（附论）
夫产后心痛者。盖心者。血之主。人有伏冷宿寒。因产脏虚。遇风寒客之。与血气相搏。
血
经络通。心痛自止。若误以为有所伤治之。则虚极寒益甚矣。心痛乍歇乍甚。心之支别络为
邪所伤也。若邪伤心之正经。心络寒甚。则变为真心痛。朝发夕死。夕发朝死。所以然者。
心为诸脏之主。不受邪伤。邪伤即死。药不可轻用也。
方
大岩蜜汤 治产后心痛气虚。宿冷搏血。上冲心络。非真心痛也。
生干地黄（一作熟） 当归 独活 吴茱萸 芍药 干药 甘草 桂心（胡洽不用桂心
独活甘
为散。每服半
评曰。产后心痛。虽非产蓐常病。庸或有之。久痛未必便是血痛。设是。岩蜜汤岂可用
熟地
姜三两。细辛治停寒在下焦。方本一两。却减作半两。制奇制偶。量病浅深。自有品数。不
可妄意加减。然以岩蜜汤治血痛。不若失笑散用之有效。一方无甘草。蜜。
蜀椒汤 疗产后心痛。此大寒所为。
蜀椒（二两） 芍药（三两） 半夏 当归 桂心 人参 茯苓（各三两） 甘草（一
分炙微赤炒）
二升半。去滓。下
熟干地黄散 治产后血气上攻心痛。四肢厥冷。不纳饮食。
熟干地黄（一两） 当归（三分锉赤炙） 白术（半两） 甘草（一分炙微赤锉） 桂
心赤芍药
每服三钱。水
青橘皮散 治产后血气攻心痛。
青橘皮（汤浸去瓤焙干三分锉） 木香 蓬莪术 乌药（各三分） 干姜（半两炮裂锉）
桂心
以热酒调
当归散 治产后血刺连心疼痛。
当归（一两锉微炒） 胡椒（一分） 蓬莪术 木香（各半两） 白术（三分） 上为
细散。不计时
芎 散 治产后血气与冷气相搏。上攻心痛。
芎 桂心 木香 当归（锉微炒） 桃仁（汤浸去皮尖双仁炒微黄各半两） 上捣
细罗为
桂心散 治产后血气冲心疼痛。
桂心 芫花 木香（各一两） 香墨（二挺） 上为末。以酸醋二升。先煎芫花为膏。
次入木香
吴茱萸散 治产后血气冲心。闷绝疼痛。
吴茱萸（汤浸七遍干微炒） 丁香 当归（锉微炒各半两） 熟干地黄（一两） 上捣
细为散。不
芸苔子散 治产后血气冲心痛。
芸苔（微炒） 当归（锉微炒各一两） 上捣细罗为散。不计时候。以热酒调下一钱。
治产后心疼。
又方
烧称锤投酒中服之佳。
又方
烧大豆投酒中服佳。
桂心酒 治产后疹痛及猝心痛。
用桂心三两。以酒三升。煮取二升。去滓。分三服。日三。
治产后余疹刺痛。三十六候。
以铜镜鼻七枚。投醋中。熬过。呷之。亦可入当归、芍药服之。
治产后急心疼欲死。大腑热时。根据此方吃。大腑虚冷。请减半夏、牵牛二味。
延胡索（一两） 芎 当归 芍药 蓬莪术 木香 吴茱萸 官桂（去皮） 牛膝 牵
牛（
治产后血刺心痛欲死。
用 猪汤取一盏温服之。
治产后血攻胸胁刺痛。
以蓼蒿煮服之。
（附论）
产后心痛，是因为心主血脉。人体内有潜伏的寒冷和积久的寒气，因为分娩后脏腑虚弱，遭遇风寒侵袭，与气血相互搏结。
经络通畅，心痛自然停止。如果错误地认为是有形之邪损伤而进行治疗，那么正气极度虚弱，寒气会更加严重。
心痛时好时坏，是因为心的分支络脉被邪气所伤。如果邪气伤害了心的正经，心络寒气极重，就会转变为真心痛。早上发作晚上死亡，晚上发作早上死亡。之所以这样，是因为心是五脏的主宰，不受邪气伤害，一旦受邪即死，药物不可轻易使用。
方剂
大岩蜜汤：治疗产后心痛、气虚、宿冷搏结血液，上冲心络。这不是真心痛。
生干地黄（一作熟地黄）、当归、独活、吴茱萸、芍药、干姜、甘草、桂心。（胡洽方不用桂心，将独活、甘草研为散，每次服用半两。）
评述说：产后心痛，虽然不是产褥期的常见病，但偶尔也会有。久痛未必就是血痛。假设是血痛，大岩蜜汤难道可以使用吗？熟地黄、生姜三两。细辛用于治疗下焦停寒。原方中一两，却减少为半两。这是制奇制偶的方法，根据病情的深浅，自有定数，不可随意加减。然而用大岩蜜汤治疗血痛，不如失笑散使用有效。另一版本没有甘草和蜜。
蜀椒汤：治疗产后心痛。这是由大寒引起的。
蜀椒（二两）、芍药（三两）、半夏、当归、桂心、人参、茯苓（各三两）、甘草（一分，炙至微红炒）。
（煎煮方法略，去滓，下……）
熟干地黄散：治疗产后血气上攻导致的心痛，四肢厥冷，不能进食。
熟干地黄（一两）、当归（三分，锉碎，赤芍药，炙）、白术（半两）、甘草（一分，炙至微红，锉碎）、桂心。
（煎煮方法略，每服三钱，水……）
青橘皮散：治疗产后血气攻冲导致的心痛。
青橘皮（汤浸去瓤焙干三分，锉碎）、木香、蓬莪术、乌药（各三分）、干姜（半两，炮裂，锉碎）、桂心。
（以热酒调服……）
当归散：治疗产后血刺连心疼痛。
当归（一两，锉碎，微炒）、胡椒（一分）、蓬莪术、木香（各半两）、白术（三分）。上药为细散，不计时令……
芎䓖散：治疗产后血气与冷气相搏，上攻心痛。
芎䓖、桂心、木香、当归（锉碎，微炒）、桃仁（汤浸去皮尖双仁，炒微黄，各半两）。上药捣细罗为散……
桂心散：治疗产后血气冲心疼痛。
桂心、芫花、木香（各一两）、香墨（二挺）。上药为末，以酸醋二升，先煎芫花为膏，次入木香……
吴茱萸散：治疗产后血气冲心，闷绝疼痛。
吴茱萸（汤浸七遍，干，微炒）、丁香、当归（锉碎，微炒，各半两）、熟干地黄（一两）。上药捣细为散，不计……
芸苔子散：治疗产后血气冲心痛。
芸苔（微炒）、当归（锉碎，微炒，各一两）。上药捣细罗为散，不计时候，以热酒调下一钱。
治产后心疼。
又一方：烧称锤投入酒中服用佳。
又一方：烧大豆投入酒中服用佳。
桂心酒：治疗产后疹痛及猝然心痛。
用桂心三两，以酒三升，煮取二升，去滓，分三次服，日三服。
治产后余疹刺痛，三十六候。
以铜镜鼻七枚，投入醋中，熬过，呷之。也可加入当归、芍药服用。
治产后急心疼欲死，大腑热时，根据此方吃。大腑虚冷，请减半夏、牵牛二味。
延胡索（一两）、芎䓖、当归、芍药、蓬莪术、木香、吴茱萸、官桂（去皮）、牛膝、牵牛（……）
治产后血刺心痛欲死。
