一产后气血暴虚，理当大补，但恐恶露未尽。用补须无滞血，能化又能滋生；攻块无损元气，行
中又能带补，方处万全，能无一失。世以四物汤理产，误人多矣。因地黄性寒滞血，芍药酸寒无补故也。
一产后恶露作痛，名曰儿枕痛，世多专先消散，然后议补，又有消补混方。殊不知旧血虽当消化，
新血亦当生养，若专主攻旧，新亦不宁矣。
世以济坤丹（又名救生丹）治产后，用以攻血块，下胞落胎，足见速效，其元气未免亏损。平安产
妇，毋视良剂。济坤丹不得已而用下胎、下胞、下血块，只可用一丸，不可多服，随即服汤药进补。
有妙应丸治产后停食宿肉，此乃形体劳倦，脾胃俱伤，不善调治之家，多食浓味，沉睡而复伤，
胃虽少纳，脾转输迟，食停痞塞嗳酸，此宿痰包食，不能消导，宜服三五丸，随即服汤药进补。
此“急则治其标，缓则治其本”也。
生化汤因药性功用立名，产后血块当消，新血宜生，专消则新血不宁，专生则旧血反滞。考诸药
性，惟川归、川芎、桃仁三品药性，善破旧血，骤生新血，佐以炙黑干姜、甘草引三品入于肺肝，生
血利气，五味共方则行中有补，化中有生，实产后圣药，故因名之。凡有孕至八九月，根据制方
下，名曰生化汤∶
川芎（二两） 川归（五钱） 桃仁 干姜（炙黑） 甘草（各五钱）
桃仁要去皮尖，捣如泥用，干姜要黑者，醋浸透，炒黑用。上作二三帖，至胞衣一破，速煎一帖，候
儿下地即服，不论正产半产。若少壮产妇平安无事。俱宜服二帖，消块生血。
又生化汤∶川芎（三钱） 川归（八钱） 桃仁（十粒，去皮尖） 干姜（四分，炒黑） 甘草（炙，五分）
上用水二钟，煎至七分，加酒六七茶匙，稍热服。查涩后帖，并前二帖，共煎，要在一二时辰内，
未进饮食之先，相继煎服，则下焦血块速化，而骤长新血，自无晕厥。且产妇服一帖，渐增精神，不厌
药之频也。若照常症，日服一帖，岂能挽回将绝之气血也，其胎前素弱，产后劳倦及热症
堕胎，要不抱帖数，服至病退乃止，若产妇劳甚，血崩形色脱，即加人参三四钱在内，频灌无虑。
加参生化汤 治产后危急诸症，俱可服此方。
川芎（二钱） 川归（四钱） 干姜（四分，炒黑） 甘草（五分，炙） 桃仁（十粒，去皮尖）
人参三钱或二钱，随症缓急，如甚危症，人参加至五六钱，枣三枚，水煎服，渣再煎。
加减法∶
一娩儿下，汗多倦甚，宜服此方，加人参三四钱。
一娩儿下，无力送脱胞，倦怠，宜服此方。
一胎前素弱，产后见虚症，宜服此方。
一胎前患泻，产后倦怠，宜服此方，加参四五钱。
一汗多加麻黄根二钱、黄 一钱、防风五分。
一足厥冷，加人参四五钱，附子四分；兼汗亦加参、麦
冬一钱。
一气短促，加人参四钱。
一消渴加麦冬一钱，五味子十粒。
一大便实，加苁蓉一钱。
一烦躁，加竹茹一丸。
一寒嗽，加杏仁十粒，桔梗五分。
一喘气促，加半夏一钱，杏仁十粒，桔梗五分。
一有痰，加天花粉八分，竹沥半酒钟，姜汁少许。
凡产后血块痛，用生化汤为主，血块痛散加人参生化汤为主。
产后气血突然虚弱，按理应当大补，但担心恶露尚未排尽。使用补药必须做到不滞留瘀血，既能化瘀又能生新；攻逐瘀块不能损伤元气，在行气活血的同时又能兼顾补益，处方周全，才能万无一失。世人用四物汤调理产后，误人很多了。这是因为地黄性寒导致血液凝滞，芍药酸寒没有补益作用的原因。
产后恶露引起疼痛，名叫儿枕痛，世人多专门先用消散法，然后才讨论补益，又有消补混合的方剂。却不知道旧血虽然应当消化，新血也应当生养，如果专门主攻旧血，新血也不会安宁。
世人用济坤丹（又名救生丹）治疗产后，用来攻逐血块，下胎衣、下死胎，足见其见效迅速，但元气未免亏损。对于平安生产的产妇，不要把它当作良剂。济坤丹只有在不得已的情况下用于下胎、下胞衣、下血块时，只可用一丸，不可多服，随后要服用汤药进补。
妙应丸治疗产后停滞的宿食和肉积，这是由于形体劳倦，脾胃都受伤，不善调养的家人，多吃浓味食物，沉睡后又受伤害，胃虽然少量进食，脾的转输功能迟缓，食物停滞导致痞塞、嗳气泛酸，这是宿痰包裹食物，不能消化导滞，适宜服用三五丸，随后服用汤药进补。
这就是“急则治其标，缓则治其本”的道理。
生化汤因药物的性味功用而立名，产后血块应当消除，新血应当生成，专门消除则新血不安宁，专门生新则旧血反而停滞。考察诸药的性味，只有川当归、川芎、桃仁这三味药，善于破除旧血，快速生成新血，佐以炙黑干姜、甘草引导三味药进入肺肝，生血利气，五味药共同组成方剂，则在行血中有补益，化瘀中有新生，确实是产后的圣药，所以因此命名。凡是怀孕到八九月，根据制方下面的剂量，名叫生化汤：
川芎（二两） 川当归（五钱） 桃仁 干姜（炙黑） 甘草（各五钱）
桃仁要去皮尖，捣成泥状使用，干姜要用黑色的，醋浸透，炒黑使用。以上作为二三帖，直到胞衣破裂，迅速煎煮一帖，等到婴儿落地就服用，不论正常生产还是小产。如果是年轻体壮的产妇平安无事，都适宜服用两帖，消除血块，生成新血。
又一方生化汤：川芎（三钱） 川当归（八钱） 桃仁（十粒，去皮尖） 干姜（四分，炒黑） 甘草（炙，五分）
以上用水二钟，煎至七分，加酒六七茶匙，稍热服用。查阅后面这一帖，并连同前两帖一起煎煮，要在两个时辰内，在未进食之前，相继煎服，那么下焦的血块迅速化解，而快速生长新血，自然不会有晕厥。而且产妇服用一帖后，精神逐渐增加，不嫌服药频繁。如果按照常规病症，每天服用一帖，怎么能挽回将绝的气血呢？那些胎前素来虚弱，产后劳倦以及热症堕胎的，不拘泥于帖数，服用到病退为止。如果产妇劳累严重，血崩面色苍白脱形，就在方中加入人参三四钱，频繁灌服不用担心。
川芎（二钱） 川当归（四钱） 干姜（四分，炒黑） 甘草（五分，炙） 桃仁（十粒，去皮尖） 人参三钱或二钱，随病症缓急而定，如非常危急的病症，人参加至五六钱，大枣三枚，水煎服，药渣再煎。
加减法：
