凡产后血块，孕乃成余血之所积也。夫妇人血旺气衰，二七而天癸至，三旬一见，以象月盈则亏也，
行之有恒，名曰经。有孕则经不行，其余血注于胞中，以护胎元。然一月名胎胚，二月名胎膏，三月后始成
形而名胎。方受母血之阴庇，胎形尚小，食母血尚有余，计前二月并积于胞，日久成块，至产随儿当下。多
有产妇送儿送胞，劳倦无力，或调护欠温暖，致块痛，日久方散。慎勿轻用攻血峻剂，勿多饮姜、椒、艾、
酒，若过伤大热，新血未免损失多矣。治法须频服生化汤几帖，以助血液行外，用热衣暖腹。凡产后诸症，
时俗之偏，治血块有用生地、红花以行之，苏木、牛膝以攻之。治气有用乌药、香附以顺之，枳壳、浓朴
以舒之，甚有用青皮、枳实、苏子以下气定喘，用芩、连，栀、柏以除热退烦。至若血枯大便实结，反用
承气下之而愈结，汗多小便短涩，反用五苓散通之而愈闭。其用偏门罔知固本。又有视山楂
能攻血块，弱人频服二三次者，此人必死无疑矣。
凡产后气血暴虚，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，行中又带
补养，方思万全，治无一失。世以四物汤理产，误人多矣。因地黄性寒滞血，芍药酸寒无补正也。一产后恶
露有块作痛，名曰儿枕，世多专先消散，然后议补，又有消补混方，殊不知旧血须当清化，新血亦当生养，
若专主攻旧，而新血亦不宁矣。世以济坤丹又名回生丹治产，用以攻血块下胞落胎，虽见速效，其元气未免
亏损，慎毋视为良剂。济坤丹或不得已而用以下胞下胎，只可一丸，决不可多服。今予之生化汤，因药性功
效而立名也。盖产后血块当消，新血宜生。若专消则心血不宁，专生则旧血亦反滞矣。考诸药性惟芎、归、
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，实产后圣方，因名生化汤。凡病起于血气之衰，脾胃之虚，而产后血气脾胃之虚衰尤甚。
是以丹溪先生论产后必当以大补血气为先，虽有他症，以末治之。此三言者，尽医产之大旨，若能扩充立
方用药，则治症可以无大过矣。惟医者详之。生化汤有孕至七八个月，照方预制二三帖，至胞衣易破，速煎
一帖，候儿下地即服。不问正产半产，虽少壮产妇，平安无恙，俱宜服二帖，以消血块，生养新血。
当归（八钱，酒洗） 川芎（四钱） 干姜（五分，炙黑存性） 桃仁（十五粒去皮尖）
甘草（五分，炙）
用水二盅煎七分，加酒七茶匙稍热服。渣留与后帖渣共煎，二帖共煎三次，要在一二时辰之内，未进饮
食之先，相继煎服。因下焦恶露而服，多服而频，则连化而骤生长新血，自免晕症。其
胎前素弱及产后劳倦，又当再制二帖煎服，以防昏倦。且产妇服一帖，渐增精神几分，不厌药之频也。若
照常症，今日服一帖，明日服一帖，岂能扶救将绝之气血也。若虚人见危症及热症坠胎或
劳甚，身热头痛，服药四五帖稍安，未除血痛，又当再制服之。
加参生化汤
治产后诸危急症，可通用一日一夜，必须频服之三四帖，若照常症，今日一帖，明日一帖，岂能接
补将绝之气血，救危急之症哉。
当归（三钱） 川芎（一钱五分） 干姜（四分，炙黑存性） 甘草（三分，炙） 桃
仁（十五粒，去皮尖） 人参（二钱）
若虚脱冷厥危症汗多，加参至三四钱之数，用枣水煎服，
加减法
脉脱形色脱将绝症，必服此方，频灌救之，加参四五钱。分娩后血晕血崩症，如兼汗多，形色脱去宜
服此方。若无汗不脱者，只服生化本方，不必加参。分娩后血崩形色脱，宜服此方，又宜频煎服，必加参三
四钱。分娩后手足冷发厥，服此方加参三四钱，兼汗亦加参三四钱，麦冬一钱。左尺脉弱，宜加人参。若产
后汗多，加参三、四钱。汗多渴甚，加参三、四钱，麦冬三钱。汗多气短似喘，加参三、四钱。汗多痰嗽，加
竹沥，姜汁，杏仁二十五粒。汗多嗽喘声声，加杏仁十粒，桔梗五分。无汗嗽喘气短者加半夏一钱，杏仁
十粒，桔梗五分。汗多身热气短加参三四钱，汗不止加黄 一钱。
凡产后出现的血块，是怀孕后残留的血液积聚而成的。妇女如果血气旺盛而阳气衰弱，十四岁时天癸（指月经）来潮，每三十天一次，这象征着月亮满盈之后就会亏缺。月经来潮有固定的规律，称为“经”。一旦怀孕，月经停止，剩余的血液注入胞宫（子宫），用来保护胎元。然而，怀孕第一个月称为胎胚，第二个月称为胎膏，三个月后才成形并正式称为“胎”。此时胎儿刚刚受到母体阴血的庇护，胎形尚小，摄取母血后仍有剩余，计算前两个月以及之后的积存都在胞宫中，日子久了便结成血块，到分娩时随着婴儿一起排出。
