(专治交骨不开。子死腹中。)
当归(一两) 川芎(七钱) 龟板(手掌大一片。醋炙研细末。) 头发(妇人油发鸡子大一丸
服。
(治一切难产等症)
当归(五钱) 川芎(三钱) 水七分酒三分。煎服。如横生倒产。子死腹中。加黑马料豆(一
加童便一半。煎上药服。少刻再进一服。无不效。
产后血气大虚。理应大补。但恶露未尽。用补须知无滞血。能化又能生。攻块无损元气。行
失。世以四物汤理产后。误人多矣。因地黄性寒滞血。芍药酸敛滞血
。无补故也。产后恶露作块痛。名曰儿枕。世多专用逍遥散。然后议补。又有消补混施。终
无成效。不知旧血虽急当消化。新血亦宜生养。若专攻旧血。则新血亦不宁矣。世以济坤丸
又名回生丹。用以攻块下胎落胎。虽见速效。其元气未免亏损。即幸平安。究非良剂。不得已
。而用以下胞下胎。只可一丸。决不宜多服。盖生化汤因药性功用而立名者也。夫产后血块宜消
。新血宜生。若专消则新血不宁。专生则旧血反滞。考药性川芎、当归、桃仁、三品。善破恶
血。骤生新血。佐以炙黑干姜。甘草。引三品入于脾肝。生血理气。五味共方。则行中有补
。化中有生。实产后之要药也。故名曰生化汤。凡病起于气血之衰。脾胃之虚。而产后则血
气脾胃之衰尤甚。是以丹溪先生论产后曰。必当大补气血以为先。虽兼他症。以末治之。此
三言已尽医产之大旨。若能扩充其意。用药立方。则治产可以无大过矣。夫产后惊忧劳倦。
血气暴虚。诸症乘虚易入。如有气无专耗散。或有食勿轻消导。热不可用芩连。寒不可用桂
附。寒则血块凝滞。热则新血崩流。至若中虚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。似可下也。在产后而用承气。则重亡其阴。耳聋胁痛
。乃肝肾虚。恶血之停。休用柴胡。谵语汗出。乃元气虚弱。似邪之症。勿同胃实。厥有阳
气之衰。难分寒热。非大补不能回阳而起弱。因血虚之亏。不论刚柔。非滋荣不能舒筋而活
络。又如乍寒乍热。发作有期。症似疟也。若以疟治。则迁延难愈。神不守舍。言语无伦。
病似邪也。若以邪治。危亡可待。去血多而大便结燥。苁蓉加于生化。非润燥承气之能通。
患汗多而小便短涩。六君子倍用参 茯苓。必生液助津之可利。加参生化频服。救产后之危。
长生活命屡用。苏绝谷之症。颓散脱肛。多是气血下陷。补中益气之汤堪用。口噤拳挛。乃因
血燥类风。加参生化之汤宜服。若产户入风而痛甚。宜用羌活养荣汤。玉门寒冷而不闭。洗宜
蛇床萸硫磺。怔忡惊悸。生化远志安神之药。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。棱蓬。能破恶血。青
皮。枳壳。最消胀满。一应耗血散气之剂。发汗吐下之方。只可施于少壮。岂宜用于产中。
大抵新产之后。先问恶露如何。块痛未除。未可遽加 术。腹中痛止。补中益气汤无疑。至
若亡阳脱汗。气虚喘促。速服生化加参。是用权也。又以阴亡大热。血崩厥晕。速服生化原
方。乃救急也。王太仆曰。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。服药法宜效太仆以加频。凡任生死之奇术。须着意以救危。欲俯仰
之无愧。用存心于爱物。此虽未尽产中之详。然所闻之症。皆缘近乡治验为据。未必无小补
云。
凡有孕妇之家。照生化汤方于孕至七八月。预制二三帖。至产妇胞衣一破。连煎一帖。候儿
即服其余二帖。亦相从而进。不论正生小产。年纪少壮。服此方以消
血块。生新血。能保产后一切危症。且长精神。
（专门治疗耻骨联合分离不开，导致胎儿死亡在腹中的情况。）
当归（一两） 川芎（七钱） 龟板（手掌大小的一片，用醋炙后研成细末。） 头发（取妇人油性头发，如鸡蛋大一团服用。
（治疗各种难产等症状）
当归（五钱） 川芎（三钱） 用水七分、酒三分的比例，煎煮后服用。如果是横生倒产，或者胎儿死于腹中，加入黑马料豆（黑豆的一种，需炒黑）（一升），加入一半童便（儿童尿液），煎煮上述药物服用。过一会儿再服一次，没有不有效的。
