产后血虚则阴虚，阴虚生内热。其症心胸烦满，呼吸气短，头痛闷乱，将晚转甚，与大
病后虚烦相似。用台党、归身、熟地、肉桂、酒芍各钱半，麦冬一钱。水二盏，先以粳米一
合、淡竹叶十皮，煎至一盏，去米、叶，入药，并枣三枚，煎七分温服。热甚加炒干姜一钱
。产后大热必用干姜何也，此非有余之热，乃阴虚生内热也，故以补阴药大剂服之。且干姜
能入肺，和肺气；入肝，引血药，生血。然不可独用，必与补阴药同用。此造化自然之妙，
惟天下至神可以语此。
败血未尽，阴阳不和，皆能发寒热也。何以别之？曰∶败血为病，则小腹刺痛，此为异
耳。故败血未尽者，以去滞为主，阴阳不和者，以补虚为主。若作疟治误矣。
败血未尽，乍寒乍热者何也？败血留滞则经脉皆闭，荣卫不通，闭于荣则血甚而寒，闭
于卫则阳甚而热，荣卫俱闭，则寒热交作。荣卫气行，则即解矣。惟黑神散（见前）、卷荷
散
一钱
阴阳不和，乍寒乍热者何也？产后气血亏损、阴阳俱虚，阴虚则阳胜而热，阳虚则阴胜
而寒，阴阳俱虚，则乍寒乍热。用增损八物汤∶归身、白芍（各酒洗）、干姜（炒焦黑）、川
芎
者
甚
似疟真疟何以别也？似疟寒不凛凛，热不蒸蒸，发作无时，亦不甚苦，此正气虚而无邪
气也。真疟者，寒则汤火不能御，热则冰水不能解，发作有时，烦苦困顿，此正气虚而邪气
相搏者也。
产后血虚导致阴虚，阴虚则产生内热。其症状表现为心胸烦闷胀满，呼吸气短，头痛且头目昏乱，傍晚时分症状加重，这与大病之后出现的虚烦症状相似。治疗使用台参、当归身、熟地黄、肉桂、酒白芍各一钱半，麦冬一钱。加水两盏，先用粳米一合、淡竹叶十片，煎煮至一盏，去掉米粒和竹叶，加入药物及大枣三枚，再煎至七分，温服。若热势严重，加炒干姜一钱。产后出现大热为何必须用干姜呢？这是因为并非实热有余之证，而是阴虚产生的内热，所以要用大剂量的补阴药服用。而且干姜能入肺经，调和肺气；入肝经，引导血药，促进生血。但干姜不可单独使用，必须与补阴药同用。这是造化自然的奥妙，只有天下最神妙的人才能与此谈论。
败血未尽，阴阳不和，都能引发寒热症状。如何辨别呢？回答说：若是败血致病，则小腹有刺痛感，这是其不同之处。因此，败血未尽者，以祛除瘀滞为主；阴阳不和者，以补虚为主。如果当作疟疾治疗就错了。
败血未尽，为何会出现乍寒乍热的症状呢？败血留滞会导致经脉闭塞，营卫之气不通。闭阻于营分，则血气郁甚而发冷；闭阻于卫分，则阳气郁甚而发热。若营卫俱闭，则寒热交替发作。待营卫之气运行通畅，症状即可解除。对于败血未尽引起的乍寒乍热，可用黑神散（见前文）、卷荷散一钱。
阴阳不和，为何会出现乍寒乍热的症状呢？产后气血亏损，阴阳俱虚。阴虚则阳偏胜而发热，阳虚则阴偏胜而发冷。阴阳俱虚，则出现忽冷忽热。治疗使用增损八物汤：当归身、白芍（各用酒洗）、干姜（炒至焦黑）、川芎等。
似疟与真疟如何辨别？似疟的寒冷并不凛冽刺骨，发热也不蒸蒸剧烈，发作时间没有规律，痛苦也不甚严重，这是正气虚弱而没有外邪侵袭的表现。真疟疾则是寒冷时即使汤火也不能抵御，发热时即使冰水也不能缓解，发作有固定时间，烦躁痛苦困顿，这是正气虚弱而邪气相互搏结的表现。
After childbirth, blood deficiency leads to Yin deficiency, and Yin deficiency generates internal heat. The symptoms include vexation and fullness in the chest and heart, shortness of breath, headache with mental confusion, worsening in the evening, which is similar to the deficiency vexation seen after severe illness. Use Taishen (Codonopsis Radix), Dangguishen (Angelica Sinensis Root Heart), Shudi (Rehmanniae Radix Praeparata), Rougui (Cinnamomi Cortex), Jiubaoshao (Paeoniae Radix Alba prepared with wine) each 1.5 qian, and Maidong (Ophiopogonis Radix) 1 qian. Add two cups of water, first decoct one he of Jingmi (Oryza Sativa Germ) and ten pieces of Danzhuye (Lophatheri Herba) until reduced to one cup, remove the rice and leaves, add the medicinal herbs and three dates, decoct until seven-tenths remain, and take warm. If the heat is severe, add Chao Ganjiang (Zingiberis Rhizoma Praeparatum) 1 qian. Why must Ganjiang (Zingiberis Rhizoma) be used for high fever after childbirth? This is not due to excess heat, but internal heat generated by Yin deficiency; therefore, a large dose of Yin-nourishing herbs should be taken. Moreover, Ganjiang enters the Lung meridian to harmonize Lung Qi; enters the Liver meridian to guide blood-invigorating herbs and promote blood generation. However, it cannot be used alone and must be combined with Yin-nourishing herbs. This is the subtle wonder of nature's creation, discussable only with those of supreme spiritual insight.
