杨仁斋曰∶此因产后赶血未尽所致。世俗收生，多就踏板赶血。不思生产时，已坐草近地，产毕，脏腑空
虚，又近地赶血，冷湿风邪，乘虚而入，使败血凝为血块，是谓母血冲筑硬痛。治法，以不换金正气散，加
辣桂、蓬术、干姜、川芎、白芷，热服，散其冷湿风邪，从二便出。
陈良甫曰∶积者，阴气也，五脏所生；聚者，阳气也，六腑所成。然积为阴，阴性沉伏，故痛不离其部。
聚为阳，阳性浮动，故痛无常处。皆由产后气血虚弱，风冷所乘，搏于脏腑，与血气相结，故成积聚 块也。
《大全》曰∶新产后有血与气相搏而痛者，谓之瘕。瘕者，假也，谓其痛浮假无定处也。此由夙有风冷，血
气不调，至产，血下少，故致此病。不急治，多成积结，妨害月水。
《妇人良方》曰∶产后寒气入腹，硬筑，脐下刺痛，此名曰寒疝，当用炒吴茱。若误认为恶露不尽，小腹蓄
血，则谬矣。
薛立斋曰∶有产妇腹中有一物，时痛不止，以为血瘕，用行血破气药，两胁肚腹尤甚，支节间各结小核，隐
于肉里，以为鳖子，方用下虫药。夫肝藏血而养诸筋，此肝血虚损，筋涸而挛结耳。肢节胸项，皆属肝胆部分。养
其脾土，补水以滋肝血，则筋自舒，八珍汤、逍遥散、归脾汤加减治之。
薛立斋曰∶凡真气亏损，则邪气乘之，况产得此。尤当固元气为主。若求旦夕之效而攻邪，则速其危矣。如
寒邪乘客，气血壅结，此因气病而血病也，当补养胃气，调和月经，宽缓静养为善。
慎斋按∶以上六条，序产后有血块积聚，瘕疝筋挛诸证也。产后恶血不尽，气血虚而风寒乘袭，则血凝气滞，
遂为血块瘕疝等证。若用破血耗气之剂，以攻有形之邪，祸不旋踵。故以立斋固元气一条序后，示人求本之道也。
杨仁斋说：这是由于产后恶露排不干净所导致的。世俗的接生婆，多采用让产妇踩踏板的方法来促使血液排出。她们没有考虑到，在生产时，产妇已经坐草接近地面，生产结束后，脏腑处于空虚状态，如果再用靠近地面的方式（如踩踏板）来赶血，冷湿风邪就会乘虚而入，使败血凝结成血块，这被称为母血冲筑硬痛。治疗方法，使用不换金正气散，加入辣桂、蓬术、干姜、川芎、白芷，热服，以驱散冷湿风邪，使其从大小便排出。
陈良甫说：积证，属于阴气，由五脏产生；聚证，属于阳气，由六腑形成。然而积属阴，阴性沉伏，所以疼痛位置固定不离其处。聚属阳，阳性浮动，所以疼痛部位不固定。这都是由于产后气血虚弱，风冷之邪侵袭，搏结于脏腑，与血气相互纠结，从而形成了积聚块状物。
《大全》说：新近分娩后，有因血与气相互搏结而疼痛的，称为瘕。瘕的意思是“假”，指其疼痛漂浮虚假、没有定处。这是由素来就有风冷，导致血气不调，到了分娩时，下血量少，因此导致此病。如果不及时治疗，大多会形成积结，妨害月经。
《妇人良方》说：产后寒气进入腹部，出现坚硬筑痛感，脐下刺痛，这名叫寒疝，应当使用炒吴茱萸。如果误认为是恶露不尽、小腹蓄血，那就错了。
薛立斋说：有一位产妇腹中有一物，时常疼痛不止，人们以为是血瘕，使用行血破气的药物，结果两胁和肚腹更加严重，四肢关节间各结成小核，隐藏在肉里，人们以为是鳖子，于是方用下虫药。其实肝藏血而滋养诸筋，这是肝血虚损，筋脉干枯而挛缩结聚所致。肢节胸项，都属于肝胆的部分。应当养护脾土，补水以滋肝血，那么筋脉自然舒展，可用八珍汤、逍遥散、归脾汤加减来治疗。
薛立斋说：凡是真气亏损，邪气就会乘虚而入，何况是产后这种状态。尤其应当以固护元气为主。如果追求一时的效果而去攻伐邪气，则会加速危险。比如寒邪客居体内，气血壅结，这是因为气病导致了血病，应当补养胃气，调和月经，以宽缓静养为善。
慎斋按语：以上六条，叙述了产后有血块积聚、瘕疝、筋挛等各种证候。产后恶血不尽，气血虚弱而风寒乘袭，则血凝气滞，遂形成血块、瘕疝等证。如果使用破血耗气的药剂，去攻伐有形的邪气，灾祸很快就会到来。所以将立斋关于固元气的论述放在最后，是为了向人们展示寻求根本之道的方法。
Yang Renzhai stated: This is caused by the incomplete expulsion of lochia after childbirth. Secular midwives often employ the method of having the parturient tread on a pedal to promote blood discharge. They fail to consider that during delivery, the woman has already been sitting on straw close to the ground; after birth, the zang-fu organs are empty and deficient. If one again uses methods close to the ground (such as treading) to drive out blood, cold-dampness and wind pathogens will enter through the deficiency, causing residual blood to coagulate into blood masses. This is termed "maternal blood rushing and building hard pain." The treatment method involves using Bu Huan Jin Zheng Qi San (Golden Change Upright Qi Decoction), added with La Gui (Cinnamomi Ramulus acris), Peng Zhu (Curcumae Rhizoma), Gan Jiang (Zingiberis Rhizoma), Chuan Xiong (Ligustici Chuanxiong Rhizoma), and Bai Zhi (Angelicae Dahuricae Radix), taken hot, to dissipate cold-dampness and wind pathogens, allowing them to exit via urination and defecation.
