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Zhu Danxi stated: The Wuji San (Five Accumulations Powder) from *Ju Fang* claims to treat postpartum pain caused by residual blood. In this formula, Cangzhu (Atractylodis Rhizoma) serves as the sovereign drug, Mahuang (Ephedrae Herba) as the minister drug, and Houpo (Magnoliae Officinalis Cortex) and Zhike (Aurantii Fructus) as the assistant drugs. Although it contains Shaoyao (Paeoniae Radix Alba) and Danggui (Angelicae Sinensis Radix) to nourish blood, their dosage is only one-third that of Cangzhu. Furthermore, the formula states that it is suitable for women with irregular qi and blood, cramping pain in the heart and abdomen, and amenorrhea. Why does it fail to consider what excess pathogenic factors a postpartum woman might have? Since her qi and blood are not yet replenished, she seems ill-suited for diaphoretic therapy. Even if the intention is to eliminate stale matter and generate new tissue, and the medicinal properties are mild, how can one borrow the dispersing power of Mahuang combined with Cangzhu and Zhike, thereby making the deficient body even more deficient, leading to immediate disaster?

Yu Tianmin said: It has been asked why ancient formulas mostly use Siwu Tang (Four Substances Decoction) with modifications for various postpartum diseases, while Zhu Danxi alone considers Shaoyao (Paeoniae Radix Alba) to be sour and cold, damaging the vitalizing qi, and prohibits its use. The answer is: Women who have just given birth have both qi and blood deficiency; they retain only the austere and killing energy of autumn and winter, lacking the vitalizing energy of spring and summer. Therefore, most postpartum conditions are unfavorable to cold-cooling agents and greatly benefit from warm-hot medicines to assist the source of generation for heaven and earth. The sages formulated Siwu Tang (Four Substances Decoction), using the acrid-warm nature of Xiong (Chuanxiong Rhizome) and Gui (Angelicae Sinensis Radix), assisted by the cold nature of Di (Rehmanniae Radix) and Shao (Paeoniae Radix Alba), achieving a balance of cold and warmth, making it an excellent remedy for women's diseases. If used postpartum, one must select Baishaoyao (White Paeony Root), repeatedly soak it in wine and stir-fry it to remove its sour-cold property, retaining only its ability to generate and invigorate blood. How could this be unacceptable? Later copies omitted the notes on processing due to long transmission. Zhu Danxi feared that ordinary physicians would act rashly and use it without processing, so he specifically pointed out the reasons for its harm to warn against it.

Zhang Jingyue stated: According to Zhu Danxi, Shaoyao (Paeoniae Radix Alba) is sour and cold, severely damaging the generating qi, and should be contraindicated postpartum. This statement is excessive. The coldness of Shaoyao is merely slightly cooling among blood-nourishing herbs; it is not as bitter and cold as Huangqin (Scutellariae Radix) or Lian (Coptidis Rhizome). If Shaoyao were to be contraindicated in this manner, then other even colder substances would certainly be unusable. I often see families being overly cautious after childbirth; sometimes due to excessive warming, or because the mother is young and strong, leading to over-supplementation through diet and medicine, causing internal heat and resulting in many cases of extreme heat diseases. If all postpartum conditions are considered deficient and require universal supplementation, is that truly perfect? Moreover, Shaoyao has a clear nature, is slightly sour and astringent, and is most suitable for conditions where yin qi dissipates. Is it not an essential herb for postpartum care? This point requires clarification.