产后有火证发热者，但外感之热多在表，而火证之热多在里，此由调摄太过。或时令热甚，或强饮酒，或误
服参术姜桂，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。若元气不虚，或火之甚而势之急者，宜抽薪饮、
徙薪饮。
清化饮
白芍 麦冬（去心，各二钱） 丹皮 茯苓 黄芩 生地黄（各二三钱） 石斛（一钱）
水煎，温服。
骨蒸多汗加地骨皮一钱五分；热甚而渴，或头痛加石膏一钱；下热便涩加木通一钱，或加黄柏、栀子；如
兼外邪发热加柴胡一钱。
保阴煎
生地黄 熟地黄 白芍（各二钱） 山药 川续断 黄芩 黄柏（各一钱五分） 甘草（一钱）
水煎温服。
小水多热或兼怒火动血，加山栀仁（炒）一钱；夜热身热，加地骨皮一钱五分，肺热多汗，加麦冬（去心）、
枣仁；血热甚者，加黄连一钱；血虚血滞，筋骨肿痛，加当归二钱；肢节筋骨疼痛，或肿者，加秦艽、丹皮各一钱。
抽薪饮
黄芩 石斛 木通 栀子（炒） 黄柏（各一钱） 枳壳（麸炒） 泽泻（各一钱五分） 甘草（三分细末）
水煎温服。内热甚者，冷服更佳。
热在经络肌肤者，加连翘、天花粉以解之。热在血分小肠者，加槐蕊、黄连以清之。热在阳明头面或躁烦
便实者，加石膏以降之。热在下焦小水痛涩者，加车前草、龙胆以利之。热在阴分津液不足者，加麦冬、生地黄、白芍
以滋之。
热在肠胃实结者，加大黄，芒硝以通之。
徙薪饮
陈皮（八分） 黄芩（二钱） 麦冬（去心） 白芍 黄柏 茯苓 丹皮（各一钱五分）
水煎，温服。
多郁气逆伤，肝胁痛或动血，加栀子、青皮。
Postpartum fever caused by Fire Syndrome differs from exogenous heat, which typically remains at the exterior level. Heat from Fire Syndrome is mostly internal, often resulting from excessive care or regulation. This may be due to severe seasonal heat, forced alcohol consumption, misadministration of warming tonics such as Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Shengjiang (Zingiberis Rhizoma Recens), and Rougui (Cinnamomi Cortex), excessive use of charcoal fires, overly sealed windows and doors leading to stagnant air, or excessive physical activity in women with originally robust constitutions. Any form of excess can generate Fire. When Fire flares up internally, symptoms often include tidal fever, internal heat, irritability, thirst, preference for cold drinks, headache, hyperhidrosis, constipation, dark urine, and bleeding due to Blood-Heat recklessness (blood flowing out of vessels due to heat forcing it to move erratically), without exterior signs. If the pulse is slow, slippery, and not tight, accompanied by fever, it indicates Fire Syndrome. The appropriate formulas are Qinghua Yin (Clearing and Transforming Decoction) and Bao Yin Jian (Nourishing Yin Decoction). If the Yuan Qi (Primal Qi) is not deficient, or if the Fire is extremely severe and the condition acute, Chouxin Yin (Drawing Out the Firewood Decoction) and Xixin Yin (Removing the Firewood Decoction) are suitable.
Qinghua Yin (Clearing and Transforming Decoction)
Ingredients: Baishao (Paeoniae Radix Alba), Maidong (Ophiopogonis Radix, heart removed, each 2 qian), Danpi (Moutan Cortex), Fuling (Poria), Huangqin (Scutellariae Radix), Shengdihuang (Rehmanniae Radix, each 2-3 qian), Shihu (Dendrobii Caulis, 1 qian).
Preparation: Decoct in water, take warm.
