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，有三日乳汁充盈蒸腾导致的发热，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，变证百出。凡是发热，多因血虚，阳气无所依附，浮散于体表而表现为发热，适宜以四物汤为君药，去掉川芎、生地，换成熟地，加入软苗柴胡、人参、炮姜最为有效。这是因为炮姜辛热且兼有苦咸之味，以火治火，收敛浮热，并且能引导血药进入血分，气药进入气分，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，应当使用逍遥散来清肝火、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，这是从阴虚发热立论，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，从而出现外热，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，这是寒气格拒阳气于外的表现，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，大渴引饮的，这是血脱发燥的表现，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，祸患就在眨眼之间。
Cold damage (Shanghan) occurring postpartum should not be treated with diaphoresis (sweating therapy) lightly. Fever during childbirth may result from excessive exertion, excessive blood loss, retention of lochia (postpartum uterine discharge), engorgement of milk after three days, early labor, or food stagnation. These conditions resemble cold damage; careful differentiation is essential. One must never rashly induce sweating, as the consequences are irreversible like spilled water. Postpartum, the great blood is empty. Heavy sweating may lead to collapse of Yang (collapse of vital energy); light sweating may cause twitching of sinews and muscles, or depression, dizziness, coma, convulsions, difficulty in urination, and constipation, leading to myriad complications. Fever is mostly due to blood deficiency, where Yang has no foundation and floats outward, manifesting as heat. The appropriate formula is Siwu Tang (Four Substances Decoction) as the sovereign drug, removing Chuanxiong Rhizoma (Chuanxiong) and Rehmanniae Radix Recens (Shengdi), replacing them with Rehmanniae Radix Praeparata (Shudi), and adding soft-stemmed Bupleuri Radix (Chaihu), Ginseng Radix et Rhizoma (Renshen), and Zingiberis Rhizoma Praeparatum (Paojiang). This is most effective. Paojiang is acrid, hot, and possesses bitter and salty properties. It treats fire with fire, consolidating floating heat. It also guides blood-invigorating herbs into the blood level and qi-regulating herbs into the qi level. Furthermore, it removes stasis and generates new blood, following the principle of "Yang generating Yin." Treating heat with heat aligns deeply with the teachings of the *Neijing* (Inner Canon). When righteous Qi is strengthened, external pathogens dissipate naturally.
Yang Gui stated: If there were originally Yin deficiency with fire symptoms 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 dryness of Blood occur. One should not rigidly adhere to the theory of dual deficiency of Qi and Blood. This argument is based on fever caused by Yin deficiency, and pulse diagnosis should be consulted for detailed analysis.
Xue Lizhai stated: In newly delivered women, sudden loss of Yin Blood leaves Yang without attachment, resulting in exterior heat. Siwu Tang (Four Substances Decoction) added with Paojiang (Prepared Ginger Rhizome) is suitable to nourish Yin to harmonize with Yang. If cold and purgative medicines are mistakenly taken, resulting in exterior heat, this indicates Cold rejecting Yang to the exterior. Sijunzi Tang (Four Gentlemen Decoction) added with Shengjiang (Fresh Ginger) and Rougui (Cinnamon Bark) is suitable. If there is no response, Fuzi (Aconite Lateralis Radix Praeparata) should be added urgently. If skin feels hot, face is red, and there is extreme thirst with desire to drink, this indicates blood depletion causing dryness. Danggui Buxue Tang (Tangui Tonify the Blood Decoction) is indicated. He further stated: Postpartum vexatious heat is due to Yang scattering with Yin, resulting in dual deficiency of Qi and Blood, hence aversion to cold and fever. If mistakenly treated as a Fire syndrome and administered cooling agents, disaster will ensue instantly.