【Source】

Derived and modified from Foshou San (Buddha’s Hand Powder) in ‘Ji Sheng Fang’ (1253 CE), as found in ‘Fu Qing Zhu Nu Ke: Chan Hou Pian’ (Fu Qing-zhu’s Gynecology: Postpartum Chapter) (1827 CE).

 【Composition】

Dang Gui (Angelica Sinensis), Chuan Xiong (Sichuan Lovage Rhizome), Tao Ren (Peach Kernel), Hei Jiang (Carbonized Ginger), Zhi Gan Cao (Prepared Licorice Root)
(5)

 【Categorization】

<Blood Invigorating>: Dang Gui (Angelica Sinensis)

<Tonifying Spleen and Middle Jiao>: Gan Cao (Licorice Root)

<Pungent-Warm to Release the Exterior>: Hei Jiang (Carbonized Ginger)

<Invigorating Blood and Dispelling Stasis>: Chuan Xiong (Sichuan Lovage Rhizome), Tao Ren (Peach Kernel)

【Formula Explanation】

From ‘Cheng Fang Bian Du’: After childbirth, when blood and Qi are severely deficient, it is certainly appropriate to nourish and replenish. However, if stagnant blood is not expelled, new blood cannot be generated. Therefore, for symptoms like abdominal pain, expelling blood stasis must be the primary task. In this formula, Dang Gui (Angelica Sinensis) nourishes blood, Gan Cao (Licorice Root) tonifies the Middle Jiao, Chuan Xiong (Sichuan Lovage Rhizome) regulates Qi within the blood, and Tao Ren (Peach Kernel) moves blood stasis within the blood. Pao Jiang (prepared ginger), black in color, enters the Ying (Nutritive Qi) level, assisting Dang Gui and Gan Cao in generating new blood, and aiding Chuan Xiong and Tao Ren in transforming old blood. The marvel of ‘generating and transforming’ is truly profound. The use of ‘Tong Bian’ (children’s urine) can replenish Yin, clear heat, and guide stagnant blood to descend through its natural pathway.

 【Functions】

Invigorates blood and dispels stasis, warms the channels and stops pain, promotes circulation, harmonizes Ying Qi.

 【Indications】

Postpartum lochia retention, lower abdominal pain, abdominal pain with blood clots.

 【Clinical Applications】

Poor postpartum uterine involution, postpartum uterine contraction pain, placental retention after miscarriage, persistent bleeding after artificial abortion, puerperal fever, postpartum recovery. Also applicable for conditions like uterine fibroids, endometritis, etc., presenting with blood stasis and cold stagnation.

 【Contraindications】

(1) This formula is suitable for postpartum women suffering from cold and blood stasis, and should not be used as a mandatory formula for general postpartum blood nourishment and menstruation regulation. (2) Contraindicated for those with blood heat and blood stasis. Sheng Hua Tang invigorates blood and dispels stasis and is suitable for postpartum afterpains (兒枕作痛). However, if the individual has a liver-deficient and blood-dry constitution, or pre-existing Liver Yang hyperactivity, Sheng Hua Tang, with its pungent-warm and dispersing nature, is not advisable. There have been cases where taking it led to convulsions, which must be noted. (4) All of the following are contraindications for this formula: loose stools due to Spleen and Stomach deficiency, palpitations and fright caused by excessive Heart Fire, dizziness and hypochondriac pain due to rebellious Liver Yang, dry mouth and throat due to Yin deficiency with internal heat, irregular passage of blood clots due to dysfunctional Chong and Ren channels, and any lingering warm-damp seasonal pathogens or unreleased exterior-interior pathogenic heat in the puerperium.

 【Mnemonic】

Seeing the black-faced general argue, the male tortoise flees (Hei Jiang, Gan Cao, Chuan Xiong, Dang Gui, Tao Ren).

