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*Daquan Quan Shu* states: Postpartum *rulao* (postpartum debility due to exhaustion) arises because the postpartum period is short, qi and blood are deficient, and improper nursing allows wind-cold pathogens to invade. When wind-cold clashes with qi and blood, it fails to warm the skin and muscles, causing the patient to feel weak, fatigued, and exhausted; they may lie down or rise up intermittently, their complexion becomes haggard, and food is not digested properly. Wind-cold pathogenic factors affect the lungs; as the lungs suffer slight cold, coughing and dry mouth occur, followed by dizziness and pain in all joints. Ying and Wei (nutritive and defensive qi) are affected by wind pathogens and flow into the zang-fu organs, causing frequent attacks within moments, occasional night sweats, alternating chills and fever resembling malaria, irritability and oppression in the back and shoulders, inability to lift the four limbs, and a heavy sensation making it difficult to leave the bed. These are the manifestations of *rulao*. (*Rulao* has two types, but both originate from the postpartum state. One involves concurrent external contraction, while the other stems from emotional disturbances. Additionally, cases involving internal injury from diet leading to diarrhea, or incomplete expulsion of lochia, may also present these symptoms and must be distinguished.)

Xue Ji commented: For the aforementioned symptoms, the primary treatment should be to support healthy qi, using Liujunzi Tang (Six Gentlemen Decoction) added with Danggui (Angelicae Sinensis Radix). If spleen and lung qi deficiency causes cough, asthma, and dry mouth, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) added with Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Fructus). If middle qi deficiency causes dry mouth and dizziness, use Buzhong Yiqi Tang added with Manjingzi (Vittadiniae Fructus). If liver channel blood deficiency causes limb pain, use Siwu Tang (Four Substances Decoction) added with Renshen (Ginseng Radix) and Baizhu (Atractylodis Macrocephalae Rhizoma). If liver and kidney yin deficiency with heat causes spontaneous sweating, night sweats, and alternating chills and fever, use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) added with Wuweizi. If spleen deficiency and blood weakness cause abdominal pain and irregular menstruation, use Bazhen Tang (Eight Treasures Decoction) with doubled Baizhu. If spleen deficiency and blood dryness cause skin itching, use JiaWei Xiaoyao San (Modified Free and Easy Wanderer Powder). Generally, this condition often results from spleen and stomach weakness and reduced food intake, leading to fatigue in all meridians (These few words summarize the essence). The treatment should focus on tonifying the spleen; once food intake resumes, essence and qi are generated, and the zang-fu organs find reliance upon them, allowing the disease to heal spontaneously. This should also be managed in reference to the theories and formulas for deficiency-fever conditions.

*Chanbao* states: Postpartum extreme emaciation is caused by the loss of qi and blood after childbirth. For women in middle age or those who experienced difficult labor, regardless of the number of days postpartum, one must wait until the body has recovered through proper nursing before exposing oneself to noisy environments; otherwise, qi and blood will be further injured, and symptoms of emaciation will arise. One should use Bazhen Tang to tonify qi and blood. If dietary injury damages the stomach, use Sijunzi Tang (Four Gentlemen Decoction). If retained food injures the spleen, use Liujunzi Tang. If labor exhausts original qi, use Buzhong Yiqi Tang. If belching occurs with a medicinal taste, it indicates that the medicine has re-injured the stomach; in this case, simply use Sijunzi Tang, drinking slowly and in small amounts to regulate the spleen and stomach. Once stomach qi strengthens, qi and blood will naturally generate, and all symptoms will be instantly eliminated.