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Within seven days after childbirth, if fever, headache, and aversion to cold occur, do not exclusively diagnose it as the Taiyang syndrome (Taiyang disease) of Shanghan (Cold Damage); if fever, headache, and hypochondriac pain occur, do not exclusively diagnose it as the Shaoyang syndrome (Shaoyang disease) of Shanghan. Both conditions arise from deficiency of both Qi and Blood, and disharmony of Yin and Yang, presenting similarly to external contraction. Practitioners must not lightly dismiss postpartum fever and use Mahuang Tang (Ephedra Decoction) to treat the Taiyang-like syndrome; nor should they use Chaihu Tang (Bupleurum Decoction) to treat the Shaoyang-like syndrome. Moreover, after a puerpera has lost blood, inducing sweating again would lead to the disaster of exacerbating deficiency; how could such consequences be fully described? In the past, Zhang Zhongjing stated: "Those who have lost blood should not be induced to sweat." Zhu Danxi stated: "Postpartum patients must absolutely not be treated with exterior-releasing methods." These two masters did not mean that postpartum cases truly lack concurrent Shanghan symptoms, nor did they imply that Mahuang Tang or Chaihu Tang are never appropriate for specific indications; rather, they feared that junior practitioners might have biased learning, underestimate postpartum conditions, and rigidly apply established formulas to release the exterior. Who would know that if a postpartum patient truly contracts wind or cold, adding Xiong (Ligusticum Chuanxiong Rhizome) and Jiang (Zingiberis Rhizoma Recens, Fresh Ginger) to Shenghua Tang can also disperse them!

Jiawei Shenghua Tang (Modified Shenghua Decoction): Treats fever and headache within three days after childbirth.
Ingredients: Chuanxiong Rhizome (Chuanxiong), Saposhnikovia Root (Fangfeng) (each 1 qian), Angelica Sinensis Root (Danggui) (3 qian), Honey-fried Licorice Root (Zhigancao) (4 fen), Peach Kernel (Taoren) (10 grains), Notopterygium Rhizome (Qianghuo) (4 fen).
Marginal note: Another version lacks Taoren but includes 4 fen of Charred Ginger (Heijiang).
The printed edition removes Taoren. However, one must inquire whether there is pain due to clots before considering removing Taoren. After taking two doses, if headache persists and body heat remains, add Baizhi (Angelicae Dahuricae Radix) 8 fen and Xixin (Asari Radix et Rhizoma) 4 fen; if fever does not subside and headache remains unchanged, add five scallions with roots (Congbai) and 3 qian of Ginseng Root (Renshen). Stagnation of lochia (bad blood) after childbirth can also cause chills and fever. How to differentiate? Answer: If there are paroxysmal stabbing pains, it is due to stagnated blood; if there are only chills and fever without other symptoms, it is due to disharmony of Yin and Yang. For stabbing pain, Danggui is used as a herb to harmonize blood; if the stabbing pain is caused by accumulated blood, herbs such as Honghua (Carthami Flos), Taoren, and Guibei (the tail end of Danggui root) should be used.

Rhyme prescription:
During the sixth or seventh day postpartum,
Fever, chills, and headache appear too.
Qi and Blood deficient, Yin and Yang clash,
Resembling exterior pathogen, yet surface treatment fails.
Use Fangfeng in Modified Shenghua Tang,
With Zhigancao, Qianghuo, Taoren, Danggui, and Chuanxiong.
After two doses, if headache and heat persist,
Add Baizhi, Xixin, and Congbai to resist.