〔丹〕治一妇人四月内产，发黄，四肢倦怠，食少，经事不来，时发热，脉弦。
白术（一两） 人参 秦艽 牡丹皮 生地黄 木通 柴胡 芍药（各半两） 川芎 黄芩
干葛（各一钱） 甘草（五分）
上分十二帖，水煎，食前热服。
〔薛〕产后虚烦发热，乃阳随阴散，气血俱虚。若恶寒发热，烦躁作渴，急用十全
大补汤。若热愈甚，急加桂、附。若作渴面赤，宜用当归补血汤。若误认为火证，投以
凉剂，祸在反掌。王太仆先生云∶如大寒而甚，热之不热，是无火也。热来复去，昼见
夜伏，夜发昼止，不时而热，是无火也，当治其心。如大热而甚，寒之不寒，是无水也。
热动复止，攸忽往来，时动时止，是无水也，当助其肾。故心盛则生热，肾盛则生寒。肾
虚则寒动于中，心虚则热收于内。又热不胜寒，是无火也。寒不胜热，是无水也。治法∶
前证无水者，六味丸。无火者，八味丸。气血俱虚者，八珍汤与十全大补汤。大尹俞
君之内，产后发热晡热，吐血便血，兼盗汗，小便频数，胸胁胀痛，肚腹痞闷。余曰∶此
诸脏虚损也，治当固本为善。自恃知医，用降火之剂，更加泻利肠鸣，呕吐不食，腹痛
足冷，始信余言。诊其脉，或浮洪，或沉细，或如无。其面或青黄，或赤、白，此虚寒假
热之状。时虽仲夏，当舍时从证，先用六君子汤加炮姜、肉桂数剂，胃气渐复，诸证渐
退，更佐以十全大补汤，半载全愈。儒者杨敬之内人，所患同前，但唾痰涎，或用温
补化痰之剂，不应。面色黧黑，两尺浮大，按之微细，此因命门火虚，不能生脾土，脾土
不能生诸脏而为患也。用八味丸补土之母而痊。一妇产后三日起早，况气血未定，遂
感身热目暗如风状，即以清魂散二服，得微汗而愈。滑伯仁治一产妇恶露不行，脐腹
痛，头疼寒热。众皆以为感寒，温以姜、附，益大热，手足搐搦，语谵目撺。诊其脉弦而
洪数，面赤目闭，语喃喃不可辨，舌黑如 ，燥无津润，胸腹按之不胜手。盖燥剂搏其血，
内热而风生，血蓄而为痛也。曰∶此产后热入血室，因而生风。即先为清热降火，治风
凉血，两服颇爽；继以琥珀牛黄等稍解人事，后以张从正三和散行血破瘀，三四服恶露大
下如初。时产已十日矣，于是诸证悉平。一妇盛暑月中产三日发热，其脉虚疾而大，恶
露不行，败血攻心，狂言叫呼奔走，拿捉不住。以干荷叶、生地黄、牡丹皮，浓煎汤调
下生蒲黄二钱，一服即定，恶露旋下而安。一妇产后时发昏瞀，身热汗多，眩晕口渴，或
时头痛恶心。医用四物凉血之剂，病不减，又用小柴胡，病益甚。石山至诊，得浮洪搏指。
汪曰∶产后而得是脉，又且汗多而脉不为汗衰，法在不治。所幸者，不喘不泄耳。其脉
如是，盖凉药所激也。用人参三钱，黄 二钱，甘草、当归各七分，白术、门冬各一钱，
干姜、陈皮、黄芩各五分煎服，五剂脉敛而病渐安。王佥宪宜人产后，因沐浴发热呕
恶，渴欲引冷水瓜果，谵语若狂，饮食不进，体素丰浓，不受补，医用清凉，热增剧。诊
得六脉浮大、洪数。汪曰∶产后暴损气血，孤阳外浮，内真寒而外假热，宜大补气血。与
八珍汤加炮姜八分，热减大半。病患自以素不宜参、 ，不肯再服，过一日复大热如火，
复与前剂，潜加参、 、炮姜，连进二三服，热退身凉而愈。
当归养血丸（产后腹痛。） 当归黄 汤（腰痛。） 当归补血汤 当归散（并见胎自堕半产条。）
大全人参汤（见上自汗。）
罗氏犀角饮子 治产后亡津液虚损，时自汗出，发热困倦，唇口干燥。
犀角 麦门冬 白术（各半两） 柴胡（一两） 枳壳（麸炒） 地骨皮 生地黄 甘草（炒）
当归 人参 茯苓 黄芩 黄 （各七钱）
上 咀，每服四钱，姜三片，浮麦七十粒，水煎服。
三之一汤 治产后虚劳发热，日久不安。
柴胡 黄芩 人参 半夏 川芎 当归 芍药 熟地黄 甘草（各一钱半）
作一服，水二盅，姜三片，红枣一枚，煎一盅，无时服。
