（即竹林寺传秘本）
产后血气暴虚，理当大补。但恶露未尽，用补须知，无滞血，能化又能生，攻块无损元气，行中
又得补，方为万全无失。世以芎、归、芍、地四物汤理产，误人多矣。因地黄
性寒，芍药酸敛，滞血故也。产后恶露作块痛，名曰儿枕。
世多专用消散，然后议补。又有消补浑施，终无成效。不知旧血虽当消化，新血亦当生养，若专攻旧血，则
新血亦不宁矣。世以济坤丹，又名回生丹，治以攻血块，下胞胎，虽见速效，其元气未免亏损，即幸平安，究
非良剂也。不得已而用之下胞胎，只可一丸，不可多服。夫生化汤因药性功用而立名也。夫产后血块当消，新
血宜生。若专消则新血不宁；专生则旧血反滞。考药性芎、归、桃仁三品善破恶血，骤生新血，佐以炙黑干
姜、甘草引三品入肺肝，生血理气，五味共方，则行中有补，化中有生，实产后之要药也。故名生化
汤。凡病起于血气之衰，脾胃之虚，而产后血气之虚尤甚。是以丹溪先生论产，必当大补血气为先，虽兼他症
以末治之，此三言者已尽医产大旨，若能扩充用药立方，则治产可以无大过矣。夫产后忧惊劳倦，血气暴虚诸
症乘虚易入，如有气勿专耗散，有食勿专消导，热不可用芩连，寒不可用桂附。寒则血块停滞，热则新血
崩流。至若虚中外感，见三阳表症之多，似可汗也。在产后而用麻黄，则重竭其阳。见三阴里症之多，似宜下
也。在产后而用承气，则重亡阴血。耳聋、胁痛，乃肾肝恶血之停，休用柴胡。谵语汗出，乃元弱似邪之症，
毋同胃实。厥由阳气之衰，无分寒弱，非大补不能回阳而起弱。痹因阴血之亏，不论刚弱非滋荣不能舒筋而
活络，又乍寒乍热发作有期类疟也。若以疟治，则迁延难愈。神不守舍，言语无伦，病似邪也。若以邪论，
危亡可待。去血多而大便结燥，苁蓉加于生化，非润肠承气汤之能通。患汗多而小便短涩，六君子倍多参
，必生津助液之可利，加参生化频服，救产后之危。长生活络屡用，苏绝谷
之人。颓疝脱肛，多是气虚下陷，补中益气之汤堪用。口噤拳挛乃因血燥类疯，加参生化之汤宜服。产户入
风而痛甚，服宜羌活养荣方。玉门寒冷而不闭，洗宜床菟萸硫类。怔忡惊悸，生化汤加定志。似邪恍惚，安神
丸助归脾。因气而满闷虚烦，生化汤加木香为佐。因食而酸嗳恶食，六君子加神曲、麦芽为良。苏木、莪蓬，
大能破血。青皮、壳实，最消胀满。一应耗血散气之剂，汗吐下之用，可施于少壮，岂宜用于胎产？大抵新产
之后，先问恶露如何？块痛未可遽加 术。腹中痛止，补中益气无疑。至若亡阳脱汗，气虚喘促，频服生化加
参，是从权也。又以阴亡大热，血崩厥晕，连煎生化原方，乃救急也。王太仆云∶治下补下，制以缓急，缓
则道路远而力微，急则气味浓而力重，故治产当遵丹溪，而固本服法，宜效太仆而频加，凡擅回生之奇术，
须着意以拯危，欲求俯仰之无惭，心实心以济物，此虽未尽产症之详，然见症立方，皆援近乡治验为据，未
必无小补耳。
产后血块，是孕成余血之所积也。夫妇人血耗气衰，二七而天癸至，三旬一见，以象月盈则亏也。行之有
常曰经。有孕则经不行，其余血注于胞中，以护胎元。一月始名胚，二月始名膏，三月成形而名曰胎。方受
母之荫庇胎形尚小，食母血尚有余汁，前两月并积于胞中，月久成块，至产当随儿下。多有产妇送儿送胞，劳
倦无力，或失调护，腹欠温暖，至块痛日久不散。幸勿轻服攻血峻剂，姜、椒、艾、酒，过于大热，新血未免
亏损。治法频服生化汤几帖以助血兼行，外有热衣暖腹可也。一时俗治血块，用生地、红花以行之，苏木、牛
膝以攻之。治气胀用乌药、香附以顺之，枳壳、浓朴以舒之，甚有青皮、枳实以下气定喘。芩、连、
栀、柏以退热除烦。至若血枯大便艰实，反用承气下之而愈结。汗多小便短涩，反用五苓通之而愈闷。其有
偏执，罔知固本。或有惜费不治，或有十医相通，误荐人而致夭折者，不可胜计，有谓山楂能消血块，却害
弱人，频服两三帖，必死无疑。
生化汤，凡有孕至七八月者，预制两三帖，至胞衣一
破，速前一帖，候儿下地即服．不论正产小产，虽少壮产妇，平安无羌，亦宜服两帖以消血块，生长新血。
（即竹林寺传秘本）
产后气血突然虚弱，按理应当大补。但是恶露未尽，使用补法必须谨慎，要做到不滞留瘀血，既能化瘀又能生新，攻破积块而不损伤元气，在行气活血中又得到补益，这才是万无一失的方法。世人常用川芎、当归、白芍、地黄组成的四物汤来调理产后病，误人很多。这是因为地黄性寒，白芍酸敛，容易导致瘀血停滞。产后恶露结成块状并伴有疼痛，称为“儿枕”。
世人多专门使用消散瘀血的方法，然后再议补益。又有的人消补同时施用，最终都没有成效。不知道旧血虽然应当消化，但新血也应当生养，如果专门攻伐旧血，那么新血也不会安宁。世人用济坤丹，又名回生丹，治疗以攻逐血块、排出胎盘为主，虽然见效快，但元气未免亏损，即使侥幸平安，终究不是良方。不得已而用它来排出胎盘，只可服用一丸，不可多服。生化汤是根据药物的性质和功能来命名的。产后血块应当消除，新血应当生成。如果专门消除，新血就不安宁；如果专门生新，旧血反而停滞。考察药性，川芎、当归、桃仁这三味药善于破除恶血，迅速生成新血，佐以炙黑干姜、甘草引导这三味药进入肺经和肝经，生血理气，五味药组成一方，则在行血中有补益，化瘀中有新生，确实是产后的要药。所以命名为生化汤。
