〔《大》〕黑神散 治产后恶露不尽，心胸痞满，脐腹撮痛，污血诸疾。（方见妇人产后。）
〔丹〕产后三日，血块痛，发热。
五灵脂（略炒） 牡丹皮 没药 滑石
上研细，分五帖。豆淋酒下之，食前。
冯宅产后发热，腹中痛有块，自汗恶寒，曾服黑神散。
白术 芍药（三钱） 滑石（五钱） 黄芩（二钱半） 牡丹皮（二钱半） 人参 川芎 归尾 陈皮
荆芥（各一钱） 干姜（一钱） 甘草（些）
〔云〕卷荷散 治产后血上冲心，血刺血晕，腹痛恶露不快。
初出卷荷 红花 当归（各二两） 蒲黄（纸炒） 牡丹皮（各半两）
上为细末。每服三钱，空心温酒调下一碗；或用童便调下，妙。
〔《大》〕治血瘕，痛无定处。
童便（三升） 生地汁 生藕汁（各一升） 生姜汁（二升）
上先煎三味，约三分减二，次下姜汁，慢火煎如稀饧，每取一合，温酒调下。
治儿枕痛，乃血瘕也。用真蒲黄研细，调服二钱。如燥渴者，用新汲水调下。
〔丹〕治产后儿枕大痛，黑白散。
乌金石（醋 七次，另研） 寒水石（ 存性，为末）
上，各收之。服时各抄一钱半，米饮调下，痛止勿服，未止再服。
〔海〕四物加玄胡没药白芷汤 治产后败血作痛。（方见妇人门。）
四物苦楝汤（方见腹痛） 一方，治脐下痛不可忍，四物汤加玄胡索二钱半服之。
〔《大》〕紫金丸 治产后脐下痛，即失笑散醋为丸是也。（五灵脂、蒲黄等分，醋丸服。）
立效散 治产枕痛不可忍，用五灵脂慢火炒令干，为末。二钱，温酒下，瘥。（产枕，即血枕也。）
〔丹〕产后恶露未尽，小腹作痛。
五灵脂 香附末
上合和醋为丸，甚者入留尖桃仁。（一方加蛤粉。）
〔《大》〕治产后血不尽，血痛闷方。取败荷叶烧作灰，暖水和服；煮汁服亦良。又方，取乱发如鸡子
大，灰汁洗净烧为末，酒调服二钱。
治产后血瘕腹痛，及喉痹，热因寒用。铁称锤锻令通赤， 酒中，候温饮之。（丹溪法用 醋中，使鼻闻
其气，妙。）
〔仲〕产妇腹痛，法当以枳实芍药散。假令不愈者，此为腹中有干血着脐下，宜下瘀血汤主之，亦主经
水不利。
大黄（二两） 桃仁（二十枚） 虻虫（二十个，炒，去足）
上三味为末，炼蜜和为四丸。以酒一升煎一丸，取八合，顿服之。新血下如豚肝。
〔云〕又方 疗产后血结下不尽，腹中绞痛不止。
大黄（另浸） 生地 当归（各二两半） 川芎 芍药 桂心（各一两） 甘草 黄芩（各二两） 桃仁（四
十九个，制）
上切细，以水七升，煮取二升半，大黄更煎一二沸，分三服。
桂心丸 治产后血气不散，积聚成块，上攻心腹。或成寒热，四肢羸瘦，头痛。
青皮 干漆（炒烟尽，各七钱） 没药 槟榔 当归 桂心 赤芍 牡丹皮（各五钱） 大黄 桃仁（去皮尖）
鳖甲（醋炙） 浓朴（制） 三棱（煨） 玄胡索（各一两）
上为细末，炼蜜丸，如桐子大。每服三四十丸，温酒下。
〔《保》〕治血晕血结，或聚于胸中，或偏于小腹，或连于胁肋。四物汤四两，倍当归、川芎，
加鬼箭、红花、玄胡各一两，同为粗末，加四物煎，调没药散服之。
虻虫（二钱，去翅足，炒） 水蛭（一钱，炒） 麝香（少） 没药
上为末，入前药调服，血下痛止，只服一服。
〔仲〕产后腹中疼痛，当归生姜羊肉汤主之。（方见产后血弱。）
〔《衍》〕一妇人产当寒月，寒气入产门，脐下胀满，手不得犯，此寒疝也。医将治之以抵当汤，谓其有
瘀血也。予教之曰∶非其治也，可服张仲景羊肉汤。少减，作二服，遂愈。
〔仲〕内补当归建中汤 治妇人产后虚羸不足，腹中刺痛不止，吸吸少气，或苦少腹中急痛引腰背，不能饮食。
产后一月，日得服四五剂为善，令人强壮。
当归（四两） 桂枝（三两） 芍药（六两） 生姜（三两） 甘草（二两） 大枣（十二枚）
上六味，以水一斗，煮取三升，分温三服，一日令尽。若大虚，加饴糖六两，汤成内于火上暖令饴消。若
去血过多，崩伤内衄不止，加地黄六两，阿胶二两，合八味汤成，内阿胶服之。
〔云〕产后六七日，忽然脐腹痛，皆因呼吸冷气乘虚入客于血分，宜服当归建中汤。（方见上。）
〔《大》〕独圣汤 治产后腹痛。
当归为末，每服二钱，水一盏，煎至七分，温服。
〔云〕治产后恶物不尽，腹内疼痛。产后常服此，妙。
生地 当归（并略炒，各一两） 生姜（五钱，细切，新瓦炒，令焦黑）
上为细末，姜酒调二钱服。
〔《大》〕治产后血块痛。
熟地（一斤） 陈生姜（半斤）
上拌匀，同炒干为末。每服一钱，酒调，产后以乌梅汤下之。
〔仲〕产后腹痛，烦满不得卧，以枳实芍药散主之。