用猪汤取一盏温服之。
(Attached Discussion)
Postpartum heart pain occurs because the Heart governs blood vessels. When latent cold and accumulated chill reside within the body, and due to the deficiency of the Zang-Fu organs after childbirth, wind-cold pathogens invade and contend with Qi and Blood.
When the meridians and collaterals are unobstructed, heart pain ceases naturally. If mistakenly treated as an injury by a tangible pathogen, the deficiency becomes extreme, and the cold intensifies further.
Heart pain that comes and goes is caused by evil affecting the branch collaterals of the Heart. If the evil damages the main meridians of the Heart, and the cold in the Heart collaterals is severe, it transforms into *Zhen Xin Tong* (True Heart Pain). Death may occur from morning to evening or from evening to morning. This is because the Heart is the master of all Zang-Fu organs and does not accept evil damage; once damaged, death ensues. Medicines should not be used lightly.
Formulas
**Da Yan Mi Tang** (Great Rock Honey Decoction): Treats postpartum heart pain, Qi deficiency, and old cold contending with blood, rushing up to the Heart collaterals. This is not *Zhen Xin Tong*.
Sheng Gan Di Huang (Raw Dried Rehmanniae Radix, alternatively Shu Di Huang), Dang Gui (Angelicae Sinensis Radix), Du Huo (Angelicae Pubescentis Radix), Wu Zhu Yu (Evodiae Fructus), Shao Yao (Paeoniae Radix), Gan Jiang (Zingiberis Rhizoma), Gan Cao (Glycyrrhizae Radix et Rhizoma), Gui Xin (Cinnamomi Cortex). (Hu Qia's formula excludes Gui Xin; Du Huo and Gan Cao are ground into powder, half liang taken per dose.)
Comment: Postpartum heart pain, while not a common disease of the lying-in period, does occasionally occur. Long-standing pain is not necessarily blood stasis pain. Even if it were blood stasis pain, could Da Yan Mi Tang be used? Shu Di Huang (Prepared Rehmanniae Radix), Sheng Jiang (Zingiberis Rhizoma Recens) three liang. Xi Xin (Asari Radix et Rhizoma) treats retained cold in the Lower Jiao. The original formula uses one liang, but reduces it to half liang. This follows the principles of odd and even formulations, measured by the depth of the disease, with fixed proportions; arbitrary additions or subtractions are inadvisable. However, for treating blood stasis pain with Da Yan Mi Tang, Shi Xiao San (Laughing Powder) is more effective. Another version lacks Gan Cao and honey.
