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Yang Chengliu treated a woman of the Xu family who, after childbirth, became angry and developed alternating chills and fever, hypochondriac pain, and bitter taste in the mouth. (This is Liver Fire disease, with symptoms resembling malaria. Since the Gallbladder is the Fu organ of the Liver, Liver disease affects the Gallbladder as well.) Subsequently, she gradually developed afternoon fever. Physicians diagnosed it as Wind syndrome and indiscriminately used exterior-releasing and dispersing methods. Suddenly, a mass appeared on the left side of her abdomen, palm-sized, causing day-and-night pain. Some suspected Cold coagulation, some suspected Food stagnation, some suspected Blood stasis accumulation, and some suspected Pi accumulation. Various treatments were applied, but the condition worsened, with reduced appetite and emaciation. Pulse diagnosis revealed a wiry and surging Right Guan pulse, and a wiry and rapid Left Guan pulse. Her complexion was dark and thin, and her tongue was pale yellow and dry. The pathology was anger injuring the Liver meridian, leading to deficiency of Blood and dryness-pain. The Liver resides to the left of the Stomach and is the zang organ that stores Blood. When Blood is sufficient, its lobes are soft and hang down; when Blood is deficient, its lobes become hard and protrude horizontally. Internally, they rub against the Stomach; externally, they press against the muscles. How could there be no dull pain? Those with irritable temperaments often suffer from this, especially women. Quack doctors, ignorant of the true nature, mistakenly used aromatic, drying, and attacking agents, causing countless unnecessary deaths, which is truly lamentable! He prescribed Zishui Qinggan Yin (Nourishing Water to Clear Liver Heat Decoction). After four doses, the mass disappeared and pain ceased. Subsequently, Guipi Tang (Restore the Spleen Decoction) was used without Xiangxiang (Aucklandiae Radix), adding Baishao (Radix Paeoniae Alba), Danpi (Cortex Moutan), and Shanzhi (Fructus Gardeniae). Taken intermittently for over ten doses, she recovered. (Insisting on using Guipi Tang to conclude treatment shows he adhered rigidly to the formula without flexibility.)

Another case involved a woman of the Xu family who had postpartum fever, occasional chills, headache, and fatigue. Physicians administered herbs to disperse pathogens and clear fire, resulting in irritability, thirst, and anorexia. Yang examined her pulse: superficially it seemed rapid, but deep pressure revealed a Kou (hollow) pulse, more pronounced on the left hand. Her lips and tongue were white, and her face lacked color. He prescribed Shiquan Dabu Tang (Ten Significant Tonifying Decoction) with Paojiang (Prepared Ginger Rhizome). Someone asked, "Why use Ginger and Cinnamon Twig for such intense heat?" Yang replied, "Yang Qi outside guards Yin; Yin inside anchors Yang. They rely on each other. Now, postpartum Blood and Yin are severely depleted, leaving Deficient Yang unanchored, floating outward and manifesting as heat. Unless we guide this floating Yang back to nourish the Yin, the heat will not subside. (This explanation is not entirely accurate.) Therefore, I use warming agents to tonify Blood and Qi, hoping that tonification will help consolidate and anchor." The questioner asked, "Ginger and Cinnamon Twig are pungent and dispersing; how can they tonify and consolidate?" Yang answered, "Guizhi (Cinnamomi Ramulus) combined with Yang-tonifying herbs induces sweating, but combined with Blood-nourishing herbs, it warms and promotes circulation. Raw Shengjiang (Fresh Ginger Rhizome) opens the pores and induces sweating; cooked Jiang warms the Middle and dispels Cold. However, charred Paojiang enters the Blood level and guides Qi-herbs into the Blood level to generate new Blood. Thus, the main strategy is massive tonification, using these herbs as assistants. When Yin receives Yang's assistance to generate, the heat naturally resolves." After four doses, the fever subsided and the body cooled. After ten doses, all symptoms resolved.

Generally, postpartum conditions mostly belong to Yin deficiency and Blood depletion. Using only Shengdi Huang (Rehmanniae Radix), Shudi Huang (Prepared Rehmanniae Radix), Tandong (Asparagi Radix), Maidong (Ophiopogonis Radix), and Gouqi Zi (Lycii Fructus)—all Nutritive and Nourishing agents—usually results in immediate recovery. If one tonifies both Qi and Blood while mixing in harsh agents like Jiang (Ginger) and Fuzi (Aconiti Lateralis Radix Praeparata), it either prolongs the illness or causes sequelae. Clinicians must examine this carefully. (Xu Lingtai noted: Wei Zhixiu excelled in this area, but his discussion on postpartum conditions was particularly apt.)

