寇宗 曰∶妇人产当寒月，寒气入产门，脐下胀满，手不得犯，此寒疝也。医将治以抵当汤，谓有瘀血也。
予教之曰∶非其治也，可服仲景羊肉汤。又产后六七日，忽然脐腹
痛，皆由呼吸之间，使冷气乘虚而入，宜服当归建中汤、四顺理中丸。
慎斋按∶产后有下血过多，冲任空虚，肝经血少而腹痛，脉弦者，以熟地、山茱为主，加白芍药、木瓜、
蒺藜一剂。有难产久坐，风入胞门，而腹痛欲绝，脉浮而弦，续断一两、防风五钱，服之立愈。一虚一实，不可不辨。
《家居医录》曰∶产后腹痛，恶露既去而仍痛，四神散调补之，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，或按之不痛，或更加头痛，烦热作渴，恶寒欲呕等证，此是中气被
伤，宜补脾胃为主。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。若止是发热头痛，或
兼腹痛，按之却不痛，此是血虚，用四物加炮姜、参、术，以补之。
《产宝新书》曰∶产后血块痛，用生化汤加肉桂、红花，块散痛止。慎不可用苏木、三棱、蓬术等峻厉之药。
虽山楂行气行血，亦不易多服，恐虚产母也。
慎斋按∶以上七条，序产后有腹痛之证也。产后腹痛有虚实之分，实者有恶露不尽，有干血瘀滞，有食伤裹
血。虚者有气弱寒阻，有血虚空痛。自当审因施治。在虚者固宜补气补血，而实者亦未可以峻厉克伐，重虚其虚也。
Kou Zongshi stated: When a woman gives birth during the cold months, cold pathogenic qi may enter the birth canal, causing distension and fullness below the umbilicus with tenderness to touch; this is Cold Hernia (Han Shan). Physicians might intend to treat it with Didang Tang (Madder and Ground Beetle Decoction), assuming the presence of Blood Stasis (Yu Xue).
I instructed him: This is not the correct treatment. She may take Zhang Zhongjing's Lamb Soup (Yangrou Tang). Furthermore, if seven or eight days postpartum there is sudden pain in the navel and abdomen, it is due to cold pathogenic qi entering through deficiency during respiration. It is appropriate to administer Danggui Jianzhong Tang (Angelica Sinensis Decoction for Building the Middle) or Sishun Lizhong Wan (Four-Compliant Pill to Regulate the Middle).
Shenzhai commented: In cases where excessive bleeding after childbirth leads to emptiness of the Chong and Ren vessels, resulting in Liver Meridian blood deficiency and abdominal pain with a Wiry pulse (Xian Mai), use Shudi Huang (Rehmanniae Radix Preparata) and Shanzhuyu (Corni Fructus) as principal herbs, adding Baishao Yao (Paeoniae Radix Alba), Mugua (Chaenomelis Fructus), and Jili (Tribuli Fructus) for one dose. In cases of difficult labor involving prolonged sitting, where Wind pathogen enters the Bao Men (Womb Gate) causing severe abdominal pain nearly unbearable, with a Floating and Wiry pulse, use Xu Duan (Dipsaci Radix) in an amount of 1 liang and Fang Feng (Saposhnikoviae Radix) in 5 qian; administration brings immediate relief. One pattern is Deficiency, the other Excess; they must not be confused.
Jiaju Yilu states: For postpartum abdominal pain where lochia has ceased but pain persists, treat with Bushi San (Four-God Powder) to tonify; if ineffective, use Bazhen Tang (Eight-Treasure Decoction). If pain is accompanied by nausea or a desire to vomit, use Liujunzi Tang (Six-Gentleman Decoction). If pain is accompanied by diarrhea, administer Six-Gentleman Decoction to deliver Sishen Wan (Four-Spirit Pill). If there is chest and diaphragm fullness/stuffiness, aversion to food, acid regurgitation, or abdominal pain that cannot be pressed upon, this is injury from diet; use Erchen Tang (Two-Aged Decoction) added with Baizhu (Atractylodis Macrocephalae Rhizoma) and Shanzha (Crataegi Fructus) to digest and guide out stagnation. If digestion has occurred but pain persists, or if pressing does not elicit pain, or if headache, vexing heat, thirst, aversion to cold, and vomiting arise, this indicates damage to Middle Qi; the primary approach should be tonifying the Spleen and Stomach. If fever and abdominal pain occur, with increased pain on pressure, no aversion to food, and acid regurgitation, this is Blood Stasis (Yu Xue) stagnation; eliminate it with Shixiao San (Laughing Out Powder). If there is only fever and headache, or accompanied by abdominal pain but without tenderness on pressure, this is Blood Deficiency (Xue Xu); use Siwu Tang (Four-Material Decoction) added with Paojiang (Prepared Ginger), Renshen (Ginseng Radix et Rhizoma), and Baizhu to tonify.
Chanbao Xinshu states: For pain caused by postpartum Blood Clumps (Xue Kuai), use Shenghua Tang (Generation and Transformation Decoction) added with Rougui (Cinnamomi Cortex) and Honghua (Carthami Flos). Once the clumps disperse, the pain stops. Strictly avoid using harsh and aggressive drugs such as Sumu (Borax? Note: Usually refers to Santalum Album or similar, but context implies strong blood-moving herb like Dalbergia Odorifera or similar aggressive agents, here translated as Sumu), Sanleng (Sparganii Rhizoma), and Pengzhi (Curcumae Rhizoma). Although Shanzha can move Qi and Blood, it should not be taken in large quantities, lest it further weaken the deficient mother.
Shenzhai commented: The above seven items outline the patterns of postpartum abdominal pain. Postpartum abdominal pain is divided into Excess and Deficiency. Excess patterns include incomplete expulsion of lochia, dry blood stasis, and dietary injury affecting the interior. Deficiency patterns include weak Qi with cold obstruction, and empty pain due to blood deficiency. Treatment must be based on identifying the cause. While Deficiency requires tonifying Qi and Blood, Excess patterns should not be treated with harsh attacking methods, which would further exacerbate the deficiency.