产妇发热，缘因血虚，宜四物汤加黑姜，苦温治之，则热自退。如不应，更加童便少许冲服，热自然退。但
童便性寒，不可多用。又有脾虚伤食，皆能发热。又有胃虚发热者，法当调其饮食，理其脾胃，用五味异功散补
之。如伤食，加神曲、谷芽。更有躁热，面目赤色，烦渴引饮，其派洪大，重按全无，此虚极假热也，宜服 归
补血汤，重者用十全大补汤，或再加附子，收其浮散之阳，热必自退。若误医风热，一用凉散之药，无不立见危
殆，岂非医杀之乎？
郭稽中云∶产后乍寒乍热者，多有之，不可以作疟治。概系荣卫空虚，阴阳不和，或败血为害，或脾胃之虚。
此言极见明理，胡业医
者之不察。大凡风寒发热，昼夜不退，宜于生化汤中加黑荆芥一味，足可驱邪。盖产后体虚，百节开张，腠理不
固，易受易出，此小贼也，不比伤寒之用刀兵驱盗耳。如血虚与伤食，则日晡发热，清晨必退，二症虽相似，其
中仍有分辨。伤食者，必嗳腐吞酸，胸膈满闷，谷芽陈皮汤频饮可愈；其血虚者，则无前项等象，只可用四物汤
加炮姜，可退。
若呕吐不利，腹痛食少，脉沉细而迟者，或浮大而空，宜理中汤温补之。寒热虚实，若不辨明，安能无误？
予观浙地，每必守定钩藤、秦艽，或略作寒热，即用柴胡，此皆非产后人之可当也。予亦浅学，焉敢谈人之过，
不过守前贤之训，或可免妄死者告冤也。
四物汤（见肠痒）五味异功散（即六君子除半夏，载血晕）十全大补（见玉门不闭）。
黄 补血汤
嫩黄 （一两） 当归（三钱）
水煎服。
生化汤（见前）理中汤（载后腹痛）
清魂散
荆芥穗（一钱炒黑色） 当归（五钱）
作一服为末，生姜汤调下，或加川芎（一钱），煎服亦可（此方退风，并惊风搐搦俱妙）。
Postpartum fever, caused by blood deficiency, is suitable for treatment with Siwu Decoction (Four Substances Decoction) added with Heijiang (charred dried ginger), using a bitter-warm method, after which the fever will naturally subside. If there is no response, add a small amount of Tongbian (child's urine) to take orally, and the fever will naturally recede. However, Tongbian is cold in nature and should not be used in large quantities. There are also cases of fever due to spleen deficiency and food stagnation, as well as those due to stomach deficiency. The treatment method should involve regulating diet and harmonizing the spleen and stomach, using Wuyi Yigong San (Five-Ingredient Powder for Strengthening the Spleen) for tonification. In cases of food stagnation, add Shenqu (Medicated Leaven) and Guya (Sprouted Grain). Furthermore, there are cases of restless heat, redness of the face and eyes, irritability, thirst with a desire to drink, where the pulse is surging and large but completely empty upon deep pressure; this is false heat due to extreme deficiency, suitable for taking Danggui Buxue Tang (Danggui Tonifies the Blood Decoction). For severe cases, Shiquan Dabu Tang (Ten Complete Great Tonifying Decoction) may be used, or Fuzi (Aconite Lateral Root) may be added to gather the floating and scattered Yang qi, after which the heat will surely recede. If mistakenly diagnosed as wind-heat and treated with cooling and dispersing herbs, danger will appear immediately without exception; is this not killing the patient by medical error?
Guo Jizhong stated: Postpartum alternating chills and fever occur frequently and should not be treated as malaria. It is generally due to emptiness of Ying (Nutritive Qi) and Wei (Defensive Qi), disharmony of Yin and Yang, harm from Baixue (stagnant blood), or deficiency of the spleen and stomach. This statement is extremely clear and reasonable; it is unfortunate that many practitioners fail to observe this clearly. Generally, fever caused by wind-cold persists day and night without abating; it is suitable to add Heijingjie (charred Schizonepeta Spike) to Shenghua Tang (Generate the New Decoction), which is sufficient to expel the pathogen. Because the postpartum body is deficient, joints are open, and Couli (skin pores and interstices) are insecure, pathogens easily enter and exit; this is like a petty thief, unlike the use of military force to drive away robbers in Shanghan (Cold Damage) disease. If it is blood deficiency combined with food stagnation, fever occurs around the Shen hour (3-5 PM) and must recede by early morning; although these two conditions seem similar, they can still be distinguished. In cases of food stagnation, there must be belching with a putrid odor, acid regurgitation, and fullness/stuffiness in the chest and diaphragm, which can be cured by frequently drinking Guya Chenpi Tang (Sprouted Grain and Tangerina Peel Decoction); in cases of blood deficiency, the aforementioned symptoms are absent, and only Siwu Decoction added with Paojiang (prepared ginger) can be used to reduce the fever.
If accompanied by vomiting, difficult defecation, abdominal pain, and poor appetite, with a pulse that is deep, fine, and slow, or floating, large, and empty, Lizhong Tang (Regulate the Middle Decoction) should be used for warming and tonifying. If cold and heat, deficiency and excess are not clearly differentiated, how can errors be avoided? I have observed that in Zhejiang, practitioners often rigidly adhere to Gouteng (Uncaria Ramulus cum Uncis) and Qinjiao (Gentiana Macrophylla Root), or if there is slight chills and fever, immediately use Chaihu (Bupleuri Radix); none of these are suitable for postpartum patients. My learning is shallow, how dare I discuss others' faults? I merely follow the instructions of former sages, perhaps avoiding complaints from the wrongfully dead.
Siwu Decoction (see Intestinal Itch chapter); Wuyi Yigong San (i.e., Liujunzi Tang minus Banxia, recorded in Blood Stasis chapter); Shiquan Dabu Tang (see Vagina Closure Failure chapter).
Danggui Buxue Tang
Nen Huangqi (Fresh Astragali Radix, 1 liang) Danggui (Angelicae Sinensis Radix, 3 qian)
Decoct in water and take orally.
Shenghua Tang (see previous text); Lizhong Tang (recorded in Postpartum Abdominal Pain chapter).
Qinghun San
Jingjie Sui (Schizonepetae Spica, 1 qian, stir-fried until black) Danggui (Angelicae Sinensis Radix, 5 qian)
Grind one dose into powder, mix with Ginger Decoction to take orally, or add Chuanxiong (Ligustici Chuanxiong Rhizoma, 1 qian) and decoct to take orally (this formula is excellent for expelling wind and treating convulsions due to wind-stroke).