产后 疟，在初产时绝少。即胎前久疟淹缠，产后里气通达，无不霍然。即有半月内外寒热往来，
每日应期而发，或一日二三度，其证类疟，皆由产后气血虚损，阳虚作寒，阴虚发热。或昼轻夜重，
或日哺发热，或有汗，或头有汗而不及身足，此乃元气虚弱，孤阳绝阴之证，俱宜滋荣益气扶正汤，间
服六味丸，以退寒热。如寒热往来，头痛无汗，加减养胃汤治之。若寒热已久无汗者，兼煎参术膏，
以助养胃汤药力。慎不可作疟治而用柴胡汤，及芩、连、栀、柏以退热，草果、槟、常以绝疟而误人也。
至于阴阳不和，乍寒乍热，参归汤治之。《全书》云∶阴胜寒多，理阴煎。阳胜热多，三阴煎。阳气陷
入阴中，补阴益气煎。阴阳俱虚，八珍、十全。败血不散，流入阴中而作寒热，决津煎、殿胞煎。
滋荣益气扶正汤 治产后寒热往来，有汗，每午后应期而发。
人参 熟地（各二钱） 川芎 黄 （蜜炙） 麦冬（去心。各一钱） 当归（三钱） 白术（一
钱五分，土炒） 陈皮（四分） 炙草（五分）
水煎服。间服六味丸。或加柴胡八分，青皮三分，乌梅二个。汗多，加麻黄根一钱。一方引加浮
小麦一撮，不加麻黄根。
加减养胃汤 治产后已及一月类疟，并治寒热往来，头痛无汗。
人参（一钱五分） 川芎 茯苓 苍术（米泔水制炒。各一钱） 当归（三钱，酒浸） 藿香 炙草
橘红（各四分） 半夏（八分，制）
姜一片，枣二枚，水煎服。有痰，加竹沥、姜汁。一方无制半夏，有痰方加入。久类疟无汗，兼服参术膏助之。
参术膏
人参 白术（土炒。各四两）
水六碗，各煎取汁三碗。如法再煎三次，取汁共九碗，再共熬至一腕。每日服半酒钟，白滚水化下。
参归汤 治产后阴阳不和，乍寒乍热。
当归（酒洗） 炮姜（一钱） 人参 白芍（炒） 川芎 炙草（各八分）
水煎服。
三阴煎 治肝脾虚损，精血不足，及营虚失血等病。凡中风血不养筋，及疟证汗多，邪
散而寒热犹不止者。
人参（随宜） 当归（二三钱） 熟地（三五钱） 芍药（酒炒） 枣仁（各二钱） 炙草（一钱）
水二钟，煎七分，食远服。如呕恶，加生姜三片。汗多烦躁，加五味子十四粒。汗多气虚，加蜜炙
黄一二钱。小腹隐痛，加枸杞二三钱。如有胀闷，加陈皮一钱。如腰膝筋骨无力，加炒杜仲，蒸
淮牛膝各一钱。
补阴益气煎
人参（一二钱） 当归 山药（酒炒。各二三钱） 熟地（三五钱） 陈皮 炙草（各一钱） 升
麻（三五分，若火浮于上者，去此不用） 柴胡（一二钱，如无外邪不用）
姜三片，煎服。此补中益气汤之变方，治劳倦伤阴，精不化气，阴虚外感 疟，并便结不通。凡属
阴气不足，而虚邪外侵者，用此升散，无不神效。
六味丸（见上卷诸痛门，附六味汤下。） 理阴煎（见上卷恶阻门。） 八珍汤（
见上卷诸痛门。） 十全大补汤（见上卷胎不长养门。） 决津煎（见上卷鬼胎门。）
殿胞煎（见本卷三审门。）
产后疟疾，在刚生产时极少发生。即使是产前长期患疟疾缠绵难愈，产后由于体内气机通畅，没有不立刻痊愈的。即使有半月左右出现寒热往来，每天按时发作，或者一天发作两三次，症状类似疟疾，这都是因为产后气血虚损，阳气虚弱导致发冷，阴液不足导致发热。有的白天轻晚上重，有的在傍晚时分发热，有的全身出汗，有的只有头部出汗而不到身体和足部，这是元气虚弱、孤阳绝阴的证候，都适宜服用滋荣益气扶正汤，间服六味丸（六味地黄丸），以退去寒热。如果出现寒热往来、头痛无汗的情况，用加减养胃汤治疗。如果寒热已久且无汗，可以兼煎参术膏，以助养胃汤的药力。千万不要当作疟疾来治而使用柴胡汤，以及黄芩、黄连、栀子、黄柏来退热，草果、槟榔、常山来截断疟疾，这样会误人。至于阴阳不和，忽冷忽热，用参归汤治疗。《全书》说：阴胜则寒多，用理阴煎；阳胜则热多，用三阴煎；阳气陷入阴中，用补阴益气煎；阴阳俱虚，用八珍汤或十全大补汤；败血不散，流入阴中而引发寒热，用决津煎或殿胞煎。
滋荣益气扶正汤：治疗产后寒热往来，有汗，每午后按时发作。
配方：人参、熟地黄（各二钱）、川芎、黄芪（蜜炙）、麦冬（去心，各一钱）、当归（三钱）、白术（一钱五分，土炒）、陈皮（四分）、炙甘草（五分）。
用法：水煎服。间服六味丸。或者加柴胡八分、青皮三分、乌梅二个。汗多者，加麻黄根一钱。另一法加浮小麦一撮，不加麻黄根。
加减养胃汤：治疗产后已满一个月类似疟疾，并治疗寒热往来、头痛无汗。
配方：人参（一钱五分）、川芎、茯苓、苍术（米泔水制炒，各一钱）、当归（三钱，酒浸）、藿香、炙甘草、橘红（各四分）、半夏（八分，制过）。
用法：生姜一片，大枣二枚，水煎服。有痰者，加竹沥、姜汁。另一方无制半夏，有痰时加入。久患类疟无汗者，兼服参术膏辅助。
参术膏：
配方：人参、白术（土炒，各四两）。
用法：水六碗，分别煎取汁液三碗。依法再煎三次，共取汁液九碗，再共同熬制成一碗。每日服用半酒杯，用白开水化开送下。
参归汤：治疗产后阴阳不和，忽冷忽热。
配方：当归（酒洗）、炮姜（一钱）、人参、白芍（炒）、川芎、炙甘草（各八分）。
用法：水煎服。
三阴煎：治疗肝脾虚损，精血不足，及营虚失血等疾病。凡是中风后血不养筋，以及疟证汗多，邪气已散但寒热仍不止的情况。
配方：人参（随宜用量）、当归（二三钱）、熟地黄（三五钱）、芍药（酒炒）、酸枣仁（各二钱）、炙甘草（一钱）。
用法：水二钟，煎至七分，饭后服用。如有呕吐恶心，加生姜三片。汗多烦躁，加五味子十四粒。汗多气虚，加蜜炙黄芪一二钱。小腹隐痛，加枸杞二三钱。如有胀闷，加陈皮一钱。如腰膝筋骨无力，加炒杜仲、蒸淮牛膝各一钱。
补阴益气煎：
配方：人参（一二钱）、当归、山药（酒炒，各二三钱）、熟地黄（三五钱）、陈皮、炙甘草（各一钱）、升麻（三五分，若火浮于上者，去掉此药不用）、柴胡（一二钱，如无外邪不用）。
用法：生姜三片，煎服。这是补中益气汤的变方，治疗劳倦伤阴，精不化气，阴虚外感疟疾，以及大便干结不通。凡属阴气不足，而虚邪外侵者，用此方升散，无不神效。
