产后心痛即胃脘痛。以胃脘在心之下，因伤寒气及冷物故作痛。用生化汤佐以散寒消食之品，无有不安。若腹
内痛，必血块未除，只服生化汤，佐以益母丸、鹿角炭治之，则瘀消而痛止。若风冷乘虚入腹伴痛，亦宜加味生
化汤，以方内有肉桂、吴萸，可以温散之也。若真心痛则指甲青黑，或手足冷过腕节，朝发夕死，无药可治。
加味生化汤
川芎（二钱） 当归（四钱） 炮姜 炙草（各五分） 桃仁（十粒，痛止去之）
肉桂（八分） 吴萸（七分） 姜（三片）
水煎服。伤米食，加神曲、麦芽各一钱。伤肉食，加砂仁七分，山楂肉五枚。
按∶产后胃气痛，必其人素有旧病，产后气血大亏，自然加甚。但症有九种，当辨气、血、寒、食、虫、痰、
积、虚、实，治宜加味理中汤为主。
加味理中汤
淡附子（二钱） 干姜（一钱） 茯苓（一钱） 人参（不拘） 炙草（七分） 焦术（二钱） 白蔻（二分）
肉桂心（一钱） 延胡索（醋炒一钱五分） 乳香（去净油一钱五分）
气痛，加广木香一钱，郁金酒炒一钱，良姜醋炒一钱，紫丁香十只。血痛，加五灵脂醋炒一钱五分，炮姜炭
七分代去干姜，蒲黄炒七分，归身酒炒二钱。寒痛，加吴萸一钱，小茴盐水炒一钱五分，芦盐水炒二钱，重用桂、
附。食痛，加焦神曲一钱五分，山楂砂糖炒二钱，鸡肫皮焙干二钱，广皮一钱，母丁香七分。虫痛，加川椒四十
粒，乌梅二个，吴茱萸川连一钱煮汁伴炒八分，榧子肉三钱。痰痛，加法夏二钱，草果煨一钱，沉香一钱，牡蛎
粉二钱，化橘红一钱。积痛，脾之积为痞气，加母丁香八分，陈香团二钱，佛手柑一钱，巴豆去油净取霜焙干三
分，再用湿腐乳皮包好，药汁送。但此味巴豆霜必积痞现而不化甚急，它药不效，始不得已，用之宜慎。虚痛，分
阴阳。阴虚，加熟地、姜汁、益智、砂仁，共十五粒，炒焦五钱，枸杞子酒炒，阿胶、蒲黄炒二钱，净萸肉酒炒
二钱，干姜代炮姜五分。阳虚，仍用原方增附子。实痛，去人参、焦术，加枳壳一钱，草蔻一钱，肉桂代桂枝八
分醋炒，甚者，加韭汁、制大黄三钱，用韭汁拌大黄九蒸九晒用。以上各症加减，必须认明证候施治为要。
产后心痛实际上就是胃脘痛。因为胃脘位于心脏下方，由于感受寒邪以及食用生冷食物导致疼痛。使用生化汤配合散寒消食的药物，没有不能安定的。如果腹部内疼痛，必定是血块未消除，只服用生化汤，配合益母丸、鹿角炭来治疗，那么瘀血消散而疼痛停止。如果风冷乘虚侵入腹部伴随疼痛，也适宜加味生化汤，因为方剂内有肉桂、吴茱萸，可以温散寒邪。如果是真心痛，则指甲青黑，或者手足冰冷超过腕关节，早晨发作晚上死亡，无药可治。
加味生化汤
川芎（二钱） 当归（四钱） 炮姜 炙甘草（各五分） 桃仁（十粒，疼痛停止后去掉）
肉桂（八分） 吴茱萸（七分） 生姜（三片）
水煎服。伤米食，加神曲、麦芽各一钱。伤肉食，加砂仁七分，山楂肉五枚。
按语：产后胃气痛，必定是患者素来有旧病，产后气血大亏，自然加重。但症状有九种，应当辨别气、血、寒、食、虫、痰、积、虚、实，治疗以加味理中汤为主。
加味理中汤
淡附子（二钱） 干姜（一钱） 茯苓（一钱） 人参（不拘数量） 炙甘草（七分） 焦白术（二钱） 白豆蔻（二分）
肉桂心（一钱） 延胡索（醋炒一钱五分） 乳香（去净油一钱五分）
气痛，加广木香一钱，郁金酒炒一钱，良姜醋炒一钱，紫丁香十只。血痛，加五灵脂醋炒一钱五分，炮姜炭七分代替干姜，蒲黄炒七分，当归身酒炒二钱。寒痛，加吴茱萸一钱，小茴香盐水炒一钱五分，芦根盐水炒二钱，重用肉桂、附子。食痛，加焦神曲一钱五分，山楂砂糖炒二钱，鸡肫皮焙干二钱，陈皮一钱，母丁香七分。虫痛，加川椒四十粒，乌梅二个，吴茱萸黄连一钱煮汁拌炒八分，榧子肉三钱。痰痛，加法半夏二钱，草果煨一钱，沉香一钱，牡蛎粉二钱，化橘红一钱。积痛，脾之积名为痞气，加母丁香八分，陈香团二钱，佛手柑一钱，巴豆去油净取霜焙干三分，再用湿腐乳皮包好，用药汁送服。但这味巴豆霜必须积痞显现且不化解非常紧急，其他药物无效，才不得已使用，使用时宜谨慎。虚痛，分阴阳。阴虚，加熟地黄、姜汁、益智仁、砂仁，共十五粒，炒焦五钱，枸杞子酒炒，阿胶、蒲黄炒二钱，山茱萸肉酒炒二钱，干姜代替炮姜五分。阳虚，仍用原方增加附子。实痛，去掉人参、焦白术，加枳壳一钱，草豆蔻一钱，肉桂代替桂枝八分醋炒，严重的，加韭汁、制大黄三钱，用韭汁拌大黄九蒸九晒使用。以上各种症状加减，必须认清证候施治为关键。
