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After childbirth, Yin-blood is suddenly and heavily lost, leaving Yang without attachment. Solitary Yang floats outward, often causing fever. This is heat generated by Yin deficiency; it must not be mistaken for an external contraction treated with surface-releasing methods. Shenghua Tang (Blood-Generating Decoction) is effective in reducing fever because it contains dried ginger (Ganjiang) and licorice (Gancao), illustrating the principle that "sweet and warm herbs can eliminate severe heat." Therefore, even if exterior symptoms are present after childbirth, all wind-dispelling herbs with ascending properties should not be used, as they may carry blood upward, causing dizziness. Furthermore, there is a risk of further exhausting Yang, which could lead to death from sweating collapse. Even Chuanxiong (Chuanxiong Rhizome) in Foshou San (Hand-Holding Powder), due to its acrid and dispersing nature that induces sweating and leakage, must be used only after careful consideration based on the specific condition at that time.

Since Yin-blood is already deficient after childbirth, body fluids are naturally scant. Moreover, labor fatigue leads to Qi deficiency; when Qi is deficient, digestive transformation slows down, inevitably leading to dryness of the large and small intestines. This will recover naturally over time. Alternatively, using Shenghua Tang to nourish blood and assist in generating fluids is also appropriate. Thus, although bowel movements and urination may be temporarily obstructed after childbirth, purgative or draining herbs must be strictly prohibited. It is not only that Mangxiao (Natrii Sulfas), Dahuang (Rhei Radix et Rhizoma), and Wuling San (Five-Ingredient Powder with Poria) should not be lightly tried. Even Shengdihuang (Rehmanniae Radix) and Shaoyao (Paeoniae Radix) in Siwu Tang (Four-Substance Decoction) are purely Yin in nature, damaging the vital Qi, causing diarrhea, and coagulating blood. Wuling San promotes diuresis but injures Yin; the more one promotes urination, the more dryness and constipation worsen. If mistakenly used, causing a second loss of Yin, solitary Yang without support may flee, leading to collapse. Therefore, *Jiyao* (Essentials) states: Diseases related to pregnancy and childbirth involve the Jueyin channel; one must not violate Stomach Qi or the Upper, Middle, and Lower Jiaos. One must not induce sweating, purge, or promote diuresis.

In treating postpartum conditions, the "Three Examinations" are indispensable. The first examination checks for pain in the lower abdomen to determine the presence or absence of lochia discharge. The second examination assesses whether stool is unobstructed to gauge the abundance or depletion of body fluids. The third examination evaluates whether lactation is flowing and the amount of food intake to determine whether Stomach Qi is robust or deficient. Generally, women who have normal deliveries have regulated uterine opening and closing. After birth, the uterus closes immediately. Erzhen (Placental Blood Stasis Mass), driven by Qi, breaks into small pieces and is discharged continuously, hence the prolonged duration. In cases of difficult labor, excessive injury to the uterus causes the "gate" to relax and fail to contract, resulting in the expulsion of blood clumps as large and shaped like eggplants; this is called Erzhen. If the entire mass is expelled at once, there is no worry of dripping discharge. Any remaining blood goes into urine and stool, resembling soap pod juice, with little to no lower abdominal pain. Do not mistakenly assume that postpartum blood stasis has not yet moved and recklessly use purgatives, which can be fatal.

There are postpartum cases that resemble Erzhen pain, where a mass can be felt and slight resistance occurs upon pressure. People often attribute this to residual blood from Erzhen, which is greatly mistaken. Since the fetal sac has been expelled, how can blood remain alone? The uterus housed the fetus for a long time; its sudden separation causes the Sea of Blood to become suddenly empty, resulting in pain. Injury to the uterine gate causes congestion and swelling, making it appear as if there is a mass, though it is not a true solid mass. Because the swelling has not subsided, it resists pressure. Treatment should focus on calming and nourishing the organs, and recovery will occur soon. If blood stasis requires medication, Shenghua Tang is most suitable; Dianbao Jian (Placenta-Clearing Decoction) or Sishen San (Four-God Powder) are also acceptable. If herbs such as Sumu (Sappan Wood), Honghua (Carthami Flos), Yuanhu (Corydalis Rhizoma), and Qingpi (Aurantii Fructus Pericarpium) are mistakenly used, they will damage organ Qi and exacerbate deficiency conditions. Be extremely cautious!

Dianbao Jian: Highly effective for postpartum Erzhen pain and similar symptoms.
Danggui (Angelicae Sinensis Radix, 5 qian), Chuanxiong (Chuanxiong Rhizome, 1 qian), Fuling (Poria, 1 qian), Zhi Gancao (Prepared Licorice Root, 1 qian), Rougui (Cinnamomi Cortex, 0.5 qian). Add one cup of water.
Decoct until reduced to eight-tenths, and take hot. If the pulse is fine and cold signs are present, or if vomiting occurs, add fried Huangqi Ganjiang (Fried Dried Ginger, 1 qian). If there is excess blood heat and fire, remove Rougui and add Jiuchao Shaoyao (Wine-fried White Peony Root, 1 qian).

Sishen San (See section on Abdominal Pain).