产后心痛，即胃脘痛。以胃脘在心之下，因伤寒气及伤冷物而作痛。因痛近于心，俗呼
为心
痛。殊不知心为君主之官，生血行气，统驭五脏六腑。血气盛，则泰然安宁；血气不足，怔
忡惊悸不安，心岂可痛哉?若真心痛，手足指甲见青黑色，旦发夕死，夕发旦死，昔人论之
详矣。治法当散胃中之寒气，消胃中之冷物，必用生化汤中加散寒消食之佐，无有不安。若
绵绵痛，可按而止，又问无血块了，则当虚论而加补也。其产后心痛腹痛，二症相同，因寒
食上攻于心，则心痛，下攻于腹，则腹痛。此二症治法亦大约略同，俱宜用生化汤，加肉桂
、吴茱萸等热药，温散之也。
加味生化汤
川芎（二钱） 当归（三钱） 干姜（五分） 肉桂（八分） 甘草（五分） 吴茱萸（七分）
三帖后，去茱萸。伤寒物，加茱萸、桂枝。伤肉食，加砂仁、山楂。伤饭面加神曲、麦
芽。大便不通，加肉苁蓉二钱。
产后腹痛，先问血块有无。有血块痛，只服生化汤，调一笑散、鹿角灰散，块消，痛自
止矣。若风冷，乘虚入腹作痛，宜服加味生化汤治之。
加味生化汤
川芎（二钱） 当归（四钱） 炮姜（四分） 炙甘（四分） 桃仁（十粒） 桂枝（一钱五分）
痛止即减，不止再加。伤面食，加神曲一钱，麦芽一钱（炒）。伤肉，加山楂五粒，砂
仁七分。如血块未消而痛，加一笑散二钱，酒炒元胡二钱，共为末。（一笑散即失笑散。）
产后心痛，实际上就是胃脘痛。因为胃脘位于心脏下方，由于感受寒邪或食用生冷食物而引发疼痛。因为疼痛部位靠近心脏，民间俗称为“心痛”。殊不知心是君主之官，负责生成血液、运行气机，统摄五脏六腑。如果气血旺盛，身体就会安然宁静；如果气血不足，出现怔忡（心跳剧烈、心神不宁）、惊悸不安等症状，心脏本身怎么会疼痛呢？如果是真正的真心痛，手足指甲会出现青黑色，早上发病晚上死亡，晚上发病早上死亡，前人对此论述得非常详细了。治疗方法应当疏散胃中的寒气，消除胃中的冷积食物，必须在使用生化汤的基础上，加入散寒消食的辅助药物，没有不能安愈的。如果是绵绵不断的隐痛，按压可以缓解，又询问没有血块，则应当从虚证论治并加以补益。其产后心痛和腹痛，这两种症状相同，都是因为寒食上攻于心，就会导致心痛；下攻于腹，就会导致腹痛。这两种症状的治疗方法也大致相似，都适宜使用生化汤，加入肉桂、吴茱萸等热性药物，以温通发散。
加味生化汤
川芎（二钱） 当归（三钱） 干姜（五分） 肉桂（八分） 甘草（五分） 吴茱萸（七分）
服用三帖后，去掉吴茱萸。如果是伤寒饮食所致，加入吴茱萸、桂枝。如果是伤肉食，加入砂仁、山楂。如果是伤饭面，加入神曲、麦芽。如果大便不通，加入肉苁蓉二钱。
产后腹痛，首先要询问是否有血块。如果有血块引起的疼痛，只服用生化汤，配合调服一笑散、鹿角灰散，待血块消散，疼痛自然停止。如果是风冷之邪，乘虚侵入腹部导致疼痛，适宜服用加味生化汤治疗。
加味生化汤
川芎（二钱） 当归（四钱） 炮姜（四分） 炙甘草（四分） 桃仁（十粒） 桂枝（一钱五分）
疼痛停止即减少药量，若不停止再加量。如果是伤面食，加入神曲一钱，麦芽一钱（炒制）。如果是伤肉食，加入山楂五粒，砂仁七分。如果血块未消且仍有疼痛，加入一笑散二钱，酒炒延胡索二钱，共同研为细末。（一笑散即失笑散。）
Postpartum heart pain is actually epigastric pain. Since the epigastrium is located below the heart, pain arises due to invasion of cold pathogenic factors or consumption of cold substances. Because the pain is near the heart, it is colloquially called "heart pain." However, one must not forget that the Heart is the sovereign official, responsible for generating blood and circulating Qi, commanding the five zang organs and six fu organs. When blood and Qi are abundant, the body remains tranquil and peaceful; when blood and Qi are deficient, palpitations (intense heartbeat with mental restlessness) and fright-panic occur. How could the Heart itself be in pain? If it were true heart pain, the fingernails and toenails would turn blue-black, with death occurring from morning to evening or from evening to morning, as previously discussed in detail by ancient scholars. The treatment method should involve dispersing cold qi in the stomach and eliminating cold food stagnation in the stomach. It is essential to use Shenghua Tang (Decoction for Generating New Blood) supplemented with herbs that disperse cold and aid digestion, ensuring recovery. If the pain