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The *Mai Jing* (Pulse Classic) states: Regarding the pulse after childbirth, if the Cun (inch) position at the wrist is Hong (surging), Ji (rapid), and irregular, the prognosis is poor; if it is Chen (deep) and Wei (minute) but remains rooted when pressed to the bone, the prognosis is good. It further states: A pulse that is Chen (deep), Xiao (small), Huan (relaxed), or Hua (slippery) indicates a favorable outcome; one that is Shi (excess), Da (large), Jian (firm), Xian (wiry), or Ji (rapid) indicates an unfavorable outcome; one that is Lao (solid), Ge (leather-like), Jie (knotted), Dai (intermittent), or Se (choppy) and irregular is difficult to treat. Zhu Danxi stated: During pregnancy, the pulse should be Hong (surging) and Shuo (rapid); if the pulse remains Hong and Shuo after delivery, death may occur. He also stated: If the pulse is Xi (fine) and Xiao (small) during pregnancy but becomes Hong (surging) and Da (large) after delivery, death is likely. I have observed many cases where patients with a Hong (surging) and Shuo (rapid) pulse survived after childbirth. One must understand that pulses appearing Fu (floating), Hong (surging), and Shuo (rapid) are mostly due to Blood deficiency (Blood Deficiency). Since postpartum Blood deficiency is common, this pulse presentation occurs. If this is not clearly communicated to physicians, quacks often misdiagnose it as an External Contraction (Exogenous Pathogen invasion), leading to the disaster of "deficientifying the deficient" within moments. However, within this Hong (surging) and Shuo (rapid) presentation, there is naturally a He (harmonious) and Hua (slippery) quality. It is not like the Lao (solid) and Ji (rapid) pulse which lacks Stomach Qi (Vital Energy of the Spleen and Stomach), which leads to death. The *Chan Jing* (Obstetrics Classic) states: For diseases during pregnancy, the pulse should ideally be Shi (full/excess); for diseases after childbirth, the pulse should ideally be Xu (empty/deficient). During pregnancy, the principle is to soothe Qi and calm the fetus; after childbirth, the principle is to tonify deficiency and resolve stasis. This is the key.

Generally, when a pregnant woman approaches labor, Qi and Blood become turbulent, the Bao Tai (fetal sac) ruptures, deviating from normal physiology. There must be water (amniotic fluid) descending first, commonly called Bao Jiang (placental fluid), which is the fluid nourishing the fetus. When the fluid descends, the sac ruptures and birth occurs. After childbirth, both Qi and Blood are deficient, so the pulse should appear Huan (relaxed/slow) and Hua (slippery). Huan indicates relaxation and slowness, not急促 (urgent/rushed) due to Qi depletion; Hua indicates smoothness and flow, not Ku (withered) and Se (choppy) due to Blood loss. Both are auspicious signs. Conversely, a pulse that is Shi (excess), Da (large), Xian (wiry), or Lao (solid) is unsuitable for the postpartum state of Qi and Blood deficiency. Shi indicates Excess pathogen; Da indicates pathogenic progression; Xian indicates Yin constriction and failure of distribution; Lao indicates firmness attached deeply, nearing the absence of Stomach Qi. These are contrary pulses, hence ominous.

