产后气血太虚，理宜大补，但恶露未尽，用补须防滞血。乃生之而且化之，能化能生，攻血块无损元气，行
中又带补血，方许万全，治无一失。世以四物汤治产，地黄性寒滞血，芍药酸寒无补，其不误人者几希矣。
按∶生化汤者，因药性之功而立名也，盖产后以化旧生新为要。考诸药性，川芎、当归、桃仁三品，能破旧血，
骤生新血。佐以姜炭、炙甘，引三品入于肺肝，生血理气。五味成方，行中有补，化中有生，实产后之圣药也，
故因以生化名之。凡孕妇至月足，照方预备数帖，至胞水一破，速煎一剂，候儿下地即服。不问半产、正产，虽
少壮妇女，平安无事，俱宜服之。
产后恶露有块，名曰儿枕。世多先消后补。殊不知，旧血虽当消化，新血亦宜生养，若专攻旧，则新亦不宁矣。
世以济坤丹攻血块，下胞胎者，一时虽见速效，而元气未免亏损。不得已而用之，只可一丸，不宜多服，且须随
进补剂，庶免虚弱之害。
生化汤
当归（八钱） 川芎（四钱） 桃仁（十粒） 姜炭（五分） 炙草（五分）
上用水三钟，煎八分，加酒七八匙，稍热服。渣留后帖同煎。
要在产后一二个时辰内，未进饮食之先，相继而服。则下焦血块速化，新血骤生，自免血晕等症。但此汤频服，
精神渐增，产后诸症不能乘虚而袭矣。其或劳甚血崩，形脱、喘、汗不止，急进加参生化汤数帖。或一方内加红
花五分，元胡醋炒一钱五分。或方内再加桂心七分。
加参生化汤
人参（二钱） 川芎（二钱） 当归（四钱） 姜炭（四分） 桃仁（十粒） 枣（三枚）
加减法
产后七日内未服生化汤，块痛未除，仍照前方服数帖，或加元胡、益母亦可，自然块消痛止。不可遽加参、 、
白术，补住瘀血，祸不可言。
产后三日内块痛虽未除，其产妇气血虚脱，或崩，或厥，或汗多而厥，或形色脱去，口气渐冷，或烦渴不止，
或气喘短促，无论块痛，从权加参 以扶危急。如体倦无力，气虚短促，本方多加人参。兼汗，加黄 。烦躁，
加竹茹。渴，加麦冬、五味。喘，加杏仁、桔梗。
产后大便不通，或至八九日者，由血少肠燥故也。宜生化汤加麻仁三钱，苁蓉五钱以润之，日久自通。如虚，加
人参二钱。勿用承气汤。
产后七日内，或伤寒冷，血块凝结痛甚，生化汤加肉桂五分，元胡一钱。或食冷物，连心腹痛者，再加吴萸七分。
产后肥人多痰，宜生化汤加花粉、竹沥、姜汁，或加橘红四分。毋轻用牛黄及寒冷等味。
产前素虚弱者，产后一二日已服生化汤三四帖，块痛稍减，可按揉而定，宜生化汤加人参三钱。
产后虽暑月亦要和暖。如失盖衣被，腹不温和，风邪乘虚而入，虽服生化汤，恐块痛不止，宜加肉桂四分，五
灵脂一钱。
产后劳倦血晕，服生化汤一剂，头煎后再即取一帖，加人参一二钱，汗多亦加。如形不脱去，只用鹿角炭二钱，
本汤送下，或益母丸亦可。外用细捣韭菜，纳有嘴瓷瓶内，将滚醋两碗冲入，封
其大口，以小口注产妇鼻中，敛其精神，即醒。
产后发热汗出，手足厥冷，或血崩气短，神昏气脱，乃大虚症。急须大补，庶可回生，宜加参生化汤，速进数
剂，再以生脉散代茶。毋信《产室百问》及《妇人良方》等书。
产后日久不食，闻药即吐，须用独参二三钱，或姜少许，白米一大撮，水煎服，以安胃气。如听其胃虚不能
饮食，危矣。法用胡椒少许，人乳炖热和匀，微辣与饮，加以独参汤频频进之，可效。
Postpartum Qi and Blood are extremely deficient, so theoretically, major tonification is appropriate. However, since lochia (postpartum vaginal discharge) has not yet cleared, using tonics requires caution to avoid causing blood stasis. Therefore, the treatment must be able to generate new blood while resolving stasis; it should be capable of transforming blood clots without damaging Yuan Qi (Original Energy), and incorporate blood-nourishing properties within blood-moving actions. Only then can it be considered comprehensive and flawless in treatment. The world commonly uses Siwu Tang (Four Substances Decoction) for postpartum conditions, but Shu Dihuang (Prepared Rehmannia Root) is cold in nature and tends to cause blood stagnation, and Shaoyao (Peony Root) is sour and cold with little tonifying effect; thus, cases where this does not harm patients are rare.
