凡产后诸病，古方多用四物汤加减何也？以方中有芎、归之辛温，佐以地、芍之寒凉，
温寒适中，可谓无虞矣。不知四物乃女科杂证诸疾妙剂，若用于产后，大非所宜。予考方书
之意，以为白芍重复用酒制炒，去其酸之性，但存生血活血之能；或再加黑姜辛热佐之，有
何不可。又谓芍药性清，微酸而收，最宜于阴气散失之证，岂不为产后要药。但观其再制以
酒炒，则他寒凉峻削之不宜用，概可知矣。予思芍药，初产三五日所当禁用，若产日已久，
以酒制透，为他药之佐犹可。惟四物汤中生地更凉，直走血分，且伤脾胃，为害愈甚。或云
易以熟地，补益正阴，则称为至当。独不思熟地性滞，更使血滞不快，虽有芎、归，反行牵
制而少行动，亦非新产者所宜。盖新产之妇，血气俱虚，最忌寒凉，大宜温药，以助资始资
生之源也。是以丹溪先生谓芍药伐生发之气，禁而不用，良有深意矣。予叹世之概以四物治
产后者，胡不思乎？
生化汤论曰∶产后诸证，皆缘气血骤下，元气大亏，用药不同常法。是以有虚极不能姑
待者，则当峻补之中加入温行之药，峻补则力大而可宣通，温行则流畅而不凝滞。至于逐瘀
之剂，即实证亦不可用峻厉之药，况产后大虚，恐血无主宰，一任药力，便为崩而不止，虚
则易脱，势如覆水难收矣。人遇大病之后，血气两虚，尤当调补，况产后脾胃血气之虚衰，
更有甚焉者乎。今之治产后者，亦云元气因产而亏，营运失度，不免瘀血停留致成诸疾，必
以去瘀为先，瘀消方可行补。甚有用回生丹攻血快、下胞衣、殒人性命者。此盖只知专攻旧
瘀而不知新血转伤之害，岂知块固当消，而新血尤当生也。盖专消则新血不生，专生则旧血
反滞。予考新产诸方，莫若生化汤为产后第一妙方。其方芎、归、桃仁，温中行血，善去旧
血，骤生新血，佐以炙黑干姜、炙草，引三味入于肺肝，行中有补，化中有生，故名生化，
盖因功用而立名也。又有加入益母草一钱五分，功效亦同，此实治产之良方，保全产妇之圣
药也。故冯氏因此方之妙，变化用于临产，加人参、桂、牛膝、红花，又为催生之神剂矣。
三道，以逐瘀生新，再无产后诸症之患。无论正产、半产，虽少壮产妇，俱宜服之。故此汤
为产后七日内要药，倘产下之时未及煎服，凡产后诸症仍以此汤治之。全当归八钱（酒洗），
川芎四钱，干姜四分（炙黑存性），桃仁十粒（去皮尖，打碎），炙草五分，水二钟，煎七分，
加酒小半钟。如素日不能饮酒者，加六七茶匙，稍热服之，其药渣留，并后帖药渣合而再煎
，两贴共三煎。在产下一二时辰内，未进饮食，先相继煎服。能速化旧血，而骤长新血，不
特可免目前晕厥、汗、崩、恶露停滞等患，且诸病不生，精神百倍矣。如胎前素虚之人，产
后又当再制两帖煎服以防倦困。若产下已服过一二帖而块痛未除，仍当再进几帖，则块痛无
不消矣。
凡产后出现的各种疾病，古方多采用四物汤进行加减治疗，这是为什么呢？因为方中含有川芎、当归的辛温之性，辅以地黄、白芍的寒凉之性，温与寒的程度适中，可以说没有危险了。却不知道四物汤是治疗妇科杂病和各种疾病的妙方，如果用于产后，则非常不适宜。我考察方书的用意，认为白芍应当重复使用酒制炒法，去掉它的酸收之性，只保留生血活血的功能；或者再加黑姜（炮姜）的辛热之性来佐助，有什么不可以呢？又有人说芍药性质清润，微酸而有收敛作用，最适合阴气散失的病证，这难道不是产后的要药吗？但是看它再次经过酒炒处理，那么其他那些寒凉峻烈削伐的药物不宜使用，就可以全部推知了。我认为芍药，在初产后的三五天内应当禁用，如果生产时间已经较长，用酒彻底制透，作为其他药物的佐使还可以。只是四物汤中的生地黄更凉，直接走窜血分，并且损伤脾胃，危害更加严重。有人说改用熟地黄，补益真阴，这就称为最恰当。只是没考虑到熟地黄性质黏滞，反而会使血液运行不畅，虽然有川芎、当归，但反而受到牵制而行动迟缓，也不适合新近分娩的产妇。大概新产的妇女，气血都虚弱，最忌讳寒凉药物，非常适宜温性药物，以资助先天和后天的本源。因此丹溪先生认为芍药会伐伤生发之气，禁止使用，确实有深意啊。我感叹世上的人一概用四物汤治疗产后病，怎么不去思考一下呢？
关于生化汤的论述说：产后的各种证候，都是因为气血突然下行，元气大亏，用药不同于常规方法。因此如果有虚损至极不能等待的情况，就应当在峻补之中加入温通运行的药物，峻补则力量大而可以宣通，温通则流畅而不凝滞。至于逐瘀的药剂，即使是实证也不可使用峻厉猛烈的药物，何况产后是大虚之体，恐怕血液失去主宰，任由药力驱使，就会造成崩漏不止，虚损容易脱陷，形势如同泼出去的水难以收回一样。人遇到大病之后，气血两虚，尤其应当调补，何况产后脾胃和气血的虚衰，更有比这更严重的呢。现在治疗产后病的人，也说元气因生产而亏损，营运失去节度，不免有瘀血停留导致各种疾病，必定以去除瘀血为先，瘀血消除后方可进行补益。甚至有用回生丹攻逐瘀血、快速下胞衣、导致丧命的情况。这大概是只知道专门攻逐旧瘀，而不知道会伤害新血的害处，哪里知道瘀块固然应当消除，而新血尤其应当生成啊。大概专门消瘀则新血不生，专门生血则旧血反而停滞。我考察新产的各种方剂，没有比得上生化汤为产后第一妙方。这个方子由川芎、当归、桃仁组成，能温中行血，善于去除旧血，迅速生成新血，佐以炙黑干姜、炙甘草，引导这三味药进入肺肝二经，行中有补，化中有生，所以名叫生化，是因为功用而立名的。又有加入益母草一钱五分的，功效也相同，这确实是治疗产后的良方，保全产妇的圣药。因此冯氏根据此方的奥妙，变化用于临产时，加入人参、桂枝、牛膝、红花，又成为催生的神剂了。这三种用法，以逐瘀生新为主，再无产后各种病症的祸患。无论是足月正产还是小产，即使是年轻强壮的产妇，都适宜服用。所以此汤是产后七日内的要药，倘若分娩时来不及煎服，凡是产后各种症状仍以此汤治疗。全当归八钱（酒洗），川芎四钱，干姜四分（炙黑存性），桃仁十粒（去皮尖，打碎），炙甘草五分，水两钟，煎至七分，加酒小半钟。如平时不能饮酒的人，加六七茶匙，稍热服用，药渣留下，并与后面帖数的药渣合并再煎，两帖共三煎。在产下一两个时辰内，尚未进食饮食，先相继煎服。能迅速化解旧血，而骤然生长新血，不仅可避免目前晕厥、出汗、崩漏、恶露停滞等祸患，而且各种疾病不生，精神百倍。如胎前素来虚弱的人，产后又应当再制作两帖煎服以防倦困。如果产下后已服过一两帖而块痛未除，仍应当再进几帖，则块痛无不消除。
