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Gu Shicheng stated: In cases where a parturient woman's vulva is swollen on one side or both sides, making it difficult to rise or sit, and in more severe instances where the tissues on either side of the vulva ulcerate, break open, and discharge pus with pain radiating to the lower abdomen and thighs, these conditions are caused by difficult labor. They may result from midwives manually separating the bony pelvis at the birth canal exit, inserting hands into the vagina to extract the placenta, or causing abrasions to the skin and flesh due to rough fingers and fingernails. It must be understood that the skin and flesh of the vaginal opening are delicate and tender, unable to withstand such trauma. Furthermore, continuous dripping of blood stasis causes the wounds to become increasingly macerated and ulcerated. Moreover, the vulva is the area where the meridians of the Liver, Spleen, Kidney, Chong Mai (Penetrating Vessel), and Ren Mai (Conception Vessel) converge. Once the tissue is broken, pain is inevitably drawn along the Foot-Shaoyin Kidney Meridian to the waist and thighs. It is advisable to wash the damaged areas with decocted herbal washes, and then apply Yuhong Gao (Jade Red Ointment) and Zhenzhu San (Pearl Powder), which will lead to spontaneous healing.

For vulvar swelling and pain: Decoct 1 liang (approx. 37.5g) of Zhike (Fructus Aurantii) for external washing.
For vulvar swelling and ulceration: Use equal parts of Danggui (Radix Angelicae Sinensis), Chishao (Radix Paeoniae Rubra), Baizhi (Radix Angelicae Dahuricae), Gancao (Radix Glycyrrhizae), and Kushen (Cortex Phellodendri); decoct for external washing.
For postpartum vulvar swelling and pain: Use 3 qian (approx. 11.25g) of Shechuangzi (Fructus Cnidii) and five crushed white radishes; decoct for fumigation and washing.

Chen Shigong stated: Hemorrhage following sexual intercourse in women is due to Liver deficiency with internal heat failing to store blood, and Spleen deficiency failing to control blood. Treatment should primarily utilize Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) and Guipi Tang (Restore the Spleen Decoction). (*Waike Zhengzong*, Standardized Practice of Surgery)
He further stated: Alternatively, Siwu Tang (Four Substances Decoction) can be used with added Longdancao (Radix Gentianae), Chaihu (Radix Bupleuri), Shanzhi (Fructus Gardeniae), and Huangqin (Radix Scutellariae) for treatment.

Feng Luzhan stated: Hemorrhage after sexual intercourse indicates excessive Liver fire leading to over-dispersal, combined with Liver deficiency failing to store blood and Spleen deficiency failing to control blood. The methods of Buzhong Yiqi (Tonifying the Middle and Augmenting Qi) and Guipi (Restoring the Spleen) should be applied according to the specific situation. If all six pulses are surging (Hong), this indicates Kidney Yin deficiency failing to secure and store essence and blood. Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) with added Maidong (Rhizoma Ophiopogonis) and Wuweizi (Fructus Schisandrae) is appropriate. (*Waike Jinnang*, Surgical Brocade Bag)

Chen Shigong stated: Vulvar laxity and inability to close is caused by excessive worry and overthinking. (*Waike Zhengzong*)
He further stated: Treatment should involve Xiaoyao San (Free and Easy Wanderer Powder) and Guipi Tang, with added Chaihu, Shanzhi, Baishaoyao (Radix Paeoniae Alba), and Mudanpi (Cortex Moutan), administered alternately.

Chen Shigong stated: For pain and swelling caused by injury during first-time marital intercourse, the therapeutic method should focus on soothing stagnation and harmonizing blood. (*Waike Zhengzong*)
Feng Luzhan stated: For vaginal pain in newlywed women, Siwu Tang with added Xiangfu (Rhizoma Cyperi) and Honghua (Flos Carthami) is indicated. (*Waike Jinnang*)
Jiang Shiji stated: For pain and swelling due to injury from marital intercourse, Zhenzhu San (Pearl Powder) mixed with pig spinal cord should be applied topically. (*Yangyi Shuoyue*, Brief Discussion on Surgeon's Medicine)