产后发热，有风寒外感而热者，有邪火内盛而热者，有水亏阴虚而热者，有因产劳倦虚
烦而热者，有去血过多头晕闷乱烦热者。诸证不同，治当辨察。
一、产后有外感发热者，盖临盆之际，多有露体用力，无暇他顾，此时或遇寒邪，则乘
虚而入，感之最易。若见头疼身痛，憎寒发热，或腰背拘急，脉见紧数，即产后外感证也。
然此等外感，不过随感随病，自与正伤寒宿感者不同，故略加解散即自痊。可勿谓新产之后
不宜表散，但当酌其虚实而用得其宜耳。凡产后感邪，气不甚虚者，宜三柴胡饮。若气虚脾
弱而感者，宜四柴胡、五柴胡饮。若肝脾肾三阴不足而感者，宜补阴益气煎。若虚寒之甚者
，宜理阴煎。若产妇强壮气实而感者，宜正柴胡饮。若兼内火盛而外邪不解者，宜一柴胡饮
。若风寒俱感，表里俱滞者，宜五积散。
一、产后有火证发热者，但外感之热多在表，火证之热多在里。此必以调摄太过，或时
令热甚，或强以酒，或误用参、术、姜、桂大补之药，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、保阴煎之类主之。若本元不虚，或火之甚而势之急者，即徙薪饮、抽薪饮亦所常用，不
必疑也。
一、产后有阴虚发热者，必素禀脾肾不足，及产后气血俱虚，故多有之。其证则倏忽往
来，时作时止，或昼或夜，进退不常，或精神困倦，怔忡恍惚，但察其外无表证，而脉见弦
数，或浮弦豁大，或微细无力。其来也渐，非若他证之暴至者，是即阴虚之候，治当专补真
阴，宜小营煎、三阴煎、五阴煎之类，随宜主之。若阴虚兼火而微热者，宜一阴煎。若阴虚
兼火之甚而大热者，宜加减一阴煎。若阴虚火盛，热而多汗者，宜当归六黄汤。若阴中之阳
虚，火不归源而热者，宜大营煎、理阴煎、右归饮之类主之。若血虚阳不附阴，烦热作渴者
，宜人参当归汤。若气血俱虚，发热烦躁，面赤作渴，宜八珍汤、十全大补汤。若热甚而脉
微者，宜急加桂、附，或认为火，则祸在反掌。
一、产后有去血过多发热者，其证必烦渴短气，头痛头晕，闷乱内热，是亦阴虚之属，
宜人参当归汤主之。
立斋曰∶大凡元气虚弱而发热者，皆内真寒而外假热也。但用六君或补中益气加炮姜温
补脾气，诸证自退。若四肢畏冷，急加附子。凡新产阴血暴伤，阳无所附而外热，宜用四物
、炮姜，补阴以配阳。若因误服寒凉克伐之剂而外热，此为寒气格阳于外，宜用四君子加姜
、桂；如不应，急加附子。若或肌肤发热，面目赤色，烦渴引饮，此血脱发躁，宜用当归补
血汤。
产后发热，有因风寒外感而发热的，有因邪火内盛而发热的，有因水亏阴虚而发热的，有因分娩劳倦、虚烦而发热的，有因失血过多导致头晕、闷乱、烦热的。这些证候各不相同，治疗时应当辨别察明。
一、产后有外感发热者，大概是因为临产之际，多有暴露身体、用力努责，无暇顾及其他，此时若遇到寒邪，便会乘虚而入，最容易感受。如果见到头痛身痛，憎恶寒冷且发热，或者腰背拘急不舒，脉象见紧或数，就是产后外感证。然而这类外感，不过是随感随病，自然与正伤寒（由风寒之邪引起的急性外感热病）中宿感（感邪后潜伏一段时间才发病）的情况不同，所以稍微加以解散表邪即可痊愈。不要认为新产之后不宜使用解表发散法，只应当斟酌其虚实情况，用药得当即可。凡是产后感邪，气分不甚虚弱者，适宜用三柴胡饮。若气虚脾弱而感邪者，适宜用四柴胡饮、五柴胡饮。若肝、脾、肾三阴不足而感邪者，适宜用补阴益气煎。若虚寒严重的，适宜用理阴煎。若产妇体质强壮、气实而感邪者，适宜用正柴胡饮。若兼有内火旺盛而外邪不解者，适宜用一柴胡饮。若风寒俱感，表里俱滞者，适宜用五积散。
一、产后有火证发热者，但外感之热多在体表，火证之热多在体内。这必定是因为调摄过度，或时令炎热甚重，或强行饮酒，或误用人参、白术、生姜、肉桂等大补之药，或过用炭火取暖，或门窗太密闭，人气太盛，或体质本实而动作过于剧烈。凡属太过，都能生火。火盛于内，多见潮热（定时发热或定时热势加重）、内热，烦躁口渴喜冷饮，或头痛多汗，大便干结，小便赤黄，以及血热妄行（血液不循常道而溢出脉外），只要没有表证，脉象见缓滑而不紧且发热者，便是火证，适宜用清化饮、保阴煎之类主治。若本元不虚，或火势很盛且病情急迫者，即使用徙薪饮、抽薪饮也是常用的，不必怀疑。
一、产后有阴虚发热者，必定是素体脾肾不足，加上产后气血俱虚，所以多有此证。其症状表现为忽冷忽热，时作时止，或白天或夜晚，进退无常，或精神困倦，心悸恍惚，只要观察其外部无表证，而脉象见弦数，或浮弦豁大，或微细无力。这种热势来得缓慢，不像其他证候那样突然发作，这就是阴虚的征候，治疗应当专门滋补真阴，适宜用小营煎、三阴煎、五阴煎之类，根据具体情况主治。若阴虚兼有火邪而微热者，适宜用一阴煎。若阴虚兼火邪很盛而大热者，适宜用加减一阴煎。若阴虚火盛，发热且多汗者，适宜用当归六黄汤。若阴中之阳虚，火不归源（虚火上浮）而发热者，适宜用大营煎、理阴煎、右归饮之类主治。若血虚导致阳气不能依附于阴，出现烦热作渴者，适宜用人参当归汤。若气血俱虚，发热烦躁，面红作渴，适宜用八珍汤、十全大补汤。若热势很盛而脉微者，适宜紧急加入肉桂、附子，若误认为是火证，则祸患就在顷刻之间。
一、产后有因去血过多而发热者，其症状必定是烦躁口渴、短气、头痛头晕、闷乱内热，这也是阴虚的一类，适宜用人参当归汤主治。
薛立斋说：大凡元气虚弱而发热者，都是内部真寒而外部假热。只用六君子汤或补中益气汤加炮姜温补脾气，各种症状自然会消退。若四肢畏冷，紧急加入附子。凡是新产之后阴血暴伤，阳气无所依附而外部发热，适宜用四物汤、炮姜，补阴以配合阳。若因误服寒凉克伐之剂而导致外部发热，这是寒气格拒阳气于外，适宜用四君子汤加生姜、肉桂；如无效，紧急加入附子。若肌肤发热，面目赤色，烦躁口渴引饮，这是血脱导致的发躁，适宜用当归补血汤。