很多产妇在送产婴儿和胎盘时，因劳累疲倦而无力，或者护理不当不够温暖，导致血块疼痛，需要很长时间才能消散。千万不要轻易使用攻逐瘀血的峻猛药剂，也不要大量饮用生姜、花椒、艾叶、酒等热性饮品，如果过度损伤于大热之性，新产生的血液难免会遭受损失。治疗方法应当频繁服用生化汤几剂，以助血液运行，并用热衣物暖腹。
凡是产后各种病症，世俗常有偏颇。治疗血块有用生地黄、红花来行血的，有用苏木、牛膝来攻逐的；治疗气滞有用乌药、香附来顺气的，有用枳壳、厚朴来舒展的；甚至有用青皮、枳实、苏子来降气定喘的，有用黄芩、黄连、栀子、黄柏来清热除烦的。至于血枯导致大便干结，反而用承气汤攻下，结果更加干结；汗多导致小便短少涩痛，反而用五苓散通利小便，结果更加闭塞。这些用法偏离正道，不懂得固护根本。又有的人认为山楂能攻逐血块，让体质虚弱的人频繁服用两三次，这种人必定死亡无疑。
凡是产后气血突然虚衰，理当大补，但恶露未尽，使用补法必须注意不要造成瘀滞。血既能化又能生，攻逐血块不损伤元气，在行血中又带有补养，才算万全，治疗才没有失误。世人用四物汤调理产后，误导人太多了。因为地黄性寒且易滞血，芍药酸寒并无补益正气的作用。有一种产后恶露有块作痛的情况，名叫“儿枕”，世人大多专门先消散它，然后才讨论补益，又有消补混合的方子，殊不知旧血应当清除化解，新血也应当生养，如果专门主攻旧血，那么新血也不会安宁。世人用济坤丹（又名回生丹）治疗产后，用来攻逐血块、排出胎盘堕胎，虽然见效快，但元气未免亏损，千万不要把它视为良剂。济坤丹如果不得已用来下胎排胞，只可服一丸，决不可多服。
现在我提出的生化汤，是根据药物的功效来命名的。大概产后血块应当消除，新血应当生成。如果专门消除，心血就不安宁；如果专门生新，旧血反而会停滞。考察药物性质，只有川芎、当归、桃仁这三味药，药性善于破除旧血，迅速生成新血，佐以炙黑干姜、甘草，引导三味药进入肺肝二经，生血利气，五味药共成一方。则在行血中有补益，化瘀中有新生，确实是产后的圣方，因此命名为生化汤。
凡是疾病起于血气衰败、脾胃虚弱，而产后的血气脾胃虚衰尤其严重。所以丹溪先生论述产后必须把大补血气作为首要任务，即使有其他症状，也要作为次要处理。这三句话，概括了治疗产科疾病的精髓，如果能扩充此意来立方的用药，那么治疗病症就可以没有大的过失了。希望医生们仔细斟酌。
生化汤可以在怀孕至七八个月时，按照方子预先制备两三剂，等到胞衣容易破裂时，快速煎煮一剂，等候婴儿落地后立即服用。无论是正常分娩还是小产，即使是年轻强壮的产妇，平安无事，也都适宜服用两剂，以消除血块，生养新血。
配方：当归（八钱，酒洗）、川芎（四钱）、干姜（五分，炙黑存性）、桃仁（十五粒，去皮尖）、甘草（五分，炙）。
用水二盅煎至七分，加入七茶匙酒，稍热后服用。药渣留起来与下一剂的药渣共同煎煮，两剂的药渣共煎三次，要在两个时辰之内，在未进食之前，相继煎服。因为这是针对下焦恶露而服的，多服且频服，就能连续化瘀并迅速生长新血，自然避免晕厥症状。那些胎前素体虚弱及产后劳累疲倦者，又应当再制备两剂煎服，以防昏倦。而且产妇服用一剂后，精神逐渐增加几分，不厌烦药物的频繁服用。如果像通常的病症那样，今天服一剂，明天服一剂，怎么能扶救将绝的气血呢？如果是虚人出现危症及热症坠胎或极度劳累，身体发热头痛，服药四五剂后稍微安稳，但血痛未除，又应当再制服之。
加参生化汤：
治疗产后各种危急重症，可以通用一日一夜，必须频繁服用三四剂，如果像通常病症那样，今天一剂，明天一剂，怎么能接补将绝的气血，挽救危急的病症呢？
配方：当归（三钱）、川芎（一钱五分）、干姜（四分，炙黑存性）、甘草（三分，炙）、桃仁（十五粒，去皮尖）、人参（二钱）。
加减法：
脉象微弱、形色憔悴接近衰竭的病症，必须服用此方，频繁灌服抢救，人参加至四五钱。分娩后血晕、血崩症，如果兼有汗多、形色脱失，适宜服用此方。如果没有汗且不脱失的，只服生化汤本方，不必加人参。分娩后血崩、形色脱失，适宜服用此方，又宜频繁煎服，必须加人参三四钱。分娩后手足冰冷发厥，服用此方加人参三四钱，如果兼有汗出也加人参三四钱，再加麦冬一钱。左尺脉弱，适宜加人参。如果产后汗多，加人参三、四钱。汗多口渴严重，加人参三、四钱，麦冬三钱。汗多气短似喘，加人参三、四钱。汗多痰嗽，加竹沥、姜汁、杏仁二十五粒。汗多咳嗽气喘声音响亮，加杏仁十粒、桔梗五分。无汗咳嗽气喘气短的，加半夏一钱、杏仁十粒、桔梗五分。汗多身热气短，加人参三四钱，汗不止加黄芪一钱。
