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Lu Yan from Fenghua treated a woman of the Xu family in Xinchang. The patient suffered sudden death (loss of consciousness) after childbirth, but there was slight heat in the chest and diaphragm. Upon diagnosis, Lu Yan said, "This is Blood Stagnation (Xue Men)." He used dozens of jin of Hong Hua (Carthamus tinctorius), boiled it in a large pot. When the decoction boiled, he filled a wooden bucket with the liquid and had the patient lie on top to fumigate. As the medicinal vapor faded, more was added. After a while, the woman's fingers began to move, and she woke up half a day later. This method aligns with the intent of Xu Yuzong when treating Empress Dowager Wang.

Lizhai treated a postpartum woman who experienced lower abdominal pain followed by sudden trismus (lockjaw). She was administered Shixiao San (Pain-Relieving Powder), and after a long time, she regained consciousness. Subsequently, she was treated with Si Wu Tang (Four Substance Decoction) modified with Pao Jiang (Charred Ginger), Bai Zhu (Atractylodes macrocephala Rhizome), and Chen Pi (Tangerine Peel), resulting in recovery.

Yu Zhen commented: Blood晕 (Xue Yun, fainting due to blood disorders) is all caused by E Lu (lochia) rushing to the heart. One should select verified prescriptions from texts like Ben Cao Gang Mu (Compendium of Materia Medica). The above two cases represent standard treatment methods. However, Danxi treated a woman who was pale and slender, with mental depression, who gave birth at midnight and fainted in the early morning. Urgent moxibustion was applied to Qihai (CV6) for fifteen moxa cones, after which she recovered. Later, she took herbs such as Ren Shen (Ginseng) and Bai Zhu for two months before stabilizing. This is Yang Deficiency (Yang Xu), representing an alternative treatment method.

Another postpartum patient drank alcohol after delivery, resulting in excessive lochia and Xue Yun. Her breath smelled of alcohol. This occurred because the blood moved recklessly due to the heat of alcohol, causing faintness due to deficiency. She was treated with Fo Shou San (Buddha's Hand Powder) modified with Gan Ge (Kudzu Root) 2 qian, recovering after one dose.

Lizhai stated: Drinking alcohol postpartum can cause fainting; furthermore, a crowded delivery room with noise and heat can also cause fainting.

Lizhai treated a postpartum woman with abdominal pain and fever. The Qi Kou pulse (radial artery pulse at the cun position) was large. Xue Ji attributed this to food stagnation, but the family did not believe him. Instead, they used blood-breaking and tonifying methods, which aggravated the condition, leading to fever, headache, and vomiting of saliva/phlegm. They then used herbs to clear fire, resolve phlegm, and regulate qi, resulting in cold limbs, diarrhea, and a sensation of bearing down. Only then did they regret their actions and ask, "Why?" Xue Ji replied, "This is a complication of Spleen and Stomach Deficiency (Pi Wei Xu). The method should be warming and tonifying." Thus, Liu Jun Zi Tang (Six Gentlemen Decoction) was modified with Pao Jiang 2 qian, Rou Gui (Cinnamon Bark) 1 qian, and Mu Xiang (Aucklandia Root) 1 qian. After four doses, all symptoms subsided. Subsequently, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was used, restoring the Yuan Qi (Original Qi).

Yu Zhen commented: Because the Qi Kou pulse was large, food stagnation was diagnosed. Due to erroneous medication, the condition changed to cold limbs and diarrhea with bearing down, truly becoming a Deficient-Cold syndrome. However, the pulse characteristics were unknown. If the pulse had become fine and soft, warming and tonifying would have been effective. If the pulse remained large, warming and tonifying would not have been appropriate. If the pulse was large and soft, warming and tonifying could still be used hoping for the pulse to contract. If the pulse was large and rapid, and forceful upon pressure, death would be inevitable, and warming and tonifying would be useless.

A postpartum woman suffered from abdominal pain with tenesmus, severe dysentery, physical fatigue, poor appetite, long-term emotional depression, and developed Jian Chun (silkworm lip, a type of lip lesion). She sweated profusely during sleep (night sweats) like rain, dared not sleep all night, and her spirit was emaciated. Xue Ji said, "This is Qi and Blood deficiency with internal heat." Dang Gui Liu Huang Tang (Angelica Six-Yellow Decoction) was used, with Huang Qin (Scutellaria Root), Lian Zi (Lotus Seed Plumule/often refers to Lian Xin or similar bitter cold herbs in context, here likely Lian Xin or Huang Lian based on context of 'Lian'), and Huang Bo (Phellodendron Bark) stir-fried until black. Added to the formula, sweating stopped immediately after one dose and completely after two doses. Then, Gui Pi Tang (Restore the Spleen Decoction) and Ba Zhen San (Eight Treasures Powder) were taken concurrently, gradually restoring Yuan Qi and achieving recovery.

