夫产后蓐劳者，此由生产日浅，血气虚弱，饮食未平复，不满日月，气血虚羸，将
养失所，而风冷客之。风冷搏于气血，则不能温于肌肤，使人虚乏劳倦，乍卧乍起，颜
容憔悴，食饮不消。风冷邪气而感于肺，肺受微寒，故咳嗽口干，遂觉头昏，百节疼痛。
荣卫受于风邪，流注脏腑，须臾频发，时有盗汗，寒热如疟，背膊烦闷，四肢不举，沉
重着床。此则蓐劳之候也。又曰∶妇人因产理不顺，疲极筋力，忧劳心虑，致令虚羸喘
乏，寒热如疟，头痛自汗，肢体倦怠，咳嗽痰逆，腹中绞刺，名曰蓐劳。
〔薛〕按前证当扶养正气为主，用六君子汤加当归。若脾肺气虚而咳嗽口干，用补
中益气加麦门、五味。若因中气虚而口干头晕，用补中益气加蔓荆子。若肝经血虚而肢
体作痛，用四物、参、术。若因肝肾虚弱而自汗盗汗，寒热往来者，用六味丸加五味子。
若因脾虚血弱，肚腹作痛，月经不调，用八珍汤倍加白术。若因脾虚血燥，皮肤瘙痒用
加味逍遥散。大抵此证，多因脾胃虚弱，饮食减少，以致诸经疲惫而作。当补脾胃，饮
食一进，精气生化，诸脏有所倚赖，其病自愈矣。仍参虚烦发热方论主治。
〔汪〕一妇产未盈月，因怒气血流如水，三日方止，随又劳苦，四肢无力，睡而汗出，
日晡潮热，口干，五心如炙。诸医皆用柴、芩、薄荷之类，其热愈炽。诊其脉弦大无力，此
蓐劳也。以四物汤一两，入胡黄连、秦艽、青蒿各半钱，数服热退身凉。后以黄连八珍丸，
一料而安。
石子汤 疗产后虚羸喘乏，乍寒乍热如疟，四肢疼痛，面色痿黄，名曰蓐劳。
猪石子（一双，去脂膜，四破） 香豉（一方无此，有知母） 葱白（切） 粳米
当归 芍药（各二两）
上 咀，分两剂，每剂用水三升，煮取一小碗，去渣分三服。《广济》无芍药，有人
参。
增损柴胡汤（见前往来寒热。）
猪腰子粥 治蓐劳发热。
用猪腰子一枚，去白膜，切作柳叶片，以盐酒拌。先用粳米一合，入葱、椒煮粥，盐、
醋和，将腰子铺碗底，以热粥盖之，如作
生状，空心服。
人参鳖甲散 治蓐劳。皆由在产内未满百日，体中虚损，血气尚弱，失于将理，或
劳动作伤，致成蓐劳。其状虚羸，乍起乍卧，饮食不消，时有咳嗽，头目昏痛，发歇无常，
夜有盗汗，寒热如疟，背膊拘急，沉困在床，服此大效。
人参 桂心 当归 桑寄生 白茯苓 白芍药 桃仁 麦门冬（去心） 熟地黄
甘草（各半两） 续断（二钱半） 牛膝（七钱半） 鳖甲 黄 （各一两）
上为细末，每服先以猪肾一对，去筋膜，以水两大盏，生姜半分，枣三枚，煎至一盏，
去猪肾、姜、枣，然后入药末二钱，葱白三寸，乌梅一个，荆芥五穗，煎至七分，去渣，
空心晚食前温服，此药神妙。
许仁则疗产后日浅，久坐视听言语多，或运用气力，遂觉项膊肢节皮肉痛，乍寒乍热，
此为蓐劳。
猪肾（一双，去脂膜四破） 当归 芍药 生姜（各二两） 葱白（切） 桂心（各一两）
上水八升，煮肾取六升，下药煮取二升，分温二服。
熟地黄散（见前往来寒热。）
白茯苓散 治蓐劳，缘生产日浅，久坐多语，运动用力，致头目四肢疼痛，寒热如
疟状，宜此。
白茯苓（一两） 当归 川芎 桂心 白芍药 黄 人参（各半两） 熟干地黄（一两）
咀，先以水二盏，入猪肾、（一双，去脂膜切，）姜、（三片，）枣（三枚 煎一
盏）去三物，入药半两，煎七分，去渣食前分温三服。
黄 丸（往来寒热。）
胡氏牡丹散 治产后虚羸发热，自汗，欲变蓐劳；或血气所搏，经候不调，或寒热羸瘦。
白芍药 当归 五加皮 地骨皮 人参（各半两） 没药 桂心（各二钱） 牡丹皮（三钱）
上为细末，每服二钱，水酒各半盏，如不饮酒，只用水一盏，开元钱一枚，麻油蘸
之，同煎七分，去渣通口服。煎不得搅，吃不得吹。
黄 煮散 治产后蓐劳，肌肤黄瘦，面无颜色；或憎寒壮热，四肢酸疼，心烦头痛。
鳖甲（醋炙） 黄 （各一两） 桂心 当归（炒） 桑寄生 白茯苓 白芍药 人参 熟地黄
麦门冬（去心） 甘草（炙，各半两） 牛膝（七钱半）
上为细末，每服用猪石子一对，去脂膜切破，先以水一盏，入姜半分，枣三枚，煎
至七分，去石子、姜、枣，却下药五钱，更煎至四分，去渣，空心晚食前温服，二渣并
煎。
黄 建中汤 治产后诸虚不足，发热或恶寒腹痛。
黄 （炒） 肉桂（各一两） 白芍药（炒，二两） 甘草（炒，七钱）
每服五钱，姜、枣水煎服，日二三服，虚甚者加附子。
紫河车丸 治蓐劳及产后虚弱大效。猫犬产儿，即食其胞衣，故无产疾。（方见虚劳。）
Postpartum Churu Lao (Puerperal Exhaustion) arises because the time since delivery is short, blood and qi are deficient, diet has not yet recovered, and within a month, blood and qi are depleted and emaciated. Due to improper nursing, wind-cold pathogens invade. Wind-cold clashes with blood and qi, failing to warm the skin and muscles, causing deficiency, fatigue, alternating lying down and rising, haggard appearance, and