头者，诸阳之会，产后阴虚，阴虚则阳胜，阳气上凑于头，故头痛；又有瘀血之气，上冲于头而痛者。一宜滋阴，
一宜去瘀，慎勿误治。
身热恶寒，感冒风寒也。生化汤加莲须。（和二十四）
中气虚，补中益气汤加蔓荆子少许。（补六）
气血俱虚，八珍汤。（补五）
阳气虚，补中益气汤加附子。（补六）
肾水不生肝木，六味丸加北五味。（补二）
气滞，芎乌散。（散二十四）
非阳气虚寒，则瘀血上冲。生化汤加肉桂、吴茱萸，可以治寒；失笑散加当归、川芎，可以行血。若指甲青黑，手
足冷而过节，此真心痛，不治。又恶血奔心，一丝入于心脏即死。
足纯青心下痛，寒毒攻心也。人参、白术、附子、肉桂、当归，散其下寒而上寒自解。
食冷物而作痛，生化汤加消食之剂。（和二十四）
感风邪而作痛，生化汤，荆芥、防风、生姜。（和二十四）
产后厥痛，血虚也。羊肉一斤，煮汁去肉，入当归一两，炒白芍五钱，炙甘草五分，再煎服之。（羊肉须取精者）
中无血块，绵绵而痛，按之即止，血虚也，宜八珍汤。
实则有恶露不尽，干血瘀积，食伤气滞，虚则有气弱寒阻，血虚空痛，须详审施治。虚者固宜调补气血，而
实者亦勿得峻厉克伐。
瘀血上冲，心腹胀满疼痛，牙关紧急，按之愈甚，大便难而小便易，宜失笑散（攻七）。煎汤下益母丸（即济阴丹，
和二十七。）
干血着于脐下，行气破血之药，投之不愈，知内有干血也，生化汤加炒大黄、炒虻虫。（和二十四）
胸膈饱胀，恶食吞酸，手不可按，此饮食伤也，二陈汤加山楂、神曲。（和八）
食消后而痛如故，按之痛止；或加头痛，烦热作渴，恶寒欲呕等症，此中气伤也。宜补脾胃，六君子汤。（补一）
六脉沉伏，四肢厥冷，内伤饮食，而恶血不行也。宜行血消食，失笑散加山楂、神曲（攻七。）如无恶血积食，则为
虚寒，宜补气暖胃。
产后六七日，忽然脐腹疼痛，此由呼吸之间，冷气乘虚而入也。宜四顺汤。（热三）
腹中 痛，客寒阻逆也，精羊肉煮汁，入当归、生姜煎服。
腹痛欲绝，脉浮弦，风入胞门也，川断一两，防风三钱，煎服。
冲任空虚，肝经血少，脉弦，熟地、吴茱萸、白芍、木瓜、蒺藜。
恶心作呕，六君子汤。（补一）
泄泻，六君子汤，加炮姜、砂仁、生姜、大枣。（补一）
腹中块积，生化汤加肉桂、红花。（和二十四）
六脉滑数，瘀血成痈。生化汤加丹参、丹皮。
肾气虚寒，理阴煎（热四）。胃关煎。（热五）
血少而痛，黄雌鸡汤。（补四十一）
The head is the convergence point of all Yang meridians. Postpartum yin deficiency leads to yang hyperactivity, causing yang qi to rush upward to the head, resulting in headache (headache). Alternatively, pain may be caused by blood stasis qi rushing upward to the head. One approach is suitable for nourishing yin, and another for removing blood stasis; one must be cautious not to treat incorrectly.
Body heat with aversion to cold indicates contraction of wind-cold due to exogenous pathogens. Use Shenghua Tang (Life-Birth Decoction) with added Lotus Stamen (Lianxu). (Formula 24)
Deficiency of middle jiao qi calls for Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with a small amount of Vitex Fruit (Manjingzi). (Formula 6)
Combined deficiency of qi and blood calls for Bazhen Tang (Eight-Treasure Decoction). (Formula 5)
Yang qi deficiency calls for Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with added Aconite Root (Fuzi). (Formula 6)
Kidney water failing to nourish Liver wood (Liver blood deficiency due to Kidney yin insufficiency) calls for Liuwei Wan (Six-Ingredient Pill with Rehmannia) with added Schisandra Berry (Bei Wuweizi). (Formula 2)
Qi stagnation calls for Xiongwu San (Xiongnu Powder). (Formula 24)
If it is not yang qi deficiency and cold, then it is blood stasis rushing upward. Shenghua Tang (Life-Birth Decoction) with added Cinnamon Twig (Rougui) and Evodia Fruit (Wuzhuyu) can treat cold; Shixiao San (Pain-Stopping Powder) with added Angelica Sinensis Root (Danggui) and Ligusticum Rhizome (Chuanxiong) can promote blood circulation. If the fingernails appear cyanotic and black, and the hands and feet are cold beyond the joints, this is Zhenxintong (True Heart Pain), which is incurable. Furthermore, if evil blood rushes to the heart, death occurs instantly upon even a trace entering the heart organ.