Note: The name "Shenghua Tang" (Generation-Decay Decoction) is derived from the efficacy of its ingredients, emphasizing that the key to postpartum care is transforming old blood and generating new blood. Examining the properties of the herbs, Chuanxiong (Szechwan Lovage Rhizome), Danggui (Angelica Sinensis Root), and Taoren (Peach Kernel) can break down old blood and rapidly generate new blood. Assisted by Jiangtan (Charred Ginger) and Zhigancao (Honey-fried Licorice Root), these three herbs are guided into the Lung and Liver meridians to promote blood generation and regulate Qi. These five ingredients form the prescription; it moves blood while tonifying, and transforms stasis while generating life. It is truly a sacred medicine for postpartum conditions, hence named "Shenghua." Whenever a pregnant woman reaches full term, she should prepare several doses according to this formula. Once the amniotic sac ruptures, one dose should be decocted immediately and administered as soon as the infant is born. This applies regardless of whether it is a miscarriage or a normal delivery; even for young and robust women who have had an uneventful pregnancy, it is advisable to take it.
When lochia contains clots postpartum, it is called "Erzhen" (Child's Pillow). People generally tend to eliminate stasis first and tonify later. They fail to realize that although old blood should be resolved, new blood also needs to be nourished. If one focuses solely on attacking old blood, the new blood will also become unsettled. People use Jikun Dan (Jikun Pill) to attack blood clots and expel the placenta; although quick effects are seen initially, Yuan Qi is inevitably depleted. If used out of necessity, only one pill should be taken, and excessive consumption is discouraged. Furthermore, tonic agents must be administered subsequently to avoid the harm of weakness.
Shenghua Tang (Generation-Decay Decoction)
Danggui (Angelicae Sinensis Radix) (8 qian)
Chuanxiong (Ligustici Chuanxiong Rhizoma) (4 qian)
Taoren (Persicae Semen) (10 kernels)
Jiangtan (Zingiberis Rhizoma Carbonisatum) (5 fen)
Zhigancao (Glycyrrhizae Radix et Rhizoma Praeparata cum Melle) (5 fen)
Take three zhong (ancient unit of volume) of water, decoct until reduced to eight fen (proportion), add seven or eight spoons of wine, and take warm. Reserve the dregs to decoct together with the next dose.
It is crucial to administer this consecutively within one to two shichen (2-4 hours) after birth, before any food intake. This ensures rapid resolution of lower jiao blood clots and swift generation of new blood, thereby preventing symptoms such as blood syncope. Frequent administration gradually restores spirit and energy, preventing various postpartum disorders from exploiting the deficiency. In cases of severe exertion leading to bloody discharge (hemorrhage), collapse of physical form, panting, and incessant sweating, urgently administer Jiashen Shenghua Tang (Shenghua Tang with Ginseng) for several doses. Alternatively, add Honghua (Carthami Flos/Safflower) 5 fen, or Yanhu (Corydalis Rhizoma) stir-fried with vinegar 1.5 qian. Or add Guixin (Cinnamomi Cortex/Cinnamon Bark) 7 fen.
Jiashen Shenghua Tang (Shenghua Tang with Ginseng)
Renshen (Panacis Ginseng Radix) (2 qian)
Chuanxiong (Ligustici Chuanxiong Rhizoma) (2 qian)
Danggui (Angelicae Sinensis Radix) (4 qian)
Jiangtan (Zingiberis Rhizoma Carbonisatum) (4 fen)
Taoren (Persicae Semen) (10 kernels)
Dazao (Ziziphi Jujubae Fructus) (3 pieces)
Modifications:
If Shenghua Tang was not taken within seven days postpartum and clot pain persists, continue taking the original prescription for several doses, or add Yanhu (Corydalis Rhizoma) and Yimucao (Leonuri Herba); naturally, the clots will dissipate and pain cease. Do not hastily add Renshen (Ginseng) or Baizhu (Atractylodis Macrocephalae Rhizoma), as this may trap the blood stasis, leading to dire consequences.
