答曰。产后百节开张。血脉流走。遇气弱。则经络肉分之间。血多留滞。累日不散。则骨节
不利。筋脉引急。故腰背不得转侧。手足不能动摇。身热头痛也。若医以伤寒治之。则汗出
而筋脉伤。手足厥冷。变生他病。但服趁痛散以嘿除之。
趁痛散
牛膝(酒浸) 当归 官桂 白术 黄 (各半两) 薤白(二钱半) 生姜(半两) 甘草(二钱
半) 独活(半两)
上为粗末。每服二钱。水一盏半。煎七分。去滓温服。本方每服半两。水五盏。煎二盏。分
作二次温服。
透经汤(方见十八问中)
答曰。产卧水血俱下。肠胃虚弱。津液不足。是以大便秘涩不通也。若五六日腹中闷胀者。
有燥粪在脏腑。以其干涩未能出耳。宜服麻仁丸以津润之。若误以为有热而投之以寒药。则
阳消阴长。变动百出。性命危矣。此是小柴胡汤之证误。不可不谨。
麻仁丸(三因方云。去血过多。脏燥大便秘涩。则固当润之。大黄似难轻用。候葱涎调醋茶
为丸。次以葱茶下之。必通。愚按此言大黄不可轻用者是。)
麻仁(研) 枳壳(麸炒) 人参 大黄(各半两)
上为细末。蜜丸桐子大。空心温酒下。未通加丸数服。
滋肠五仁丸。治血气不足。大肠闭滞。传送艰难。
桃仁 杏仁(各一两炒去皮尖) 柏子仁(半两) 松子仁(一钱三字) 郁李仁(麸炒) 陈皮(
别为末四两)
上五仁别研为膏。合橘皮同研。炼蜜为丸。桐子大。每服三十丸至五十丸。食前米饮下。更
看虚实加减。
答：产后全身关节松弛开张，血脉运行流动。若遇气虚，则在经络和肌肉腠理之间，血液容易停留阻滞，多日不散，导致骨节活动不利，筋脉拘急牵引，因此出现腰背不能转侧、手足不能动摇、身体发热、头痛等症状。如果医生误用治疗伤寒的方法（发汗法）来治疗，会导致出汗过多而损伤筋脉，出现手足厥冷，进而变生其他疾病。此时只需服用趁痛散以默默消除病邪。
趁痛散
牛膝（酒浸）、当归、官桂、白术、黄芪（各半两）、薤白（二钱半）、生姜（半两）、甘草（二钱半）、独活（半两）。
以上药物研为粗末。每次服用二钱，加水一盏半，煎至七分，去渣后温服。本方也可每次服用半两，加水五盏，煎至两盏，分两次温服。
透经汤（方剂见第十八问中）
答：分娩时卧位生产，水液与血液同时下行，导致肠胃虚弱，津液不足，因此出现大便秘结涩滞不通的症状。如果五六天后腹部闷胀，说明有燥屎存在于脏腑之中，只是因为干涩未能排出而已。适宜服用麻仁丸以滋润肠道。如果误认为是有热邪而投用寒凉药物，则会导致阳气消减、阴气增长，变化百出，危及生命。这是将小柴胡汤证误治的案例，不可不谨慎。
麻仁丸（《三因方》记载：失血过多，脏燥导致大便秘涩，确实应当润下。大黄似乎难以轻易使用。可用葱汁调醋茶制成丸药，再用葱茶送服，必然通畅。我按语认为此言强调大黄不可轻用是正确的。）
麻仁（研磨）、枳壳（麸炒）、人参、大黄（各半两）。
以上药物研为细末，用蜂蜜制成梧桐子大小的丸药。空腹时用温酒送服。若未通便，可增加丸数服用。
滋肠五仁丸，治疗气血不足、大肠闭滞、传送艰难。
桃仁、杏仁（各一两，炒后去皮尖）、柏子仁（半两）、松子仁（一钱三分）、郁李仁（麸炒）、陈皮（另研为末四两）。
以上五种仁类分别研磨成膏，与橘皮混合研磨，用炼蜜制成梧桐子大小的丸药。每次服用三十丸至五十丸，饭前用米饮送服。更需根据虚实情况进行加减。
Answer: After childbirth, the joints and bones are relaxed and open, and the blood vessels are flowing. If Qi is weak, blood tends to stagnate in the meridians and muscle layers (Couli), remaining for days without dispersing. This leads to stiffness in the bone joints and tension in the tendons and vessels, resulting in symptoms such as inability to turn or bend the waist and back, inability to move the hands and feet, body heat, and headache. If a physician mistakenly treats this with methods for Cold Damage (Shanghan) [such as sweating], it will cause excessive sweating, damaging the tendons and vessels, leading to coldness of the hands and feet, and generating other pathological changes. One should simply administer Chentong San to silently resolve the condition.