Any blood clots appearing after childbirth are formed by the accumulation of residual blood from pregnancy. In women, if blood is abundant and Qi is deficient, Tian Gui (menstrual fluid) arrives at age fourteen, occurring once every thirty days, symbolizing that when the moon is full, it begins to wane. Menstruation follows a regular pattern and is called "Jing" (menses). Once pregnant, menstruation ceases, and the remaining blood flows into the Bao Gong (uterus) to protect the Tai Yuan (fetal origin). However, in the first month of pregnancy, it is called "Tai Pei" (embryo), in the second month "Tai Gao" (fetal paste), and only after three months does it take shape and be formally named "Tai" (fetus). At this stage, the fetus has just received protection from the mother's Yin blood; the fetal form is still small, and after consuming maternal blood, there is still surplus. Calculating the accumulation from the first two months onwards within the uterus, over time these residues form clots, which should be expelled along with the infant at delivery.
Many parturients, due to exhaustion and weakness during the delivery of the infant and placenta, or due to inadequate care and lack of warmth, experience pain from these clots, which may take a long time to dissipate. One must not lightly use harsh purgatives for blood stasis, nor drink large amounts of warming substances like ginger, pepper, mugwort, or wine. Excessive heat will inevitably damage the newly generated blood. The treatment method requires frequent administration of Shenghua Tang (Decoction for Generating Blood) for several doses to assist blood circulation, while keeping the abdomen warm with hot clothing.
