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After childbirth, Yin blood is suddenly and heavily lost, leaving Yang without attachment. This causes solitary Yang to float outward, often resulting in fever. This is heat generated by Yin deficiency; it must not be mistaken for an external contraction treated with diaphoretic (sweating) methods. Shenghua Tang (Postpartum Transformation Decoction) is effective in reducing fever because it contains Ginger Rhizome (Shengjiang) and Licorice Root (Gancao), illustrating the principle that "sweet and warm herbs can eliminate severe heat." Therefore, even if there are exterior symptoms after childbirth, all wind-dispelling drugs with ascending properties should not be used, as they may carry blood upward, causing dizziness, and risk further exhausting Yang, which could lead to death from sweating collapse. Even Chuanxiong Rhizome (Chuanxiong) in Foshou San (Buddha's Hand Powder), which has a pungent and dispersing nature capable of inducing sweating and leaking Qi, must be used cautiously based on the specific condition at the time.

Since Yin blood is already deficient postpartum, body fluids are naturally scant. Moreover, labor fatigue leads to Qi deficiency; deficiency slows down the transmission and transformation functions of the Zang-Fu organs, inevitably leading to dryness and depletion of the Large Intestine and Small Intestine. This will recover naturally over time. Alternatively, using Shenghua Tang to nourish blood and assist in generating fluids is also appropriate. Thus, although urination and defecation may be temporarily difficult postpartum, purgative or diarrhea-inducing drugs must be strictly prohibited. Not only are drugs like Mirabilite (Xiaoshi), Rhubarb (Dahuang), and Wuling San (Five-Ingredient Powder with Poria) difficult to use lightly, but also Rehmannia Root (Shengdi) and Peony Root (Shaoyao) in Siwu Tang (Four-Substance Decoction), being purely Yin in nature, damage the vital Qi, cause diarrhea, and congeal blood. Wuling San promotes urination but injures Yin; the more one promotes urination, the more dry and constipated the body becomes. Misuse would cause a second loss of Yin, making it inevitable for solitary Yang to detach and collapse. Therefore, *Jiyao* (Essentials of Medicine) states: Diseases related to pregnancy and childbirth originate from the Jueyin Liver channel; one must not violate the Stomach Qi or the Upper, Middle, and Lower Jiao. One must not induce sweating, purge, or promote urination.

Shenghua Tang (See discussion on Shenghua Tang later in this volume.)

In treating postpartum conditions, the "Three Examinations" are indispensable. The first examination checks for pain or absence of pain in the lower abdomen to determine the presence or absence of lochia discharge. The second examination assesses whether bowel movements are unobstructed or obstructed to gauge the abundance or depletion of body fluids. The third examination evaluates whether lactation is established and the amount of food intake to determine whether the Stomach Qi is robust or deficient. By examining these three aspects and correlating pulse findings with clinical manifestations, if the pulse and symptoms match, treatment will lead to recovery. If the pulse and symptoms contradict each other, even without critical signs, complications are likely. For instance, lochia discharge usually lasts until one month postpartum, but sometimes clears up in six or seven days; this cannot be generalized. Although maternal constitution varies, the Qi and Blood allocated to the fetus also differ. If fetal vitality is strong, Qi and Blood are fully directed to the fetus, resulting in less stasis. If fetal vitality is weak, there is excess Qi and Blood nourishment, resulting in more stasis. Also, excessive bleeding during delivery leads to less postpartum bleeding, while minimal bleeding during delivery leads to more postpartum bleeding; this is due to natural circumstances.

Generally, women who deliver normally have regulated opening and closing of the uterus. Postpartum, the uterus closes immediately. The "Erzhen" (fetal pillow, referring to retained blood clots) moves with Qi, breaks into small pieces, and is discharged continuously, hence the prolonged duration. In cases of difficult labor causing excessive uterine injury, the closure mechanism relaxes and fails to contract, potentially expelling large blood clots resembling eggplants. This is called Erzhen. If expelled entirely at once, there is no risk of lingering discharge. Even if residual blood exits via urine like soap pod juice, with slight abdominal discomfort, one must not mistake this for unexpelled stasis and blindly administer purgatives, which could be fatal. Sometimes postpartum patients experience pain resembling Erzhen pain, where palpation reveals a mass and mild resistance upon pressure. People often attribute this to retained blood in the Erzhen, but this is incorrect. Since the placenta and fetus have been expelled, how can blood remain alone? The uterus, having housed the fetus for a long time, suddenly separates, causing sudden emptiness in the Sea of Blood, resulting in pain. Injury to the cervical os causes congestion and swelling, creating the illusion of a mass, though it is not a true solid mass. Since the swelling has not subsided, it resists pressure. Treatment should focus on nurturing the organs, and recovery will occur naturally. If blood stasis requires medication, Shenghua Tang is best; Dianbao Jian (Placenta-Clearing Decoction) or Sishen San (Four-God Powder) are also suitable. Misusing drugs like Broomrape Root (Sumu), Safflower (Honghua), Corydalis Rhizome (Yanhusuo), or Green Tangerine Peel (Qingpi) damages organ Qi and exacerbates deficiency; caution is essential. I once observed a postpartum woman who felt a hard, oblong, cucumber-like structure in her lower abdomen upon palpation, resembling stasis, but without pain. She worried it was stasis or a mass (*jia*). I reassured her: "No pain and no resistance indicate deficiency rather than excess; sufficient blood will resolve it naturally; do not worry." Months later, it indeed gradually disappeared.

Dianbao Jian (Placenta-Clearing Decoction) is miraculous for treating postpartum Erzhen pain and related conditions.
Angelica Sinensis Root (Danggui) (5 qian), Ligusticum Wallichii Rhizome (Chuanxiong) (1 qian), Poria Cocos (Fuling) (1 qian), Roasted Licorice Root (Zhigancao) (1 qian), Cinnamon Bark (Rougui) (0.5 qian).
Boil with one zhong of water until reduced to eight fen; take hot. If the pulse is fine and cold, or vomiting occurs, add roasted Dried Ginger (Ganjiang) (1 qian). If there is abundant blood heat and fire, remove Rougui and add wine-fried Peony Root (Shaoyao) (1 qian). If the pulse is weak indicating Yin deficiency, add Prepared Rehmannia Root (Shudihuang) (3 qian). If there is Qi stagnation, add processed Cyperus Rhizome (Zhi Xiangfu) (1 qian). For lower back pain, add Salt-water fried Eucommia Bark (Du Zhong) (1-2 qian).

Shenghua Tang (See discussion on Shenghua Tang later in this volume.) Sishen San (See Abdominal Pain section in this volume.)