六味丸（见上卷诸痛门，附六味汤下。） 理阴煎（见上卷恶阻门。） 八珍汤（见上卷诸痛门。） 十全大补汤（见上卷胎不长养门。） 决津煎（见上卷鬼胎门。） 殿胞煎（见本卷三审门。）
Malaria occurring postpartum is extremely rare immediately after childbirth. Even if the patient suffered from chronic malaria during pregnancy, once the internal qi becomes unobstructed after delivery, recovery is almost instantaneous. In cases where chills and fever alternate for about half a month, occurring daily at specific times or two to three times a day with symptoms resembling malaria, these are caused by deficiency and damage of qi and blood postpartum. Yang deficiency leads to cold sensations, while yin deficiency leads to fever. Some patients experience milder symptoms during the day and heavier ones at night; some have fever in the late afternoon; some sweat profusely; some only sweat on the head without sweating on the body or feet. These constitute syndromes of weak primordial qi and isolated yang with absolute yin deficiency. All such cases should be treated with Zirong Yiqi Fuzheng Tang (Nourishing Blood and Boosting Qi to Support Uprightness Decoction), taken intermittently with Liuwei Wan (Six-Ingredient Pill), to alleviate chills and fever. If chills and fever alternate accompanied by headache and absence of sweating, Jiajian Yangwei Tang (Modified Stomach-Nourishing Decoction) should be used. For prolonged chills and fever without sweating, Shenhu Gao (Ginseng and Atractylodes Paste) can be decocted concurrently to enhance the efficacy of Yangwei Tang. One must strictly avoid treating this as malaria using Chaihu Tang (Bupleurum Decoction), or employing Huangqin (Scutellariae Radix), Huanglian (Coptidis Rhizoma), Zhizi (Gardeniae Fructus), and Huangbai (Phellodendri Cortex) to reduce heat, or Caoguo (Tsaoko Fructus), Binglang (Arecae Semen), and Changshan (Dichroae Radix) to arrest malaria, as this would lead to medical error. Regarding disharmony of yin and yang causing alternating chills and fever, Shengu Tang (Ginseng and Angelica Decoction) is indicated. The *Quan Shu* states: When yin predominates leading to excessive cold, Liyin Jian (Yin-Regulating Infusion) is used; when yang predominates leading to excessive heat, Sanyin Jian (Three-Yin Infusion) is used; when yang qi sinks into yin, Buyin Yiqi Jian (Tonifying Yin and Boosting Qi Infusion) is used; when both yin and yang are deficient, Bazhen Tang (Eight-Treasure Decoction) or Shiquan Dabu Tang (Ten-Ingredient Great Tonifying Decoction) are used; when stagnant blood fails to disperse and flows into yin causing chills and fever,iejuejin Jian (Juejin Infusion) or Dianbao Jian (Dianbao Infusion) are used.
