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Mild cough after childbirth is due to Lung Qi deficiency. Treatment should use Shenghua Decoction (Decoction for Generating Blood) added with Bei Sha Shen (Radix Glehniae), or wine-fried Huang Qin (Radix Scutellariae); if the voice is heavy and cough persists, it is due to Wind pathogen invasion or deflection of deficient fire upward. If caused by Wind, add Hei Jing Jie Sui (Flos Schizonepetae Preparatus) to Shenghua Decoction; if caused by Fire, remove Hei Jiang (Rhizoma Zingiberis Preparatus) from Shenghua Decoction and add Chao Mai Dong (Tuber Ophiopogonis Preparatus). There are also cases in winter where cold air strikes the Lung causing cough, treated with Hei Jiang plus fresh Ginger, which stops spontaneously. However, the Lung is a delicate organ and cannot be delayed, otherwise blood stasis may rise. Or prolonged cough damages the Lung, leading to hemoptysis and evolving into consumptive disease. In summary, drugs for the Lung meridian should not be harsh and drying; moistening agents should be used to avoid errors.

For drugs treating the Lung meridian, tonification uses Sha Shen (Radix Glehniae) and Huang Qin (Radix Scutellariae); clearing heat uses Bei Mu (Bulbus Fritillariae Cirrhosae) and Xing Ren (Semen Armeniacae Amarum); dispersing uses Jing Jie (Herba Schizonepetae) and Jie Geng (Radix Platycodonis); cooling uses Sang Bai Pi (Cortex Mori Radicis) and Bai Shao (Radix Paeoniae Alba); these principles are fixed. Furthermore, using Dang Shen (Radix Codonopsis), Bai Zhu (Rhizoma Atractylodis Macrocephalae), Fu Ling (Poria), and Gan Cao (Radix Glycyrrhizae) to tonify the Spleen follows the principle of "tonifying the mother when deficient." Using Shu Di Huang (Radix Rehmanniae Preparata) and E Jiao (Colla Corii Asini) to tonify the Kidney follows the principle of "tonifying the child," facilitating the mutual generation of Metal and Water. To prevent prolonged cough from becoming consumptive, one must tonify Earth (Spleen) and Water (Kidney), utilizing the mutual generation of child and mother; this is also a fixed rule. This applies not only to postpartum cough but also to ordinary coughs; students of medicine must understand this principle.

(Commentary by Xu: Postpartum cough is often due to insecure interstices easily attracting external pathogens. Treatment should be based on differentiation of deficiency/excess, cold/heat, and exterior/interior. Shenghua Decoction is not a formula specifically for coughing. How can one indiscriminately modify this formula without distinguishing between Wind and Fire? This shows a lack of understanding of its true meaning.)

Abdominal distension after childbirth occurs only when the placenta has not been expelled; it resolves naturally after delivery. My cousin's wife had her abdomen contracted after giving birth, but the next day suddenly became distended like a drum, worse than before pregnancy, with unbearable fullness and shortness of breath. Physicians were at a loss, and her life was in danger. I had just returned from a long journey and was urgently summoned. Her abdomen was large and hard, with obstruction of urination and defecation. The family claimed food stagnation from pre-delivery diet. I said, "Incorrect." The pulse was soft and choppy, indicating no food retention. It must be that cold wind entered the uterus during delivery, causing blood stasis to coagulate internally. Use Shenghua Decoction with Rou Gui (Cortex Cinnamomi) (1 qian), decocted well, then swallow Shixiao Wan (Elixir of Instant Success) (3 qian) with the decoction, and mix Huarui San (Powder of Flower Stamen) (3 qian). After two doses, abdominal distension halved. Then use Shenghua Decoction with doubled Hei Jiang, taken for several doses until recovery. Without detailed pulse diagnosis and relying solely on patient statements to use digestive aids would be an error. This case is recorded for reference.

