产后血块，是孕成余血之所积也。夫妇人血旺气衰，二七而天癸至，三旬一见，以象月盈则
亏，行之有常则曰经。有孕则经水不行，其余血注于胞中以护胎元。一月名胎胚，二月名始膏，
三月始成形而名胎，方受母血之荫庇。胎形尚小，虽食母血，而尚有余汁，并前两月之血，积于
胞中，日久成块。至产时，当随儿下。或因产妇送儿送胞劳倦无力，或谓调护失宜，腹欠温暖，
至血块日久不散，疼痛拒按，并宜生化汤助血行血，外用热衣暖腹可也。慎勿轻服峻剂，至崩脱不救。
凡产后晕厥二症，皆由气血并竭，苟非急补，何能挽其将绝之元神，无庸疑义者也。但晕在
临盆，症急犹甚于厥，用药不及，急救法救之，如其人微虚者，则眼花头眩，或心下满闷，神昏
口噤，不知人事，少顷即苏，或因亡血过多，以致虚火乘虚泛上，而神不清，身无所主，其阴血
暴亡，心神失养，心与胞络，君相之火，得血则安，亡血则危。火上炽，故令人昏冒；火乘肺，
故瞑目不省人事。是阴血暴亡，不能镇抚也。《经》云∶病气不足，宜补，不宜泻。瞑目合眼，病悉属阴，暴去有形之
血，则火上炽。均宜频灌生化汤，或从权急救，生化汤二、三帖，先补血分之亏，则块化、血旺、神清而晕止。大虚者，
其症面白眼闭，口开手冷，多汗神昏，六脉微细之甚，是气随血脱而欲绝，当剂人参方可回阳，恐势
急而补阴不及，须以兼用气药。此阳生阴长之理也。以权急救加参生化汤最效。但凡大病大虚之
人，皆能作晕。产后之晕，因血去而名之曰血晕，实非因血而致晕也。即有恶血上逆、血滞等症，
亦莫若生化汤温而行之，去瘀止晕之妙。予见江南产科，有用当归一钱、益母草一钱，人参二钱，
红花六分，炮姜八分，煎热，冲童便服之，以治晕。此方兼得之义，庶几近之。至于厥症，在分
娩之后，因产时用力过多，劳倦伤脾，孤脏不能注于四傍，故手足逆冷而发厥。《经》云∶阳气衰
于下，则为寒厥。厥气上行，满脉去形。盖逆气上满于经络，则神气浮越，去身而散也。宜大补回
阳，生化汤连用二服，俟气血旺而神复，厥症自止矣。又非偏补血分之可得而愈也。若服药而口渴，
另用参麦散以代茶，助津以救脏燥也。又有四肢逆冷、泄痢，类伤寒阴症，不可用四逆汤，必生化
汤倍参煎服，或加熟附子一片，则可以止逆回阳，而见参、归之功矣。若血块痛止而厥，滋荣益气汤
最效。凡晕厥，乃产后危急二症，若新产块痛未除，又未可遽加 、术，故急加人参，从权以救之。
俟晕止厥回，再去参以除块痛，此要诀也。
从权急救生化汤 治三等血晕，兼化瘀生新。
川芎（三钱） 当归（六钱或八钱酒洗） 干姜（四分炙黑） 桃仁（十粒去皮尖） 炙草（五分）
荆芥穗（四分炒黑，汗多忌用）
枣二枚，水煎服。劳倦甚及血崩，或汗多形气脱而晕，加人参三钱，肉桂四分，急服一、二帖，
其效如神，决不可疑参为补而缓之。
从权急救加参生化汤 治产后形色脱晕。
人参（三钱） 川芎（二钱） 当归（四钱酒洗） 干姜（四分炙黑） 桃仁（十粒去皮尖）
炙草（五分） 荆芥（四分炒黑，汗多忌用）
枣二枚，水煎服。血块痛甚，加肉桂七分；汗多加麻黄根一钱；如无块痛，加蜜炙黄 一钱以
止汗。
加参生化汤（附大补回阳生化汤） 人参（二钱） 川芎（四钱） 当归（八钱酒洗）
干姜（四分炙黑） 炙草（五分） 桃仁（十粒去皮尖）
枣二枚，水煎服。此方产后诸危急症通用。一日夜须服三、四帖，方能接绝之气。如产后三日
内，块痛未除，俟元气稍复，已有生意，当去参，仍服生化原方。虚脱、厥逆、汗多，加人参三、
四钱；脉与形俱脱将绝，必用此方频灌；汗多、身热、气短，加人参；左尺脉弱，亦加人参；汗不
止，三、四剂后，加蜜炙黄 一钱。一方∶川芎、当归减半，名大补回阳生化汤，治新产厥症，
枣引，速煎二服即效。若厥症作渴，佐以生脉、五味饮代茶，以救津液，则渴减厥回。
滋荣益气汤 治血块痛止而厥。
人参 当归（各二钱） 川芎 白术（土炒） 黄 （蜜炙各钱半或一钱） 熟地（二钱）
麦冬（八分或一钱去心） 炙草（四分） 五味子（十粒） 川附子（五、六分或一钱制）
水煎服。汗多加麻黄根、炒枣仁各一钱。
Postpartum blood clots are accumulated residual blood from pregnancy. In women, if blood is abundant and qi is relatively weak, Tian Gui (substances promoting reproductive maturity) arrives around age fourteen, occurring once a month, analogous to the moon waning after being full; regular occurrence is termed menstruation. During pregnancy, menstruation ceases, and residual blood flows into the Baogong (uterus) to protect the fetal origin. At one month of gestation, it is called Tai Pei (fetal embryo); at two months, Shi Gao (beginning paste); at three months, it begins to take form and is named Tai (fetus), receiving nourishment from maternal blood. The fetal form is still small; although it consumes maternal blood, there remains surplus fluid, which, combined with blood from the previous two months, accumulates in the Baogong. Over time, this forms blood clots. At delivery, these should be expelled along with the infant. If due to the mother's exhaustion from labor or improper care leading to abdominal coldness, the blood clots fail to dissipate for a long time, causing pain and tenderness upon pressure, it is appropriate to administer Shenghua Tang (Decoction for Generating New Blood) to promote blood circulation, and apply warm clothing to the abdomen. One must not lightly administer harsh purgatives, lest they cause collapse that cannot be saved.
