〔娄〕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。
〔薛〕产后疟疾，因脾胃虚弱，饮食停滞，或因外邪所感，或郁怒伤脾，或暑邪所
伏。审系饮食，用六君加桔梗、苍术、藿香。如外邪多而饮食少，用藿香正气散。如外邪
少而饮食多，用人参养胃汤。饮食劳役，用补中益气汤。气血虚弱，用十全大补加炮姜。
虚寒，用六君加姜、桂。元气脱陷，急加附子。大凡久疟多属元气虚寒，盖气虚则寒，血
虚则热，胃虚则恶寒，阴火下流则寒热交作，或吐泻不食，腹痛烦渴，发热谵语，或手足
逆冷，寒战如栗。虽见百证，当峻温补，其病自退。若误用清脾、截疟之类，多致不起。
一产妇患疟，发热作渴，胸膈胀满，遍身作痛，三日不食，咽酸呕气，此是饮食所伤，
脾胃不能消化，用六君加神曲、山楂，四剂而不作酸，乃去神曲、山楂，又数剂而饮食
进。其大便不通，至三十五日，计进饮食七十余碗，腹始闷，令用猎胆汁导而通之，其
粪且不甚燥。一产妇患疟久不愈，百病蜂起，其脉或洪大，或微细，或弦紧，或沉伏，
难以名状。用六君加炮姜，二十余剂，脉证稍得，又用参、术煎膏，佐以归脾汤百余剂
而瘥。一产妇朝寒暮热，或不时寒热，久不愈。用六君子、补中益气兼服，百余剂而
寻愈。
草果饮子 治妇人产后疟疾，寒热相半者，或多热者宜此。
半夏（汤泡） 赤茯苓 甘草（炙） 草果（炮去皮） 川芎 陈皮 白芷（各二钱） 青皮（去白）
良姜 紫苏（各二钱半） 干葛（四钱）
上 咀，每服三钱，水一大盏，姜三片，枣二个，同煎至七分，去渣，当发日侵早，连
进三服，无有不安。
生熟饮子 治产后疟疾多寒者。
肉豆蔻 草果仁 浓朴（生去粗皮） 半夏 陈皮 甘草 大枣（去核） 生姜
上八味，等分细锉和匀，一半生，一半用湿绵纸裹煨令香熟，去纸，与一半生者和
匀，每服秤五钱重，水二盏，煎至七分，食前一服，食后一服。
《补遗》产后疟疾，热多寒少者，清脾汤。寒多热少者，养胃汤。久而不已者，七宝饮
截之。（方并见杂病疟）
【娄全善论述】产后疟疾，多由恶露（产后残留的瘀血）夹杂寒热邪气而引发。治疗大法适宜用柴胡四物汤来调理。若热象偏重者，宜用草果饮子；寒象偏重者，宜用生熟饮子。
【薛己论述】产后疟疾，是因为脾胃虚弱，饮食停滞，或因感受外邪，或因郁怒损伤脾气，或因暑邪潜伏体内所致。如果确认是饮食所伤，使用六君子汤加桔梗、苍术、藿香。如果是外邪较重而饮食停滞较轻，使用藿香正气散。如果是外邪较轻而饮食停滞较重，使用人参养胃汤。如果是饮食不节兼过度劳累所致，使用补中益气汤。如果是气血虚弱，使用十全大补汤加炮姜。如果是虚寒证，使用六君子汤加干姜、肉桂。如果是元气脱陷，急需加入附子。大凡久患疟疾多属于元气虚寒，因为气虚则生寒，血虚则生热，胃虚则厌恶寒冷，阴火下流则导致寒热交替发作，或者出现呕吐腹泻、不能进食、腹痛烦渴、发热说胡话，或者手足逆冷、寒战如栗。虽然见到各种症状，应当峻烈地温补，疾病自然消退。如果误用清脾、截疟之类的药物，大多会导致病情恶化甚至死亡。
有一位产妇患疟疾，发热口渴，胸膈胀满，全身疼痛，三天未进食，咽部泛酸、嗳气，这是饮食所伤，脾胃无法消化，使用六君子汤加神曲、山楂，服用四剂后不再泛酸，于是去掉神曲、山楂，又服用数剂后饮食逐渐恢复。另一位产妇大便不通，直到第三十五天，累计进食七十多碗饭，腹部才开始感到闷胀，让人用猪胆汁灌肠导便以通便，其粪便并不十分干燥。还有一位产妇患疟疾日久不愈，百病丛生，其脉象有的洪大，有的微细，有的弦紧，有的沉伏，难以名状。使用六君子汤加炮姜，服用二十余剂后，脉象和症状稍有好转，又用人参、白术煎膏，配合归脾汤服用百余剂后痊愈。还有一位产妇早晨怕冷傍晚发热，或不时出现寒热交替，久治不愈。使用六君子汤、补中益气汤联合服用，百余剂后逐渐痊愈。
草果饮子：治疗妇人产后疟疾，寒热各半者，或多热者适宜此方。
半夏（汤泡） 赤茯苓 甘草（炙） 草果（炮制去皮） 川芎 陈皮 白芷（各二钱） 青皮（去白）
良姜 紫苏（各二钱半） 干葛（四钱）
以上药材切碎，每次服用三钱，水一大盏，生姜三片，大枣二个，同煎至七分，去渣，在疟疾发作当天的清晨，连续服用三次，没有不安稳的。
生熟饮子：治疗产后疟疾多寒者。
肉豆蔻 草果仁 浓朴（生品去粗皮） 半夏 陈皮 甘草 大枣（去核） 生姜
以上八味药，等分细切混合均匀，一半生用，一半用湿绵纸包裹煨至香熟，去掉纸，与另一半生药混合均匀，每次称五钱重，水二盏，煎至七分，饭前服一次，饭后服一次。
[Lou Quanshan's Discussion] Postpartum malaria is mostly caused by lochia (residual blood after childbirth) mixed with cold and heat pathogens. The general treatment principle is to regulate it with Chaihu Siwu Tang. If heat predominates, Caoguo Yinzi should be used; if cold predominates, Shengshu Yinzi should be used.
