产后遍身疼痛者,因产百节开张,血脉流散,气弱不充,则经络间血多凝滞不散,筋脉急引,骨节不
利,故有腰背不能转侧,手足不能伸屈,或身热头痛者,起痛散主之。若误作伤寒,发表汗出,则筋脉
动,手足厥冷,变为痉证,又当十全大补汤也。若指节疼痛,补中益肾汤。足膝肿或痛,独活寄生汤。
《医通》云∶产后败血,或流于腰胯,或流入髀股,痛不可拊,痛处热肿,流注日深,渐至身面浮肿,
调经散进或琥珀地黄丸最当。若虚风所侵,以致肢体沉重不利,筋脉急引,发热头痛,四神散加桂枝、姜、
枣,和营止痛最捷,勿误为伤寒治也。以手按而痛益甚,是瘀滞。按而痛少缓,是血虚。以此别虚实,
庶无差谬。冯氏云∶产后手足身痛,是血虚不能荣也。手足走痛者,是气血不能荣养四末。而浊气流于四
肢则肿,阴火游行四旁则痛也。不出养荣加黑姜主之。
起痛散 治产后遍身疼痛,由气血虚有滞,不可误作伤寒施治。
当归(二钱,酒浸) 黄 (一钱,蜜炙) 白术(土炒) 淮牛膝(蒸) 独活 肉桂 韭白(
各八分) 甘草(三分)
姜三片,水煎,热服。《尊生》方无黄 ,韭白止五分。
补中益肾汤 专治产后虚劳,指节疼痛,头疼汗出。
人参 黄 (蜜炙) 淡豆豉(各一钱) 当归(二钱,酒浸) 韭白(五分) 生姜(三片) 猪肾(一付)
先将猪肾煎熟,取汁二盏,煎药八分,温服。
十全大补汤(见上卷胎不长养门。) 独活寄生汤(见上卷诸痛门。) 调经散琥珀地黄丸(
俱见本卷腰痛门。) 四神散(见本卷腹痛门。) 养荣汤(见本卷脱汗亡阳门。)
Postpartum generalized body pain arises because the joints and bones open up during childbirth, causing blood vessels to disperse. Qi deficiency fails to fill the channels, leading to stagnation of blood within the meridians that does not dissipate. This causes spasms and traction of the sinews and vessels, resulting in stiffness of the bone joints. Consequently, there may be an inability to turn or bend the waist and back, inability to extend or flex the hands and feet, or symptoms such as feverish sensation, headache, etc. The principal prescription is Qitong San (Pain-Relieving Powder). If mistakenly treated as Taiyang disease (Cold Damage) with diaphoretic methods causing sweating, it will agitate the sinews and vessels, leading to cold extremities and transformation into Jing Zheng (Spasm Syndrome, characterized by muscle spasms and opisthotonos). In this case, Shiquan Dabu Tang (Ten Complete Tonifying Decoction) should be used. If there is pain in the finger joints, Buzhong Yishen Tang (Tonify Middle and Benefit Kidney Decoction) is indicated. For swelling or pain in the feet and knees, Duhuo Jisheng Tang (Angelica Pubescens and Dorstenia Decoction) is indicated.
*Yi Tong* states: Postpartum Bai Xue (stagnant lochia/blood), flowing into the waist and hips or into the thighs, causes severe pain that cannot be touched. The painful area becomes hot and swollen. As the pathogen flows deeper, it gradually leads to edema of the whole body and face. Tiao Jing San (Regulate Menses Powder) or Hupo Dihuang Wan (Amber and Rehmannia Pill) are most appropriate. If invaded by Xu Feng (deficiency wind), causing heavy limbs with limited mobility, spasms of sinews and vessels, fever, and headache, Sishen San (Four Spirit Powder) added with Guizhi (Cinnamon Twig), Shengjiang (Fresh Ginger), and Dazao (Jujube) harmonizes Ying and Wei (Nutritive and Defensive levels) and stops pain most rapidly. Do not mistakenly treat it as Taiyang disease. If pressing with hand exacerbates the pain, it indicates blood stasis stagnation; if pressing alleviates the pain slightly, it indicates blood deficiency. Use this to distinguish between excess and deficiency, thereby avoiding errors. Feng Shi stated: Postpartum pain in hands, feet, and body is due to blood deficiency failing to nourish. Wandering pain in hands and feet indicates that Qi and Blood fail to nourish the four extremities. Turbid fluids flowing into the four limbs cause swelling, while Yin Fire wandering around causes pain. This falls under the treatment scope of Yangrong Jia Heijiang Tang (Nourish Prosperity Decoction plus Blackened Ginger).
Qitong San (Pain-Relieving Powder): Treats postpartum generalized body pain caused by Qi and Blood deficiency with stagnation. Do not mistakenly treat as Taiyang disease.
Danggui (Radix Angelicae Sinensis, 2 qian, soaked in wine), Huangqi (Radix Astragali Membranacei, 1 qian, honey-fried), Baizhu (Rhizoma Atractylodis Macrocephalae, stir-baked with soil), Huainiuxi (Radix Achyranthis Bidentatae, steamed), Duhuo (Radix Angelicae Pubescentis), Rougui (Cortex Cinnamomi), Jiubai (Stem and Leaf of Allium Tuberosum, each 8 fen), Gancao (Radix Glycyrrhizae Uralensis, 3 fen).
Shengjiang (Fresh Ginger, 3 slices), decocted in water, taken warm. The formula in *Zunsheng* lacks Huangqi, and Jiubai is only 5 fen.
Buzhong Yishen Tang (Tonify Middle and Benefit Kidney Decoction): Specifically treats postpartum consumptive disease with deficiency, pain in finger joints, headache, and sweating.
Renshen (Radix Ginseng), Huangqi (Radix Astragali Membranacei, honey-fried), Danshichidouchi (Semen Sojae Preparatum, each 1 qian), Danggui (Radix Angelicae Sinensis, 2 qian, soaked in wine), Jiubai (Stem and Leaf of Allium Tuberosum, 5 fen), Shengjiang (Fresh Ginger, 3 slices), Zhushen (Kidney of Porcine, one piece).
First, boil the pig kidney until cooked, take two cups of the juice, then decoct the herbs until reduced to 0.8 parts, and take warm.
Shiquan Dabu Tang (see Volume Upper, Section on Failure of Fetal Growth). Duhuo Jisheng Tang (see Volume Upper, Section on Various Pains). Tiao Jing San, Hupo Dihuang Wan (both see this Volume, Section on Lower Back Pain). Sishen San (see this Volume, Section on Abdominal Pain). Yangrong Tang (see this Volume, Section on Profuse Sweating and Collapse of Yang).