产后疟疾，因脾胃虚弱，饮食停滞，或因外邪所感，或郁怒伤脾，或暑邪所伏，审系饮食，
用六君加桔梗、苍术、藿香。如外邪多而饮食少，用藿香正气散。如外邪少而饮食多，用人
参养胃汤。饮食劳役，用补中益气汤。气血虚弱，用十全大补加炮姜，虚寒用六君加姜、桂
。元气脱陷，急加附子。大凡久疟，多属元气虚寒，盖气虚则寒，血虚则热，胃虚则恶寒，
阴火下流则寒热交作，或吐泻不食，腹痛烦渴，发热谵语，或手足逆冷，寒战如栗，虽见百
症，当峻温补，其病自退，若误用清脾、截疟之类，多致不起。
治验
一产妇患疟，发热作渴，胸膈胀满，遍身作痛，三日不食，咽酸嗳气，此是饮食所伤，脾胃
不能消化，用六君加神曲、山楂，四剂而不作酸，乃去神曲、山楂，又数剂而饮食进，其大
便不通，至三十五日，计进饮食七十余碗，腹始闷，令用猪胆汁导而通之，其粪且不甚燥。
一产妇患疟久不愈，百病蜂起，其脉或洪大，或微细，或弦紧，或沉伏，难以名状，用六君
加炮姜二十余剂，脉症稍得；又用参术煎膏，佐以归脾汤，百余剂而瘥。
一产妇朝寒暮热，或不时寒热，久不愈，用六君子、补中益气兼服，百余剂而寻愈。
产后疟疾心脾痛见小产。
（二症治同兼呕吐）
产后泻痢，或因饮食伤损脾土，或脾土虚不能消食，当审而治之。若米食所伤，用六君加谷
。若面食所伤，用六君加麦 。若肉食所伤，用六君加山楂、神曲。凡兼呕吐，皆加藿香
。若兼咽酸或呕吐，用前药送越鞠丸。若肝木来侮脾土，用六君加柴胡、炮姜。若寒水反来
侮土，用钱氏益黄散。若久泻，或元气下陷，兼补中益气汤以升发阳气。若泻痢色黄，乃脾
土真气，宜加木香、肉果。若属脾土虚寒，当用六君加木香、姜、桂。若脾肾虚寒，用补中
益气及四神丸。若属命门火衰，而脾土虚寒，用八味丸以补土母。若小便涩滞，肢体渐肿，
或兼喘咳，用金匮肾气丸以补脾肾，利水道。若胃气虚弱，而四肢浮肿，治须补胃为主。若
久而不愈，或非饮食所伤而致，乃属肾气亏损。盖胞胎主于任而系于肾，况九月十月，乃肾
与膀胱所养，必用四神、六味、八味三药以补肾，若用分利导水之剂，是虚其虚也。
治验
一产妇泻痢，发热作渴，吐痰甚多，肌体消瘦，饮食少思，或胸膈痞满，或小腹胀坠年余矣
，余以为脾胃泻，朝用二神丸，夕用六君子汤，三月余而痊。
一妇人产后泄泻，兼呕吐咽酸，面目浮肿，此脾气虚寒，先用六君加炮姜为主，佐以越鞠丸
而咽酸愈，又用补中益气加茯苓、半夏而脾胃康。
一产妇泻痢年余，形体骨立，内热晡热，自汗盗汗，口舌糜烂，日吐痰三碗许，脉洪大，重
按全无，此命门火衰，脾土虚寒而假热，然痰者乃脾虚不能统摄归源也，用八味丸补火以
生土，用补中益气汤兼补肺金而脾胃健。
一产妇腹痛后重，去痢无度，形体倦怠，饮食不进，与死为邻，此脾肾俱虚，用四神丸、十
全大补汤而愈。但饮食难化，肢体倦怠，用补益汤调理而康。
一妇人五月患痢，日夜无度，小腹坠痛，发热恶寒，用六君子汤送香连丸，二服渐愈，仍以
前汤送四神丸，四服痊愈。至七月终，怠惰嗜卧，四肢不收，体重节痛，口舌干燥，饮食无
味，大便不实，小便频数，洒淅恶寒，凄惨不乐，此肺之脾胃虚，而阳气寒不伸也，用升阳益胃汤而痊。
Postpartum malaria is caused by the weakness of the Spleen and Stomach, food stagnation, external pathogenic factors, emotional depression injuring the Spleen, or latent summer-heat pathogens. If confirmed to be due to dietary injury, Liu Jun Zi Tang (Six Gentlemen Decoction) with Jie Geng (Platycodon Root), Cang Zhu (Atractylodis Rhizoma), and Huo Xiang (Pogostemonis Herba) is used. If external pathogens are predominant while food stagnation is minor, Huo Xiang Zheng Qi San (Agaricus Rectificating Powder) is used. If external pathogens are minor while food stagnation is significant, Ren Shen Yang Wei Tang (Ginseng Nourishing the Stomach Decoction) is used. For cases due to dietary irregularities and overwork, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is used. For deficiency of Qi and Blood, Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) with Pao Jiang (Prepared Ginger) is used; for deficiency-cold patterns, Liu Jun Zi Tang with Gan Jiang (Dried Ginger) and Rou Gui (Cinnamon Bark) is used. In cases of collapse and sinking of Yuan Qi (Original Qi), Fu Zi (Aconiti Lateralis Radix Praeparata) should be added