产后发热，有风寒外感而热者；有邪火内盛而热者；有水亏阴虚而热者；有因产劳倦，虚烦而热者；有
去血过多，头晕闷乱烦热者。诸证不同，治当辨察。
产后有外感发热者，盖临盆之际，多有露体用力，无暇他顾，此时或遇寒邪，则乘虚而入，感之最易。若
见头疼身痛，憎寒发热，或腰背拘急，脉见紧数，即产后外感证也。然此等外感，不过随感随病，自与正伤寒
宿感者不同，故略加解散，即自痊。可勿谓新产之后，不宜表散。但当酌其虚实而用得其宜耳。凡产后感
邪气，不甚虚者，宜三柴胡饮；若气虚脾弱而感者，宜四柴胡、五柴胡饮。若肝脾肾三阴不足而感者，宜补
阴益气煎；若虚寒之甚者，宜理阴煎。若产妇强壮，气实而感者，宜正柴胡饮。若兼内火盛而外邪不解者，
宜一柴胡饮。若风寒俱感，表里俱滞者，宜五积散。
三柴胡饮（见热入血室）
四柴胡饮（见热入血室）
五柴胡饮（见《新方八阵·散阵》）五为土数，从脾胃也。脾土为五脏之本，凡中气不足而外邪
有不散者，非此不可。此与四柴胡饮相表里，但四柴胡饮止调气分，此则兼培血气，以逐寒邪，尤切于
时用者也，神效不可尽述。凡伤寒、疟疾、痘疮，皆所宜用。
柴胡（一至三钱） 当归（二、三钱） 熟地（三、五钱） 白术（二、三钱
芍药（钱半炒用） 炙甘草（一钱） 陈皮（酌用或不必用）
水一钟半，煎七分，食远热服。寒胜无火者，减芍药加生姜三、五、七片或干姜一、二钱，或再加桂枝
一、二钱，则更妙。脾滞者，减白术。气虚者，加人参随宜。腰痛者，加杜仲。头痛者，加川芎。劳倦伤脾阳
虚者，加升麻一钱。
补阴益气煎（见热入血室）
理阴煎（见血寒经迟）
正柴胡饮（见《新方八阵·散阵》）凡外感风寒，发热恶寒，头疼身痛， 疟初起等证。凡血
气平和，宜从平散者，此方主之。
柴胡（一至三钱） 防风（一钱） 陈皮（一钱半） 芍药（二钱） 甘草（一钱） 生姜（三五片）
水一钟半，煎七八分，热服。如头痛者，加川芎一钱。如热而兼渴者，加葛根一、二钱。如呕恶者，加半
夏一钱五分。如湿胜者，加苍术一钱。如胸腹有微滞者，加浓朴一钱。如寒气胜而邪不易解者，加麻黄一、
二、三钱，去浮沫服之，或苏叶亦可。
一柴胡饮（见热入血室）
五积散（见产后腹痛）
产后有火证发热者，但外感之热多在表，火证之热
多在里。此必以调摄太过，或时令热甚，或强以酒，或误用参、术、姜、桂大补之药，或过用炭火，或窗牖
太密，人气太盛，或气体本实而过于动作。凡属太过者，皆能生火。火盛于内，多见潮热、内热，烦渴喜冷，
或头痛多汗，便实尿赤，及血热妄行。但无表证，脉见缓滑不紧而发热者，便是火证。宜清化饮、保阴煎之类
主之。若本元不虚，或火之甚而势之急者，即徙薪饮、抽薪饮亦所常用，不必疑也。
清化饮（见血热经早）
保阴煎（见血热经早）
徙薪饮（见崩淋经漏不止）
抽薪饮（见血热经早）
产后有阴虚发热者，必素禀脾肾不足，及产后气血俱虚，故多有之。其证则倏忽往来，时作时止，或昼或
夜，进退不常，或精神困倦，怔忡恍惚，但察其外无表证而脉见弦数，或浮弦豁大，或微细无力，其来也渐，
非若他证之暴至者，是即阴虚之候。治当专补真阴，宜小营煎、三阴煎、五阴煎之类，随宜主之。
小营煎（见血虚经乱）
三阴煎（见血虚经乱）
五阴煎（见血虚经乱）
若阴虚兼火而微热者，宜一阴煎。若阴虚兼火之甚而大热者，宜加减一阴煎。若阴虚火盛，热而多汗者，
宜当归六黄汤。若阴中之阳虚，火不归源而热者，宜大营煎、理阴煎、右归饮之类主之。若血虚阳不附阴，烦热
作渴者，宜人参当归汤。若气血俱虚，发热烦躁，面赤作渴，宜八珍汤、十全大补汤。若热甚而脉微者，宜急加桂、
附，或以为火，则祸在反掌。
一阴煎（见血虚经乱）
加减一阴煎（见血热经迟）
当归六黄汤（见热入血室）
大营煎（见血热经早）
理阴煎（见血寒经迟）
右归饮（见肾虚经乱）
人参当归汤（见《妇人规古方》）治去血过多，内热短气，头痛闷乱，骨节作痛，或虚烦咽燥。
人参 当归 生地 桂心 麦冬 白芍药（各等分）
上用粳米一合，竹叶十片，水二钟，煎一钟，去米，入药五钱，枣二枚，煎服。或总煎之亦可，虚甚者，
用熟地黄。
八珍汤（见经不调）
十全大补汤（见调经论外备用方）
产后有去血过多发热者，其证必烦渴短气，头痛头晕，闷乱内热，是亦阴虚之属，宜人参当归汤主之。
立斋曰∶大凡元气虚弱而发热者，皆内真寒而外假热也。但用六君或补中益气加炮姜温补脾气，诸证自
退。若四肢畏冷，急加附子。“凡新产阴血暴伤，阳无所附而外热，宜用四物炮姜，补阴以配阳；若因误服寒
凉克伐之剂而外热，此为寒气格阳于外，宜用四君子加姜、桂；如不应，急加附子；若或肌肤发热，面目赤色，
烦渴引饮，此血脱发躁。宜用当归补血汤。”
六君子汤（见经期腹痛）
补中益气汤（见经不调）
当归补血汤（见崩淋经漏不止）
