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Gao Yunxuan, a left prefect in Suiyang, had a wife, Lady Liang. Born into a wealthy family (Gao Liang Zhi Bing), her constitution was extremely weak and timid, and she had given birth many times. During the childbirth in the year Wuwu, she had never experienced difficulty, and after delivery, her spirit remained robust.

Mr. Gao Yunxuan did not take it seriously and was chatting with me in the courtyard. Suddenly, due to excessive postpartum bleeding, someone rushed to report that his wife had collapsed on the ground. I hurriedly examined her and found her mouth open and hands relaxed (Shou Sa - fingers unable to clench), face and lips black, and breathing ceased. Fortunately, fresh Ginseng was available at home. Unable to decoct it in time, I chewed a piece of Ginseng root, placed it in the patient's mouth, and poured boiling water down her throat. She barely swallowed it but immediately vomited it all out, as the Stomach Qi could no longer receive or retain substances. I continued chewing and pouring, using five pieces of Ginseng in total. Although she vomited, not all of it was expelled. After a long while, she let out a belch, and her breathing gradually returned. We then administered large doses of Ginseng and Atractylodes Macrocephala (Baizhu) orally, leading to her recovery. Subsequent deliveries were uneventful. Last year, she became pregnant again and developed mild hemorrhoids. I stated, "Hemorrhoids during pregnancy are difficult to treat with medication; we should manage it slowly." Mr. Gao agreed deeply, but his wife insisted on rapid cure. Knowing this was impossible, I declined treatment and advised her to seek another physician. Several doctors were consulted without effect. An external surgeon was then engaged who recklessly used harsh, toxic drugs. Although the fetus was not lost, the hemorrhoids worsened and prolapsed further, causing day-and-night wailing and extreme distress. Her spirit and physical form were exhausted. By the month of delivery, her face and lips were pale, her voice and breath were faint, and her six pulses were empty, floating, and rootless. That night, three qian of Ginseng were administered along with one dose of Shiquan Dabu Decoction (Ten Significant Tonifying Decoction). The next morning, when the amniotic fluid broke, seven qian of Ginseng were decocted and taken with chicken broth soup. Immediately, a male infant was born, and the mother's spirit was better than before. Unexpectedly, three days later, she contracted an external pathogen, presenting with headache, body pain, aversion to cold, and fever. She recovered after taking Shuliao Wuji San (Prepared Wuji Powder).

A few days later, suddenly due to anger, she experienced abrupt upper abdominal distension and急促 breathing (asthma), continuous coughing, chest and breast fullness/pain, and phlegm rattling in the throat. She could not eat or drink; even sipping tea caused blockage above and below, with Qi failing to connect continuously. She required assistance to sit upright and could not lie down, fainting intermittently. The household was in panic. Upon pulse diagnosis, her pulse was fine, rapid, and irregular, approaching ten beats per breath cycle. I recognized this as rootless Qi and escaping Qi rushing upward. I prescribed Bawei Dihuang Tang (Eight-Ingredient Rehmannia Root Decoction) hoping to guide the Qi back to its source, but two doses had no effect. I said, "For such a syndrome, only massive tonification of True Yuan can save her." Thus, I prescribed Liuwei Huiyang Yin (Six-Ingredient Return Yang Decoction) containing Ginseng, Aconite, Cinnamon Twig, Ginger, Angelica Sinensis, and Prepared Rehmannia Root, each 3 qian, plus 5 qian of Deer Antler Velvet. After one dose, her breathing calmed, and she could lie down. After four doses, she was fully recovered. Her previously dry intestines were moistened, and the pain from hemorrhoids ceased. In the eyes of common people, such pulse and symptom patterns would lead them to suspect that excessive Ginseng intake during delivery caused the issue, believing that chest-opening and Qi-descending herbs were necessary. If Qingjiang (clearing and descending) herbs were used, death would follow instantly, and they would blame the previous Ginseng use, likely attacking my reputation. They fail to realize that if Ginseng and Atractylodes had not been aggressively used during delivery, she would have expired at the moment of birth and survived until now! The current asthma is actually due to the Ginseng efficacy wearing off, revealing the underlying deficiency. Heart-Kidney non-interaction (Ziwu Bu Jiao) leads to immediate exhaustion. Without powerful tonic formulas, how could this be reversed? This case survived truly because Mr. Gao possessed superior knowledge, had his own judgment, and listened only to my advice, resulting in swift efficacy like a drumstick hitting a drum. Anyone following vulgar views would have absolutely no chance of survival.

Both Bi Syndrome (Obstruction) and Tuo Syndrome (Collapse) must be differentiated not only in postpartum cases but also in stroke, phlegm obstruction, Qi syncope, summerheat wind, sudden collapse, and unconsciousness. Jaw tightness and clenched fists constitute Bi Syndrome, indicating excess conditions where dispersing wind and resolving phlegm may be used. Mouth opening, hand relaxation, eye closure, urinary incontinence, and snoring constitute Tuo Syndrome. Mouth opening indicates Heart Qi exhaustion; hand relaxation indicates Spleen Qi exhaustion; eye closure indicates Liver Qi exhaustion; urinary incontinence indicates Kidney Qi exhaustion; snoring indicates Lung Qi exhaustion. All are signs of complete Yuan Qi exhaustion. Only massive administration of Ginseng and Aconite might save one in ten.

I have seen countless postpartum women die from Tuo Syndrome because they dared not take Ginseng. I heard of a woman who died suddenly after a faint spell postpartum; another yawned and died with her mouth open. These are Tuo Syndromes. There are also reckless individuals who do not understand Tuo Syndrome or recognize Ginseng, obstructing treatment and preventing Ginseng use, leading to death. How many such deaths occur? If the dead had consciousness, would they not mourn eternally?