is continuous and dull, relieved by pressure, and there are no blood clots, it should be treated as a deficiency syndrome and supplemented accordingly. Postpartum heart pain and abdominal pain share the same etiology: if cold food attacks upward to the heart, it causes heart pain; if it attacks downward to the abdomen, it causes abdominal pain. The treatment methods for these two conditions are also roughly similar, both suitable for using Shenghua Tang (Decoction for Generating New Blood) added with hot-natured herbs such as Rougui (Cortex Cinnamomi) and Wuzhuyu (Fructus Evodiae) to warm and disperse.
Modified Shenghua Tang (Decoction for Generating New Blood)
Chuanxiong Rhizoma (2 qian) Danggui Radix (3 qian) Ganjiang Rhizoma Zingiberis (0.5 fen) Rougui Cortex Cinnamomi (0.8 fen) Glycyrrhizae Radix et Rhizoma (0.5 fen) Wuzhuyu Fructus Evodiae (0.7 fen)
After three doses, remove Wuzhuyu. For injury by cold-dietary factors, add Wuzhuyu and Guizhi Ramulus Cinnamomi. For injury by meat, add Shaoren Fructus Amomi and Shanzha Fructus Crataegi. For injury by rice and wheat products, add Shenqu Massas Fermentata and Maiya Fructus Hordei Germinatus. For constipation, add Rongzong Herba Cistanches (2 qian).
For postpartum abdominal pain, first inquire whether blood clots are present. If pain is caused by blood clots, administer only Shenghua Tang (Decoction for Generating New Blood), mixed with Xiaoyao San (Powder for Joyful Dispersal) and Lujiaohui Pulvis Cornus Cervi Corneum. Once the clots dissipate, the pain will cease. If wind-cold invades the abdomen due to deficiency causing pain, Modified Shenghua Tang (Decoction for Generating New Blood) is appropriate.
Modified Shenghua Tang (Decoction for Generating New Blood)
Chuanxiong Rhizoma (2 qian) Danggui Radix (4 qian) Paojiang Rhizoma Zingiberis Preparatum (0.4 fen) Zhigancao Radix et Rhizoma Glycyrrhizae Preparata (0.4 fen) Taoren Semen Pruni (10 grains) Guizhi Ramulus Cinnamomi (1.5 qian)
Reduce dosage once pain stops; increase if pain persists. For injury by flour-based foods, add Shenqu Massas Fermentata (1 qian) and Maiya Fructus Hordei Germinatus (1 qian, stir-fried). For injury by meat, add Shanzha Fructus Crataegi (5 grains) and Shaoren Fructus Amomi (0.7 fen). If blood clots remain unresolved and pain persists, add Xiaoyao San (Powder for Joyful Dispersal) (2 qian) and Yuanhu Rhizoma Corydalis Praeparata cum Vino (2 qian), ground together into powder. (Xiaoyao San is identical to Shixiao San.)