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Any blood clots appearing after childbirth are formed by the accumulation of residual blood from pregnancy. In women, if blood is abundant and Qi is deficient, Tian Gui (menstrual fluid) arrives at age fourteen, occurring once every thirty days, symbolizing that when the moon is full, it begins to wane. Menstruation follows a regular pattern and is called "Jing" (menses). Once pregnant, menstruation ceases, and the remaining blood flows into the Bao Gong (uterus) to protect the Tai Yuan (fetal origin). However, in the first month of pregnancy, it is called "Tai Pei" (embryo), in the second month "Tai Gao" (fetal paste), and only after three months does it take shape and be formally named "Tai" (fetus). At this stage, the fetus has just received protection from the mother's Yin blood; the fetal form is still small, and after consuming maternal blood, there is still surplus. Calculating the accumulation from the first two months onwards within the uterus, over time these residues form clots, which should be expelled along with the infant at delivery.

Many parturients, due to exhaustion and weakness during the delivery of the infant and placenta, or due to inadequate care and lack of warmth, experience pain from these clots, which may take a long time to dissipate. One must not lightly use harsh purgatives for blood stasis, nor drink large amounts of warming substances like ginger, pepper, mugwort, or wine. Excessive heat will inevitably damage the newly generated blood. The treatment method requires frequent administration of Shenghua Tang (Decoction for Generating Blood) for several doses to assist blood circulation, while keeping the abdomen warm with hot clothing.

Regarding various postpartum conditions, folk practices often have biases. For treating blood clots, some use Sheng Di Huang (Rehmanniae Radix Preparata) and Hong Hua (Carthami Flos) to move blood, or Su Mu (Sappan Lignum) and Niu Xi (Achyranthis Bidentatae Radix) to attack stasis. For treating Qi stagnation, some use Wu Yao (Linderae Radix) and Xiang Fu (Cyperi Rhizoma) to smooth Qi, or Zhi Qiao (Aurantii Fructus) and Hou Po (Magnoliae Officinalis Cortex) to relax. Some even use Qing Pi (Citri Reticulatae Pericarpium Viride), Zhi Shi (Aurantii Fructus Immaturus), and Su Zi (Perillae Fructus) to descend Qi and calm asthma, or Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Zhi Zi (Gardeniae Fructus), and Huang Bai (Phellodendri Cortex) to clear heat and relieve irritability. As for constipation due to blood dryness, using Cheng Qi Tang (Order the Qi Decoction) to purge results in further constipation; for scanty, painful urination due to excessive sweating, using Wu Ling San (Five-Ingredient Powder with Poria) to promote urination results in further retention. These approaches deviate from the correct path and fail to understand the importance of consolidating the root. Furthermore, some believe Shan Zha (Crataegi Fructus) can dissolve blood clots and allow weak individuals to take it frequently for two or three times; such persons will undoubtedly die.

After childbirth, Qi and Blood are suddenly deficient, so major tonification is indicated. However, since E Lu (lochia) is not yet exhausted, tonification must be used with caution to avoid causing stagnation. Blood can transform and generate; attacking clots does not damage Yuan Qi, and moving blood while simultaneously nourishing constitutes a comprehensive approach, ensuring no errors in treatment. The world's use of Si Wu Tang (Four Substance Decoction) for postpartum care has misled many. This is because Di Huang (Rehmanniae Radix) is cold and causes stagnation, and Shao Yao (Paeoniae Radix Alba) is sour and cold, offering no benefit to righteous Qi. A condition where lochia forms clots causing pain is called "Er Zhen" (Child's Pillow). The world mostly focuses on dissolving it first before discussing tonification, or uses mixed formulas for both dissolving and tonifying. They do not realize that old blood must be cleared and transformed, and new blood must also be generated and nourished. If one specializes only in attacking old blood, the new blood will also be unsettled. The world uses Ji Kun Dan (also known as Hui Sheng Dan) to treat postpartum conditions, aiming to attack blood clots, expel the placenta, and induce abortion. Although it shows rapid effects, it inevitably damages Yuan Qi. Do not regard it as a good remedy. If Ji Kun Dan is used out of necessity to expel the placenta or fetus, only one pill should be taken; it must not be taken in excess.

My proposed Shenghua Tang is named based on the efficacy of its ingredients. Generally, postpartum blood clots should be eliminated, and new blood should be generated. If one specializes only in elimination, Heart Blood will be unsettled; if one specializes only in generation, old blood will remain stagnant. Examining the properties of herbs, only Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix), and Tao Ren (Persicae Semen) possess the property of effectively breaking down old blood and rapidly generating new blood. These are assisted by Zhi Hei Gan Jiang (Prepared Blackened Ginger Rhizome) and Gan Cao (Glycyrrhizae Radix et Rhizoma) to guide the three herbs into the Lung and Liver meridians. Together, these five herbs generate blood and benefit Qi. Thus, in moving blood there is tonification, and in resolving stasis there is generation. It is truly a sacred formula for postpartum care, hence named Shenghua Tang.

