薛立斋曰∶前证若阳气虚寒，岩蜜汤温之。瘀血上冲，失笑散行之。血既散而痛仍作，八珍汤补之。大凡心
腹作痛，以手按之不痛，此血虚也，须用补养之剂。
慎斋按∶以上四条，序产后有心痛之证
也。心痛在产后，非血虚火逆，即寒凝伤血，《产宝》用岩蜜汤，治虚寒血凝，则得矣。若《大全》，火冲心
包络，而亦用岩蜜汤治之，岂热药从治之意，能无助邪为患。至有产后杀血心痛，亦属恶露不尽。如陈无择评
大岩蜜汤下云，产后心痛，虽非产蓐常疾，痛或有九，未必便是血痛。设是岩蜜汤，岂可用熟地泥血，安能去痛。
以此汤活血痛，不若失笑散更捷。予谓产后心痛，属血者多。但有寒热虚实不同。若云未必便是血痛，则非矣。
《金匮要略》曰∶产后腹痛，法当以枳实芍药散。假令不愈，此为腹中有干血着脐下，宜下瘀血汤主之。
《大全》曰∶产后恶血，虽常通行，或因外感五邪，内伤七气，致令斩然而止，余血壅滞，所下不尽，故令
腹痛，当审因治之。
王节斋曰∶假如产妇数朝内，或饮食如常，忽作腹痛，六脉沉伏，四肢厥冷，此恶露不尽，伤食裹血，而脉
不起也，不可误认为气血两虚，用大补剂，须用消导行血之药。
《金匮要略》曰∶产后腹中 痛，当归生姜羊肉汤主之。注曰∶ 痛者，缓缓痛也。概属客寒相阻，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。羊肉补气， 疼属气弱，故宜之。
薛立斋说：上述证候如果是阳气虚弱且伴有寒象，用岩蜜汤来温补。如果是瘀血上冲，用失笑散来活血化瘀。如果血液已经消散但疼痛仍然发作，用八珍汤来补益。大凡心腹部作痛，用手按压时不感到疼痛，这是血虚的表现，必须使用补养的方剂。
慎斋按语：以上四条内容，叙述了产后出现心痛证候的情况。产后发生心痛，如果不是血虚导致火气上逆，就是寒气凝滞损伤血液。《产宝》使用岩蜜汤治疗虚寒导致的血凝，这是正确的。但如果像《大全》所说，是火邪冲击心包络，却仍然使用岩蜜汤来治疗，这难道是“热因热用”的反治法吗？这样做难道不会助长邪气造成危害吗？至于有产后因大量失血引起的心痛，也属于恶露不尽的情况。如陈无择在评述大岩蜜汤时指出，产后心痛虽然不属于产褥期的常见疾病，但疼痛可能有九种类型，未必都是血瘀引起的疼痛。如果是这种情况，岂能使用熟地黄这种滋腻碍血的药物？又怎能去除疼痛呢？以此汤治疗血瘀疼痛，不如失笑散更为快捷有效。我认为产后心痛，属于血虚或血瘀的居多。但是其中有寒、热、虚、实的不同。如果说“未必就是血瘀疼痛”，那就是错误的。
《金匮要略》说：产后腹痛，按照法则应当使用枳实芍药散。假如服药后病不愈，这是因为腹中有干血（陈旧性瘀血）附着在脐下，适宜用下瘀血汤主治。
《大全》说：产后恶露（余血），虽然通常通畅下行，但如果因为外感五邪（风、寒、暑、湿、燥/火），内伤七气（喜、怒、忧、思、悲、恐、惊），导致突然停止，余血壅滞，排出不尽，所以引起腹痛，应当审察病因进行治疗。
王节斋说：例如产妇在分娩后几天内，或者饮食正常，忽然发生腹痛，六脉沉伏，四肢厥冷，这是恶露不尽，加上伤食裹血，导致脉象不起。不可误认为是气血两虚，而使用大补的方剂，必须使用消食导滞、行血化瘀的药物。
《金匮要略》说：产后腹中隐隐作痛，用当归生姜羊肉汤主治。注解说：隐痛者，是指缓缓作痛。这大多属于客寒（外来寒气）阻滞所致，所以用当归疏通血分的滞涩，用生姜行散气分的寒气。以羊肉为君药，是因为所谓“形不足者，补之以味”。羊肉能补气，隐痛属于气弱，所以适宜使用此方。
Xue Lizhai stated: If the aforementioned syndrome is due to deficiency of Yang Qi and cold, it should be warmed with Yanmi Tang (Rock Honey Decoction). If blood stasis rushes upward, Shixiao San (Pain-Relieving Powder) should be used to promote circulation. If the blood has dispersed but pain persists, Bazhen Tang (Eight-Treasure Decoction) should be used for tonification. Generally speaking, if pain in the heart or abdomen does not worsen upon manual pressure, this indicates Blood Deficiency (deficiency of nutritive blood), and tonic agents must be employed.
