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Yi Silan treated a woman from Ruizhou. More than half a month postpartum, she experienced vomiting of clear fluid rising from the stomach, which was initially diagnosed as Stomach Cold (Wei Han). A decoction of Ginger and Pepper was prepared for her to drink. Initially, she felt relief, but after three to five days, the amount of clear fluid increased, her breath became cold, her four limbs turned cold, abdominal coldness became unbearable, and she occasionally experienced shivering. The previous physician had used Siwu Tang (Four Substances Decoction) with added Ginseng Radix et Rhizoma (Renshen) and Processed Ginger Rhizome (Paojiang). While there was slight relief upon initial intake, it eventually became ineffective. Yi Silan examined her and found no pulse in all six positions. Pressing deeply with three fingers beyond the Chi position, he detected a solid, rapid, and forceful pulse, identical on both sides. Her voice was loud and vigorous; she could speak four or five sentences in one breath. Her lips were dry and cracked, cheeks red, bowel movements occurred once every five to six days, and urine was scanty and dark red. This indicated a Excess Heat syndrome (Shi Re Zheng). Upon inquiry, Yi learned that local custom regarded chicken stir-fried with pepper as a tonic for postpartum women. This patient consumed this dish three times daily, leading to the illness after half a month, clearly indicating accumulated heat. Her cold mouth, vomiting of water, and Jue syndrome (cold extremities/fainting) were due to extreme heat mimicking water (True Heat, False Cold). The shivering was caused by heat entering the Blood Chamber (Xue Shi) and wind generated by excessive heat. Yi prescribed Sanhuang Tang (Three Yellows Decoction) continuously. All six pulses became palpable, the clear fluid gradually decreased, and she lost the desire to consume the Ginger-Pepper decoction. After four days of medication, heat rose from the mouth, and small yellow millet-like sores appeared on the tongue and mouth. Bowel movement had not occurred for eight days. He administered Sizheng San (Four Poria Powder) combined with Liangge San (Cool the Chest Powder) on an empty stomach. By noon, there was still no movement. He then prepared a decoction of Licorice Root (Gancao), mixed with five qian of Yuanming Fen (Natrii Sulfas), and administered it hot. After about an hour, mild borborygmus occurred in the abdomen, followed by vomiting of one to two bowls of sour fluid, and two consecutive bowel movements. Subsequently, she was regulated with Sizheng San, Sanhuang Tang, Gardenia Fruit (Shanzhi), and Aurantium Fructus (Zhike). She recovered completely after one month. Generally, when diagnosing the pulse, if it is extremely large or extremely minute, great caution is required. If the pulse is extremely large but weak, one must guard against Yang Qi floating outward. If the pulse is extremely minute, found only after prolonged searching under the fingers, and feels firmer when pressed to the bone with slightly increased pressure, it should not be mistaken for Deficiency Cold. In this case, the pulse was absent in all six positions but was solid, rapid, and forceful behind the Chi position. This is known as the Hidden Pulse (Fu Ni Mai). Yang Qi is hidden below, reaching extreme hyperactivity. How can one rigidly adhere to the notion that postpartum conditions prohibit the use of Cold-Cooling herbs?

Yu Zhen commented: Master Yi has many medical cases, and this is the first. His elucidation of pulse theory can be considered a secret transmission from immortals.

Another woman, postpartum, drank over twenty bowls of tea and porridge daily. After one month, several patches of ice-cold areas appeared all over her body. When pressed with a finger, the cold sensation would travel upward from the finger through to the heart. This condition persisted for two years, and various treatments failed. She was treated with Bawu Tang (Eight Substances Decoction) minus Rehmanniae Radix Preparata (Dihuang), plus Citri Reticulatae Pericarpium (Juhong), mixed with Ginger Juice (Jiangzhi) and Bamboo Sap (Zhuli) equivalent to one wine cup. After ten doses, warmth returned.

Yu Zhen commented: This is Phlegm-Fluid (Tan Yin) flowing into the muscles; originally, it was not a strange disease. However, the phenomenon where pressing causes coldness to resonate in the heart of the observer is indeed peculiar. It is likely that because her Qi and Blood were already deficient, the areas where Phlegm-Fluid stagnated were places where Ying and Wei Qi could not reach; these patches are essentially "dead flesh." The medicinal efficacy relied entirely on Ginger Juice and Bamboo Sap, each one cup. Without Bawu Tang, how could the circulation of Ying and Wei Qi be assisted? Dihuang was removed to avoid its cloying nature, and Juhong was added for its penetrating quality. It seems appropriate to additionally add Arisaema Cum Bile (Nanxing) and Sinapis Semen (Baijiezi) and other herbs.