Postpartum fever may arise from external contraction of wind-cold; from internal excess of pathogenic fire; from deficiency of water and yin; from fatigue and exertion during childbirth leading to deficiency vexation; or from excessive blood loss causing dizziness, oppression, restlessness, and heat. These syndromes differ, and treatment must be differentiated and examined carefully.
In postpartum cases with external contraction fever, it is often because during labor, the body is exposed and effort is exerted, leaving no time for other precautions. At this time, if cold pathogen is encountered, it enters through the deficiency, making infection very easy. If headache and body pain, aversion to cold with fever, or stiffness and tension in the waist and back are seen, and the pulse is tight and rapid, this is a postpartum external contraction syndrome. However, such external contractions occur immediately upon exposure and differ naturally from true Shanghan (Cold Damage) with lingering pathogens. Therefore, slight dispersing measures will lead to self-recovery. One should not assume that after recent childbirth, exterior-dispersing methods are contraindicated. One only needs to assess deficiency and excess and apply appropriate treatment. For postpartum patients contracting pathogens who are not significantly deficient, San Chai Hu Yin (Three Bupleurum Decoction) is suitable. For those with Qi deficiency and weak Spleen contracting pathogens, Si Chai Hu Yin (Four Bupleurum Decoction) or Wu Chai Hu Yin (Five Bupleurum Decoction) are suitable. For those with insufficiency of Liver, Spleen, and Kidney Yin contracting pathogens, Bu Yin Yi Qi Jian (Decoction to Tonify Yin and Boost Qi) is suitable. For severe deficiency-cold, Li Yin Jian (Decoction to Regulate Yin) is suitable. For robust postpartum women with excess Qi contracting pathogens, Zheng Chai Hu Yin (Standard Bupleurum Decoction) is suitable. For those with internal fire excess and unresolved exterior pathogens, Yi Chai Hu Yin (One Bupleurum Decoction) is suitable. For simultaneous contraction of wind-cold with stagnation in both interior and exterior, Wu Ji San (Five Accumulations Powder) is suitable.
