〔大〕产后遍身疼痛者何？答曰∶产后百节开张，血脉流散，遇气弱则经络肉分之
间，血多留滞，累日不散，则骨节不利，筋脉急引，故腰背不得转侧，手足不能动摇，身
热头痛也。若医以为伤寒治之，则汗出而筋脉动惕，手足厥冷，变生他病，但服趁痛散
除之。
〔薛〕前证若以手按而痛甚，是血滞也。用四物、炮姜、红花、桃仁、泽兰，补而散
之。若按而痛稍缓，此是血虚也。用四物、炮姜、人参、白术，补而养之。 一产妇身腹
作痛，发热不食，烦躁不寐，盗汗胁痛，服解散祛血之药，不时昏愦，六脉洪大如无，用
补中益气加炮姜、半夏，一剂顿退二三，又剂寝食甘美，但背强而痛，用八珍散大补汤
调理而安。一产妇遍身头项作痛，恶寒拘急，脉浮紧，此风寒之证也。用五积散一剂，
汗出而愈。但倦怠发热，此邪气去而真气虚也，用八珍汤调补而痊。一妇六月产后多
汗，人倦不敢袒被，故汗出被里，冷则浸渍，得风湿疼痛，遂以羌活续断汤数服而愈。
趁痛散 （《云岐》）治产后气弱血滞，遍身疼痛，及身热头疼。
牛膝 当归 桂心 白术 黄 独活 生姜（各半两） 甘草 薤白（各二钱半）
上 咀，每服半两，水参盏，煎至一盏半，去渣，食前服。
陈无择评曰∶趁痛散不特治产后气弱血滞，兼能治太阳经感风头疼，腰背痛，自汗
发热。若其感寒伤食，忧恐惊怒，皆致身疼发热头痛，况有蓐劳，诸证尤甚，趁痛散皆
不能疗。不若五积散入醋煎用却不妨。
五积散加酒煎，治感寒头痛身疼，方见伤寒门。恐与四物各半服之稳当。加桃仁煎，
治腰痛，逐败血，去风湿。
〔大〕治产后遍身青肿疼痛，及众疾。
牛膝 大麦 （各等分）
上为细末，以新瓦罐子中填一重麦 ，一重牛膝，如此填满，用盐泥固济，火 过赤，
放冷，研为散。但是产后诸疾，热酒调二钱下。
活血丹 苍术四物各半汤（并见杂病身痛。）
乌金散，治产后骨节四肢疼痛。（见后狂言谵语。）
【大】产后出现全身疼痛的原因是什么？回答说：产后全身关节松弛开张，血脉运行散乱，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，因此腰背无法转动侧身，手足不能随意动摇，并伴有身体发热、头痛等症状。如果医生误认为是伤寒来治疗，使用发汗法，会导致出汗后筋脉跳动抽搐，手足冰冷，从而变生其他疾病。此时只需服用趁痛散即可消除病症。
【薛】上述症状如果用手按压时疼痛加剧，这是血滞（血液瘀滞）的表现。应使用四物汤、炮姜、红花、桃仁、泽兰，以补益兼消散的方法治疗。如果按压时疼痛稍缓，这是血虚（血液亏虚）的表现。应使用四物汤、炮姜、人参、白术，以补益滋养的方法治疗。有一位产妇身体和腹部作痛，发热且食欲不振，烦躁不安难以入睡，盗汗且胁肋疼痛，服用了发散解表及祛瘀血的药物后，不时出现神志昏沉迷糊的症状，六脉洪大但重按无力（如无），改用补中益气汤加入炮姜、半夏，服用一剂后症状退去二三分，再服用一剂后睡眠和饮食恢复正常，仅背部僵硬疼痛，用八珍散大补汤调理而痊愈。另一位产妇全身及头颈部疼痛，恶寒且肢体拘急，脉象浮紧，这是风寒的证候。服用五积散一剂，出汗后痊愈。但随后出现倦怠和发热，这是邪气已去而真气虚弱所致，用八珍汤调补而康复。还有一位妇女在六月产后出汗较多，因疲倦不敢掀开被子，导致汗液浸渍被内，受冷后浸渍肌肤，引发风湿疼痛，于是服用羌活续断汤数剂而痊愈。
趁痛散（出自《云岐子脉诀》）：治疗产后气弱血滞引起的全身疼痛，以及身体发热、头痛。
药材组成：牛膝、当归、桂心、白术、黄芪、独活、生姜（各半两）；甘草、薤白（各二钱半）。
煎服方法：将药材切碎，每次取半两，加水一盏，煎至一盏半，滤去药渣，饭前温服。
陈无择评论说：趁痛散不仅治疗产后气弱血滞，还能治疗太阳经受风引起的头痛、腰背痛、自汗发热。如果是感受寒邪或伤食，或因忧恐惊怒导致的身疼发热头痛，况且还有蓐劳（产后虚损劳热），各种症状尤为严重，趁痛散都不能治愈。不如使用五积散加醋煎煮服用，这样更为妥当。
五积散加酒煎煮，治疗感受寒邪引起的头痛身疼，方剂见伤寒门。恐怕与四物汤各半合用更为稳妥。加入桃仁煎煮，治疗腰痛，驱逐败血，去除风湿。
【大】治疗产后全身青肿疼痛，以及多种杂病。
药材组成：牛膝、大麦（各等分）。
制作与服用方法：将药材研为细末，在新瓦罐中一层层填入大麦和牛膝，填满后用盐泥密封固定，用火煅烧至通红，放凉后研成散剂。凡是产后各种疾病，用热酒调服二钱。
[Da] What is the cause of generalized body pain after childbirth? The answer is: After childbirth, all joints and bones are relaxed and open, and blood vessels run diffusely. If Qi is deficient, blood tends to stagnate in the meridians and between muscle layers. If this stagnation persists for days without resolving, it leads to impaired joint mobility and tendon/meridian spasms and traction. Consequently, one cannot turn or bend the waist and back, cannot move the hands and feet freely, and experiences feverish sensation, headache, etc. If a physician mistakenly treats this as Taiyang disease (a syndrome caused by pathogenic factors affecting the Taiyang meridian) and uses sweating methods, it will cause sweating followed by twitching of tendons and muscles, and cold extremities, leading to other complications. In such cases, simply administering Chentong San (Urging Pain Powder) will resolve the condition.