Shenzhai commented: The above four items outline syndromes of Heart Pain (pain in the epigastric/cardiac region) occurring postpartum. Postpartum Heart Pain is either caused by Fire rebelling upward due to Blood Deficiency or by Cold coagulation damaging the Blood. Chanbao (Precious Prescriptions for Childbirth) uses Yanmi Tang to treat Blood coagulation due to deficiency-cold, which is appropriate. However, if Daquan (Complete Works on Gynecology) suggests that Fire attacks the Pericardium Collateral yet still employs Yanmi Tang, is this an application of "treating heat with heat" (reverse treatment)? Would this not risk aiding the pathogenic factor and causing harm? Regarding postpartum Heart Pain caused by severe blood loss, it also belongs to the category of incomplete expulsion of Lochia (postpartum discharge). As Chen Wuyue commented on Da Yanmi Tang: Postpartum Heart Pain, although not a common disease of the lying-in period, pain may have nine types; it is not necessarily Blood Stasis pain. In such cases, how can Shudi (Rehmanniae Radix Preparata, prepared Rehmannia root) be used, given its cloying nature that impedes blood flow? How can it relieve pain? To treat Blood Stasis pain with this decoction is inferior to the more rapid efficacy of Shixiao San. I believe that most cases of postpartum Heart Pain are related to Blood. However, there are differences between Cold, Heat, Deficiency, and Excess. To claim that it is "not necessarily Blood Stasis pain" is incorrect.
Jinkui Yaolue (Essential Prescriptions from the Golden Cabinet) states: For postpartum abdominal pain, the method dictates using Zhishi Shaoyao San (Immature Bitter Orange and Peony Powder). If it does not heal, this indicates Dry Blood (chronic blood stasis) adhering below the umbilicus, and Xiayuxue Tang (Decoction to Purge Blood Stasis) should be primarily administered.
Daquan states: Although Lochia usually flows smoothly after childbirth, external contraction of the Five Pathogens (Wind, Cold, Summerheat, Dampness, Dryness/Fire) or internal injury from the Seven Emotions (Joy, Anger, Worry, Overthinking, Sorrow, Fear, Fright) can cause it to stop abruptly. Residual blood becomes stagnant and is not fully expelled, thus causing abdominal pain. One must examine the etiology to treat accordingly.
Wang Jiezhai stated: For instance, if a parturient woman, within several days post-delivery, maintains normal diet but suddenly experiences abdominal pain, with six pulses being deep and hidden, and limbs cold, this indicates incomplete expulsion of Lochia combined with food stagnation entangling blood, resulting in suppressed pulses. This should not be mistaken for Dual Deficiency of Qi and Blood treated with strong tonics; rather, herbs that resolve stagnation and promote blood circulation should be used.
Jinkui Yaolue states: For dull, lingering abdominal pain after childbirth, Danggui Shengjiang Yangrou Tang (Angelica Sinensis, Ginger, and Mutton Decoction) is indicated. The annotation explains: "Lingering pain" refers to slow, dull pain. This generally belongs to obstruction by exogenous Cold. Therefore, Danggui (Angelicae Sinensis Radix) is used to unblock stagnation in the Blood aspect, and Shengjiang (Zingiberis Rhizoma Recens, fresh ginger) is used to circulate Cold in the Qi aspect. Mutton is used as the sovereign herb because, as stated, "for those lacking form, flavor is used to tonify." Mutton tonifies Qi, and since lingering pain belongs to Qi weakness, this formula is suitable.