San Chai Hu Yin (See Re Ru Xue Shi / Heat Entering the Blood Chamber)
Si Chai Hu Yin (See Re Ru Xue Shi / Heat Entering the Blood Chamber)
Wu Chai Hu Yin (See Xin Fang Ba Zhen · San Zhen / New Formulas Eight Arrays · Dispersing Array). Five is the number of Earth, relating to the Spleen and Stomach. Spleen Earth is the root of the five Zang organs. For cases where Middle Qi is insufficient and exterior pathogens do not disperse, this formula is indispensable. It is exterior-interior related to Si Chai Hu Yin, but while Si Chai Hu Yin only regulates the Qi aspect, this formula also nourishes Blood and Qi to drive out cold pathogens, fitting current times particularly well. Its miraculous effects cannot be fully described. It is suitable for Shanghan (Cold Damage), Malaria, and Smallpox.
Chai Hu (Bupleuri Radix) (1-3 qian) Dang Gui (Angelicae Sinensis Radix) (2-3 qian) Shu Di Huang (Prepared Rehmanniae Radix) (3-5 qian) Bai Zhu (Atractylodis Macrocephalae Rhizoma) (2-3 qian) Shao Yao (Paeoniae Radix Alba) (1.5 qian, stir-fried) Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma) (1 qian) Chen Pi (Citri Reticulatae Pericarpium) (use as needed or omit)
Boil with 1.5 zhong of water until reduced to 0.7 zhong. Take hot on an empty stomach, some time after meals. If cold predominates without fire, reduce Shao Yao and add 3, 5, or 7 slices of Sheng Jiang (Zingiberis Rhizoma Recens) or 1-2 qian of Gan Jiang (Zingiberis Rhizoma), or add 1-2 qian of Gui Zhi (Cinnamomi Ramulus) for better effect. For Spleen stagnation, reduce Bai Zhu. For Qi deficiency, add Ren Shen (Ginseng Radix et Rhizoma) as appropriate. For lower back pain, add Du Zhong (Eucommiae Cortex). For headache, add Chuan Xiong (Ligustici Chuanxiong Rhizoma). For spleen Yang deficiency due to fatigue and overexertion, add Sheng Ma (Cimicifugae Rhizoma) 1 qian.
Bu Yin Yi Qi Jian (See Re Ru Xue Shi / Heat Entering the Blood Chamber)
Li Yin Jian (See Xue Han Jing Chi / Cold-Blood Delayed Menstruation)
Zheng Chai Hu Yin (See Xin Fang Ba Zhen · San Zhen / New Formulas Eight Arrays · Dispersing Array). Suitable for external contraction of wind-cold with fever and aversion to cold, headache and body pain, early stage of malaria, etc. For cases where Blood and Qi are balanced and mild dispersing is indicated, this formula is primary.
Chai Hu (Bupleuri Radix) (1-3 qian) Fang Feng (Saposhnikoviae Radix) (1 qian) Chen Pi (Citri Reticulatae Pericarpium) (1.5 qian) Shao Yao (Paeoniae Radix Alba) (2 qian) Gan Cao (Glycyrrhizae Radix et Rhizoma) (1 qian) Sheng Jiang (Zingiberis Rhizoma Recens) (3-5 slices)
Boil with 1.5 zhong of water until reduced to 0.7-0.8 zhong. Take hot. For headache, add Chuan Xiong (Ligustici Chuanxiong Rhizoma) 1 qian. For heat with thirst, add Ge Gen (Puerariae Lobatae Radix) 1-2 qian. For nausea and vomiting, add Ban Xia (Pinelliae Tuber) 1.5 qian. For dampness predominance, add Cang Zhu (Atractylodis Rhizoma) 1 qian. For slight stagnation in chest and abdomen, add Hou Po (Magnoliae Officinalis Cortex) 1 qian. If cold is strong and pathogens difficult to resolve, add Ma Huang (Ephedrae Herba) 1-3 qian, remove foam before taking, or Su Ye (Perillae Folium) may be used.
