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For women after childbirth, Yin blood is deficient, and Yang Qi has no foundation to rely on, causing it to float and scatter outward; therefore, fever often occurs. The treatment principle is to use Siwu Tang (Four Substances Decoction) to tonify Yin blood, and combine it with Zhi Ganjiang (Honey-fried Dried Ginger), which is bitter and warm, to treat in accordance with the disease's manifestation, consolidating the floating Yang Qi so that it returns to rely on Yin. However, postpartum Spleen and Stomach are weak, and many cases of fever arise from overeating leading to food stagnation; mistaking this for blood deficiency will result in ineffectiveness. Thus, when encountering postpartum fever, if symptoms such as chest and diaphragm fullness and oppression, belching, aversion to food, and diarrhea are present, treat it solely as food stagnation. If there is fever but digestion and appetite remain normal, then apply the standard method of tonifying blood.

My commentary: After recent childbirth, Yin blood is suddenly and severely injured, leaving Yang Qi without attachment, resulting in external heat. It is appropriate to use Siwu Tang combined with Pao Jiang (Baked Dried Ginger) to tonify Yin to harmonize with Yang. If external heat results from the mistaken administration of cold and purgative medicines, this indicates that Cold pathogen is isolating Yang Qi externally; it is appropriate to use Sijunzi Tang (Four Gentlemen Decoction) added with Sheng Jiang (Fresh Ginger) and Rougui (Cinnamon Bark). If ineffective, add Fuzi (Prepared Aconite Root) urgently. If skin feels hot, face and eyes appear red, accompanied by irritability, thirst, and desire to drink, this is restlessness due to blood loss and hair shedding; Danggui Buxue Tang (Danggui Tonifies Blood Decoction) should be used. If chest and diaphragm fullness, belching of rotten smells, aversion to food, acid regurgitation, vomiting, diarrhea, and fever occur, this is caused by food stagnation; Sijunzi Tang added with Houpo (Magnolia Bark) and Shanzha (Hawthorn Fruit) should be used. If chest and diaphragm fullness, reduced appetite, fever, or difficulty digesting food occur, this is due to Spleen Qi deficiency; Liujunzi Tang (Six Gentlemen Decoction) added with Pao Jiang should be used. If harsh and severe medicines are used, leading to abdominal pain, thirst with heat, alternating chills and fever, and vomiting, this indicates further injury to Middle Qi; urgently use Liujunzi Tang added with Pao Jiang. Mistaking this for a Heat syndrome and administering other cooling agents would be an error.

After the fever subsides following severe diseases such as Shanghan (Cold Damage) or Shiqi (Seasonal Epidemic Diseases), first administer one or two doses of Ginseng and sweet-warm herbs to support Yuan Qi (Original Qi), followed by Yin-nourishing, fluid-generating, and dryness-moistening herbs. This is because after severe illness, sweat is externally depleted, and water and grain essences are internally exhausted, inevitably leading to symptoms such as dark and scanty urination and constipation; one must understand this to prevent complications.

My commentary: After severe illness, grain is consumed, fluids are lost, essence scatters, and Wei Qi (Defensive Qi) perishes, often leading to dryness and depletion of bowel movements and urination. The key treatment should be Bu Zhong Yi Qi (Tonifying the Middle and Augmenting Qi). The Spleen resides in the Middle Jiao, acting as a hub to irrigate the four directions, and assists the Stomach in transporting and transforming Jin-Ye (Body Fluids). Moreover, the Large Intestine governs Jin (Thin Fluids), and the Small Intestine governs Ye (Turbid Fluids); both derive their Qi from the Stomach. Once Stomach Qi is replenished, body fluids will naturally generate and circulate. In cases of severe dryness, alternative methods using acrid-to-moisten and bitter-to-drain approaches should be employed.