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*Daquan* (The Great Compendium) states: Postpartum lochia retention occurs due to the exhaustion and injury of the zang-fu organs after childbirth, resulting in deficiency and depletion of Qi and Blood. It may also be caused by cold pathogens lingering in the Bao Luo (uterine collaterals), or by exposure to wind and cooling after childbirth. Wind and cold pathogens invade through the deficiency and contend with the Blood, causing stagnation and obstruction, preventing free flow. The blood accumulates internally, thus leading to postpartum lochia retention.

Xue Ji stated: For the aforementioned symptoms, Shixiao San (Pain-Relieving Powder) should be used. If there is Qi stagnation and Blood coagulation, Huarui Shi San (Flower Ochre Stone Powder) should be used.

*Daquan* states: Postpartum lochia non-stop occurs due to damage to the menstrual blood after childbirth, resulting in deficiency and insufficiency. Or, during delivery, lochia blood was not completely expelled and remained in the abdomen. Coupled with cold pathogens in the zang-fu organs, this leads to disharmony of Qi and Blood, causing lochia to drip continuously without stopping.

Xue Ji stated: For the aforementioned symptoms, if Liver Qi Heat fails to control the Blood, Liuwei Wan (Six-Ingredient Pill with Rehmannia) should be used. If Liver Qi Deficiency fails to store the Blood, Xiaoyao San (Free and Easy Wanderer Powder) should be used. If Spleen Qi Deficiency fails to contain the Blood, Liujunzi Tang (Six-Gentlemen Decoction) should be used. If Spleen and Stomach Qi sinks and fails to command the Blood, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) should be used. If Spleen Meridian Depression Heat causes Blood to fail to return to its source, Jiaweigui Pi Tang (Modified Gui Pi Decoction) should be used. If Liver Meridian Wind Pathogen causes Blood to boil, Yiwei Fangfeng Wan (Single-Ingredient Saposhnikovia Pill) should be used.

Chen Shi asked: What is postpartum metrorrhagia? He answered: After childbirth, the meridians are exhausted and have not yet recovered. Fatigue damages and disturbs them, causing sudden violent bleeding that drips continuously.
Alternatively, immoderate consumption of sour and salty foods damages Ying Wei (Nutritive and Defensive Qi), leading to weakness, which can also transform into Bingzhong (Metrorrhagia). If the lower abdomen is full and painful, it indicates the Liver Meridian is already damaged, making it difficult to treat. One should urgently服用 Guding Wan (Solidify Metal Pill) to stop the bleeding.

Xue Ji stated: For the aforementioned symptoms, if Blood stagnation causes lower abdominal fullness, Shixiao San should be used. If Blood deficiency causes lower abdominal empty distension, Xiong Tang (Ligusticum Decoction) should be used. Refer to previous discussions for other cases.

*Daquan* states: Postpartum heart pain is due to Yin Blood deficiency, allowing Fire to rush upward along the Xinbao Luo (Pericardium Collaterals), named Xinbaoluo Tong (Heart Pericardium Collateral Pain). It is suitable to treat with Dayanmi Tang (Great Rock Honey Decoction, also known as Guixin Tang, composed of Shudi, Danggui, Duhuo, Wuyu, Baishao, Ganjiang, Guixin, Tongcao each 2 qian, and Xixin, Gancao each 5 fen). If Cold Pathogen injures the Heart Meridian, it is named Zhenxintong (True Heart Pain), for which there is no curative medicine (Heart pain occurring postpartum differs from ordinary diseases; one must seek the cause in the Blood aspect).

Xue Ji stated: Lower abdominal pain, commonly known as Erzhen Kuai (Child Pillow Mass), should be treated with Shixiao San to move and dissipate. If the lochia has passed but pain persists, Sishen San (Four-Spirit Powder) should be used to regulate. If ineffective, Bazhen San (Eight-Treasure Powder) should be used. If pain is accompanied by nausea or a desire to vomit, Liujunzi Tang should be used. If pain is accompanied by diarrhea, Sishen Wan should be taken with Liujunzi Tang. If diarrhea, pain, and tenesmus occur, Buzhong Yiqi Tang should be taken with Sishen Wan. If chest and diaphragm feel full and distended, or if there is food aversion and acid regurgitation, or abdominal pain where pressing is intolerable, this is caused by dietary accumulation. Erchen Tang added with Shanzha and Baizhu should be used to digest and guide out the accumulation. If digestion is complete but pain persists, or if headache, irritability, fever, thirst, aversion to cold, and vomiting appear, this indicates damage to Zhong Qi (Middle Qi); treatment should focus on tonifying the Spleen and Stomach. If fever and abdominal pain occur, with severe pain upon pressing, no food aversion, and no acid regurgitation, this is Blood stasis stagnation; Shixiao San should be used to eliminate it. (Note: The original text mentions several types of abdominal pain: use Xuanhusuo San for Qi stagnation, Wuji San for External Cold, Siwu Tang plus Muxiang and Chaihu for Anger, Sizijunzi Tang, Danggui, and Paojiang for Yang Qi deficiency, and Liujunzi Tang, Danggui, and Paojiang for Spleen Deficiency and Blood Weakness. Generally, if abdominal pain does not hurt when pressed, it is Blood Deficiency, requiring tonic dietary remedies.) If there is only headache and fever, or headache combined with other symptoms, but no pain upon pressing, this belongs to Blood Deficiency; Siwu Tang plus Paojiang, Renshen, and Baizhu should be used to tonify.

