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 *Rulao* (Consumptive Disease after Childbirth) arises because the time since delivery is short, blood and qi are deficient, diet has not yet normalized, and within a month, the deficiency and emaciation of blood and qi, combined with improper nursing care, allow wind-cold pathogens to invade. Wind-cold clashes with blood and qi, failing to warm the skin and muscles, causing the patient to feel weak, fatigued, alternating between lying down and rising, with a haggard complexion and indigestion. When wind-cold pathogenic factors affect the Lung, and the Lung suffers slight cold, it results in coughing, dry mouth, dizziness, and pain throughout 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, accompanied by occasional night sweats, chills and fever resembling malaria, irritability in the back and shoulders, inability to lift the limbs, and a heavy sensation keeping the patient bedridden. These are the manifestations of *Rulao*. It is also stated: If a woman experiences difficult labor, exhausting her sinews and strength, and suffers from worry and mental fatigue, leading to deficiency, emaciation, panting, and weakness, chills and fever like malaria, headache, spontaneous sweating, limb fatigue, coughing with counterflow phlegm, and cramping/stabbing pain in the abdomen, this is named *Rulao*.
[Xue Ji] Regarding the aforementioned syndromes, the primary treatment should be to nourish and support righteous qi, using Liujunzi Tang (Six Gentlemen Decoction) with added Danggui (Angelicae Sinensis Radix). If cough and dry mouth are caused by Spleen and Lung qi deficiency, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with added Maimendong (Ophiopogonis Radix) and Wuweizi (Schisandrae Fructus). If dry mouth and dizziness are due to Middle Qi deficiency, use Buzhong Yiqi Tang with added Manjingzi (Vittatenii Fructus). If limb pain is due to Liver Blood deficiency, use Siwu Tang (Four Substance Decoction) with added Renshen (Ginseng Radix et Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma). If spontaneous and night sweats with alternating chills and fever are due to Kidney and Liver deficiency, use Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia) with added Wuweizi. If abdominal pain and irregular menstruation are due to Spleen deficiency and Blood weakness, use Bazhen Tang (Eight Treasures Decoction) with doubled Baizhu. If skin itching is due to Spleen deficiency and Blood dryness, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). Generally, this syndrome often stems from Spleen and Stomach weakness and reduced food intake, leading to exhaustion of the meridians. One must tonify the Spleen and Stomach; once food intake improves and essence/qi generation resumes, the Zang-Fu organs will have reliance, and the disease will heal itself. Refer also to the treatise on treating deficiency vexation and fever.
[Wang Ji] A female patient, less than a month postpartum, suffered anger-induced bleeding where blood flowed like water, stopping only after three days. Subsequently, she overexerted herself, resulting in limb weakness, nocturnal sweating, afternoon tidal fever, dry mouth, and burning sensations in the five centers (palms, soles, and chest). Physicians used Chaihu (Bupleuri Radix), Huangqin (Scutellariae Radix), Bohe (Menthae Haplocalycis Herba), etc., but the heat intensified. Her pulse was wiry, large, and powerless, indicating *Rulao*. Prescribed Siwu Tang (1 liang) with Huhuanglian (Coptidis Rhizoma variant/Anemarrhenae Rhizoma contextually implied as heat-clearing bitter cold, likely Coptidis here given name), Qinjiao (Gentianae Macrophyllae Radix), and Qinghao (Artemisiae Annuae Herba) each 0.5 qian. After several doses, fever subsided and body cooled. Later, Huanglian Bazhen Wan (Coptidis Eight Treasures Pill) cured her in one course.
Shizi Tang: Treats postpartum deficiency, panting, chills and fever like malaria, limb pain, sallow complexion, named *Rulao*.
Zhu Shizi (Pig Kidney, 1 pair, remove fat membrane, cut into four pieces) Xiangchi (Fermented Soybean Paste) [Note: Some versions omit this, using Zhimu instead] Congbai (Scallion White, chopped) Jingmi (Glutinous Rice) Danggui (Angelicae Sinensis Radix) Shaoyao (Paeoniae Radix Alba, 2 liang each)
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. *Guangji Fang* omits Shaoyao and adds Renshen.
Zengsun Chaihu Tang (See section on Alternating Chills and Fever).
Zhuyaozi Zhou (Pig Kidney Porridge): Treats *Rulao* fever.
Take one Pig Kidney, remove white membrane, slice into willow-leaf shapes, mix with salt and wine. First, cook 1 he of Jingmi (Glutinous Rice) with Congbai (Scallion White) and Hua jiao (Sichuan Pepper) to make porridge, season with salt and vinegar. Place kidney slices at the bottom of the bowl, cover with hot porridge (resembling raw meat preparation), and consume on an empty stomach.
Renshen Biejia San (Ginseng and Turtle Shell Powder): Treats *Rulao*. Caused by being less than 100 days postpartum, internal deficiency, weak blood and qi, lack of proper care, or injury from labor/exertion. Symptoms include emaciation, alternating rest/activity, indigestion, occasional cough, dizzy/painful head and eyes, irregular attacks, night sweats, chills/fever like malaria, stiffness in back/shoulders, heaviness in bed. This formula is highly effective.
