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According to *Shengji Zonglu* (General Records of the Holy Relief): After childbirth, the Chong and Ren meridians (meridians regulating menstruation and pregnancy) are deficient, and both Qi and Blood are weak. The latent heat enters the Foot-Yangming Stomach Meridian. The straight branch descends from the Quepen point (ST12), down into the interior of the breast, passes below the navel, and enters the Qichuan area. The Chong Mai originates at the Qichuan area. Generally, the Foot-Yangming Meridian ascends along both sides of the navel and disperses in the chest. When this meridian is attacked by pathogenic heat, the blood is stirred and beaten, and the Qi becomes stagnant. Stirring and beating cause pain; stagnation causes swelling. This condition is common after childbirth, caused by the accumulation of milk colliding with the Qi.

Shenzhen's commentary: The above six sections describe syndromes of lactation failure in postpartum women. Women rely on Blood for their physiological functions; Blood transforms upward into milk and downward into menstrual flow. The transformation of Blood originates from the refined essences derived from food and drink processed by the Spleen and Stomach, which are transported and transformed into milk and menses. If the Qi of the Spleen and Stomach is vigorous after childbirth, Blood is abundant and milk production is plentiful. If the Qi of the Spleen and Stomach declines, Blood diminishes and milk production decreases. This explains why Xue Lizhai emphasized strengthening the Spleen and Stomach and nourishing the source of transformation as key treatments for lactation issues. To neglect the Spleen and Stomach and merely attempt to tonify Qi and Blood, or to solely engage in using galactagogues, is like seeking a thousand gold coins from a beggar—it is impossible to achieve.

Chen’s *Sanyin Fanglun* states: During labor, excessive exertion can cause prolapse of the Yin organs or eversion of the vagina, accompanied by pressing pain and swelling. Heavy lifting and sexual fatigue can also trigger these symptoms, often accompanied by continuous discharge of clear fluid and dribbling urination. Powdered sulfur, cuttlefish bone, and Schisandra berry should be applied topically.

Chen Liangfu stated: Failure of the vaginal opening to close is due to inherent weakness of Yuan Qi (Original Qi) and lack of proper care during pregnancy, resulting in an inability of Qi and Blood to consolidate. Use Shiquan Dabu Tang (Ten Significant Decoction for Great Tonification). For initial postpartum vulvar swelling or painful non-closure, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). For swelling without closure, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with added Schisandra berry. Cold-natured medicines must be strictly avoided.

Xue Lizhai stated: Non-closure of the Yumen (vaginal introitus) indicates deficiency of Qi and Blood; treat with Shiquan Dabu Tang (Ten Significant Decoction for Great Tonification). Swelling and pain indicate deficiency-heat in the Liver Meridian; treat with Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder).

Shenzhen's commentary: The above three sections describe two postpartum syndromes: organ prolapse and non-closure. All postpartum conditions should generally be treated based on severe deficiency of Qi and Blood, especially cases of uterine prolapse or vaginal laxity. Therefore, in the medical records of Zhu Danxi and Xue Lizhai, there are descriptions of tissue protruding from the vagina resembling a handkerchief, a bowl, a bifurcated shape, a strip of flesh, or a piece of detached uterus. All these manifestations stem from Qi deficiency and Blood collapse affecting the Zi Hu Bao Men (uterine gate). Their prescriptions primarily consist of Ginseng, Astragalus, Angelica sinensis, and Rehmannia root, combined with herbs that lift and astringe. Clinicians can attain profound understanding through such approaches.