产后证最重而难治者，莫如蓐劳。蓐劳之因有二∶一由内伤，由产理不顺调养失宜，或忧劳思虑，伤其脏
腑，荣卫不宣，令人寒热如疟，头痛自汗、痰咳气逆，虚羸喘乏，体倦肢怠，宜补虚汤。一由外感未满，日月
气血虚耗，风冷乘之，与气血相搏，不能温于肌肤，令人发热憔悴，饮食不消，肢体烦痛。若风冷之邪感入于
肺，肺受微寒，咳嗽口干，头晕体痛，荣卫受风，流注脏腑，发眩盗汗，寒热如疟，背膊
烦痛，肢体沉重，宜茯苓散、加味佛手散。若初产后蓐劳困倦，宜猪肾汤。若虚汗不止，宜母鸡汤。若兼脏寒，
宜羊肉汤。若气血俱虚，宜十全大补汤。若兼外邪发热，宜补阴益气煎。若兼外邪发热而中寒，背恶寒者，宜理
阴煎加减治之。若兼阳虚内寒，宜五君子煎。若阳盛阴虚兼内热者，宜五福饮加白芍、黄芩、地骨皮之类，随
宜用之。
补虚汤
人参 黄 （蜜炙，各一钱半） 肉桂 炙甘草（各五分） 川芎 当归 白芍 白术（蜜炙，各一钱）
上加姜三片，枣二枚，水煎服。
热轻加茯苓二钱；热重加黄芩（酒炒）一钱；热甚加干姜（炒黑）一钱，引入肝经去血。
茯苓散
茯苓（一两） 当归 川芎 熟地黄 白芍 黄 （蜜炙） 人参 肉桂（各五分）
上为末，先用猪腰一对，姜三片，枣二枚，水三盏，煎二盏；去渣，入药末五钱，煎一盏服。
加味佛手散
当归 川芎 黄 （蜜炙，各一两） 柴胡 前胡（各一钱五分）
上为末，每服五钱。加桃枝、柳枝各三寸，乌梅一个，姜三片，枣一枚，水煎服。如有痰除去乌梅。
猪肾汤
当归 白芍（酒炒，各一两）
水三碗，煎至二碗，去渣，将猪腰切如骰子块，同晚米一合，香豉一钱，加葱椒盐煮稀粥，空心服。日二
次神效。或加
人参更妙。
母鸡汤
人参 黄 白术（蜜炙） 茯苓 麻黄根 牡蛎（ ，各三钱） 母鸡（一只，去毛）
杂水六七碗，同药煮至三碗，任意服之。
羊肉汤
精羊肉（四两） 当归 川芎（各五钱） 生姜（一两）
上以水十盏，煎至四盏，分四次空心服。
十全大补汤
人参 白术（蜜炙） 黄 （蜜炙） 茯苓 熟地黄 当归 川芎 白芍（各一钱） 炙甘草 肉桂（各五分）
姜（三片） 枣（二枚）
水煎服。
补阴益气煎
人参（一二钱） 当归（一二钱） 山药（酒炒，二三钱） 熟地黄（三五钱） 陈皮（一钱） 炙甘草（一钱）
升麻（三五分） 柴胡（一二钱） 姜（三五片）
水煎，食远温服。
如火浮于上去升麻，如无外邪去柴胡。
理阴煎
熟地黄（三五钱） 当归（二三钱） 炙甘草（一二钱） 干姜（炒黄，一二钱） 或加肉桂（一钱）
水煎温服。
风寒外感，邪未入深，加柴胡一钱五分；若中寒，背畏寒，加细辛一钱，甚者再加附子一钱。
五君子煎
人参 白术（蜜炙） 茯苓（各二钱） 炙甘草 干姜（炒黄，一钱）
水一钟半，煎服。
五福饮
人参（一二钱） 熟地黄（二三钱） 当归（二三钱） 白术（蜜炙，一钱） 炙甘草（一钱）
水煎，食远服。或加生姜三五片。
The most severe and difficult-to-treat conditions after childbirth are none other than "Rulao" (Postpartum Exhaustion). There are two main causes of Rulao: First, internal injury caused by improper delivery management, inadequate recuperation, or excessive worry, labor, and overthinking, which damage the Zang-Fu organs. This leads to the stagnation of Ying (Nutritive Qi) and Wei (Defensive Qi), causing symptoms such as alternating chills and fever resembling malaria, headache, spontaneous sweating, phlegm with cough, rebellious Qi, emaciation, asthenic panting, general fatigue, and limb lethargy. In such cases, Buxu Tang (Tonify Deficiency Decoction) is appropriate. Second, external contraction occurring within the postpartum period when Qi and Blood are depleted. Wind-cold pathogens invade and contend with Qi and Blood, failing to warm the skin and muscles, resulting in fever, emaciation, indigestion, and vexatious pain in the limbs. If wind-cold pathogens enter the Lung, causing slight cold in the Lung, symptoms include cough, dry mouth, dizziness, body pain. If Ying and Wei are affected by wind, flowing into the Zang-Fu organs, it may cause vertigo, night sweats, alternating chills and fever like malaria, vexatious pain in the back and shoulders, and heavy limbs. In these cases, Fuling San (Poria Powder) or Jiawei Foshou San (Modified Buddha's Hand Powder) are appropriate.
