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Yi Silan treated a woman who, more than half a month after childbirth, experienced regurgitation and vomiting of clear fluid from the stomach. The physician diagnosed it as Stomach Cold (Wei Han) and prescribed boiled chicken with extra Zanthoxylum (Jiaojiao, 花椒) and Ginger (Shengjiang, 生姜). Initially, she felt relief. (However, for individuals with internal heat or deficient fire, initial administration of acrid-warm herbs may yield minor effects.) By the third to fifth day, the amount of clear fluid increased further, leading her to drink decoctions of ginger and zanthoxylum frequently. Approaching one month, her breath became cold, limbs turned cold and inverted (Si Zhi Fa Jue), she suffered from continuous upward rebellion of qi day and night, unbearable cold sensation in the abdomen, and occasional shivering. She was administered Sijunzi Tang (Four Gentlemen Decoction) with Ren Shen (Ginseng Root) ranging from 1 qian to 2 qian. There was slight relief initially, but no effect over time. Pao Jiang (Prepared Ginger) was added, yet still ineffective. The consensus was to use Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction). (This is the path inevitably taken by mediocre physicians.) Yi examined her pulse; all six pulses were imperceptible at first. Using his index finger to re-examine the Chi position (Cun-Kou pulse position corresponding to Kidney/Lower Burner), and placing his middle and ring fingers behind the Chi position, (a subtle diagnostic method), he found the pulse to be solid, rapid, and forceful, identical on both sides. Her voice was loud and vigorous, able to speak three to five sentences in one breath. Her lips were dry, cheeks red, bowel movements occurred once every five to six days, and urine was scanty and dark red. This indicated a Excess-Heat syndrome. Upon inquiry, he learned that local custom considered pepper-fried chicken as a tonic postpartum. This woman ate it three times daily, resulting in this illness after half a month. He then prescribed Sanhuang Tang (Three Yellows Decoction). After consuming four bowls continuously, all six pulses became palpable, and she lost the desire for ginger-pepper decoction. After another four bowls, her shivering ceased, and the clear fluid reduced by half. After four days of medication, heat rose in her mouth, and small yellow millet-like sores appeared all over her tongue and lips. Bowel movement had been absent for eight days. He administered Siling San (Four Poria Powder) combined with Liangge San (Cool the Diaphragm Powder) on an empty stomach. By noon, there was no movement. He then prepared a decoction of Gan Cao (Licorice Root), mixed with 5 qian of Yuanming Fen (Natrii Sulfas, Mirabilite), and administered it hot. Within about one shichen (two hours), mild borborygmus occurred in the abdomen, followed by vomiting of one to two bowls of sour fluid and two episodes of defecation. Another 5 qian of Yuanming Fen was given, resulting in the passage of more than ten hard fecal pellets. Subsequently, she was regulated with Siling San, Sanhuang Tang, Zhi Zi (Gardenia Fruit), and Zhi Ke (Aurantium Fructus), achieving full recovery. The host remarked: "In our region, physicians always consider such cases as deficiency and use Ginger and Aconite. You, Sir, upon a single examination, prescribed a large dose of Sanhuang Tang and used cold-natured agents like Mirabilite to purge, without being hindered by the postpartum state. What is your insight?" Yi replied: "The pulse and symptoms are obvious; it is merely a lack of detailed observation. The *Pulse Methods* state: 'Extremely large or extremely minute pulses require careful deliberation.' When encountering a pulse that is extremely large but weak, one must guard against floating and scattering Yang Qi. If a pulse is extremely minute and only found after prolonged searching, becoming firmer when pressed to the bone with slight additional pressure, it should not be mistaken for Deficiency-Cold. In this case, the three positions on both sides were imperceptible initially. Re-examining the Chi position with the index finger, and the area behind it with the middle and ring fingers, revealed a solid, rapid, and forceful pulse. This is what is called a Hidden Pulse (Fu Ni Mai). It indicates Yang Qi hidden in the lower jiao, reaching extreme hyperactivity. Furthermore, constipation, scanty dark urine, dry lips, red cheeks, vigorous qi, and loud speech clearly indicate Excess-Heat from both pulse and symptom perspectives. If it were true Deficiency-Cold, the pulse would be floating, large, and weak, not solid and rapid. Symptoms would show faint breathing, not strong demeanor. The cold breath, vomiting of clear fluid, cold limbs, and shivering are precisely manifestations of 'Extreme Heat resembling Water' and the principle of Yang being restrained while Yin floats. Shivering indicates heat entering the Blood Chamber (Xue Shi); extreme heat generates wind. The heat resides in the Liver and Kidney, not the Heart Meridian, hence her speech is sincere and not delirious. The cause lies in excessive consumption of pepper and chicken. Pepper is acrid and hot, capable of dispersing cold and driving out stasis; chicken belongs to Xun (Wind/Wood) and enters the Liver, its warm nature activating stagnant blood and nourishing new blood. Chicken can be eaten regularly, but pepper is extremely hot and toxic; excess leads to accumulation of heat-toxin in the intestines and stomach, causing various strange syndromes. As for developing cold symptoms after taking ginger and pepper, this aligns with the ancient saying: 'Taking too much Huang Lian (Coptis Rhizome) causes heat; taking too much Ginger and Aconite causes cold.' Using Sanhuang Tang works because Huang Lian is bitter and enters the Heart; bitterness drains downward, like heaven's qi descending, naturally drawing earth's qi up. Huang Qin (Scutellaria Root) clears heat-toxin from the Large Intestine; Huang Bai (Phellodendron Bark) generates Kidney Water to control Fire; Gan Cao slightly detoxifies the other herbs; Yuanming Fen softens hardness. Siling San combined with Liangge San clears and promotes urination and defecation. Thus, after taking this medicine, sores appeared on the mouth and tongue, allowing toxins to exit via the mouth. Although it does not tonify postpartum deficiency, removing internal pathogens allows Righteous Qi to flourish, thereby filling the weakness. Thus, within non-tonification lies great tonification."

