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Postpartum diseases present with myriad variations, yet they fundamentally fall into two categories: excess and deficiency. Excess manifests as stagnation of blood stasis; deficiency results from excessive blood loss. For cases of blood stasis stagnation, resolving it is not difficult; however, for those with excessive blood loss, restoring the body's vital energy is far from easy. This distinction determines whether Ginseng Radix et Rhizoma (Renshen) is applicable or contraindicated, a difference as vast as heaven and earth. Nevertheless, in cases where primordial Qi is severely deficient while lochia remains incomplete, one may add Chuanxiong Rhizoma (Chuanxiong), Angelicae Sinensis Radix (Danggui), Cinnamomi Cortex (Rougui), and Motherwort Herba (Yimucao) to Si Jun Zi Tang (Four Gentlemen Decoction) to tonify Qi and Blood and warm the channels. Alternatively, remove Atractylodis Macrocephalae Rhizoma (Baizhu), double the dosage of Renshen, and add Er Chen Tang (Two-Cured Decoction) to strengthen the Middle Jiao and resolve dampness-phlegm. This approach simultaneously tonifies the Spleen-Stomach Qi and unblocks the blood vessels, which is more appropriate. Moreover, the etiologies of postpartum disorders are manifold and difficult to enumerate. Some arise from illnesses contracted during pregnancy that manifest postpartum; some result from difficult labor; some are caused by concurrent miscellaneous diseases; others stem from inherent physical weakness. For instance, food retention during pregnancy leading to indigestion postpartum; or wind-cold invasion causing fever that worsens postpartum; or severe malaria and dysentery causing extreme debility that exacerbates postpartum; or frustration from infertility causing melancholy; or dissatisfaction from bearing multiple daughters causing inner displeasure; or premature consumption of rich foods triggering sudden chills and fever; or abrupt changes in lifestyle allowing external pathogens to invade; or sudden fright disturbing the Heart Spirit; or unchecked anger causing Liver Qi stagnation. Regardless of whether blood stasis is present, all these factors can burden the postpartum state. Furthermore, men tend to be quick-acting, so postpartum illness is less common among them; women tend to be Yin-dominant and sluggish, making postpartum illness more frequent. Those with strong primordial Qi recover easily from postpartum disorders; those with chronic Qi deficiency find treatment difficult.

My wife, in the year Wuxu, carried twins. From the fifth month until term, her physique became emaciated. She required three qian of Renshen daily to consume half a bowl of rice; without it for a day, she could not eat. Ten days before delivery, she took approximately one liang of Renshen daily, resulting in an easy and safe delivery. Postpartum, she remained well. In the spring of Jiachen, she gave birth to another son. Having not taken Renshen during pregnancy, she suffered severe postpartum deficiency. Beyond twenty days, she suddenly developed a greenish complexion, irritability, and recurrent fainting spells. Her pulse was purely wiry and thin, and she refused food. I recognized that her True Qi had declined, the Heart and Spleen were deprived of nourishment, and the Liver Wood became hyperactive and oppressive. I prescribed Gui Pi Tang (Restore the Spleen Decoction) with five qian of Renshen and one qian of Prepared Aconite Root (Shu Fuzi). After several doses, symptoms recurred intermittently. Increasing Renshen to one liang and Fuzi to two qian yielded no change. Adding another five qian of Renshen and three qian of Fuzai still failed to stabilize the condition. Finally, increasing Renshen to two liang and Fuzi to four qian resolved the anger and ceased the fainting. Subsequently, dosages were gradually reduced, and after over two months of regulation, she recovered. I then marveled at the efficacy of Renshen, capable of rescuing vitality from the brink of extinction and regulating organ functions during severe imbalance. If such a case occurred in another household, who would trust and persist with such high doses of Renshen? Thus, in discussing postpartum diseases, I use this case as an illustration.