indigestion. When wind-cold pathogens affect the Lung, the Lung suffers slight cold, leading to cough, dry mouth, dizziness, and pain in all joints. When Ying and Wei (Nutritive and Defensive Qi) are affected by wind pathogens and flow into the zang-fu organs, symptoms occur frequently in short intervals, sometimes with night sweats, chills and fever resembling malaria, oppression in the back and shoulders, inability to lift the limbs, and heaviness in bed. These are the signs of Churu Lao. It is also said: Women suffering from difficult labor, extreme physical exhaustion, and mental worry become emaciated, panting, and weak, with chills and fever like malaria, headache, spontaneous sweating, limb fatigue, cough with reverse flow of phlegm, and cramping/stabbing pain in the abdomen; this is named Churu Lao.
[Xue Ji] Regarding the above syndromes, the primary treatment should be to nourish and support righteous qi, using Liu Jun Zi Tang (Six Gentlemen Decoction) added with Dang Gui. If Spleen and Lung qi deficiency causes cough and dry mouth, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) added with Mai Men Dong and Wu Wei Zi. If middle qi deficiency causes dry mouth and dizziness, use Bu Zhong Yi Qi Tang added with Man Jing Zi. If Liver channel blood deficiency causes limb pain, use Si Wu Tang (Four Substance Decoction) added with Ren Shen and Bai Zhu. If Kidney and Liver weakness causes spontaneous and night sweats with alternating chills and fever, use Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia) added with Wu Wei Zi. If Spleen deficiency and blood weakness cause abdominal pain and irregular menstruation, use Ba Zhen Tang (Eight Treasures Decoction) with doubled Bai Zhu. If Spleen deficiency and blood dryness cause skin itching, use Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder). Generally, this syndrome is mostly due to Spleen and Stomach weakness and reduced food intake, leading to exhaustion of the meridians. One should tonify the Spleen and Stomach; once food enters, essence and qi are generated, and the viscera have reliance, so the disease heals itself. Refer to the discussion on formulas for deficiency vexation and fever for treatment principles.
