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Jiawei Shenghua Decoction (Modified Birth-Generating Decoction), Jiawei Erchen Decoction (Modified Two-Aged Decoction), Huoxiang Zhengqi Decoction (Patchouli Decoction to Rectify the Qi)

10. Postpartum malaria is often caused by blood stasis, leading to disharmony of Ying and Wei (Nutritive and Defensive Qi), manifesting as alternating chills and fever. Chaihu (Bupleuri Radix) and Biejia (Trionycis Carapax) should be added to Shenghua Tang (Birth-Generating Decoction). If caused by phlegm and food retention, Shan Zha (Crataegi Fructus), Houpo (Magnoliae Officinalis Cortex), and Chenpi (Citri Reticulatae Pericarpium) should be added to Erchen Tang (Two-Aged Decoction). If due to external pathogenic factors (wind-cold-dampness), Zhengqi San (Powder to Rectify the Qi) is used. The formula consists of Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma), Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma), Suye (Perillae Folium), Houpo (Magnoliae Officinalis Cortex), Gancao (Glycyrrhizae Radix et Rhizoma), Dafupi (Arecae Pericarpium), Jiegeng (Platycodonis Radix), Huoxiang (Agastaches Herba), and Baizhi (Angelicae Dahuricae Radix). When decocting, add Shengjiang (Zingiberis Rhizoma Recens) and Dazao (Jujubae Fructus) as guides and decoct together.

[Note] Malaria occurring postpartum is mostly due to retained blood stasis causing disharmony of Ying and Wei, hence the alternating chills and fever. It is suitable to use Shenghua Tang (Birth-Generating Decoction) with added Chaihu (Bupleuri Radix) and Biejia (Trionycis Carapax). If caused by phlegm or food accumulation, it is suitable to use Erchen Tang (Two-Aged Decoction) with added Shan Zha (Crataegi Fructus) and Houpo (Magnoliae Officinalis Cortex). If indeed caused by external wind-cold, Huoxiang Zhengqi San (Patchouli Powder to Rectify the Qi) can be used for treatment. This formula comprises Chenpi (Citri Reticulatae Pericarpium), Banxia (Pinelliae Rhizoma), Fuling (Poria), Baizhu (Atractylodis Macrocephalae Rhizoma), Suye (Perillae Folium), Houpo (Magnoliae Officinalis Cortex), Gancao (Glycyrrhizae Radix et Rhizoma), Dafupi (Arecae Pericarpium), Jiegeng (Platycodonis Radix), Huoxiang (Agastaches Herba), and Baizhi (Angelicae Dahuricae Radix).
See Volume 3 for the formula of Erchen Tang (Two-Aged Decoction).

11. Postpartum imbalance leads to weak Qi and Blood; external wind-cold invades while blood stasis remains internally. Excessive dietary injury combined with fatigue and anger results in a condition where deficiency coexists with excess. Symptoms include alternating chills and fever, umbilical and abdominal pain, poor appetite, lethargy, dizziness, bone-steaming tidal fever, night sweats, cough with phlegm and wheezing, sallow complexion, emaciation, and inability to sustain physical strength. For Rutu Laolao (Postpartum Consumption), one must first regulate the Spleen and Stomach, then harmonize Ying and Wei (Nutritive and Defensive Qi) and tonify the deficiency.

[Note] Postpartum Qi and Blood are both deficient. Carelessness in daily life allows external wind-cold to attack, while blood stasis stays inside. Furthermore, excessive consumption of rich foods causes damage, and worry, labor, or anger exacerbate the condition. This is a syndrome of excess pathogens amidst underlying deficiency. It leads to alternating chills and fever, distending pain in the umbilical and abdominal regions, reluctance to eat, preference for lying down, dizziness and confusion upon rising, bone-steaming tidal fever, night sweats, spontaneous sweating, phlegm-wheezing, cough, sallow complexion, muscle wasting, and inability to support physical effort. This is named Rutu Laolao (Postpartum Consumption), which is difficult to treat. To cure this disease, one must first regulate the Spleen and Stomach so that diet strengthens and the body can withstand the medicinal power. Then, harmonize Ying and Wei (Nutritive and Defensive Qi) and tonify the deficiency, only then can full recovery be achieved.