产后血气极度虚弱，理应大补气血。但是恶露未尽，使用补药时必须注意不要造成瘀血停滞，既要能化瘀又要能生新血，攻破积块而不损伤元气，运行血脉而不耗散正气。世人常用四物汤调理产后，误导了很多人的地方在于：地黄性寒且容易滞血，芍药味酸收敛也容易导致滞血，所以单纯补血反而没有补益效果。产后恶露结成块状并疼痛，称为“儿枕”。世人多专用逍遥散，然后才考虑进补。又有消补混用的，最终都没有成效。不知道旧血虽然急需化解，但新血也应当生养。如果专攻旧血，那么新血也会不得安宁。世人用济坤丸（又名回生丹），用来攻破积块、下胎落胎，虽然见效快，但元气未免亏损，即使侥幸平安，终究不是良剂。不得已而用以下胞下胎的药物，只可服一丸，决不宜多服。这是因为生化汤是根据药物的性味功用而立名的。产后血块宜消除，新血宜生成。如果专事消除，新血就不安宁；如果专事生成，旧血反而会停滞。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。佐以炙黑的干姜和甘草，引导这三味药进入脾经和肝经，生血理气。五味药共同组成方剂，则在行血中有补益，在化瘀中有新生，确实是产后的要药。所以名叫生化汤。凡是疾病起于气血衰弱、脾胃虚弱，而产后则是气血脾胃的衰弱尤为严重。所以朱丹溪先生论述产后病说：“必须以大补气血为先”，即使兼有其他症状，也要作为次要来治疗。这三句话已经概括了治疗产后病的根本宗旨。如果能扩充其意旨，用药立方，那么治疗产病就可以没有大的过失了。产后因惊恐、忧虑、劳累、疲倦，导致血气突然虚弱，各种病症乘虚而入。如果有气机耗散而无定所，或者有食积勿轻易使用消导药。热证不可用黄芩、黄连，寒证不可用肉桂、附子。寒则血块凝滞，热则新血崩漏流出。至于中气虚弱外感风寒，出现三阳表证较多的情况，似乎可以用发汗法。但在产后使用麻黄，则会再次竭伤阳气；出现三阴里证较多的情况，似乎可以用泻下法。但在产后使用承气汤，则会再次亡失阴液。耳聋胁痛，是肝肾虚弱、恶血停聚所致，不要用柴胡；谵语汗出，是元气虚弱、类似邪气的症状，不要当作胃实热证来处理。如果有阳气衰微，难以分辨寒热，非大补不能回阳而起死回生。因为血虚亏损，不论刚痉柔痉，非滋养营血不能舒筋活络。又如忽冷忽热，发作有定时，症状像疟疾。如果用治疟的方法，则迁延难愈。神志不守舍，言语无条理，病似邪祟。如果用治邪的方法，危亡立至。失血多而导致大便结燥，在生化汤中加入肉苁蓉，这不是润燥或承气汤所能通下的。患汗多而导致小便短涩，六君子汤加倍用人参、茯苓，必然能生津助液从而利尿。加参生化汤频服，可以挽救产后危症，多次用于救活生命，缓解绝谷之症。脱肛颓散，多是气血下陷，补中益气汤可以使用。口噤拳挛，是因为血燥类似风证，加参生化汤适宜服用。如果产户受风而疼痛剧烈，宜用羌活养荣汤。玉门寒冷而不闭合，洗浴宜用蛇床子、山茱萸、硫磺。怔忡惊悸，用生化汤配合远志等安神药物。似邪恍惚，用安神丸辅助归脾汤。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、麦芽为良。苏木、莪术、蓬莪术，能破除恶血；青皮、枳壳，最善消除胀满。一切耗血散气的药剂，发汗、催吐、泻下的方子，只可施用于年轻力壮之人，岂适用于产妇？大抵新产之后，先询问恶露情况。如果块痛未除，不可急于加入白术、苍术。腹中痛止，补中益气汤无疑。至于亡阳脱汗，气虚喘促，速服加参生化汤，这是权变之法。又以阴亡大热，血崩厥晕，速服生化汤原方，这是救急之法。王太仆说：“治疗下部疾病，补益下部，制剂要根据缓急而定。缓则药力微弱，急则气味浓厚而药力沉重。”所以治疗产后病应当遵循丹溪先生的理论以固本，服药方法宜效法王太仆的理论以频繁少量服用。凡是关乎生死的神奇医术，必须着力去挽救危急。想要俯仰无愧于心，就要存仁爱万物之心。这虽然未能详尽列举产后所有的细节，但所提到的病症，都是依据近乡治疗的验案为依据，未必没有小小的补益吧。
凡是有孕妇的家庭，参照生化汤的方子，在怀孕到七八个月时，预先制备二三帖。等到产妇胞衣破裂，立即煎服一帖，等候婴儿出生后，再服用剩下的两帖，也顺势进服。不论是正常分娩还是小产，年纪少壮，服用此方能消除血块，生成新血，能保全产后一切危症，并且能长养精神。
(Indicated specifically for the failure of the pubic symphysis to separate, resulting in fetal death in utero.)
