产后发热多血伤，大法四物加炮姜。头疼恶寒外感热，四物柴胡葱白良。呕吐胀闷伤食气，异功
查曲浓朴姜。脾不化食六君子。瘀血腹痛生化汤，当归川芎丹参共，桃仁红花炮干姜。
【注】产后发热，多因阴血暴伤，阳无所附。大法宜四物汤加炮姜，从阴引阳为正治。
若头疼恶寒而发热者，属外感，不当作伤寒治，惟宜用四物加柴胡、葱白服之。若呕吐
胀闷，属伤食；若倦怠气乏者，属伤气，宜用异功散加山楂、神曲、浓朴、生姜治之。若
因脾虚不能化食而停食发热者，宜六君子汤。若因瘀血发热者，必兼腹痛，宜用生化汤，即
当归、川芎、丹参、桃仁、红花、姜炭也。
六君子汤 异功散 四物汤（方俱见首卷）
劳力发热用十全，气血两虚八珍痊，血脱躁热补血效，虚阳外越参附煎。
【注】产后发热，因产时用力劳乏者，宜十全大补汤；气血两虚者，八珍汤；去血过
多，血脱烦躁干渴，面赤而热者，宜当归补血汤。若阴血暴脱，孤阳无附而外越发热者，
急进参附汤。迟则必大汗大喘，是阳欲亡，虽药必无救矣！
十全大补汤 八珍汤 当归补血汤（方俱见首卷）
寒热往来递更换，乍寒乍热时热寒，寒热似疟按时发，壮热憎寒热畏寒。
【注】产后寒热，名既不同，其证亦异，当先明辨之。如曰寒热往来者，谓寒去热来，
热去寒来，递相更换也。曰乍寒乍热者，谓有时寒有时热，寒热无定时也。曰寒热似疟
者，谓或先寒后热，或先热后寒，一定不移，至其时而始作也。曰壮热憎寒者，谓其身既
壮热，而复时时畏寒也。
往来寒热阴阳格，时热时寒荣卫乖，寒热似疟瘀兼食，壮热憎寒带表推。
【注】产后血气虚损，阴阳不和，则寒热往来；阴阳相乘，荣卫不调，则时寒时热；败
血不散，饮食停滞，则寒热似疟；汗出遇风则壮热憎寒。有诸内，自形诸外，辨之既明，
然后治无不愈矣。
Postpartum fever is mostly due to Yin-blood injury; the general principle is Siwu Tang (Four Substances Decoction) with Paojiang (Charred Ginger). Headache and aversion to cold with external-fever are well treated by Siwu Tang plus Chaihu (Bupleuri Radix) and Congbai (Scallion White). Vomiting, distension, and fullness due to food stagnation and Qi constraint are treated with Yigong San (Six Gentlemen Decoction modified) plus Shanzha (Crataegi Fructus), Shenqu (Medicated Leaven), Houpo (Magnoliae Officinalis Cortex), and Jiangsheng (Fresh Ginger). Spleen failing to transform food requires Liujunzi Tang (Six Gentlemen Decoction). Blood stasis causing abdominal pain and fever is treated with Shenghua Tang (Decoction for Generating New Blood), composed of Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Danshen (Salviae Miltiorrhizae Radix et Rhizoma), Taoren (Persicae Semen), Honghua (Carthami Flos), and Paoganjiang (Charred Dried Ginger).
[Note] Postpartum fever is mostly caused by sudden loss of Yin-blood, leaving Yang without attachment. The general principle is to use Siwu Tang (Four Substances Decoction) with Paojiang (Charred Ginger), guiding Yang from Yin as the correct treatment. If headache, aversion to cold, and fever occur, it belongs to external contraction; it should not be treated as Shanghan (Cold Damage), but rather Siwu Tang (Four Substances Decoction) with Chaihu (Bupleuri Radix) and Congbai (Scallion White) should be taken. If vomiting and distension occur, it belongs to food injury; if fatigue and Qi deficiency occur, it belongs to Qi injury, and Yigong San (Six Gentlemen Decoction modified) with Shanzha (Crataegi Fructus), Shenqu (Medicated Leaven), Houpo (Magnoliae Officinalis Cortex), and Jiangsheng (Fresh Ginger) should be used. If food stagnation causes fever due to Spleen deficiency failing to transform food, Liujunzi Tang (Six Gentlemen Decoction) is appropriate. If blood stasis causes fever, it must be accompanied by abdominal pain, and Shenghua Tang (Decoction for Generating New Blood), consisting of Danggui (Angelicae Sinensis Radix), Chuanxiong (Ligustici Chuanxiong Rhizoma), Danshen (Salviae Miltiorrhizae Radix et Rhizoma), Taoren (Persicae Semen), Honghua (Carthami Flos), and Jiangtan (Charred Ginger/Paoganjiang), should be used.
Liujunzi Tang (Six Gentlemen Decoction), Yigong San (Six Gentlemen Decoction Modified), Siwu Tang (Four Substances Decoction) (Formulas are all in Volume 1).
Fever due to overexertion is treated with Shiquan Dabu Tang (Ten Great Tonifying Decoction); Qi and Blood dual deficiency is cured with Bazhen Tang (Eight Treasures Decoction); blood depletion causing restlessness and heat is effectively treated by nourishing blood; floating Yang escaping outward is treated with Shenfu Tang (Ginseng and Aconite Decoction).
[Note] Postpartum fever caused by exertion during childbirth should be treated with Shiquan Dabu Tang (Ten Great Tonifying Decoction); Qi and Blood dual deficiency should be treated with Bazhen Tang (Eight Treasures Decoction); excessive blood loss leading to blood depletion, irritability, dry mouth/thirst, red face, and fever should be treated with Danggui Buxue Tang (Danggui's Blood-Nourishing Decoction). If Yin-blood suddenly collapses, leaving solitary Yang unattached and floating outward causing fever, Shenfu Tang (Ginseng and Aconite Decoction) must be administered urgently. Delay will result in profuse sweating and severe panting, indicating impending Yang collapse; even with medication, rescue will be impossible!
Shiquan Dabu Tang (Ten Great Tonifying Decoction), Bazhen Tang (Eight Treasures Decoction), Danggui Buxue Tang (Danggui's Blood-Nourishing Decoction) (Formulas are all in Volume 1).
Alternating chills and fever change sequentially; sudden chills and sudden fever occur irregularly; chills and fever resemble malaria occurring at fixed times; high fever with aversion to cold.
[Note] Postpartum chills and fever have different names and distinct manifestations, which must be clearly distinguished first. "Alternating chills and fever" refers to chills subsiding while fever arises, and fever subsiding while chills arise, alternating sequentially. "Sudden chills and sudden fever" refers to having chills at some times and fever at others, with no fixed timing. "Chills and fever resembling malaria" refers to either chills preceding fever or fever preceding chills, with a fixed pattern that begins at specific times. "High fever with aversion to cold" refers to the body having high fever yet constantly feeling afraid of cold.
Alternating chills and fever indicate Yin-Yang repulsion; intermittent fever and chills indicate Ying-Wei disharmony; chills and fever resembling malaria indicate blood stasis combined with food retention; high fever with aversion to cold should be analyzed as an exterior syndrome.
[Note] Postpartum Qi and Blood deficiency and Yin-Yang disharmony lead to alternating chills and fever; mutual aggression of Yin and Yang and Ying-Wei disharmony lead to intermittent chills and fever; retained blood not dispersing and food stagnation lead to chills and fever resembling malaria; sweating followed by exposure to wind leads to high fever and aversion to cold. Internal conditions naturally manifest externally; once clearly differentiated, treatment will invariably succeed.