《大全》曰∶凡产后头痛发热，不可便作外伤感冒治。此等多是血虚，或者败血作梗，
宜以和平之剂必效，如玉露散，或四物加柴胡。若便以小柴胡、竹叶石膏之类，不救者多矣。
吴蒙斋曰∶新产后伤寒，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，切不可便发汗。大抵产后，大血空虚，汗
之则变筋惕肉 ，或郁冒昏迷，或搐搦，或便秘，其害非轻。凡有发热，宜与四物为君，加柴胡、人参、炮姜最
效。盖干姜辛热，能引血药入血分，气药入气分，且能去恶生新，有阳生阴长之道。以热治热，深合《内经》
之旨。
慎斋按∶以上三条，序产后有外感发热之证也。产后发热，状类伤寒，虽有外感，禁用发表。唯以养血为
主，佐以散风寒之剂。如生化汤、芎归汤，倍加川芎、葱白。若吴氏论发热数种，又当分因治之。如恶露未尽，
腹痛未除，形壮脉实，五七朝内不见虚证，人参尚宜斟酌。如有虚证，必以桃仁与人参同用为当。
《金匮要略》曰∶产后病解能食，七八日更发热，此为胃实，大承气汤主之。
徐注曰∶此条言大虚之后有实证，即当以实治，故谓病解能食，则经络脏腑之气俱平，无产后本病可疑。至
七八日更发热，不恶寒，又无表证可疑。明是食复之象，故曰胃实，大承气峻逐之，恐因循致虚也。
《妇人大全良方》说：凡是产后出现头痛和发热，不能立刻当作外感风寒感冒来治疗。这种情况大多是由于血虚，或者是败血（瘀血）阻滞所致，适宜使用平和的药剂，必定有效，如玉露散，或者在四物汤基础上加入柴胡。如果直接使用小柴胡汤、竹叶石膏汤之类的方剂，不治好的情况就很多了。
吴蒙斋说：新近生产后患伤寒，不可以轻易使用发汗法。分娩时导致的发热，有因用力过度引起的，有因失血过多引起的，有因恶露排出不畅引起的，有三日左右乳汁郁积引起的，还有早起劳作、饮食停滞引起的。这些症状类似伤寒，关键在于仔细详细地辨别，切不可轻易发汗。大抵产后，血液大量空虚，如果发汗，则会导致筋脉跳动、肌肉抽搐，或者头晕目眩昏迷，或者抽搐痉挛，或者便秘，其危害不轻。凡是有发热症状，适宜以四物汤为主药，加入柴胡、人参、炮姜最为有效。因为干姜辛热，能引导血药进入血分，气药进入气分，并且能祛除恶露、生出新血，符合“阳生阴长”的道理。用热药治热证，深合《黄帝内经》的宗旨。
慎斋按语：以上三条，叙述了产后患有外感发热的证候。产后发热，症状类似伤寒，即使有外感因素，也禁用发表（发汗解表）之法。唯有以养血为主，辅以疏散风寒的药剂。如生化汤、芎归汤，加倍使用川芎、葱白。至于吴氏论述的几种发热，又应当根据病因分别治疗。如恶露未尽，腹痛未除，形体壮实，脉象有力，在五到七天内没有见到虚证表现，人参的使用尚需斟酌。如果已有虚证表现，必须将桃仁与人参同用才恰当。
《金匮要略》说：产后病邪已解，能够进食，过了七八天又出现发热，这是胃中有实邪（食积），以大承气汤主治。
徐忠可注解说：这一条讲的是在大虚之后出现实证，就应当以治实的方法处理，所以说病邪已解且能进食，说明经络脏腑之气都已平复，没有产后本病的可疑之处。到了七八天再次发热，且不恶寒，又没有表证的可疑之处。这明显是饮食复发的迹象，所以说是胃实，用大承气汤峻猛攻下，是担心因循守旧导致正气更虚。
The *Daquan* (Complete Good Prescriptions for Women) states: Whenever headache and fever occur after childbirth, they should not immediately be treated as external contraction of cold-heat pathogens (common cold). Such cases are mostly due to blood deficiency or stagnation of foul blood (stasis), and it is appropriate to use mild and harmonizing formulas, which will surely be effective, such as Yulu San (Jade Dew Powder) or Siwu Tang (Four Substances Decoction) with added Chaihu (Bupleuri Radix). If one directly uses formulas like Xiaochaihu Tang (Minor Bupleurum Decoction) or Zhuyeshigao Tang (Leaf and Gypsum Decoction), there are many cases that cannot be cured.
Wu Mengzhai stated: For postpartum patients suffering from Taiyang disease (cold damage), sweating methods should not be used lightly. Fevers during childbirth can arise from physical exertion, excessive blood loss, retention of lochia, milk stasis around the third day, or early labor combined with food stagnation. These conditions resemble Taiyang disease, but careful differentiation is essential; sweating must absolutely be avoided. Generally, after childbirth, the blood volume is severely depleted. Inducing sweating may lead to twitching of sinews and muscles, dizziness and fainting, convulsions, or constipation, causing serious harm. For any fever, it is best to use Siwu Tang (Four Substances Decoction) as the principal formula, adding Chaihu (Bupleuri Radix), Renshen (Ginseng Radix et Rhizoma), and Paojiang (Prepared Ginger). Dried ginger is acrid and hot; it guides blood-invigorating herbs into the blood level and qi-regulating herbs into the qi level, while also expelling foul blood and generating new blood, following the principle of "Yang generating Yin." Using heat to treat heat deeply aligns with the principles of the *Neijing* (Inner Canon).
Shen Zhai commented: The above three passages describe postpartum fevers caused by external pathogenic factors. Postpartum fever resembles Taiyang disease; even if an external cause exists, dispersing and releasing exterior methods (sweating) are contraindicated. The primary approach should be nourishing blood, assisted by agents that disperse wind-cold. Examples include Shenghua Tang (Generation of Life Decoction) or Xionggui Tang (Cyathula and Angelica Decoction), with increased doses of Chuanxiong (Ligusticum Chuanxiong Rhizome) and Congbai (Scallion White). Regarding the various types of fever discussed by Mr. Wu, treatment should be differentiated according to the specific cause. If lochia is not yet exhausted and abdominal pain persists, but the patient’s constitution is robust and the pulse is forceful, with no signs of deficiency within five to seven days, the use of Renshen (Ginseng Radix et Rhizoma) should be considered cautiously. If signs of deficiency are present, combining Taoren (Prunus Persica Seed) with Renshen (Ginseng Radix et Rhizoma) is appropriate.
The *Jingui Yaolue* (Essential Prescriptions from the Golden Cabinet) states: After childbirth, if the disease has resolved and the patient can eat, but fever recurs after seven or eight days, this indicates stomach excess (food retention), and Da Chengqi Tang (Major Order the Qi Decoction) should be administered.
Xu Zhongke noted: This passage discusses a excess condition arising after severe deficiency; thus, it should be treated by addressing the excess. It states that if the disease has resolved and the patient can eat, it implies that the qi of the meridians and zang-fu organs has stabilized, leaving no doubt regarding postpartum-specific diseases. When fever recurs on the seventh or eighth day without aversion to cold and without exterior syndrome signs, it clearly indicates recurrence due to dietary indiscretion, hence termed "stomach excess." Da Chengqi Tang (Major Order the Qi Decoction) is used to vigorously purge the excess, fearing that delay would lead to further depletion of healthy qi.