产后伤寒，不可轻易发汗。产时有伤力发热，有去血过多发热，有恶露不去发热，
有三日蒸乳发热，有早起劳动，饮食停滞发热，状类伤寒，要在仔细详辨，切不可孟浪
发汗，犹覆水难收也。产后大血空虚，汗之重则亡阳，轻则筋惕肉 ，或郁冒昏迷，或
搐溺便秘，变症百出。凡有发热，多因血虚，阳无所根据，浮散于外而为热，宜于四物
为君去川穹、生地换熟地，加软苗柴胡、人参、炮姜最效。盖炮姜辛热而兼苦咸，以火
而治火，收其浮热，且能引血药入血分，气药入气分，更能去恶生新，有阳生阴长之
道，以热治热，深合《内经》之旨，正气得力外邪自散矣。
养癸曰∶如胎前原有阴虚火症，产后去血过多，必大发热烦躁汗出等症，若根据前
法，大补气血，其证必甚，当用逍遥散以清肝火，养肝血，因去血既多，肝虚血燥之
故，不可泥于气血两虚，此以阴虚发热立论，当以脉候参详。
薛立斋曰∶新产妇人，阴血暴亡、阳无所附，而外热也，宜四物加炮姜，补阴以配
阳。若误服寒凉克削之剂，而外热者，此为寒气格阳于外也，宜四君子加姜、桂，不
应，急加附子。若肌肤发热，面赤大渴引饮者，此血脱发燥也，当归补血汤，又日∶产
后虚烦发热，乃阳随阴散，气血俱虚，故恶寒发热，若误作火证，投以凉剂，祸在反掌。
产后患伤寒，不可轻易使用发汗法。分娩时因用力过度导致的发热，有因失血过多导致的发热，有因恶露排出不畅导致的发热，有三日乳汁郁积导致的发热，有因早起劳作、饮食停滞导致的发热，这些症状类似伤寒，关键在于仔细详细辨别，切不可鲁莽地发汗，因为后果如同泼出去的水难以收回。产后大血空虚，若发汗过重则会导致亡阳，发汗过轻则可能导致筋脉跳动、肌肉抽搐，或者出现郁冒昏迷，或者抽搐、小便不利、便秘等症状，变症百出。凡是发热，多因血虚，阳气无所依附，浮散于外而表现为热，适宜以四物汤为君药，去掉川芎、生地黄，换成熟地黄，加入软苗柴胡、人参、炮姜最为有效。因为炮姜辛热且兼有苦咸之性，以火治火，收敛浮热，并且能引导血药入血分，气药入气分，更能祛除瘀血、生成新血，符合“阳生阴长”的道理，以热治热，深合《内经》的宗旨，正气得力，外邪自然消散。
养癸说：如果胎前原有阴虚火旺的病症，产后失血过多，必然出现大发热、烦躁、出汗等症状，如果按照前面的方法，大补气血，病情必定加重，应当用逍遥散来清肝火、养肝血，因为失血既多，导致肝虚血燥的缘故，不可拘泥于气血两虚的理论，这是基于阴虚发热立论，应当结合脉象详细参详。
薛立斋说：刚生产后的产妇，阴血突然亡失，阳气无所依附，而出现外热，适宜用四物汤加炮姜，补阴以配阳。如果误服寒凉克削的药物，而出现外热的，这是因为寒气格拒阳气于外，适宜用四君子汤加生姜、肉桂，若无反应，急忙加入附子。如果肌肤发热，面色红赤，极度口渴想喝水的，这是血脱发燥，用当归补血汤。又说：产后虚烦发热，是阳气随阴血散失，气血俱虚，所以恶寒发热，如果误作火证，投以凉剂，灾祸就在眨眼之间。
After childbirth, when contracting a cold (Shanghan), one must not lightly employ sweating methods. Fever during delivery may arise from excessive physical exertion, from excessive blood loss, from lochia stasis, from milk engorgement on the third day, or from early labor and food stagnation; these conditions resemble Shanghan, but require careful differentiation. One must never rashly induce sweating, as the consequences are irreversible like spilt water. Postpartum, the great blood is empty; heavy sweating leads to Yang collapse, while light sweating may cause muscle twitching, convulsions, dizziness with fainting, or convulsions, urinary difficulty, and constipation, leading to myriad complications. Generally, fever is often due to blood deficiency, where Yang has no foundation and floats outward, manifesting as heat. It is advisable to use Siwu Tang (Four Substances Decoction) as the principal formula, removing Chuanxiong Rhizoma (Chuanxiong) and Rehmanniae Radix Recens (Shengdi Huang), replacing them with Rehmanniae Radix Preparata (Shu Di Huang), and adding soft-stemmed Bupleuri Radix (Chaihu), Ginseng Radix et Rhizoma (Renshen), and prepared Zingiberis Rhizoma (Paojiang). This is most effective. Prepared Zingiberis Rhizoma is pungent and hot, with bitter and salty properties; it treats fire with fire, consolidates floating heat, guides blood-invigorating herbs into the blood level and qi-regulating herbs into the qi level, eliminates evil and generates newness, following the principle of "Yang generating Yin." Treating heat with heat deeply aligns with the teachings of the *Neijing* (Classic of Internal Medicine); when righteous Qi is strengthened, external pathogens disperse naturally.
Yang Gui stated: If there were originally Yin deficiency with fire hyperactivity before pregnancy, and postpartum excessive blood loss occurs, symptoms such as high fever, irritability, and sweating will inevitably appear. If one follows the previous method of heavily tonifying Qi and Blood, the condition will worsen. Instead, Xiaoyao San (Free and Easy Wanderer Powder) should be used to clear Liver fire and nourish Liver blood. Due to excessive blood loss, Liver deficiency and blood dryness result. One must not rigidly adhere to the theory of dual Qi and Blood deficiency. This argument is based on Yin deficiency fever and requires detailed analysis through pulse diagnosis.
Xue Lizhai stated: In newly delivered women, sudden loss of Yin blood leaves Yang without attachment, causing external heat. Siwu Tang (Four Substances Decoction) with added Paojiang (Prepared Zingiberis Rhizoma) is suitable to tonify Yin to harmonize Yang. If cold and draining formulas are mistakenly taken, resulting in external heat, this indicates Cold rejecting Yang to the exterior. Sijunzi Tang (Four Gentlemen Decoction) with Shengjiang (Fresh Zingiberis Rhizoma) and Rougui (Cinnamomi Cortex) is appropriate; if ineffective, Fuzi (Aconiti Lateralis Radix Preparata) should be urgently added. If skin feels hot, face is red, and there is extreme thirst with desire to drink, this is blood depletion causing dryness; Danggui Buxue Tang (Danggui Tonifies the Blood Decoction) is indicated. He also stated: Postpartum vexatious fever results from Yang scattering with Yin, leaving both Qi and Blood deficient, hence aversion to cold and fever. If mistakenly treated as a Fire syndrome and administered cooling agents, disaster will strike instantly.