香桂散
18.去血过多血虚痛, 去少壅瘀有余疼, 伤食恶食多胀闷, 寒入胞中
见冷形. 血虚当归建中治, 瘀壅失笑有奇功, 伤食异功加查麴, 胞寒
香桂桂归芎.
【注】产后腹痛, 若因去血过多而痛者, 为血虚痛; 若因恶露去少,
及瘀血壅滞而痛者, 为有余疼; 若因伤食而痛者, 必恶食胀闷; 若因
风寒乘虚入于胞中作痛者, 必见冷痛形状. 血虚宜当归建中汤; 血瘀
宜失笑散, 伤食宜异功散加山查, 神麴; 胞寒宜香桂散, 即佛手散加
桂心也.
当归建中汤 失笑散 异功散 方俱见首卷
延胡索散
19.少腹痛微名儿枕, 硬痛尿利血瘀疼, 尿涩淋痛蓄水证, 红肿须防
??疝癃. 儿枕瘀血延胡散, 归芍蒲桂琥珀红, 蓄水须用五苓散,??
疝吴萸温散行.
【注】产后少腹痛, 其痛若微, 乃产时血块未净, 名儿枕痛. 若少腹
坚硬, 小便利者, 为瘀血痛; 少腹硬而小便不利, 淋涩胀痛者, 乃蓄
水作痛; 若坚硬红肿而痛者, 须防成??, 疝, 癃之证. 因儿枕瘀血者
,宜延胡索散, 即当归, 赤芍, 蒲黄, 肉桂, 琥珀, 红花也. 因水蓄
者,宜五苓散. 若将成??, 疝, 癃者, 当以吴茱萸汤温散之.
吴茱萸汤 方见首卷 五苓散 方见三卷
Xianggui San (Fragrant Cinnamon Powder)
18. Excessive blood loss leading to Blood deficiency causes pain; scanty lochia leading to Blood stasis obstruction causes excess-type pain; food injury causing aversion to food and frequent distension and fullness; cold pathogen entering the uterus manifests as cold intolerance. Blood deficiency should be treated with Danggui Jianzhong Tang (Cinnamon Twig Decoction for Tonifying the Middle); Blood stasis obstruction is effectively treated with Shixiao San (Displeasure-Dispelling Powder); Food injury is treated with Yigong San (Extraordinary Merit Powder) added with Shan Zha (Crataegi Fructus) and Shen Qu (Massa Medicata Fermentata); Uterine cold is treated with Xianggui San, composed of Guixin (Cinnamomi Cortex), Danggui (Angelicae Sinensis Radix), and Xiong (Chuanxiong Rhizoma).
[Note] Postpartum abdominal pain: if caused by excessive blood loss, it is called Blood deficiency pain; if caused by scanty lochia and stagnation of Blood stasis, it is called excess pain; if caused by dietary injury, there must be aversion to food, distension, and fullness; if caused by wind-cold invading the uterus through a deficiency, cold pain symptoms will appear. Blood deficiency is suitable for Danggui Jianzhong Tang; Blood stasis is suitable for Shixiao San; Food injury is suitable for Yigong San added with Shan Zha and Shen Qu; Uterine cold is suitable for Xianggui San, which is Foshou San (Buddha's Hand Powder) added with Guixin (Cinnamomi Cortex).
The formulas for Danggui Jianzhong Tang, Shixiao San, and Yigong San are all found in the first volume.
Yanhusuo San (Corydalis Powder)
19. Mild pain in the lower abdomen is named Erzhen (Child Pillow) pain; hard and painful lower abdomen with free urination indicates Blood stasis pain; difficult, dribbling, and painful urination indicates Water accumulation syndrome; redness and swelling require prevention of Hernia or urinary retention. Erzhen Blood stasis is treated with Yanhusuo San, composed of Danggui (Angelicae Sinensis Radix), Baishao/Chishao (Paeoniae Radix Alba/Rubra), Puhuang (Pollinis Typhae), Rougui (Cinnamomi Cortex), Hupo (Succinum), and Honghua (Carthami Flos); Water accumulation requires Wuling San (Five-Ingredient Powder with Poria); Hernia conditions are treated with Wuzhuyu Tang (Evodia Decoction) to warm and disperse.
[Note] Postpartum lower abdominal pain: if the pain is mild, it is due to incomplete expulsion of blood clots during childbirth, named Erzhen pain. If the lower abdomen is hard but urination is free, it is Blood stasis pain; if the lower abdomen is hard with difficulty in urination, dribbling, and painful distension, it is Water accumulation pain; if hard, red, swollen, and painful, one must guard against the formation of Hernia or Lin (Strangury)/Long (Urinary Retention) syndromes. For Erzhen Blood stasis, Yanhusuo San is suitable, composed of Danggui, Chishao, Puhuang, Rougui, Hupo, and Honghua. For Water accumulation, Wuling San is suitable. For conditions about to develop into Hernia or Long, Wuzhuyu Tang should be used to warm and disperse.
The formula for Wuzhuyu Tang is found in the first volume; the formula for Wuling San is found in the third volume.