三分散 治产后日久，虚劳发热。
川芎 当归 芍药 熟地黄 白术 白茯苓 黄 （各一钱） 柴胡 人参（各一钱半）
黄芩 半夏 甘草（各半钱）
上作一服，水二盅，生姜三片，红枣一枚，煎至一盅，食前服。
加味逍遥散 治产后发热，口干作渴，唇裂生疮。
当归 白芍药 干葛（各二钱） 生地黄 川芎 黄芩（各一钱半） 人参（九分）
麦门冬（九分） 柴胡（一钱） 乌梅（二个） 甘草（六分）
上锉散，分作二服，用水一盅，煎至染分，空心服。
〔娄〕产后发热，多属虚寒，惟干姜加入补药中神效，此丹溪法也。
人参当归汤 治产后去血过多，血虚则阴虚，阴虚则生内热，心胸烦满，呼吸短气，
头痛闷乱，晡时转甚，与大病后虚烦相类。（方见前产后虚烦。）
【丹溪】治疗一位在怀孕四月时生产（早产）的妇女，出现面色发黄，四肢倦怠无力，食欲减退，月经停止，时常发热，脉象弦。
白术（一两） 人参 秦艽 牡丹皮 生地黄 木通 柴胡 芍药（各半两） 川芎 黄芩
干葛（各一钱） 甘草（五分）
以上药材分为十二帖，加水煎煮，饭前热服。
【薛己】产后虚烦发热，是由于阳气随着阴血耗散而外越，导致气血俱虚。如果伴有恶寒发热、烦躁作渴，应立即使用十全大补汤。如果热势更甚，应立即加入桂枝、附子。如果出现口渴、面赤，宜用当归补血汤。如果误认为是火证，投以凉剂，灾祸就在顷刻之间。王太仆先生说：如极度寒冷且严重，用热药治疗却不温热，这是无火（肾阳虚衰）。热来复去，白天显现夜间潜伏，夜间发作白天停止，不时发热，这是无火，应当治心。如极度炎热且严重，用寒药治疗却不清凉，这是无水（肾阴亏虚）。热动复止，忽然往来，时而发动时而停止，这是无水，应当助肾。所以心盛则生热，肾盛则生寒。肾虚则寒动于中，心虚则热收于内。又热不胜寒，是无火；寒不胜热，是无水。治疗方法：前述证候属无水的，用六味丸。属无火的，用八味丸。气血俱虚的，用八珍汤与十全大补汤。大尹俞君的妻子，产后发热及傍晚潮热，吐血便血，兼有盗汗，小便频数，胸胁胀痛，肚腹痞闷。我说：这是诸脏虚损，治疗应当以固本为善。她自恃懂医，使用降火之剂，更加出现泻利肠鸣、呕吐不食、腹痛足冷，才相信我的话。诊其脉，或浮洪，或沉细，或若无。其面色或青黄，或赤、白，这是虚寒假热的征状。当时虽处仲夏，当舍时令而从证候，先用六君子汤加炮姜、肉桂数剂，胃气渐复，诸证渐退，再佐以十全大补汤，半年后痊愈。儒者杨敬之的妻子，所患与前相同，但唾痰涎，或用温补化痰之剂，无效。面色黧黑，两尺脉浮大，按之微细，这是因为命门火虚，不能生脾土，脾土不能生养诸脏而为患。用八味丸补益土之母（肾）而痊愈。一妇人产后三日早起，况且气血未定，遂感身热目暗如中风状，即服用清魂散二服，得微汗而愈。滑伯仁治疗一位产妇恶露不行，脐腹痛，头疼寒热。众人都以为是感寒，用姜、附温补，反而热势更大，手足搐搦，语谵目撺。诊其脉弦而洪数，面赤目闭，语喃喃不可辨，舌黑如炭，干燥无津润，胸腹按之不胜手。大概是燥剂搏结其血，内热而生风，血蓄积而为痛。说：这是产后热入血室，因而生风。即先进行清热降火，治风凉血，两服颇见效；继以琥珀牛黄等稍解人事，后以张从正三和散行血破瘀，三四服后恶露大下如初。此时产已十日了，于是诸证悉平。一妇人在盛暑月中产后三日发热，其脉虚疾而大，恶露不行，败血攻心，狂言叫呼奔走，拿捉不住。用干荷叶、生地黄、牡丹皮，浓煎汤调下生蒲黄二钱，一服即定，恶露旋下而安。一妇人产后时发昏瞀，身热汗多，眩晕口渴，或时头痛恶心。医生用四物凉血之剂，病不减，又用小柴胡，病益甚。石山至诊，得浮洪搏指。汪曰：产后而得是脉，又且汗多而脉不为汗衰，法在不治。所幸的是，不喘不泄耳。其脉如是，大概是凉药所激也。用人参三钱，黄芪二钱，甘草、当归各七分，白术、麦冬各一钱，干姜、陈皮、黄芩各五分煎服，五剂后脉敛而病渐安。王佥宪宜人产后，因沐浴发热呕恶，渴欲引冷水瓜果，谵语若狂，饮食不进，体素丰浓，不受补，医生用清凉药，热增剧。诊得六脉浮大、洪数。汪曰：产后暴损气血，孤阳外浮，内真寒而外假热，宜大补气血。给予八珍汤加炮姜八分，热减大半。病患自以素不宜参、芪，不肯再服，过一日复大热如火，复与前剂，潜加参、芪、炮姜，连进二三服，热退身凉而愈。