Postpartum heart pain is actually epigastric pain. Since the epigastrium is located below the heart, pain occurs due to invasion of cold pathogenic factors and consumption of cold foods. Using Shenghua Tang (Decoction for Generating Blood) combined with herbs that dispel cold and promote digestion will ensure recovery. If there is pain inside the abdomen, it must be due to retained blood stasis; taking only Shenghua Tang (Decoction for Generating Blood) supplemented with Yimu Wan (Motherwort Pill) and Cervus Cornu Carbonis (Charred Deer Horn) will resolve the stasis and stop the pain. If wind-cold invades the abdomen due to deficiency causing pain, Jiawei Shenghua Tang (Modified Decoction for Generating Blood) is also appropriate, as the formula contains Rou Gui (Cinnamon Bark) and Wu Zhu Yu (Evodia Fruit), which can warm and disperse cold. If it is Zhenxin Tong (True Heart Pain), the fingernails turn cyanotic and black, or the hands and feet become cold extending beyond the wrist joints; if it appears in the morning, death occurs by evening, and there is no cure.
Jiawei Shenghua Tang (Modified Decoction for Generating Blood)
Chuan Xiong (Ligusticum Chuanxiong Rhizome) (2 qian)
Dang Gui (Angelica Sinensis Radix) (4 qian)
Pao Jiang (Prepared Ginger)
Zhi Cao (Honey-fried Licorice Root) (each 5 fen)
Tao Ren (Prunus Persica Seed) (10 grains, remove when pain stops)
Rou Gui (Cinnamomi Cortex) (8 fen)
Wu Zhu Yu (Euodiae Fructus) (7 fen)
Sheng Jiang (Fresh Ginger Rhizome) (3 slices)
Decoct in water and take orally. For rice food stagnation, add Shen Qu (Medicated Leaven) and Mai Ya (Hordei Fructus Germinatus) each 1 qian. For meat food stagnation, add Sha Ren (Amomi Fructus) 7 fen and Shan Zha Rou (Crataegi Fructus) 5 pieces.
Note: Postpartum stomach qi pain implies the patient has a pre-existing condition; postpartum severe depletion of qi and blood naturally exacerbates it. However, there are nine types of symptoms, requiring differentiation into qi, blood, cold, food, parasites, phlegm, accumulation, deficiency, and excess. Treatment should primarily focus on Jiawei Lizhong Tang (Modified Decoction for Regulating the Middle).
