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Shuhe stated: If the Cun (inch) pulse at the wrist is surging, rapid, and irregular after childbirth, it indicates death. If the pulse is deep, faint, yet still palpable with heavy pressure to the bone, it indicates life. He further stated: A deep, small, and slippery pulse indicates life; a full, large, firm, wiry, and urgent pulse indicates death. Danxi stated: During pregnancy, the pulse should be surging and rapid; if it remains surging and rapid after delivery, it indicates death. He also stated: If the pulse is fine and small during pregnancy but becomes surging and large after delivery, it mostly indicates death. The *Chanjing* (Classic of Childbirth) states: For diseases during pregnancy, the pulse should ideally be substantial; for diseases after childbirth, the pulse should ideally be deficient. During pregnancy, one should soothe Qi and secure the fetus; after childbirth, one should tonify deficiency and resolve stasis. This is the key principle.

During labor, Qi and Blood are in turmoil, the fetal sac ruptures, deviating from normal conditions. Amniotic fluid must break first, commonly known as "Baopang" (fetal membrane fluid), which is the fluid nourishing the fetus. Once the fluid flows out, the sac ruptures and birth occurs. After delivery, both Qi and Blood are severely deficient, so the pulse should appear slow and slippery. "Slow" implies leisurely and relaxed, not hurried due to Qi depletion; "slippery" implies smooth and fluent, not withered and rough due to Blood loss. Both are auspicious signs. However, a full, large, wiry, or firm pulse is unsuitable for postpartum Qi and Blood deficiency. "Full" indicates excess pathogen; "large" indicates pathogenic advance; "wiry" indicates Yin constriction and failure of dissemination; "firm" indicates rigidity and stagnation, approaching a lack of Stomach Qi. All these are adverse pulses.

Upon completion of delivery, drink a cup of hot urine from a male child under ten years old ("Tongbian"). Do not lie down immediately; instead, sit quietly with eyes closed, then get into bed after a short while. One should lie on the back or sit upright, not on the side; knees should be bent, not legs extended high against the headboard. The headboard should be padded thickly with mats, and walls should be sealed without gaps to prevent "thief wind" (drafts). Apply vinegar to the nose, use vinegar charcoal fumigation, or burn lacquerware. Gently massage from the heart area down to the navel with the hand to ensure complete expulsion of lochia, preventing blood slipping or counterflow. Continue this for three days. Regardless of abdominal pain, take five to seven doses of Tongbian mixed with wine, warmed. Although wine promotes blood circulation, helps expel lochia, and stimulates lactation, the Zang-Fu organs are currently weak, so it should not be consumed excessively or immediately after delivery, lest it draw blood into the four limbs causing "blood vertigo" (syncope due to blood loss). If Stomach Qi is weak or there is internal cold, Tongbian should also be prohibited to avoid damaging Stomach Qi. Instead, frequently consume thin congee made with Baizhu (Atractylodis Macrocephalae Rhizoma), gradually adding small amounts of fatty meat and pig trotters. Guard speech, regulate the Seven Emotions, avoid frequent hair combing and foot washing, limiting these practices to 100 days postpartum. If Qi and Blood are weak, regardless of the month, otherwise symptoms such as pain in hands, feet, waist, and legs may occur, named "Rulao" (postpartum consumption), which is difficult to treat. There is no need to ask whether the baby is male or female after birth, as conversation may leak Qi, and love/hate may strain the Spirit. Great joy and anger are strictly forbidden. Joy causes Qi to scatter, potentially leading to abnormal bleeding; anger causes Qi to rebel, potentially forming masses ("Jia"). Do not sleep alone, lest it cause empty fright; do not scrape the tongue coating, lest it damage Heart Qi; do not brush teeth, lest it cause blood rebellion. Only when Qi and Blood have stabilized should one resume daily affairs. Violating taboos initially seems slight as an autumn hair, but the resulting illness can be heavy as a mountain. Can one not be cautious?

