Postpartum limb edema and swollen syndromes:an introduction of postpartum limb edema, postpartum swollen.


 TCM Knowledge:Gynecology Syndromes,Women Syndromes ✵Gynecology of TCM is a branch to study the physiological and pathological characteristics of women and to prevent and treat syndromes specific to women. Gynecology of TCM research scope including irregular menstruation, amenia, metrorrhagia, infertility, postpartum syndromes, breast syndromes, and miscellaneous syndromes, etc.

Postpartum limb edema and swollen syndromes.
 
 ✵The women limb edema and swollen syndromes after childbirth, and related syndromes are introduced: postpartum limb edema, postpartum swollen, partially swollen or edema during menses, etc.

Postpartum limb edema.
Postpartum limb edema 
 ✵The postpartum limb edema is a case of limb edema occurring following childbirth, due to various pathogenic reasons. It is also known as limb edema after childbirth.

 ✧ In the TCM system, the pathogenic reasons for the postpartum limb edema normally are residue blood accumulated in five Zang-viscera, flow into limbs via channels, lead to the yellowish complexion and limb edema. If misdiagnosed as water Qi with water regulation herbs, will lead to exhausting. In the case deficiency after childbirth, use exhausting herbs again, is a double deficiency, and risks.

 ✧Ancient herbalists who hold a syndrome differentiation viewpoint with similar explain of pathogenic reasons, and the relevant representative work are introduced and quoted:

 "Edema after childbirth: a woman suffers from residue blood not passing down completely(lochiorrhagia), flow into channels and collaterals by a chance of deficiency, mixed with Qi, stagnancy stasis and not move, rotten as water, as a result, lead to edema in four limbs(edema of hands and arms, feet and legs), sudden chills and sudden fever, should not be treated as water Qi..." [06].Different types are introduced:
 ⑴.A woman suffers from edema in four limbs(edema of hands and arms, feet and legs) after childbirth, residue blood not passing down completely, deficiency, sudden chills sudden fever...
 ⑵.A woman suffers from deficiency and weakness after childbirth, space between skin and muscles are not dense, lost proper regulation and supplement, affected by wind and dampness externally, edema and swollen on face and eyes, swelling of four limbs(swelling of hands and arms, feet and legs).

 "Edema after childbirth: a woman suffers from residue blood flow into meridians and collaterals, develops to water and general edema..." [07].



 ✵The postpartum limb edema common types are known including:

 ✧⑴.Postpartum limb edema, edema after childbirth, affected by pathogens cold and heat, wind dampness, emotional factors(happy, anger, worry, pavor), blood and Qi combat, stay in meridians.

 ✧⑵.Postpartum limb edema, deficiency in Zang-viscera after childbirth, affected by wind and cold pathogen, fullness and pains in chest, colic pain in abdomen and hypochondria, nausea and throw up, poor appetite, edema on body and face, aversion to cold and shiver, or unstoppable diarrhea, lack Qi and fatigue drowsiness, sudden deficiency of Zang-viscera after childbirth, cold pathogen and old disease.

 ✧⑶.Postpartum limb edema, after childbirth, hard and big as a plate in the region from the heart to the abdomen, border or edge is similar to a plate, it is the case of edema due to retained fluid, belongs to Qi Fen(Qi phase).

 ✧⑷.Postpartum limb edema, deficiency and edema, dyspnea with rapid respiration. It is the case which should prompt diuresis.

 ✧⑸.Postpartum limb edema, swelling and edema after childbirth, dyspnea with rapid respiration, polydipsia(fidget and thirst), inhibited urination.

 ✧⑹.Postpartum limb edema, wind deficiency after childbirth, Qi stagnant and affect upward, edema and swelling on head and face.

 ✧⑺.Postpartum limb edema, hurt of Qi and blood due to consumption after childbirth, deficiency in the striae and interstitial space(Cou Li), affected and visiting by wind pathogen, wind pathogen combat with Qi, lead to deficiency swelling and floating, wind-puff(Qi-swelling, emphysema), in the case skin is similar to ripe plum, will develop to edema.

 ✧⑻.Postpartum limb edema, blue swelling on whole body and pains, suffering from uterine bleeding.

 ✧⑼.Postpartum limb edema, blood deficiency after childbirth, wind-puff, edema.

Postpartum swollen.
Postpartum swollen 
 ✵The postpartum swollen is a syndrome of swollen occurring following childbirth, due to various pathogenic reasons. It is also known as swollen after childbirth.

 ✧ In the TCM system, the pathogenic reasons for the postpartum swollen normally are difficulty in urination, dampness accumulation, Qi deficiency of the urinary bladder, spleen deficiency and lung deficiency, etc.

 ✧Ancient herbalists who hold a syndrome differentiation viewpoint with similar explain of pathogenic reasons, and the relevant representative work are introduced and quoted:

 "Case postpartum swollen of the whole body, whole body deficient swollen...

 Case postpartum general edema, or edema of the whole body after childbirth...