Postpartum fever may arise from external contraction of wind-cold, internal excess of pathogenic fire, deficiency of yin due to fluid depletion, fatigue and mental restlessness after childbirth, or excessive blood loss leading to dizziness, oppression, and irritability. These syndromes differ, and treatment must be based on differentiation and observation.
First, postpartum fever due to external contraction: During delivery, the body is often exposed and exertion is required, leaving little time for protection. At this time, if cold pathogens are encountered, they easily enter through the deficiency, making infection most likely. If headache, body ache, aversion to cold with fever, or stiffness and tension in the waist and back are observed, along with a tight or rapid pulse, it is a case of postpartum external contraction. However, such external contractions occur immediately upon exposure and differ from true Shanghan (Cold Damage) where pathogens lie dormant before manifesting. Therefore, slight dispersal of the exterior will lead to recovery. One should not assume that exterior-releasing methods are contraindicated after recent childbirth; rather, one must assess deficiency and excess to apply appropriate treatment. For postpartum patients contracting pathogens without significant Qi deficiency, San Chaihu Yin (Three Bupleurum Decoction) is suitable. For those with Qi deficiency and weak Spleen contracting pathogens, Si Chaihu Yin (Four Bupleurum Decoction) or Wu Chaihu Yin (Five Bupleurum Decoction) are suitable. For those with insufficiency of the Liver, Spleen, and Kidney Yin contracting pathogens, Buyin Yiqi Jian (Yin-Nourishing and Qi-Replenishing Decoction) is suitable. For severe deficiency-cold, Liyin Jian (Nourishing Yin Decoction) is suitable. For robust postpartum women with excess Qi contracting pathogens, Zheng Chaihu Yin (Standard Bupleurum Decoction) is suitable. For cases with internal fire excess and unresolved exterior pathogens, Yi Chaihu Yin (One Bupleurum Decoction) is suitable. For simultaneous contraction of wind and cold with stagnation in both interior and exterior, Wuji San (Five Accumulations Powder) is suitable.