Diseases arise from the decline of Qi and Blood and the deficiency of the Spleen and Stomach; postpartum deficiency of Qi, Blood, Spleen, and Stomach is particularly severe. Therefore, Mr. Danxi stated that postpartum treatment must prioritize major tonification of Qi and Blood. Even if other symptoms exist, they should be treated as secondary matters. These three statements summarize the main principles of obstetric medicine. If physicians can expand upon this to formulate prescriptions, treatments will likely avoid major errors. Physicians should study this carefully.

Shenghua Tang can be prepared in advance (two or three doses) from the seventh or eighth month of pregnancy. When the membranes are about to rupture, quickly decoct one dose and administer it immediately after the infant is born. Whether it is a normal delivery or a miscarriage, even for young and strong parturients who are safe and sound, it is advisable to take two doses to eliminate blood clots and generate new blood.

Ingredients: Dang Gui (8 qian, washed with wine), Chuan Xiong (4 qian), Gan Jiang (5 fen, prepared blackened retaining nature), Tao Ren (15 grains, peeled and removed of tips), Gan Cao (5 fen, prepared).

Decoct with 2 cups of water until reduced to 0.7 cup. Add 7 tea spoons of wine, warm slightly, and take. Retain the dregs and combine them with the dregs of the next dose. Decoct the combined dregs three times across two doses. Administer continuously within two shichen (4 hours), prior to any food intake. Since this addresses lower Jiao E Lu, frequent and repeated administration allows for continuous transformation of stasis and rapid growth of new blood, thereby avoiding syncope. For those constitutionally weak before pregnancy or suffering from postpartum fatigue, prepare two additional doses to prevent fainting and exhaustion. After taking one dose, the patient's spirit gradually improves; do not dislike the frequency of medication. If administered conventionally, one dose today and one tomorrow, how can it rescue the nearly exhausted Qi and Blood? For weak patients presenting with critical conditions, heat-induced abortion, or extreme fatigue with fever and headache, taking four or five doses may bring slight relief, but if blood pain persists, continue administration.

Jia Shen Shenghua Tang (Shenghua Tang with Ginseng):
Treats various critical postpartum conditions. It can be used continuously for a day and night, requiring frequent administration of three to four doses. If administered conventionally, one dose today and one tomorrow, how can it reconnect and tonify nearly exhausted Qi and Blood to save critical conditions?

Ingredients: Dang Gui (3 qian), Chuan Xiong (1.5 qian), Gan Jiang (4 fen, prepared blackened retaining nature), Gan Cao (3 fen, prepared), Tao Ren (15 grains, peeled and removed of tips), Ren Shen (2 qian).

For critical conditions involving collapse, cold limbs, and excessive sweating, increase Ren Shen to 3-4 qian, decoct with jujube water, and take.

Modifications:
For pulseless conditions and physical appearance indicating impending collapse, this formula must be taken, administered frequently to rescue. Increase Ren Shen to 4-5 qian. For postpartum blood syncope or flooding accompanied by excessive sweating and loss of complexion, this formula is suitable. If there is no sweating and no collapse, take only the basic Shenghua Tang without adding Ren Shen. For postpartum flooding with loss of complexion, this formula is suitable, preferably decocted frequently, with Ren Shen increased to 3-4 qian. For postpartum cold extremities and convulsions, take this formula with Ren Shen 3-4 qian; if accompanied by sweating, add Ren Shen 3-4 qian and Mai Dong (Ophiopogonis Tuber) 1 qian. If the Left Chi pulse is weak, add Ren Shen. For postpartum excessive sweating, add Ren Shen 3-4 qian. For excessive sweating with severe thirst, add Ren Shen 3-4 qian and Mai Dong 3 qian. For excessive sweating with shortness of breath resembling asthma, add Ren Shen 3-4 qian. For excessive sweating with phlegm and cough, add Zhu Li (Bambusae Succus), Jiang Zhi (Zingiberis Recens Juice), and Xing Ren (Armeniacae Semen Amarum) 25 grains. For excessive sweating with loud coughing and wheezing, add Xing Ren 10 grains and Jie Geng (Platycodonis Radix) 5 fen. For no sweating with coughing, wheezing, and shortness of breath, add Ban Xia (Pinelliae Rhizoma Preparatum) 1 qian, Xing Ren 10 grains, and Jie Geng 5 fen. For excessive sweating with body heat and shortness of breath, add Ren Shen 3-4 qian; if sweating does not stop, add Huang Qi (Astragali Radix) 1 qian.