产后血大来。当审血之红紫。神形色之虚实。如血紫有块。乃当去之败血。止留反作痛。不
可论崩。如鲜红之血大来。乃是惊伤心不能主血。怒伤肝不能藏血。劳伤脾不能统血归经耳
。当以崩治。先宜频服生化汤几帖。则行中有补。血宁生旺矣。若形脱或多汗气促。宜服倍
参生化汤以益气。斯阳生而阴长矣。此非棕灰等之可止者。再如产已半月外患崩。又宜升举
大补汤治之。
分娩后血崩。
川芎(一钱) 当归(去尾四钱) 姜炭(四分) 炙甘草 荆芥 乌梅( 灰) 蒲黄(炒各五分)
桃仁(十粒) 枣(二枚) 煎服。忌姜。椒。热物。并生冷。如鲜血大来。加白芷(五分)
血竭形脱。并汗多气促。俱加人参(三四钱) 若无汗不脱不促。只服生化汤多几帖。则血自
宁。世有言芎归但能活血不可治崩。此误人之论。
块痛已除。血崩。
黄 白术 人参 当归 生地 麦冬 川芎(各一钱) 陈皮 炙草 升麻 白芷 荆
芥穗(各四分) 黄连(四分) 如汗多加麻黄根(一钱) 浮麦(一撮)大便不通加肉苁蓉(一钱)
禁用大黄。如有气磨木香(一钱) 痰加贝母(六分) 竹沥。姜汁。寒嗽加杏仁。桔梗。知
母(各一钱) 惊悸加枣仁。柏子仁(各一钱) 伤面食加麦芽(一钱) 伤米食加神曲(一钱)
伤肉食加山楂。砂仁。(各八分) 身热不可用芩。连。黄柏。伤食及怒气。均不可专用耗散
无补之方。宜上方加减。药引俱用枣。煎服。
产后大量出血。应当审视血液的颜色是红还是紫，以及患者神色形态的虚实状况。如果血色紫暗且有血块，这是应当祛除的败血，若强行止血反而会导致疼痛，这种情况不能按血崩论治。如果是鲜红色的血液大量涌出，这是由于惊恐损伤了心脏，导致心不能主司血液；愤怒损伤了肝脏，导致肝不能藏纳血液；劳累损伤了脾脏，导致脾不能统摄血液回归经脉所致。这种情况应当按照血崩来治疗。首先适宜频繁服用生化汤几剂，这样在行血的同时兼有补益作用，血液就能安宁并恢复旺盛。如果出现形体脱失（极度虚弱）或多汗、气短急促的症状，适宜服用加倍人参量的生化汤以益气，这样阳气生发而阴血随之生长。这绝不是用棕榈灰等收敛止血药所能止住的。再如分娩半个月以后出现血崩，又适宜用升举大补汤来治疗。
【方剂一：生化汤加减】
川芎（一钱）、当归（去尾梢四钱）、姜炭（四分）、炙甘草、荆芥、乌梅（烧灰）、蒲黄（炒制，各五分）、桃仁（十粒）、大枣（两枚）。煎汤服用。忌食生姜、花椒、热性食物，以及生冷食物。如果鲜血大量涌出，加白芷（五分）。如果血竭（形容血液枯竭或极度虚弱之象，此处指代严重耗损状态）伴形体脱失，以及多汗气促，均加入人参（三至四钱）。如果没有出汗、没有形体脱失、气息不急促，只多服几帖生化汤，血液自然安宁。世间有人说川芎和当归只能活血而不能治疗血崩，这是误人的言论。
【方剂二：滋荣益气止崩汤加减】
血块疼痛已经消除，仍有血崩症状。
黄芪、白术、人参、当归、生地、麦冬、川芎（各一钱）、陈皮、炙甘草、升麻、白芷、荆芥穗（各四分）、黄连（四分）。如果出汗多，加麻黄根（一钱）、浮小麦（一撮）。大便不通畅，加肉苁蓉（一钱），禁用大黄。如果有气滞胀闷，加木香（一钱）。有痰，加贝母（六分）、竹沥、姜汁。寒性咳嗽，加杏仁、桔梗、知母（各一钱）。惊悸不安，加酸枣仁、柏子仁（各一钱）。因面食积滞受伤，加麦芽（一钱）。因米食积滞受伤，加神曲（一钱）。因肉食积滞受伤，加山楂、砂仁（各八分）。身体发热时不可使用黄芩、黄连、黄柏。饮食积滞及怒气导致的病症，均不可专门使用耗散而无补益作用的方剂，适宜在上述基础方上加减。药引均用大枣，煎汤服用。
Postpartum massive hemorrhage. One must examine whether the blood is red or purple, and assess the deficiency or excess of the patient's spirit, complexion, and physical form. If the blood is dark purple with clots, these are retained blood (retained blood) that should be expelled; forcibly stopping them will cause pain, and this condition should not be treated as metrorrhagia (postpartum hemorrhage). If bright red blood flows profusely, it indicates that fright has injured the Heart (Heart), causing it to fail in governing the blood; anger has injured the Liver (Liver), causing it to fail in storing the blood; and overexertion has injured the Spleen (Spleen), causing it to fail in controlling the blood to remain within the vessels. This condition should be treated as metrorrhagia. Initially, it is appropriate to frequently administer Shenghua Tang (Decoction for Generating New Blood) for a few doses, so that while promoting blood circulation, tonification is also provided, allowing the blood to calm down and flourish. If there is collapse of the physical form (extreme weakness), excessive sweating, or shortness of breath, one should administer Shenghua Tang with doubled Ginseng Radix et Rhizoma (Renshen, 人参) to tonify Qi, thereby generating Yang and nourishing Yin. This cannot be stopped by agents such as Cinnabar Ash (Zonghui, 棕榈灰). Furthermore, if metrorrhagia occurs more than half a month after delivery, Shengju Dabu Tang (Decoction for Lifting and Great Tonification) should be used for treatment.