[Wang Ji] A woman less than a month postpartum, due to anger, had blood and qi flowing out like water, stopping only after three days. She then engaged in hard labor, resulting in limb weakness, sweating during sleep, afternoon tidal fever, dry mouth, and burning sensation in the five centers (palms, soles, and chest). Physicians used Chai Hu, Huang Qin, Bo He, etc., but the heat intensified. Her pulse was wiry, large, and powerless, indicating Churu Lao. Prescribed Si Wu Tang (1 liang), added with Hu Huang Lian, Qin Jiao, and Qing Hao (each half qian). After several doses, fever subsided and body cooled. Later, Huang Lian Ba Zhen Wan (Coptis Eight Treasures Pill) was taken for one dose, bringing stability.
Shi Zi Tang (Pig Kidney Decoction): Treats postpartum emaciation, panting, chills and fever like malaria, limb pain, sallow complexion, named Churu Lao.
Zhu Shi Zi (Pig Kidney, 1 pair, remove fat membrane, cut into four pieces) Xiang Chi (Fermented Soybean Paste; some versions omit this and use Zhi Mu instead) Cong Bai (Scallion White, sliced) Jing Mi (Glutinous Rice) Dang Gui (Angelicae Sinensis Radix) Shao Yao (White Peony Root, each 2 liang)
Crush ingredients, divide into two doses. Each dose boiled in 3 sheng of water until reduced to one small bowl. Strain and take in three divided doses. Guang Ji Fang omits Shao Yao and adds Ren Shen.
Zeng Sun Chai Hu Tang (See section on Alternating Chills and Fever).
Zhu Yao Zi Zhou (Pig Kidney Porridge): Treats Churu Lao fever.
Take one pig kidney, remove white membrane, slice into willow-leaf shapes, mix with salt and wine. First, cook 1 he of Jing Mi with Cong and Jiao (Sichuan Pepper) to make porridge, season with salt and vinegar. Place kidney slices at the bottom of the bowl, cover with hot porridge as if making raw slices, and consume on an empty stomach.
Ren Shen Bie Jia San (Ginseng and Turtle Shell Powder): Treats Churu Lao. Caused by being less than 100 days postpartum, internal deficiency, weak blood and qi, lack of proper care, or injury from labor. Symptoms include emaciation, alternating rising and lying, indigestion, occasional cough, dizzy/painful head and eyes, irregular paroxysms, night sweats, chills/fever like malaria, stiffness in back/shoulders, heaviness in bed. This formula is highly effective.
Ren Shen (Ginseng) Gui Xin (Cinnamon Heart) Dang Gui (Angelicae Sinensis Radix) Sang Ji Sheng (Taxilli Herba) Bai Fu Ling (Poria) Bai Shao Yao (White Peony Root) Tao Ren (Persic Semen) Mai Men Dong (Ophiopogonis Tuber, heart removed) Shu Di Huang (Prepared Rehmanniae Radix) Gan Cao (Licorice Root, each half liang) Xu Duan (Dipsaci Radix, 2.5 qian) Niu Xi (Achyranthis Bidentatae Radix, 7.5 qian) Bie Jia (Testudinis Carapax et Plastrum) Huang Qi (Astragali Radix, each 1 liang)
Grind into fine powder. For each dose, first decoct 1 pair of pig kidneys (remove fascia), 2 liang of water, half qian of Sheng Jiang (Fresh Ginger), and 3 Zao (Jujubes) until reduced to 1 liang. Remove kidneys, ginger, and jujubes. Add 2 qian of herb powder, 3 cun of Cong Bai, 1 W Mei (Smoked Plum), and 5 spikes of Jing Jie (Schizonepetae Spica). Decoct until 0.7 portion remains. Strain and take warm on an empty stomach and before evening meal. This medicine is miraculous.
Xu Ren Ze treats postpartum cases where, due to short time since delivery, prolonged sitting, excessive hearing/vision/speech, or physical exertion, one feels pain in neck, shoulders, limbs, skin, and flesh, with alternating chills and fever. This is Churu Lao.
