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Chen Liangfu stated: After childbirth, the primordial Qi (vital energy) is severely depleted, and new blood has not yet been generated; treatment should primarily focus on significantly tonifying Qi and Blood. If lochia (postpartum uterine discharge) has not fully cleared, blood-invigorating herbs should be added to the tonifying prescription. If wind-cold pathogenic factors cause stagnation due to a common cold, tonification must be performed first, followed by releasing the exterior and resolving stagnation; one must not casually use harsh medicines that damage Qi and Blood.

He Song'an stated: Postpartum Qi and Blood are severely damaged, and all matters require careful protection. One must not rely on physical robustness to engage in overwork, leading to internal injury or external contraction of the Six Excesses (pathogenic factors) and Seven Emotions, causing unpredictable harm. Therefore, for postpartum conditions, the primary approach is to significantly tonify Qi and Blood. Even if other symptoms exist, they should be treated as secondary. If one wishes to eliminate pathogens, it is appropriate to combine them with tonifying agents; one should not exclusively use harsh medicines that further deplete Qi and Blood.

Shenzhai commented: The above four points outline the methods of attacking (purging) and tonifying for treating postpartum conditions. Zhang Hezi's discussion focuses specifically on attacking pathogens. Zhu Danxi's discussion focuses specifically on tonifying deficiency. The methods of these two sages each have their own insights, but Zhu Danxi's theory is superior. Therefore, one must integrate the views from *Liangfang* (referring to Chen Liangfu) and the orthodox school (referring to Zhu Danxi) for reference, which is the appropriate approach.

Yu Tianmin stated: Someone asked about postpartum conditions. Zhu Danxi said that the primary approach should be significantly tonifying Qi and Blood, and even if there are miscellaneous symptoms, they should be treated secondarily. He also stated that postpartum wind-stroke should never be treated as ordinary wind-stroke using wind-dispelling drugs. Then, regardless of the symptoms, is it always appropriate to significantly tonify Qi and Blood? I reply: By examining the characters "primary" (Zhu) and "secondary" (Mo), the meaning becomes clear. In cases of deficiency without other symptoms, it is appropriate to significantly tonify Qi and Blood, and the disease will heal itself. If the deficiency leads to wind-cold contraction, wind-dispelling agents should be included alongside Qi and Blood tonics. If Spleen deficiency leads to dietary injury affecting the Taiyin channel, digestive-resolving agents should be added to the Qi and Blood tonics. If chills and fever occur because blood stasis and lochia have not fully cleared, the blood stasis must first be expelled before significantly tonifying Qi and Blood. The Classics state: There are cases where the root is treated first and the branch second, and cases where the branch is treated first and the root second. It also states: In emergencies, treat the branch; when stable, treat the root. Zhu Danxi's use of "primary" and "secondary" corresponds to the concepts of "root" (Ben) and "branch" (Biao).

Ye Yiqian stated: Someone asked: Postpartum Qi and Blood are extremely deficient; even if there are miscellaneous symptoms, they are treated secondarily. Yet it is also said that postpartum treatment must prioritize removing lochia. Which is correct? One must understand that ancient texts each have their specific applicability. For example, if excessive blood loss occurs after childbirth, resulting in syncope (blood fainting), the pulse will likely be wiry, floating, large, and scattered. This indicates that Yin Blood has been exhausted, leaving Yang Qi without support. Large doses of Chuanxiong Rhizome (Chuanxiong) and Angelicae Sinensis Radix (Danggui), added with Prepared Aconite Lateralis Radix Preparate (Fuzi) and Dried Ginger (Ganjiang), should be administered at once to tonify deficiency. If pain is caused by stagnant blood, blood-invigorating medicines should be used concurrently. This prioritizes significant tonification as the root and other symptoms as the branch. However, if three or four days after childbirth, residual stasis suddenly stops, accompanied by lower back and abdominal pain, gradually developing tidal fever and cough, with a surging, full, and rapid pulse, this indicates that foul blood has accumulated and rushed upward to affect the Heart and Lungs. The lochia and blood have clumped together and remain stagnant. Without using blood-invigorating and Qi-moving medicines to resolve the stasis, how can peace be restored? If one only knows that tonification is necessary and purging is forbidden, the illness will inevitably worsen. Therefore, although postpartum conditions are generally characterized by deficiency, there are also excess conditions. One should not rigidly adhere to the sayings that "there is no heat after childbirth" or "there is no deficiency before childbirth." For instance, during pregnancy, morning sickness, poor appetite, abdominal distension, clear and loose stools, menstrual bleeding, and restless fetus do not respond to warming and tonifying medicines; how else could the condition be cured? Does this not prove that deficiency exists before childbirth? Similarly, postpartum cold damage and febrile diseases involving irritability, thirst, and constipation do not respond to bitter-cold medicines; how else can they be resolved? Does this not prove that heat exists after childbirth? Nowadays, people see floating, surging, wiry, and tight pulses after childbirth and immediately claim there is heat. They do not know that postpartum pulses differ from those of other diseases. A surging and large pulse after childbirth indicates the dispersion of Qi and Blood and a lack of internal retention, hence manifesting such a pulse. Using cooling prescriptions in this context can kill instantly; this must not be ignored.

Shenzhai commented: The above two points outline the principles for distinguishing between attacking and tonifying methods in postpartum care. Balancing attacking and tonifying therapies in postpartum medicine is the most difficult task. Tonifying for deficiency and purging for excess are fixed rules. However, cases where deficiency coexists with excess pathogens are very common in postpartum conditions. Zhu Danxi's discussion was specifically established to warn physicians against ignoring severe postpartum deficiency while solely focusing on attacking pathogens. Little do they realize that strictly adhering to Zhu Danxi's methods also carries the risk of harm from overly vigorous tonification. This is why the discussions by Yu Tianmin and Ye Yiqian should be urgently studied and pondered.