生干地黄 当归 独活 吴茱萸 芍药 干姜 甘草 桂心 小草（各一两） 细辛（半
两）
上为散，每服半两。水三盏，煎至一盏，去滓，稍热服。评曰∶产后心痛，虽非产蓐
常疾，痛或有九痛，未必便是血痛。设是岩蜜汤，岂可用熟地黄？熟地黄泥血，安能去痛？
此方本出《千金》，用生干地黄耳。茱萸一升合准，五两干姜，三两细辛，治陈寒在下焦。
方本一两，却减半两，制奇制偶，量病浅深，自有品数，不可妄意加减。然以岩蜜汤治血痛，
不若失笑散用之有效。
治心腹痛欲死，百药不效，服此顿愈。与第八论紫金丸大同小异。（见本卷八论）
五灵脂 蒲黄（等分）
上为末，先用酽醋调二钱熬膏，入水一盏，煎至七分，食前热服，是验。
疗产后心痛，此大寒所为方。
蜀椒（二合） 芍药（三两） 半夏 当归 桂心 人参 甘草 茯苓（各二两） 生
姜汁（五合） 蜜（一升）
上切，以水九升，煮椒令沸；下诸药，煮取二升半，去滓；下姜汁、蜜等，更煎取三升
。一服五合至六合。（《千金》同）
论曰∶产后恶露不尽，腹痛者何？答曰∶产后恶血虽常通行，或因外感五邪，内伤七气
，致令斩然而止；余血停积，壅滞不行，所下不尽，故令腹痛。《产宝》云∶皆因妊娠当风
取凉，则胞络有冷，至于产时，其血必少。或新产时而取风凉，皆令风冷搏于血，血则壅滞
不得宣通，蓄积在内，有时恶露不尽，故令腹痛。
生干地黄、当归、独活、吴茱萸、芍药、干姜、甘草、桂心、小草（各一两）、细辛（半两）。
以上药物研为散剂，每次服用半两。用水三盏，煎煮至一盏，滤去药渣，趁稍热时服用。评论说：产后心痛，虽然不是产褥期的常见疾病，但疼痛可能有九种类型，未必就是血瘀引起的疼痛。如果是岩蜜汤证，难道可以用熟地黄吗？熟地黄性质黏腻，会阻碍血液运行，怎么能去除疼痛呢？此方原本出自《千金方》，使用的是生干地黄。其中吴茱萸一升折算为五两，干姜三两，细辛三两，用于治疗下焦的陈旧性寒邪。原方剂量为一两，这里却减半为半两，这是根据奇偶制方原则，衡量病情的深浅，自有其法度，不可随意加减。然而用岩蜜汤治疗血瘀疼痛，不如使用失笑散效果显著。
治疗心腹剧烈疼痛欲死，各种药物无效，服用此方立刻痊愈。与第八论中的紫金丸大同小异。（见本卷第八论）
以上药物研为末，先用浓醋调拌二钱熬成膏状，加入水一盏，煎煮至七分，饭前热服，疗效确切。
治疗产后心痛，这是针对大寒之邪所设的方剂。
蜀椒（二合）、芍药（三两）、半夏、当归、桂心、人参、甘草、茯苓（各二两）、生姜汁（五合）、蜂蜜（一升）。
以上药物切碎，用水九升，先煮蜀椒至沸腾；然后加入其他药物，煎煮取液二升半，滤去药渣；再加入生姜汁、蜂蜜等，继续煎煮取液三升。每次服用五合至六合。（《千金方》记载相同）
论述说：产后恶露不尽，出现腹痛的原因是什么？回答说：产后恶血通常应当通畅排出，但如果因外感风、寒、暑、湿、燥“五邪”，或内伤情志“七气”，导致血流突然中断；余血停滞积聚，壅塞阻滞不能通行，所以恶露排不干净，从而引起腹痛。《产宝》说：都是因为妊娠期间迎风纳凉，导致胞络受冷，到了分娩时，血量必然减少。或者在刚生产完时吹风受凉，都会使风冷之邪与血液相搏结，血液因此壅滞而不能宣通，蓄积在体内，有时恶露排不尽，所以引起腹痛。
Sheng Gan Di Huang (Radix Rehmanniae Preparata, Fresh), Dang Gui (Radix Angelicae Sinensis), Du Huo (Radix Angelicae Pubescentis), Wu Zhu Yu (Fructus Evodiae), Shao Yao (Radix Paeoniae Alba/Galerae), Gan Jiang (Rhizoma Zingiberis Preparatum), Gan Cao (Radix Glycyrrhizae), Gui Xin (Cortex Cinnamomi), Xiao Cao (Herba Glehniae) (each 1 liang), Xi Xin (Herba Asari) (0.5 liang).