*Daquan* states: Erzhen (Child Pillow) refers to blood clumps existing in the womb prior to pregnancy. During delivery, these clumps break apart and are expelled with the infant, posing no harm. However, if the parturient's zang-fu organs are affected by Wind-Cold, causing Blood to coagulate and stagnate in the lower abdomen without flowing freely, it will cluster and cause pain, named Erzhen. *Jingui Yaolue* states: Seven or eight days postpartum, without Taiyang symptoms, but with hardness and pain in the lower abdomen, this is incomplete expulsion of lochia. With constipation, irritability, and fever, and a pulse that is slightly solid, with doubled fever, evening irritability, anorexia, delirium upon eating, and relief at night, Da Chengqi Tang should be primarily used. Heat binds internally in the Bladder. (Note: The treatment in *Jingui Yaolue* focuses on interior excess in Shaoyang/Taiyin syndromes rather than lochia, hence the pulse and symptoms involve cold and heat. Reflecting on "without Taiyang symptoms" and "heat binding in the Bladder" reveals the intent. Although it says lochia is incomplete and there is constipation with irritability and heat, why not use Taoren Chengqi Tang but instead Da Chengqi Tang? Because the heat binds in the Bladder, Da Chengqi Tang is appropriate.)

*Daquan* states: Postpartum distension and Qi pain in both hypochondriac regions are caused by retained water in the Bladder. Due to incomplete lochia expulsion postpartum, water stagnates and contends with Qi, accumulating in the Bladder, causing hypochondriac distension. The agitation between Qi and Water causes pain. (The view that hypochondriac distension-pain is caused by retained water in the Bladder—what is the rationale? What decoction is used? The principles of overcoming and restraining are integrated, hence the treatment differs.)

Xue Ji stated: For the aforementioned pain symptoms, if Liver Meridian Blood Stasis is present, Yanhusuo San should be used. If Liver Meridian Qi Stagnation is present, Sizijunzi Tang, Qingpi, and Chaihu should be used. If Liver Meridian Blood Deficiency is present, Siwu Tang, Renshen, Baizhu, and Chaihu should be used. If both Qi and Blood are deficient, Bazhen Tang plus Chaihu should be used. If Kidney Water is insufficient to generate Liver Wood, Liuwei Wan should be used. If Lung Metal energy is excessive and overacts on Liver Wood, Xiebai Tang should be used, referring to previous discussions as the main approach.

*Daquan* states: The Kidney governs the waist and legs. Postpartum lower back pain occurs because the woman's Kidney position is connected to the Bao (uterus). Childbirth exhausts Kidney Qi and damages the Bao Luo. During recovery, Wind-Cold invades; Cold Qi attacks the waist, causing lower back pain. If Cold and Heat pathogenic factors linger in the spine, the pain will persist for a long time. Subsequent pregnancies will inevitably cause further damage. This is because the Bao Luo belongs to the Kidney, which governs the waist.

Xue Ji stated: For the aforementioned symptoms, if True Qi is deficient and pathogens take advantage, Danggui Huangqi Tang or Shiquan Dabu Tang should be used as the main formula, assisted by Jisheng Tang. If ineffective, Shiquan Dabu Tang plus Fuzi should be used.

*Daquan* states: The head is the convergence of all Yang meridians. After childbirth, the five Zang organs are all deficient, Stomach Qi is weak, dietary intake is insufficient, and Grain Qi is lacking, leading to Empty Heat. Yang Qi fails to remain secure and rushes upward to the head. Excess Yang and Deficient Yin result in headache. There is also postpartum headache caused by敗血 (decayed blood), which cannot be ignored; Heilong Dan discusses this in detail.

*Daquan* states: What causes generalized body pain after childbirth? The answer is: After childbirth, the joints open, and blood vessels disperse. When Qi is weak, Blood flows and stagnates between the meridians and muscle layers. If it does not dissipate over several days, the bone joints become stiff, sinews and tendons contract tightly, causing lower back pain preventing turning, inability to move hands and feet, body fever, and headache. If treated as Shanghan (Cold Damage), sweating will occur, causing meridian tremors and palpitations, cold extremities, and transformation into other symptoms. Only Chen Tong San should be taken to eliminate it. (It is correct that pain from Qi weakness and Blood stagnation should not be treated as Shanghan, but why are pain from Blood deficiency and Wind-Cold not discussed?)

Xue Ji stated: For the aforementioned symptoms, if pressing with the hand (the method of pressing is excellent) exacerbates the pain, it is Blood Stasis. Siwu Tang, Paojiang, Honghua, Tao Ren, and Zelan should be used to tonify and dissipate. If pressing alleviates the pain slightly, it is Blood Deficiency. Siwu Tang, Paojiang, Renshen, and Baizhu should be used to tonify and nourish.