**Zirong Yiqi Fuzheng Tang (Nourishing Blood and Boosting Qi to Support Uprightness Decoction)**
Indications: Postpartum alternating chills and fever with sweating, occurring periodically every afternoon.
Ingredients: Renshen (Ginseng Radix et Rhizoma), Shudi (Rehmanniae Radix Praeparata) [2 qian each]; Chuanxiong (Ligustici Chuanxiong Rhizoma); Huangqi (Astragali Radix, honey-fried); Maidong (Ophiopogonis Radix, heart removed) [1 qian each]; Danggui (Angelicae Sinensis Radix) [3 qian]; Baizhu (Atractylodis Macrocephalae Rhizoma, earth-fried) [1.5 qian]; Chenpi (Citri Reticulatae Pericarpium) [4 fen]; Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata) [5 fen].
Usage: Decoct in water and take orally. Intermittently administer Liuwei Wan. Alternatively, add Chaihu (Bupleuri Radix) [8 fen], Qingpi (Citri Reticulatae Pericarpium Viride) [3 fen], and Wumei (Mume Fructus) [2 pieces]. For excessive sweating, add Mahuanggen (Ephedrae Herba Caulisque Radix) [1 qian]. Another prescription adds Fuxiaomai (Tritici Levis Fructus) [a pinch] instead of Mahuanggen.
**Jiajian Yangwei Tang (Modified Stomach-Nourishing Decoction)**
Indications: Malaria-like symptoms occurring one month postpartum, and alternating chills and fever with headache and absence of sweating.
Ingredients: Renshen (Ginseng Radix et Rhizoma) [1.5 qian]; Chuanxiong (Ligustici Chuanxiong Rhizoma); Fuling (Poria); Cangzhu (Atractylodis Rhizoma, stir-fried with rice wash water) [1 qian each]; Danggui (Angelicae Sinensis Radix, wine-soaked) [3 qian]; Huoxiang (Agastaches Herba); Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata); Juhong (Citri Reticulatae Pericarpium Rubrum) [4 fen each]; Banxia (Pinelliae Rhizoma Preparatum) [8 fen, processed].
Usage: Add Shengjiang (Zingiberis Rhizoma Recens) [1 slice] and Dazao (Jujubae Fructus) [2 pieces], decoct in water and take orally. For phlegm, add Zhuli (Bambusae Caulis in Taeniam) and Jiangzhi (Zingiberis Succus). Another version lacks processed Banxia and adds it only when phlegm is present. For prolonged malaria-like symptoms without sweating, concurrently administer Shenhu Gao to assist.