Yu Zhen commented: This case was not difficult regarding the use of Gui Pi Tang and Ba Zhen San, but difficult regarding the use of Dang Gui Liu Huang Tang. It is regrettable that the pulse was not recorded. However, preserving this case shows that ancient physicians used specific medicines for specific diseases, without rigidly adhering to the notion that postpartum conditions must always be heavily tonified. Bitter-cold herbs should be stopped once the disease is addressed.

A postpartum woman had lower abdominal pain and a palpable mass. The pulse was Kou (hollow) and Se (choppy). She was treated with Si Wu Tang modified with Yan Hu Suo (Corydalis Rhizome), Hong Hua (Safflower), Tao Ren (Peach Kernel), Niu Xi (Achyranthes Root), and Mu Xiang, resulting in recovery.

A postpartum woman suffered severe lower abdominal pain and trismus. This was due to internal retention of Blood Stasis (Yu Xue). She was administered Shixiao San, expelled blood, and regained consciousness. She was subsequently treated with Si Wu Tang modified with Pao Jiang, Bai Zhu, and Chen Pi, resulting in recovery.

Yu Zhen commented: These two cases represent the standard treatment for pain caused by lochia.

A postpartum woman had lower abdominal pain. Administration of Qi-regulating and blood-breaking herbs was ineffective. Her pulse was Hong (surging) and Shu (rapid). This indicated that the blood stasis had ulcerated internally into pus. Gua Zi Ren Tang (Melon Seed Decoction) was used for two doses, stopping the pain. Tai Yi Gao (Great One Ointment) was then used to drain the pus, resulting in recovery. This condition is common postpartum; even if not an abscess, this method is effective.

A postpartum woman had lower abdominal pain and difficulty urinating. Yi Yi Ren Tang (Coix Seed Decoction) was used. Pain stopped after two doses. Si Wu Tang modified with Tao Ren and Hong Hua was then used to expel blood stasis, resulting in recovery. Generally, these conditions are caused by disharmony of Ying and Wei (Nutritive and Defensive Qi) or retention of blood stasis. If the pulse is Hong and Shu, pus has formed; if only Shu, slight pus exists; if Chi Jin (slow and tight), it is blood stasis, which resolves with purgation. If the abdomen is distended and large, with water sounds upon turning, or if pus discharges from the umbilicus or stool, La Fan Wan (Beeswax Alum Pill), Tai Yi Gao, and interior-supporting herbs should be used.

A woman in the cold midwinter suffered severe postpartum abdominal pain and felt a mass. Various treatments failed. Someone advised boiling Lamb Meat 4 liang, Shu Di Huang (Prepared Rehmannia Root) 2 liang, and Sheng Jiang (Fresh Ginger) 1 liang in water. After two or three doses, she recovered.

Yu Zhen commented: Yizi said: Feeling a mass suggests cold pathogen gathering due to deficiency, rather than a true solid excess. Otherwise, how could lamb meat and prepared rehmannia cure it? This demonstrates skillful reading. Regarding the citation from Yan Yi: A woman gave birth in the cold month; cold pathogen entered the birth canal, causing distending pain below the navel, intolerant to touch. This is Han Shan (Cold Hernia). The physician wanted to treat with Di Dang Tang (Di Dang Decoction), believing it was blood stasis. I instructed him: "This is not the correct treatment. Administer Zhang Zhongjing's Lamb Meat Decoction, slightly reduced in dosage, divided into two servings." The formula is the original one plus Chuan Xiong (Sichuan Lovage Rhizome), decocted with wine and water, or with green onion and salt. It is slightly more acrid-warm compared to using prepared rehmannia. However, it generally treats deficient-cold abdominal pain. If in the cold month, blood coagulates due to cold, forming stasis and pain, one should use Hu Po Wan (Amber Pill), Xiang Gui San, and herbs such as Jiang (Ginger), Gui (Cinnamon), Wu Zhu Yu (Evodia Fruit), Tao Ren, Peng Ze (Curcuma), and Wu Ling Zhi (Trogopterus Dung). Not all formulas by Zhang Zhongjing would be effective in such cases. Moreover, those adept at understanding should view it inversely. Cold transforming into heat, such as Xia Yu Xue Tang (Drain Blood Stasis Decoction) from Jin Gui Yao Lue and Yu Zhu San (Jade Candle Powder) from He Jian, are examples. For those fearing harsh drugs, Hui Sheng Dan (Life-Restoring Pill) is excellent. Ye Tianshi's medical records mention taking Da Huang (Rhubarb Root and Rhizome) boiled in vinegar as a single ingredient, so the medicine enters the diseased area without affecting healthy areas. This is a truly brilliant interpretation. Perhaps Mr. [the author/patient] derived this insight from the method of decocting Duo Ming Dan (Life-Taking Pill) with vinegar and water.