Chai Yuqing treated the wife of Qian Yusha, an official attendant. Three days postpartum, she had scant lochia, dry complexion and lips, dry mouth, and body heat. (Similar to the previous case where lips and tongue were white and the face lacked color.) Chai intended to use Renshen (Ginseng Radix). Qian doubted this, believing tonics should not be used postpartum. Chai said, "If there were an external pathogen, there would be a specific treatment method. Now the condition belongs to deficiency. Abandoning Renshen will surely lead to complications. The saying 'Renshen cannot be used postpartum' is the view of those who do not understand medicine and of women." He then administered Renshen Danggui San (Ginseng and Angelica Powder) plus 1 qian of high-quality Guizhi (Cinnamomi Ramulus). The next day, her mouth felt moist and saliva flowed. After half a month of regulation, she recovered.

Lu Zuyu treated the daughter-in-law of Patrol Officer Nie. More than 100 days postpartum, she suffered from dry intestinal constipation, defluxion of Deficient Fire upward, hematochezia, borborygmus, abdominal fullness, shortness of breath, and internal/external heat. She could not eat for half a month. Treatments aimed at nourishing Blood and clearing fire aggravated the condition. Pulses were floating, surging, and rapid, but empty upon deep pressure. Spleen and Kidney pulses felt even more hollow. This indicated consumption of Yuan Qi postpartum and insufficiency of True Yin, rather than Excess Heat. He prescribed Bawei Wan (Eight-Ingredient Pill), taken with light salt water in the morning, 3 qian per dose. He also prepared a decoction of Sijunzi Tang (Four Gentlemen Decoction) added with Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Maidong (Ophiopogonis Radix), Zhimu (Anemarrhenae Rhizoma), and Lianrou (Lotus Seed Endosperm). After several doses, symptoms eased slightly. Later, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Baishao and Maidong was used, and she recovered after one month.

Ma Yuanyi treated a woman of the Lu family. Less than a month postpartum, due to slight disturbance in daily routine, she experienced hematochezia for three days and subsequently insomnia all night. This was excessive blood loss after childbirth, compounding deficiency with deficiency. Any disturbance injures the Liver; Liver injury causes blood to overflow, and Qi fails to remain secure. Qi deficiency and Blood weakness mean the Heart Spirit lacks nourishment, hence the eyes cannot close. He prescribed a large dose of Guipi Tang (Restore the Spleen Decoction), using up to 1 liang of Renshen (Ginseng Radix) and adding 3 qian of Lurong (Cervi Cornus Pantotrichum). She recovered after two months. (The reasoning was correct, but the prescription was not fully appropriate.)

Wei Yuheng stated: The wife of Xu Zhuxi, several days postpartum, had fever, spontaneous sweating, red face, headache, aversion to food, and insomnia. Lochia was extremely scant and pale. Her abdomen was distended and painful at times. Her pulse was surging, large, and rapid. He said, "This is Blood deficiency. Abdominal distension and red face indicate a tendency toward Bing (hemorrhage). Severe tonification is required." When asked why, he replied, "Red face indicates Yang floating upward; abdominal distension indicates Yin sinking downward. When Yang flies upward, Yin must sink downward; this is inevitable." He prescribed Shudi Huang (Prepared Rehmanniae Radix) 1 liang, plus Gouqi Zi (Lycii Fructus) and Zaoren (Ziziphi Spinosae Semen) 5 qian each. One dose later, a hard mass suddenly appeared on the right lower abdomen, very tender to touch. Suspecting Blood stasis caused by mistaken tonification, they wanted to change the plan. Fortunately, the patient usually took his medicines, so he continued. He said, "This mass arose suddenly. Even if it were Blood stasis, it would not be this severe. This is exactly Liver and Spleen losing Blood, becoming dry and distended. With tonification, it is still manageable; otherwise, Jue (cold extremities/collapse) and Bing (hemorrhage) would occur. Now the large pulse is converging, and the red face is receding. This is not a medication error, but insufficient dosage. Double the previous prescription, add 5 qian of fried Baishao (Paeoniae Radix Alba) and 1 qian of Zhi Gancao (Prepared Licorice Root). After one dose, the mass flattened; after another, it vanished. Reduce the dosage by half and take several doses; all symptoms resolved. If this case were treated as Blood stasis, survival would be impossible."