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After childbirth, blood deficiency leads to Yin deficiency, and Yin deficiency generates internal heat. The symptoms include vexation and fullness in the chest and heart, shortness of breath, headache with mental confusion, worsening in the evening, which is similar to the deficiency vexation seen after severe illness. Use Taishen (Codonopsis Radix), Dangguishen (Angelica Sinensis Root Heart), Shudi (Rehmanniae Radix Praeparata), Rougui (Cinnamomi Cortex), Jiubaoshao (Paeoniae Radix Alba prepared with wine) each 1.5 qian, and Maidong (Ophiopogonis Radix) 1 qian. Add two cups of water, first decoct one he of Jingmi (Oryza Sativa Germ) and ten pieces of Danzhuye (Lophatheri Herba) until reduced to one cup, remove the rice and leaves, add the medicinal herbs and three dates, decoct until seven-tenths remain, and take warm. If the heat is severe, add Chao Ganjiang (Zingiberis Rhizoma Praeparatum) 1 qian. Why must Ganjiang (Zingiberis Rhizoma) be used for high fever after childbirth? This is not due to excess heat, but internal heat generated by Yin deficiency; therefore, a large dose of Yin-nourishing herbs should be taken. Moreover, Ganjiang enters the Lung meridian to harmonize Lung Qi; enters the Liver meridian to guide blood-invigorating herbs and promote blood generation. However, it cannot be used alone and must be combined with Yin-nourishing herbs. This is the subtle wonder of nature's creation, discussable only with those of supreme spiritual insight.

If lochia (residual blood) is not fully expelled, or if Yin and Yang are disharmonious, both can cause alternating chills and fever. How to distinguish them? It is said: If caused by residual blood, there will be stabbing pain in the lower abdomen, which is the distinguishing feature. Therefore, for residual blood, the primary treatment is to remove stasis; for Yin-Yang disharmony, the primary treatment is to tonify deficiency. Treating it as malaria would be a mistake.

Why does residual blood cause intermittent chills and fever? Residual blood stagnation causes blockage of the meridians, preventing the smooth flow of Ying (Nutritive) and Wei (Defensive) Qi. Blockage in Ying leads to excessive blood stasis causing cold; blockage in Wei leads to excessive Yang causing heat. If both Ying and Wei are blocked, chills and fever alternate. When Ying and Wei Qi circulate freely, the condition resolves. For intermittent chills and fever due to residual blood, use Heishen San (Black Spirit Powder - see previous text) or Juanhe San (Polygonati Odorati Rhizoma Powder) 1 qian.

Why does Yin-Yang disharmony cause intermittent chills and fever? After childbirth, Qi and Blood are depleted, and both Yin and Yang are deficient. Yin deficiency leads to Yang hyperactivity causing heat; Yang deficiency leads to Yin hyperactivity causing cold. With both Yin and Yang deficient, intermittent chills and fever occur. Treatment uses Zengsun Bawu Tang (Modified Eight Substance Decoction): Dangguishen (Angelica Sinensis Root Heart), Baishao (Paeoniae Radix Alba, each washed with wine), Ganjiang (Zingiberis Rhizoma, stir-fried until charred black), Chuanxiong (Ligusticum Chuanxiong Rhizome), etc.

How to distinguish between malaria-like symptoms and true malaria? Malaria-like symptoms involve chills that are not piercingly cold, fever that is not intensely hot, irregular onset times, and mild suffering; this indicates deficiency of Zheng Qi (Upright Qi) without pathogenic factors. True malaria involves chills so severe that hot water or fire cannot relieve them, and fever so intense that ice or water cannot cool them; it has regular onset times, accompanied by vexation, bitterness, and exhaustion; this indicates deficiency of Zheng Qi with struggle against pathogenic factors.