[Xue] For the aforementioned symptoms, if pressing with the hand exacerbates the pain, it indicates Blood Stasis (stagnation of blood). Use Siwu Tang (Four Substances Decoction), Paojiang (Prepared Ginger), Honghua (Safflower), Taoren (Peach Kernel), and Zelan (Prunella Vulgaris Herb) to tonify and dissipate. If pressing causes only slight relief from pain, it indicates Blood Deficiency (deficiency of blood). Use Siwu Tang (Four Substances Decoction), Paojiang (Prepared Ginger), Renshen (Ginseng Root), and Baizhu (Atractylodes Macrocephala Rhizome) to tonify and nourish.
One postpartum woman suffered from abdominal and bodily pain, fever, anorexia, irritability, insomnia, night sweats, and hypochondriac pain. After taking dispersing and blood-removing herbs, she frequently experienced confusion and faintness. Her six pulses were surging yet empty upon deep pressure. She was treated with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Paojiang (Prepared Ginger) and Banxia (Pinellia Tuber). After one dose, symptoms improved by two or three parts; after another dose, her sleep and appetite returned to normal. However, she still had stiffness and pain in the back. She recovered after being regulated with Bazhen San Dabu Tang (Eight Treasures Great Tonifying Decoction).
Another postpartum woman suffered from generalized pain in the body, head, and neck, aversion to cold, and stiffness. Her pulse was floating and tight, indicating a Wind-Cold syndrome. One dose of Wuji San (Five Accumulations Powder) induced sweating and cured her. Subsequently, she felt fatigued and feverish, which indicated that the pathogenic factor had departed but the True Qi was deficient. She recovered after being regulated and tonified with Bazhen Tang (Eight Treasures Decoction).
A woman who gave birth in the sixth month sweated excessively. Due to fatigue, she dared not uncover herself, causing sweat to soak into the bedding. The cold moisture penetrated the skin, resulting in Wind-Dampness pain. She was cured after taking several doses of Qianghuo Xuduan Tang (Notopterygium and Dipsacus Decoction).
Chentong San (Urging Pain Powder) [from *Yunqi*]: Treats generalized body pain due to postpartum Qi deficiency and Blood stasis, as well as feverish sensation and headache.
Ingredients: Huainiu (Achyranthes Bidentata Root), Danggui (Angelica Sinensis Radix), Guixin (Cinnamon Twig), Baizhu (Atractylodes Macrocephala Rhizome), Huangqi (Astragalus Membranaceus Root), Duhuo (Angelica Pubescens Radix), Shengjiang (Fresh Ginger Rhizome) (each 0.5 liang); Gancao (Licorice Root), Xiebai (Allium Macrostemon Bulb) (each 2.5 qian).
Preparation and Administration: Coarsely crush the herbs. Take 0.5 liang per dose, add one cup of water, decoct until one and a half cups remain, strain, and take before meals.
Chen Wuyue commented: Chentong San not only treats postpartum Qi deficiency and Blood stasis but also treats headache, lower back pain, spontaneous sweating, and fever caused by Wind affecting the Taiyang Meridian. However, if the body pain, fever, and headache are caused by Cold invasion, food retention, or emotional disturbances like worry, fear, shock, or anger, especially when complicated by Chulao (postpartum consumptive disease), Chentong San is ineffective. It is better to use Wuji San (Five Accumulations Powder) decocted with vinegar.
Wuji San (Five Accumulations Powder) decocted with wine treats headache and body pain due to Cold invasion (see Shanghan Section). It may be safer to administer half of this formula together with Siwu Tang (Four Substances Decoction). Adding Taoren (Peach Kernel) treats lower back pain, expels retained blood, and dispels Wind-Dampness.
[Da] Treats generalized cyanotic swelling and pain after childbirth, as well as various diseases.
Ingredients: Huainiu (Achyranthes Bidentata Root), Damai (Hordeum Vulgare Grain) (equal parts).
Preparation and Administration: Grind into fine powder. Layer barley and Achyranthes root alternately in a new clay pot, filling it completely. Seal with salt mud, calcine over fire until red hot, cool down, and grind into powder. For any postpartum disorder, mix 2 qian with warm wine and ingest.
Huoxue Dan (Blood Invigorating Pill), Cangzhu Siwu Gemban Tang (Half Cangzhu Half Siwu Decoction) (both see General Diseases - Body Pain section).
Wujin San (Black Gold Powder): Treats bone and limb pain after childbirth (see later section on Delirium and Confusion).