If lochia (residual blood) is not fully expelled, or if Yin and Yang are disharmonious, both can cause alternating chills and fever. How to distinguish them? It is said: If caused by residual blood, there will be stabbing pain in the lower abdomen, which is the distinguishing feature. Therefore, for residual blood, the primary treatment is to remove stasis; for Yin-Yang disharmony, the primary treatment is to tonify deficiency. Treating it as malaria would be a mistake.
Why does residual blood cause intermittent chills and fever? Residual blood stagnation causes blockage of the meridians, preventing the smooth flow of Ying (Nutritive) and Wei (Defensive) Qi. Blockage in Ying leads to excessive blood stasis causing cold; blockage in Wei leads to excessive Yang causing heat. If both Ying and Wei are blocked, chills and fever alternate. When Ying and Wei Qi circulate freely, the condition resolves. For intermittent chills and fever due to residual blood, use Heishen San (Black Spirit Powder - see previous text) or Juanhe San (Polygonati Odorati Rhizoma Powder) 1 qian.
Why does Yin-Yang disharmony cause intermittent chills and fever? After childbirth, Qi and Blood are depleted, and both Yin and Yang are deficient. Yin deficiency leads to Yang hyperactivity causing heat; Yang deficiency leads to Yin hyperactivity causing cold. With both Yin and Yang deficient, intermittent chills and fever occur. Treatment uses Zengsun Bawu Tang (Modified Eight Substance Decoction): Dangguishen (Angelica Sinensis Root Heart), Baishao (Paeoniae Radix Alba, each washed with wine), Ganjiang (Zingiberis Rhizoma, stir-fried until charred black), Chuanxiong (Ligusticum Chuanxiong Rhizome), etc.
How to distinguish between malaria-like symptoms and true malaria? Malaria-like symptoms involve chills that are not piercingly cold, fever that is not intensely hot, irregular onset times, and mild suffering; this indicates deficiency of Zheng Qi (Upright Qi) without pathogenic factors. True malaria involves chills so severe that hot water or fire cannot relieve them, and fever so intense that ice or water cannot cool them; it has regular onset times, accompanied by vexation, bitterness, and exhaustion; this indicates deficiency of Zheng Qi with struggle against pathogenic factors.