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Xu Dacun’s Note: This type of syndrome is most common; why are only a few cases of warm tonification collected?

Xue Lizhai treated the wife of Grand Steward Yu, who presented with postpartum fever, afternoon tidal fever, hematemesis (vomiting blood), hematochezia (blood in stool), accompanied by night sweats, frequent urination, distending pain in the chest and hypochondrium, and abdominal fullness. This indicates deficiency and damage of multiple zang-organs. The treatment should prioritize securing the root. Relying on her own medical knowledge, she used heat-clearing and fire-draining agents, which exacerbated diarrhea, borborygmus (intestinal rumbling), vomiting, anorexia, abdominal pain, and cold feet. Only then did she believe Xue’s words. Her pulse was examined as floating and surging in some instances, deep and fine in others, or seemingly absent. (Pulses of extreme deficiency often appear thus.) Her complexion was either greenish-yellow or reddish-white, presenting the appearance of deficiency-cold with false-heat. Although it was midsummer, one should disregard the season and follow the symptoms. Initially, Liu Jun Zi Tang (Six Gentlemen Decoction) was administered with processed Sheng Jiang (Baked Ginger) and Rou Gui (Cinnamon Bark). After several doses, stomach qi gradually recovered, and various symptoms subsided. Subsequently, Shi Quan Da Bu Tang (Ten Significant Tonifying Decoction) was added, resulting in complete recovery after half a year.

The wife of Scholar Yang Jingzhi suffered from the same syndrome as described above, but also expectorated phlegm-saliva. Warm-tonifying and phlegm-resolving agents were ineffective. Her complexion was dark, and the chi pulses at both wrists were floating and large but fine upon deep pressure. This was due to the decline of Mingmen Fire (Gate of Life Fire), which failed to generate Pi Tu (Spleen Earth); consequently, Spleen Earth could not nourish the other zang-organs, leading to pathology. Ba Wei Wan (Eight-Ingredient Pill) was used to tonify the mother of Spleen Earth (i.e., Kidney), resulting in recovery.

A woman presented with postpartum blood exhaustion (exhaustion of Yin-blood), morning chills, evening fevers, abdominal distension and pain that was non-tender upon palpation. It was considered a deficiency of both Qi and Blood, and Ba Zhen Tang (Eight Treasures Decoction) was used, but this aggravated fever and irritability. Dang Gui Bu Xue Tang (Dong Quai Decoction for Tonifying Blood) was then employed, and the fever and irritability gradually ceased. Ba Zhen Tang was combined with Mai Dong (Ophiopogon Root) and Wu Wei Zi (Schisandra Fruit), leading to the gradual restoration of Qi and Blood.

A parturient presented with morning chills and predominant evening fevers, or intermittent chills and fevers, persisting for a long time without cure. Liu Jun Zi Tang (Six Gentlemen Decoction) and Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) were administered concurrently. After more than a hundred doses, she stabilized.

Shen Yaofeng treated a woman surnamed Zou who had postpartum diarrhea. Treatment with Ren Shen (Ginseng) and Fu Zi (Aconite Root) for warming and tonifying was ineffective. Wu Jingyi from Xincheng diagnosed it as deficiency-cold accompanied by sinking of Qi. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was modified with Shu Di Huang (Prepared Rehmannia Root), Fu Ling (Poria), Gui Zhi (Cinnamon Twig), and Fu Zi (Aconite Root), yielding immediate results. This demonstrates that statements in formula literature claiming that lower deficiency precludes lifting and raising therapies are not entirely accurate.