For various diseases occurring after childbirth, ancient formulas often use Siwu Tang (Four Substances Decoction) with modifications. Why? Because the formula contains Xiong (Ligusticum Chuanxiong Rhizome) and Gui (Angelica Sinensis Radix) which are acrid and warm, assisted by Di (Rehmannia Glutinosa Radix) and Shao (Paeonia Lactiflora Radix) which are cold and cool. The balance of warmth and cold is moderate, so it can be considered safe. However, one does not realize that Siwu Tang is an excellent remedy for miscellaneous gynecological diseases. If used for postpartum conditions, it is highly inappropriate. I have examined the intent of medical texts, believing that Bai Shao (White Peony Root) should be repeatedly processed with wine and stir-fried to remove its sour astringent nature, retaining only its ability to generate and invigorate blood; or black ginger (Zingiberis Rhizoma Preparatum) could be added for its acrid and hot properties as an assistant, which would be acceptable. Others argue that Shaoyao (Paeoniae Radix) has a clear nature, is slightly sour and astringent, making it most suitable for conditions where Yin Qi dissipates, thus questioning if it is not a key herb for postpartum care. But observing that it is again processed with wine frying, one can infer that other harsh, cold, and cooling herbs are unsuitable. I consider that Shaoyao should be strictly contraindicated in the first three to five days after delivery. If some time has passed since delivery, and it is thoroughly processed with wine, it may serve as an assistant to other herbs. However, Sheng Di Huang (Raw Rehmannia Root) in Siwu Tang is even colder, directly entering the Blood aspect, and damaging the Spleen and Stomach, causing greater harm. Some suggest substituting Shu Di Huang (Prepared Rehmannia Root) to tonify True Yin, calling this the most appropriate method. Yet they fail to consider that Shu Di Huang is cloying and sticky, further causing blood stasis and sluggishness. Although there are Xiong and Gui, their movement is hindered and slowed down, which is also unsuitable for newly delivered women. Generally, women who have just given birth have both Qi and Blood deficiency; they most fear cold and cool substances and greatly benefit from warm medicines to assist the source of generation and nourishment. Therefore, Mr. Danxi stated that Shaoyao attacks the vitalizing Qi, and its prohibition has profound meaning. I sigh at those in the world who indiscriminately use Siwu Tang for postpartum cases; why do they not reflect upon this?
