产后寒中感寒，及饮食冷物，下攻小腹作痛，前已论之矣。又有因血虚痛及小腹者，亦服生
化汤妙。至血块作痛，俗名儿枕痛者，亦用生化汤；不应，用延胡生化汤均可。密斋云∶脐下胞
胎所系之处，血之所聚也，产后血去不尽，即成小腹痛症。刺痛无时，痛则有形，须臾痛止，又
不见形，血症黑神散主之。然有产妇小腹作痛，服行气破血药不效，其脉洪数，此瘀血内溃为脓
也。是因营卫不调，瘀血停滞，宜急治之，缓则腐化为脓，最难治疗。若流注关节，则患骨疽；
失治，多为败症。脉数而洪，已有脓；迟紧乃瘀血也，下之愈。
延胡生化汤 即生化汤加延胡一钱。治小腹儿枕块痛。如无块，但小腹痛，可按而止者，
属虚，以生化汤加入延胡索散，再加入熟地二钱。
延胡索散 肉桂 延胡
各等分，合为细末，听用。
产后腰痛者，由肾位系胞，腰为肾腑，产则劳伤肾气，损动胞络，或虚未平复，而风冷乘之
者，皆致腰痛。若寒冷邪气连滞背脊，痛久未已，后忽有孕，必致损动，宜养荣壮肾汤主之。如
产后日久腰痛，济阴大造丸治之。如恶露方行，忽断绝不来，腰中重痛，下注两股，痛如锥刺
入骨，此血滞经络，不即通之，必作痈疽。《医通》用调经散加陵鲤甲，或琥珀地黄丸。
养荣壮肾汤 治产后腰痛，属劳伤，或风寒所来。
当归（二钱） 独活 桂心 川芎 杜仲（盐水制断丝） 续断肉（制） 桑寄生（各八分，真）
防风（四分） 生姜（三片）
煎服。如服二帖后，疼痛不止，肾虚也，加熟地三钱，再服。
局方调经散 治产后败血，乘虚停积于五脏，循经入于四肢，留滞日深，腐坏如水，渐至身
体面目浮肿。或因产败血上干于心，心不受触，致心烦躁，卧起不安，如见鬼神，言语颠倒，并宜服之。
赤芍 没药（别研） 琥珀（别研） 桂心 当归（各一钱） 细辛（去苗） 麝香（别研，各五分）
上为末，和匀，每服一钱，温酒，入生姜少许服，一方每服五分，以痛止为度。
琥珀地黄丸 治产后恶露未净，胸腹痛，小便不利。
琥珀（别研） 延胡（同糯米炒，去米） 当归（各一两） 蒲黄（四两，生半炒半） 干生地（
八两） 生姜（一斤）
上将地黄咀碎酒浸，生姜切片，各捣取汁留滓，无油杓中，用姜汁炒地黄滓，地黄汁炒姜滓，
各干为末，忌犯铁器，炼白蜜为丸，弹子大，每服一丸，空心，当归煎汤调服。
After childbirth, pain in the lower abdomen caused by contracting cold pathogens or consuming cold foods has been discussed previously. For pain extending to the lower abdomen due to Blood deficiency, Shenghua Tang (Life Generation Decoction) is effective. For pain caused by blood clots, commonly known as "child pillow pain" (postpartum uterine contraction pain), Shenghua Tang is also used; if ineffective, Yanhu Shenghua Tang (Corydalis and Life Generation Decoction) may be used. Mizhai stated: The area below the umbilicus is where the uterus and fetus are connected, and a gathering place for Blood. If postpartum lochia is not completely expelled, it forms lower abdominal pain. The stabbing pain occurs intermittently; when painful, a mass is palpable, but disappears shortly after the pain ceases. This type of Blood stasis pattern should be treated with Heishen San (Black Divine Powder). However, some postpartum women experience lower abdominal pain that does not respond to Qi-moving and Blood-breaking herbs. Their pulse is surging and rapid, indicating that stagnant Blood has ulcerated internally and turned into pus. This results from disharmony between Ying (Nutrient) and Wei (Defensive) levels and stagnation of Blood. Urgent treatment is required; delay will lead to putrefaction into pus, making it difficult to treat. If the pathogen flows into the joints, bone abscesses (Gu Ju) may develop; failure to treat properly often leads to critical conditions. A surging and rapid pulse indicates pus formation; a slow and tight pulse indicates Blood stasis, which can be resolved by purgation.
