妇人产后少腹疼痛，甚则结成一块，按之愈疼，人以为儿枕之疼也，谁知是瘀血作祟乎！夫儿枕者，前人谓儿头枕
之物也。儿枕之不疼，岂儿生不枕而反疼，是非儿枕可知矣。既非儿枕，何故作疼？乃是瘀血未散，结作成团而作疼耳。
凡此等症，多是壮健之妇血有余，而非血不足也。似乎可用破血之药；然血活则瘀自除，血结则瘀作祟；若不补血而反
败血，虽瘀血可消，毕竟耗损难免，不若于补血之中，以行逐瘀之法，则气血不耗，而瘀亦尽消矣。
方用散结定疼汤。
当归（一两，酒洗） 川芎（五钱，酒洗） 丹皮（二钱，炒） 益母草（三钱） 黑芥穗（二钱） 乳香（一
钱，去油） 山楂（十粒，炒黑） 桃仁（七粒，泡去皮尖，炒，研）
水煎服。一剂而疼止而愈，不必再剂也。此方逐瘀于补血之中，消块于生血之内，妙在不专攻疼痛，而疼痛
止。彼世人一见儿枕之疼，动用元胡、苏木、蒲黄、灵脂之类以化块，又何足论哉！
妇人产后少腹疼痛，按之即止，人亦以为儿枕之疼也，谁知是血虚而然乎！夫产后亡血过多，血室空虚，原
能腹疼，十妇九然。但疼有虚实之分，不可不辨∶如燥糠触体光景，是虚疼而非实疼也。大凡虚疼宜补，而产后之
虚疼，尤宜补焉。惟是血虚之疼，必须用补血之药，而补血之味，多是润滑之品，恐与大肠不无相碍；然产后血
虚，肠多干燥，润滑正相宜也，何碍之有。
方用肠宁汤。
当归（一两，酒洗） 熟地（一两，九蒸） 人参（三钱） 麦冬（三钱，去心） 阿胶（三钱，蛤粉炒） 山
药（三钱，炒） 续断（二钱） 甘草（一钱） 肉桂（二分，去粗，研）
水煎服。一剂而疼轻，二剂而疼止，多服更宜，此方补气补血之药也；然补气而无太郁之忧，补血而无太滞之患，
气血既生，不必止疼而疼自止矣。
眉批∶前后二方极效，不必加减。
歌括∶妇人产后少腹疼，甚结成块按更痛。
瘀血作祟非儿枕，补逐兼行自有功。
散结定疼当归芎，丹皮益母与黑荆。
乳香山楂桃仁炒，一剂痛止勿多用。
产后腹痛按止焉，血虚作痛不同前。
血室空虚宜补血，相间补气两法全。
肠宁汤中用当归，地黄阿胶参麦桂。
山药续断生甘草，气血既生疼自回。
Postpartum abdominal pain in women, where the lower abdomen hurts and may even form a lump that becomes more painful upon pressure, is often mistaken by people as "child pillow" pain. However, who knows it is actually caused by blood stasis! The term "child pillow" refers to what the fetus's head rested on during birth. If the child pillow were the cause of pain, would those who did not rest their heads on it be free from pain? Thus, it is evident that this is not due to the child pillow. Since it is not the child pillow, why does it hurt? It is because the blood stasis has not dispersed, condensing into a mass that causes pain.
Such conditions are mostly found in robust women with an excess of blood (excess syndrome), rather than a deficiency of blood (deficiency syndrome). Superficially, it might seem appropriate to use drugs that break blood stasis; however, when blood flows freely, stasis naturally resolves; when blood stagnates, stasis wreaks havoc. If one fails to nourish blood and instead uses drugs that damage blood, although the stasis may be eliminated, depletion of vital energy is inevitable. It is better to employ methods of promoting circulation and dispelling stasis within the context of nourishing blood, so that both qi and blood remain undamaged, and the stasis is completely resolved.
The formula used is Sanjie Dingteng Tang (Disperse Knots and Stop Pain Decoction).
