郭稽中曰∶产后乍寒乍热，多是败血为害，或阴阳不和。若概作疟治，则误矣。
娄全善曰∶产后疟疾，多由污血挟寒热而作。大法，宜柴胡四物汤调之。热多者，草果饮子。寒多者，生
熟饮子。
《产宝新书》曰∶产后类疟分二证，产后半月内外，寒热往来，或午后日晡夜间发热，或一日两三度，其发
有期，其证类疟。由气血并竭，阳虚寒作，阴虚发热也。慎毋以疟治，虽小柴胡汤，不可轻用。唯调补气血，
寒热自除。仲景云，伤寒往来寒热，一日二三度发。此阴阳俱虚，不可更发汗，更吐，更下，其意亦同。
薛立斋曰∶产后疟疾，总以补胃气为主，佐草果饮之类。若胃气稍充，以草果饮为主，佐以补胃药。盖气
虚则寒，血虚则热，胃气虚则恶寒，胃气下陷，则寒热交作。当大补气血，其病自退。若误用清脾截疟之类，
多致不起。
慎斋按∶以上三条，序产后有疟疾之证也。疟病在夏秋之交，本风寒暑湿四气之感。而产后之疟，虽有外邪，
当从气血两虚为治。阳虚外感，阴虚内热，阴阳两虚则寒热交作，故宜大补气血为主。若郭氏以败血为害，固
当消瘀，亦必兼补气血始善。故一切治疟诸方，如小柴、清脾、截疟、四兽之属，概不可施。况草果饮有川芎、
白芷、紫苏、柴胡、青皮、良姜之发表耗气。立斋以补胃气立论，诚得治疟之本。若以草果饮为主佐则失矣，不
能无辨。
Guo Jizhong stated: Sudden chills and fever after childbirth are mostly caused by the harm of stagnant blood (referring to retained blood outside the vessels) or disharmony between Yin and Yang. If treated generally as malaria, it would be a mistake.
Lou Quanshan stated: Postpartum malaria is mostly triggered by foul blood mixed with cold and heat pathogens. The general treatment principle is to regulate with Chaihu Siwu Tang (Bupleurum Four Substances Decoction). For cases with more heat, Caoguo Yinzi (Tsaoko Drink) is used. For cases with more cold, Shengshu Yinzi (Raw and Cooked Drink) is used.
The *Xinbian Chanbao* states: Postpartum symptoms resembling malaria are divided into two patterns. Within half a month after childbirth, alternating chills and fever occur, or fever arises in the afternoon, at dusk, or at night, occurring two or three times a day with regular intervals, resembling malaria. This is due to the exhaustion of both Qi and Blood; deficiency of Yang generates cold, while deficiency of Yin generates heat. One must strictly avoid treating it as malaria; even Xiaochaihu Tang (Minor Bupleurum Decoction) should not be used lightly. Only by regulating and tonifying Qi and Blood will the chills and fever naturally subside. Zhang Zhongjing said that in Shanghan disease, alternating chills and fever occurring two or three times a day indicates deficiency of both Yin and Yang, and one should not induce sweating, vomiting, or purgation again; the intent is similar.
Xue Lizhai stated: Postpartum malaria should primarily focus on tonifying Stomach Qi, assisted by formulas such as Caoguo Yinzi. If Stomach Qi is slightly replenished, Caoguo Yinzi becomes the primary formula, assisted by Stomach-tonifying herbs. Since Qi deficiency leads to cold aversion, Blood deficiency leads to heat, Stomach Qi deficiency causes aversion to cold, and sinking of Stomach Qi results in alternating chills and fever. One should greatly tonify Qi and Blood, and the illness will recede. Misusing formulas for clearing the spleen and intercepting malaria often leads to fatal outcomes.
Shenzhen’s commentary: The above three passages describe postpartum malaria. Malaria occurs during the transition between summer and autumn, originally caused by the invasion of Wind-Cold, Summer-Heat, and Dampness. However, postpartum malaria, although involving external pathogens, should be treated based on dual deficiency of Qi and Blood. Yang deficiency leads to external contraction, Yin deficiency leads to internal heat, and dual deficiency of Yin and Yang results in alternating chills and fever; thus, great tonification of Qi and Blood is appropriate. If following Guo’s view that stagnant blood is the cause, although removing stasis is necessary, it must be combined with tonifying Qi and Blood to be effective. Therefore, all malaria-treating formulas, such as Xiaochaihu Tang, Qingpi Yin, Jienue Dan, and Six Beast Powder, should absolutely not be used. Moreover, Caoguo Yinzi contains herbs like Chuanxiong Rhizome (Chuanxiong), Angelica Dahurica Root (Baizhi), Perilla Leaf (Zisu), Bupleurum Root (Chaihu), and Tangerine Peel (Qingpi), which have dispersing properties that consume Qi. Xue Lizhai’s theory of tonifying Stomach Qi indeed grasps the root of treating malaria. However, using Caoguo Yinzi as the main formula is inappropriate and requires differentiation.