Regarding various postpartum conditions, folk practices often have biases. For treating blood clots, some use Sheng Di Huang (Rehmanniae Radix Preparata) and Hong Hua (Carthami Flos) to move blood, or Su Mu (Sappan Lignum) and Niu Xi (Achyranthis Bidentatae Radix) to attack stasis. For treating Qi stagnation, some use Wu Yao (Linderae Radix) and Xiang Fu (Cyperi Rhizoma) to smooth Qi, or Zhi Qiao (Aurantii Fructus) and Hou Po (Magnoliae Officinalis Cortex) to relax. Some even use Qing Pi (Citri Reticulatae Pericarpium Viride), Zhi Shi (Aurantii Fructus Immaturus), and Su Zi (Perillae Fructus) to descend Qi and calm asthma, or Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Zhi Zi (Gardeniae Fructus), and Huang Bai (Phellodendri Cortex) to clear heat and relieve irritability. As for constipation due to blood dryness, using Cheng Qi Tang (Order the Qi Decoction) to purge results in further constipation; for scanty, painful urination due to excessive sweating, using Wu Ling San (Five-Ingredient Powder with Poria) to promote urination results in further retention. These approaches deviate from the correct path and fail to understand the importance of consolidating the root. Furthermore, some believe Shan Zha (Crataegi Fructus) can dissolve blood clots and allow weak individuals to take it frequently for two or three times; such persons will undoubtedly die.
After childbirth, Qi and Blood are suddenly deficient, so major tonification is indicated. However, since E Lu (lochia) is not yet exhausted, tonification must be used with caution to avoid causing stagnation. Blood can transform and generate; attacking clots does not damage Yuan Qi, and moving blood while simultaneously nourishing constitutes a comprehensive approach, ensuring no errors in treatment. The world's use of Si Wu Tang (Four Substance Decoction) for postpartum care has misled many. This is because Di Huang (Rehmanniae Radix) is cold and causes stagnation, and Shao Yao (Paeoniae Radix Alba) is sour and cold, offering no benefit to righteous Qi. A condition where lochia forms clots causing pain is called "Er Zhen" (Child's Pillow). The world mostly focuses on dissolving it first before discussing tonification, or uses mixed formulas for both dissolving and tonifying. They do not realize that old blood must be cleared and transformed, and new blood must also be generated and nourished. If one specializes only in attacking old blood, the new blood will also be unsettled. The world uses Ji Kun Dan (also known as Hui Sheng Dan) to treat postpartum conditions, aiming to attack blood clots, expel the placenta, and induce abortion. Although it shows rapid effects, it inevitably damages Yuan Qi. Do not regard it as a good remedy. If Ji Kun Dan is used out of necessity to expel the placenta or fetus, only one pill should be taken; it must not be taken in excess.
My proposed Shenghua Tang is named based on the efficacy of its ingredients. Generally, postpartum blood clots should be eliminated, and new blood should be generated. If one specializes only in elimination, Heart Blood will be unsettled; if one specializes only in generation, old blood will remain stagnant. Examining the properties of herbs, only Chuan Xiong (Ligustici Chuanxiong Rhizoma), Dang Gui (Angelicae Sinensis Radix), and Tao Ren (Persicae Semen) possess the property of effectively breaking down old blood and rapidly generating new blood. These are assisted by Zhi Hei Gan Jiang (Prepared Blackened Ginger Rhizome) and Gan Cao (Glycyrrhizae Radix et Rhizoma) to guide the three herbs into the Lung and Liver meridians. Together, these five herbs generate blood and benefit Qi. Thus, in moving blood there is tonification, and in resolving stasis there is generation. It is truly a sacred formula for postpartum care, hence named Shenghua Tang.
Diseases arise from the decline of Qi and Blood and the deficiency of the Spleen and Stomach; postpartum deficiency of Qi, Blood, Spleen, and Stomach is particularly severe. Therefore, Mr. Danxi stated that postpartum treatment must prioritize major tonification of Qi and Blood. Even if other symptoms exist, they should be treated as secondary matters. These three statements summarize the main principles of obstetric medicine. If physicians can expand upon this to formulate prescriptions, treatments will likely avoid major errors. Physicians should study this carefully.