After childbirth, Qi and Blood are suddenly deficient; theoretically, major tonification is required. However, there is a concern that lochia (postpartum discharge) has not yet fully cleared. When using tonifying herbs, one must ensure they do not cause blood stasis; the formula should be able to resolve stasis while simultaneously generating new blood. When using purgative herbs to break masses, one must avoid damaging Yuan Qi (Original Qi); the method of moving Qi and Blood should also incorporate tonification. Only by prescribing comprehensively can one achieve perfection and avoid errors. In modern times, people use Siwu Tang (Four Substances Decoction) to manage postpartum conditions, which has misled many. This is because Shu Dihuang (Prepared Rehmannia Root) is cold in nature and causes blood stagnation, and Shaoyao (Peony Root) is sour and cold, lacking tonifying properties.
Postpartum pain caused by lochia is called "Erzhen Tong" (Fetal Pillow Pain). People often focus exclusively on resolving stasis first, then discuss tonification, or use mixed formulas for both resolving and tonifying. They fail to realize that although old blood should be resolved, new blood must also be generated and nourished. If one focuses solely on attacking old blood, the new blood will not remain tranquil.
People use Jikun Dan (also known as Jiusheng Dan) to treat postpartum conditions, using it to attack blood masses, expel the placenta, and induce abortion. While this shows rapid efficacy, it inevitably damages Yuan Qi. For safe deliveries, it should not be regarded as a good remedy. Jikun Dan should only be used when absolutely necessary to expel the fetus, placenta, or blood masses. Only one pill should be taken, not more, followed immediately by decoctions for tonification.
Miaoying Wan treats retained food and meat accumulation after childbirth. This results from physical exhaustion injuring the Spleen and Stomach. Families who do not manage care well may overconsume rich flavors, sleep deeply causing further injury, leading to reduced stomach intake but slow Spleen transportation. Food retention causes fullness, belching, and acid regurgitation. This is old phlegm wrapping around food, unable to be digested or guided out. It is appropriate to take three to five pills, followed immediately by decoctions for tonification.
This illustrates the principle: "In acute cases, treat the branch (symptoms); in chronic cases, treat the root (cause)."