Another cousin's wife developed a rash postpartum. A smallpox specialist was consulted, stating, "This is measles." He used Jie Geng (Radix Platycodonis), Jing Jie (Herba Schizonepetae), and Fang Feng (Radix Saposhnikoviae) to disperse. Two days later, she suddenly developed wheezing, sweating, fever, and oppression, nearly dying. I examined her pulse: Cun (inch) was large, Chi (cubit) was empty, and pressing felt slow. I said, "This is not measles." Due to deficiency-cold in the lower body, rootless floating fire drifted upward, causing a false rash with mosquito-bite-like marks hidden under the skin. Moreover, having given birth only seven days ago, she could not withstand such cooling and dispersing herbs. This error arose because the smallpox doctor did not understand obstetric conditions. Urgently administer Shiquan Dabu Tang (Decoction for Ten Thousand Complete Tonification) with Fu Zi (Radix Aconiti Lateralis Preparata). Sweating and wheezing stopped. After two doses, switch to Bazhen Tang (Eight Treasures Decoction). After half a month, Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) cured her. If misdiagnosed as failed measles eruption leading to death, no one would blame the physician. Thus, physicians should rather decline treatment to let experts handle it than greedily attempt treatment and risk lives.

A woman surnamed Yu in Haining carried triplets, all failing to thrive. At labor, the midwife saw the placenta partially expelled and pulled it down by hand, damaging the Dai Mai (Girdle Vessel), causing abdominal pain. One leg curled and could not extend for a month, with severe pain preventing lying down. I diagnosed this as "Diao Jiao Chang Yong" (Hanging Foot Intestinal Abscess). The pulse was rapid, indicating matured toxin. Prescribed Huang Qi (Radix Astragali), Zao Jiao Ci (Gleditsiae Sinensis Spina), Jia Pian (Placenta Testudinis/Cutis Cornus Tigris - note: historically Shan Ban Jia Pian), Chen Pi (Pericarpium Citri Reticulatae), Dang Gui (Radix Angelicae Sinensis), plus Kui Gen (Radix Malvae) decocted in wine and water. The next day, several bowls of pus were discharged, and she stabilized.

A woman from a local family in Wulin suffered postpartum abdominal pain unresponsive to various medicines. Upon my examination, intestinal abscess was diagnosed, but the family doubted it and sought another doctor. Half a month later, pain worsened, appetite ceased, and bowel/bladder functions obstructed. Her Chi pulse was rapid. I stated, "The abscess has formed pus. Previous prescriptions were for dissolving toxins, which you refused. Now that it is ripe, pus must be drained. Delay further risks organ damage." I prescribed the previous formula with added Kui Gen. Pus was discharged, pain decreased. Subsequently, Ren Shen (Radix Ginseng), Huang Qi (Radix Astragali), Di Huang (Radix Rehmanniae), and Dang Gui (Radix Angelicae Sinensis) were used for tonification, followed by Siwu Tang (Four Substance Decoction) and Bazhen Tang (Eight Treasures Decoction) for over a month until recovery.

A wife of a man surnamed Chen living at Xiaofenqiang suffered postpartum urinary retention with painful distension. I diagnosed "Blood stasis blocking the Bladder, Qi transformation failure." Prescribed Shenghua Decoction with Rou Gui (Cortex Cinnamomi) and Ze Lan (Herba Lycopi). By midnight, urine passed but was not smooth. The next day, Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) swallowed with Shixiao Wan (Elixir of Instant Success) resulted in free urination and recovery.

Mr. Wu asked at a banquet, "Why did it resolve without diuretics? Why did Qian Zheng Zi (Semen Plantaginis), Mu Tong (Caulis Akebiae), and Siling San (Four-Powder Decoction) worsen the blockage?" I replied, "Treating symptoms without addressing the root source is of no benefit."

Ms. Xu, my cousin's daughter, previously suffered chills and fever postpartum. Doctors first used Gou Teng (Ramulus Uncariae cum Uncis) and Jing Jie (Herba Schizonepetae) without effect, then Chai Hu Tang (Bupleurum Decoction), worsening fever, facial redness, and epistaxis. I diagnosed "Blood deficiency syndrome; Chai Hu caused blood to rush upward, which was erroneous. Another dose would be fatal." Urgently prescribed Siwu Tang (Four Substance Decoction) with Niu Xi (Radix Achyranthis Bidentatae) and Fu Shen (Sclerotium Poriae Cum Radix Pini) to stop bleeding. Switched to Bazhen Tang (Eight Treasures Decoction) with Hei Jiang (Rhizoma Zingiberis Preparatus) to reduce fever. Later tonified with Dang Gui (Radix Angelicae Sinensis), Di Huang (Radix Rehmanniae), and Bai Zhu (Rhizoma Atractylodis Macrocephalae) for recovery. She later suffered postpartum consumption with a boil on the shoulder, which I also cured. She is now healthy. Proper prenatal tonification ensured safe deliveries unnoticed.