Yi Chai Hu Yin (See Re Ru Xue Shi / Heat Entering the Blood Chamber)
Wu Ji San (See Chan Hou Fu Tong / Postpartum Abdominal Pain)
For postpartum fire-syndrome fever, external contraction heat is mostly at the exterior, while fire-syndrome heat is mostly at the interior. This is necessarily due to excessive care/regulation, extreme seasonal heat, forced alcohol consumption, misuse of major tonics like Ren Shen (Ginseng Radix et Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Sheng Jiang (Zingiberis Rhizoma Recens), Rou Gui (Cinnamomi Cortex), excessive use of charcoal fires, too-tight windows and doors causing stagnant air, or constitutionally robust individuals engaging in excessive activity. All such excesses can generate fire. Fire excess internally manifests as tidal fever, internal heat, vexation and thirst preferring cold, or headache with profuse sweating, constipation, dark urine, and reckless bleeding due to blood heat. As long as there are no exterior signs, and the pulse is slow, slippery, not tight, yet fever persists, it is a fire syndrome. Qing Hua Yin (Clearing and Transforming Decoction) or Bao Yin Jian (Preserving Yin Decoction) are suitable. If the root Yuan Qi is not deficient, or if fire is very strong and the condition urgent, Xi Xin Yin (Removing Firewood Decoction) or Chou Xin Yin (Drawing Out Firewood Decoction) are commonly used, without hesitation.
Qing Hua Yin (See Xue Re Jing Zao / Blood-Heat Early Menstruation)
Bao Yin Jian (See Xue Re Jing Zao / Blood-Heat Early Menstruation)
Xi Xin Yin (See Beng Lin Jing Lou Bu Zhi / Metrorrhagia and Leukorrhea with Non-stop Bleeding)
Chou Xin Yin (See Xue Re Jing Zao / Blood-Heat Early Menstruation)
Postpartum yin-deficiency fever occurs necessarily in those with innate Spleen and Kidney insufficiency, and postpartum dual deficiency of Qi and Blood. The symptoms come and go suddenly, starting and stopping intermittently, day or night, irregular in progression. There may be mental fatigue, palpitations, and trance-like states. Observing no exterior signs, but seeing a string-taut and rapid pulse, or floating-string-taut and hollow-large pulse, or faint, thin, and powerless pulse, which arises gradually rather than abruptly like other syndromes, indicates yin deficiency. Treatment should focus on tonifying True Yin. Xiao Ying Jian (Small Nourishing Decoction), San Yin Jian (Three Yin Decoction), or Wu Yin Jian (Five Yin Decoction) are suitable according to circumstances.
Xiao Ying Jian (See Xue Xu Jing Luan / Blood-Deficiency Menstrual Disorder)
San Yin Jian (See Xue Xu Jing Luan / Blood-Deficiency Menstrual Disorder)
Wu Yin Jian (See Xue Xu Jing Luan / Blood-Deficiency Menstrual Disorder)
For yin deficiency with accompanying fire and slight heat, Yi Yin Jian (One Yin Decoction) is suitable. For yin deficiency with severe fire and high heat, Jia Jian Yi Yin Jian (Modified One Yin Decoction) is suitable. For yin deficiency with fire excess, heat, and profuse sweating, Dang Gui Liu Huang Tang (Dang Gui Six-Huang Decoction) is suitable. For deficiency of Yang within Yin, with fire failing to return to its source causing heat, Da Ying Jian (Great Nourishing Decoction), Li Yin Jian (Decoction to Regulate Yin), or You Gui Yin (Right-Restoring Decoction) are suitable. For blood deficiency with Yang unable to attach to Yin, causing vexation, heat, and thirst, Ren Shen Dang Gui Tang (Ren Shen and Dang Gui Decoction) is suitable. For dual deficiency of Qi and Blood, with fever, irritability, red face, and thirst, Ba Zhen Tang (Eight-Treasure Decoction) or Shi Quan Da Bu Tang (Ten Complete Great Tonifying Decoction) are suitable. If heat is severe but the pulse is faint, Guizhi (Cinnamomi Ramulus) and Fuzi (Aconiti Lateralis Radix Praeparata) should be added urgently; mistaking this for fire syndrome would bring disaster instantly.