For initial postpartum exhaustion and fatigue, Zhushen Tang (Pig Kidney Decoction) is suitable. For persistent deficiency sweating, Muji Tang (Hen Soup) is suitable. For concurrent organ coldness, Yangrou Tang (Mutton Soup) is suitable. For combined Qi and Blood deficiency, Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction) is suitable. For concurrent external pathogenic fever, Buyin Yiqi Jian (Nourish Yin and Boost Qi Decoction) is suitable. For concurrent external pathogenic fever with interior cold and aversion to cold on the back, Liyin Jian (Regulate Yin Decoction) modified is suitable. For concurrent Yang deficiency with interior cold, Wu Junzi Jian (Five Gentlemen Decoction) is suitable. For excess Yang with Yin deficiency and interior heat, Wufu Yin (Five Blessings Drink) added with Baishao (White Peony Root), Huangqin (Scutellaria Root), and Digupi (Groundcherry Bark) is suitable, used according to specific indications.
Buxu Tang (Tonify Deficiency Decoction)
Renshen (Ginseng Radix), Huangqi (Astragali Radix, honey-fried, each 1.5 qian), Rougui (Cinnamon Twig), Zhigancao (Licorice Root, honey-fried, each 0.5 qian), Chuanxiong (Ligusticum Rhizome), Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba), Baizhu (Atractylodis Macrocephalae Rhizoma, honey-fried, each 1 qian).
Add three slices of fresh ginger and two jujubes. Decoct in water and take orally.
If heat is mild, add Fuling (Poria) 2 qian; if heat is severe, add Huangqin (Scutellaria Root, wine-fried) 1 qian; if heat is extreme, add Ganjiang (Dried Ginger, charred) 1 qian to guide the medicine into the Liver channel and remove blood stasis.
Fuling San (Poria Powder)
Fuling (Poria, 1 liang), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligusticum Rhizome), Shudihuang (Rehmanniae Radix Preparata), Baishao (Paeoniae Radix Alba), Huangqi (Astragali Radix, honey-fried), Renshen (Ginseng Radix), Rougui (Cinnamon Twig, each 0.5 qian).
Grind into powder. First, decoct one pair of pig kidneys, three slices of fresh ginger, two jujubes, and three cups of water until reduced to two cups. Strain, add five qian of the herbal powder, and decoct until one cup remains. Take orally.
Jiawei Foshou San (Modified Buddha's Hand Powder)
Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligusticum Rhizome), Huangqi (Astragali Radix, honey-fried, each 1 liang), Chaihu (Bupleuri Radix), Qianhu (Peucedani Radix, each 1.5 qian).
Grind into powder. Take five qian per dose. Add three cun of peach branch, three cun of willow branch, one dark plum, three slices of fresh ginger, and one jujube. Decoct in water and take orally. If phlegm is present, remove the dark plum.
