For edema of the legs, abdominal distension resembling a drum, or ascites, Jisheng Shenqi Wan (Jisheng Kidney Qi Pill) is appropriate. Feng Shi stated: For postpartum edema, if cold water insults Earth (Spleen), nourish the Spleen and Lung; if edema is due to Qi deficiency, tonify the Spleen and Stomach; if edema is due to water qi, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction); if accompanied by wheezing, coughing, and a deep, thin, and forceless pulse, this indicates decline of Mingmen Fire and deficiency-cold of Spleen Earth, treated with Bawei Wan (Eight-Ingredient Pill). Abdominal fullness due to Qi deficiency rather than blood stasis can be treated by administering Buzhong Yiqi Tang to deliver Bawei Wan; one formula raises and tonifies clear Yang, while the other gathers and accepts turbid Qi. Once ascending and descending functions are restored, the fullness will naturally subside.
Buzhong Lishui Tang (Tonify Middle and Promote Water Decoction): Treats edema and promotes water metabolism more than seven days postpartum.
Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma, stir-fried with soil, 2 qian each), Fu Ling (Poria), Bai Shao (Paeoniae Radix Alba, stir-fried, 1 qian each), Mu Gua (Chaenomelis Fructus, 8 fen), Chen Pi (Citri Reticulatae Pericarpium, 5 fen), Zi Su (Perillae Folium), Zhi Cang Zhu (Atractylodis Rhizoma, processed), Mu Tong (Akebiae Caulis), Da Fu Pi (Arecae Pericarpium, washed with black soybean water), Hou Po (Magnoliae Officinalis Cortex, processed with ginger juice, 4 fen each).
If there is severe congestion and fullness, use Zhi Ban Xia (Pinelliae Tuber, processed), Chen Pi, and Zhi Xiang Fu (Cyperi Rhizoma, processed) to regulate.
Xiao Tiaojing San (Small Regulate Menses Powder): Treats postpartum edema caused by residual blood.
Dang Gui Shen (Angelicae Sinensis Radix, wine-washed), Chi Shao (Paeoniae Radix Rubra), Gui Xin (Cinnamomi Ramulus Medulla, 1 qian each), Mo Yao (Myrrha), Hu Po (Electrum, 1 fen each), She Xiang (Moschus), Xi Xin (Asari Radix et Rhizoma, 5 li each), Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted, 2 fen).
Grind into powder, take 5 fen per dose, mixed with ginger juice and wine.
Tiaojing Tang (Regulate Menses Decoction):
Dang Gui Shen (Angelicae Sinensis Radix, wine-washed), Chi Shao (Paeoniae Radix Rubra), Dan Pi (Moutan Cortex), Gui Xin (Cinnamomi Ramulus Medulla), Chi Fu Ling (Poria cum Risu), Chen Pi (Citri Reticulatae Pericarpium), Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted, 1 qian each), Xi Xin (Asari Radix et Rhizoma), Pao Jiang (Zingiberis Rhizoma, processed), 5 fen each.
Jiawei Wupi Tang (Modified Five-Peel Decoction): Treats postpartum weakness, loose interstices, improper regulation, external invasion of wind-dampness, causing edema of the face and limbs.
Sang Bai Pi (Mori Cortex), Chen Pi (Citri Reticulatae Pericarpium), Fu Ling Pi (Poria Cum Cortice), Da Fu Pi (Arecae Pericarpium), Sheng Jiang Pi (Zingiberis Rhizoma Recens Cortex, 1 qian each), Han Fang Ji (Stephaniae Tetrandrae Radix), Zhi Ke (Aurantii Fructus Immaturus), Zhu Ling (Polyporus, 8 fen each), Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma, roasted, 5 fen).