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，
自无此败血如水之证。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。如脚肿或肚肿，或成鼓肿，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，宜益脾胃。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，虚气而非血也，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
苏木通 制苍术 大腹皮（黑豆水制净） 浓朴（姜汁制，各四分）
水煎服。如壅满，用制半夏、陈皮、制香附监之。虚，加人参。热，加去心麦冬、炒黄芩以清肺金。
大便不通，加郁李仁、麻仁各一钱。
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）
姜一片，水煎服。
加味五皮汤 治产后虚弱，腠理不密，调理失宜，外受风湿，面目浮肿，四肢肿者。
桑白皮 陈皮 茯苓皮 大腹皮（黑豆水制净） 生姜皮（各一钱） 汉防己 枳壳（麸炒） 猪
苓（各八分） 炙草（五分）
生姜引，水煎服。此方重在外受风湿四字，故用此渗利之剂。
五皮散（见本卷痢滞门。） 生化汤（见本卷生化汤论后。） 济生肾气丸（见上卷
诸痛门，附六味地黄汤下。） 补中益气汤（见上卷诸痛门。） 八味地黄丸（见上卷诸痛
门，附六味地黄汤下。）
产后出现手足浮肿，皮肤光亮润泽，这是脾虚不能制约水湿，肾虚不能运化水液所致。治疗应以大补为主，用补中利水汤来治疗。
如果是因寒邪湿气侵袭体表，导致无汗而浮肿，可在前方中加入姜皮、半夏、苏叶，或者使用五皮散也可以。又有因败血乘虚停滞积聚，沿着经络流入四肢，停留日久深重，腐败坏乱如水状，从而导致面目和四肢浮肿，忽冷忽热。医生如果不认识这种病证，误当作水气病来治疗，多用导水利尿的药物。凡是治疗水气的药物极易使人虚弱，产后身体本就虚弱，再用药进一步损伤正气，这就叫做“重虚”，往往导致早逝。如果在分娩结束后随即服用生化汤，化瘀生新，自然就不会出现这种败血如水样的病证。如今既然已经延误治疗，适宜服用小调经散，使血液运行通畅，浮肿自消。密斋使用调经汤，又加上加味五皮汤，使气血流行，风湿消散，浮肿自然消除。如果水气病变涉及肺脏，失去肃降下行的功能，患者必然会出现咳嗽，小便涩滞量少，可以立即辨别出来。如果是脚肿或腹部肿胀，或者形成鼓胀，适宜使用济生肾气丸。冯氏说：产后浮肿，如果是寒水侮土（寒水反克脾土），适宜调养脾肺。如果是气虚引起的浮肿，适宜补益脾胃。如果是水气引起的浮肿，适宜使用补中益气汤。如果兼有气喘咳嗽且脉象沉细无力，这是命门火衰，脾土虚寒的表现，用八味丸主治。腹部胀满的，是虚气而非瘀血，可用补中益气汤送服八味丸。一方升补清阳，一方敛纳浊气，升降功能恢复，胀满自然消除。
补中利水汤：治疗产后七日以后，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、木通、制苍术、大腹皮（黑豆水制净）、浓朴（姜汁制，各四分）。
水煎服。如果壅塞胀满，用制半夏、陈皮、制香附来监制它。体虚的，加人参。有热的，加去心麦冬、炒黄芩以清肺金。大便不通的，加郁李仁、麻仁各一钱。
小调经散：治疗产后浮肿，因败血阻滞者。
当归身（酒洗）、赤芍、桂心（各一钱）、没药、琥珀（各一分）、麝香、细辛（各五厘）、炙甘草（二分）。
研为末，每次服用五分，用姜汁和酒调服。
调经汤：
当归身（酒洗）、赤芍、丹皮、桂心、赤茯苓、陈皮、炙甘草（各一钱）、细辛、炮姜（各五分）。
生姜一片，水煎服。
加味五皮汤：治疗产后虚弱，腠理不紧密，调理失当，外受风湿，导致面目浮肿，四肢肿胀。
桑白皮、陈皮、茯苓皮、大腹皮（黑豆水制净）、生姜皮（各一钱）、汉防己、枳壳（麸炒）、猪苓（各八分）、炙甘草（五分）。
生姜为引，水煎服。此方重在应对“外受风湿”四字，所以使用这种渗湿利水的药剂。
五皮散（见本卷痢滞门）。
生化汤（见本卷生化汤论后）。
济生肾气丸（见上卷诸痛门，附六味地黄汤下）。
补中益气汤（见上卷诸痛门）。
八味地黄丸（见上卷诸痛门，附六味地黄汤下）。
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 fluids. Treatment should primarily focus on substantial tonification, using Buzhong Lishui Tang (Supplement the Middle and Promote Water Decoction) for management.