Shenghua Tang is named based on the properties and functions of its herbs. Postpartum blood masses should be resolved, and new blood should be generated. Resolving only leads to unrest in new blood; generating only leads to stagnation of old blood. Examining the properties of the herbs, Chuan Xiong (Sichuan Lovage Rhizome), Chuan Danggui (Sichuan Angelica Root), and Tao Ren (Peach Seed) are excellent at breaking old blood and rapidly generating new blood. They are assisted by Zhi Hei Ganjiang (Charred Dried Ginger) and Gancao (Licorice Root) to guide these three herbs into the Lung and Liver meridians, generating blood and benefiting Qi. The combination of these five ingredients ensures that tonification accompanies movement, and generation accompanies resolution. It is truly the sacred medicine for postpartum conditions, hence the name. For pregnancies reaching eight or nine months, according to the prescription below, it is named Shenghua Tang:
Chuanxiong (2 liang) Chuan Danggui (5 qian) Taoren (Peach Seed) Ganjiang (Dried Ginger, charred) Gancao (Licorice Root, each 5 qian)
Taoren must have skin and tips removed, pounded into a paste for use. Ganjiang must be blackened, soaked in vinegar thoroughly, and stir-fried until black. Prepare two to three doses. Once the membranes rupture, quickly decoct one dose and administer immediately after the baby is born, regardless of normal delivery or miscarriage. For young and robust women with safe deliveries, taking two doses is advisable to resolve masses and generate blood.
Another version of Shenghua Tang: Chuanxiong (3 qian) Chuan Danggui (8 qian) Taoren (10 grains, skin and tips removed) Ganjiang (4 fen, stir-fried black) Gancao (2 qian, roasted)
Decoct the above in two zhong of water until reduced to seven-tenths. Add six or seven tea spoons of wine, and drink slightly warm. Reviewing this last dose along with the previous two doses, decoct them together. Administer continuously within one or two shichen (hours), before eating. This will rapidly resolve lower jiao blood masses and rapidly grow new blood, preventing fainting. Moreover, after taking one dose, the patient's spirit gradually improves, so frequent medication is not tiresome. If treating routine symptoms, taking one dose daily cannot reverse critically depleted Qi and Blood. For those weak before pregnancy, exhausted after childbirth, or suffering from heat-induced miscarriage, do not limit the number of doses; continue until the illness recedes. If the puerpera is severely exhausted with hemorrhage and pale complexion, add Renshen (Ginseng Root) 3-4 qian and administer frequently without worry.
Jia Shen Shenghua Tang (Shenghua Tang with Ginseng) treats various critical postpartum syndromes; all can take this formula.
Chuanxiong (2 qian) Chuan Danggui (4 qian) Ganjiang (4 fen, stir-fried black) Gancao (5 fen, roasted) Taoren (10 grains, skin and tips removed) Renshen (Ginseng Root) 3 qian or 2 qian, depending on urgency. For very critical cases, increase Renshen to 5-6 qian. Add three Jujubes (Chinese Date). Decoct in water, drink, and decoct the dregs again.
Modifications:
After delivery, if sweating is profuse and fatigue is severe, take this formula with added Renshen 3-4 qian.
After delivery, if unable to expel the placenta due to weakness, or feeling fatigued, take this formula.
If constitutionally weak before pregnancy and showing deficiency signs after childbirth, take this formula.
If suffering from diarrhea before pregnancy and fatigue after childbirth, take this formula with added Renshen 4-5 qian.
For excessive sweating, add Mahuanggen (Ephedra Root) 2 qian, Huangqi (Astragalus Root) 1 qian, Fangfeng (Saposhnikovia Root) 5 fen.
For cold feet, add Renshen 4-5 qian, Fuzi (Aconite Root) 4 fen; if accompanied by sweating, also add Renshen and Maidong (Ophiopogon Tuber) 1 qian.
For shortness of breath, add Renshen 4 qian.
For Xiao Ke (Wasting-Thirst), add Maidong 1 qian, Wuweizi (Schisandra Fruit) 10 grains.
For dry stool, add Congrong (Cistanche Stem) 1 qian.
For irritability, add Zhuru (Bamboo Shavings) one pill.
For cold cough, add Xingren (Apricot Seed) 10 grains, Jiegeng (Platycodon Root) 5 fen.
For wheezing and rapid breathing, add Banxia (Pinellia Tuber) 1 qian, Xingren 10 grains, Jiegeng 5 fen.
For phlegm, add Tianhuafen (Trichosanthes Root) 8 fen, Zhuli (Bamboo Juice) half a wine cup, Jiangzhi (Ginger Juice) a little.
For postpartum blood mass pain, use Shenghua Tang as the main formula. After the pain from blood masses subsides, use Jia Shen Shenghua Tang as the main formula.