urgently. Generally, chronic malaria mostly belongs to deficiency-cold of Yuan Qi. Qi deficiency generates cold, Blood deficiency generates heat, Stomach deficiency causes aversion to cold, and downward flow of Yin Fire leads to alternating chills and fever, or vomiting, diarrhea, anorexia, abdominal pain, irritability, thirst, fever, delirium, cold extremities, and severe shivering like trembling millet. Although numerous symptoms may appear, vigorous warming and tonification should be employed, and the disease will naturally recede. If mistakenly treated with formulas that clear the Spleen or arrest malaria, it often leads to death.
Case Record 1:
A postpartum woman suffered from malaria with fever, thirst, chest and diaphragm fullness, generalized body pain, no food intake for three days, sour regurgitation, and belching. This was due to dietary injury where the Spleen and Stomach could not digest food. Liu Jun Zi Tang with Shen Qu (Massa Medicata Fermentata) and Shan Zha (Crataegi Fructus) was administered. After four doses, sour regurgitation ceased. Shen Qu and Shan Zha were then removed, and after several more doses, appetite returned. However, bowel movements remained unsmooth. By the thirty-fifth day, having consumed over seventy bowls of food, abdominal distension occurred. Pig bile suppositories were used to facilitate defecation; the stool was not very dry.
Case Record 2:
A postpartum woman suffered from prolonged malaria with various symptoms arising simultaneously. Her pulse was sometimes surging and large, sometimes minute and fine, sometimes wiry and tight, sometimes deep and hidden, making it difficult to describe. Liu Jun Zi Tang with Pao Jiang was administered for over twenty doses, leading to slight improvement in pulse and symptoms. Then, a paste made from Ren Shen (Ginseng Root) and Bai Zhu (Atractylodis Macrocephalae Rhizoma) was used, assisted by Gui Pi Tang (Restore the Spleen Decoction). After over one hundred doses, she recovered.
Case Record 3:
A postpartum woman experienced morning chills and evening fevers, or intermittent chills and fevers, which persisted for a long time. Liu Jun Zi Tang and Bu Zhong Yi Qi Tang were taken concurrently. After over one hundred doses, she gradually recovered.
Postpartum malaria accompanied by Heart and Spleen pain, occurring alongside miscarriage.
(The treatment for these two conditions is the same; add Huo Xiang if vomiting is present.)