A woman, eight days postpartum, was mistakenly administered Gun Tan Wan (Rolling Phlegm Pill) by a physician, resulting in incessant vomiting and diarrhea day and night. Zhou Yunlai from Suzhou treated her, administering eight qian of Renshen combined with Lithosi Fragmentum (Chishizhi) and Yuyuliang Fructus (Yuyuliang), which immediately stopped the vomiting and diarrhea. Later, another patient from the same family presented with facial redness, panting, cold limbs, and a weak pulse, having been treated for exterior contraction. I examined her and identified empty deficiency of the Middle Qi, intending to prescribe Gui Pi Tang with Pao Jiang (Prepared Ginger). Zhou Yunlai suggested, "Why not tonify Yin first, then Yang?" I replied, "With floating Fire, astringing is acceptable." Thus, Liu Wei Di Huang Wan (Six-Ingredient Rehmannia Pill) was modified with Rougui, Yuanzhi, and Zaoren. Her breathing gradually stabilized, and her pulse became palpable. Upon my departure, she experienced sudden reversal cold syndrome (Jue Ni). I was away and could not arrive in time. Zhou Yunlai administered four qian of Renshen and eight fen of Zhi Fuzi (Processed Aconite Root), temporarily stabilizing her. Later, through our mutual friend Tang Songsheng, consultation with Zhou Yunlai led to a successful outcome using warming and tonifying methods. However, due to her youth and occasional decline in Qi and Blood, although cured, she later developed hemorrhoids and fistulas. Treatment with Yin-nourishing and fire-clearing herbs often resulted in lingering conditions. This demonstrates that medication must not be used lightly.

A woman suffered from malaria during pregnancy, presenting with sallow complexion. I continuously administered Liu Jun Zi Tang (Six-Gentleman Decoction), but she delivered before the malaria ceased. Postpartum, the malaria worsened, and lochia flow was scant. A colleague prescribed Pao Jiang, causing severe abdominal pain and retention of blood stasis. I prescribed Yan Hu Suo, Chuanxiong, Danggui, Yimucao, Shan Zha, and Chen Pi. One dose stopped the pain and promoted lochia discharge. Subsequently, Liu Jun Zi Tang with doubled Baizhu was given. Within a few doses, Spleen Qi strengthened, and the malaria subsided.

A woman suffered from excessive blood loss postpartum, developing chills and fever, cold limbs, and a minute pulse. I administered Ba Zhen Tang (Eight-Treasure Decoction) with Gan Jiang (Dried Ginger) and Fuzi. One dose stopped the chills and fever; several doses improved appetite and spirit, leading to complete recovery.

A woman postpartum, frustrated and angry, retained incomplete lochia, presenting with chills, fever, profuse spontaneous sweating, and intermittent delirium. I prescribed Yuanzhi, Fushen, Zaoren, Muxiang, Duzhong, Danggui, and Yimucao. Continuous administration stopped the sweating, but delirium persisted. I added Niuxi and Pao Jiang to the previous formula, expelling a mass of accumulated blood. Zheng from Kunshan joined the consultation, suggesting adding Yu Zhu (Polygonatum Odoratum Rhizome), Bei Mu, and Che Qian Zi. After three more doses, mental clarity returned, followed by regulatory treatment for full recovery.

A woman postpartum developed edema and distension, with complete cessation of lochia. Diuretic and swelling-reducing herbs were ineffective. I prescribed Wulingzhi, Yanhusuo, Taoren, Zelanyan, Honghua, and Niuxi. This induced massive lochia discharge, stopping the panting and reducing the edema. She subsequently recovered with tonic therapy.

A woman suffered from abdominal pain during pregnancy, restless day and night. By midnight, her breath was faint, pulse intermittent, and fetal movement ceased. Concerned about damaged fetal Qi, I urgently administered Wu You San (Worry-Free Powder). Pain slightly subsided, but the fetus did not move. I then prepared Xiong Gui Tang with one liang of Danggui, five qian of Chuanxiong, and two qian of Xueyu Tan (Charred Human Hair). Decocted and drunk immediately, the pulse reappeared, and fetal movement resumed. Intermittent administration of Du Shen Tang (Single Ginseng Decoction) and Wu You San led to a safe delivery.

A woman with pre-existing chronic disease was at risk of dystocia. I advised preparing Jia Wei Xiong Gui Tang (Modified Chuanxiong-Danggui Decoction). At delivery, the fetus descended but did not exit quickly. The midwife panicked. I ordered immediate decoction and administration of the prepared medicine. Within half an hour, delivery was achieved. These are cases personally verified by me. How miraculous are the formulas established by the sages!