Xueyun Syndrome (Blood Syncope) is originally caused by Qi deficiency leading to temporary fainting, though blood stagnation and abundant phlegm can also cause it. If the form, Qi, and pulse all indicate excess, with chest/abdominal distension/pain, coarse breathing, clenched fists, and jaw tightness, this is Blood Reversal Syndrome, treated with Heishen San (Black Divine Powder). If there is no distension or pain, it belongs to Qi deficiency, treated with a large dose of Xionggui Tang (Angelica and Ligusticum Decoction) plus Cinnamon Bark.

For sudden fainting where medicine is unavailable, heat a steelyard weight until red, place it in a clay basin near the bed, pour vinegar over it, and let the vinegar fumes enter the nose to restore consciousness.

Postpartum, all vessels are empty. Washing too early can cause facial paralysis with jaw lock, convulsions, and opisthotonos; or anger-induced fever and confusion. Use Jingjie Sui (Schizonepeta Spikes) wine-fried until black, and Dang Gui (Angelica Sinensis) 3 qian each. Decoct with half cup water, half cup wine, and half cup child's urine to one cup. Administer orally. For jaw lock, pry open with a hairpin to administer. Pinch the nose and massage the throat to ensure swallowing, which will revive the patient. This is Postpartum Jing Syndrome, known as Convulsive Disease in pediatrics.

Damage to visceral Qi during pregnancy, rupture of the uterine ligaments, and sudden fetal expulsion is called Xiao Chan (Miscarriage). The depletion of the uterus is more severe than normal delivery. However, treatment differs from normal delivery, prioritizing nourishment and tonification.

Feng Chuzhan stated: "Miscarriage must not be underestimated; recuperation should be tenfold that of normal delivery. Normal delivery is like a ripe fruit falling naturally; miscarriage is like forcibly picking it, breaking the skin and severing the stem." Neglect often leads to disease and death. This condition begins with blood gathering to form the fetus, continues with essence and blood nourishing it, and ends with frequent loss due to insufficiency of essence and blood. Thus, blood stasis is minimal. If abdominal pain with palpable masses occurs, it is mostly due to blood deficiency and Qi rebellion. Massive warm tonification generates new blood and dispels stasis. If digestive and moving methods are used, rebellious Qi rises further, often leading to untreatable conditions. Additionally, blood deficiency abdominal pain combined with Yin deficiency failing to grasp Qi can cause hernias. Bawei Dihuang Wan (Eight-Ingredient Rehmannia Pill) plus Achyranthes Bidentata (Niuxi) and Schisandra Chinensis (Wuweizi) taken morning and evening will heal spontaneously.

Zhang Jingyue stated: "Miscarriages vary by timing. Those in the second or third month are 'near'; those in the fifth or sixth are 'far'. Early miscarriage has a lighter course; late miscarriage is heavier. This is common knowledge. However, there is an even earlier type: conception and expulsion occurring simultaneously. Among families struggling with infertility, five or six out of ten suffer this. The cause is always sexual indulgence, though people generally ignore or deny it. I write this to guide the lost, hoping to help future generations. When the fetal origin begins, in one month it is like a dewdrop, in two months like a peach blossom. After three to four months, blood vessels and form appear; after five to six months, bones, muscles, and hair grow. Initially, it is merely a drop of profound essence. At this stage, the 'bellows' (Qi mechanism) lacks foundation, and the root has no ground. Consolidating it makes it firm; rupturing it causes flow. Therefore, after conception, one must strictly observe sexual restraint to prevent overflow. Young men indulge without fear. Even if the fetus is stable, preservation is rare. Those with exceptional vitality may persist in intercourse despite failure or resume after failure. At this time, the 'host' (fetus/uterus) desires stillness, but the 'guest' (sexual activity) refuses rest. Like a madman banging on doors, driven by watery nature and hot temperament, the door opens, and the essence flows away. Flowers fly with butterflies; fruits fall together. Mixing with filth, one loses track of yesterday's conception and today's expulsion, or first-day conception and mid-month expulsion. Conception and expulsion happen simultaneously, leaving no trace. In obvious miscarriages, the fetus is formed, and the loss is felt; in hidden miscarriages, the fetus resembles water, flowing away unnoticed. Thus, many families have no full-term births due to frequent minor losses. Men marrying prostitutes have few children because their uteri are 'slippery' and accustomed to minor losses. I have seen infertile men seeking prescriptions. Asked about potency, they say they can perform; asked about endurance, they say they last long. Yet they complain, 'Everyone has children except me.' Do they not realize others have obvious births while they suffer hidden ones? Furthermore, those miscarrying at three or five months, even weak women, often do so due to unrestrained sexual desire injuring maternal Qi. Thus, those relying on strength often have no children, as strength destroys itself; those indulging without restraint often cannot rear children, as they steal the fetal Yuan Qi. Is this solely the woman's fault?"

These are words of truth from Jingyue. Ancients said "few desires, many sons," which is the explanation. People lament infertility, unaware that once conceived, the fetus is secretly damaged, repeatedly conceived and repeatedly damaged, leading to lifelong childlessness. It is indeed fitting. However, for women suffering repeated miscarriages due to weakness or Yin-Yang imbalance, and for physicians having no strategy to secure pregnancy, this is pitiable. I possess a divine and sacred formula for securing pregnancy, proven effective. Trust and practice it, and you will not err.