[Formula 1: Modified Shenghua Tang]
Chuanxiong Rhizome (Chuanxiong, 川芎) (1 qian), Angelica Sinensis Root (Danggui, 当归) (4 qian, tail removed), Charred Ginger Rhizome (Jiangtan, 姜炭), Honey-fried Licorice Root (Zhigancao, 炙甘草), Schizonepeta Spike (Jingjie, 荆芥), Smoked Plum (Wumei, 乌梅) (charred to ash), Yellow Poppy Seed (Puhuang, 蒲黄) (stir-fried, each 5 fen), Peach Kernel (Taoren, 桃仁) (10 grains), Jujube Fruit (Zao, 大枣) (2 pieces). Decoct and take orally. Avoid fresh ginger, Sichuan pepper, hot-natured foods, and raw/cold foods. If bright red blood flows profusely, add White Peony Root (Baizhi, 白芷) (5 fen). If there is severe depletion (Xuejie, 血竭 - referring to extreme exhaustion state here) accompanied by collapse of form, excessive sweating, and shortness of breath, add Ginseng Radix et Rhizoma (Renshen, 人参) (3-4 qian). If there is no sweating, no collapse, and no shortness of breath, simply taking a few more doses of Shenghua Tang will naturally calm the blood. It is said in the world that Chuanxiong and Danggui can only invigorate blood but cannot treat metrorrhagia; this is a misleading argument.
[Formula 2: Zirong Yiqi Zhibeng Tang / Nourishing and Qi-Tonifying Hemostatic Decoction]
Clot-related pain has been resolved, but metrorrhagia persists.
Astragalus Membranaceus Root (Huangqi, 黄芪), Atractylodes Macrocephala Rhizome (Baizhu, 白术), Ginseng Radix et Rhizoma (Renshen, 人参), Angelica Sinensis Root (Danggui, 当归), Rehmannia Glutinosa Root Preparata (Shengdi, 生地), Ophiopogon Japonicus Tuber (Maidong, 麦冬), Chuanxiong Rhizome (Chuanxiong, 川芎) (each 1 qian), Tangerine Peel (Chenpi, 陈皮), Honey-fried Licorice Root (Zhigancao, 炙草), Cimicifuga Rhizome (Shengma, 升麻), White Peony Root (Baizhi, 白芷), Schizonepeta Spike (Jingjiesui, 荆芥穗) (each 4 fen), Coptis Rhizome (Huanglian, 黄连) (4 fen). If sweating is excessive, add Equisetum Hiemale Stem (Mahuanggen, 麻黄根) (1 qian) and Floating Wheat (Fumai, 浮麦) (a pinch). If bowel movement is obstructed, add Cistanche Deserticola Stem (Roucongrong, 肉苁蓉) (1 qian); Rhubarb (Dahuang, 大黄) is prohibited. If there is Qi stagnation and distension, add Costus Root (Muxiang, 木香) (1 qian). If there is phlegm, add Pinellia Tuber (Beimu, 贝母) (6 fen), Bamboo Sap (Zhuli, 竹沥), and Ginger Juice (Jiangzhi, 姜汁). If there is cold cough, add Apricot Seed (Xingren, 杏仁), Platycodon Root (Jiegeng, 桔梗), and Anemarrhena Rhizome (Zhimu, 知母) (each 1 qian). If there is palpitations due to fright, add Sour Jujube Seed (Zaoren, 枣仁) and Biota Seed (Baiziren, 柏子仁) (each 1 qian). If injured by food stagnation from flour products, add Malt (Maiya, 麦芽) (1 qian). If injured by food stagnation from rice products, add Medicated Leaven (Shenqu, 神曲) (1 qian). If injured by food stagnation from meat products, add Hawthorn Fruit (Shanzha, 山楂) and Amomum Fruit (Sharen, 砂仁) (each 8 fen). When there is body heat, do not use Scutellaria Root (Qin, 黄芩), Coptis Rhizome (Lian, 黄连), or Phellodendron Bark (Huangbai, 黄柏). For conditions caused by food stagnation or anger, do not exclusively use formulas that disperse without tonifying; instead, modify the above formula. The decoction vehicle should be Jujube Fruit (Zao, 大枣). Decoct and take orally.