Danggui (Radix Angelicae Sinensis, 1 liang, washed with wine), Chuanxiong (Rhizoma Chuanxiong, 5 qian, washed with wine), Danpi (Cortex Moutan, 2 qian, stir-fried), Yimucao (Herba Leonuri, 3 qian), Heijingsui (Flos Artemisiae Argyi Carbonized, 2 qian), Ruxiang (Resina Frankincense, 1 qian, oil removed), Shanzha (Fructus Crataegi, 10 grains, stir-fried until black), Taoren (Semen Persicae, 7 grains, soaked, skin and tips removed, stir-fried, crushed).
Decoct in water and take orally. One dose stops the pain and cures the condition; no further doses are necessary. This formula dispels stasis while nourishing blood and eliminates masses while generating blood. Its brilliance lies in not specifically attacking the pain, yet the pain ceases naturally. Those who, upon seeing postpartum abdominal pain attributed to the "child pillow," immediately resort to substances like Yanhusuo (Rhizoma Corydalis), Sumu (Lignum Sappan), Puhuang (Pollen Typhae), and Lingzhi (Resina Trogopterori) to dissolve masses, are hardly worth discussing.
In cases where postpartum lower abdominal pain ceases upon pressure, people also mistake it for "child pillow" pain, but who knows it is actually due to blood deficiency? Postpartum hemorrhage leads to excessive blood loss and emptiness of the Blood Chamber (Uterus), which originally causes abdominal pain; nine out of ten women experience this. However, pain must be distinguished between deficiency and excess: a sensation akin to dry chaff touching the body indicates deficiency pain, not excess pain. Generally, deficiency pain requires tonification, and postpartum deficiency pain especially warrants tonification. Specifically for pain caused by blood deficiency, blood-nourishing herbs must be used. Most blood-nourishing herbs have lubricating properties, which might seem obstructive to the Large Intestine; however, since postpartum blood deficiency often leads to intestinal dryness, these lubricating properties are perfectly suitable and cause no obstruction.
The formula used is Changning Tang (Intestinal Nourishing Decoction).
Danggui (Radix Angelicae Sinensis, 1 liang, washed with wine), Shudi (Radix Rehmanniae Preparata, 1 liang, steamed nine times), Renshen (Radix Ginseng, 3 qian), Maidong (Radix Ophiopogonis, 3 qian, heart removed), Ejiao (Colla Corii Asini, 3 qian, stir-fried with donkey-hide gelatin powder), Shanyao (Rhizoma Dioscoreae, 3 qian, stir-fried), Xuduan (Radix Dipsaci, 2 qian), Gancao (Radix Glycyrrhizae, 1 qian), Rougui (Cortex Cinnamomi, 2 fen, coarse bark removed, crushed).
Decoct in water and take orally. One dose reduces the pain, two doses stop the pain; prolonged use is even more beneficial. This is a formula that tonifies both qi and blood; however, it tonifies qi without causing excessive stagnation, and tonifies blood without causing excessive cloying heaviness. Once qi and blood are generated, there is no need to specifically stop the pain, as it will cease naturally.
Marginal Note: Both formulas mentioned above are extremely effective and do not require modification.
Verse Summary:
Women suffer lower abdominal pain after childbirth, forming lumps that hurt more when pressed.
Blood stasis is the culprit, not the child pillow; combining tonification and stasis-dispelling yields success.
Sanjie Dingteng Tang contains Danggui and Chuanxiong, along with Danpi, Yimucao, and Heijingjie.
Stir-fried Ruxiang, Shanzha, and Taoren suffice; one dose stops pain, avoid overuse.
Postpartum abdominal pain relieved by pressing differs from the previous type, caused by blood deficiency.
Emptiness of the Blood Chamber requires blood tonification, complemented by qi tonification for completeness.
Changning Tang uses Danggui, Dihuang, Ejiao, Renshen, Maidong, and Rougui.
Shanyao, Xuduan, and raw Gancao ensure that once qi and blood are restored, pain returns to normal.