Danggui (Angelicae Sinensis Radix) (1 liang), Chuanxiong (Ligustici Chuanxiong Rhizoma) (7 qian), Guiban (Testudinis Carapax et Plastrum) (a piece the size of a palm, stir-fried with vinegar and ground into fine powder). Fatou (Capilli Humanis Depurati) (a ball the size of an egg made from the oily hair of a woman, taken orally.
(Treating various difficult labor conditions, etc.)
Danggui (Angelicae Sinensis Radix) (5 qian), Chuanxiong (Ligustici Chuanxiong Rhizoma) (3 qian). Decoct with 70% water and 30% wine, then take orally. If presenting with transverse or breech presentation, or fetal death in utero, add Heima Liaodou (Glycines Max Semen Nigrum, fried black) (1 sheng), and add half volume of Tongbian (Urine of healthy child). Decoct the above herbs and take orally. Administer another dose after a short while; there will be no failure of efficacy.
Postpartum blood and qi are extremely deficient, and it is appropriate to greatly tonify them. However, since lochia has not yet cleared, when using tonifying agents, one must ensure there is no stagnation of blood; the formula must be able to resolve stasis while generating new blood, break down masses without damaging yuan qi, and move blood without dissipating zheng qi. The world commonly uses Siwu Tang (Four Substances Decoction) to regulate postpartum conditions, which has misled many because Dihuang (Rehmanniae Radix Praeparata) is cold in nature and tends to cause blood stagnation, and Shaoyao (Paeoniae Radix Alba/Rubra) is sour and astringent, also tending to cause stagnation. Thus, merely tonifying blood yields no benefit. Postpartum lochia forming masses with pain is called "Erzhen" (Fetal Pillow). The world often exclusively uses Xiaoyao San (Free and Easy Wanderer Powder) first, and only then considers tonification. Others mix resolving and tonifying methods, ultimately achieving no effect. They do not realize that although old blood needs urgent resolution, new blood also requires nourishment and generation. If one focuses solely on resolving old blood, new blood will also become unsettled. The world uses Jikun Wan (Womb-Supplementing Pill, also known as Huisheng Dan (Life-Returning Elixir)) to break down masses and expel the fetus. Although it shows rapid effects, it inevitably damages yuan qi. Even if peace is achieved by chance, it is ultimately not a good prescription. If forced to use formulas to expel the placenta and fetus, only one pill should be taken; it is absolutely inappropriate to take more. This is because Shenghua Tang (Decoction for Generating Blood) is named based on the properties and functions of its herbs. Postpartum blood masses should be resolved, and new blood should be generated. If one focuses solely on resolution, new blood becomes unsettled; if one focuses solely on generation, old blood becomes stagnant. Examining the herb properties, Chuanxiong (Ligustici Chuanxiong Rhizoma), Danggui (Angelicae Sinensis Radix), and Taoren (Persicae Semen) are three items that excel at breaking down evil blood and rapidly generating new blood. Assisted by Zhihei Ganjiang (Zingiberis Rhizoma Praeparatum, fried black) and Gancao (Glycyrrhizae Radix et Rhizoma), these three items are guided into the Spleen and Liver meridians to generate blood and regulate qi. These five ingredients together form the prescription, wherein movement contains tonification, and transformation contains generation. It is truly an essential medicine for postpartum conditions. Hence, it is named Shenghua Tang. Generally, diseases arise from the decline of blood and qi and the deficiency of the Spleen and Stomach, but postpartum decline in blood, qi, Spleen, and Stomach is particularly severe. Therefore, Mr. Zhu Danxi discussed postpartum conditions saying: "One must prioritize great tonification of blood and qi." Even if other symptoms are present, they should be treated as secondary. These three words have exhausted the main principles of treating postpartum conditions. If one can expand upon this meaning when prescribing herbs and formulating recipes, treating childbirth-related illnesses will involve few major errors. Postpartum, due to fright, worry, fatigue, and exhaustion, blood and qi suddenly become deficient, and various syndromes easily enter through the deficiency. If there is qi consumption without specific dispersion, or food retention, do not lightly use digestive aids. For heat, do not use Huangqin (Scutellariae Radix) and Lianzi (Coptidis Rhizoma); for cold, do not use Rongui (Cinnamomi Cortex) and Fuzi (Aconiti Lateralis Radix Praeparata). Cold causes blood masses to coagulate and stagnate; heat causes new blood to hemorrhage and flow. As for deficiency of the middle jiao with external contraction presenting with many Taiyang exterior syndromes, sweating might seem appropriate. However, using Mahuang (Ephedrae Herba) in postpartum would doubly exhaust