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Xu Zhai (Xu Feng) stated: When a woman's Qi and Blood are abundant, her breasts may feel distended and painful. If the infant does not suckle, she may experience pain, distension, chills, and fever. In such cases, use two to three liang of stir-fried malt, decocted in water and taken orally, which can effectively alleviate these symptoms. Malt has the property of dissipating essence, thereby cutting off the source of milk production. This demonstrates its strong dissipating power; hence, the *Bencao* (Materia Medica) states that it can deplete Kidney Qi. However, if breast swelling and pain are caused by excessive Liver Fire due to depression and anger, one should naturally soothe the Liver, resolve stagnation, and simultaneously nourish and harmonize the Blood. This will prevent Liver Yang from becoming hyperactive, and the swelling will subside on its own. If the stagnation is severe, causing Blood stasis and discomfort, compounded by milk accumulation leading to suppuration, this becomes Ru Yong (Breast Abscess). At this stage, Qi and Blood are severely damaged, so heavy tonification is essential, with only a slight addition of herbs to soothe the Liver and resolve toxicity. If one exclusively uses purgative methods, the ulcerated tissue will fail to generate pus, and the pus-filled tissue will fail to heal.

Postpartum uterine prolapse often results from excessive exertion during childbirth, causing the vagina to protrude externally, accompanied by a sensation of pressure, swelling, and pain. Lifting heavy objects or sexual fatigue can also trigger this condition, along with continuous clear discharge and dribbling urination. Internal treatment should focus on lifting and tonifying, while external application should involve sulfur, cuttlefish bone, and Schisandra berry ground into powder and applied locally.

Failure of the vulva to close is due to inherent weakness of Yuan Qi and lack of proper care during pregnancy, resulting in an inability of Qi and Blood to consolidate. Shiquan Dabu Tang (Ten Ingredients Decoction for Great Tonification) is indicated. In some cases, primiparas may experience swelling of the vaginal opening or pain with incomplete closure, which is attributed to Deficient Heat in the Liver Meridian; Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) is appropriate. For swelling without closure, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with added Schisandra berry is used. Even if the swelling is severe and accompanied by heat, cold-natured herbs must be strictly avoided. Postpartum syndromes are fundamentally characterized by severe deficiency of Qi and Blood. How much more so for uterine prolapse and failure of the vulva to close, which are caused by Qi deficiency and Blood loss! Medical records from Danxi and Lizhai show that although symptoms vary, treatments invariably involve Ginseng, Angelica, and Rehmannia, combined with herbs that lift and astringe. There is even a case of a pregnant woman with abdominal distension who delivered after two days, with a piece of placenta resembling pig liver falling out. She presented with sallow complexion, tidal fever, spontaneous sweating, poor appetite, and fatigue. After thirty doses of Shiquan Dabu Tang, she recovered.

The origins of postpartum syndromes can be categorized into three types: 1. Blood deficiency with Fire agitation; 2. Rejected blood acting recklessly; 3. Dietary injury. How do we explain this? Qi belongs to Yang, and Blood belongs to Yin. The *Classic* states: "Yang deficiency generates external cold; Yin deficiency generates internal heat." Since postpartum hemorrhage leads to excessive blood loss, Blood deficiency causes Fire agitation, resulting in irritability and fever—this is the first point. Blood is like water; flowing downward is its nature. However, splashing it can make it leap over the forehead; channeling it vigorously can make it flow uphill. This is not the nature of water but the result of external force. Similarly, postpartum Deficient Fire rises, and rejected blood acts recklessly, causing dizziness and abdominal pain—this is the second point. The *Classic* says: "Lesser Fire generates Qi; Greater Fire consumes Qi." Li Dongyuan stated: "Fire is the thief of Yuan Qi; they cannot coexist. When one prevails, the other declines." Postpartum, Yuan Qi is severely damaged, and the Spleen and Stomach are weak. Without the Mother (Kidney Water) to nourish the Earth (Spleen), it is difficult to steam and rot the five grains. If dietary intake is excessive, it leads to epigastric fullness, vomiting, and diarrhea—this is the third point. The treatment principles are: tonify if Blood deficiency with agitation; disperse if rejected blood acts recklessly; assist the Spleen and Stomach to digest if dietary injury occurs. Zhu Danxi said: "At the time when postpartum Qi and Blood are extremely depleted, all treatments for various syndromes should primarily focus on greatly tonifying Qi and Blood. Even if there are mixed syndromes, treat them later."