Postpartum diarrhea and dysentery may result from dietary damage to the Spleen Earth, or Spleen Earth deficiency failing to digest food. Treatment must be determined through careful differentiation. If injured by rice, Liu Jun Zi Tang with Gu Ya (Sprouted Grain) is used. If injured by wheat/noodles, Liu Jun Zi Tang with Mai Ya (Sprouted Hordeum) is used. If injured by meat, Liu Jun Zi Tang with Shan Zha and Shen Qu is used. For all cases accompanied by vomiting, Huo Xiang is added. If accompanied by sour regurgitation or vomiting, the aforementioned medicines are taken with Yue Ju Wan (Yueju Pill). If Liver Wood insults Spleen Earth, Liu Jun Zi Tang with Chai Hu (Bupleuri Radix) and Pao Jiang is used. If Cold Water insults Earth, Qian Shi Yi Huang San (Qian’s Strengthening Earth Powder) is used. For chronic diarrhea or sinking of Yuan Qi, Bu Zhong Yi Qi Tang is added to raise and generate Yang Qi. If diarrhea/dysentery stool is yellow, indicating the true Qi of Spleen Earth, Mu Xiang (Aucklandiae Radix) and Rou Dou Kou (Myristicae Semen) are added. If belonging to Spleen Earth deficiency-cold, Liu Jun Zi Tang with Mu Xiang, Gan Jiang, and Rou Gui is used. If Spleen and Kidney deficiency-cold exist, Bu Zhong Yi Qi Tang and Si Shen Wan (Four Spirits Pill) are used. If Ming Men Fire (Gate of Life Fire) decline causes Spleen Earth deficiency-cold, Ba Wei Wan (Eight-Ingredient Pill) is used to tonify the Mother of Spleen Earth (Kidney). If urination is obstructed, limbs gradually swell, or wheezing/coughing occurs, Jin Gui Shen Qi Wan (Golden Cabinet Kidney Qi Pill) is used to tonify Spleen and Kidney and promote water passage. If Stomach Qi is weak with limb edema, treatment must focus on tonifying the Stomach. If prolonged and not due to dietary injury, it belongs to Kidney Qi deficiency. Since the conception vessel (Ren Mai) governs the uterus and connects to the Kidney, and during the ninth and tenth months, the fetus is nourished by the Kidney and Bladder, Si Shen Wan, Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia), and Ba Wei Wan must be used to tonify the Kidney. Using draining and water-promoting agents would further deplete the deficiency.
Case Record 4:
A postpartum woman had diarrhea and dysentery with fever, thirst, excessive phlegm expectoration, emaciation, poor appetite, occasional chest diaphragm stuffiness, and lower abdominal bearing-down sensation lasting over a year. I diagnosed this as Spleen-Stomach diarrhea. She took Er Shen Wan (Two Spirits Pill) in the morning and Liu Jun Zi Tang in the evening. After over three months, she recovered.
Case Record 5:
A woman had postpartum diarrhea accompanied by vomiting, sour regurgitation, and facial/ocular edema. This indicated Spleen Qi deficiency-cold. Initially, Liu Jun Zi Tang with Pao Jiang was used as the main formula, assisted by Yue Ju Wan, which cured the sour regurgitation. Then, Bu Zhong Yi Qi Tang with Fu Ling (Poria) and Ban Xia (Pinelliae Rhizoma) was used to restore Spleen and Stomach health.
Case Record 6:
A postpartum woman suffered from diarrhea and dysentery for a year, appearing skeletal, with internal heat worsening in the afternoon, spontaneous sweating, night sweats, oral ulcers, expectorating about three bowls of phlegm daily, and a surging-large pulse that vanished upon heavy pressure. This indicated Ming Men Fire decline and Spleen Earth deficiency-cold manifesting as false heat. The phlegm resulted from Spleen deficiency failing to control and return fluids to their source. Ba Wei Wan was used to tonify Fire to generate Earth, and Bu Zhong Yi Qi Tang was used to assist Lung Metal, thereby strengthening the Spleen and Stomach.
Case Record 7:
A postpartum woman had abdominal pain with tenesmus, profuse dysentery, physical fatigue, and inability to eat, nearing death. This indicated dual deficiency of Spleen and Kidney. Si Shen Wan and Shi Quan Da Bu Tang were administered, leading to recovery. However, due to difficulty digesting food and limb fatigue, Bu Yi Tang (Tonifying Decoction) was used for conditioning until she regained health.
Case Record 8:
A woman contracted dysentery in the fifth month, with day and night frequency, lower abdominal bearing-down pain, fever, and aversion to cold. Liu Jun Zi Tang was used to deliver Xiang Lian Wan (Xianglian Pill). After two doses, she improved. Subsequently, the same decoction delivered Si Shen Wan. After four doses, she fully recovered. By the end of the seventh month, she exhibited lethargy, desire to lie down, flaccid limbs, heavy body and joint pain, dry mouth and tongue, tasteless diet, loose stools, frequent urination, chilliness, and melancholy. This indicated deficiency of Lung and Spleen-Stomach with constrained Yang Qi due to cold. Sheng Yang Yi Wei Tang (Raise Yang and Benefit Stomach Decoction) was used, resulting in recovery.