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After childbirth, the deficiency and depletion of Qi and Blood, disharmony of Yin and Yang, and failure of lochial stasis (stagnant blood) to dissipate can cause alternating chills and fever. When Yin is in excess, there are sudden chills; when Yang is in excess, there are sudden fevers; when Yin and Yang contend with each other, there are intermittent chills or fevers. If organ damage occurs due to labor during childbirth, and weak Blood fails to circulate freely, it also leads to the retention of lochial stasis. If this stasis enters the Lung, fever results; if it enters the Spleen, coldness results. (Why does lochial stasis entering the Lung cause fever, while entering the Spleen causes cold? Is it because the Lung governs Qi, and Qi disharmony leads to heat, while the Spleen controls Blood, and Blood failing to nourish leads to cold? Or do Spleen Yin and Lung Yang generate cold and heat independently? However, the general treatment principle focuses on expelling stasis, though the methods of warming and cooling differ.) If mistakenly treated as malaria, it would be erroneous. For cases of Yin-Yang disharmony, Zengsun Siwu Tang (Modified Four Substances Decoction) is appropriate; for cases of retained lochial stasis, Duoming Dan (Life-Restoring Pill) should be used. Question: How to distinguish between these two? Answer: Intermittent stabbing pain indicates lochial stasis. Chills and fever without other symptoms indicate Yin-Yang disharmony (The use of Zengsun Siwu Tang is not fixed; it should be modified according to the specific condition).

According to Xue Ji: Postpartum chills and fever, caused by weakness of Qi and Blood or impairment of the Spleen and Stomach, are deficiency syndromes. The Classic states: Yin deficiency leads to fever, and Yang deficiency leads to aversion to cold. If accompanied by constipation, it particularly belongs to Qi and Blood deficiency, and one must absolutely avoid using exterior-releasing or fire-descending methods. If the Cun position (distal radial pulse) is faint, it is named Yang Qi deficiency, where Yin Qi ascends into the Yang aspect causing aversion to cold; Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) is required. If the Chi position (proximal radial pulse) is weak, it is named Yin Qi deficiency, where Yang Qi sinks into the Yin aspect causing fever; Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) is used. Generally, when Yin is insufficient, Yang follows it inward, sinking internally and causing fever; when Yang is insufficient, Yin follows it upward, invading externally and causing aversion to cold. This is because the Yin and Yang fail to distinguish their proper locations, leading to a struggle between cold and heat, thus resulting in both aversion to cold and fever. Bazhen Tang (Eight-Treasure Decoction) should be used. If after illness there is heat in the four limbs, or fatigue in form and Qi, this is due to unrestored Yuan Qi (Original Qi) being invaded by damp-heat; Buzhong Yiqi Tang is suitable. If there is skin heat, extreme thirst with desire to drink, red face, and red eyes, this is heat due to Blood deficiency; Danggui Buxue Tang (Angelica Tonifying Blood Decoction) should be used.