Second, postpartum fever due to Fire syndrome: Exterior heat from external contraction usually resides at the surface, whereas heat from Fire syndrome resides internally. This is invariably caused by excessive care or environmental factors: extreme seasonal heat, forced alcohol consumption, erroneous use of strongly tonifying herbs like Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Shengjiang (Zingiberis Rhizoma Recens), or Rougui (Cinnamomi Cortex); excessive use of charcoal fires; overly sealed windows and doors causing stagnant air; or excessive physical activity in individuals with originally robust constitutions. Any excess can generate fire. Internal fire excess typically presents as tidal fever (fever that occurs at specific times or worsens periodically) and internal heat, irritability, thirst preferring cold drinks, headache with profuse sweating, dry stools, dark urine, and reckless bleeding due to blood-heat, provided there are no exterior signs and the pulse is slow, slippery, not tight, yet accompanied by fever. This indicates Fire syndrome, treated with Qinghua Yin (Clearing Transforming Decoction) or Baoyin Jian (Preserving Yin Decoction). If the root vitality is not deficient, or if the fire is intense and the condition acute, Xixin Yin (Removing Firewood Decoction) or Chouxin Yin (Drawing Out Firewood Decoction) are commonly used without hesitation.
Third, postpartum fever due to Yin deficiency: This necessarily stems from constitutional insufficiency of the Spleen and Kidneys, compounded by postpartum deficiency of both Qi and Blood. Symptoms include alternating sensations, intermittent onset, occurring day or night irregularly, mental fatigue, palpitations, and mental confusion. Provided there are no exterior signs, but the pulse is wiry and rapid, or floating, wiry, and large/hollow, or faint, thin, and forceless, and the onset is gradual rather than sudden, this is a sign of Yin deficiency. Treatment should focus exclusively on nourishing True Yin, using Xiaoying Jian (Minor Camp Decoction), Sanyin Jian (Three Yin Decoction), or Wuyin Jian (Five Yin Decoction) as appropriate. If Yin deficiency is accompanied by mild fire, Yiyin Jian (One Yin Decoction) is suitable. If Yin deficiency is accompanied by severe fire and high fever, Jiajian Yiyin Jian (Modified One Yin Decoction) is suitable. If Yin deficiency with fire excess causes fever and profuse sweating, Danggui Liu Huang Tang (Angelica Hexapartite Decoction) is suitable. If Yang within Yin is deficient, causing fire to fail to return to its source (floating fire) and resulting in fever, Daying Jian (Major Camp Decoction), Liyin Jian (Nourishing Yin Decoction), or Yougui Yin (Right Restoration Decoction) are suitable. If Blood deficiency leads to Yang failing to attach to Yin, causing irritability, heat, and thirst, Renshen Danggui Tang (Ginseng and Angelica Decoction) is suitable. If both Qi and Blood are deficient, causing fever, irritability, red face, and thirst, Bazhen Tang (Eight Treasures Decoction) or Shiquan Dabu Tang (Ten Complete Tonification Decoction) are suitable. If the heat is severe but the pulse is faint, Guizhi (Cinnamon Twig) and Fuzi (Prepared Aconite Lateral Root) should be added urgently; misidentifying this as fire will lead to disaster in an instant.
Fourth, postpartum fever due to excessive blood loss: Symptoms must include irritability, thirst, shortness of breath, headache, dizziness, oppression, and internal heat. This also belongs to Yin deficiency, treated with Renshen Danggui Tang (Ginseng and Angelica Decoction).
Xue Lizhai stated: Generally, fever arising from weak Yuan Qi (Primal Qi) is characterized by true cold inside and false heat outside. Using Liujunzi Tang (Six Gentlemen Decoction) or Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Paojiang (Roasted Ginger) to warm and tonify Spleen Qi will cause symptoms to recede. If limbs are cold, add Fuzi (Prepared Aconite Lateral Root) urgently. In new mothers where Yin blood is suddenly injured and Yang has no attachment, causing external heat, Siwu Tang (Four Substances Decoction) and Paojiang (Roasted Ginger) should be used to nourish Yin and harmonize Yang. If external heat results from erroneously taking cold and purgative agents, this is cold rejecting Yang to the exterior; use Sijunzi Tang (Four Gentlemen Decoction) with Shengjiang (Fresh Ginger) and Rougui (Cinnamon Bark); if ineffective, add Fuzi (Prepared Aconite Lateral Root) urgently. If skin feels hot, face and eyes are red, and there is irritability, thirst, and desire to drink, this is agitation due to blood loss and hair follicle exhaustion; use Danggui Buxue Tang (Angelica Tonifying Blood Decoction).