凡是疾病起于气血衰弱、脾胃虚弱，而产后气血的虚弱尤为严重。因此丹溪先生论述分娩，认为必定当以大补气血为先，即使兼有其他症状，也应以后者次要处理，这三句话已经概括了治疗产科疾病的宗旨，如果能扩充用药组方的思路，那么治疗产科疾病就可以没有大的过失了。产后因忧惊劳倦导致气血暴虚，各种病症容易乘虚而入，如果有气滞不要专门耗散，有食积不要专门消导，热证不可用黄芩、黄连，寒证不可用肉桂、附子。用寒凉药则血块停滞，用温热药则新血崩漏。至于虚人外感，见到三阳表证较多，似乎可以用发汗法。但在产后使用麻黄，则会再次竭伤阳气。见到三阴里证较多，似乎适宜用泻下法。但在产后使用承气汤，则会再次亡失阴血。耳聋、胁痛，是肾肝恶血停滞所致，不要用柴胡。谵语汗出，是元气虚弱似邪之症，不要当作胃实热证来处理。厥逆是由于阳气衰微，不分寒弱，非大补不能回阳而起弱。痹证是因为阴血亏虚，不论刚柔，非滋养荣血不能舒筋活络。还有乍寒乍热、发作有期类似疟疾的情况。如果用治疟疾的方法治疗，则会迁延难愈。神不守舍，言语无伦次，病似邪祟。如果用邪祟论治，危亡就在眼前。失血多导致大便结燥，在生化汤中加入肉苁蓉，这不是润肠承气汤所能通下的。患汗多而小便短涩，六君子汤加倍人参，必须生津助液才能利尿，加参生化汤频服，可以挽救产后的危局。长生活络方屡用，能救绝谷之人。颓疝脱肛，多是气虚下陷，补中益气汤可以使用。口噤拳挛是因为血燥类似风痉，加参生化汤适宜服用。产户受风而疼痛剧烈，服用宜羌活养荣方。玉门寒冷而不闭合，清洗宜用菟丝子、山茱萸、硫磺类。怔忡惊悸，生化汤加定志丸。似邪恍惚，安神丸辅助归脾汤。因气滞而满闷虚烦，生化汤加木香为佐使。因食积而酸嗳恶食，六君子汤加神曲、麦芽为好。苏木、莪术，大能破血。青皮、枳实，最消胀满。一切耗血散气的药剂，以及汗、吐、下法的使用，可以施用于少壮之人，岂宜用于胎产？大抵新产之后，先问恶露情况如何？血块疼痛不可急于加入白术。腹中疼痛停止，补中益气无疑。至于亡阳脱汗，气虚喘促，频服加参生化汤，这是权宜之计。又以阴亡大热，血崩厥晕，连续煎服生化原方，这是急救之法。王太仆说：治疗下部疾病，补益下部，制方要根据缓急，缓则道路远而药力微弱，急则气味浓而药力沉重，所以治疗产科疾病应当遵循丹溪先生的理论，而固本服药的方法，应当效仿王太仆而频繁添加，凡是擅长回生奇术的人，必须着力拯救危重病人，想要求得心无愧怍，必须诚心诚意救济万物，这虽然未能详尽列举所有产后病症，但是见症立方，都援引近乡的治疗经验为依据，未必没有小小的补益。
产后血块，是怀孕后余血积聚而成的。妇女血耗气衰，十四岁天癸至，三十岁一月一行，以象征月亮满则亏。运行有常度叫做月经。怀孕后月经停止，其余血注入胞宫，以保护胎元。一个月开始叫胚，两个月开始叫膏，三个月成形叫胎。刚刚受到母体荫庇，胎形尚小，吃母血尚有余汁，前两月并积于胞中，日久成块，到生产时应当随婴儿一起排出。多有产妇送儿送胞，劳倦无力，或者调护不当，腹部欠温暖，导致血块疼痛日久不散。千万不要轻率服用攻血峻剂，姜、椒、艾、酒，过于大热，新血未免亏损。治疗方法是频服几帖生化汤以助血兼行，外面用热衣暖腹即可。一时俗治血块，用地黄、红花来行血，苏木、牛膝来攻逐。治气胀用乌药、香附来顺气，枳壳、厚朴来舒展，甚至有青皮、枳实来下气定喘。黄芩、黄连、栀子、黄柏来退热除烦。至于血枯大便艰实，反而用承气汤泻下而导致更加结燥。汗多小便短涩，反而用五苓散通利而导致更加闷乱。那些偏执己见，不懂得固本的人。或者有吝惜费用不治的，或者有十个医生互相串通，误荐他人而导致夭折的，不可胜数。有人说山楂能消血块，却伤害弱者，频服两三帖，必死无疑。
生化汤，凡是有孕至七八个月者，提前制作两三帖，到胞衣破裂，速服前一帖，等婴儿落地即服。不论正产小产，即使是少壮产妇，平安无恙，也宜服两帖以消血块，生长新血。
(Ji Zhulinsi Chuan Mi Ben)
After childbirth, Qi and Blood suddenly become deficient; theoretically, major tonification is indicated. However, since lochia (postpartum discharge) has not yet cleared, the use of tonics requires caution: one must avoid stagnating blood, be capable of resolving stasis while generating new blood, break down