Both postpartual fainting (Yun) and convulsive coma (Jue) result from simultaneous depletion of qi and blood. Without urgent tonification, how can the nearly extinct Yuan Shen (original spirit) be restored? This is beyond doubt. However, Yun occurring during labor is more acute than Jue. If medication is too slow, emergency methods must be used. If the patient has slight deficiency, symptoms include blurred vision, dizziness, chest fullness, unconsciousness, locked jaw, and loss of consciousness, recovering after a short while. Or, due to excessive blood loss, deficient fire rises vacuously, causing unclear spirit and loss of bodily control. Sudden loss of yin blood deprives the heart spirit of nourishment. The Ministerial Fire and Sovereign Fire in the Heart and Bao Luo (pericardium/uterine connection) are calm with blood but endangered without it. Intense fire causes昏冒 (dizziness/fainting); fire invading the Lung causes closed eyes and unconsciousness. This is because sudden yin blood loss fails to anchor yang. The Classic states: "When disease qi is insufficient, tonify, do not drain." Closed eyes indicate yin pathology; sudden loss of有形 (formative) blood intensifies fire. Frequent administration of Shenghua Tang is suitable, or emergency measures using two to three doses of Shenghua Tang to first tonify blood deficiency, thereby resolving clots, strengthening blood, clearing spirit, and stopping fainting. For severe deficiency, symptoms include pale face, closed eyes, open mouth, cold hands, profuse sweating, unconsciousness, and extremely fine pulses. This indicates qi following blood loss toward extinction. A dose of Renshen (Ginseng Radix) is required to restore yang. Given the urgency, tonifying yin alone is insufficient; qi-tonifying herbs must be added. This follows the principle of yang generating yin. Emergency Renshen-added Shenghua Tang is most effective. Severe illness and extreme deficiency can cause fainting. Postpartal fainting is named Xue Yun (Blood Fainting) due to blood loss, though it is not directly caused by blood per se. Even with adverse blood rising or blood stasis, Shenghua Tang's warming and moving action is superior for resolving stasis and stopping fainting. I have observed obstetricians in Jiangnan using Danggui (Angelicae Sinensis Radix) 1 qian, Yimucao (Leonuri Herba) 1 qian, Renshen 2 qian, Honghua (Carthami Flos) 6 fen, Paojiang (Prepared Zingiberis Rhizoma) 8 fen, decocted hot and taken with child's urine to treat fainting. This formula balances aspects well. Regarding Jue occurring after delivery, excessive effort during labor damages the Spleen. The solitary organ cannot irrigate the four extremities, causing cold limbs and Jue. The Classic states: "Yang qi declining below results in Cold Jue." Jue qi rising fills meridians, separating from form. Rebellious qi filling meridians causes floating spirit scattering. Great tonification to restore yang is indicated; two doses of Shenghua Tang consecutively will restore qi and blood, allowing spirit to return and Jue to cease. Pure blood tonification is insufficient. If thirst occurs after medication, Shenmai San (Decoction for Tonifying Qi and Nourishing Yin) should be used as tea to assist fluids and save dry organs. Cases with cold limbs and diarrhea resemble Shaoyin syndrome of Cold Damage; Si Ni Tang (Frigid Extremities Decoction) is contraindicated. Instead, use Shenghua Tang with doubled Renshen, or add one slice of Shu Fuzi (Prepared Aconiti Lateralis