The *Quan Shu* quotes Danxi: "After childbirth, one should greatly tonify Qi and Blood; even if other miscellaneous syndromes exist, they should be treated secondarily." The intent is that Qi and Blood depart with the fetus, resulting in severe deficiency. Therefore, regardless of various symptoms, great tonification should take precedence, while others can be delayed. This method is currently followed by obstetricians. However, although postpartum Qi and Blood loss indeed often results in deficiency syndromes, there are cases of deficiency, non-deficiency, and pure excess. Treatment must distinguish between deficiency and excess based on symptoms and individual constitution. One must not rigidly adhere to the belief that great tonification is always necessary, as this may aid the pathogen. This distinction requires extreme caution. I follow the method of modifying and treating concurrently with Shenghua Tang (Life-Restoring Decoction), daring not to use heavy tonics immediately, thereby placing other syndromes in a secondary position. As seen in the General Discussion on Syncope, "if blood stasis pain is not resolved, one should not hastily add [tonic herbs]," which illustrates this point. Furthermore, postpartum deficiency syndromes depend on the person's Yuan Qi (Original Qi); those with a constitution of inherent weakness are prone to this. Some may become weaker after Qi and Blood loss. In such cases, one must examine the pulse according to the person, and the syndrome according to the pulse. If Pulse Qi, Form Qi, and Disease Qi are all insufficient, it should be treated as total deficiency. If Form Qi is insufficient but Disease Qi is sufficient, or if accompanied by Fire pathogen, external contraction, or food stagnation, this is "deficiency with excess," requiring careful examination and treatment. For total deficiency, I later prescribe formulas such as Ginseng-Added Shenghua Tang or Emergency Shenghua Tang. For deficiency with excess, I prescribe Modified Shenghua Tang according to the syndrome, administering them based on their deficiency or excess status. These are methods that prioritize postpartum care while addressing concurrent issues.

Regarding postpartum non-deficiency: some women had no prior illness, were young and strong, or had constitutions accustomed to hardship and poverty. These individuals originally had no deficiency. Upon conception, the fetus adds a burden, causing Qi and Blood congestion, leading to distension and vomiting. These are "excess" conditions created by the addition of the fetus. After delivery, relief is felt, the retained matter is expelled, and the body returns to its original state. Such cases are very common among ordinary births; where is the deficiency? Although internal injury or external contraction cannot be ruled out, if illness occurs, removing the cause leads to recovery. If one universally applies heavy tonification, can the body bear it? Even though labor consumes Qi and Blood temporarily, the remaining congested state consists mainly of substances supporting the fetus. What needs to go goes; what needs to be generated regenerates. Within a few days, recovery is inevitable. This is the natural law of Shenghua (generation and transformation). Why assume all postpartum states are deficient? If one rigidly insists on heavy tonification for all postpartum cases, "excess reinforcing excess" syndromes will inevitably occur, turning mild conditions severe and severe ones critical. I believe that for young and vigorous women with no postpartum deficiency, using only dark brown sugar water soup, or adding a little wine to resolve stasis, is sufficient. Medication is not strictly necessary. Even taking one or two doses of Shenghua Tang is not a heavy tonic that causes excess; it is beneficial and harmless. If there is internal injury or external contraction, Shenghua Tang should be modified according to the syndrome.

Regarding postpartum pure excess syndromes: External contraction of Wind-Cold presents with headache, fever, constipation, abdominal fullness, and a tight, solid, surging, large, and forceful pulse; this is an Excess syndrome of exterior pathogens. Severe Fire excess presents with heat, thirst, restlessness, irritability, constipation, abdominal distension, blackened mouth/nose/tongue, craving for cold drinks, excessive eye discharge, painful red urination, and a surging-slippery pulse; this is an Excess syndrome of internal heat. Liver qi stagnation due to anger presents with chest and hypochondriac distension/pain, difficulty in defecation, and a wiry-slippery pulse; this is an Excess syndrome of rebellious Qi. Incomplete expulsion of Lochia (postpartum discharge) with blood stasis rushing upward presents with heart/abdominal distension/fullness, pain refusing pressure, difficult defecation but free urination; this is an Excess syndrome of rebellious Blood. Additionally, wealthy families who overprotect, or overuse Ren Shen (Ginseng Root), Bai Zhu (Atractylodes Rhizome), causing Qi congestion; or overuse sugar, wine, charcoal fire, causing internal heat; or where childbirth was not deficient but heavy tonics were wrongly used, increasing illness—this is an Excess syndrome of improper nursing/care. Also, overeating after childbirth to prevent fatigue, forcing consumption, leading to retention and stagnation—this is an Excess syndrome of internal injury. These are merely important examples to illustrate the general picture. However, if there is an exterior pathogen, it must be released; if there is Fire pathogen, it must be cleared; if there is internal injury/stagnation, it must be unblocked and digested. In my treatment of these syndromes, I list modifications to Shenghua Tang accordingly. This prioritizes postpartum care while simultaneously treating the specific syndrome. As the saying goes, "The Way proceeds without contradiction," ensuring complete safety.