masses without damaging Yuan Qi, and achieve tonification within the process of promoting circulation. Only then can it be considered flawless. The world commonly uses Siwu Tang (Four Substances Decoction), composed of Chuanxiong, Danggui, Baishao, and Dihuang, to manage postpartum conditions, which has misled many. This is because Dihuang is cold in nature, and Baishao is sour and astringent, leading to blood stagnation. When postpartum lochia forms clumps accompanied by pain, it is called "Erzhen" (Baby Pillow).
The world often specializes in methods to dissipate stasis first, and only then discusses tonification. Others apply dissipation and tonification simultaneously but ultimately achieve no effect. They do not realize that although old blood should be resolved, new blood must also be nourished. If one exclusively attacks old blood, new blood will not remain tranquil. People use Jikun Dan, also known as Huisheng Dan, to treat blood masses and expel the placenta. Although it shows rapid effects, it inevitably damages Yuan Qi. Even if peace is fortunately achieved, it is ultimately not a good formula. If used out of necessity to expel the placenta, only one pill should be taken, and it should not be overdosed. Shenghua Tang is named based on the properties and functions of its herbs. Postpartum blood masses should be eliminated, and new blood should be generated. Exclusive elimination makes new blood unstable; exclusive generation causes old blood to stagnate. Examining the herb properties, Chuanxiong, Danggui, and Taoren are excellent at breaking down evil blood and rapidly generating new blood. These three are assisted by Zhihei Ganjiang (Charred Dried Ginger) and Gancao (Licorice Root) to guide the three herbs into the Lung and Liver meridians, generating blood and regulating Qi. With these five ingredients forming the prescription, there is tonification within circulation, and generation within resolution. It is truly an essential medicine for postpartum care, hence the name Shenghua Tang.
