薛立斋案载∶一产妇腹中有物作痛，投破气行血药尤甚，肢节胸项各结小核，隐于肉里。此肝血虚也。
盖肝为藏血之脏而主筋，血虚则筋急而挛。见于肢节胸项者，以诸筋皆属于节，而胸项又肝之部分也。用
八珍、逍遥、归脾加减治验。
薛立斋案载∶一产妇小腹作痛，行气破血，不应。脉洪数，此瘀血成脓也。用瓜子仁汤，二剂痛止；更
以太乙膏下脓而愈。产后多有此证，虽非痈，用之神效。脉洪数，已有脓；脉但数，微有脓；脉迟紧，但
有瘀血，尚未成脓，下血即愈。若腹胀大，转侧作水声，或脓从脐出，或从大便出，宜用蜡矾丸、太乙膏
及托里散。凡瘀血宜急治，缓则化为脓，难治。若流注关节，则患骨疽，失治多为坏证。
王孟英按∶《古今医案按》载∶一妇产后恼怒，左少腹结一块，每发时小腹胀痛，从下攻上，膈间、乳上
皆痛，饮食入胃即吐，遍治不效。叶香岩用炒黑小茴一钱，桂酒炒当归二钱，自制鹿角霜、菟丝子各一钱
五分，生楂肉三钱，川芎八分，水煎，送阿魏丸七分，八剂而愈。次用乌鸡煎丸，原方半料，永不复发。俞
东扶云∶消积之方，如桃仁煎，用大黄、虻虫、芒硝；东垣五积丸，俱用川乌、巴霜；《局方》圣散子、三
棱煎丸，俱用 砂、干漆。此皆峻厉之剂，用而中病，固有神效；若妄试轻尝，鲜不败事。试阅叶案“积聚
门”，并无古方狠药，如《千金》硝石丸，人参、硝、黄并用。丹溪犹以为猛剂，学人但将丹溪治积聚诸案细
绎，自有悟处。而黑神丸，生、熟漆并用，尤勿轻试。每见服之误事。因思漆身为癞之言，则飞补之说，其
可惑乎！
薛立斋医案记载：有一位产妇腹部有肿块并伴有疼痛，服用破气行血的药物后症状反而加重，四肢关节及胸项部位皮下各出现小结节，隐没在肌肉之中。这是肝血虚弱的表现。
因为肝是贮藏血液的脏器并且主管筋脉，血虚则导致筋脉拘急而痉挛。这些症状出现在四肢关节和胸项部位，是因为所有的筋脉都汇聚于关节，而胸项部位又是肝经所主的区域。使用八珍汤、逍遥散、归脾汤加减治疗，取得了验证有效的结果。
薛立斋医案又记载：一位产妇小腹部疼痛，服用行气破血药物无效。脉象洪大而数，这是瘀血化脓的表现。使用瓜子仁汤，服用两剂后疼痛停止；随后改用太乙膏排出脓液而痊愈。产后多有此类证候，虽然不属于痈疽，但使用该方神效。脉象洪大且数，说明已有脓液形成；脉象仅数而不洪，说明仅有少量脓液；脉象迟而紧，说明只有瘀血，尚未形成脓液，此时攻下瘀血即可痊愈。如果腹部胀大，身体转动时听到水声，或者脓液从肚脐流出，或从大便排出，适宜使用蜡矾丸、太乙膏以及托里散。凡是瘀血应当紧急治疗，拖延则会化为脓液，难以治愈。如果瘀血流注到关节，就会引发骨疽，延误治疗多成为坏证（难治之症）。
王孟英按语：《古今医案按》记载：一位产妇因产后恼怒，左侧少腹结成一肿块，每次发作时小腹胀痛，疼痛感由下向上攻冲，膈部、乳房上方皆痛，饮食入胃即呕吐，遍治无效。叶天士使用炒黑的小茴香一钱，桂酒炒当归二钱，自制的鹿角霜、菟丝子各一钱五分，生山楂肉三钱，川芎八分，水煎煮，送服阿魏丸七分，八剂后痊愈。接着使用乌鸡煎丸，原方的一半剂量，从此永不复发。俞东扶评论说：消除积块的方剂，如桃仁煎，使用大黄、虻虫、芒硝；李东垣的五积丸，均使用川乌、巴豆霜；《局方》的圣散子、三棱煎丸，均使用硇砂、干漆。这些都是峻烈猛厉的药物，如果使用得当击中病灶，固然有神奇效果；但如果胡乱尝试轻率用药，很少有不败事的。试看叶天士医案中“积聚”门类，并没有使用古代方剂中的狠药，例如《千金方》的硝石丸，人参、芒硝、大黄并用，丹溪尚且认为这是猛剂，学习者只要仔细研读丹溪治疗积聚的各个医案，自然会有领悟之处。至于黑神丸，生漆、熟漆并用，尤其不要轻易尝试。常见有人服用此药误事。想到“漆疮致癞”的说法，那么所谓“飞补”的理论，难道可以被迷惑吗！
Xue Lizhai’s medical case records: A postpartum woman had a mass in her abdomen causing pain. After administering Qi-breaking and blood-activating herbs, her symptoms worsened. Small nodules appeared subcutaneously in her limbs, joints, chest, and neck. This is due to Liver Blood deficiency.