当归养血丸（治疗产后腹痛。） 当归黄芪汤（治疗腰痛。） 当归补血汤 当归散（并见胎自堕半产条。）
大全人参汤（见上自汗。）
罗氏犀角饮子 治疗产后亡津液虚损，时自汗出，发热困倦，唇口干燥。
犀角 麦门冬 白术（各半两） 柴胡（一两） 枳壳（麸炒） 地骨皮 生地黄 甘草（炒）
当归 人参 茯苓 黄芩 黄芪（各七钱）
以上锉碎，每服四钱，姜三片，浮麦七十粒，水煎服。
三之一汤 治疗产后虚劳发热，日久不安。
柴胡 黄芩 人参 半夏 川芎 当归 芍药 熟地黄 甘草（各一钱半）
作一服，水二盅，姜三片，红枣一枚，煎一盅，无时服。
三分散 治疗产后日久，虚劳发热。
川芎 当归 芍药 熟地黄 白术 白茯苓 黄芪（各一钱） 柴胡 人参（各一钱半）
黄芩 半夏 甘草（各半钱）
以上作一服，水二盅，生姜三片，红枣一枚，煎至一盅，食前服。
加味逍遥散 治疗产后发热，口干作渴，唇裂生疮。
当归 白芍药 干葛（各二钱） 生地黄 川芎 黄芩（各一钱半） 人参（九分）
麦门冬（九分） 柴胡（一钱） 乌梅（二个） 甘草（六分）
以上锉散，分作二服，用水一盅，煎至染分（约二分），空心服。
【娄全善】产后发热，多属虚寒，惟独干姜加入补药中神效，这是丹溪的方法。
人参当归汤 治疗产后去血过多，血虚则阴虚，阴虚则生内热，心胸烦满，呼吸短气，头痛闷乱，晡时转甚，与大病后虚烦相类。（方见前产后虚烦。）
[Danxi] Treated a woman who delivered prematurely at four months of gestation, presenting with jaundice (yellowing of the skin and eyes), fatigue in the four limbs, poor appetite, amenorrhea, intermittent fever, and a wiry pulse.
Baizhu (Atractylodis Rhizoma, 1 liang) Renshen (Ginseng Radix et Rhizoma) Qinjiao (Gentianae Macrophyllae Radix) Mudanpi (Moutan Cortex) Shengdihuang (Rehmanniae Radix) Mutong (Akebiae Caulis) Chaihu (Bupleuri Radix) Shaoyao (Paeoniae Radix) [each half liang] Chuanxiong (Ligustici Chuanxiong Rhizoma) Huangqin (Scutellariae Radix)
Gegen (Puerariae Lobatae Radix) [each 1 qian] Gancao (Glycyrrhizae Radix et Rhizoma, 5 fen)
Divide into twelve doses, decoct in water, and take hot before meals.
