张三锡治一妇，月中着恼，素体浓多痰，臂痛移走，两足且肿，以为虚治，服参、归，痛益甚，恶心迷闷。
作郁痰治，二陈、越鞠加秦艽、丹皮，二服稍减。大便四五日不去矣，投搜风丸后，用化痰舒气，二陈、二术、
酒芩、酒柏、木通、泽泻、香附，调理而愈。
陆养愚治凌绎泉夫人，妊将七月，忽两足软痿，不能履地，分娩后顿愈，一月后仍作，且胸胁痛，夜分发
热。或以四物入牛膝、木瓜、虎骨、鹿胶，或作或止。后以脾主四肢，与参、术，胀痛闷绝。仍用养血之品，
无进退，经年。诊之，询其饮食如常，肌肉如故，足胫浮肿，胸胁揉按则微痛，否则痞闷，其脉沉缓而滑，此
湿痰积于胸，流于四肢，故痛而缓，宜乎滋阴不减，补气增剧也。用二陈汤加苍术、威灵仙、黄柏、白芥子，
数剂痛定热除。加苡仁，十剂步履如故。
薛立斋治一产妇，身腹作痛，发热不食，烦躁不寐，盗汗胁痛。服解散祛血之药，不时昏愦，六脉洪大无
力。用补中益气加炮姜、半夏，一剂顿退二三，又剂饮食甘美。但背强而痛，用八珍散、十全大补汤调理而安。
一产妇遍身头顶作痛，发热不食，脉浮紧，此风寒之症也，用五积散，一剂汗出而愈。但倦怠发热，此邪
气去而真气虚也，用八珍汤调理而愈。
周慎斋治一妇，产后受湿，遍身疼痛。众以风药治之，遂致卧床不起，手足渐细，此产后气血虚，而风药
愈损气血故也。治宜大补气血，用参、 各钱半，防己五分，煎服愈。
一产妇遍身痛，坐不得卧，已经两月，痰多食减，众治不效，以参、归各一两，木香一钱为末，酒煎，分
为九次服之愈。
马元仪治卜氏外家，产后胸中作痛，痛甚则迫切不能支，至欲求死，诸治不效。延至五月，病转危急。诊其
脉，两手弦涩少神，不能转侧，不得言语，曰∶胸中者，阳气所治之部，今为阴邪所入，阴与阳搏，所以作痛。
前医破气不应，转而和血，又转而温补，又转而镇逆，不知阴阳相结，补之则无益，攻之则愈结。若镇堕之，
益足以抑遏生阳，而阻滞邪气。惟交通一法，足尽开阳入阴，通上彻下之妙，使阴治于下，阳治于上，太虚之
府旷然，何胸痛之有哉？用人参三钱，肉桂一钱，合仲景黄连汤，一剂痛减，二三剂顿释。次进加桂理中汤，
数剂全愈。
接∶是症即胸痹是也，故入痛痹门。
缪仲淳治王善长夫人，产后腿痛，不能行立，久之，饮食不进，困惫之极。诊之曰∶此脾阴不足之候，脾
主四肢，阴不足故病下体。向所饮药虽多，皆燥苦之剂，不能益阴。用石斛、木瓜、牛膝、白芍、枣仁为主，
生地、枸杞、茯苓、黄柏为臣，甘草、车前为使，一剂辄效，四剂而起。
来天培治潘履端内，年约四旬，患头身手足麻木疼痛，产后感风，不能节劳，致风入经络，而成痛风之症
也。询之，果以前岁产后而起。以归身、红花养血，钩藤、秦艽通络，黄芩、银花清火，羌活走百节，川芎理
头痛，菖蒲利肠消满，甘草缓痛，姜皮达肌肤、通腠理。服二剂而头痛愈，腹胀减，惟发热身疼未除，更心神
恍惚不寐，脉稍和。此表症稍退，里热未清，改用生地、归、芍、柴胡、地骨皮、续断、钩藤、半夏曲、枳壳、
枣仁、建莲，二剂而诸症痊。惟两膝内肿痛，扶杖而行，此风入三阴，而将愈矣。前方减柴胡、地骨皮、半夏
曲、枳壳，加丹皮、赤芍、红花、威灵仙、清风藤、防己、牛膝、五加皮、生甘草，又三四剂全愈。
薛立斋治人产妇，六月，多汗人倦，不敢袒被，故汗出被里，冷则浸渍，得风湿，身疼痛，遂以羌活续断
汤，数服愈。（未选入。）
张三锡治疗一位妇人，因在月经期间情绪恼怒，加之体质本就痰湿较重，出现手臂疼痛且游走不定，两足肿胀。起初误认为是虚证而进行补益治疗，服用人参、当归后，疼痛反而加剧，并出现恶心、神志昏闷的症状。
随后按照郁结痰阻来治疗，使用二陈汤和越鞠丸，加入秦艽、丹皮，服用两剂后症状稍减。但大便四五日未通，于是投用搜风丸，之后采用化痰理气的方法，方用二陈汤、苍术、白术、酒黄连、酒黄柏、木通、泽泻、香附，经过调理最终痊愈。
陆养愚治疗凌绎泉的夫人，怀孕将满七月时，突然双下肢软弱痿废，无法站立行走，分娩后症状顿时消失，但一个月后又复发，且伴有胸胁疼痛，夜间发热。有人建议用四物汤加入牛膝、木瓜、虎骨、鹿角胶，病情时好时坏。后来根据“脾主四肢”的理论，给予人参、白术补气，结果导致胀痛憋闷至极。又改用养血药物，但疗效进退不明显，病程持续一年。诊察时，询问得知其饮食正常，肌肉无明显消瘦，但足胫浮肿，胸胁部揉按时微痛，否则感觉痞塞闷胀，脉象沉缓而滑。这是湿痰积聚于胸中，流注于四肢所致，因此表现为疼痛且肢体弛缓。滋阴法不减，但补气会加重病情。于是使用二陈汤加苍术、威灵仙、黄柏、白芥子，数剂后疼痛停止、热退。再加薏苡仁，十剂后步履恢复正常。