If the swelling is caused by cold pathogenic factors and dampness invading the exterior, resulting in anhidrosis and edema, add Ginger Peel (Zi Pi), Pinellia Rhizome (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 (Bai Xue) stagnating due to deficiency, flowing along the meridians into the four limbs, accumulating deeply over time, decomposing and becoming watery, thus causing edema of the face and limbs accompanied by alternating chills and fever. If physicians fail to recognize this condition and mistakenly treat it as fluid retention, they often employ diuretic drugs excessively. All drugs treating fluid retention are extremely draining to the body; since the postpartum state is already deficient, using such drugs further depletes the patient, a situation 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. Since treatment has been delayed, Xiao Tiaojing San (Small Regulating Menses Powder) should be administered to promote blood circulation and resolve edema. Mi Zhai used Tiaojing Tang (Regulating Menses Decoction) combined with Jiawei Wupi Tang (Modified Five-Peel Decoction) to facilitate the flow of Qi and Blood, dissipate wind-dampness, and thereby eliminate edema. If the fluid pathology involves the Lung, losing its descending function, the patient will inevitably develop coughing and scanty, difficult urination, which can be distinguished immediately. For edema of the legs or abdomen, or distension resembling drumming, Jisheng Shenqi Wan (Jisheng Kidney Qi Pill) is appropriate. Feng Shi stated: For postpartum edema, if Cold-Water insults Earth (Spleen), nourishing the Spleen and Lung is suitable. If edema is due to Qi deficiency, tonifying the Spleen and Stomach is suitable. If edema is due to fluid retention, Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction) is suitable. 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 deficient Qi rather than blood stasis should be treated with Buzhong Yiqi Tang administering Bawei Wan. One formula raises and tonifies clear Yang, while the other gathers and assimilates turbid Qi; once ascending and descending functions are restored, distension and fullness will naturally subside.
Buzhong Lishui Tang (Supplement the Middle and Promote Water Decoction): Treats edema and promotes water metabolism after seven days postpartum.
Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma, stir-fried with soil, each 2 qian), Fu Ling (Poria), Bai Shao (White Peony Root, stir-fried, each 1 qian), Mu Gua (Chaenomeles Fruit, 0.8 qian), Chen Pi (Citrus Reticulatae Pericarpium, 0.5 qian), Zi Su (Perilla Fructus/Leaf context implies leaf here usually but text says Zi Su, likely Perilla Leaf/Fructus distinction needed, assuming Leaf based on exterior syndrome), Mu Tong (Akebia Stem), Zhi Cang Zhu (Prepared Atractylodis Rhizoma), Da Fu Pi (Areca Seed Pericarpium, washed clean with black soybean water), Hou Po (Magnolia Bark, processed with ginger juice, each 0.4 qian).
Decoct in water and take orally. If there is obstruction and fullness, use Zhi Ban Xia (Prepared Pinellia Rhizoma), Chen Pi, and Zhi Xiang Fu (Prepared Cyperi Rhizoma) to moderate it. For deficiency, add Ren Shen. For heat, add Mai Dong (Ophiopogon Tuber, heart removed) and Huang Qin (Scutellaria Root, stir-fried) to clear Lung Metal. For constipation, add Yu Li Ren (Prunus Semen) and Ma Ren (Cannabis Seed), each 1 qian.
Xiao Tiaojing San (Small Regulating Menses Powder): Treats postpartum edema caused by residual blood.
Dang Gui Shen (Angelica Sinensis Root Head, washed with wine), Chi Shao (Red Peony Root), Gui Xin (Cinnamon Twig Heart, each 1 qian), Mo Yao (Myrrha), Hu Po (Amber, each 1 fen), She Xiang (Musk), Xi Xin (Asarum, each 5 li), Zhi Gan Cao (Honey-fried Licorice Root, 2 fen).
Grind into powder. Take 5 fen per dose, mixed with Ginger Juice and Wine.
Tiaojing Tang (Regulating Menses Decoction):
Dang Gui Shen (Angelica Sinensis Root Head, washed with wine), Chi Shao (Red Peony Root), Dan Pi (Moutan Cortex), Gui Xin (Cinnamon Twig Heart), Chi Fu Ling (Red Poria, each 1 qian), Chen Pi (Citrus Reticulatae Pericarpium), Zhi Gan Cao (Honey-fried Licorice Root, each 1 qian), Xi Xin (Asarum), Pao Jiang (Prepared Ginger, each 5 fen).
Add one slice of fresh Ginger, decoct in water and take orally.
Jiawei Wupi Tang (Modified Five-Peel Decoction): Treats postpartum weakness, loose interstices (Cou Li), improper care, external invasion of wind-dampness, leading to edema of the face and limbs.
Sang Bai Pi (Mulberry Root Bark), Chen Pi (Citrus Reticulatae Pericarpium), Fu Ling Pi (Poria Skin), Da Fu Pi (Areca Seed Pericarpium, washed clean with black soybean water), Sheng Jiang Pi (Fresh Ginger Skin, each 1 qian), Han Fang Ji (Stephania Tetrandra), Zhi Ke (Bitter Orange, stir-fried with bran), Zhu Ling (Polyporus, each 0.8 qian), Zhi Gan Cao (Honey-fried Licorice Root, 0.5 fen).
Use fresh Ginger as a guide, decoct in water and take orally. This formula focuses on the phrase "external invasion of wind-dampness," hence employing these draining and promoting agents.
Wupi San (Five-Peel Powder) (See Dysentery and Stagnation Section in this volume).
Shenghua Tang (Generate New Decoction) (See Discussion on Generate New Decoction in this volume).
Jisheng Shenqi Wan (Jisheng Kidney Qi Pill) (See Various Pain Section in Upper Volume, attached under Liuwei Dihuang Wan).
Buzhong Yiqi Tang (Tonify the Middle and Augment Qi Decoction) (See Various Pain Section in Upper Volume).
Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill) (See Various Pain Section in Upper Volume, attached under Liuwei Dihuang Wan).