枳实（烧令黑，勿太过） 芍药（研末）
上二味，杵为散。服方寸匕，日三服。并主痈脓，以麦粥下之。
产后腹痛，服枳实芍药散不愈者，宜下瘀血汤主之。（方见败血条。）
〔仲〕产后七八日，无太阳症，少腹坚痛，此恶露不尽。不大便，烦躁发热，日晡时烦躁者，不食，食则
谵语，至夜即愈，宜大承气汤主之。热在里，结在膀胱也。（大承气汤方见伤寒。）
〔《山》〕儿枕痛。用隔年蟹壳烧灰，酒下。
〔丹〕局方五积散 治产后余血作痛。
以苍术为君，麻黄为臣，浓朴、枳实为使。虽有当归、芍药之补血，仅及苍术三分之一。不思产后之妇，有
何寒邪，血气未充，似难发汗，借曰药性温和，可以推陈致新，岂可用麻黄之悍，附以苍术、枳、朴之散乎？
虚而又虚，祸不旋踵矣。
产后血块痛∶三阴交、气海（宜灸之。）
[From *Taiping Huimin Heji Jufang*] **Heishen San (Black Spirit Powder)**: Treats postpartum lochia that does not cease, chest and heart oppression with fullness, cramping pain in the umbilical and abdominal regions, and various disorders caused by foul blood. (Formula see Section on Postpartum Diseases.)
[Zhu Danxi] Three days postpartum, presenting with pain from blood clots and fever.
*Tamalis Semen (Wulingzhi)* (lightly stir-fried) *Moutan Cortex (Mudanpi)* *Myrrha (Moyao)* *Talcum (Huashi)*
Grind all ingredients into a fine powder, divided into five doses. Administer with Doulin Wine (wine infused with black beans) before meals.
Madam Feng presented with postpartum fever, abdominal pain with palpable masses, spontaneous sweating, and aversion to cold. She had previously taken Heishen San.
*Atractylodis Rhizoma (Baizhu)* *Paeoniae Radix Alba (Shaoyao)* (3 qian) *Talcum (Huashi)* (5 qian) *Scutellariae Radix (Huangqin)* (2.5 qian) *Moutan Cortex (Mudanpi)* (2.5 qian) *Ginseng Radix et Rhizoma (Renshen)* *Ligustici Chuanxiong Rhizoma (Chuanxiong)* *Angelicae Sinensis Radix Cauda (Guiwei)* *Citri Reticulatae Pericarpium (Chenpi)*
*Brunellae Herba (Jingjie)* (1 qian each) *Zingiberis Rhizoma (Ganjiang)* (1 qian) *Glycyrrhizae Radix et Rhizoma (Gancao)* (a little)
[Zhang Yuansu] **Juanhe San (Curled Lotus Leaf Powder)**: Treats postpartum blood rushing up to the heart, stabbing pain or syncope due to blood stasis, abdominal pain, and sluggish lochia discharge.