薛立斋治疗一位产妇，身体腹部疼痛，发热不能进食，烦躁失眠，盗汗且胁痛。服用发散解表及祛瘀血药物后，时常出现神志昏乱，六脉洪大但无力。改用补中益气汤加炮姜、半夏，一剂后症状减退二三成，再服则食欲改善，饮食香甜。但背部僵硬疼痛，后用八珍散、十全大补汤调理而安。
另一位产妇遍身及头顶疼痛，发热不能进食，脉浮紧，这是风寒之症，用五积散，一剂发汗后痊愈。但随后出现倦怠发热，这是邪气已去而真气虚弱所致，用八珍汤调理而愈。
周慎斋治疗一位妇人，产后感受湿气，遍身疼痛。众人用风药（祛风药）治疗，导致卧床不起，手足逐渐变细，这是因为产后气血虚弱，而风药进一步损耗了气血。治疗应当大补气血，用人参、黄芪各钱半，防己五分，煎服而愈。
另一位产妇遍身疼痛，坐卧不得，已经两个月，痰多食少，众人治疗无效。用党参、当归各一两，木香一钱研为末，酒煎，分九次服用而愈。
马元仪治疗卜氏的外家亲属，产后胸中疼痛，痛势剧烈难以忍受，甚至想求死，各种治疗均无效。拖延至五月，病情转为危急。诊其脉，两手弦涩且缺乏神气，不能翻身侧卧，不能言语。马元仪说：“胸中是阳气所治的部位，如今被阴邪侵入，阴与阳相互搏结，所以产生疼痛。前医破气无效，转而和血，又转而温补，又转而镇逆，却不知道阴阳相结，补益则无益，攻伐则使结聚更甚。如果用镇压坠下之法，更足以抑制生发之阳气，而阻滞邪气排出。只有‘交通’这一方法，能够尽开阳气入阴、贯通上下之妙，使阴气治于下，阳气治于上，胸中太虚之府空旷明朗，哪里还有胸痛呢？”于是用人参三钱，肉桂一钱，合用张仲景的黄连汤，一剂后疼痛减轻，二三剂后疼痛顿消。接着进服加桂理中汤，数剂后完全痊愈。
缪仲淳治疗王善长的夫人，产后腿痛，不能行走站立，日久饮食不进，困倦疲惫至极。诊察后说：“这是脾阴不足的征候，脾主四肢，阴不足故病在下体。之前所服药物虽多，皆为燥苦之剂，不能滋养阴液。”于是用石斛、木瓜、牛膝、白芍、酸枣仁为主药，生地、枸杞、茯苓、黄柏为臣药，甘草、车前子为使药，一剂即见效，四剂后便能起床。
来天培治疗潘履端的内人，年龄约四十岁，患头、身、手、足麻木疼痛，因产后感受风邪，不能节制劳累，致使风邪进入经络，形成痛风之症。询问得知，确实是从前一年产后开始发病。用当归身、红花养血，钩藤、秦艽通络，黄芩、金银花清火，羌活走窜百节，川芎调理头痛，石菖蒲利肠消满，甘草缓急止痛，生姜皮达肌肤、通腠理。服用两剂后头痛痊愈，腹胀减轻，惟独发热身疼未除，且出现心神恍惚、失眠，脉象稍和。这是表证稍退，里热未清，改用生地、当归、白芍、柴胡、地骨皮、续断、钩藤、半夏曲、枳壳、酸枣仁、建莲，两剂后诸症痊愈。惟独两膝内侧肿痛，需扶杖而行，这是风邪深入三阴经，即将痊愈之兆。前方减去柴胡、地骨皮、半夏曲、枳壳，加入丹皮、赤芍、红花、威灵仙、清风藤、防己、牛膝、五加皮、生甘草，又三四剂后完全痊愈。
薛立斋治疗一位产妇，六月间，多汗且人倦，不敢掀开被子，故汗出浸渍在被子里，受冷则浸渍，得风湿之邪，身体疼痛，遂用羌活续断汤，数服后痊愈。（未选入。）
Zhang Sanxi treated a woman who had become emotionally distressed during her menstrual period. Her constitution was naturally prone to phlegm-dampness, and she presented with migrating arm pain and swelling in both feet. Initially misdiagnosed as deficiency, treatment with Ginseng Radix (Renshen) and Angelicae Sinensis Radix (Danggui) exacerbated the pain, leading to nausea and mental confusion.
