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Postpartum massive hemorrhage. One must examine whether the blood is red or purple, and assess the deficiency or excess of the patient's spirit, complexion, and physical form. If the blood is dark purple with clots, these are retained blood (retained blood) that should be expelled; forcibly stopping them will cause pain, and this condition should not be treated as metrorrhagia (postpartum hemorrhage). If bright red blood flows profusely, it indicates that fright has injured the Heart (Heart), causing it to fail in governing the blood; anger has injured the Liver (Liver), causing it to fail in storing the blood; and overexertion has injured the Spleen (Spleen), causing it to fail in controlling the blood to remain within the vessels. This condition should be treated as metrorrhagia. Initially, it is appropriate to frequently administer Shenghua Tang (Decoction for Generating New Blood) for a few doses, so that while promoting blood circulation, tonification is also provided, allowing the blood to calm down and flourish. If there is collapse of the physical form (extreme weakness), excessive sweating, or shortness of breath, one should administer Shenghua Tang with doubled Ginseng Radix et Rhizoma (Renshen, 人参) to tonify Qi, thereby generating Yang and nourishing Yin. This cannot be stopped by agents such as Cinnabar Ash (Zonghui, 棕榈灰). Furthermore, if metrorrhagia occurs more than half a month after delivery, Shengju Dabu Tang (Decoction for Lifting and Great Tonification) should be used for treatment.

[Formula 1: Modified Shenghua Tang]
Chuanxiong Rhizome (Chuanxiong, 川芎) (1 qian), Angelica Sinensis Root (Danggui, 当归) (4 qian, tail removed), Charred Ginger Rhizome (Jiangtan, 姜炭), Honey-fried Licorice Root (Zhigancao, 炙甘草), Schizonepeta Spike (Jingjie, 荆芥), Smoked Plum (Wumei, 乌梅) (charred to ash), Yellow Poppy Seed (Puhuang, 蒲黄) (stir-fried, each 5 fen), Peach Kernel (Taoren, 桃仁) (10 grains), Jujube Fruit (Zao, 大枣) (2 pieces). Decoct and take orally. Avoid fresh ginger, Sichuan pepper, hot-natured foods, and raw/cold foods. If bright red blood flows profusely, add White Peony Root (Baizhi, 白芷) (5 fen). If there is severe depletion (Xuejie, 血竭 - referring to extreme exhaustion state here) accompanied by collapse of form, excessive sweating, and shortness of breath, add Ginseng Radix et Rhizoma (Renshen, 人参) (3-4 qian). If there is no sweating, no collapse, and no shortness of breath, simply taking a few more doses of Shenghua Tang will naturally calm the blood. It is said in the world that Chuanxiong and Danggui can only invigorate blood but cannot treat metrorrhagia; this is a misleading argument.

[Formula 2: Zirong Yiqi Zhibeng Tang / Nourishing and Qi-Tonifying Hemostatic Decoction]
Clot-related pain has been resolved, but metrorrhagia persists.
Astragalus Membranaceus Root (Huangqi, 黄芪), Atractylodes Macrocephala Rhizome (Baizhu, 白术), Ginseng Radix et Rhizoma (Renshen, 人参), Angelica Sinensis Root (Danggui, 当归), Rehmannia Glutinosa Root Preparata (Shengdi, 生地), Ophiopogon Japonicus Tuber (Maidong, 麦冬), Chuanxiong Rhizome (Chuanxiong, 川芎) (each 1 qian), Tangerine Peel (Chenpi, 陈皮), Honey-fried Licorice Root (Zhigancao, 炙草), Cimicifuga Rhizome (Shengma, 升麻), White Peony Root (Baizhi, 白芷), Schizonepeta Spike (Jingjiesui, 荆芥穗) (each 4 fen), Coptis Rhizome (Huanglian, 黄连) (4 fen). If sweating is excessive, add Equisetum Hiemale Stem (Mahuanggen, 麻黄根) (1 qian) and Floating Wheat (Fumai, 浮麦) (a pinch). If bowel movement is obstructed, add Cistanche Deserticola Stem (Roucongrong, 肉苁蓉) (1 qian); Rhubarb (Dahuang, 大黄) is prohibited. If there is Qi stagnation and distension, add Costus Root (Muxiang, 木香) (1 qian). If there is phlegm, add Pinellia Tuber (Beimu, 贝母) (6 fen), Bamboo Sap (Zhuli, 竹沥), and Ginger Juice (Jiangzhi, 姜汁). If there is cold cough, add Apricot Seed (Xingren, 杏仁), Platycodon Root (Jiegeng, 桔梗), and Anemarrhena Rhizome (Zhimu, 知母) (each 1 qian). If there is palpitations due to fright, add Sour Jujube Seed (Zaoren, 枣仁) and Biota Seed (Baiziren, 柏子仁) (each 1 qian). If injured by food stagnation from flour products, add Malt (Maiya, 麦芽) (1 qian). If injured by food stagnation from rice products, add Medicated Leaven (Shenqu, 神曲) (1 qian). If injured by food stagnation from meat products, add Hawthorn Fruit (Shanzha, 山楂) and Amomum Fruit (Sharen, 砂仁) (each 8 fen). When there is body heat, do not use Scutellaria Root (Qin, 黄芩), Coptis Rhizome (Lian, 黄连), or Phellodendron Bark (Huangbai, 黄柏). For conditions caused by food stagnation or anger, do not exclusively use formulas that disperse without tonifying; instead, modify the above formula. The decoction vehicle should be Jujube Fruit (Zao, 大枣). Decoct and take orally.