 Case postpartum deficient swollen, panting or short of breath..." [02].

 "In the condition of edema in hands and feet after childbirth, the skin is bright, it is mainly due to the reasons include spleen deficiency and could not regulate water, lung deficiency and could not transport water." [03].

 "Case over seven days after childbirth, a woman suffers from edema in hands and feet, bright skin. Other symptoms might be observed: difficulty in defecation(constipation), affected by the cold pathogen, dampness pathogen hurt the exterior, no perspiration and distension.

 Case after childbirth, a woman suffers from wind dampness affection, hurt the spleen meridian, Qi stagnancy and blood stasis, lead to puffiness and edema in face and eyes, swelling and distension in limbs with panting(distension or edema of hands and arms, feet and legs, with panting)." [03].



 The swollen and distension, also could be classified into blood-phase or water-phase in TCM, normally the case menses stopped first, edema of limbs(edema of hands and arms, hands and legs), urination is inhibited, is the condition swollen and distension of the blood-phase type; the case urination is inhibited, then edema of limbs(edema of hands and arms, hands and legs), then menses is stopped, is the condition swollen and distension of the water-phase type.

 ✧Ancient herbalists who hold a syndrome differentiation viewpoint with similar explain of pathogenic reasons, and the relevant representative work are introduced and quoted:

 "Swollen and distension of blood-phase or water-phase: a woman suffers from menses stopped..., In the case, menses stopped first, edema of limbs(hands and feet, arms and legs), urination is inhibited, it is the condition swollen and distension of the blood-phase type; In the case urination inhibited, then edema of limbs(hands and feet, arms legs), then menses is stopped, it is the condition swollen and distension of the water-phase type....; Other reasons are known: improper diet and life habits, the disorder of seven emotions and six exogenous pathogens, hurt the spleen and stomach..." [04].Different types are introduced:
 ⑴.A woman suffers from menses is stopped first, edema of limbs(edema of hands and arms, feet and legs), urination is inhibited, it is the condition swollen and distension of the blood-phase type;
 ⑵.A woman suffers from urination is inhibited, then edema of limbs(edema of hands and arms, feet and legs), then menses is stopped, it is the condition swollen and distension of the water-phase type.
 ⑶.A woman suffers from obstruction of collaterals, blood is transformed into water, flow to limbs(hands and arms, feet and legs), all edema and distension, it is also the condition of the blood-phase type.

 "A woman suffers from edema and swollen after childbirth, there are cases due to residue blood stagnancy and retained, blocking the Ying and Wei system, disorder of circulation, edema on the face and limbs(edema of the face, hands, arms, feet, and legs);...there are cases due to great deficiency of Qi and blood, edema of limbs and body(edema of the body, hands and arms, feet and legs);…there are cases edema due to water Qi(dampness pathogen), surely cough, frequent urination..." [05].Actually, the edema and swollen was also classified into the blood-phase type or the water-phase type, by herbalist 叶桂(Yè Guì).

 "General edema after childbirth: a woman suffers from cyanotic swelling(cyanotic edema), skin looks like ripe plum fruit, it is a syndrome sick in the blood-phase...; In case fullness and distention in the heart and chest, the skin is swelling and thick, urination is not inhibited, it is a syndrome sick in the Qi-phase...; In case the skin is thin and bright, panting and cough in sleep, it is the case of dropsy or edema..." [07].



Partially swollen or edema during menses.
Knowledge 
 ✵The partially swollen or edema during menses is syndrome edema or swollen on partial body part during menses, normally due to spleen deficiency.
 ✵Ancient herbalists who hold a syndrome differentiation viewpoint with similar explain of pathogenic reasons, and the relevant representative work are introduced and quoted:

 "A woman suffers from partially swollen edema during menses, it is the condition due to spleen deficiency and weakness..." [06].



References:
  • 01.Postpartum limb edema and swollen syndromes:an introduction of postpartum limb edema, postpartum swollen.
  • 02.Song Shi Nǚ Ke Cuo Yao(the Synopsis of Song's Gynaecology).By 宋林皋(Sòng Lín Gāo)[Ming].
  • 03.Jiēzhāi Gōng Tāi Chǎn Yī àn(Births Cases of Jie Zhai Gong).By 王纶(Wáng Guān)[Ming].
  • 04.Nǚ Ke Bǎi Xiào Quán Shū(the Efficacious Complete Book of Gynaecology).By 龚居中(Gōng Jūzhōng)[Ming,1630].
  • 05.Ye Shi Nǚ Ke Zhèng Zhì(the Syndromes and Therapeutics of Ye's Gynaecology).By 叶桂(Yè Guì)[1817].
  • 06.Fù Kē Bèi Kǎo(the References of Gynaecology).By 何应豫(Hé Yīngyù)[1820].
  • 07.Fù Kē Liáng Fāng(the Effective Prescription of Gynecology).By 何梦瑶(Hé Mèngyáo)[1751].

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