yang. Presenting with many Yin interior syndromes, purgation might seem appropriate. However, using Chengqi Tang (Major Order the Qi Decoction) in postpartum would doubly lose yin. Deafness and hypochondriac pain indicate Liver and Kidney deficiency and stagnation of evil blood; do not use Chaihu (Bupleuri Radix). Delirium and sweating indicate weakness of yuan qi and symptoms resembling pathogenic factors; do not treat as excess heat in the Stomach. If there is decline of Yang qi, making cold and heat indistinguishable, only great tonification can restore Yang and revive the weak. Due to blood deficiency, regardless of rigid or flaccid spasms, only nourishing Ying blood can relax sinews and activate collaterals. Again, alternating chills and fever with periodic onset resembles malaria. Treating it as malaria leads to prolonged and difficult cure. Restlessness of the spirit and incoherent speech resemble possession by evil spirits. Treating it as such awaits danger and death. Excessive blood loss leading to dry, constipated stool: adding Congrong (Cynomorii Fructus) to Shenghua Tang provides moistening and unblocking beyond what Runzao (Moistening Dryness) or Chengqi Tang can achieve. Excessive sweating leading to scanty, dysuric urine: Liujunzi Tang (Six Gentlemen Decoction) with doubled Renshen (Ginseng Radix et Rhizoma) and Fuling (Poria) generates fluids and assists Jin (body fluids) to promote urination. Frequent administration of Jiashen Shenghua Tang (Shenghua Tang with Ginseng) saves critical postpartum conditions, frequently used to save lives, alleviating critical starvation states. Prolapsed rectum is mostly due to sinking of blood and qi; Buzhong Yiqi Tang (Decoction to Tonify the Middle and Augment the Qi) is applicable. Trismus and clenched fists result from blood dryness resembling wind; Jiashen Shenghua Tang is suitable. Severe pain in the vaginal orifice due to wind invasion: Qianghuo Yangrong Tang (Notopterygii Root Decoction to Nourish Ying) is indicated. Coldness and laxity of the vulva: wash with Shechuangzi (Cnidii Fructus), Yuzhuyu (Corni Fructus), and Liuhuang (Sulfur). Palpitations and fright: use Shenghua Tang combined with Yuanzhi (Polygalae Radix) for calming the spirit. Similar to possession with trance: Anshen Wan (Calming Spirit Pill) assists Guipi Tang (Restore the Spleen Decoction). Fullness and empty irritability due to qi stagnation: add Muxiang (Aucklandiae Radix) to Shenghua Tang as an assistant. Sour belching and aversion to food due to food retention: Liujunzi Tang with Shenqu (Massae Medicatae Fermentatae) and Maiya (Hordei Fructus Germinatus) is excellent. Sumu (Daemonorops Draco Resina), Ezhu (Curcumae Rhizoma), and Pengzhu (Curcumae Phaeocaulis Rhizoma) break down evil blood; Qingpi (Citri Reticulatae Pericarpium Viride) and Zhike (Aurantii Fructus Immaturus) best eliminate distension. All agents that consume blood and dissipate qi, and formulas for sweating, vomiting, and purging, are only applicable to the young and strong; how could they be suitable for parturient women? Generally, after recent delivery, first inquire about lochia. If mass pain persists, do not hastily add Baizhu (Atractylodis Macrocephalae Rhizoma) or Cangzhu (Atractylodis Rhizoma). Once abdominal pain stops, Buzhong Yiqi Tang is undoubtedly correct. In cases of Yang collapse with profuse sweating and Qi deficiency with panting, quickly administer Jiashen Shenghua Tang; this is a flexible adaptation. In cases of Yin collapse with high fever, hemorrhage, syncope, and dizziness, quickly administer the original Shenghua Tang; this is emergency rescue. Wang Taipu said: "Treating lower disorders and tonifying the lower, the preparation depends on urgency. Slow action means distant pathways and weak force; urgent action means strong flavor and heavy force." Therefore, treating postpartum conditions should follow Danxi's theory to consolidate the root, and the method of taking medicine should follow Taipu's theory to administer frequently. Any miraculous technique concerning life and death must be applied with focus to save crises. To have no shame before heaven and earth, one must harbor a heart of loving all things. Although this does not detail every aspect of postpartum care, the syndromes mentioned are based on verified cases from nearby villages; they may offer some minor benefit.
For families with pregnant women, prepare two or three doses of Shenghua Tang according to the formula when pregnancy reaches seven or eight months. When the amniotic sac ruptures, decoct and administer one dose immediately. After the baby is born, continue administering the remaining two doses in succession. Whether for full-term delivery or miscarriage, regardless of age or constitution, taking this formula resolves blood masses, generates new blood, protects against all critical postpartum conditions, and enhances vitality.