Milk is formed from Qi and Blood. Postpartum women should not eat salt, as salt stops bleeding and prevents milk production, and induces difficult-to-treat coughs. In summer, avoid cooling fans and cold foods, and never sleep facing the wind. On the third day after birth, tradition dictates a "Third-Day Bath." It is said that without it, the skin will become rough and scaly later in life. In summer heat, bathing is optional; however, after winter, bathing is strictly prohibited to prevent wind entering the umbilicus, causing "umbilical tetanus" (Qifeng). Many who skip the bath grow up with healthy skin. Wise people consider skipping the bath acceptable. Since the fetus grows in the warm maternal abdomen, upon birth, it loses Yang warmth. Even in summer, clothing must be thorough to exclude external wind. Hence the saying, "No fear of June" (referring to infants tolerating heat well if protected). To cut the umbilical cord, use moxa twine soaked in sesame oil, burn it until charred, then cut. Bind the stump with soft cloth wrapped in thick cotton to prevent wind exposure and urine contamination, which is crucial for preventing umbilical tetanus. Newborn skin is tender and pores are open; use worn adult cotton for clothes to preserve meridian essence, and coarse cloth to toughen the skin, benefiting the child for life.

On the second day, inspect the infant's mouth roof. If white blisters ("mouth pearls") appear, gently puncture them with a silver spoon, ensuring they are removed and not swallowed, then apply Peking ink. If left untreated, they harden, preventing feeding and leading to "mouth closure" syndromes. Also check the gums for "horse teeth" (epstein pearls); pierce them if necessary, allow slight bleeding, and apply ink. Store the placenta in a stable porcelain bottle of appropriate size; small bottles may cause infant regurgitation. Keep maternal blood-stained clothes out of direct sun, and wet infant clothes out of night dew. Bird droppings on clothes can cause toxic sores and malnutrition syndromes ("Gan"). Ancient texts define the first month as the "small full moon" and the second as the "great full moon." Avoiding rage, overwork, and sexual desire during these two months ensures lifelong health and fertility. Human life is precious; abandoning children due to poverty or overcrowding harms Heavenly Harmony and is strictly forbidden.

Postpartum syndromes should not be treated generally with tonics, lest blood stasis remain. Pathogens cannot be expelled without promoting blood circulation. Even in deficiency syndromes, Qi recovery depends on Blood movement, but methods must be moderate, not overly harsh. Critical postpartum conditions include "Three Rushes" (Bai Xue Chong Fei, Chong Xin, Chong Wei -敗血 rushing to Lung, Heart, Stomach) and "Three Urgencies" (vomiting, diarrhea, excessive sweating). Medications are subject to three prohibitions: 1. Foshou San, because Chuanxiong is acrid and dispersing, causing sweat and leakage. 2. Siwu Tang, because Shengdi is cold, causing diarrhea and coagulating blood; Baishao is sour and cold, damaging vital Qi. 3. Xiaochaihu Tang, because Huangqin is cool, obstructing lochia discharge. Additionally, three therapies are prohibited: diaphoresis (sweating), purgation (downward draining), and diuresis. Do not violate the Stomach or Upper/Middle/Lower Jiao. Treat miscellaneous symptoms by primarily tonifying Qi and Blood. Sexual intercourse is prohibited until 100 days postpartum; otherwise, it leads to death or chronic weakness and myriad diseases. Women suffering from wind patterns and lower abdominal coldness often do so due to early resumption of sexual activity.

Ancient formulas for postpartum diseases often modify Siwu Tang. However, Danxi prohibited Baishao because its sour-cold nature damages rising Qi. Why? Because postpartum women have dual deficiency of Qi and Blood, possessing only the withering energy of Autumn/Winter, lacking the sprouting energy of Spring/Summer. Thus, cold-cool herbs are taboo, and warm-hot herbs are preferred to support the source of generation. Ancestors formulated Siwu Tang using Xionggui (acrid-warm) to offset Dishaodi (cold), achieving balance for gynecological disorders. For postpartum use, Baishao must be stir-fried with wine repeatedly to remove its sour-cold nature, retaining only blood-nourishing and moving properties. Adding Heijiang (charred ginger) makes it suitable. Baishao is slightly sour and astringent, ideal for dissipating Yin Qi, making it a key postpartum herb. Ancestors warned against cold-sour herbs, yet many ignore that Shengdi is even colder and directly harms the Blood level. If necessary, replace Shengdi with Shudi. Blindly using Siwu Tang for postpartum cases has misled many.

