产后心痛，为阴血亏损，随火上冲心络，名曰心包络痛，宜归脾汤主之。若寒伤心经，名曰真心痛，则无药可救矣。
凡产后寒气上攻则心痛，下攻则腹痛，兼血块者，宜服生化汤加桂。若独用热药攻寒，其痛虽止而血妄行，反虚产母。
况寒者必挟虚而燥；热者必佐阴药，方能制其僭越也。
产后恶血，或因外感六淫，内伤七情，致令斩然而止，瘀血壅滞，所下不尽，故令腹痛，当审因治也。如产妇期数
内，或饮食如常，忽作腹痛，六脉沉伏，四肢厥冷，此恶血不尽，伤食裹血而脉不起也，不可误认为气血两虚，而用大
补，须兼消导行血之药。
《要略》曰∶产后腹中 痛，当归生姜羊肉汤主之。病痛者，缓缓痛也，属客寒相阻。故以当归通血分之滞，生姜
行气分之寒。君以羊肉者，所谓形不足补以味，况羊肉又能补气， 痛属气弱，故宜之。
寇氏曰∶妇人产当寒月，寒气入产门，脐下胀满，手不得犯，此寒疝也，宜仲景羊肉汤。或产后脐腹忽痛，乃呼吸
之间冷风乘虚而入，宜当归建中汤、四顺理中汤。
产后腹痛，恶露既去而仍痛，四神调补之，不应八珍汤。若痛而恶心，或欲作呕，六君子汤；若痛而泄泻，六君子
汤送四神丸；若胸膈饱闷，或恶食吞酸，或腹痛手不可按，此是饮食所伤，用二陈加白术、山楂，消导之；若食既消而
仍痛，按之不痛，更加头痛，烦热作渴，恶寒欲呕等症，此是中气被伤，宜温补脾胃为主；若发热腹痛，按之痛甚，不
恶食吞酸，此是瘀血停滞，失笑散消之；若只发热，头痛，腹痛，按之却不痛，此是血虚，用四物加炮姜、参、术，以
补之。
Postpartum heart pain is caused by the deficiency of Yin and blood, with deficient fire rising along with Qi to attack the Pericardium Collateral (Xinbaoluo). This condition is named "Pericardium Collateral Pain" (Xinbaoluo Tong) and should be treated primarily with Guipi Tang (Restore the Spleen Decoction). If Cold pathogen damages the Heart Meridian, it is called "True Heart Pain" (Zhenxintong), for which there is no curable medicine.
Generally, if Cold pathogen attacks upward after childbirth, it causes heart pain; if it attacks downward, it causes abdominal pain. If accompanied by blood clots, Shenghua Tang (Generate New Blood Decoction) added with Guizhi (Cinnamon Twig) is appropriate. If only hot-natured drugs are used to attack Cold, although the pain may cease, it will cause blood to move recklessly, further weakening the postpartum mother.
Moreover, Cold conditions must be accompanied by deficiency and dryness; Heat conditions must be assisted by Yin-nourishing herbs to control their hyperactivity.
Postpartum lochia retention (E xue) may occur due to external contraction of the Six Excesses or internal injury from the Seven Emotions, causing sudden cessation of discharge. Stagnant blood accumulates, leading to incomplete expulsion and thus abdominal pain. The etiology must be examined for treatment. For instance, if a puerpera within the confinement period has normal diet but suddenly suffers abdominal pain, with deep and hidden pulses and cold extremities, this indicates retained lochia and food stagnation entangling blood, preventing pulse manifestation. It should not be mistaken for dual deficiency of Qi and Blood requiring strong tonification; instead, herbs for resolving stagnation and promoting blood circulation should be combined.
The *Jingui Yaolue* states: For postpartum abdominal pain, Danggui Shengyang Roushou Tang (Angelica Sinensis, Ginger, and Mutton Decoction) is indicated. "Yutong" refers to lingering, slow pain, belonging to obstruction by exogenous Cold. Therefore, Danggui (Dongquai Root) is used to unblock stagnation in the Blood aspect, and Shengjiang (Fresh Ginger) to circulate Cold in the Qi aspect. Mutton is used as the sovereign herb because "deficiency of form is supplemented by flavor," and moreover, mutton can tonify Qi. Since pain often belongs to Qi weakness, it is suitable.
Kou Zongshi stated: When women give birth in cold months, Cold enters the birth canal, causing distension and fullness below the umbilicus that cannot be touched by hand; this is Cold Hernia (Hanshan), and Zhang Zhongjing's Mutton Decoction is appropriate. Or, if sudden pain occurs in the umbilical and abdominal region after childbirth, it is due to cold wind entering through respiration while the body is empty; Danggui Jianzhong Tang (Angelica Sinensis Decocted Middle Jiao Decoction) or Sishun Lizhong Tang (Four Smooth Regulating the Middle Jiao Decoction) is appropriate.
For postpartum abdominal pain, if lochia has passed but pain persists, Sishen Wan (Four Miracles Pill) should be used for regulation and tonification first; if ineffective, Bazhen Tang (Eight Treasures Decoction) follows. If pain is accompanied by nausea or a desire to vomit, Liujunzi Tang (Six Gentlemen Decoction) is used. If pain is accompanied by diarrhea, Liujunzi Tang is administered with Sishen Wan. If there is fullness and oppression in the chest and diaphragm, aversion to food, acid regurgitation, or abdominal pain where pressure is intolerable, this is injury due to diet; Erchen Tang (Two Aged Substances Decoction) plus Baizhu (Atractylodes Macrocephala Rhizome) and Shanzha (Hawthorn Fruit) should be used to resolve stagnation. If food stagnation has resolved but pain remains, and pressing does not elicit pain, accompanied by headache, vexation, heat, thirst, aversion to cold, and desire to vomit, this is damage to Middle Qi; warming and tonifying the Spleen and Stomach should be the main approach. If fever and abdominal pain occur, with increased pain upon pressure, but without aversion to food or acid regurgitation, this is stagnant blood; Shixiao San (Pain-Dispersing Powder) is used to dissipate it. If there is only fever, headache, and abdominal pain, but no pain upon pressure, this is Blood deficiency; Siwu Tang (Four Substances Decoction) plus Paojiang (Prepared Ginger), Renshen (Ginseng Root), and Baizhu (Atractylodes Macrocephala Rhizome) should be used for tonification.