陈临川《良方》云∶“妇人血崩而心痛甚，名曰杀血心痛。由心脾血虚也。若小产去血过多而
心痛甚者，亦然。用乌贼鱼骨炒为末，醋汤调下，失笑散亦效。”
失笑散（见经期腹痛）
立斋曰∶“前证若阴血耗散，用乌贼丸收敛之。若瘀血不散，用失笑散行散之。若心血虚弱，用芎归汤补
养之。若郁结伤血，用归脾汤调补之。”
乌贼鱼骨丸（见《妇人规古方》）此即内经治血枯方。
乌贼鱼骨（去甲四两） 芦茹（一两即茜根）
上为末，以雀卵捣丸小豆大，每服五丸或十丸，鲍鱼煎汤下，以饭压下。鲍鱼即今之淡干鱼也。
芎归汤（见《妇人规古方》）一名佛手散，亦名当归汤。治产后去血过多，烦晕不省，并一切胎气不
安，亦下死胎。
川芎（二钱） 当归（三、五钱）
上咀，每用半两，水煎服。若腹疼加桂；若腹痛、自汗、头眩、少气，加羊肉，若不应，用八珍汤。若用
下胎，当为末，以酒调服。
归脾汤（见经不调）
附案 一妇人血崩兼心痛三年矣，诸药不应，每痛甚，虚证悉具，面色萎黄。余曰∶心主血，盖
由去血过多，心无所养，以致作痛，宜用十全大补汤，参、术倍之。三十余剂稍愈，百余剂全愈。
愚谓杀血心痛，既由血去过多而心痛甚，明属心无所养，但当专用甘温以养营气。如十全大补汤、大营
煎、小营煎、五福饮之类为宜。若失笑散者，惟气滞血逆而用以行之、散之则可，必不可以治血虚也。再如乌
贼丸，乃《内经·腹中论》用治血枯者，亦恐于血虚心痛未必即效，用者审之。
陈临川在《良方》中说：“妇女血崩（大量阴道出血）导致心痛剧烈，称为杀血心痛。这是由于心脾两脏血液亏虚所致。如果是小产（流产）后失血过多而引发剧烈心痛的，情况也是如此。可以使用乌贼鱼骨炒成粉末，用醋汤送服；失笑散（一种活血化瘀止痛的方剂）也有效。”
立斋（薛己，号立斋）说：“上述病症如果属于阴血耗散，应使用乌贼丸来收敛固涩。如果属于瘀血阻滞不散，应使用失笑散来行气活血、消散瘀滞。如果属于心血虚弱，应使用芎归汤（由川芎和当归组成的补血方剂）进行补养。如果属于情志郁结损伤血液，应使用归脾汤（益气补血、健脾养心的方剂）进行调理补益。”
乌贼鱼骨丸（见《妇人规古方》），这就是《黄帝内经》中治疗血枯（精血枯竭）的方子。
配方：乌贼鱼骨（去甲壳四两）、芦茹（一两，即茜草根）。
将上述药物研为细末，用雀卵捣烂混合制成如小豆大小的丸药。每次服用五丸或十丸，用鲍鱼煎煮的汤送服，服药后再吃些饭以压住药力。鲍鱼就是现在的淡干鱼。
芎归汤（见《妇人规古方》），又名佛手散，也叫当归汤。用于治疗产后失血过多导致的烦躁眩晕、不省人事，以及一切胎气不安，也能用于排出死胎。
配方：川芎（二钱）、当归（三至五钱）。
将药材切碎，每次取半两，加水煎服。如果腹痛，加入桂枝；如果腹痛、自汗、头晕、气短，加入羊肉；如果无效，改用八珍汤。如果要用于下胎，应将药研为粉末，用酒调服。
归脾汤（见经不调章节）。
附案：有一位妇女患血崩兼随心痛三年了，各种药物都无效。每当疼痛剧烈时，虚证表现全部具备，面色萎黄。我说：“心主血脉，大概是因为失血过多，心脏失去滋养，从而导致疼痛，适宜使用十全大补汤（气血双补的方剂），并加倍人参和白术的用量。服用三十多剂后症状稍有好转，服用一百多剂后完全痊愈。”
我认为，杀血心痛既然因为失血过多而导致心痛剧烈，明确属于心脏缺乏滋养，应当专门使用甘温性质的药物来滋养营气。如十全大补汤、大营煎、小营煎、五福饮等方剂比较适宜。至于失笑散，只适用于气滞血逆的情况，用来行气散瘀是可以的，但绝对不能用于治疗血虚。另外，乌贼丸是《黄帝内经·腹中论》中用于治疗血枯的方子，恐怕对于血虚引起的心痛未必立即见效，使用者需谨慎斟酌。
Chen Linchuan in *Liangfang* states: "When a woman suffers from metrorrhagia (profuse uterine bleeding) accompanied by severe heart pain, it is termed 'Sha Xue Xin Tong' (Blood-Killing Heart Pain). This arises from the deficiency of blood in the Heart and Spleen. The same applies if severe heart pain occurs due to excessive blood loss following a miscarriage. One may use Sepiae Endoconcha (Cuttlefish Bone) stir-fried into powder, taken with vinegar water; Shixiao San (Formula for Stopping Pain) is also effective."