Chentong San (Urging Pain-Relieving Powder)
* *Achyranthis Bidentatae Radix* (Jiuxu Niuqi, 牛膝) - wine-soaked
* *Angelicae Sinensis Radix* (Danggui, 当归)
* *Cinnamomi Ramulus* (Guigui, 官桂)
* *Atractylodis Macrocephalae Rhizoma* (Baizhu, 白术)
* *Astragali Membranacei Radix* (Huangqi, 黄芪)
*(Each: half tael)*
* *Allii Macrostemonis Bulbus* (Xiebai, 薤白)
*(Two qian and a half)*
* *Zingiberis Recens Rhizoma* (Shengjiang, 生姜)
*(Half tael)*
* *Glycyrrhizae Radix et Rhizoma* (Gancao, 甘草)
*(Two qian and a half)*
* *Angelicae Pubescentis Radix* (Duhuo, 独活)
*(Half tael)*
Grind the above into coarse powder. Take two qian per dose, add one and a half lamps of water, decoct until seven-tenths remain, remove the dregs, and take warm. Alternatively, take half a tael per dose, add five lamps of water, decoct until two lamps remain, divide into two doses, and take warm.
Toujing Tang (Formula see Question 18)
Answer: During childbirth, fluids and blood descend together, leading to weakness of the stomach and intestines and insufficiency of body fluids (Jinye). Therefore, feces become dry, hard, and difficult to pass. If there is abdominal fullness and oppression after five or six days, it indicates that dry stool exists within the zang-fu organs but cannot be expelled due to dryness and astringency. It is appropriate to administer Maren Wan to moisten and lubricate. If mistakenly treated as having Heat by administering cold-natured herbs, Yang will decline and Yin will grow, leading to myriad pathological changes and endangering life. This is a case of misdiagnosing Shaoyang Syndrome (Xiao Chai Hu Tang pattern); caution is essential.
Maren Wan (Hemp Seed Pill)
*(Note from "San Yin Fang": When excessive blood loss causes organ dryness and constipation, moistening is indeed indicated. Dahuang [Rhubarb] should not be used lightly. One may prepare pills using green onion juice mixed with vinegar tea, and take them with green onion tea; passage will surely occur. My commentary agrees that emphasizing the cautious use of Dahuang is correct.)*
* *Cannabis Fructus* (Maren, 麻仁) - ground
* *Citri Reticulatae Pericarpium Viride* (Zhike, 枳壳) - bran-fried
* *Panax Ginseng Radix* (Renshen, 人参)
* *Rhei Radix et Rhizoma* (Dahuang, 大黄)
*(Each: half tael)*
Grind the above into fine powder, mix with honey, and make pills the size of paulownia seeds. Take with warm wine on an empty stomach. If bowel movement has not occurred, increase the number of pills taken.
Zichang Wuren Wan (Intestine-Nourishing Five Seeds Pill), treating insufficiency of Qi and Blood, obstruction of the Large Intestine, and difficulty in transportation.
* *Pruni Semen* (Taoren, 桃仁)
* *Armeniacae Semen Amarum* (Xingren, 杏仁)
*(Each: one tael, fried, skin and tip removed)*
* *Platycladi Semen* (Baiziren, 柏子仁)
*(Half tael)*
* *Pini Korum* (Songziren, 松子仁)
*(One qian and three fen)*
* *Prunus Simonii Semen* (Yuliren, 郁李仁) - bran-fried
* *Citri Reticulatae Pericarpium* (Chenpi, 陈皮)
*(Separately ground into powder: four taels)*
Grind the five seeds separately into a paste, combine with orange peel, grind together, and form pills with refined honey, sized like paulownia seeds. Take thirty to fifty pills per dose before meals with rice water. Adjust according to deficiency or excess patterns.