《产宝百问》曰∶产后小腹痛，由恶露凝结，或外寒抟之。若久而不散，必成血瘕，月水不调。
《大全》曰∶儿枕者，由母胎中宿有血块，因产时其血破败，与儿俱下则无患。若产妇脏腑风冷，使血凝
滞在小腹，不能流通，令结聚疼痛，名曰儿枕痛。胎以食母之血，十月满足，余血结成块，俗呼为儿枕。欲产
时，血块先动，败血裹其子，是以难产。
薛立斋曰∶有产妇小腹作痛，服行气破血药不效，脉洪数，此瘀血内溃为脓也。大抵此证，因荣卫不调，
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，失治多为败证。脉数而洪，已有脓，
迟紧乃瘀血也，下之愈。若腹胀大，转侧作水声，或脓从脐出，或从大便出，宜蜡矾丸、太乙膏，或瓜子仁汤，
下脓而愈。
单养贤曰∶产后脐下痛，在七日内未曾服药者，当作恶露不尽论。如按而痛止者属虚，加味生化汤。
慎斋按，以上四条，序产后有小腹痛之证也。产后小腹痛，非恶露瘀蓄，即风寒乘袭。小腹为足厥阴部分，
藏血之所。儿产后，一有不慎，则风寒乘虚，与恶血凝结，即有儿枕痛之名。若瘀血溃脓，亦不早治之故也，
临证宜虑及之。
《大全》曰∶产后恶露方行，忽然渐止，断绝不来，腰中重痛，下注两股，痛如锥刺入骨，此由血滞经
络。不即通之，必作痈疽，宜桃仁汤、五香连翘汤。
慎斋按∶产后恶露不行，血滞经络，而作痈疽，必是血气大虚，荣卫不调所致，必八珍、十全可疗，用桃
仁、五香则谬矣。
《产宝百问》说：产后小腹部疼痛，是由于恶露（产后排出的余血浊液）凝结，或者受到外寒侵袭所致。如果时间久了不消散，必定形成血瘕（腹内结块），导致月经不调。
《大全》说：所谓“儿枕”，是因为母亲在胎中原本就有血块，分娩时这些败血与胎儿一同排出就没有祸患。如果产妇脏腑受风冷侵袭，使血液凝滞在小腹部，不能流通，从而结聚产生疼痛，名叫儿枕痛。胎儿依靠母体血液滋养，十月期满，剩余的血液结成块状，俗称儿枕。临产时，血块先动，败血包裹住胎儿，因此导致难产。
薛立斋说：有的产妇小腹部疼痛，服用行气破血的药物无效，脉象洪大且数，这是瘀血在内溃烂化脓了。大体上这个病证，是因为营卫不调，瘀血停滞，应当紧急治疗。拖延就会腐化成脓，最难治疗。如果流注到关节，就会患上骨疽（生于骨骼的疮疡），失治多成为败证。脉象数而洪大，说明已有脓；脉象迟紧，则是瘀血，用攻下法可以痊愈。如果腹部胀大，转动身体时有水声，或者脓液从肚脐流出，或从大便排出，宜用蜡矾丸、太乙膏，或瓜子仁汤，排出脓液后痊愈。
单养贤说：产后脐下疼痛，如果在七天内未曾服药，应当作为恶露不尽来论治。如果按压后疼痛停止的属于虚证，用加味生化汤。
慎斋按语：以上四条，叙述了产后有小腹部疼痛的病证。产后小腹部疼痛，不是恶露瘀积蓄留，就是风寒乘虚侵袭。小腹是足厥阴肝经所主的部分，是藏血的地方。产妇如果稍有疏忽，风寒就会乘虚而入，与恶血凝结，就有了儿枕痛的名目。如果是瘀血溃烂成脓，也是因为没有及早治疗的缘故，临证时应当考虑到这一点。
《大全》说：产后恶露刚行，忽然逐渐停止，断绝不来，腰部沉重疼痛，向下放射至两腿，疼痛像锥子刺入骨头一样，这是由于血液滞留在经络中。如果不立即疏通，必定会发作痈疽，宜用桃仁汤、五香连翘汤。
慎斋按语：产后恶露不行，血液滞留在经络中而发作痈疽，必定是气血大虚，营卫不调所致，必须用八珍汤、十全大补汤才能治愈，使用桃仁、五香类药物就错了。
*Chanbao Baiwen* states: Postpartum lower abdominal pain is caused by the coagulation of *Eluo* (lochia, residual blood and turbid fluid discharged after childbirth), or by invasion of external cold. If it persists for a long time without dissipating, it will inevitably form a *Xuejia* (blood mass/abdominal lump), leading to irregular menstruation.