Pure cyanosis of the feet with pain below the heart indicates cold toxin attacking the heart. Use Ginseng Radix (Renshen), Atractodes Macrocephala Rhizome (Baizhu), Aconite Root (Fuzi), Cinnamon Twig (Rougui), and Angelica Sinensis Root (Danggui) to disperse lower cold, thereby resolving upper cold.
Pain triggered by consuming cold foods calls for Shenghua Tang (Life-Birth Decoction) with added digestive agents. (Formula 24)
Pain triggered by wind pathogen invasion calls for Shenghua Tang (Life-Birth Decoction) with added Schizonepeta Spike (Jingjie), Saposhnikovia Root (Fangfeng), and Fresh Ginger (Shengjiang). (Formula 24)
Postpartum convulsive pain is due to blood deficiency. Take one jin of mutton, boil to extract juice, discard the meat, add one liang of Angelica Sinensis Root (Danggui), five qian of stir-fried White Peony Root (Baishao), and five fen of honey-fried Licorice Root (Zhigancao), then decoct again and administer. (Select high-quality mutton.)
Absence of blood clumps in the abdomen with lingering pain that ceases upon pressure indicates blood deficiency; Bazhen Tang (Eight-Treasure Decoction) is appropriate.
Excess patterns involve incomplete lochia discharge, dried blood accumulation, or food injury leading to qi stagnation. Deficiency patterns involve weak qi with cold obstruction or empty pain from blood deficiency; treatment requires careful differentiation. While deficiency cases suit tonifying qi and blood, excess cases must not be treated with harsh purgatives.
Blood stasis rushing upward causes abdominal distension and pain, trismus (lockjaw), worsened by pressure, difficult defecation but easy urination; Shixiao San (Pain-Stopping Powder) is indicated (Formula 7). Decoct and take with Yi Mu Wan (Motherwort Pill, also known as Jiyin Dan, Formula 27).
Dried blood adhering below the umbilicus, unresponsive to qi-moving and blood-breaking herbs, confirms internal dried blood; use Shenghua Tang (Life-Birth Decoction) with added stir-fried Rhubarb (Dahuang) and stir-fried Blister Beetle (Machong). (Formula 24)
Fullness and bloating in the chest and diaphragm, anorexia with acid regurgitation, and tenderness to touch indicate food injury; Erchen Tang (Two-Aged Decoction) with added Hawthorn Fruit (Shanzha) and Medicated Leaven (Shenqu) is used (Formula 8).
If pain persists after digestion, ceasing upon pressure; or accompanied by headache, irritability, fever, thirst, aversion to cold, and nausea, this indicates damage to middle qi. Tonify the spleen and stomach with Liujunzi Tang (Six-Gentleman Decoction) (Formula 1).
Six pulses sinking and hidden, with cold limbs, indicate internal food injury obstructing blood flow. Promote blood circulation and digest food with Shixiao San (Pain-Stopping Powder) plus Hawthorn Fruit (Shanzha) and Medicated Leaven (Shenqu) (Formula 7). Without blood stasis or food retention, it is deficiency-cold; tonify qi and warm the stomach.
Sudden umbilical and abdominal pain on the sixth or seventh day postpartum results from cold air entering through respiration while the body is deficient; Sishun Tang (Four-Compliance Decoction) is indicated (Formula 3).
Abdominal pain due to external cold obstruction: decoct fine mutton juice with Angelica Sinensis Root (Danggui) and Fresh Ginger (Shengjiang).
Severe abdominal pain with floating and wiry pulse indicates wind invading the uterus (baomen); use Dipsacus Root (Chuanduan) one liang and Saposhnikovia Root (Fangfeng) three qian, decocted and administered.
Emptiness of Chong and Ren vessels with scant Liver blood and wiry pulse: use Prepared Rehmannia Root (Shudi), Evodia Fruit (Wuzhuyu), White Peony Root (Baishao), Quince (Mugua), and Tribulus Fruit (Jili).
Nausea and vomiting: Liujunzi Tang (Six-Gentleman Decoction) (Formula 1).
Diarrhea: Liujunzi Tang (Six-Gentleman Decoction) with added Fried Ginger (Paojiang), Amomum Fruit (Sharen), Fresh Ginger (Shengjiang), and Jujube (Dazao) (Formula 1).
Abdominal masses: Shenghua Tang (Life-Birth Decoction) with added Cinnamon Twig (Rougui) and Safflower (Honghua) (Formula 24).
Slippery and rapid six pulses indicate abscess formation from blood stasis: Shenghua Tang (Life-Birth Decoction) with added Salvia Root (Danshen) and Moutan Bark (Danpi).
Kidney qi deficiency-cold: Liyin Jian (Yin-Warming Decoction) (Formula 4); Weiguan Jian (Stomach-Gate Decoction) (Formula 5).
Pain due to blood deficiency: Yellow Hen Chicken Soup (Huangjiji Tang) (Formula 41).