The above herbs are ground into a powder. Each dose is 0.5 liang. Add three zhan of water, decoct until one zhan remains, remove the dregs, and take while slightly warm. Commentary: Postpartum heart pain, although not a common disease of the puerperium, pain may have nine types, which may not necessarily be blood stasis pain. If it were treated with Yan Mi Tang, how could Shu Di Huang (Prepared Radix Rehmanniae) be used? Shu Di Huang is cloying and tends to obstruct blood circulation; how can it relieve pain? This formula originally comes from *Qian Jin Fang*, using Sheng Gan Di Huang. One sheng of Wu Zhu Yu is equivalent to five liang, three liang of Gan Jiang, and three liang of Xi Xin, treating chronic cold in the Lower Jiao (Lower Burner). The original formula dosage is one liang, but here it is halved to half a liang. This follows the principle of odd/even prescription composition, measuring the depth of the disease, with its own standards; one must not arbitrarily add or subtract. However, using Yan Mi Tang to treat blood stasis pain is not as effective as using Shi Xiao San (Pulse-Checking Powder).
Treats severe heart and abdominal pain that feels like death, where all other medicines fail; taking this formula brings immediate relief. It is largely similar to Zi Jin Wan (Purple Gold Pill) discussed in the eighth treatise. (See Treatise 8 of this volume.)
Wu Ling Zhi (Excrement Trogopteri), Pu Huang (Pollen Typhae) (equal parts).
The above herbs are ground into powder. First, mix two qian with strong vinegar and boil into a paste. Add one zhan of water, decoct until seven fen remain, and take hot before meals. This is verified to be effective.
Treats postpartum heart pain; this is a formula designed for severe cold.
Shu Jiao (Fructus Zanthoxyli), Shao Yao (Radix Paeoniae Alba/Galerae) (3 liang), Ban Xia (Rhizoma Pinelliae), Dang Gui (Radix Angelicae Sinensis), Gui Xin (Cortex Cinnamomi), Ren Shen (Radix Ginseng), Gan Cao (Radix Glycyrrhizae), Fu Ling (Sclerotium Poriae) (each 2 liang), Sheng Jiang Zhi (Jucius Zingiberis Recens) (5 he), Mi (Mel) (1 sheng).
Cut the herbs. Add nine sheng of water, boil Shu Jiao until boiling; then add the other herbs, decoct to obtain two and a half sheng, remove dregs; add Sheng Jiang Zhi and Mi, etc., and decoct again to obtain three sheng. Take five he to six he per dose. (*Qian Jin Fang* records the same.)
Discussion: What causes postpartum lochia不尽 (incomplete discharge) accompanied by abdominal pain? The answer is: Although postpartum evil blood (lochia) usually flows smoothly, if due to external contraction of the Five Pathogens (Wind, Cold, Summerheat, Dampness, Dryness) or internal injury from the Seven Emotions, the flow is suddenly interrupted; residual blood stagnates and accumulates, becoming blocked and unable to circulate, so the discharge is incomplete, thus causing abdominal pain. *Chan Bao* states: All cases arise because during pregnancy, one exposed oneself to wind and sought coolness, causing cold in the Ba Luo (Uterine Collaterals). By the time of delivery, the blood volume must be scant. Or, if one exposes oneself to wind and coolness immediately after childbirth, wind-cold combats with the blood, causing the blood to stagnate and fail to circulate freely. Accumulating internally, sometimes the lochia is not completely discharged, thus causing abdominal pain.