The Liver stores Blood and governs the sinews (tendons). When Blood is deficient, the sinews become tight and contractile. These manifestations occur in the limbs, joints, chest, and neck because all sinews converge at the joints, and the chest and neck are regions governed by the Liver meridian. Treatment with Bazhen Tang (Eight-Treasure Decoction), Xiaoyao San (Free and Easy Wanderer Powder), and Guipi Tang (Restore the Spleen Decoction), modified as appropriate, proved effective.
Xue Lizhai’s medical case also records: A postpartum woman suffered from lower abdominal pain. Qi-moving and blood-breaking treatments were ineffective. Her pulse was洪数 (Hong-Shu: surging and rapid), indicating that blood stasis has turned into pus. She was treated with Gua Zi Ren Tang (Melon Seed Decoction); after two doses, the pain ceased. Subsequently, Taiyi Gao (Taiyi Plaster) was used to drain the pus, leading to recovery. This condition is common postpartum; although it is not an abscess (Yong 痈), this treatment is highly effective. A surging and rapid pulse indicates established pus; a merely rapid pulse indicates slight pus formation; a slow and tight pulse indicates only blood stasis without pus formation, which can be cured by purging the blood. If the abdomen is distended and produces a splashing sound upon turning, or if pus discharges from the umbilicus or via the bowels, La Fan Wan (Beeswax and Alum Pill), Taiyi Gao, and Tuoli San (Support the Interior Powder) are indicated. Blood stasis should be treated urgently; if delayed, it transforms into pus and becomes difficult to treat. If the stasis flows into the joints, it may cause bone abscess (Gu Ju 骨疽); failure to treat properly often results in incurable conditions.
Wang Mengying’s commentary: "Gujin Yi'an An" records: A postpartum woman became angry, resulting in a lump in the left lower abdomen. Each episode caused lower abdominal distension and pain, radiating upward from below to the diaphragm and upper breasts. Food eaten was immediately vomited. Various treatments failed. Ye Tianshi prescribed Chao Hei Xiao Hui Xiang (Stir-fried Black Fennel) 1 qian, Gui Jiu Chao Dang Gui (Angelica Sinensis stir-fried with Cinnamon Wine) 2 qian, self-made Lu Jiao Shuang (Deer Antler Frost) 1.5 qian, Tu Si Zi (Cuscuta Seed) 1.5 qian, Sheng Zha Rou (Raw Hawthorn Flesh) 3 qian, Chuan Xiong (Ligusticum Rhizome) 0.8 fen, decocted in water, taken with A Wei Wan (Asafoetida Pill) 0.7 fen. After eight doses, she recovered. Thereafter, Wu Ji Jian Wan (Black Chicken Decoction Pill), half the original dosage, was administered, preventing recurrence. Yu Dongfu commented: Formulas for resolving accumulations, such as Tao Ren Jian (Peach Kernel Decoction), use Da Huang (Rhubarb Root and Rhizome), Meng Chong (Blister Beetle), and Mang Xiao (Mirabilite); Li Dongyuan’s Wu Ji Wan (Five Accumulations Pill) uses Chuan Wu (Aconite Lateral Root) and Ba Shuang (Croton Seed Resin); the Ju Fang’s Sheng San Zi and San Leng Jian Wan (Sanleng Decoction Pill) use Nao Sha (Sal Ammoniac) and Gan Qi (Dry Lacquer). These are all harsh and potent preparations. If they hit the target correctly, they indeed have miraculous effects; however, reckless experimentation rarely ends well. Reviewing Ye Tianshi’s cases on "Accumulation," none used harsh ancient drugs like Xiao Shi Wan (Niter Pill) from Qianjin Fang, which combines Ren Shen (Ginseng Root), Xiao Shi (Niter), and Da Huang/Huang Qin (though typically Da Huang/Huang Bai, here implying strong purgatives). Even Danxi considered such combinations fierce. Students who carefully study Danxi’s cases on treating accumulations will gain insight. Regarding Hei Shen Wan (Black Divine Pill), which uses both raw and cooked lacquer, one must not experiment lightly. Cases of harm from its use are frequent. Considering the saying that lacquer causes leprosy-like skin lesions, how can one be deluded by the theory of "Fei Bu" (Flying Tonification)?