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Dan Yangxian stated: When administering Shenghua Decoction (Invigorating Blood Decoction) with the addition of Ginseng Radix et Rhizoma (Renshen, 人参) postpartum, it is indicated only when there is severe hemorrhage (blood flooding), syncope due to blood loss, and signs of collapse in both complexion and physical form. If there are no signs of deficiency-collapse, Ginseng should not be added. If there are blood stasis clumps causing severe pain that does not shift location, only Safflower (Honghua, 红花) and Cinnamon Twig (Guirui, 肉桂) should be added. One must absolutely avoid using Ginseng Radix et Rhizoma (Renshen, 人参) and Atractylodes Rhizome (Baizhu, 白术) to tonify qi, as doing so may cause death.

Shenzhai commented: The above seven items outline the taboos regarding medication during the postpartum period. Mismanagement is common in postpartum diseases; therefore, one must be extremely detailed and cautious when prescribing.

Ye Yiqian stated: *Liangfang* records that removing stale blood (blood stasis) should be the priority postpartum. If blood circulation is sluggish and stagnant, various diseases arise. Since postpartum vital energy (yuanqi, 元气) is already deficient and its transportation and transformation are disordered, blood stasis inevitably remains. The practitioner must first expel the stasis; only after the stasis is eliminated can tonification proceed. This is the primary principle. Nowadays, people see internal deficiency symptoms postpartum and hastily administer sweet-warm formulas containing Ginseng Radix et Rhizoma (Renshen, 人参), leading to death from blood stasis attacking the heart. One must be cautious.

Shenzhai commented: The above item outlines the treatment principle of eliminating stasis first during the postpartum period. Although deficiency patterns are indeed common postpartum, among patterns of deficiency mixed with excess, none is more critical than stagnation of blood stasis. This item deserves special attention.

Zhang Zihe stated: Postpartum conditions must never be treated merely as general deficiency and insufficiency. Doing so will inevitably lead to bone-steaming tidal fever, alternating chills and heat, inability to eat, emaciation of the skin and muscles, and amenorrhea. The Classics state: "Cold leads to decreased appetite; heat consumes muscle mass." People become emaciated because incompetent physicians use drugs to excessively consume their essence. Alas! Do people die simply due to fate?

Shenzhai commented: In postpartum conditions, deficiency is common while excess is rare. Zhang Zihe’s assertion that one must not treat them as general deficiency implies a method relying on harsh purgative or attacking therapies. Can the postpartum body withstand the three methods of sweating, vomiting, and purging? Zhao Sizhen sighed that Zhang Zihe’s writings have direct language and clear meaning, yet he attends to one aspect while neglecting another. Truly insightful words.

Zhu Danxi stated: When treating disease postpartum, one must first consolidate qi and blood. Therefore, the main approach postpartum is to greatly tonify qi and blood. Even if there are miscellaneous syndromes, they should be treated as secondary issues.

Wang Shishan stated: Within one hundred days postpartum, even if miscellaneous syndromes exist, one must follow Zhu Danxi’s method, treating them as secondary issues, and focus primarily on greatly tonifying qi and blood. One must not use attacking therapies. This is a correct exposition.