Jiawei Lizhong Tang (Modified Decoction for Regulating the Middle)
Dan Fu Zi (Prepared Aconite Lateralis Radix) (2 qian)
Gan Jiang (Dried Ginger Rhizome) (1 qian)
Fu Ling (Poria) (1 qian)
Ren Shen (Ginseng Radix et Rhizoma) (as needed)
Zhi Cao (Honey-fried Licorice Root) (7 fen)
Jiao Bai Zhu (Charred Atractylodis Macrocephalae Rhizoma) (2 qian)
Bai Kou (Amomi Fructus Rotundus) (2 fen)
Rou Gui Xin (Inner Bark of Cinnamon Twig) (1 qian)
Yan Hu Suo (Corydalis Rhizoma, stir-fried with vinegar) (1.5 qian)
Ru Xiang (Olibanum, free from oil) (1.5 qian)
For qi pain, add Guang Mu Xiang (Aucklandiae Radix) 1 qian, Yu Jin (Curcumae Radix, wine-fried) 1 qian, Liang Jiang (Alpiniae Officinarum Rhizoma, vinegar-fried) 1 qian, and Zi Ding Xiang (Caryophylli Flos) 10 pieces. For blood pain, add Wu Ling Zhi (Trogopterori Faeces, vinegar-fried) 1.5 qian, Pao Jiang Tan (Charred Prepared Ginger) 7 fen replacing Gan Jiang, Pu Huang (Typhae Pollen, stir-fried) 7 fen, and Dang Gui Shen (Angelica Sinensis Radix, wine-fried) 2 qian. For cold pain, add Wu Zhu Yu (Euodiae Fructus) 1 qian, Xiao Hui Xiang (Foeniculi Fructus, salt-water fried) 1.5 qian, Lu Gen (Phragmitis Rhizoma, salt-water fried) 2 qian, and heavily use Rou Gui (Cinnamomi Cortex) and Fu Zi (Aconiti Lateralis Radix Praeparata). For food pain, add Jiao Shen Qu (Charred Medicated Leaven) 1.5 qian, Shan Zha (Crataegi Fructus, fried with brown sugar) 2 qian, Ji Jun Pi (Galli Gigerii Endothelium Corneum, roasted dry) 2 qian, Chen Pi (Citri Reticulatae Pericarpium) 1 qian, and Mu Ding Xiang (Caryophylli Flos) 7 fen. For parasite pain, add Chuan Jiao (Sichuan Pepper) 40 grains, Wu Mei (Mume Fructus) 2 pieces, Wu Zhu Yu (Euodiae Fructus) and Huang Lian (Coptidis Rhizoma) 1 qian boiled in water to stir-fry Ba Fen (8 fen), and Fei Zi Rou (Torreya Nucifera Seed) 3 qian. For phlegm pain, add Fa Xia (Pinelliae Rhizoma Preparatum) 2 qian, Cao Guo (Tsaoko Fructus, baked) 1 qian, Chen Xiang (Aquilariae Lignum Resinatum) 1 qian, Mu Li Fen (Concha Ostreae Powder) 2 qian, and Hua Ju Hong (Exocarpium Citri Grandis) 1 qian. For accumulation pain, where spleen accumulation is called Pi Qi (Stagnation), add Mu Ding Xiang (Caryophylli Flos) 8 fen, Chen Xiang Tuan (Agarwood) 2 qian, Fo Shou Gan (Citri Sarcodactylis Fructus) 1 qian, and Ba Dou (Crotonis Fructus, oil removed, frost obtained, roasted dry) 3 fen. Wrap this well with wet fermented bean curd skin and administer with herbal decoction. This Ba Dou Frost (Crotonis Fructus Frost) should only be used reluctantly when accumulation stagnation manifests and does not resolve urgently, and other medicines fail; use with caution. For deficiency pain, differentiate yin and yang. For yin deficiency, add Shu Di Huang (Rehmanniae Radix Preparata), Jiang Zhi (Ginger Juice), Yi Zhi Ren (Alpiniae Oxyphyllae Fructus), and Sha Ren (Amomi Fructus), totaling 15 grains, charred 5 qian, Gou Qi Zi (Lycii Fructus, wine-fried), E Jiao (Colla Corii Asini), and Pu Huang (Typhae Pollen, stir-fried) 2 qian, Yu Rou (Corni Fructus, wine-fried) 2 qian, Gan Jiang (Dried Ginger Rhizome) 5 fen replacing Pao Jiang. For yang deficiency, still use the original formula adding Fu Zi (Aconiti Lateralis Radix Praeparata). For excess pain, remove Ren Shen (Ginseng Radix et Rhizoma) and Jiao Bai Zhu (Charred Atractylodis Macrocephalae Rhizoma), add Zhi Ke (Aurantii Fructus) 1 qian, Cao Kou (Alpiniae Katsumadai Semen) 1 qian, Rou Gui (Cinnamomi Cortex) replacing Gui Zhi (Cinnamomi Ramulus) 8 fen vinegar-fried. In severe cases, add Jiu Zhi (Allium Tuberosum Juice) and Zhi Da Huang (Rhei Radix et Rhizoma Preparata) 3 qian, using Da Huang (Rhei Radix et Rhizoma) mixed with Jiu Zhi (Allium Tuberosum Juice), steamed and sun-dried nine times. For modifications of the above various symptoms, it is essential to clearly identify the syndrome pattern before treatment.