Zhushen Tang (Pig Kidney Decoction)
Danggui (Angelicae Sinensis Radix), Baishao (Paeoniae Radix Alba, wine-fried, each 1 liang).
Decoct three bowls of water until reduced to two bowls. Strain. Cut pig kidneys into dice-sized cubes. Cook together with one heaping measure of late rice, one qian of fermented soybean (Chidouchi), scallions, Sichuan pepper, and salt into a thin porridge. Take on an empty stomach. Twice daily for miraculous effect. Adding Renshen (Ginseng Radix) is even better.
Muji Tang (Hen Soup)
Renshen (Ginseng Radix), Huangqi (Astragali Radix), Baizhu (Atractylodis Macrocephalae Rhizoma, honey-fried), Fuling (Poria), Mahuanggen (Ephedrae Radix et Rhizoma), Muli (Ostreae Concha, calcined, each 3 qian), one hen (de-feathered).
Add six or seven bowls of water. Simmer with herbs until reduced to three bowls. Take as desired.
Yangrou Tang (Mutton Soup)
Lean mutton (4 liang), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligusticum Rhizome, each 5 qian), Shengjiang (Fresh Ginger, 1 liang).
Decoct ten cups of water until reduced to four cups. Divide into four doses and take on an empty stomach.
Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction)
Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma, honey-fried), Huangqi (Astragali Radix, honey-fried), Fuling (Poria), Shudihuang (Rehmanniae Radix Preparata), Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligusticum Rhizome), Baishao (Paeoniae Radix Alba, each 1 qian), Zhigancao (Licorice Root, honey-fried), Rougui (Cinnamon Twig, each 0.5 qian), fresh ginger (three slices), jujube (two pieces).
Decoct in water and take orally.
Buyin Yiqi Jian (Nourish Yin and Boost Qi Decoction)
Renshen (Ginseng Radix, 1-2 qian), Danggui (Angelicae Sinensis Radix, 1-2 qian), Shanyao (Dioscoreae Rhizoma, wine-fried, 2-3 qian), Shudihuang (Rehmanniae Radix Preparata, 3-5 qian), Chenpi (Citri Reticulatae Pericarpium, 1 qian), Zhigancao (Licorice Root, honey-fried, 1 qian), Shengma (Cimicifugae Rhizoma, 0.3-0.5 qian), Chaihu (Bupleuri Radix, 1-2 qian), fresh ginger (3-5 slices).
Decoct in water. Take warm well after meals.
If fire floats upward to the head, remove Shengma (Cimicifugae Rhizoma); if there is no external pathogen, remove Chaihu (Bupleuri Radix).
Liyin Jian (Regulate Yin Decoction)
Shudihuang (Rehmanniae Radix Preparata, 3-5 qian), Danggui (Angelicae Sinensis Radix, 2-3 qian), Zhigancao (Licorice Root, honey-fried, 1-2 qian), Ganjiang (Dried Ginger, fried yellow, 1-2 qian). Optionally add Rougui (Cinnamon Twig, 1 qian).
Decoct in water and take warm.
For wind-cold exterior contraction where pathogens have not penetrated deeply, add Chaihu (Bupleuri Radix) 1.5 qian; for interior cold with aversion to cold on the back, add Xixin (Asari Radix) 1 qian; for severe cases, add Fuzi (Aconiti Lateralis Radix Preparata) 1 qian.
Wu Junzi Jian (Five Gentlemen Decoction)
Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma, honey-fried), Fuling (Poria, each 2 qian), Zhigancao (Licorice Root, honey-fried), Ganjiang (Dried Ginger, fried yellow, 1 qian).
Decoct one and a half zhong of water and take orally.
Wufu Yin (Five Blessings Drink)
Renshen (Ginseng Radix, 1-2 qian), Shudihuang (Rehmanniae Radix Preparata, 2-3 qian), Danggui (Angelicae Sinensis Radix, 2-3 qian), Baizhu (Atractylodis Macrocephalae Rhizoma, honey-fried, 1 qian), Zhigancao (Licorice Root, honey-fried, 1 qian).
Decoct in water. Take well after meals. Alternatively, add three to five slices of fresh ginger.