**Shenhu Gao (Ginseng and Atractylodes Paste)**
Ingredients: Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma, earth-fried) [4 liang each].
Usage: Add 6 bowls of water, decoct each separately to obtain 3 bowls of liquid. Repeat the decoction process three times according to method, collecting a total of 9 bowls of liquid. Further simmer until reduced to 1 bowl. Take half a wine cup daily, dissolved in plain boiled water.
**Shengu Tang (Ginseng and Angelica Decoction)**
Indications: Postpartum disharmony of yin and yang causing alternating chills and fever.
Ingredients: Danggui (Angelicae Sinensis Radix, wine-washed); Paojiang (Zingiberis Rhizoma Preparatum) [1 qian]; Renshen (Ginseng Radix et Rhizoma); Baishao (Paeoniae Radix Alba, stir-fried); Chuanxiong (Ligustici Chuanxiong Rhizoma); Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata) [8 fen each].
Usage: Decoct in water and take orally.
**Sanyin Jian (Three-Yin Infusion)**
Indications: Liver and spleen deficiency and damage, insufficiency of essence and blood, and disorders such as nutritive deficiency with blood loss. Applicable for conditions where wind-stroke results in blood failing to nourish tendons, or where malaria causes excessive sweating, pathogenic factors have dispersed, yet chills and fever persist.
Ingredients: Renshen (Ginseng Radix et Rhizoma) [as appropriate]; Danggui (Angelicae Sinensis Radix) [2-3 qian]; Shudi (Rehmanniae Radix Praeparata) [3-5 qian]; Shaoyao (Paeoniae Radix, wine-stir-fried); Suanzaoren (Ziziphi Spinosae Semen) [2 qian each]; Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata) [1 qian].
Usage: Add 2 zhong of water, decoct to 0.7 portion, take well after meals. For nausea and vomiting, add Shengjiang (Zingiberis Rhizoma Recens) [3 slices]. For excessive sweating with irritability, add Wuweizi (Schisandrae Chinensis Fructus) [14 grains]. For excessive sweating with qi deficiency, add honey-fried Huangqi (Astragali Radix) [1-2 qian]. For dull pain in the lower abdomen, add Gouqi (Lycii Fructus) [2-3 qian]. For distension and fullness, add Chenpi (Citri Reticulatae Pericarpium) [1 qian]. For weakness in waist, knees, bones, and joints, add Chao Duzhong (Eucommiae Cortex, stir-fried) and Zheng Huainiuxi (Achyranthis Bidentatae Radix, steamed) [1 qian each].
**Buyin Yiqi Jian (Tonifying Yin and Boosting Qi Infusion)**
Ingredients: Renshen (Ginseng Radix et Rhizoma) [1-2 qian]; Danggui (Angelicae Sinensis Radix); Shanyao (Dioscoreae Rhizoma, wine-stir-fried) [2-3 qian each]; Shudi (Rehmanniae Radix Praeparata) [3-5 qian]; Chenpi (Citri Reticulatae Pericarpium); Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata) [1 qian each]; Shengma (Cimicifugae Rhizoma) [3-5 fen; omit if fire floats upward]; Chaihu (Bupleuri Radix) [1-2 qian; omit if no external pathogen].
Usage: Add 3 slices of Shengjiang (Zingiberis Rhizoma Recens), decoct and take. This is a modified formula of Buzhong Yiqi Tang (Tonify the Middle and Boost Qi Decoction), treating injury to yin from overwork, failure of essence to transform into qi, yin deficiency with external contraction of malaria, and constipation. It is effective for ascending and dispersing in cases of insufficient yin qi with invasion by deficient pathogens.
*Liuwei Wan (Six-Ingredient Pill)* (See Volume I, Section on Various Pains, under Liuwei Tang). *Liyin Jian* (See Volume I, Section on Morning Sickness). *Bazhen Tang* (See Volume I, Section on Various Pains). *Shiquan Dabu Tang* (See Volume I, Section on Failure of Fetal Nourishment). *Juejin Jian* (See Volume I, Section on Ghost Fetus). *Dianbao Jian* (See this volume, Section on Three Examinations).