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Wu Yuanzhong's wife. After childbirth, she suffered from a condition of fright (Jing). Her body felt floating and unstable, as if in the clouds. Upon opening her eyes, she experienced vertigo. She was unable to stand steadily. Her four limbs were sore and weak. All physicians treated it with methods to calm the spirit and tonify deficiency. Consequently, the preceding symptoms worsened. Only Zai Yuanli stated: "The left pulse is Kou (hollow) and Se (choppy), yet her expression remains unchanged. This is due to fright causing blood stasis accumulation in the Pericardium Collateral." Subsequently, one dou (a unit of volume) of dark, lacquer-like blood was discharged, and she recovered. The ancients said, "A great excess condition may resemble a debilitated state," which refers to this case.

Zhen's commentary: This syndrome must be universally considered as a deficiency pattern. If one does not distinguish the Kou and Se qualities of the left pulse, how could one deduce the blood stasis in the Pericardium? People only know that fright is the cause; they do not realize that pathological products resulting from fright can become new pathogenic factors. In such cases, treating only the fright is futile. This case can be cited to illustrate others.

Wang Shishan treated a woman who had not yet reached one month postpartum. Due to anger, she experienced bleeding flowing like water, which stopped after three days. Subsequently, due to overexertion, she suffered from weakness in the four limbs, sweating during sleep, tidal fever in the afternoon (Shen-You hours), dry mouth, and five-palm heat (burning sensation in palms, soles, and chest). All physicians used herbs such as Chai Hu (Bupleuri Radix), Huang Qin (Scutellariae Radix), and Bo He (Menthae Haplocalycis Herba), but the fever intensified. Palpation revealed a Xian (wiry) and Da (large) pulse that was empty upon pressure. This was identified as Ru Lao (postpartum consumptive disease). A decoction of Si Wu Tang (Four Substances Decoction) 1 liang, with Hu Huang Lian (Picrorhizae Rhizoma), Qin Jiao (Gentianae Macrophyllae Radix), and Qing Hao (Artemisiae Annuae Herba) each added at 5 fen, was administered. After several doses, the fever subsided and the body cooled. Later, she took one dose of Huang Lian Ba Zhen Wan (Coptis Eight Treasure Pill) and stabilized.

Zhen's commentary: The use here of Huang Lian, Hu Huang Lian, Qin Jiao, and Qing Hao demonstrates that Xue Ji’s formulas, Ba Zhen Tang (Eight Treasure Decoction) and Shi Quan Da Bu Tang (Ten Significant Tonifying Decoction), are not rigid, fixed protocols.

A puerperal woman suffered from upward reversal of blood flow, leading to Bi Xu (epistaxis/nosebleed). She had a dry mouth, restless heart, and black tongue coating. This was likely due to ascending blood stasis. Yi Mu Wan (Motherwort Pill) was prescribed, taken with child's urine (Tong Bian) to dissolve and administer several pills. Subsequently, the nosebleed gradually ceased, and lochia discharge became smooth.

Zhen's commentary: Various gynecological texts consider postpartum epistaxis a critical/dangerous syndrome. Using Yi Mu Wan dissolved in child's urine imitates the treatment method for Dao Jing (retrograde menstruation). There are cases of recovery, but this should not be regarded as a guaranteed cure.

Lizhai (Xue Ji) treated the wife of Grand Secretary Yu. Postpartum, she had fever and evening tidal fever, hematemesis (vomiting blood), hematochezia (blood in stool), accompanied by night sweats, frequent urination, distending pain in the chest and hypochondrium, and abdominal fullness/stuffiness. Xue Ji said: "This is damage and deficiency of various zang organs. Treatment should prioritize securing the root." Relying on her own medical knowledge, she used fire-descending agents, which exacerbated her condition with diarrhea, borborygmus, vomiting, anorexia, abdominal pain, and cold feet. Only then did she believe Xue Ji and seek consultation. Her pulse was either Fu Hong (floating and flooding), Chen Xi (deep and fine), or nearly imperceptible. Her complexion was either cyan-yellow or red-white. These are signs of false heat due to deficiency. It was midsummer, so the season should be disregarded in favor of the syndrome. Initially, Liu Jun Zi Tang (Six Gentlemen Decoction) with Pao Jiang (Prepared Ginger) and Rou Gui (Cinnamon Bark) was given. After several doses, stomach qi gradually recovered, and symptoms subsided. This was supplemented with Shi Quan Da Bu Tang (Ten Significant Tonifying Decoction). Half a year later, she fully recovered.

Zhen's commentary: The pulse findings in this case serve as strong evidence for a major deficiency pattern.

A puerperal woman suffered from cough with profuse sputum, flushed face, dry mouth, internal heat, and evening tidal fever, occurring intermittently. This was Fire of Yin flaring upward. Spleen and Kidney should be tonified. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) and Liu Wei Di Huang Wan (Six Ingredient Pill with Rehmannia) were used, resulting in recovery.

A puerperal woman suffered from diarrhea and dysentery for over a year. Her body was emaciated, with bones prominent. She had internal heat, evening tidal fever, spontaneous sweating, and night sweats. Her mouth and tongue were ulcerated. She vomited approximately three bowls of sputum daily. Her pulse was Hong Da (flooding and large) but completely absent upon deep pressure. This indicated decline of Ming Men (Gate of Life) fire, deficiency-cold of Spleen Earth manifesting as false heat. The vomiting of sputum resulted from Spleen deficiency failing to control and return fluids to their source. Ba Wei Wan (Eight-Ingredient Pill) was used to tonify fire to generate earth. Bu Zhong Yi Qi Tang was used to tonify Lung Metal, thereby strengthening the Spleen and Stomach.

Zhen's commentary: These two cases represent the orthodox treatment methods of Xue Ji. If memorized thoroughly, one will naturally avoid deviating into paths of merely clearing heat/resolving exterior or nourishing yin/draining fire.