Chen Liangfu stated: Accumulation (Ji) belongs to Yin qi and is generated by the five zang organs; gathering (Ju) belongs to Yang qi and is formed by the six fu organs. However, Ji is Yin, and its nature is sinking and latent; therefore, pain does not leave its specific location. Ju is Yang, and its nature is floating and mobile; therefore, pain has no fixed location. All these arise from postpartum deficiency of qi and blood, where wind-cold pathogens invade and contend within the zang-fu organs, knotting with qi and blood, thus forming accumulations and gatherings.
Da Quan stated: In the immediate postpartum period, pain caused by the contention between blood and qi is termed Xia (mass). "Xia" means "false," indicating that the pain is floating, illusory, and without a fixed location. This results from pre-existing wind-cold, leading to disharmony of qi and blood. During delivery, the amount of vaginal bleeding is scant, thereby causing this disease. If not treated promptly, it often develops into solid accumulations, obstructing menstruation.
Fu Ren Liang Fang stated: When postpartum cold pathogen enters the abdomen, causing hardness, pressing pain, and stabbing pain below the umbilicus, this is named Han Shan (Cold Hernia). One should use Chao Wu Zhu Yu (Stir-baked Evodiae Fructus). Mistaking this for incomplete lochia or blood stasis in the lower abdomen would be erroneous.
Xue Lizhai stated: There was a parturient who had an object in her abdomen causing incessant intermittent pain. It was considered Blood Xia (Blood Mass), and blood-invigorating and qi-breaking medicines were used, resulting in exacerbated pain in the hypochondrium and abdomen. Small nodules formed in the joints, hidden within the muscles, which people mistakenly identified as "turtle eggs." Consequently, vermifuge drugs were prescribed. Actually, the Liver stores blood and nourishes the sinews. This condition arises from Liver blood deficiency and damage, causing sinews to dry up and contract/knot. The limbs, joints, chest, and neck all belong to the Liver and Gallbladder regions. One should nourish Spleen Earth and tonify Water to moisten Liver blood, so that the sinews will naturally relax. Treatment involves modifying Ba Zhen Tang (Eight Treasures Decoction), Xiao Yao San (Free and Easy Wanderer Powder), or Gui Pi Tang (Restore the Spleen Decoction).
Xue Lizhai stated: Whenever True Qi is depleted, Evil Qi takes advantage of the situation, especially in the postpartum state. One must primarily focus on consolidating Yuan Qi (Original Qi). If one seeks immediate effects by attacking the pathogen, danger will be hastened. For instance, when Cold Pathogen lodges internally, causing stagnation and knotting of qi and blood, this is a case where Qi pathology leads to Blood pathology. One should tonify Stomach Qi, regulate menstruation, and prioritize gentle rest and tranquility.
Shen Zhai commented: The above six passages describe various postpartum syndromes including blood mass accumulation, Xia hernia, and tendon contraction. After childbirth, if lochia is not fully expelled, and qi and blood are deficient while Wind-Cold invades, blood coagulates and qi stagnates, leading to syndromes such as blood masses and Xia hernia. Using formulas that break blood and consume qi to attack tangible pathogens will bring disaster swiftly. Therefore, placing Lizhai's passage on consolidating Yuan Qi at the end serves to demonstrate the principle of seeking the root cause.