20.胁痛瘀滞犯肝经, 左血右气要分明, 血用延胡散可治, 气宜四君
加柴青, 去血过多属虚痛, 八珍加桂补其荣.
【注】产后胁痛, 因气血瘀滞, 干犯肝经. 在左多属血, 在右多属气
.血宜延胡索散, 气宜四君子汤 加柴胡, 青皮. 若因去血过多而痛
者,为虚痛, 宜八珍汤加肉桂, 以补其荣血自愈.
四君子汤 八珍汤 方俱见首卷
21.腰疼下注两股痛, 风冷停瘀滞在经, 佛手散加独活桂, 续断牛膝
桑寄生, 血多三阴伤气血, 地黄桂附续杜寻.
【注】产后腰疼下注两股皆痛者, 乃产时风冷乘之, 瘀血滞于肝经,
宜用佛手散加独活, 肉桂, 续断, 牛膝, 防风, 桑寄生, 以温散而行
之.若因去血过多, 三阴经气亏损者, 则当用六味地黄汤加肉桂, 附
子,续断, 杜仲, 以温补之.
佛手散 六味地黄汤 方俱见首卷
趁痛散
22.产后身疼荣不足, 若因客感表先形, 趁痛散用归耆术, 牛膝甘独
薤桂心, 血瘀面唇多紫胀, 四物秦艽桃没红.
【注】产后遍身疼痛, 多因去血过多, 荣血不足, 或因风寒外客, 必
有表证. 二者俱宜用趁痛散, 即当归, 黄耆, 白术, 牛膝, 甘草, 独
活,薤白, 桂心也. 若面唇紫色身胀痛者, 必是停瘀所致, 宜用四物
汤,加秦艽, 桃仁, 没药, 红花以行之.
四物汤 方见首卷
20. Hypochondriac pain caused by blood stasis invading the Liver Meridian requires clear differentiation between left-sided blood disorders and right-sided Qi disorders. Blood stasis is treated with Yanhu San (Corydalis Rhizome Powder); Qi stagnation is treated with Sijunzi Tang (Four Gentlemen Decoction) added with Chai Hu (Bupleuri Radix) and Qing Pi (Aurantii Fructus Pericarpium). Pain resulting from excessive blood loss is a deficiency pain, treated with Bazhen Tang (Eight Treasures Decoction) added with Rou Gui (Cinnamomi Cortex) to nourish Ying Blood.
[Note] Postpartum hypochondriac pain arises from Qi and blood stasis interfering with the Liver Meridian. Left-sided cases mostly involve blood; right-sided cases mostly involve Qi. Blood stasis is suitable for Yanhusuo San (Corydalis Rhizome Powder); Qi stagnation is suitable for Sijunzi Tang (Four Gentlemen Decoction) added with Chai Hu (Bupleuri Radix) and Qing Pi (Aurantii Fructus Pericarpium). If the pain is due to excessive blood loss, it is a deficiency pain, suitable for Bazhen Tang (Eight Treasures Decoction) added with Rou Gui (Cinnamomi Cortex) to tonify Ying Blood, leading to natural recovery. The formulas for Sijunzi Tang (Four Gentlemen Decoction) and Bazhen Tang (Eight Treasures Decoction) are found in the first volume.
21. Lower back pain radiating to both thighs indicates wind-cold retention and blood stasis obstructing the meridians. Treat with Foshou San (Hand Buddha Powder) added with Duhuo (Angelicae Pubescentis Radix), Rou Gui (Cinnamomi Cortex), Xuduan (Dipsaci Radix), Niuxi (Achyranthis Bidentatae Radix), and Sangjisheng (Taxilli Herba). If excessive blood loss injures the Three Yin meridians causing Qi and blood deficiency, seek Dihuang, Rou Gui (Cinnamomi Cortex), Fuzi (Aconiti Lateralis Radix Praeparata), Xuduan (Dipsaci Radix), and Duzhong (Eucommiae Cortex) [formulated as Liuwei Dihuang Tang added].
[Note] Postpartum lower back pain radiating to both thighs occurs when wind-cold pathogens invade during childbirth, causing blood stasis to stagnate in the Liver Meridian. It is suitable to use Foshou San (Hand Buddha Powder) added with Duhuo (Angelicae Pubescentis Radix), Rou Gui (Cinnamomi Cortex), Xuduan (Dipsaci Radix), Niuxi (Achyranthis Bidentatae Radix), Fangfeng (Saposhnikoviae Radix), and Sangjisheng (Taxilli Herba) to warm, disperse, and promote circulation. If excessive blood loss leads to depletion of Qi in the Three Yin meridians, one should use Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill) added with Rou Gui (Cinnamomi Cortex), Fuzi (Aconiti Lateralis Radix Praeparata), Xuduan (Dipsaci Radix), and Duzhong (Eucommiae Cortex) for warming tonification. The formulas for Foshou San (Hand Buddha Powder) and Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill) are found in the first volume.
Chentong San
22. Postpartum generalized body pain is mostly due to insufficient Ying Blood; if caused by external pathogenic invasion, exterior symptoms appear first. Use Chentong San (Pain-Relieving Powder) composed of Danggui (Angelicae Sinensis Radix), Huangqi (Astragali Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Niuxi (Achyranthis Bidentatae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Duhuo (Angelicae Pubescentis Radix), Xiebai (Allii Macrostemonis Bulbus), and Guixin (Cinnamomi Ramulus). If the face and lips are purple and swollen, it is caused by blood stasis; treat with Siwu Tang (Four Substances Decoction) added with Qinjiao (Gentianae Macrophyllae Radix), Taoren (Persicae Semen), Moyao (Myrrha), and Honghua (Carthami Flos) to promote blood circulation.
[Note] Postpartum generalized body pain is mostly due to excessive blood loss leading to insufficient Ying Blood, or due to external invasion of wind-cold, necessarily accompanied by exterior syndromes. Both conditions are suitable for Chentong San (Pain-Relieving Powder), consisting of Danggui (Angelicae Sinensis Radix), Huangqi (Astragali Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Niuxi (Achyranthis Bidentatae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Duhuo (Angelicae Pubescentis Radix), Xiebai (Allii Macrostemonis Bulbus), and Guixin (Cinnamomi Ramulus). If the face and lips are purple and the body is distended and painful, it must be caused by retained blood stasis; it is suitable to use Siwu Tang (Four Substances Decoction) added with Qinjiao (Gentianae Macrophyllae Radix), Taoren (Persicae Semen), Moyao (Myrrha), and Honghua (Carthami Flos) to move blood. The formula for Siwu Tang (Four Substances Decoction) is found in the first volume.