**Shu Jiao Tang** (Sichuan Pepper Decoction): Treats postpartum heart pain caused by severe cold.
Shu Jiao (Sichuan Peppercorn), Shao Yao, Ban Xia (Pinelliae Rhizoma), Dang Gui, Gui Xin, Ren Shen (Ginseng Radix), Fu Ling (Poria), Gan Cao (one fen, roasted until slightly red).
**Shu Gan Di Huang San** (Prepared Dried Rehmannia Powder): Treats postpartum blood and Qi attacking upward causing heart pain, cold limbs, and inability to take food.
Shu Gan Di Huang, Dang Gui (three fen, crushed, Chi Shao Yao [Red Paeoniae Radix], roasted), Bai Zhu (Atractylodis Macrocephalae Rhizoma, half liang), Gan Cao (one fen, roasted until slightly red, crushed), Gui Xin.
**Qing Ju Pi San** (Green Tangerine Peel Powder): Treats postpartum blood and Qi attacking causing heart pain.
Qing Ju Pi (Green Tangerine Peel, soaked in hot water, pith removed, dried, three fen, crushed), Mu Xiang (Aucklandiae Radix), Peng E Zhu (Curcumae Phaeocaulis Rhizoma), Wu Yao (Linderae Radix) (each three fen), Gan Jiang (half liang, processed until cracked, crushed), Gui Xin.
(Mixed with hot wine for administration.)
**Dang Gui San** (Angelica Powder): Treats postpartum stabbing pain piercing through to the Heart.
Dang Gui (one liang, crushed, slightly stir-fried), Hu Jiao (Pepper, one fen), Peng E Zhu, Mu Xiang (each half liang), Bai Zhu (three fen). Ground into fine powder, taken at any time.
**Xiong Gui San** (Kwan-Hsiung and Cinnamon Powder): Treats postpartum blood and Qi contending with cold qi, attacking upward causing heart pain.
Xiong Gui (Ligusticum Chuanxiong Rhizoma), Gui Xin, Mu Xiang, Dang Gui (crushed, slightly stir-fried), Tao Ren (Persicae Semen, soaked in hot water, skin and pointed ends removed, double-kernel, stir-fried until slightly yellow, each half liang). Ground into fine mesh powder.
**Gui Xin San** (Cinnamon Heart Powder): Treats postpartum blood and Qi rushing to the Heart causing pain.
Gui Xin, Yuan Hua (Genkwa Flos), Mu Xiang (each one liang), Xiang Mo (Ink Stick, two tings). Ground into powder. With two sheng of sour vinegar, first decoct Yuan Hua into a paste, then add Mu Xiang.
**Wu Zhu Yu San** (Evodia Powder): Treats postpartum blood and Qi rushing to the Heart, causing suffocation and severe pain.
Wu Zhu Yu (soaked in hot water seven times, dried, slightly stir-fried), Ding Xiang (Caryophylli Flos), Dang Gui (crushed, slightly stir-fried, each half liang), Shu Gan Di Huang (one liang). Ground into fine powder.
**Yun Tai Zi San** (Rapeseed Seed Powder): Treats postpartum blood and Qi rushing to cause heart pain.
Yun Tai (Brassica Napus Seed, slightly stir-fried), Dang Gui (crushed, slightly stir-fried, each one liang). Ground into fine mesh powder. Taken at any time, one qian mixed with hot wine.
Treating postpartum heart ache.
Another prescription: Burn a weight hammer, throw it into wine, and drink. It is beneficial.
Another prescription: Burn soybeans, throw them into wine, and drink. It is beneficial.
**Gui Xin Jiu** (Cinnamon Wine): Treats postpartum rash pain and sudden heart pain.
Use three liang of Gui Xin, boil in three sheng of wine until two sheng remain. Remove dregs. Divide into three doses, taken three times daily.
Treating postpartum residual rash stabbing pain and thirty-six conditions.
Take seven copper mirror noses, put them in vinegar, roast/boil, and sip. Can also be taken with Dang Gui and Shao Yao.
Treating acute postpartum heart pain nearly causing death. When the large bowels are hot, follow this prescription. If the large bowels are deficient and cold, reduce the dosage of Ban Xia and Qian Niu by half.
Yan Hu Suo (Corydalis Rhizoma, one liang), Xiong Gui, Dang Gui, Shao Yao, Peng E Zhu, Mu Xiang, Wu Zhu Yu, Guan Gui (Cinnamon Bark, peeled), Niu Xi (Achyranthis Bidentatae Radix), Qian Niu (Pharbitidis Semen)...
Treating postpartum blood stabbing heart pain nearly causing death.
Use pig stomach soup, take one wan cup warm.
Treating postpartum blood attacking chest and hypochondrium causing stabbing pain.
Decoct Liao Hao (Polygoni Multiflori Vine or similar herb) and drink.