Renshen (Ginseng Radix et Rhizoma) Guixin (Cinnamomi Ramulus) Danggui (Angelicae Sinensis Radix) Sangjisheng (Taxilli Caulis) Baifuling (Poria) Baishaoyao (Paeoniae Radix Alba) Taoren (Persicae Semen) Maimendong (Ophiopogonis Radix, heart removed) Shudihuang (Rehmanniae Radix Praeparata) Gancao (Licorice Root, 0.5 liang each) Xuduan (Dipsaci Radix, 2.5 qian) Niuxi (Achyranthis Bidentatae Radix, 7.5 qian) Biejia (Testudinis Carapax et Plastrum) Huangqi (Astragali Radix, 1 liang each)
Grind to fine powder. For each dose, first boil 1 pair of Pig Kidneys (remove fascia), 2 liang of water, 0.5 fen of Shengjiang (Fresh Ginger), and 3 Dazao (Jujubae Fructus) until reduced to 1 liang. Remove kidneys, ginger, and dates. Add 2 qian of medicine powder, 3 cun of Congbai (Scallion White), 1 Wumei (Mume Fructus), and 5 spikes of Jingjie (Schizonepetae Spica). Boil until 0.7 portion remains. Strain and take warm on an empty stomach and before evening meal. This medicine is miraculous.
Xu Renze treats postpartum cases where short duration is followed by prolonged sitting, excessive listening/speaking, or physical exertion, leading to pain in neck, shoulders, limbs, skin, and flesh, with alternating chills and fever. This is *Rulao*.
Pig Kidney (1 pair, remove fat membrane, cut into four) Danggui (Angelicae Sinensis Radix) Shaoyao (Paeoniae Radix Alba) Shengjiang (Fresh Ginger, 2 liang each) Congbai (Scallion White, chopped) Guixin (Cinnamomi Ramulus, 1 liang each)
Boil in 8 sheng of water until kidneys yield 6 sheng. Add remaining herbs, boil until 2 sheng remain. Divide into two warm doses.
Shudihuang San (See section on Alternating Chills and Fever).
Baifuling San (Poria Powder): Treats *Rulao* caused by short postpartum period, prolonged sitting, excessive talking, and physical exertion, leading to head/limb pain and chills/fever like malaria.
Baifuling (Poria, 1 liang) Danggui (Angelicae Sinensis Radix) Chuanxiong (Ligustici Chuanxiong Rhizoma) Guixin (Cinnamomi Ramulus) Baishaoyao (Paeoniae Radix Alba) Huangqi (Astragali Radix) Renshen (Ginseng Radix et Rhizoma, 0.5 liang each) Shugan Dihuang (Prepared Rehmannia Root, 1 liang)
Crush. First boil 2 liang of water with 1 Pig Kidney (remove fat membrane, chop), 3 slices of Ginger, and 3 Dates until reduced to 1 liang. Remove these three items. Add 0.5 liang of medicine powder, boil until 0.7 portion remains. Strain and take warm in three divided doses before meals.
Huangqi Wan (For Alternating Chills and Fever).
Hu Shi Mudan San (Dr. Hu's Peony Powder): Treats postpartum deficiency, fever, spontaneous sweating, impending *Rulao*; or blood/qi clumping causing irregular menstruation, or chills/fever with emaciation.
Baishaoyao (Paeoniae Radix Alba) Danggui (Angelicae Sinensis Radix) Wujia pi (Acanthopanacis Cortex) Digupi (Lycii Cortex) Renshen (Ginseng Radix et Rhizoma, 0.5 liang each) Moyao (Myrrha) Guixin (Cinnamomi Ramulus, 2 qian each) Mudanpi (Moutan Cortex, 3 qian)
Grind to fine powder. Take 2 qian per dose with 0.5 sheng water and 0.5 sheng wine. If non-drinker, use 1 sheng water. Add one Kaiyuan Tongbao coin, dip in Sesame Oil, and decoct together until 0.7 portion remains. Strain and drink. Do not stir during decoction; do not blow on while drinking.
Huangqi Zhu San (Decocted Astragalus Powder): Treats postpartum *Rulao*, sallow/emaciated skin, pale face; or aversion to cold with high fever, sore limbs, vexation, headache.
Biejia (Testudinis Carapax et Plastrum, vinegar-fried) Huangqi (Astragali Radix, 1 liang each) Guixin (Cinnamomi Ramulus) Danggui (Angelicae Sinensis Radix, fried) Sangjisheng (Taxilli Caulis) Baifuling (Poria) Baishaoyao (Paeoniae Radix Alba) Renshen (Ginseng Radix et Rhizoma) Shudihuang (Rehmanniae Radix Praeparata) Maimendong (Ophiopogonis Radix, heart removed) Gancao (Licorice Root, honey-fried, 0.5 liang each) Niuxi (Achyranthis Bidentatae Radix, 7.5 qian)
Grind to fine powder. For each dose, take 1 pair of Pig Kidneys, remove fat membrane and chop. Boil in 1 sheng water with 0.5 fen Ginger and 3 Dates until 0.7 portion remains. Remove kidneys, ginger, dates. Add 5 qian of medicine powder, boil until 0.4 portion remains. Strain and take warm on empty stomach and before evening meal. Combine residues for second decoction.
Huangqi Jianzhong Tang (Astragalus Decoction to Establish the Middle): Treats various deficiencies postpartum, fever, or chills/abdominal pain.
Huangqi (Astragali Radix, fried) Rougui (Cinnamomi Cortex, 1 liang each) Baishaoyao (Paeoniae Radix Alba, fried, 2 liang) Gancao (Licorice Root, fried, 7 qian)
Take 5 qian per dose, decoct with Ginger and Dates in water. Take 2-3 times daily. Add Fuzi (Aconiti Lateralis Radix Praeparata) if deficiency is severe.
Ziheche Wan (Placenta Pill): Highly effective for *Rulao* and postpartum weakness. Cats and dogs eat their placentas immediately after birth, thus avoiding postpartum diseases. (Formula see Deficiency Consumption chapter).