[Xue Ji's Discussion] Postpartum malaria arises from spleen and stomach weakness with food stagnation, or from external pathogenic factors, or from anger damaging the spleen, or from latent summer-heat pathogens. If confirmed as food injury, use Liujunzi San plus Jiegeng, Cangzhu, and Huoxiang. If external pathogens are heavy and food stagnation is light, use Huoxiang Zhengqi San. If external pathogens are light and food stagnation is heavy, use Renshen Yangwei Tang. If caused by improper diet and overwork, use Buzhong Yiqi Tang. If qi and blood are deficient, use Shiquan Dabu Tang plus Paojiang. If there is deficiency-cold, use Liujunzi San plus Ganjiang and Rougui. If yuan qi collapses and sinks, Fuzi must be added urgently. Generally, chronic malaria belongs to deficiency-cold of yuan qi, because qi deficiency generates cold, blood deficiency generates heat, stomach deficiency causes aversion to cold, and downward flow of yin fire causes alternating chills and fever, or vomiting and diarrhea with anorexia, abdominal pain with irritability and thirst, fever with delirium, or cold extremities and shivering like a chestnut. Although various symptoms appear, one should vigorously tonify with warmth, and the disease will recede. If mistakenly using drugs for clearing spleen or cutting malaria, it often leads to death.
A postpartum woman suffered from malaria with fever and thirst, fullness in the chest and diaphragm, body-wide pain, no food intake for three days, sour regurgitation, and belching. This was food injury where the spleen and stomach could not digest. She was given Liujunzi San plus Shenqu and Shanzha. After four doses, the sourness ceased, so Shenqu and Shanzha were removed. After several more doses, her appetite returned. Another postpartum woman had constipation for thirty-five days, having consumed over seventy bowls of food, until her abdomen felt stifling. Pig bile enema was used to promote bowel movement, and the stool was not very dry. A postpartum woman suffered from prolonged malaria with myriad diseases arising. Her pulse was sometimes surging and large, sometimes faint and fine, sometimes string-taut and tight, sometimes deep and hidden, difficult to describe. She was treated with Liujunzi San plus Paojiang for over twenty doses, after which her pulse and symptoms improved slightly. Then, a paste made from Renshen and Baizhu was administered, assisted by Guipi Tang for over a hundred doses, leading to recovery. Another postpartum woman experienced morning chills and evening fevers, or intermittent chills and fever, persisting for a long time. She was treated with Liujunzi Zi Wan and Buzhong Yiqi Tang concurrently for over a hundred doses, leading to gradual recovery.
Caoguo Yinzi: Treats postpartum malaria in women with equal chills and fever, or those with predominant heat.
Banxia (soaked in boiling water) Chi Fuling Gancao (roasted) Caoguo (roasted and peeled) Chuanxiong Chenpi Baizhi (each 2 qian) Qingpi (peeled) Liangjiang Zisu (each 2.5 qian) Gange (4 qian)
All ingredients are chopped. Take 3 qian per dose, add one large cup of water, three slices of ginger, and two jujubes. Decoct to 70% volume, remove dregs. On the morning before the malaria attack, take three doses consecutively without fail.
Shengshu Yinzi: Treats postpartum malaria with predominant cold.
Roudoukou Caoguoren Houpo (raw, coarse bark removed) Banxia Chenpi Gancao Dazao (pitted) Shengjiang
The above eight herbs are finely chopped and mixed equally. Half are used raw, half are wrapped in wet cotton paper and baked until fragrant and cooked. Remove the paper and mix with the raw half. Weigh 5 qian per dose, add two cups of water, decoct to 70% volume. Take one dose before meals and one dose after meals.
[Supplement] For postpartum malaria with more heat than chills, use Qingpi Tang. For more chills than heat, use Yangwei Tang. For persistent cases, use Qibao Yin to cut the malaria. (Formulas are found in the section on miscellaneous diseases - malaria.)