All diseases arise from the decline of Qi and Blood and the deficiency of the Spleen and Stomach, with postpartum Qi and Blood deficiency being particularly severe. Therefore, Mr. Danxi argued in his discussions on childbirth that major tonification of Qi and Blood must come first. Even if other symptoms are present, they should be treated secondarily. These three statements summarize the main principles of treating obstetric conditions. If one can expand upon medication and prescription formulation, treating obstetric cases can be done without major errors. After childbirth, due to worry, fright, fatigue, and overwork, Qi and Blood become acutely deficient, making various syndromes prone to entering through this deficiency. If there is Qi stagnation, do not specialize in dispersing it; if there is food retention, do not specialize in digesting it. For heat patterns, do not use Huangqin (Scutellaria Root) and Lianzi (Lotus Plumule); for cold patterns, do not use Guizhi (Cinnamon Twig) and Fuzi (Aconite Root). Using cold herbs causes blood masses to stagnate; using hot herbs causes new blood to hemorrhage. Regarding exterior contraction in a deficient person, if many Yangming or Taiyang exterior symptoms are seen, sweating might seem appropriate. However, using Mahuang (Ephedra Herb) in postpartum patients would doubly exhaust Yang. If many Yin interior symptoms are seen, purgation might seem suitable. However, using Chengqi Tang (Gut-Clearing Decoction) in postpartum patients would doubly deplete Yin Blood. Deafness and hypochondriac pain are caused by the stagnation of evil blood in the Kidney and Liver; do not use Chaihu (Bupleurum Root). Delirium and sweating are symptoms of Yuan deficiency resembling pathogenic invasion; do not treat them as excess Heat in the Stomach. Jue (Cold Extremities/Reversal) is due to the decline of Yang Qi; regardless of cold or weakness, only major tonification can restore Yang and revive weakness. Bi syndrome is due to the deficiency of Yin Blood; regardless of rigidity or flaccidity, only nourishing Ying and Blood can relax tendons and activate collaterals. Additionally, alternating chills and fever occurring at regular intervals resemble Malaria. If treated as Malaria, the condition will linger and be difficult to cure. If the Spirit does not reside in its house, and speech is incoherent, the disease resembles possession. If treated as possession, death may follow quickly. Excessive blood loss leading to dry, constipated stool: adding Rongren (Cistanche Stem) to Shenghua Tang is superior to the purgative action of Runchang Chengqi Tang. Sweating excessively with scanty, difficult urination: Liu Junzi Tang (Six Gentlemen Decoction) with doubled Ginseng is necessary to generate fluids and assist liquids to promote diuresis. Frequent administration of Shenghua Tang with Ginseng can save critical postpartum cases. Changsheng Huoluo Fang (Longevity Collateral-Activating Formula) has been used repeatedly to save those who have stopped eating. Genital prolapse and rectal prolapse are mostly due to Qi deficiency sinking; Buzhong Yiqi Tang (Middle-Warming and Qi-Supplementing Decoction) is applicable. Trismus and clenched fists are due to Blood dryness resembling wind spasms; Shenghua Tang with Ginseng is suitable. Severe pain in the vagina due to wind invasion: Qianghuo Yangrong Fang (Notopterygium Nourishing Ying Decoction) is indicated. Coldness and laxity of the vulva: washing with Tusizi (Cuscuta Seed), Shanzhuyu (Cornus Fruit), and Liuhuang (Sulfur) is appropriate. Palpitations and fright: add Dingzhi Wan (Stabilizing Spirit Pill) to Shenghua Tang. Apparent spirit-like trance: Anshen Wan (Calming Spirit Pill) assists Guipi Tang (Restore the Spleen Decoction). Fullness, vexation, and irritability due to Qi stagnation: add Muxiang (Aucklandia Root) as an assistant to Shenghua Tang. Sour belching and aversion to food due to food retention: Liu Junzi Tang with Shenqu (Medicated Leaven) and Maiya (Germinated Barley) is excellent. Sumu (Sappan Wood) and Ezhu (Curcuma Rhizome) greatly break blood stasis. Qingpi (Green Tangerina Peel) and Zhishi (Immature Bitter Orange) best reduce distension. All agents that consume Blood and scatter Qi, as well as the use of sweating, vomiting, and purging methods, may be applied to young and