Radix), to stop rebellion, restore yang, and demonstrate the efficacy of Renshen and Danggui. If blood clot pain stops but Jue persists, Zirong Yiqi Tang (Decoction for Nourishing Blood and Tonifying Qi) is most effective. Fainting and Jue are critical postpartal conditions. If fresh postpartal clot pain remains, avoid abrupt use of Baizhu (Atractylodis Macrocephalae Rhizoma) and Cangzhu (Atractylodis Rhizoma); thus, urgently add Renshen for emergency rescue. Once fainting and Jue resolve, remove Renshen to address clot pain; this is the key principle.
Emergency Shenghua Tang (Adapted): Treats three grades of Blood Fainting, resolving stasis and generating new blood.
Chuanxiong (Sanqian) Danggui (Liuqian or Baqian, wine-washed) Ganjiang (Sifen, charred by frying) Taoren (Shili, peeled and pitted) Zhigancao (Wufen) Jingjiesui (Sifen, charred by frying; avoid if sweating excessively).
Two Jujubes, decocted in water. For severe exhaustion, metrorrhagia, or sweating with qi/blood collapse and fainting, add Renshen (Sanqian) and Rougui (Sifen). Take urgently for one to two doses; effect is miraculous. Do not hesitate due to fear of Renshen being too tonic and slow.
Emergency Renshen-Added Shenghua Tang: Treats postpartal pallor and collapse fainting.
Renshen (Sanqian) Chuanxiong (Erqian) Danggui (Siqian, wine-washed) Ganjiang (Sifen, charred by frying) Taoren (Shili, peeled and pitted) Zhigancao (Wufen) Jingjie (Sifen, charred by frying; avoid if sweating excessively).
Two Jujubes, decocted in water. For severe clot pain, add Rougui (Qifen); for excessive sweating, add Mahuanggen (Yiqian); if no clot pain, add Zhi Huangqi (Yiqian) to stop sweating.
Renshen-Added Shenghua Tang (Including Da Bu Hui Yang Shenghua Tang):
Renshen (Erqian) Chuanxiong (Siqian) Danggui (Ba qian, wine-washed) Ganjiang (Sifen, charred by frying) Zhigancao (Wufen) Taoren (Shili, peeled and pitted).
Two Jujubes, decocted in water. This formula is general for all critical postpartal conditions. Three to four doses per day and night are needed to reconnect dying qi. If within three days postpartum and clot pain persists, wait until yuan qi recovers slightly and life returns, then remove Renshen and resume original Shenghua Tang. For collapse, Jue, and sweating, add Renshen (Sanqian or Siqian); for pulse and form collapse nearing death, frequent administration is mandatory. For sweating, fever, and shortness of breath, add Renshen; for weak left Chi pulse, add Renshen; if sweating persists, after three to four doses, add Zhi Huangqi (Yiqian). Alternative: Halve Chuanxiong and Danggui, named Da Bu Hui Yang Shenghua Tang, for treating new postpartal Jue. Use Jujube as guide, decoct quickly for two doses for immediate effect. If Jue presents with thirst, supplement with Shengmai San and Wuwei Yin as tea to save fluids, reducing thirst and reversing Jue.
Zirong Yiqi Tang: Treats Jue persisting after blood clot pain resolves.
Renshen Danggui (Each Erqian) Chuanxiong Baizhu (Earth-fried) Huangqi (Honey-fried, each Qianban or Yiqian) Shudi (Erqian) Maidong (Bafen or Yiqian, heart removed) Zhigancao (Sifen) Wuweizi (Shili) Chuan Fuzi (Wulifen or Yiqian, processed).
Decoct in water. For excessive sweating, add Mahuanggen and Chao Zaoren (Each Yiqian).