Yi Yin Jian (See Xue Xu Jing Luan / Blood-Deficiency Menstrual Disorder)
Jia Jian Yi Yin Jian (See Xue Re Jing Chi / Blood-Heat Delayed Menstruation)
Dang Gui Liu Huang Tang (See Re Ru Xue Shi / Heat Entering the Blood Chamber)
Da Ying Jian (See Xue Re Jing Zao / Blood-Heat Early Menstruation)
Li Yin Jian (See Xue Han Jing Chi / Cold-Blood Delayed Menstruation)
You Gui Yin (See Shen Xu Jing Luan / Kidney-Deficiency Menstrual Disorder)
Ren Shen Dang Gui Tang (See Fu Ren Gui Ancient Formulas). Treats excessive blood loss, internal heat, shortness of breath, headache, oppression, bone-joint pain, or deficiency vexation and dry throat.
Ren Shen (Ginseng Radix et Rhizoma) Dang Gui (Angelicae Sinensis Radix) Sheng Di Huang (Rehmanniae Radix) Gui Xin (Cinnamomi Cortex) Mai Dong (Ophiopogonis Tuber) Bai Shao Yao (Paeoniae Radix Alba) (equal parts)
Take 1 he of Jing Mi (Oryza Sativa Germen), 10 leaves of Zhu Ye (Bambusae Folium), and 2 zhong of water. Boil to 1 zhong, remove rice grains, add 5 qian of the herbal mixture and 2 dates, then decoct and take. Alternatively, decoct all together. For severe deficiency, use Shu Di Huang (Prepared Rehmanniae Radix).
Ba Zhen Tang (See Jing Bu Diao / Irregular Menstruation)
Shi Quan Da Bu Tang (See Tiao Jing Lun Wai Bei Yong Fang / Supplementary Formulas for Regulation of Menstruation Discussion)
For postpartum fever due to excessive blood loss, symptoms include vexation, thirst, shortness of breath, headache, dizziness, oppression, and internal heat. This belongs to yin deficiency and is treated primarily with Ren Shen Dang Gui Tang (Ren Shen and Dang Gui Decoction).
Xue Lizhai stated: Generally, fever arising from weak Yuan Qi is true cold inside and false heat outside. Using Liu Jun Zi Tang (Six-Gentlemen Decoction) or Bu Zhong Yi Qi Tang (Tonify the Middle and Boost Qi Decoction) with Pao Jiang (Prepared Zingiberis Rhizoma) to warm and tonify Spleen Qi will cause symptoms to recede. If limbs are cold, add Fuzi (Aconiti Lateralis Radix Praeparata) urgently. "For new childbirth with sudden injury to Yin Blood, where Yang has no attachment causing exterior heat, Si Wu Tang (Four-Substance Decoction) with Pao Jiang (Prepared Zingiberis Rhizoma) is suitable to tonify Yin to match Yang. If exterior heat results from misusing cold-cooling and attacking agents, this is cold qi repelling Yang to the exterior; Si Jun Zi Tang (Four-Gentlemen Decoction) with Jiang (Ginger) and Gui (Cinnamon) is suitable. If ineffective, add Fuzi (Aconiti Lateralis Radix Praeparata) urgently. If skin and muscles are hot, face and eyes are red, with vexation, thirst, and desire to drink, this is blood loss causing hair-raising agitation. Dang Gui Bu Xue Tang (Dang Gui Tonify Blood Decoction) is suitable."
Liu Jun Zi Tang (See Jing Qi Fu Tong / Menstrual Abdominal Pain)
Bu Zhong Yi Qi Tang (See Jing Bu Diao / Irregular Menstruation)
Dang Gui Bu Xue Tang (See Beng Lin Jing Lou Bu Zhi / Metrorrhagia and Leukorrhea with Non-stop Bleeding)