产后七日内，发热头痛恶寒，毋专论伤寒为太阳症；发热头痛胁痛，毋专论伤寒为少阳症，二症皆由气血两虚，阴
阳不和而类外感。治者慎勿轻产后热门，而用麻黄汤以治类太阳症；又勿用柴胡汤以治类少阳症。且产母脱血之后，而
重发其汗，虚虚之祸，可胜言哉！昔仲景云∶“亡血家不可发汗。”丹溪云∶“产后切不可发表。”二先生非谓产后真无伤
寒之兼症也，非谓麻黄汤、柴胡汤之不可对症也，诚恐后辈学业偏门而轻产，执成方而发表耳。谁知产后真感风感寒，
生化中芎、姜亦能散之乎！
加味生化汤 治产后三日内发热头痛症。
川芎 防风（各一钱） 当归（三钱） 炙草（四分） 桃仁（十粒） 羌活（四分）
眉批∶一本无桃仁，有黑姜四分。
查刊本去桃仁。然必须问有块痛与否，方可议去。服二帖后，头仍痛，身仍热，加白芷八分、细辛四分；如发热不
退，头痛如故，加连须葱五个、人参三钱。产后败血不散，亦能作寒作热，何以辨之？曰∶时有刺痛者，败血也；但寒
热无他症者，阴阳不和也。刺痛用当归，乃和血之药；若乃积血而刺痛者，宜用红花、桃仁、归尾之类。
歌括∶产后六七日当中，发热恶寒头亦痛。
气血两虚阴阳捍，类似外感表无功。
加味生化用防风，炙草羌活桃归芎。
二剂头痛身仍热，再加白芷细辛葱。
产后七日内，出现发热、头痛、恶寒的症状，不要仅仅将其诊断为伤寒的太阳病；若出现发热、头痛、胁痛的症状，不要仅仅将其诊断为伤寒的少阳病。这两种症状都是由气血两虚、阴阳不和引起的，表现为类似外感病的证候。治疗者千万不要轻视产后发热的情况，而使用麻黄汤来治疗类太阳病；也不要使用柴胡汤来治疗类少阳病。况且产妇在失血之后，如果再强行发汗，导致虚上加虚的危害，难道能说尽吗！过去张仲景说：“亡血家不可发汗。”朱丹溪说：“产后切不可发表（使用解表药）。”这两位先生并不是说产后真的没有兼夹伤寒的情况，也不是说麻黄汤、柴胡汤不能对症使用，而是担心后辈医生学业偏颇，轻视产后病症，拘泥于成方而滥用解表药罢了。谁知道产后真正感受风邪或寒邪时，在生化汤中加入川芎、生姜也能发散之啊！
加味生化汤：治疗产后三日内发热、头痛的症状。
药材组成：川芎、防风（各一钱），当归（三钱），炙甘草（四分），桃仁（十粒），羌活（四分）。
眉批：另一个版本没有桃仁，有四分黑姜。
查考刊本去掉了桃仁。然而必须询问是否有瘀块疼痛，才可以考虑去掉桃仁。服用两帖后，如果头痛仍未缓解，身体仍然发热，加入白芷八分、细辛四分；如果发热不退，头痛依旧，加入带须葱五个、人参三钱。产后败血不散，也能引起忽冷忽热，如何辨别呢？回答说：如果时有刺痛感的，是败血（瘀血）所致；如果只是寒热往来而没有其他症状的，是阴阳不和所致。刺痛属于血虚不荣，用当归调和血液；如果是积血阻滞导致的刺痛，适宜使用红花、桃仁、当归尾之类的药物。
歌诀：产后六七日当中，出现发热、恶寒且头部疼痛。
气血两虚阴阳捍（护/乱），类似外感表证无效功。
加味生化用防风，炙草羌活桃归芎。
二剂头痛身仍热，再加白芷细辛葱。
Within seven days after childbirth, if fever, headache, and aversion to cold occur, do not exclusively diagnose it as the Taiyang syndrome (Taiyang disease) of Shanghan (Cold Damage); if fever, headache, and hypochondriac pain occur, do not exclusively diagnose it as the Shaoyang syndrome (Shaoyang disease) of Shanghan. Both conditions arise from deficiency of both Qi and Blood, and disharmony of Yin and Yang, presenting similarly to external contraction. Practitioners must not lightly dismiss postpartum fever and use Mahuang Tang (Ephedra Decoction) to treat the Taiyang-like syndrome; nor should they use Chaihu Tang (Bupleurum Decoction) to treat the Shaoyang-like syndrome. Moreover, after a puerpera has lost blood, inducing sweating again would lead to the disaster of exacerbating deficiency; how could such consequences be fully described? In the past, Zhang Zhongjing stated: "Those who have lost blood should not be induced to sweat." Zhu Danxi stated: "Postpartum patients must absolutely not be treated with exterior-releasing methods." These two masters did not mean that postpartum cases truly lack concurrent Shanghan symptoms, nor did they imply that Mahuang Tang or Chaihu Tang are never appropriate for specific indications; rather, they feared that junior practitioners might have biased learning, underestimate postpartum conditions, and rigidly apply established formulas to release the exterior. Who would know that if a postpartum patient truly contracts wind or cold, adding Xiong (Ligusticum Chuanxiong Rhizome) and Jiang (Zingiberis Rhizoma Recens, Fresh Ginger) to Shenghua Tang can also disperse them!
Jiawei Shenghua Tang (Modified Shenghua Decoction): Treats fever and headache within three days after childbirth.
Ingredients: Chuanxiong Rhizome (Chuanxiong), Saposhnikovia Root (Fangfeng) (each 1 qian), Angelica Sinensis Root (Danggui) (3 qian), Honey-fried Licorice Root (Zhigancao) (4 fen), Peach Kernel (Taoren) (10 grains), Notopterygium Rhizome (Qianghuo) (4 fen).
Marginal note: Another version lacks Taoren but includes 4 fen of Charred Ginger (Heijiang).
The printed edition removes Taoren. However, one must inquire whether there is pain due to clots before considering removing Taoren. After taking two doses, if headache persists and body heat remains, add Baizhi (Angelicae Dahuricae Radix) 8 fen and Xixin (Asari Radix et Rhizoma) 4 fen; if fever does not subside and headache remains unchanged, add five scallions with roots (Congbai) and 3 qian of Ginseng Root (Renshen). Stagnation of lochia (bad blood) after childbirth can also cause chills and fever. How to differentiate? Answer: If there are paroxysmal stabbing pains, it is due to stagnated blood; if there are only chills and fever without other symptoms, it is due to disharmony of Yin and Yang. For stabbing pain, Danggui is used as a herb to harmonize blood; if the stabbing pain is caused by accumulated blood, herbs such as Honghua (Carthami Flos), Taoren, and Guibei (the tail end of Danggui root) should be used.
Rhyme prescription:
During the sixth or seventh day postpartum,
Fever, chills, and headache appear too.
Qi and Blood deficient, Yin and Yang clash,
Resembling exterior pathogen, yet surface treatment fails.
Use Fangfeng in Modified Shenghua Tang,
With Zhigancao, Qianghuo, Taoren, Danggui, and Chuanxiong.
After two doses, if headache and heat persist,
Add Baizhi, Xixin, and Congbai to resist.