Yanhu Shenghua Tang consists of Shenghua Tang plus one qian of Yanhusuo (Corydalis Rhizome). It treats lower abdominal pain due to child pillow masses. If there is no mass, but only lower abdominal pain relieved by pressure, it belongs to deficiency. In this case, add Yanhusuo San to Shenghua Tang, along with two qian of Shudihuang (Prepared Rehmannia Root).
Yanhusuo San comprises Rougui (Cinnamon Bark) and Yanhusuo in equal parts, ground into fine powder for use.
Postpartum lower back pain arises because the Kidney position connects to the uterus, and the waist is the mansion of the Kidney. Childbirth labors and injures Kidney Qi and damages the Bao Mai (Uterine Vessels). If deficiency has not yet recovered, Wind-Cold pathogens may invade, causing lower back pain. If Cold pathogens linger on the spine and pain persists, followed by a new pregnancy, damage is likely; Yangrong Zhuangshen Tang (Nourish Ying and Strengthen Kidney Decoction) should be used. For chronic lower back pain long after childbirth, Ji Yin Da Zao Wan (Ji Yin Great Creation Pill) is indicated. If lochia suddenly stops after just starting, accompanied by heavy pain in the waist radiating down both thighs like needle insertion into the bone, this is Blood stagnation in the meridians. If not unblocked immediately, abscesses may form. *Yi Tong* recommends Tiaojing San (Regulate Menses Powder) plus Lingli Jia (Lingli Shell), or Hupo Dihuang Wan (Amber and Rehmannia Pill).
Yangrong Zhuangshen Tang treats postpartum lower back pain due to labor injury or Wind-Cold.
Danggui (Angelica Sinensis Root, 2 qian) Duhuo (Angelica Pubescens Root) Guixin (Cinnamon Twig/Cortex Cinnamomi) Chuanxiong (Ligusticum Chuanxiong Rhizome) Duzhong (Eucommia Bark, processed with salt water to break fibers) Xuduan (Dipsacus Root, processed) Sangjisheng (Taxillus Branch, authentic) Fangfeng (Saposhnikovia Root, 4 fen) Shengjiang (Fresh Ginger, 3 slices)
Decoct and take orally. If pain persists after two doses, it indicates Kidney deficiency; add three qian of Shudihuang and continue taking.
Ju Fang Tiaojing San treats postpartum Bai Xue (Dead Blood), which accumulates in the Five Zang organs due to deficiency, travels along meridians to the four limbs, stays deep for days, rots like water, and gradually causes edema of the body and face. Or, if postpartum dead blood disturbs the Heart, causing irritability, restlessness, hallucinations, and disordered speech, this formula is suitable.
Chishao (Red Peony Root) Moyao (Myrrh, separately ground) Hupo (Amber, separately ground) Guixin (Cinnamon Twig) Danggui (Angelica Sinensis Root, 1 qian each) Xixin (Asarum Root, de-tipped) Shexiang (Musk, separately ground, 5 fen each)
Grind all into powder, mix evenly. Take one qian per dose with warm wine and a little fresh ginger; alternatively, take five fen per dose until pain stops.
Hupo Dihuang Wan treats postpartum incomplete expulsion of lochia, chest and abdominal pain, and difficulty urinating.
Hupo (Amber, separately ground) Yanhusuo (Corydalis Rhizome, stir-fried with glutinous rice, remove rice) Danggui (Angelica Sinensis Root, 1 liang each) Puhuang (Typha Pollen, 4 liang, half raw, half stir-fried) Ganshengdi (Dried Raw Rehmannia Root, 8 liang) Shengjiang (Fresh Ginger, 1 jin)
First, chop Shengdi and soak in wine. Slice Shengjiang. Crush each separately to extract juice, retaining the dregs. Using a non-oily spoon, stir-fry Shengdi dregs with Shengjiang juice, and stir-fry Shengjiang dregs with Shengdi juice. Dry them and grind into powder. Avoid contact with iron vessels. Refine white honey to make pills the size of quail eggs. Take one pill on an empty stomach, washed down with decoction of Danggui.