Regarding the discussion on Shenghua Tang: All postpartum syndromes arise because Qi and Blood suddenly descend, leading to a massive depletion of Yuan Qi (Primal Qi). Medication differs from standard methods. Thus, in cases of extreme deficiency that cannot wait, one must add warming and moving herbs within strong tonification. Strong tonification provides great power for unblocking, while warming promotes smooth flow without stagnation. As for blood-dispelling agents, even in excess patterns, harsh and severe drugs should not be used. How much more so in postpartum massive deficiency, where fear exists that Blood loses its master, and任由 (at the mercy of) drug force leads to unstoppable hemorrhage. Deficiency easily leads to collapse, a situation like spilt water that cannot be gathered back. After serious illness, when both Qi and Blood are deficient, regulation and tonification are especially important. How much more so for the deficiency and decline of Spleen, Stomach, Qi, and Blood after childbirth! Current practitioners treating postpartum cases say that Yuan Qi is depleted by childbirth, circulation loses its rhythm, inevitably leaving blood stasis that causes various diseases. They insist on removing stasis first, tonifying only after stasis clears. Some even use Huisheng Dan (Revival Pill) to attack blood quickly and expel the placenta, resulting in death. This stems from knowing only to attack old stasis without realizing the harm to new blood. One should know that while masses must be dissolved, generating new blood is even more crucial. Exclusively dissolving prevents new blood from forming; exclusively generating causes old blood to stagnate. I have examined formulas for new deliveries, finding none superior to Shenghua Tang as the premier miraculous formula for postpartum care. Its ingredients—Xiong, Gui, and Tao Ren (Persicae Semen)—warm and move blood, excellently eliminating old blood and rapidly generating new blood. Assisted by Zhi Hei Gan Jiang (Charred Dried Ginger) and Zhi Cao (Honey-fried Licorice), they guide the three main herbs into the Lung and Liver channels. Movement contains tonification, transformation contains generation, hence named "Shenghua" (Generate and Transform), named according to its function. Adding Yi Mu Cao (Leonurus Japonicus Herba) at 1.5 qian yields similar efficacy. This is truly a good prescription for treating childbirth, a sacred medicine for preserving the mother. Therefore, Feng modified this formula for use during labor, adding Ren Shen (Ginseng Radix), Gui Zhi (Cinnamomi Ramulus), Niu Xi (Achyranthis Bidentatae Radix), and Hong Hua (Carthami Flos), creating a divine agent for inducing labor. These three applications focus on dispelling stasis and generating new blood, preventing all postpartum complications. Whether full-term delivery or miscarriage, even for young and robust mothers, it is suitable. Thus, this decoction is essential medicine within seven days postpartum. If not prepared immediately after delivery, it remains the treatment for all postpartum symptoms. Quan Dang Gui (Whole Angelica Sinensis Radix) 8 qian (washed with wine), Chuan Xiong 4 qian, Gan Jiang 4 fen (charred black, retaining character), Tao Ren 10 grains (skin and tip removed, crushed), Zhi Cao 5 fen. Add two zhong of water, decoct to seven tenths, add a small half zhong of wine. For those unable to drink alcohol normally, add six or seven tea spoons. Take slightly warm. Retain the dregs and combine with the dregs of subsequent doses for re-decoction; two doses yield three decoctions. Within one or two shichen (2-4 hours) after delivery, before eating, administer sequentially. It can rapidly transform old blood and suddenly grow new blood, not only avoiding current risks like fainting, sweating, hemorrhage, and lochia stagnation, but also preventing various diseases and restoring boundless spirit. For those constitutionally weak before pregnancy, prepare two additional doses after delivery to prevent fatigue. If one or two doses have been taken after delivery but mass pain persists, continue administering several more doses, ensuring the mass pain disappears.