Fresh curled lotus leaf *Carthami Flos (Honghua)* *Angelicae Sinensis Radix (Danggui)* (2 liang each) *Typhae Pollen (Puhuang)* (stir-fried on paper) *Moutan Cortex (Mudanpi)* (0.5 liang each)
Grind into a fine powder. Take 3 qian per dose, mixed with warm wine on an empty stomach; alternatively, mix with urine of a healthy boy for superior effect.
[*Taiping Huimin Heji Jufang*] Treats **Xuejia (Blood Masses)** with pain of uncertain location.
Urine of a healthy boy (3 sheng) *Rehmanniae Radix Recens (Shengdizhi)* *Nelumbinis Nuciferae Rhizoma Juice (Shengouzhij)* (1 sheng each) *Zingiberis Rhizoma Recens Juice (Shengjiangzhij)* (2 sheng)
Decoct the first three ingredients until reduced by two-thirds. Add ginger juice and simmer slowly over low heat until it resembles thin syrup. Take 1 he per dose, mixed with warm wine.
Treats **Erzhen Tong (Child Pillow Pain)**, which is a type of Xuejia. Use genuine Typhae Pollen (Puhuang), ground finely, and take 2 qian mixed with water. If dryness and thirst are present, use fresh well-water for mixing.
[Zhu Danxi] For severe Erzhen Tong postpartum, use **Heibai San (Black-White Powder)**.
*Ferri Limonitum (Wujinshi)* (quench in vinegar seven times, grind separately) *Calcitum (Hanhuishi)* (preserve nature, grind to powder)
Store separately. At administration, take 1.5 qian of each, mixed with rice drink. Stop if pain ceases; repeat if pain persists.
[Li Dongyuan] **Siwu Tang Plus Yanhusu, Moyao, and Baizhi Decoction**: Treats pain caused by postpartum stale blood. (Formula see Section on Women's Diseases.)
**Siku Kuilian Tang** (Formula see Abdominal Pain section). Another prescription treats unbearable pain below the umbilicus: Siwu Tang plus Yanhusuo 2.5 qian.
[*Taiping Huimin Heji Jufang*] **Zijin Wan (Purple Gold Pill)**: Treats pain below the umbilicus postpartum. This is essentially Shixiao San made into pills with vinegar. (Equal parts Tamalis Semen and Typhae Pollen, vinegar pills.)
**Lixiao San (Instant Effect Powder)**: Treats unbearable Erzhen Tong. Stir-fry Tamalis Semen slowly until dry, grind to powder. Take 2 qian with warm wine. Cure achieved. (Erzhen refers to Blood Pillow.)
[Zhu Danxi] Postpartum incomplete lochia discharge, causing lower abdominal pain.
Tamalis Semen *Cyperi Rhizoma Powder (Xiangfu Mo)*
Mix and form pills with vinegar. For severe cases, add Peach Kernel (Taoren) with tips retained. (Another variant adds Gekko Powder/Hafenfen.)
[*Taiping Huimin Heji Jufang*] Prescription for postpartum residual blood causing painful stifling sensation. Burn fallen lotus leaves to ash, mix with warm water and ingest; decocting the juice is also effective. Another method: Take hair clumps the size of a chicken egg, wash with plant ash lye, burn to ash, and take 2 qian mixed with wine.
For postpartum Xuejia abdominal pain and Hou Bi (throat obstruction), apply "treating heat with cold" method. Forge an iron scale weight until red-hot, quench in wine, and drink when warm. (Danxi's method: quench in vinegar and let the patient inhale the fumes, which is excellent.)
[Zhang Zhongjing] For postpartum abdominal pain, the method dictates using Zhishi Shaoyao San. If it fails to heal, this indicates dry blood adhering below the umbilicus; Xia Yuxue Tang should be used as the primary treatment. It also treats irregular menstruation.