Shixiao San (see Abdominal Pain during Menstruation).
Lizhai (Xue Ji) states: "For the aforementioned condition, if Yin-blood is depleted and scattered, use Wuzei Wan (Sepia Pill) to astringe and consolidate. If stasis-blood fails to dissipate, use Shixiao San to promote circulation and disperse stasis. If Heart-blood is weak, use Xiong Gui Tang (Cnidium and Angelica Decoction) to tonify and nourish. If emotional constraint damages blood, use Guipi Tang (Restore the Spleen Decoction) to regulate and tonify."
Wuzei Wan (see *Furen Gui Ancient Formulas*), which is the formula for treating Blood Dryness (Jingxue Kuijie) from the *Huangdi Neijing*.
Ingredients: Sepiae Endoconcha (4 liang, shell removed), Rubia Cordifolia Radix et Rhizoma (1 liang, i.e., Qiancao Gen).
Grind the above into powder, mix with quail eggs to form pills the size of small beans. Take 5 or 10 pills per dose, washed down with broth made from dried cuttlefish (Baoyu), followed by rice to settle the medicine. Baoyu refers to today's dried salted fish.
Xiong Gui Tang (see *Furen Gui Ancient Formulas*), also known as Foshou San or Danggui Tang. It treats postpartum conditions involving excessive blood loss leading to restlessness, dizziness, unconsciousness, and all forms of fetal instability; it can also expel dead fetus.
Ingredients: Chuanxiong Rhizome (2 qian), Angelica Sinensis Radix (3-5 qian).
Crush the herbs, take half a liang each time, decoct in water and drink. If abdominal pain is present, add Cinnamomi Ramulus (Guizhi); if abdominal pain, spontaneous sweating, vertigo, and shortness of breath occur, add Mutton; if ineffective, switch to Bazhen Tang (Eight Treasures Decoction). To induce abortion, grind into powder and take mixed with wine.
Guipi Tang (see Irregular Menstruation).
Attached Case: A woman suffered from metrorrhagia combined with heart pain for three years. Various medicines were ineffective. Whenever the pain was severe, all signs of deficiency were evident, and her complexion was sallow. I said: "The Heart governs blood. It is likely that excessive blood loss has deprived the Heart of nourishment, causing pain. It is appropriate to use Shiquan Dabu Tang (Ten Great Tonifying Decoction), doubling the dosage of Ginseng Radix (Renshen) and Atractylodis Macrocephalae Rhizoma (Baizhu)." After taking more than thirty doses, symptoms slightly improved; after over one hundred doses, she fully recovered.
I hold that Sha Xue Xin Tong, arising from excessive blood loss leading to severe heart pain, clearly belongs to the category of the Heart lacking nourishment. One should exclusively use sweet-warm substances to nourish Ying-Qi. Formulas such as Shiquan Dabu Tang, Daying Jian, Xiaoying Jian, and Wufu Yin are suitable. As for Shixiao San, it is only applicable when Qi stagnation and reversed Blood flow exist, used to move and disperse; it must not be used to treat Blood deficiency. Furthermore, Wuzei Wan is used in the *Huangdi Neijing·Fuzhong Lun* to treat Blood Dryness; it may not necessarily be effective for heart pain caused by Blood deficiency. Users should exercise caution.