Shenghua Tang can be prepared in advance (two or three doses) from the seventh or eighth month of pregnancy. When the membranes are about to rupture, quickly decoct one dose and administer it immediately after the infant is born. Whether it is a normal delivery or a miscarriage, even for young and strong parturients who are safe and sound, it is advisable to take two doses to eliminate blood clots and generate new blood.
Ingredients: Dang Gui (8 qian, washed with wine), Chuan Xiong (4 qian), Gan Jiang (5 fen, prepared blackened retaining nature), Tao Ren (15 grains, peeled and removed of tips), Gan Cao (5 fen, prepared).
Decoct with 2 cups of water until reduced to 0.7 cup. Add 7 tea spoons of wine, warm slightly, and take. Retain the dregs and combine them with the dregs of the next dose. Decoct the combined dregs three times across two doses. Administer continuously within two shichen (4 hours), prior to any food intake. Since this addresses lower Jiao E Lu, frequent and repeated administration allows for continuous transformation of stasis and rapid growth of new blood, thereby avoiding syncope. For those constitutionally weak before pregnancy or suffering from postpartum fatigue, prepare two additional doses to prevent fainting and exhaustion. After taking one dose, the patient's spirit gradually improves; do not dislike the frequency of medication. If administered conventionally, one dose today and one tomorrow, how can it rescue the nearly exhausted Qi and Blood? For weak patients presenting with critical conditions, heat-induced abortion, or extreme fatigue with fever and headache, taking four or five doses may bring slight relief, but if blood pain persists, continue administration.
Jia Shen Shenghua Tang (Shenghua Tang with Ginseng):
Treats various critical postpartum conditions. It can be used continuously for a day and night, requiring frequent administration of three to four doses. If administered conventionally, one dose today and one tomorrow, how can it reconnect and tonify nearly exhausted Qi and Blood to save critical conditions?
Ingredients: Dang Gui (3 qian), Chuan Xiong (1.5 qian), Gan Jiang (4 fen, prepared blackened retaining nature), Gan Cao (3 fen, prepared), Tao Ren (15 grains, peeled and removed of tips), Ren Shen (2 qian).
For critical conditions involving collapse, cold limbs, and excessive sweating, increase Ren Shen to 3-4 qian, decoct with jujube water, and take.
Modifications:
For pulseless conditions and physical appearance indicating impending collapse, this formula must be taken, administered frequently to rescue. Increase Ren Shen to 4-5 qian. For postpartum blood syncope or flooding accompanied by excessive sweating and loss of complexion, this formula is suitable. If there is no sweating and no collapse, take only the basic Shenghua Tang without adding Ren Shen. For postpartum flooding with loss of complexion, this formula is suitable, preferably decocted frequently, with Ren Shen increased to 3-4 qian. For postpartum cold extremities and convulsions, take this formula with Ren Shen 3-4 qian; if accompanied by sweating, add Ren Shen 3-4 qian and Mai Dong (Ophiopogonis Tuber) 1 qian. If the Left Chi pulse is weak, add Ren Shen. For postpartum excessive sweating, add Ren Shen 3-4 qian. For excessive sweating with severe thirst, add Ren Shen 3-4 qian and Mai Dong 3 qian. For excessive sweating with shortness of breath resembling asthma, add Ren Shen 3-4 qian. For excessive sweating with phlegm and cough, add Zhu Li (Bambusae Succus), Jiang Zhi (Zingiberis Recens Juice), and Xing Ren (Armeniacae Semen Amarum) 25 grains. For excessive sweating with loud coughing and wheezing, add Xing Ren 10 grains and Jie Geng (Platycodonis Radix) 5 fen. For no sweating with coughing, wheezing, and shortness of breath, add Ban Xia (Pinelliae Rhizoma Preparatum) 1 qian, Xing Ren 10 grains, and Jie Geng 5 fen. For excessive sweating with body heat and shortness of breath, add Ren Shen 3-4 qian; if sweating does not stop, add Huang Qi (Astragali Radix) 1 qian.