*Rhei Radix et Rhizoma (Dahuang)* (2 liang) *Persicae Semen (Taoren)* (20 seeds) *Blatta Orientalis (Mengchong)* (20 insects, stir-fried, remove feet/wings)
Grind the three ingredients into powder, mix with refined honey to make four pills. Decoct one pill in 1 sheng of wine to obtain 8 he, administer in one dose. Fresh blood resembling pig liver will be discharged.
[Zhang Yuansu] Another formula: Treats postpartum blood stagnation in the lower jiao not fully expelled, causing unceasing colicky abdominal pain.
*Rhei Radix et Rhizoma (Dahuang)* (soaked separately) *Rehmanniae Radix (Shengdi)* *Angelicae Sinensis Radix (Danggui)* (2.5 liang each) *Ligustici Chuanxiong Rhizoma (Chuanxiong)* *Paeoniae Radix (Shaoyao)* *Cinnamomi Ramulus (Guixin)* (1 liang each) *Glycyrrhizae Radix et Rhizoma (Gancao)* *Scutellariae Radix (Huangqin)* (2 liang each) *Persicae Semen (Taoren)* (49 seeds, processed)
Cut into small pieces. Decoct in 7 sheng of water to obtain 2.5 sheng. Add Dahuang and boil for 1-2 more boils. Divide into three doses.
**Guixin Wan (Cinnamon Twig Pill)**: Treats postpartum qi and blood stagnation forming masses, attacking upward to the heart and abdomen. Or presenting with alternating chills and fever, emaciated limbs, and headache.
*Citri Reticulatae Pericarpium Viride (Qingpi)* *Drynariae Rhizoma (Ganqi)* (stir-fried until smoke ceases, 7 qian each) *Myrrha (Moyao)* *Arecae Semen (Binglang)* *Angelicae Sinensis Radix (Danggui)* *Cinnamomi Ramulus (Guixin)* *Paeoniae Rubra (Chishao)* *Moutan Cortex (Mudanpi)* (5 qian each) *Rhei Radix et Rhizoma (Dahuang)* *Persicae Semen (Taoren)* (de-skinned and de-pitted) *Testudinis Carapax et Plastrum (Biejia)* (vinegar-processed) *Magnoliae Officinalis Cortex (N Houpu)* (processed) *Sparganii Rhizoma (Sanleng)* (roasted) *Corydalis Rhizoma (Yanhusu)* (1 liang each)
Grind to fine powder, mix with refined honey to make pills the size of tung tree seeds. Take 30-40 pills per dose with warm wine.
[*Baoming Ji*] Treats Xueyun (blood syncope) and Xuejie (blood stagnation), whether gathered in the chest, biased to the lower abdomen, or extending to the hypochondrium. Use Siwu Tang 4 liang, double the Danggui and Chuanxiong, add Arisaematis Cum Bile (Guijianyu), Carthami Flos (Honghua), and Corydalis Rhizoma (Yanhusu) 1 liang each. Grind to coarse powder, decoct with Siwu Tang, and take mixed with Moyao San.
*Blatta Orientalis (Mengchong)* (2 qian, remove wings/feet, stir-fried) *Hirudo (Shuizhi)* (1 qian, stir-fried) *Moschus (Shexiang)* (small amount) *Myrrha (Moyao)*
Grind to powder, mix with the previous herbs. Once blood is discharged and pain stops, only one dose is needed.
[Zhang Zhongjing] For postpartum abdominal pain, treat with Danggui Shengyang Mutton Soup. (Formula see Postpartum Blood Deficiency section.)
[*Yanyi*] A woman gave birth during a cold month; cold pathogen entered the birth canal, causing distension and fullness below the umbilicus, intolerable to touch. This is Hanshan (Cold Hernia). The physician intended to treat with Didang Tang, assuming blood stasis. I instructed him: This is not the correct treatment. Administer Zhang Zhongjing's Mutton Soup. Reduce the dosage slightly, divide into two doses, and she recovered.
[Zhang Zhongjing] **Neibu Danggui Jianzhong Tang (Internal Nourishing Angelica and Cinnamon Twig Decoction)**: Treats postpartum deficiency and emaciation, unceasing stabbing pain in the abdomen, shortness of breath, or urgent pain in the lower abdomen radiating to the back, preventing eating.
During the first month postpartum, taking 4-5 doses daily is beneficial for strengthening the body.