If within three days postpartum, clot pain persists, but the parturient suffers from Qi and Blood collapse, hemorrhage, syncope, profuse sweating with syncope, loss of complexion and vitality, cooling breath, incessant irritability and thirst, or shortness of breath, regardless of clot pain, resort to adding Renshen (Ginseng) to support critical conditions. For fatigue and weakness, shortness of due to Qi deficiency, increase the dosage of Renshen in the base formula. If accompanied by sweating, add Huangqi (Astragali Radix). For irritability, add Zhuru (Bambusae Caulis in Taenia). For thirst, add Maidong (Ophiopogonis Radix) and Wuweizi (Schisandrae Chinensis Fructus). For panting, add Xingren (Armeniacae Semen Amarum) and Jiegeng (Platycodonis Radix).
Constipation postpartum, lasting up to eight or nine days, is caused by blood deficiency and intestinal dryness. It is suitable to use Shenghua Tang with Mahuang Ren (Ephedrae Semen/Hemp Seed - *Note: Text says Mahuang, likely referring to Huomaren/Hemp Seed contextually for moistening, but literal translation follows text*) 3 qian and Rongrong (Cistanches Herba) 5 qian to moisten; passage will occur naturally over time. If deficient, add Renshen (Ginseng) 2 qian. Do not use Chengqi Tang (Major Order the Qi Decoction).
Within seven days postpartum, if exposed to cold causing blood clots to coagulate with severe pain, add Rougui (Cinnamomi Cortex) 5 fen and Yanhu (Corydalis Rhizoma) 1 qian to Shenghua Tang. If pain in the heart and abdomen results from consuming cold foods, add Wuyu (Evodiae Fructus) 7 fen.
Obese women postpartum often have phlegm-dampness; Shenghua Tang should be added with Huafen (Trichosanthis Radix), Zhuli (Bambusae Caulis in Taenia), and Jiangzhi (Zingiberis Succus/ginger juice), or JuHong (Citri Reticulatae Pericarpium Rubrum) 4 fen. Avoid easily using Niuhuang (Bovis Calculus) and cold-natured herbs.
Women who were constitutionally weak prior to pregnancy should take Shenghua Tang for three to four doses within one or two days postpartum. If clot pain subsides slightly, massage can help settle it; at this stage, Shenghua Tang with Renshen (Ginseng) 3 qian is suitable.
Even in summer months postpartum, warmth must be maintained. If covered inadequately and the abdomen becomes cool, Wind pathogen may enter due to deficiency. Even if Shenghua Tang is taken, clot pain may persist; add Rougui (Cinnamomi Cortex) 4 fen and Wulingzhi (Trogopterori Faeces) 1 qian.
For postpartum blood syncope due to labor and fatigue, take one dose of Shenghua Tang. After the first decoction, prepare another dose, adding Renshen (Ginseng) 1-2 qian; add more if sweating is profuse. If physical form is not collapsed, use Lujiaotan (Cornu Cervi Pantotrichum Carbonisatum) 2 qian, taken with the decoction, or Yi Mu Wan (Yimucao Pills) is also acceptable. Externally, finely crush fresh Leiu (Allii Tuberosi Herba/Buck choy), place in a porcelain bottle with a spout, pour in two bowls of boiling vinegar, seal the large mouth, and insert the small spout into the nostrils of the parturient to gather her spirit and consciousness, which will induce awakening.
Postpartum fever with sweating, cold extremities, or hemorrhage with shortness of breath, coma, and Qi collapse, indicates a severe deficiency syndrome. Urgent major tonification is required to restore life; use Jiashen Shenghua Tang (Shenghua Tang with Ginseng) rapidly for several doses, followed by Shengmai San (Generate the Pulse Powder) as tea. Do not trust books such as "Chan Shi Bai Wen" (Hundred Questions of the Delivery Room) or "Fu Ren Liang Fang" (Good Prescriptions for Women).
If postpartum anorexia persists for many days, with vomiting upon smelling medicine, use Dushen Tang (Single Ginseng Decoction) 2-3 qian, or a little ginger, and a large pinch of white rice, decocted in water and taken to stabilize Stomach Qi. If left untreated, allowing Stomach deficiency to prevent eating is dangerous. A method involves using a little pepper, hot steamed human milk mixed evenly, given slightly spicy to drink, combined with frequent administration of Dushen Tang (Single Ginseng Decoction), which can be effective.