 【Modifications】

(1) If lochia has discharged and abdominal pain is mild, remove Tao Ren (Peach Kernel).(2) If blood clots persist and abdominal pain is severe, add Shi Xiao San (Sudden Smile Powder) and Yan Hu Suo (Corydalis Rhizome) to dispel stasis and stop pain.(3) If cold is severe, and there is cold pain in the lower abdomen, add Rou Gui (Cinnamon Bark) to warm the channels and dispel cold.(4) If Ren Shen (Ginseng) is added to this formula, it is called ‘Jia Shen Sheng Hua Tang’ (Sheng Hua Tang with Ginseng) from ‘Fu Qing Zhu Nu Ke’. It treats postpartum women within the first one or two days, where blood clots have not yet dissolved, but there is Qi and blood collapse, dizziness or fainting, or even profuse sweating like pearls, gradually cooling breath, vexing thirst, and urgent dyspnea.(5) If blood clots have not dissipated, Ren Shen (Ginseng) or Huang Qi (Astragalus Root) should not be added, as adding them will cause the pain to persist.(6) For blood dizziness or deficiency dizziness, add 6-7 fen of Jing Jie Sui (Schizonepeta Spike).(7) For postpartum women with Qi deficiency or Qi collapse, lassitude and weakness, add Ren Shen (Ginseng) and Huang Qi (Astragalus Root).(8) For Yang deficiency collapse, add Fu Zi (Processed Aconite Root) and Rou Gui (Cinnamon Bark); for deficient pulse with vexing thirst, add Mai Dong (Ophiopogon Root) and Wu Wei Zi (Schisandra Fruit).(9) For Qi prolapse with phlegm, add Chen Pi (Tangerine Peel) and Zhu Li (Bamboo Sap).(10) For blood deficiency with blood dryness and constipation, add Ma Ren (Hemp Seed), Xing Ren (Apricot Kernel), and Cong Rong (Cistanche Deserticola).(11) For profuse sweating and insomnia, add Fu Shen (Poria with Hostwood), Suan Zao Ren (Sour Jujube Seed), and Huang Qi (Astragalus Root).(12) For profuse sweating in the upper body, add Ma Huang Gen (Ephedra Root); for profuse sweating in the lower body, add Han Fang Ji (Stephania Tetrandra).(13) For vexation and heat, add Dan Pi (Moutan Bark) and Di Gu Pi (Lycium Bark).(14) For lockjaw resembling wind-stroke, opisthotonos, and convulsions, add 3-4 fen each of Jing Jie (Schizonepeta) and Fang Feng (Siler Root).(15) If lochia is not fully discharged, accompanied by alternating chills and fever, headache, flank distention, and inevitable distending pain in the lower abdomen, add 3-4 fen each of Hong Hua (Safflower), Dan Pi (Moutan Bark), and Rou Gui (Cinnamon Bark), and 1 qian of Xuan Hu (Corydalis Rhizome).(16) For internal injury due to diet, add Shan Zha (Hawthorn Fruit), Chen Pi (Tangerine Peel), Sha Ren (Cardamom Pod), or Shen Qu (Medicated Leaven), Mai Ya (Malt).(17) For external injury due to cold-dampness, add Cang Zhu (Atractylodes Rhizome) and Bai Zhu (White Atractylodes Rhizome).(18) For blood stagnation and food stagnation, with dry stools in the stomach and distending pain in the umbilicus and abdomen, add 2 qian of Da Huang (Rhubarb Root).(19) For postpartum persistent uterine bleeding, resembling a leaky roof, dark and non-reddish, sometimes stopping, sometimes flowing, sometimes watery, sometimes with clots, dripping incessantly – this indicates extreme Qi and blood deficiency. One must not mistakenly use cold-cooling herbs. If the pulse is floating and thready (indicating collapse), add Fu Zi (Processed Aconite Root) and other Yang-tonifying herbs, otherwise, there will be no salvation. Adding 3 qian of Ren Shen (Ginseng) would be even better.

 【Pharmacology】

Effects on uterine weight, enhanced uterine smooth muscle contraction, effects on uterine tissue morphology, anti-thrombotic, blood-tonifying, anti-inflammatory, and analgesic effects.