[Xue Ji] Postpartum deficiency vexation and fever result from Yang following Yin dissipating outward, leading to deficiency of both Qi and Blood. If accompanied by aversion to cold and fever, restlessness, and thirst, immediately use Shiquan Dabu Tang (Decoction for Tenfold Great Tonification). If the heat is more severe, immediately add Guizhi (Cinnamomi Ramulus) and Fuzi (Aconiti Lateralis Radix Praeparata). If there is thirst and facial redness, use Danggui Buxue Tang (Decoction for Tonifying Blood with Angelica). If mistakenly diagnosed as a Fire syndrome and treated with cooling agents, disaster will ensue instantly. Wang Taipu stated: If there is extreme cold that does not respond to warming treatment, it indicates Deficiency of Fire (Kidney Yang Deficiency). If heat comes and goes, appearing during the day and hiding at night, or occurring at night and ceasing during the day, this also indicates Deficiency of Fire, and the Heart should be treated. If there is extreme heat that does not respond to cooling treatment, it indicates Deficiency of Water (Kidney Yin Deficiency). If heat moves and stops, coming and going suddenly, starting and stopping intermittently, this also indicates Deficiency of Water, and the Kidney should be assisted. Thus, excess in the Heart generates Heat, and excess in the Kidney generates Cold. Kidney deficiency causes Cold to move within; Heart deficiency causes Heat to collect internally. Furthermore, if Heat cannot overcome Cold, it is Deficiency of Fire; if Cold cannot overcome Heat, it is Deficiency of Water. Treatment methods: For the aforementioned syndromes indicating Deficiency of Water, use Liuwei Wan (Six-Ingredient Pill with Rehmannia); for Deficiency of Fire, use Bawei Wan (Eight-Ingredient Pill with Rehmannia). For deficiency of both Qi and Blood, use Bazhen Tang (Eight-Treasure Decoction) and Shiquan Dabu Tang. The wife of Grand Steward Yu suffered from postpartum fever and afternoon tidal fever, hematemesis and hematochezia, spontaneous night sweats, frequent urination, distending pain in the chest and hypochondrium, and fullness in the abdomen. I said: This is damage to the Zang organs; treatment should focus on securing the root. Relying on her medical knowledge, she used fire-descending agents, which worsened her condition with diarrhea, borborygmus, vomiting, anorexia, abdominal pain, and cold feet, until she finally accepted my advice. Her pulse was either floating and surging, or deep and fine, or barely perceptible. Her complexion was either greenish-yellow, or red and white, indicative of false heat due to deficiency. Although it was midsummer, one must disregard the season and follow the syndrome. Initially, use Liujunzi Tang (Six-Gentlemen Decoction) with Paojiang (Prepared Zingiberis Rhizoma) and Rougui (Cinnamomi Cortex) for several doses. As stomach Qi gradually recovered and symptoms subsided, supplement with Shiquan Dabu Tang, resulting in complete recovery after half a year. The wife of Scholar Yang Jingzhi suffered from similar symptoms but expectorated phlegm-saliva; warm-tonifying and phlegm-resolving agents were ineffective. Her complexion was dark black, and the Chi pulses on both wrists were floating and large but fine upon pressure. This was due to Deficiency of Mingmen Fire failing to generate Spleen Earth, and Spleen Earth failing to nourish the other Zang organs. She recovered using Bawei Wan to tonify the mother of Earth (Kidney). A woman rose early three days postpartum; since Qi and Blood were unsettled, she contracted body heat and blurred vision resembling wind-stroke. Two doses of Qinghun San (Clear Soul Powder) induced slight sweating and cured her. Hua Borren treated a parturient with retained lochia, umbilical and abdominal pain, headache, chills, and fever. Most attributed it to cold contraction and treated with warming agents like Jiang (Zingiberis Rhizoma) and Fu (Aconiti Radix), which exacerbated the heat, causing convulsions of hands and feet, delirious speech, staring eyes, and muttering unintelligibly. Her pulse was wiry, surging, rapid, and large; face red, eyes closed, tongue black like charcoal, dry without moisture, and chest/abdomen tender to touch. Likely, drying agents bound the blood, internal heat generated wind, and blood stasis caused pain. He stated: This is postpartum heat entering the Blood Chamber, generating wind. First, clear heat and descend fire, treat wind and cool blood; two doses brought relief. Then, use Hupo (Succinum) and Niuhuang (Calculus Bovis) to slightly restore consciousness, followed by Zhang Congzheng's Sanhe San (Three-Harmonies Powder) to move blood and break stasis. After three to four doses, lochia flowed profusely