strong individuals, but surely should not be used during pregnancy and childbirth. Generally, after recent delivery, one must first ask about the status of lochia. If there are painful masses, do not hastily add Baizhu (Atractylodes Macrocephala Rhizome). If abdominal pain stops, Buzhong Yiqi Tang is undoubtedly indicated. In cases of Yang collapse with sweating, and Qi deficiency with panting, frequent administration of Shenghua Tang with Ginseng is a temporary measure. In cases of Yin collapse with intense heat, and uterine bleeding with syncope, continuously decocting the original Shenghua Tang is an emergency rescue method. Wang Taipu said: "To treat the lower part, tonify the lower part; the prescription should follow urgency. If slow, the path is long and the force is weak; if urgent, the flavor is strong and the force is heavy." Therefore, treating obstetric conditions should follow Danxi's theories, and the method of taking tonic medicines should emulate Wang Taipu by frequent supplementation. Those skilled in miraculous life-saving arts must focus on rescuing the critically ill. To seek a clear conscience in all endeavors, one must sincerely intend to benefit beings. Although this does not detail every postpartum syndrome, prescribing based on symptoms draws upon local clinical experiences as evidence, offering perhaps some minor benefit.
Postpartum blood masses are accumulations of residual blood from conception. Women experience Blood consumption and Qi decline; at age fourteen, Tian Gui (Menstrual Essence) arrives. At thirty, menstruation occurs monthly, symbolizing the moon's waxing and waning. Regular flow is called Jing (Menses). During pregnancy, menses cease, and residual blood flows into the Baozhong (Uterus) to protect the Taiyuan (Fetal Origin). One month marks the Pei (Embryo), two months mark the Gao (Paste), and three months mark the Tai (Fetus) when form is established. Initially sheltered by the mother, the fetal shape is small, and maternal Blood consumption leaves surplus fluid. For the first two months, this accumulates in the uterus. Over time, it forms masses, which should descend with the infant at birth. Many postpartum women, exhausted from delivering the baby and placenta, lack strength, or suffer improper care, resulting in a cold abdomen. Consequently, blood mass pain persists for a long time without dissipating. Do not lightly administer harsh blood-breaking agents. Jiang (Ginger), Jiao (Pepper), Ai (Mugwort), and Jiu (Alcohol) are overly hot and may damage new Blood. The treatment method is to frequently take several doses of Shenghua Tang to assist Blood and move circulation, while externally warming the abdomen with hot clothing. Contemporary folk treatments for blood masses use Shengdi (Rehmannia Root) and Honghua (Carthamus Flower) to move blood, Sumu (Sappan Wood) and Niuxi (Achyranthes Root) to attack stasis. For Qi distension, Wuyao (Lindera Root) and Xiangfu (Cyperus Rhizome) are used to smooth Qi, Zhike (Bitter Orange Pericarp) and Houpo (Magnolia Bark) to relax. Some even use Qingpi (Green Tangerina Peel) and Zhishi (Immature Bitter Orange) to direct Qi downward and calm asthma. Huangqin (Scutellaria Root), Lianzi (Lotus Plumule), Zhizi (Gardenia Fruit), and Huangbai (Phellodendron Bark) are used to clear heat and relieve vexation. In cases of Blood dryness causing hard stools, using Chengqi Tang to purge leads to increased constipation. With excessive sweating and scanty urine, using Wuling San (Five Ingredient Powder with Poria) to promote urination leads to increased oppression. Those who are biased and ignorant of rooting the foundation... Or those who hesitate due to cost, or where ten doctors collude, misprescribing and causing premature death—these numbers are countless. Some claim Hawthorn (Shanzha) can dissolve blood masses, but it harms the weak. Frequent intake of two or three doses will certainly lead to death.
Shenghua Tang: For pregnant women at seven or eight months, prepare two or three doses in advance. Upon rupture of the membranes, quickly take one dose. Once the infant is born, take another. Regardless of normal delivery or miscarriage, even for young and strong postpartum women who are safe and sound, it is advisable to take two doses to resolve blood masses and generate new Blood.