His niece, also my nephew's wife, suffered postpartum convulsions in the year Guisi while I was in Zhejiang. I diagnosed "Internal Liver Wind stirring, compounded by external pathogen invasion." With persistent fever, excessive sweating, and limb twitching, she had developed spasm and coma. Exterior pathogens resolved, but internal deficiency was severe. Prescribed Gui Xiong Tang (Angelica and Chuanxiong Decoction) with a little Hei Jing Jie (Flos Schizonepetae Preparatus), externally fumigated with vinegar-soaked charcoal. Sweating decreased. Then administered Jiang Gui Siwu Tang (Ginger and Cinnamon Four Substance Decoction) to reduce fever. Next day, switched to Bazhen Tang (Eight Treasures Decoction) with Rou Gui (Cortex Cinnamomi) for several doses until cure.

Madam of Wu Dawen suffered postpartum abdominal distension and irregular urination. Pulse was slow and soft, indicating Cold congealing in the Chong and Ren vessels, with Qi stagnation. Prescribed Wuwei Yigong San (Five-Ingredient Extraordinary Skill Powder) with Fu Zi (Radix Aconiti Lateralis Preparata) (1 qian) for several doses until stable.

Granddaughter-in-law of Mr. Xu Sizai from Changshan, at five months pregnancy, was diagnosed with menstrual obstruction by a doctor who prescribed Hong Hua (Flos Carthami), Tao Ren (Semen Persicae), Xiang Fu (Rhizoma Cyperi), and Yi Mu Cao (Herba Leonuri) to move blood. Midnight brought hemorrhage. I was summoned from West Street. She was unconscious with depleted form and pulse. Immediately administered Ren Shen (Radix Ginseng) (2 qian), Zhi Huang Qi (Radix Astragali Preparata) (1 liang), E Jiao (Colla Corii Asini) (2 qian), Shu Di Huang (Radix Rehmanniae Preparata) (8 qian), Fu Zi (Radix Aconiti Lateralis Preparata) (1 qian). Decocted and灌ed. By dawn, pulse returned, consciousness recovered. Vomitus contained fetal membranes, revealing the error of blood-moving herbs causing miscarriage. Had we delayed and dared not tonify severely, survival would have been impossible.

Madam of Magistrate Xiang in Hangzhou suffered miscarriage with hemorrhagic collapse. Physicians hesitated to prescribe. Upon examination, pulse was absent, chest/oppression full, shortness of breath, sweating—critical condition. I formulated Jiawei Liangyi Tang (Modified Two Principles Decoction): Ren Shen (Radix Ginseng) (2 qian), Shu Di Huang (Radix Rehmanniae Preparata) (1 liang), E Jiao (Colla Corii Asini) (3 qian), Ai Ye (Folium Artemisiae Argyi) (1 qian), Fu Zi (Radix Aconiti Lateralis Preparata) (1 qian), Zhi Huang Qi (Radix Astragali Preparata) (1 liang), Dang Gui (Radix Angelicae Sinensis) (3 qian). Urged immediate decoction. Family feared tonification, took half a dose, oppression persisted. I insisted on full dose. Chest relief, breathing normalized, pulse resumed. Next morning, original formula repeated. Previous doctor arrived, hesitant. Seeing my prescription, pondered, then said, "Absent pulse and shortness of breath indicate certain death. Your courage to use strong tonification is admirable; I dare not." I explained, "This is the *Neijing* principle of 'treating obstruction with tonification.' Qi fails to root, lower body fails to grasp Qi, causing floating upward. Lower deficiency, upper excess. Blood lost, Yang unattached. Without strong tonification, collapse is imminent. How else to revive?" Physicians were deeply impressed.