Library

The epigastrium (upper abdomen) is located below the heart. Postpartum, pain may occur due to invasion of cold pathogens or consumption of cold foods. Because this pain is near the heart, it is colloquially referred to as "heart pain." However, one must not forget that the Heart is the official of the Sovereign, governing the circulation of blood and Qi, and commanding all zang-fu organs. When blood and Qi are abundant, the body remains peaceful and tranquil; when blood and Qi are deficient, palpitations and fright with restlessness occur, but severe pain should not happen. If cold directly damages the Heart Meridian, resulting in "True Heart Pain," it presents similarly to "True Headache," both being critical conditions with no curative treatment available. In such cases, the fingernails and toenails turn bluish-black, and death occurs from morning to evening or vice versa; this has been discussed in detail in various medical texts. For pain at the stomach opening, one should dissipate cold accumulations in the stomach using Shenghua Li Xiao Fang (Life-Generating Immediate Efficacy Decoction), which yields excellent results without fail. If only hot medicines are used to attack cold, although the pain may cease, it will cause reckless bleeding, further weakening the postpartum mother. Moreover, cold pathogenic factors often accompany deficiency, and drying-hot medicines must be assisted by yin-nourishing herbs to restrain their excessive hyperactivity. As for lingering, dull pain, one should inquire whether blood stasis clots have been completely expelled. If the pain can be slightly relieved by rubbing and pressing, it indicates a deficiency pattern, requiring tonifying formulas. Generally speaking, postpartum cold food attacking upward to the heart causes heart pain, while attacking downward to the abdomen causes abdominal pain; the treatment for pain in the heart and abdomen is roughly similar. Feng Shi stated: Postpartum loss of yin-blood allows defying fire to rush upward along the pericardium meridians, named "Pericardium Meridian Pain," which is appropriately treated with Guipi Tang (Restore the Spleen Decoction). *Yi Tong* (General Treatise on Medicine) uses Lizhong Tang (Regulate the Middle Decoction) added with Danggui (Angelica Sinensis Root).

Shenghua Li Xiao Fang (Life-Generating Immediate Efficacy Decoction): Treats epigastric pain caused by consuming cold foods postpartum.
Chuanxiong Rhizome (2 qian)
Danggui Radix Angelicae Sinensis (4 qian)
Peach Kernel (10 grains, skin and tip removed)
Gingeris Rhizoma Preparatum (charred black)
Glycyrrhizae Radix et Rhizoma Praeparata (5 fen each)
Cinnamomi Cortex (4 fen each)
Evodiae Fructus
Decoct in water and take orally. Another version excludes Peach Kernel. If injured by meat consumption, add Crataegi Fructus (Hawthorn Fruit) and Amomi Fructus Rotundus (Cardamom). If injured by flour-based food consumption, add Shenqu Fermentatum (Medicated Leaven) and Maiya Germinatus Hordei (Barley Sprout). For constipation, add Congrong Herba (Cistanche Herb) washed with wine. *Zunsheng Quan Shu* states: If pain persists, use Puhuang Pollen Typhae (2.5 qian), Tulingzhi Faex Lingzhi (1.4 qian), Mutong Akebiae Caulis (1 qian), Chishao Radix Paeoniae Rubra (1 qian), Moyho Resina (1 qian), Yanhusuo Rhizoma Corydalis (1.5 qian), Jianghuang Rhizoma Curcumae Longae (1.5 qian), and a drop of salt brine. This formula is intended for pain caused by blood stasis, used when previous medications fail to relieve the pain.

Guipi Tang (Restore the Spleen Decoction) (See Volume Upper, Section on Metrorrhagia and Miscarriage).
Lizhong Tang (Regulate the Middle Decoction) (See Volume Upper, Section on Malaria, attached under Zhishi Lizhong Tang).