**Postpartum Regulation Decoction**: Treats Qi and Blood deficiency, lower back pain, alternating deficient heat, dry throat, and sore throat, indicating impending Chulao (Postpartum Consumption). Prepared by decocting Shu Di Huang (Prepared Rehmannia Root, 5 qian, stir-fried dry), Mai Dong (Ophiopogon Tuber, stir-fried until dry), Bai Zhu (Atractylodes Rhizome, processed with milk and stir-fried, 2 qian each), Bai Shao (White Peony Root, 1.2 qian, wine-fried), Fu Ling (Poria, 1.5 qian), Du Zhong (Eucommia Bark, 2 qian, wine-mixed and stir-fried until yellow), Xu Duan (Dipsacus Root, 1.5 qian), Ming Niu Xi (Cyathula Root, 2 qian), and Hei Jiang (Black Ginger, 0.6 qian). If lochia does not flow, decoct in water and take warm.

**Shenghua Tang (Generate the New Decoction)**: Generates new blood and removes stasis postpartum; highly effective. Composed of Dang Gui (Angelica Sinensis Root, 3 qian), Chuan Xiong (Ligusticum Rhizome, 1 qian), Tao Ren (Peach Seed, 13 grains), Hei Jiang (Black Ginger, 1 qian), and Zhi Gan Cao (Honey-fried Licorice Root, 0.8 qian). Decoct in water and take.

**Duoming Dan (Life-Restoring Pill)**: Treats retained blood in the uterus causing chest oppression and heart distress, persisting for a long time. Composed of Fu Zi (Prepared Aconite Child Root, peeled and navels removed), Mu Dan Pi (Moutan Cortex, 1 liang each). Grind into powder. Mix with one sheng of sour vinegar and one liang of Da Huang (Rhubarb Root) powder, boil into a paste, and form pills the size of tung seeds. Take 50 pills with warm wine.

**Another Prescription**: Treats rectal prolapse postpartum. Soak 2 liang of Zhi Ke (Bitter Orange Fruit) in decocted water and apply warm compresses; the prolapse will reduce after a while.

**Another Prescription**: Treats uterine inversion/prolapse. Use Jing Jie (Schizonepeta Spike), Huo Xiang Ye (Patchouli Leaf), and Chou Chun Pi (Toona Bark) in equal parts. Decoct and fumigate/wash the area; the uterus will return to position.

**Another Prescription**: For retained placenta and fetal death in utero. Take 2 qian of Xiao Ming Jian (Mirabilite) mixed with hot child urine; the placenta will pass immediately.

**Siwei Tang (Four-Ingredient Decoction)**: Treats all ailments immediately after delivery. Composed of Dang Gui (Angelica Sinensis Root), Yan Hu Suo (Corydalis Rhizome), Xue Jie (Dragon's Blood), and Mo Yao (Myrrh, 0.5 fen each). Some add Hong Hua (Carthamus Flower). Grind into powder, mix with half zhong of hot child urine, and take.

**Danggui Xuejie Wan (Angelica and Dragon's Blood Pill)**: Treats retained lochia forming masses, chest stuffiness, and hard pain in the hypochondrium. Composed of Dang Gui (Angelica Sinensis Root, stir-fried), Xue Jie (Dragon's Blood), Peng Ze (Curcuma Zedoaria), and Shao Yao (Peony Root, 1 qian each). Some include Wu Ling Zhi (Trogopterus Feces). Grind into powder, bind with vinegar paste, and form pills the size of tung seeds. Take 50-60 pills with warm wine before meals on an empty stomach.

