Library

Ren Shen (Ginseng Radix), Shu Di Huang (Rehmanniae Radix Praeparata) (each 2 qian), Huang Qi (Astragali Radix), Bai Zhu (Atractylodis Rhizoma), Chuan Xiong (Chuanxiong Rhizoma), Mai Dong (Ophiopogonis Radix), Ma Huang Gen (Ephedrae Herbae Radix et Rhizoma, specifically the root) (each 1 qian), Dang Gui (Angelicae Sinensis Radix) (3 qian), Chen Pi (Citri Reticulatae Pericarpium) (4 fen), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma) (5 fen). Decoct and take orally during the day. At night, additionally take Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia), swallowed with clear water.
(Wu's Note: Although Ma Huang Gen has the property of dispersing while retaining and can stop sweating, it is ultimately a potent herb and should not be used in heavy doses; substituting it with other herbs is appropriate.)

Postpartum chills alternating with fever, headache, absence of sweat, resembling malaria.

Dong Bai Zhu (Stir-fried Atractylodis Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), Huo Xiang (Agastaches Herba) (each 4 fen), Bai Fu Ling (Poria), Chuan Xiong (Chuanxiong Rhizoma), Chen Pi (Citri Reticulatae Pericarpium) (each 1 qian), Ban Xia (Pinelliae Tuber) (8 fen), Dang Gui (Angelicae Sinensis Radix) (3 qian), Ren Shen (Ginseng Radix) (1.5 qian), Jiang (Zingiberis Rhizoma Recens, one slice). If there is phlegm, add Zhu Li (Bambusae Succus), Jiang Zhi (Zingiberis Rhizoma Recens Expressum), Ban Xia Qu (Pinelliae Fermentatum). If constitution is weak, additionally take He Che Wan (Placenta Hominis Pill). If prolonged malaria with absence of sweat persists, additionally take Shen Zhu Gao (Ginseng and Atractylodes Paste).

Within seven days postpartum, if fever, headache, and aversion to cold occur, do not exclusively diagnose it as Tai Yang disease (disease pattern of the Tai Yang channel). If fever, headache, and hypochondriac pain occur, do not exclusively diagnose it as Shao Yang disease (disease pattern of the Shao Yang channel). Both conditions arise from deficiency of both qi and blood, and disharmony of yin and yang, mimicking external contraction. Practitioners must not lightly dismiss the postpartum state, nor adhere to erroneous methods by using Ma Huang Tang (Ephedra Decoction) to treat Tai Yang-like patterns, nor use Chai Hu Tang (Bupleurum Decoction) to treat Shao Yang-like patterns. Moreover, after blood loss in parturient women, inducing heavy sweating would lead to the disaster of exacerbating deficiency, which is beyond description. Zhang Zhongjing once said: Those who have lost blood should not undergo sweating therapy. Zhu Danxi said: Postpartum women strictly should not undergo releasing-the-exterior therapy. These two masters did not mean that parturient women truly cannot suffer from Tai Yang disease, nor that Ma Huang Tang or Chai Hu Tang are inappropriate for their symptoms. They were genuinely concerned that later learners might adhere to erroneous paths, neglect the postpartum condition, and rigidly apply established formulas to release the exterior. Even if it is known that the postpartum woman has truly contracted wind-cold, the Chuan Xiong and Sheng Jiang (Fresh Ginger) within Sheng Hua Tang (Invigorate Blood Decoction) can also disperse it. Furthermore, the *Nei Jing* states: The qi of the northwest is dispersed and released; the qi of the southeast is gathered and warmed. This means that although the disease is the same, the treatment differs. The meaning of the classic implies that people in the southeast are frail, whereas those in the northwest are robust, leading to differences in illness presentation. For postpartum consumptive fatigue, treatment methods do not distinguish between north and south; generally, sweet-warm herbs are used to greatly tonify, with a slight addition of dispersing agents. Even if other symptoms exist, they are treated as secondary. One must not be rigidly dogmatic to avoid harming patients.
(Wu's Note: The Classic states: Diseases of the Two Yang channels originate from the Heart and Spleen, referring to internal injury. There may also be fever and aversion to cold, which should not be confused with external contraction, especially in the postpartum period. Learners should investigate this carefully.)