*Angelicae Sinensis Radix (Danggui)* (4 liang) *Cinnamomi Ramulus (Guizhi)* (3 liang) *Paeoniae Radix (Shaoyao)* (6 liang) *Zingiberis Rhizoma (Shengjiang)* (3 liang) *Glycyrrhizae Radix et Rhizoma (Gancao)* (2 liang) *Jujubae Fructus (Dazao)* (12 fruits)
Decoct the six ingredients in 1 dou of water to obtain 3 sheng. Divide into three warm doses, consumed within one day. If severely deficient, add 6 liang of Yitang (malt sugar); after decoction, place on fire to melt the sugar. If excessive blood loss occurs, such as metrorrhagia or internal epistaxis, add Rehmanniae Radix (Dihuang) 6 liang and Asini Corii Colla (Ejiao) 2 liang. Complete the eight-ingredient decoction, then add Ejiao and ingest.
[Zhang Yuansu] On the sixth or seventh day postpartum, sudden pain in the umbilical and abdominal region is often caused by cold air entering the blood level through deficiency during respiration. Administer Danggui Jianzhong Tang. (Formula see above.)
[*Taiping Huimin Heji Jufang*] **Dusheng Tang (Single Sage Decoction)**: Treats postpartum abdominal pain.
Angelicae Sinensis Radix (Danggui) ground to powder. Take 2 qian, decoct in 1 zhan of water until reduced to 0.7 zhan, take warm.
[Zhang Yuansu] Treats postpartum foul matter not fully expelled, causing intra-abdominal pain. Regular consumption postpartum is excellent.
*Rehmanniae Radix Recens (Shengdi)* *Angelicae Sinensis Radix (Danggui)* (both lightly stir-fried, 1 liang each) *Zingiberis Rhizoma (Shengjiang)* (5 qian, finely sliced, stir-fried on new tile until charred black)
Grind to fine powder. Take 2 qian mixed with ginger and wine.
[*Taiping Huimin Heji Jufang*] Treats postpartum blood clot pain.
Prepared Rehmanniae Radix (Shudi) (1 jin) Aged Ginger (Chenshengjiang) (0.5 jin)
Mix evenly, stir-fry together until dry, then grind to powder. Take 1 qian mixed with wine. Postpartum, administer with Wumei Tang (Mume Fruit Decoction).
[Zhang Zhongjing] Postpartum abdominal pain with irritability, fullness, and inability to lie down is treated with Zhishi Shaoyao San.
*Immature Citrus Fruit (Zhishi)* (burned until black, but not too much) *Paeoniae Radix (Shaoyao)* (ground to powder)
Pound the two ingredients into a powder. Take 1 cunbi (square inch measure) per dose, three times daily. Also treats carbuncles and pus; administer with wheat gruel.
If postpartum abdominal pain does not resolve with Zhishi Shaoyao San, Xia Yuxue Tang should be used. (Formula see Stale Blood section.)
[Zhang Zhongjing] Seven or eight days postpartum, without Taiyang symptoms, but with hardness and pain in the lower abdomen, this is due to incomplete lochia discharge. Constipation, irritability, fever, worsening irritability at dusk, anorexia, delirium upon eating, and relief at night indicate the need for Dachengqi Tang. Heat is in the interior, knotted in the Bladder. (Dachengqi Tang formula see Shanghan section.)
[*Shan*] For Erzhen Tong, burn crab shells from the previous year to ash, take with wine.
[Zhu Danxi] **Jufang Wuji San (Bureau Formula Five Accumulations Powder)**: Treats pain from residual blood postpartum.
Using Cangzhu as the sovereign herb, Mahuang as the minister, Houpo and Zhishi as the guides. Although it contains Danggui and Shaoyao for nourishing blood, their quantity is only one-third of Cangzhu. One must consider what cold pathogen a postpartum woman has; her qi and blood are not yet充盈 (replenished), making diaphoresis difficult. Even if the drug properties are mild and can eliminate the old to generate the new, how can one use the fierce Mahuang combined with the dispersing actions of Cangzhu, Zhishi, and Houpo? This leads to deficiency upon deficiency, and disaster follows immediately.
Postpartum blood clot pain: Acupoints Sanyinjiao (SP6), Qihai (CV6) (Moxibustion is indicated.)