**Ruilian San (Lotus Powder)**: Treats postpartum metrorrhagia resembling a spring gush. Composed of Rui Lian (Lotus Calyx, 100 pieces, charred but retaining properties), Zong Lu Tan (Areca Palm Husk Charcoal), Dang Gui (Angelica Sinensis Root, 1 liang each), Guan Gui (Cassia Twig, 5 qian), Bing Lang (Areca Nut, 1 piece), Li Yu Lin (Carp Scales, stir-fried), and Chuan Xiong (Ligusticum Rhizome, 0.75 qian each). Grind into powder. Take 3 qian per dose, mixed with ginger-warmed wine. If bleeding persists, take another dose. For severe hemorrhage, this astringent formula stops bleeding after three consecutive doses.

**Qianjin San (Thousand Gold Powder)**: Equivalent to the ingredients of Shiquan Dabu Tang. Treats postpartum consumption with inability to eat. Composed of Bai Zhu (Atractylodes Rhizome), Fu Ling (Poria), Huang Qi (Astragalus Root, 1 liang each), Ren Shen (Ginseng Root), Chuan Xiong (Ligusticum Rhizome), Shu Di Huang (Prepared Rehmannia Root), Shao Yao (Peony Root), Dang Gui (Angelica Sinensis Root, 1 liang each), Rou Gui (Cinnamon Bark, 1.5 liang), and Gan Cao (Licorice Root, stir-fried, 5 qian). Cut into small pieces. Take 1 liang per dose, decocted with ginger and jujube, and take warm on an empty stomach.

**Renshen Tang (Ginseng Decoction)**: Treats general postpartum deficiency, fever, and night sweats. Composed of Dang Gui Shen (Angelica Root Neck) and Ren Shen (Ginseng Root) in equal proportions. Grind into powder. Take one pig kidney, remove the membrane, slice it, and boil with three sheng of water, half he of glutinous rice, and two stalks of scallion white until cooked. Strain to obtain one zhong of clear juice. Add 2 qian of the powder, decoct until eight-tenths remain, and take.

**Fuling San (Poria Powder)**: Treats postpartum Chulao (Consumption) due to early exertion after childbirth, causing cold pain in limbs, alternating chills and fever, and malaria-like symptoms. Composed of Fu Ling (Poria, 1 liang), Dang Gui (Angelica Sinensis Root), Chuan Xiong (Ligusticum Rhizome), Gui Xin (Cinnamon Heart), Bai Shao (White Peony Root), Huang Qi (Astragalus Root), Ren Shen (Ginseng Root), and Shu Di Huang (Prepared Rehmannia Root, 5 qian each). Add two pig kidneys (devoid of fat membrane, finely ground), three slices of ginger, and two jujubes to two zhong of water. Decoct until one zhong remains. Remove kidneys, ginger, and jujubes. Add 0.5 fen of Mo Yao (Myrrh). Boil until seven-tenths remain. Strain and consume, divided into two warm doses.

**Renshen Suyin (Ginseng and Tamari Indica Decoction)**: Treats postpartum blood entering the lungs, causing facial flushing, panting, and near-death state. Composed of Ren Shen (Ginseng Root, 1 liang, powdered) and Su Mu (Sappan Wood, 2 liang, crushed). Decoct two bowls of water with Sappan Wood until one bowl remains. Strain and mix in the Ginseng powder. Adjust dosage as needed.

**Maren Wan (Hemp Seed Pill)**: Treats constipation due to blood loss and fluid depletion postpartum. Composed of Ma Zi Ren (Hemp Seed, separately ground, superior grade), Zhi Ke (Bitter Orange Fruit, bran-stir-fried, superior grade), and Ren Shen (Ginseng Root, medium grade). Grind into powder, bind with honey, and form pills the size of tung seeds. Take 50 pills with warm wine.

**Another Prescription**: Treats vaginal prolapse due to excessive exertion postpartum. Decoct Siwu Tang (Four-Substance Decoction). Add a small amount of Long Gu (Fossilized Bone Powder). Take two doses consecutively on an empty stomach. Fumigate and wash with sesame oil-infused water to reduce the prolapse.