as initially. By the tenth day postpartum, all symptoms resolved. A woman delivered in midsummer heat, three days postpartum developed fever with a deficient, rapid, and large pulse, retained lochia, and敗血 (rotten blood) attacking the Heart, causing manic speech, shouting, running, and inability to restrain. Concentrated decoction of Ganheyeh (Lotus Leaf), Shengdihuang, and Mudanpi, mixed with 2 qian of Sheng Puhuang (Polygoni Cuspidati Rhizoma), settled her after one dose, and lochia flowed, bringing peace. Another woman experienced intermittent postpartum syncope, body heat, profuse sweating, vertigo, thirst, and occasional headache and nausea. Doctors used Siwu Tang (Four-Substance Decoction) to cool blood without effect, then Xiaochaihu Tang (Minor Bupleurum Decoction), worsening the condition. Shi Shanzhi diagnosed a floating, surging, and forceful pulse. Wang said: Obtaining such a pulse postpartum, especially with profuse sweating where the pulse does not weaken accordingly, indicates a hopeless prognosis. Fortunately, there is no panting or diarrhea. Such a pulse is likely provoked by cooling medicines. Use 3 qian Renshen, 2 qian Huangqi (Astragali Radix), 7 fen each of Gancao and Danggui (Angelicae Sinensis Radix), 1 qian each of Baizhu and Maidong (Ophiopogonis Radix), and 5 fen each of Ganjiang (Zingiberis Rhizoma), Chenpi (Citri Reticulatae Pericarpium), and Huangqin; decoct and take. After five doses, the pulse normalized and the illness gradually improved. The wife of Vice Commissioner Wang developed fever, vomiting, and nausea after bathing postpartum, desired cold water and fruits, spoke deliriously like a madman, refused food, and had a robust constitution unsuited to tonification. Doctors used cooling agents, increasing the heat. Six pulses were floating, large, surging, and rapid. Wang said: Postpartum sudden loss of Qi and Blood leads to solitary Yang floating externally, true cold internally and false heat externally; thus, greatly tonify Qi and Blood. Prescribe Bazhen Tang with 8 fen Paojiang. Heat decreased by more than half. The patient, accustomed to avoiding Renshen and Huangqi, refused further doses. One day later, high fever returned. The same prescription was given again, secretly adding Renshen, Huangqi, and Paojiang. After two or three doses, heat receded, body cooled, and she recovered.
Danggui Yangxue Wan (for postpartum abdominal pain.) Danggui Huangqi Tang (for lower back pain.) Danggui Buxue Tang Danggui San (see also section on spontaneous abortion and miscarriage.)
Daquan Renshen Tang (see above for spontaneous sweating.)
Luo's Xijiao Yinzi Treats postpartum fluid depletion and deficiency, spontaneous sweating, fever, fatigue, and dry lips and mouth.
Xijiao (Rhinocerotis Cornu) Maidong Baizhu [each half liang] Chaihu (1 liang) Zhike (Stir-fried with bran) Goubipi (Lycii Cortex) Shengdihuang Gancao (Stir-fried) Danggui Renshen Fuling Huangqin Huangqi [each 7 qian]
Crush into pieces. Take 4 qian per dose with 3 slices of ginger and 70 grains of Fumai (Floating Wheat), decoct in water and drink.
Sanzhiyi Tang Treats postpartum deficiency consumption with fever, lasting long without relief.
Chaihu Huangqin Renshen Banxia Chuanxiong Danggui Shaoyao Shudihuang Gancao [each 1.5 qian]
Make one dose, add 2 zhong of water, 3 slices of ginger, and 1 red date. Decoct to 1 zhong. Take at any time.
Sanfen San Treats prolonged postpartum deficiency consumption with fever.
Chuanxiong Danggui Shaoyao Shudihuang Baizhu BaiFuling Huangqi [each 1 qian] Chaihu Renshen [each 1.5 qian] Huangqin Banxia Gancao [each 0.5 qian]
Make one dose, add 2 zhong of water, 3 slices of fresh ginger, and 1 red date. Decoct to 1 zhong. Take before meals.
Jiawei Xiaoyao San Treats postpartum fever, dry mouth with thirst, cracked lips, and sores.
Danggui Baishaoyao Gegen [each 2 qian] Shengdihuang Chuanxiong Huangqin [each 1.5 qian] Renshen (9 fen) Maidong (9 fen) Chaihu (1 qian) Wumei (2 pieces) Gancao (6 fen)
Crush into powder, divide into two doses. Add 1 zhong of water, decoct to approximately 2 fen (a small amount), and take on an empty stomach.
[Lou Quanshan] Postpartum fever mostly belongs to deficiency-cold. Only when Ganjiang (Zingiberis Rhizoma) is added to tonifying medicines does it show miraculous efficacy; this is Danxi's method.
Renshen Danggui Tang Treats excessive blood loss postpartum. Blood deficiency leads to Yin deficiency, and Yin deficiency generates internal heat, causing vexation and fullness in the chest and heart, shortness of breath, headache, confusion, worsening in the evening (Bushi), similar to deficiency vexation after severe illness. (Formula see previous section on postpartum deficiency vexation.)