产后心痛，为阴血亏损，随火上冲心络，名曰心包络痛，宜归脾汤主之。若寒伤心经，名曰真心痛，则无药可救矣。
凡产后寒气上攻则心痛，下攻则腹痛，兼血块者，宜服生化汤加桂。若独用热药攻寒，其痛虽止而血妄行，反虚产母。
况寒者必挟虚而燥；热者必佐阴药，方能制其僭越也。
产后恶血，或因外感六淫，内伤七情，致令斩然而止，瘀血壅滞，所下不尽，故令腹痛，当审因治也。如产妇期数
内，或饮食如常，忽作腹痛，六脉沉伏，四肢厥冷，此恶血不尽，伤食裹血而脉不起也，不可误认为气血两虚，而用大
补，须兼消导行血之药。
《要略》曰∶产后腹中 痛，当归生姜羊肉汤主之。病痛者，缓缓痛也，属客寒相阻。故以当归通血分之滞，生姜
行气分之寒。君以羊肉者，所谓形不足补以味，况羊肉又能补气， 痛属气弱，故宜之。
寇氏曰∶妇人产当寒月，寒气入产门，脐下胀满，手不得犯，此寒疝也，宜仲景羊肉汤。或产后脐腹忽痛，乃呼吸
之间冷风乘虚而入，宜当归建中汤、四顺理中汤。
产后腹痛，恶露既去而仍痛，四神调补之，不应八珍汤。若痛而恶心，或欲作呕，六君子汤；若痛而泄泻，六君子
汤送四神丸；若胸膈饱闷，或恶食吞酸，或腹痛手不可按，此是饮食所伤，用二陈加白术、山楂，消导之；若食既消而
仍痛，按之不痛，更加头痛，烦热作渴，恶寒欲呕等症，此是中气被伤，宜温补脾胃为主；若发热腹痛，按之痛甚，不
恶食吞酸，此是瘀血停滞，失笑散消之；若只发热，头痛，腹痛，按之却不痛，此是血虚，用四物加炮姜、参、术，以
补之。
产后出现心痛，是由于阴血亏损，虚火随气上冲至心包络所致，这种症状称为“心包络痛”，适宜使用归脾汤治疗。如果是寒邪损伤了心经，则称为“真心痛”，这种情况通常无药可救。
凡是产后寒气上攻会导致心痛，下攻会导致腹痛；如果兼有血块，适宜服用生化汤并加入桂枝。如果单纯使用热性药物来驱寒，虽然疼痛可能停止，但会导致血液妄行，反而使产妇更加虚弱。
况且寒证必然夹杂虚证且伴有燥象；热证必须配合滋阴药物，才能制约其亢盛之势。
产后恶露不尽（恶血），可能是因为外感六淫邪气或内伤七情，导致恶露突然中断，瘀血壅滞，排出不尽，从而引起腹痛，应当审察病因进行治疗。例如产妇在产期之内，饮食如常，却突然发生腹痛，脉象沉伏，四肢厥冷，这是恶血未尽、食积裹挟瘀血导致脉气不起的表现，不可误认为是气血两虚而使用大补之剂，必须兼用消食导滞和活血的药物。
《金匮要略》中说：产后腹中疼痛，适用当归生姜羊肉汤治疗。“㽲痛”是指缓慢持续的疼痛，属于客寒阻滞所致。因此用当归来疏通血分的瘀滞，用生姜来行散气分的寒邪。以羊肉为君药，是因为“形不足者，温之以气；精不足者，补之以味”，况且羊肉又能补气，腹痛多属气弱，所以适宜使用。
寇氏说：妇女如果在寒冷月份生产，寒气侵入产门，导致脐下胀满，手不能触碰，这是寒疝病，适宜使用张仲景的羊肉汤。或者产后脐腹部突然疼痛，是呼吸之间冷风乘虚而入所致，适宜使用当归建中汤或四顺理中汤。
产后腹痛，如果恶露已经排净但仍然疼痛，先用四神丸调理补益；若无效，再用八珍汤。如果腹痛伴有恶心，或有呕吐倾向，使用六君子汤；如果腹痛伴有泄泻，用六君子汤送服四神丸；如果胸膈部饱闷，或厌恶食物、吞酸，或腹痛且手不可按压，这是饮食所伤，使用二陈汤加白术、山楂，以消食导滞；如果食积已消但疼痛仍在，按压时不痛，且伴有头痛、烦热口渴、恶寒欲呕等症状，这是中气受损，应以温补脾胃为主；如果发热且腹痛，按压时疼痛加剧，且不厌恶食物、不吞酸，这是瘀血停滞，使用失笑散消散瘀血；如果只是发热、头痛、腹痛，但按压时不痛，这是血虚，使用四物汤加炮姜、人参、白术，以补益气血。
Postpartum heart pain is caused by the deficiency of Yin and blood, with deficient fire rising along with Qi to attack the Pericardium Collateral (Xinbaoluo). This condition is named "Pericardium Collateral Pain" (Xinbaoluo Tong) and should be treated primarily with Guipi Tang (Restore the Spleen Decoction). If Cold pathogen damages the Heart Meridian, it is called "True Heart Pain" (Zhenxintong), for which there is no curable medicine.
