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Cold damage (Shanghan) occurring postpartum should not be treated with diaphoresis (sweating therapy) lightly. Fever during childbirth may result from excessive exertion, excessive blood loss, retention of lochia (postpartum uterine discharge), engorgement of milk after three days, early labor, or food stagnation. These conditions resemble cold damage; careful differentiation is essential. One must never rashly induce sweating, as the consequences are irreversible like spilled water. Postpartum, the great blood is empty. Heavy sweating may lead to collapse of Yang (collapse of vital energy); light sweating may cause twitching of sinews and muscles, or depression, dizziness, coma, convulsions, difficulty in urination, and constipation, leading to myriad complications. Fever is mostly due to blood deficiency, where Yang has no foundation and floats outward, manifesting as heat. The appropriate formula is Siwu Tang (Four Substances Decoction) as the sovereign drug, removing Chuanxiong Rhizoma (Chuanxiong) and Rehmanniae Radix Recens (Shengdi), replacing them with Rehmanniae Radix Praeparata (Shudi), and adding soft-stemmed Bupleuri Radix (Chaihu), Ginseng Radix et Rhizoma (Renshen), and Zingiberis Rhizoma Praeparatum (Paojiang). This is most effective. Paojiang is acrid, hot, and possesses bitter and salty properties. It treats fire with fire, consolidating floating heat. It also guides blood-invigorating herbs into the blood level and qi-regulating herbs into the qi level. Furthermore, it removes stasis and generates new blood, following the principle of "Yang generating Yin." Treating heat with heat aligns deeply with the teachings of the *Neijing* (Inner Canon). When righteous Qi is strengthened, external pathogens dissipate naturally.

Yang Gui stated: If there were originally Yin deficiency with fire symptoms before pregnancy, and postpartum excessive blood loss occurs, symptoms such as high fever, irritability, and sweating will inevitably appear. If one follows the previous method of heavily tonifying Qi and Blood, the condition will worsen. Instead, Xiaoyao San (Free and Easy Wanderer Powder) should be used to clear Liver Fire and nourish Liver Blood. Due to excessive blood loss, Liver deficiency and dryness of Blood occur. One should not rigidly adhere to the theory of dual deficiency of Qi and Blood. This argument is based on fever caused by Yin deficiency, and pulse diagnosis should be consulted for detailed analysis.

Xue Lizhai stated: In newly delivered women, sudden loss of Yin Blood leaves Yang without attachment, resulting in exterior heat. Siwu Tang (Four Substances Decoction) added with Paojiang (Prepared Ginger Rhizome) is suitable to nourish Yin to harmonize with Yang. If cold and purgative medicines are mistakenly taken, resulting in exterior heat, this indicates Cold rejecting Yang to the exterior. Sijunzi Tang (Four Gentlemen Decoction) added with Shengjiang (Fresh Ginger) and Rougui (Cinnamon Bark) is suitable. If there is no response, Fuzi (Aconite Lateralis Radix Praeparata) should be added urgently. If skin feels hot, face is red, and there is extreme thirst with desire to drink, this indicates blood depletion causing dryness. Danggui Buxue Tang (Tangui Tonify the Blood Decoction) is indicated. He further stated: Postpartum vexatious heat is due to Yang scattering with Yin, resulting in dual deficiency of Qi and Blood, hence aversion to cold and fever. If mistakenly treated as a Fire syndrome and administered cooling agents, disaster will ensue instantly.