Modifications: For bone-steaming fever with hyperhidrosis, add Gubupi (Cortex Lycii) 1.5 qian; for severe heat with thirst or headache, add Shigao (Gypsum Fibrosum) 1 qian; for lower-jiao heat with dysuria, add Mutong (Akebiae Caulis) 1 qian, or add Huangbai (Phellodendri Cortex) and Zhizi (Gardeniae Fructus); if complicated by exogenous pathogenic fever, add Chaihu (Bupleuri Radix) 1 qian.
Bao Yin Jian (Nourishing Yin Decoction)
Ingredients: Shengdihuang (Rehmanniae Radix), Shudihuang (Rehmanniae Radix Preparata), Baishao (Paeoniae Radix Alba, each 2 qian), Shanyao (Dioscoreae Rhizoma), Chuanxuduan (Dipsaci Radix), Huangqin (Scutellariae Radix), Huangbai (Phellodendri Cortex, each 1.5 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 1 qian).
Preparation: Decoct in water, take warm.
Modifications: For frequent hot urination or bleeding due to Liver-Fire moving Blood, add fried Zhiziren (Gardeniae Fructus) 1 qian; for night fever, add Gubupi (Cortex Lycii) 1.5 qian; for Lung-Heat with hyperhidrosis, add Maidong (Ophiopogonis Radix, heart removed) and Zaoren (Ziziphi Spinosae Semen); for severe Blood-Heat, add Huanglian (Coptidis Rhizoma) 1 qian; for Blood deficiency with Blood stasis causing joint and bone swelling/pain, add Danggui (Angelicae Sinensis Radix) 2 qian; for pain or swelling in limbs and joints/bones, add Qinjiao (Gentianae Macrophyllae Radix) and Danpi (Moutan Cortex, each 1 qian).
Chouxin Yin (Drawing Out the Firewood Decoction)
Ingredients: Huangqin (Scutellariae Radix), Shihu (Dendrobii Caulis), Mutong (Akebiae Caulis), Zhizi (Gardeniae Fructus, fried), Huangbai (Phellodendri Cortex, each 1 qian), Zhiqiao (Aurantii Fructus Pericarpium, bran-fried), Zexie (Alismatis Rhizoma, each 1.5 qian), Gancao (Glycyrrhizae Radix et Rhizoma, 0.3 qian, finely powdered).
Preparation: Decoct in water, take warm. Cold administration is better for severe internal heat.
Modifications: For heat in meridians and skin/muscle, add Lianqiao (Forsythiae Fructus) and Tianhuafen (Trichosanthis Radix) to resolve; for heat in the Blood level and Small Intestine, add Huairui (Stamen Sophorae Flavescentis) and Huanglian (Coptidis Rhizoma) to clear; for heat in the Yangming channel affecting the head/face or restlessness with constipation, add Shigao (Gypsum Fibrosum) to descend; for heat in the Lower Jiao causing painful/dysuric urination, add Cheqiancao (Plantaginis Herba) and Longdan (Gentianae Radix) to promote diuresis; for heat in the Yin level with insufficient fluids, add Maidong (Ophiopogonis Radix), Shengdihuang (Rehmanniae Radix), and Baishao (Paeoniae Radix Alba) to nourish.
For solid accumulation in the stomach and intestines, add Dahuang (Rhei Radix et Rhizoma) and Mangxiao (Natrii Sulfas) to unblock.
Xixin Yin (Removing the Firewood Decoction)
Ingredients: Chenpi (Citri Reticulatae Pericarpium, 0.8 qian), Huangqin (Scutellariae Radix, 2 qian), Maidong (Ophiopogonis Radix, heart removed), Baishao (Paeoniae Radix Alba), Huangbai (Phellodendri Cortex), Fuling (Poria), Danpi (Moutan Cortex, each 1.5 qian).
Preparation: Decoct in water, take warm.
Modifications: For injury due to Qi stagnation and counterflow causing Liver/costal pain or bleeding, add Zhizi (Gardeniae Fructus) and Qingpi (Citri Reticulatae Pericarpium Viride).