Zhu Shen (Pig Kidney, 1 pair, remove fat membrane, cut into four) Dang Gui Shao Yao Sheng Jiang (Fresh Ginger, each 2 liang) Cong Bai (Scallion White, sliced) Gui Xin (Cinnamon Heart, each 1 liang)
Boil in 8 sheng of water. Boil kidneys to get 6 sheng. Add other herbs and boil to get 2 sheng. Take warm in two divided doses.
Shu Di Huang San (See section on Alternating Chills and Fever).
Bai Fu Ling San (Poria Powder): Treats Churu Lao caused by short time since delivery, prolonged sitting, excessive talking, and physical exertion, leading to head/eye/limb pain and chills/fever like malaria. Use this formula.
Bai Fu Ling (Poria, 1 liang) Dang Gui Chuan Xiong (Ligusticum Chuanxiong Rhizoma) Gui Xin Bai Shao Yao Huang Qi Astragalus Radix) Ren Shen (Panax Ginseng Radix, each half liang) Shu Gan Di Huang (Prepared Dry Rehmanniae Radix, 1 liang)
Crush. First decoct 2 liang of water with 1 pig kidney (remove fat membrane, slice), 3 slices of Sheng Jiang, and 3 Zao until reduced to 1 liang. Remove these three items. Add half liang of herb powder, decoct until 0.7 portion remains. Strain and take warm in three divided doses before meals.
Huang Qi Wan (See Alternating Chills and Fever).
Hu Shi Mu Dan San (Hu's Moutan Powder): Treats postpartum emaciation and fever, spontaneous sweating, impending Churu Lao; or blood/qi clash causing irregular menstruation, or chills/fever with emaciation.
Bai Shao Yao Dang Gui Wu Jia Pi (Acanthopanacis Cortex) Di Gu Pi (Lycii Cortex) Ren Shen (each half liang) Mo Yao (Myrrha) Gui Xin (each 2 qian) Mu Dan Pi (Moutan Cortex, 3 qian)
Grind into fine powder. Take 2 qian per dose with half a cup of water and half a cup of wine. If non-drinker, use 1 cup of water. Add one Kai Yuan Qian (ancient coin), dip in Ma You (Sesame Oil), and decoct together until 0.7 portion remains. Strain and drink through. Do not stir while decocting; do not blow on it when drinking.
Huang Qi Zhu San (Huang Qi Decoction Powder): Treats postpartum Churu Lao, sallow/emaciated skin, pale face; or aversion to cold with high fever, sore limbs, vexation, headache.
Bie Jia (Turtle Shell, vinegar-processed) Huang Qi (each 1 liang) Gui Xin Dang Gui (Stir-fried) Sang Ji Sheng Bai Fu Ling Bai Shao Yao Ren Shen Shu Di Huang Mai Men Dong (Heart removed) Gan Cao (Roasted, each half liang) Niu Xi (7.5 qian)
Grind into fine powder. For each dose, take 1 pair of pig kidneys, remove fat membrane and slice. First decoct 1 liang of water with half qian of Sheng Jiang and 3 Zao until 0.7 portion remains. Remove kidneys, ginger, and jujubes. Add 5 qian of herb powder, decoct until 0.4 portion remains. Strain and take warm on an empty stomach and before evening meal. Combine residue for second decoction.
Huang Qi Jian Zhong Tang (Huang Qi Decocting Middle Decoction): Treats various deficiencies postpartum, fever, or chills/abdominal pain.
Huang Qi (Stir-fried) Rou Gui (Cinnamon Bark, each 1 liang) Bai Shao Yao (Stir-fried, 2 liang) Gan Cao (Roasted, 7 qian)
Take 5 qian per dose, decoct with Sheng Jiang and Zao in water. Take 2-3 times daily. For severe deficiency, add Fu Zi (Aconite Lateralis Radix Praeparata).
Zi He Che Wan (Placenta Pill): Highly effective for Churu Lao and postpartum weakness. Cats and dogs eat their placenta immediately after birth, thus avoiding postpartum diseases. (Formula see Deficiency Labor section).