Madam Lu developed a rash postpartum, consisting of fine, grain-like papules, neither sparse nor dense. Jing Jie (Schizonepeta Spike), Chan Tui (Cicada Slough), and Niu Bang Zi (Arctium Fruit) were used. After one dose, the rash fully erupted on the head and face. The next day, signs of resolution appeared, but suddenly she experienced loose stools several times and felt spiritual unrest. Upon inquiry regarding her distress, she reported fever and thirst, and her speech seemed tremulous. Her pulse was deficient, fine, rapid, with seven beats per respiration. Master Shen Jin Dawen diagnosed this as Yang Collapse Syndrome, belonging to the Shaoyin (Lesser Yin) channel. Sheng Fu Zi (Raw Aconite Root), three qian, was washed, briefly soaked, sliced, and baked until resembling fried rice color; Pao Gan Jiang (Baked Dried Ginger), eight fen; Chao Gan Cao (Stir-fried Licorice Root), one qian; and Chao Bai Shao (Stir-fried White Peony Root), one qian five fen, were decocted in water. One spoonful of Tong Bian (Child’s Urine) and four small teaspoons of Qing Yu Dan Chi (Green Fish Gallbladder Bile) [used because pig gallbladder bile was unavailable] were added. After ingestion, she slept immediately. Upon waking, fever and thirst were eliminated. Huang Qi Jian Zhong Tang (Astragalus Decoction for Establishing the Middle) was subsequently administered with Dan Shen (Salvia Root) and Su Mu (Sappan Wood), resulting in stability after two doses.

When postpartum lochia fails to discharge, residual blood infiltrates the Large Intestine, causing profuse uncontrollable diarrhea or passage of dark green-black matter. De Qi San (De Qi Powder) is extremely effective. Select four or five spikes of large Jing Jie (Schizonepeta Spike), ignite them in a cup, burn to ash, ensuring no oil or open fire touches them. Add a small amount of She Xiang (Musk), grind uniformly, and mix with one liang of boiling water to swallow. Although this medicine is mild, it can cure serious illnesses; do not neglect it. Additionally, Jiao La Tang (Gelatin and Beeswax Decoction) from *Qian Jin Fang* treats postpartum dysentery: Huang La (Yellow Beeswax), size of two chess pieces; E Jiao (Donkey-Hide Gelatin), two qian; Dang Gui (Angelica Sinensis Root), two qian half; Huang Lian (Coptis Rhizome), three qian; Huang Bo (Phellodendron Bark), one qian; and Chen Mi (Old Rice), half sheng, are decocted in water to make a soup, in which the medicine is prepared and taken.

Pei Zhaoqi treated a woman with persistent postpartum fever, excessive sweating, and delirious speech. Her six pulses were surging and large yet deficient. She had not closed her eyes for six days and nights; whenever she tried to sleep, she felt as if floating in clouds. Treatment with Ren Shen (Ginseng), Bai Zhu (Atractylodes Macrocephala Rhizome), Dang Gui (Angelica Sinensis Root), Bai Zhu (Atractylodes Macrocephala Rhizome), Mu Dan Pi (Moutan Cortex), Tong Bian (Child’s Urine), and Chao Hei Gan Jiang (Charred Black Dried Ginger) was ineffective and instead worsened dizziness, tinnitus, nausea, epigastric discomfort, and retching without vomiting. Pei suddenly realized: "This is not a great deficiency of Qi and Blood, but rather an abundance of Phlegm-Saliva." The prescription was changed to Ban Xia (Pinellia Tuber), three qian; Tian Ma (Gastrodia Rhizome), two qian; Fu Ling (Poria), Ju Hong (Tangerine Peel), Bai Kou Ren (White Cardamom Seed), Hou Po (Magnolia Bark), Huang Lian (Coptis Rhizome), and Zhi Shi (Immature Bitter Orange), each one qian; Zhu Ru (Bamboo Shavings), three qian. These were decocted in Tie Xiu Shui (Iron Rust Water). After two doses, her Qi smoothed, spirit cleared, body cooled, and pulse quieted. Ren Shen Da Bu Wan (Ginseng Great Tonifying Pill) was then administered, twice daily, to cultivate Yuan Qi (Primal Qi) in the Stomach, resulting in complete recovery after a month.

For postpartum weakness, one bowl of Tofu Milk is mixed with one beaten egg, plus one sheet of Tofu Skin, fourteen Long Yan Rou (Longan Aril), and one liang of Bai Sha Tang (White Rock Sugar). Boil thoroughly together. Take on an empty stomach at Wugeng (3–5 AM). Improper regulation postpartum often prolongs into consumptive disease. Poor families lack funds for medicine, while wealthy families are often harmed by incorrect medication. This formula is sweet, neutral, gentle, tonifies Blood, and nourishes Yin, suitable for both rich and poor, truly being an excellent remedy.