Commentary: This is a presentation of Extreme Fire resembling Water, a sign of reversal when things reach their extreme. Many have died from this condition due to treatment with drying-heat and warming-tonifying methods. Alas!

Scholar Xu stated: "I recall a woman who, after childbirth, stayed in a sealed pavilion where a fire was lit. After sleeping for a long time or upon waking, she was dazed as if drunk and unconscious, causing panic among her family. Xu used Jing Jie (Schizonepeta Spike) assisted by Jiaojie San (Intersecting Dissolution Powder). He said: 'After ingestion, she sleeps; while sleeping, she scratches her head with her left hand; upon waking, she recovers.' (This is because she was oppressed by Fire Evil.)"

Wei Yuheng stated: "Shi Helan's wife was prone to illness and knowledgeable in medicine, highly valuing *Jingyue Quanshu*. For years, she took mostly warming and tonifying formulas, consuming approximately half a jin each of Guizhi (Cinnamon Twig) and Fuzi (Prepared Aconite Root). Recently, due to prolonged postpartum lochia discharge, intermittent red and white discharge, worsening cough, and urinary incontinence. Pulse diagnosis showed a beating sensation on the right hand, wiry and rapid pulses at both Guan positions (Liver/Spleen), and a weak pulse at the right Chi position. Her face had a reddish glow, the center of her tongue lacked coating, she felt cold air in the chest, preferred hot drinks, and disliked coolness. She had been taking Shoupi Jian (Spleen Longevity Decoction) plus Ginger and Cinnamon. I presented a case analysis to her, stating: 'The root disease is insufficiency of the Three Yin meridians. Long-term use of warming tonics has caused Qi aspects to become excessive, leading to chronic persistence. The error lies in mistaking loose stools, cold sensations, and preference for hot drinks for Spleen-Stomach Deficiency-Cold. One fails to realize that excessive Fire forcing downward causes diarrhea, rising upward causes cold sensations, and stagnation in the middle jiao temporarily dissipates with acrid-warm herbs. This principle is rarely discussed in medical texts. Now, due to blood loss postpartum, blood deficiency exacerbates Fire. Facial redness indicates Fire flaming upward. Red and white lochia indicates Liver-Spleen Heat. Cough and incontinence indicate Lung Deficiency, Liver Excess, and Kidney failing to secure. Acrid-warm desiccating herbs should be avoided immediately. The prescription uses Raw and Prepared Rehmannia Root (Shu Di Huang, Sheng Di Huang), Goji Berry (Gou Qi Zi), Glehnia Root (Sha Shen), Ophiopogon Tuber (Mai Dong), and Dendrobium Stem (Dai Du Hu). Initially, she feared the cold nature of Ophiopogon, considering 2 qian too heavy, using only 6 fen. After several doses, she felt comfortable, gradually increasing to 1.5 qian. After more than ten doses, she no longer desired hot drinks, and symptoms stabilized. Melon Seed (Lou Ren) was added. After twenty-plus doses, she passed green-black debris in stool daily, filling the room with pungent odor. This is because the heat of Cinnamon and Ginger had long oppressed the colon; as Ying Qi (Nutritive Qi) replenished, it could no longer contain the pathogenic factors, which were expelled downward. If warming tonics were continued, the harm would be incalculable. I record this as a warning against biased use of warming tonics."

Two sisters-in-law from the Yang family: The elder sister had just given birth, suffering from fever, dizziness, inability to sit or stand, falling when sitting, red and white lochia, swollen breasts, and swelling beside the vulva the size of a chicken egg, with severe pain threatening abscess formation. Specialists prescribed Pao Jiang, Bai Zhu (Atractylodes Macrocephala Rhizome), Jing Jie, and Guizhi, which worsened vomiting, nausea, and insomnia. Pulse was wiry and rapid, exceeding six beats per respiration. Prescribed Raw Rehmannia Root, Goji Berry, Vincenteae Herba (Di Ding), Ophiopogon Tuber, Angelica Sinensis Radix (Dang Gui), Honeysuckle Flower (Jin Yin Hua), Licorice Root, Coptis Rhizome, and Melon Seed. Fully recovered in six doses. The younger sister, one month postpartum, suffered from deafness, frequent pain in the head, breasts, and abdomen, continuous leukorrhea, and swaying like a thread during bathing, with painful and swollen vulva. Physicians used aromatic-drying herbs, worsening the condition. She also recovered with modifications of the previous formula. Additionally, Zhu Langzhai's sister had prolonged red and white discharge postpartum, dry mouth, and sore throat. The previous formula had Di Ding and Dang Gui removed, and Bai Shao (White Peony Root) added. Fully healed in four prescriptions. Initially, the infant born to the elder Yang sister vomited immediately upon breastfeeding. After the mother took medicine, the infant stopped vomiting. All these cases represent Yin Deficiency with Hyperactive Fire in the Shaoyang and Jueyin meridians. To treat postpartum conditions with acrid-warm herbs is to kill the patient.