Generally, if Cold pathogen attacks upward after childbirth, it causes heart pain; if it attacks downward, it causes abdominal pain. If accompanied by blood clots, Shenghua Tang (Generate New Blood Decoction) added with Guizhi (Cinnamon Twig) is appropriate. If only hot-natured drugs are used to attack Cold, although the pain may cease, it will cause blood to move recklessly, further weakening the postpartum mother.
Moreover, Cold conditions must be accompanied by deficiency and dryness; Heat conditions must be assisted by Yin-nourishing herbs to control their hyperactivity.
Postpartum lochia retention (E xue) may occur due to external contraction of the Six Excesses or internal injury from the Seven Emotions, causing sudden cessation of discharge. Stagnant blood accumulates, leading to incomplete expulsion and thus abdominal pain. The etiology must be examined for treatment. For instance, if a puerpera within the confinement period has normal diet but suddenly suffers abdominal pain, with deep and hidden pulses and cold extremities, this indicates retained lochia and food stagnation entangling blood, preventing pulse manifestation. It should not be mistaken for dual deficiency of Qi and Blood requiring strong tonification; instead, herbs for resolving stagnation and promoting blood circulation should be combined.
The *Jingui Yaolue* states: For postpartum abdominal pain, Danggui Shengyang Roushou Tang (Angelica Sinensis, Ginger, and Mutton Decoction) is indicated. "Yutong" refers to lingering, slow pain, belonging to obstruction by exogenous Cold. Therefore, Danggui (Dongquai Root) is used to unblock stagnation in the Blood aspect, and Shengjiang (Fresh Ginger) to circulate Cold in the Qi aspect. Mutton is used as the sovereign herb because "deficiency of form is supplemented by flavor," and moreover, mutton can tonify Qi. Since pain often belongs to Qi weakness, it is suitable.
Kou Zongshi stated: When women give birth in cold months, Cold enters the birth canal, causing distension and fullness below the umbilicus that cannot be touched by hand; this is Cold Hernia (Hanshan), and Zhang Zhongjing's Mutton Decoction is appropriate. Or, if sudden pain occurs in the umbilical and abdominal region after childbirth, it is due to cold wind entering through respiration while the body is empty; Danggui Jianzhong Tang (Angelica Sinensis Decocted Middle Jiao Decoction) or Sishun Lizhong Tang (Four Smooth Regulating the Middle Jiao Decoction) is appropriate.
For postpartum abdominal pain, if lochia has passed but pain persists, Sishen Wan (Four Miracles Pill) should be used for regulation and tonification first; if ineffective, Bazhen Tang (Eight Treasures Decoction) follows. If pain is accompanied by nausea or a desire to vomit, Liujunzi Tang (Six Gentlemen Decoction) is used. If pain is accompanied by diarrhea, Liujunzi Tang is administered with Sishen Wan. If there is fullness and oppression in the chest and diaphragm, aversion to food, acid regurgitation, or abdominal pain where pressure is intolerable, this is injury due to diet; Erchen Tang (Two Aged Substances Decoction) plus Baizhu (Atractylodes Macrocephala Rhizome) and Shanzha (Hawthorn Fruit) should be used to resolve stagnation. If food stagnation has resolved but pain remains, and pressing does not elicit pain, accompanied by headache, vexation, heat, thirst, aversion to cold, and desire to vomit, this is damage to Middle Qi; warming and tonifying the Spleen and Stomach should be the main approach. If fever and abdominal pain occur, with increased pain upon pressure, but without aversion to food or acid regurgitation, this is stagnant blood; Shixiao San (Pain-Dispersing Powder) is used to dissipate it. If there is only fever, headache, and abdominal pain, but no pain upon pressure, this is Blood deficiency; Siwu Tang (Four Substances Decoction) plus Paojiang (Prepared Ginger), Renshen (Ginseng Root), and Baizhu (Atractylodes Macrocephala Rhizome) should be used for tonification.