**Zhuti Tang (Pig Trotter Decoction)**: Treats lactating women with weak energy, sluggish pulse, and blocked milk secretion. Composed of one pig trotter and 5 liang of Tong Cao (Tetrapanax Pith). Wash the trotter thoroughly, boil in ten dou of water until it becomes a soup/congee, and eat. One nursing mother with low milk supply accidentally ate red bean soup at home; that night, her milk flowed like a spring. This method proved effective repeatedly.

**Yongquan San (Surging Spring Powder)**: Treats scanty milk due to Qi deficiency. Composed of Qu Mai Sui (Persicaria Spikes), Men Dong (Ophiopogon Tuber), Wang Bu Liu Xing (Vaccaria Seeds), Shan Jia Chuan (Pangolin Scales, fried until yellow), and Zi Long Gu (Purple Fossilized Bone) in equal parts. Grind into powder. Take 1 qian per dose with hot wine. Eat pig trotter soup first, then take the medicine. Comb the breasts over thirty times with a wooden comb. Take three times daily. As the saying goes: "Pangolin scales and Vaccaria seeds, once eaten by women, ensure constant milk flow."

**Fanhun Dan (Soul-Returning Pill)**: Treats various childbirth syndromes, including retained dead fetus, foul lochia, retained placenta, breech presentation, and malposition. Clears heat and nourishes blood prenatally; promotes elimination of old and generation of new postnatally. Effective for all. Composed of Ye Da Ma (Wild Hemp/Leonurus Herb, also known as Yi Mu Cao, flowers and leaves harvested in April-May when purple flowers bloom, dried in shade, 0.5 jin), Chi Shao Yao (Red Peony Root, 6 qian), Dang Gui (Angelica Sinensis Root, 7 qian), and Mu Xiang (Aucklandia Root, 5 qian). Grind into powder, bind with honey, and form pills the size of a bullet. Dissolve one pill in child urine with wine, mint tea, rice water, Guizhi Tang (Cinnamon Twig Decoction), jujube tea, or Qin Jiao Tang (Gentiana Macrophylla Decoction), according to the patient's preference.

**Danggui Yangrou Tang (Angelica and Mutton Decoction)**: Treats postpartum fever, spontaneous sweating, and limb pain, known as Chulao (Postpartum Consumption). Composed of Huang Qi (Astragalus Root, 1 liang), Ren Shen (Ginseng Root), Dang Gui (Angelica Sinensis Root, 7 qian), Sheng Jiang (Fresh Ginger, 5 qian), and fatty mutton (1 jin). Boil the mutton to extract the juice, remove the meat, add the herbs, decoct, and take. If lochia is not cleared, add Rou Gui (Cinnamon Bark); its acrid and hot nature will promote blood circulation.

**Chentong San (Pain-Relieving Powder)**: Treats postpartum blood stasis, muscle spasms, rigidity of the lower back and neck, and generalized body pain. Composed of Huang Qi (Astragalus Root), Dang Gui (Angelica Sinensis Root, soaked in wine), Guan Gui (Cassia Twig, not exposed to direct fire), Bai Zhu (Atractylodes Rhizome), Du Huo (Angelica Pubescens Root), Sheng Jiang (Fresh Ginger, 5 qian), Chuan Niu Xi (Cyathula Root, soaked in wine, 5 qian), Zhi Gan Cao (Honey-fried Licorice Root, 3 qian), and Xie Bai (Allium Macrostemon Bulb, 3.5 qian). Cut into small pieces. Take 4 qian per dose, decocted in water. Adding Sang Ji Sheng (Taxillus Branches, 0.5 liang) is especially beneficial. For Chuan Niu Xi, select thick, plump, moist, bright yellow roots. It is a mistake to identify black roots as Chuan Niu Xi and yellow ones as Huai Niu Xi. The *Compendium of Materia Medica* notes: Black roots are female Cyathula, which are hard, brittle, and weak in efficacy, so southern practitioners generally exclude them from prescriptions.