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29. The causes of postpartum fever are not limited to one aspect; they include internal injury from diet, external contraction of wind-cold, blood stasis, blood deficiency, and physical exertion. Even the "steaming breast" (physiological fever caused by milk secretion) occurring on the third day is a natural phenomenon. When dealing with Yin deficiency or blood loss leading to the dispersion of Yang Qi outward, one must carefully consider whether to use attacking or tonifying methods, and warming or cooling therapies.

[Note] The reasons for postpartum fever are not singular. For instance, if there is excessive intake of food and drink, accompanied by chest fullness, vomiting, and anorexia, it is classified as fever due to food stagnation. If laboring early in the morning leads to contraction of wind-cold, it is classified as fever due to external contraction. If lochia does not discharge properly and blood stasis remains stagnant, it is classified as fever due to blood stasis. If excessive blood loss results in insufficient Yin-blood, it is classified as fever due to blood deficiency. There are also cases of fever due to fatigue from excessive effort during childbirth, and fever due to steaming breast after three days. One must meticulously distinguish between excess (repletion) and deficiency syndromes, deciding whether to employ purgative/attacking methods, tonifying methods, cold-cooling drugs for direct treatment, or warm-heating drugs for counter-treatment. The key lies in careful clinical differentiation.

Jiawei Siwu Tang (Modified Siwu Decoction), Jiawei Yigong San (Modified Yigong Powder), Shenghua Tang (Shenghua Decoction).

30. Postpartum fever often stems from severe injury to Yin-blood due to hemorrhage. The general principle is to use Siwu Tang (Four Substances Decoction) with Pao Jiang (Charred Ginger). For exterior-contraction fever presenting with headache, aversion to cold, and fever, Siwu Tang combined with Chai Hu (Bupleuri Radix) and Cong Bai (Scallion White) is effective. For vomiting, abdominal distension, and stuffiness caused by food stagnation affecting Qi, Yigong San (Yigong Powder) with Shan Zha (Crataegi Fructus), Shen Qu (Massa Medicata Fermentata), Hou Po (Magnoliae Officinalis Cortex), and Sheng Jiang (Fresh Ginger) should be used. For fever caused by food retention due to Spleen deficiency failing to transform food, Liujunzi Tang (Six Gentlemen Decoction) is indicated. For fever caused by blood stasis accompanied by abdominal pain, Shenghua Tang is indicated, composed of Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma), Tao Ren (Persicae Semen), Hong Hua (Carthami Flos), and Pao Gan Jiang (Charred Dried Ginger).

[Note] Postpartum fever is mostly due to sudden damage to Yin-blood, leaving Yang Qi without attachment. The general principle favors Siwu Tang (Four Substances Decoction) added with Pao Jiang (Charred Ginger), drawing Yang back from Yin as the correct treatment. If headache, aversion to cold, and fever occur, it belongs to exterior contraction and should not be treated as Shanghan (Cold Damage); instead, Siwu Tang (Four Substances Decoction) with Chai Hu (Bupleuri Radix) and Cong Bai (Scallion White) is appropriate. If vomiting, distension, and stuffiness occur, it belongs to food stagnation. If fatigue and Qi deficiency occur, it belongs to Qi injury, and Yigong San (Yigong Powder) with Shan Zha (Crataegi Fructus), Shen Qu (Massa Medicata Fermentata), Hou Po (Magnoliae Officinalis Cortex), and Sheng Jiang (Fresh Ginger) is suitable. If food retention and fever result from Spleen deficiency failing to digest food, Liujunzi Tang (Six Gentlemen Decoction) is indicated. If fever is caused by blood stasis, it must be accompanied by abdominal pain, and Shenghua Tang (Shenghua Decoction) is indicated, consisting of Dang Gui (Angelicae Sinensis Radix), Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dan Shen (Salviae Miltiorrhizae Radix et Rhizoma), Tao Ren (Persicae Semen), Hong Hua (Carthami Flos), and Jiang Tan (Charred Ginger).

Liujunzi Tang (Six Gentlemen Decoction), Yigong San (Yigong Powder), Siwu Tang (Four Substances Decoction) formulas are all found in the first volume.

Shiquan Dabu Tang (Ten Complete Tonic Decoction), Bazhen Tang (Eight Treasures Decoction), Danggui Buxue Tang (Danggui Blood-Nourishing Decoction), Shenfu Jian (Ginseng and Aconite Decoction).

31. For fever caused by physical exertion, Shiquan Dabu Tang (Ten Complete Tonic Decoction) should be used. For dual deficiency of Qi and Blood, Bazhen Tang (Eight Treasures Decoction) cures. For restlessness and heat due to blood loss, Danggui Buxue Tang (Danggui Blood-Nourishing Decoction) is effective. For fever due to floating Yang from deficiency, Shenfu Jian (Ginseng and Aconite Decoction) is used.

[Note] Postpartum fever caused by excessive effort and fatigue during childbirth is treated with Shiquan Dabu Tang (Ten Complete Tonic Decoction). For dual deficiency of Qi and Blood, Bazhen Tang (Eight Treasures Decoction) is used. For excessive blood loss leading to blood collapse, characterized by irritability, dry mouth/thirst, flushed face, and fever, Danggui Buxue Tang (Danggui Blood-Nourishing Decoction) is indicated. If Yin-blood suddenly collapses, causing isolated Yang to have no attachment and float outward resulting in fever, Shenfu Tang (Ginseng and Aconite Decoction) must be administered urgently. Delay will inevitably lead to profuse sweating and severe panting, indicating impending Yang collapse; even then, medication may be futile!

Shiquan Dabu Tang (Ten Complete Tonic Decoction), Bazhen Tang (Eight Treasures Decoction), Danggui Buxue Tang (Danggui Blood-Nourishing Decoction) formulas are all found in the first volume.