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*Chanbao Baiwen* states: Postpartum lower abdominal pain is caused by the coagulation of *Eluo* (lochia, residual blood and turbid fluid discharged after childbirth), or by invasion of external cold. If it persists for a long time without dissipating, it will inevitably form a *Xuejia* (blood mass/abdominal lump), leading to irregular menstruation.

*Daqan* states: The term "Erzhen" (Child's Pillow) refers to pre-existing blood clots in the mother's womb. During delivery, if these degenerated bloods are expelled along with the infant, no harm ensues. However, if the mother's zang-fu organs are affected by wind-cold, causing blood to stagnate and fail to circulate in the lower abdomen, resulting in clustered pain, it is named "Erzhen Pain." The fetus nourishes on maternal blood; when ten months are complete, the remaining blood forms clots, commonly called "Erzhen." At the time of birth, these clots move first, and the degenerated blood wraps around the child, thereby causing difficult labor.

Xue Lizhai stated: There are cases where a postpartum woman suffers from lower abdominal pain, but administration of qi-moving and blood-breaking herbs proves ineffective. The pulse is surging and rapid, indicating that the stagnant blood has ulcerated internally into pus. Generally, this condition arises from disharmony of Ying and Wei (nutritive and defensive qi) and stagnation of stagnant blood, requiring urgent treatment. Delay leads to putrefaction into pus, which is extremely difficult to treat. If the pathogen flows into the joints, it results in *Guju* (bone abscess); failure to treat properly often leads to critical conditions. A rapid and surging pulse indicates the presence of pus; a slow and tight pulse indicates stagnant blood, which can be cured by purgation. If the abdomen is distended and large, producing a splashing sound upon turning, or if pus discharges from the umbilicus or through the stool, one should use *Lafan Wan* (Wax and Alum Pill), *Taiyi Gao* (Taiyi Plaster), or *Gua Zi Ren Tang* (Bitter Apricot Seed Decoction) to discharge the pus, leading to recovery.

Shan Yangxian stated: For postpartum pain below the navel, if no medication has been taken within seven days, it should be treated as incomplete expulsion of lochia. If pressing on the area stops the pain, it belongs to deficiency, and *Jiawei Shenghua Tang* (Modified Birth-Generating Decoction) should be used.

Shen Zhai commented: The above four passages describe syndromes of lower abdominal pain after childbirth. Lower abdominal pain after childbirth is either due to accumulation of stagnant lochia or invasion of wind-cold. The lower abdomen is the domain of the Foot Jueyin Liver Meridian, the residence of blood storage. If a postpartum woman is not careful, wind-cold invades the deficiency, condensing with lochia to form the condition known as Erzhen Pain. If stagnant blood ulcerates into pus, it is also due to lack of early treatment; clinicians must consider this.

*Daqan* states: When postpartum lochia begins to flow but suddenly ceases gradually and stops completely, accompanied by heavy pain in the waist radiating down to both thighs, with pain like needles piercing into the bone, this is caused by blood stagnation in the meridians. If not unblocked immediately, it will inevitably develop into carbuncles and sores (*Yongju*). One should use *Tao Ren Tang* (Peach Kernel Decoction) or *Wuxiang Lianqiao Tang* (Five Fragrances and Forsythia Decoction).

Shen Zhai commented: When postpartum lochia fails to proceed, and blood stagnates in the meridians leading to carbuncles and sores, it must be caused by severe deficiency of Qi and Blood, and disharmony of Ying and Wei. It must be treated with *Bazhen Tang* (Eight-Treasure Decoction) or *Shiquan Dabu Tang* (Ten Complete Tonifying Decoction). Using Tao Ren (Peach Kernel) and Wuxiang (Five Fragrances) would be erroneous.