The priority in postpartum care is eliminating stale blood. Stagnant blood causes various diseases. Since Yuan Qi is depleted and transport is impaired, stasis inevitably remains. Physicians must first expel stasis before tonifying. This is the primary principle. If deficiency is extreme and cannot wait, add warming-moving herbs to strong tonics. Strong tonics provide power for circulation; warming herbs ensure flow without stagnation. Even for excess syndromes requiring stasis removal, harsh drugs are contraindicated. Postpartum Yuan Qi is greatly deficient; without control, blood may hemorrhage uncontrollably under drug influence. Deficiency leads to collapse, irreversible like spilled water. Therefore, Shenghua Tang is best: it moves while tonifying, tonifies while moving, is warm without stagnation, and does not harm Stomach Qi.

Postpartum Yuan Qi is largely depleted, and new blood has not yet formed. Headache, fever, nausea, and fullness are false manifestations of deficiency. Primarily tonify Qi and Blood. If lochia is incomplete, add blood-moving herbs to tonics. If complicated by wind-cold stagnation, combine tonification with dispersing and digesting agents. Do not indiscriminately use harsh drugs that damage Qi and Blood, mistaking exterior pathogens for true Qi injury.

After delivery, even without disease, rest and labor management are essential. Regulate Spleen and Stomach, consume delicious food to stabilize Zang-Fu and harmonize Qi and Blood, preventing disease. However, Middle Qi is weak and digestion is poor; do not overeat, lest it damage Spleen and Stomach.

Siwu Tang contains Shengdi (cool/stagnant) and Baishao (sour/cold), which damage Spleen/Stomach and vital Qi, often harming postpartum women. Shenghua Tang removes these, adding warm-moving blood herbs. For "Zhenmao" (afterbirth mass) pain,世人 often use blood-breaking formulas before tonifying. Mixing breaking and tonifying is wrong; old blood must be resolved, but new blood must be nourished. Attacking only old blood damages new blood. Huisheng Dan breaks blood masses and expels placenta but severely damages Yuan Qi. Shenghua Tang is named for its function: resolving old blood while generating new blood. Pure resolution stops new blood generation; pure generation traps old blood. Xiong, Gui, and Taoren remove old blood and generate new blood rapidly. Heijiang and Zhigancao guide these into Lung and Liver, generating blood, benefiting Qi, moving while tonifying. Warmth ensures free flow, complete lochia discharge, and no sequelae. It is the sacred medicine for postpartum. Zhang added Renshen, Guizhi, Niuxi, and Honghua to this formula, making it highly effective for inducing labor prenatally.

Placenta retention has two types: distension due to lochia entering the sac, or deficiency unable to expel it. If lochia enters the sac, the abdomen distends and hurts; use Mingdan or Shixiao San to resolve stasis. Delay is fatal. If Yuan Qi is too weak to expel it, the abdomen does not distend/pain; use Baosheng Wuyou San to secure Yuan Qi. However, Wanquan Tang (without Renshen) is most appropriate.

Childbirth is the most critical event in women's diseases. In obstetrics, induction is hardest during labor, and placenta retention is hardest after birth. Ancient texts prioritize Huarui Shi San, but stone minerals are unsuitable for severe intestinal/stomach deficiency. Shenghua Tang and Wanquan Tang are better choices. Another option is Chuan Foshou San plus Honghua, Yimucao, Xiangfu, Shanzha, Chenpi, and Niuxi, decocted lightly, taken with concentrated urine. Another method: if placenta is retained long after birth, risking maternal exhaustion and blood flooding the uterus, urgently cut the umbilical cord and tie a weight to it to prevent blood flowing back into the uterus, causing the placenta to shrink and fall. The mother must remain calm. Tie first, then cut. Otherwise, the uterus may rise and crush the heart, causing death. Be extremely cautious.