*Daqan* states: The term "Erzhen" (Child's Pillow) refers to pre-existing blood clots in the mother's womb. During delivery, if these degenerated bloods are expelled along with the infant, no harm ensues. However, if the mother's zang-fu organs are affected by wind-cold, causing blood to stagnate and fail to circulate in the lower abdomen, resulting in clustered pain, it is named "Erzhen Pain." The fetus nourishes on maternal blood; when ten months are complete, the remaining blood forms clots, commonly called "Erzhen." At the time of birth, these clots move first, and the degenerated blood wraps around the child, thereby causing difficult labor.
Xue Lizhai stated: There are cases where a postpartum woman suffers from lower abdominal pain, but administration of qi-moving and blood-breaking herbs proves ineffective. The pulse is surging and rapid, indicating that the stagnant blood has ulcerated internally into pus. Generally, this condition arises from disharmony of Ying and Wei (nutritive and defensive qi) and stagnation of stagnant blood, requiring urgent treatment. Delay leads to putrefaction into pus, which is extremely difficult to treat. If the pathogen flows into the joints, it results in *Guju* (bone abscess); failure to treat properly often leads to critical conditions. A rapid and surging pulse indicates the presence of pus; a slow and tight pulse indicates stagnant blood, which can be cured by purgation. If the abdomen is distended and large, producing a splashing sound upon turning, or if pus discharges from the umbilicus or through the stool, one should use *Lafan Wan* (Wax and Alum Pill), *Taiyi Gao* (Taiyi Plaster), or *Gua Zi Ren Tang* (Bitter Apricot Seed Decoction) to discharge the pus, leading to recovery.
Shan Yangxian stated: For postpartum pain below the navel, if no medication has been taken within seven days, it should be treated as incomplete expulsion of lochia. If pressing on the area stops the pain, it belongs to deficiency, and *Jiawei Shenghua Tang* (Modified Birth-Generating Decoction) should be used.
Shen Zhai commented: The above four passages describe syndromes of lower abdominal pain after childbirth. Lower abdominal pain after childbirth is either due to accumulation of stagnant lochia or invasion of wind-cold. The lower abdomen is the domain of the Foot Jueyin Liver Meridian, the residence of blood storage. If a postpartum woman is not careful, wind-cold invades the deficiency, condensing with lochia to form the condition known as Erzhen Pain. If stagnant blood ulcerates into pus, it is also due to lack of early treatment; clinicians must consider this.
*Daqan* states: When postpartum lochia begins to flow but suddenly ceases gradually and stops completely, accompanied by heavy pain in the waist radiating down to both thighs, with pain like needles piercing into the bone, this is caused by blood stagnation in the meridians. If not unblocked immediately, it will inevitably develop into carbuncles and sores (*Yongju*). One should use *Tao Ren Tang* (Peach Kernel Decoction) or *Wuxiang Lianqiao Tang* (Five Fragrances and Forsythia Decoction).
Shen Zhai commented: When postpartum lochia fails to proceed, and blood stagnates in the meridians leading to carbuncles and sores, it must be caused by severe deficiency of Qi and Blood, and disharmony of Ying and Wei. It must be treated with *Bazhen Tang* (Eight-Treasure Decoction) or *Shiquan Dabu Tang* (Ten Complete Tonifying Decoction). Using Tao Ren (Peach Kernel) and Wuxiang (Five Fragrances) would be erroneous.