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Whenever excessive effort during childbirth leads to fatigue and injury to the Spleen Qi, the isolated Zang organ (Spleen) fails to distribute essence to the four extremities (Heart, Liver, Lung, Kidney). Consequently, the feet become cold and reversed, with Jue Qi (pathogenic cold/counterflow qi) ascending. The Classics state: "When Yang Qi is deficient at the lower part, it results in Cold Jue." As Jue Qi ascends, it fills the vessels and separates from the form. When counterflow Qi ascends and fills the meridians, the Shen Spirit becomes floating and disperse, leaving the body. In such cases, unless urgent treatment with a potent, large-dose tonic is administered to raise the Qi and return it to its origin, restore Yang, and recover the Shen, the condition cannot be resolved. It is advisable to heavily use Ren Shen (Ginseng Root) and [missing herb name], so that when Qi and Blood are abundant and the Shen recovers, the Jue syndrome will naturally cease. Ren Shen Sheng Hua Tang (Ginseng Birth-Expelling Decoction) is indicated. If there is no mass or pain, Zi Rong Yi Qi Tang (Nourish Blood and Benefit Qi Decoction) should be used. (See Supplement 37, Supplement 38)

Postpartum residual blood, mixed with serous fluid, is termed E Lu (Lochia). When Qi and Blood are robust, E Lu is discharged with delivery. However, if Qi and Blood are weak, or if accompanied by Cold pathogens or Wind pathogens, the E Lu may stagnate and fail to flow. Ascending attack causes Xue Yun (Blood Fainting); accumulation of stasis forms Er Zhen (Child Pillow/Mass postpartum). If not expelled over time, it leads to abdominal pain, heart pain, generalized fever, heat sensation in the palms, soles, and chest (Five Hearts Heat), bone-steaming tidal fever, which comes and goes resembling Malaria (Nue Ji), masses in the hypochondrium, borborygmus (rumbling in the abdomen), epigastric discomfort, dizziness, poor appetite, emaciation, and resembles deficiency syndromes. One must be cautious not to misdiagnose or mistreat this, lest it develop into Xue Gu (Blood Distension) and other conditions. It is appropriate to combine Sheng Hua Tang (Birth-Expelling Decoction) with Shi Xiao San (Excellent Payment Powder), employing a method of tonifying while resolving stasis. (See Harmonize 24, Attack 7) Qi Zhen San (Pillow-Raising Powder) is also good. (See Attack 9) If E Lu flows into the limbs, back, and waist, swelling and pain will eventually occur; one should quickly apply Cong Yan (Scallion Moxibustion/Ironing) to dissipate it, and internally administer Jia Shen Sheng Hua Tang (Sheng Hua Tang with Ginseng). If not treated promptly, the accumulated material will transform into pus, for which Shen Xian Hui Nong San (Divine Return Pus Powder) is indicated. (See Attack 11) However, due to insufficient Qi and Blood, this formula should not be used lightly. Aversion to cold and fear of heat indicate Qi Deficiency; Shi Quan Da Bu Tang (Great Tonification of Ten Thousand Tonic Decoction) is suitable. (See Supplement 39) Tidal fever in the late afternoon (Ri Bu Chao Re) indicates Blood Deficiency; Si Wu Tang (Four Substance Decoction) with Ren Shen (Ginseng Root), Bai Zhu (Atractylodes Macrocephala Rhizome), and Mu Dan Pi (Moutan Cortex) is indicated. (See Supplement 7) Vomiting and reversal of Qi indicate Stomach Qi Deficiency; Liu Jun Zi Tang (Six Gentlemen Decoction) with fried Gan Jiang (Dried Ginger) is suitable. (See Supplement 1) Poor appetite and physical fatigue indicate Spleen Deficiency; Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is appropriate. (See Supplement 6) Cold extremities and frequent urination indicate Kidney Qi Deficiency; Bu Zhong Yi Qi Tang with Yi Zhi Ren (Alpinia Oxyphylla Fruit) is indicated. Ironing Method: Take one bunch of scallions, pound them into a paste/biscuit, apply to the affected area, cover with two or three layers of thick cloth, and iron with a warm iron using mild heat.