Subsequently, it was treated as depression-phlegm stagnation using Er Chen Tang (Two-Cured Decoction) and Yue Ju Wan (Pill of Resolving Depression), modified with Gentianae Macrophyllae Radix (Qinjiao) and Moutan Cortex (Danpi). After two doses, symptoms slightly decreased. However, bowel movements were absent for four to five days. A Feng Search Pill (Sofeng Wan) was administered, followed by a regimen to resolve phlegm and regulate qi, comprising Er Chen Tang, Atractylodis Rhizoma (Cangzhu), Atractylodis Macrocephalae Rhizoma (Baizhu), Scutellariae Radix prepared with wine (Jiu Huangqin), Phellodendri Cortex prepared with wine (Jiu Huangbai), Akebia Caulis (Mutong), Alisma Rhizoma (Zexie), and Cyperi Rhizoma (Xiangfu). The patient recovered after regulation.
Lu Yangyu treated Lady Ling Yi quan, who was nearly seven months pregnant when she suddenly developed weakness and flaccidity in both lower limbs, unable to stand or walk. Symptoms resolved immediately after delivery but recurred one month later, accompanied by chest and hypochondriac pain and night fever. Some physicians prescribed Si Wu Tang (Four-Substance Decoction) modified with Achyranthis Bidentatae Radix (Niuxi), Chaenomelis Fructus (Mugua), Panthera Ossis (Hugu), and Cervi Cornu Colla (Lujiao), resulting in intermittent improvement. Later, based on the theory that "the Spleen governs the four limbs," Ren Shen and Atractylodis Rhizoma (Baizhu) were given to tonify Qi, causing severe distending pain and suffocation. Blood-nourishing herbs were then used, but progress was stagnant for a year. Upon examination, her diet and muscle mass were normal, but calves were edematous. Chest and hypochondriac tenderness was mild upon palpation, otherwise feeling stifling and distended. The pulse was deep, slow, and slippery. This indicated damp-phlegm accumulating in the chest and flowing into the limbs, causing pain and flaccidity. Yin-nourishing methods did not worsen the condition, but Qi-tonifying methods aggravated it. Er Chen Tang was modified with Cangzhu, Sparagmi Radix (Weilingxian), Phellodendri Cortex (Huangbai), and Brassicae Semen Album (Baijiezi). After several doses, pain ceased and fever subsided. Coicis Semen (Yiren) was added, and after ten doses, walking ability returned to normal.
Xue Lizhai treated a postpartum woman presenting with body and abdominal pain, fever, anorexia, restlessness, insomnia, spontaneous sweating, and hypochondriac pain. Administration of exterior-releasing and blood-invigorating herbs caused frequent episodes of delirium; the six pulses were surging yet forceless. Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) was modified with processed Zingiberis Rhizoma (Paojiang) and Pinelliae Tuber (Banxia). After one dose, symptoms improved by two or three tenths; after another dose, appetite improved. However, back stiffness and pain persisted. She was regulated with Ba Zhen San (Eight-Treasure Powder) and Shi Quan Da Bu Tang (Ten-Absolutely Great Tonifying Decoction) until stable.
Another postpartum woman suffered from generalized and vertex headache, fever, and anorexia with a floating-tight pulse, indicating Wind-Cold syndrome. Wu Ji San (Five Accumulations Powder) was administered, and after one dose inducing sweating, she recovered. Subsequent fatigue and fever indicated that pathogenic factors had departed but True Qi was deficient. Ba Zhen Tang (Eight-Treasure Decoction) was used for regulation, leading to recovery.
Zhou Shenzhai treated a woman who contracted Dampness postpartum, resulting in generalized body pain. Physicians treated her with Wind-dispelling herbs, which led to bedridden status and wasting of the limbs. This occurred because postpartum Qi and Blood were deficient, and Wind herbs further depleted them. Treatment required substantial tonification of Qi and Blood using Ginseng Radix (Renshen) and Astragali Radix (Huangqi) each at 1.5 qian, plus Stephaniae Tetrandrae Radix (Fangji) at 0.5 qian, decocted and taken orally, resulting in cure.
Another postpartum woman suffered from generalized pain, unable to sit or lie down for two months, with excessive phlegm and reduced appetite. Previous treatments failed. Renshen and Danggui each at 1 liang, and Aucklandiae Radix (Muxiang) at 1 qian were powdered, decocted in wine, and divided into nine doses, leading to recovery.
Ma Yuanyi treated a relative of the Bu family who suffered from postpartum chest pain so severe it was unbearable, even prompting suicidal thoughts. Treatments failed for five months until the condition became critical. Pulses were wiry and choppy with little spirit in both hands; she could not turn over or speak. Ma stated: "The chest is the domain governed by Yang Qi. Now, Yin pathogens have invaded, and Yin and Yang are battling, causing pain. Previous physicians attempted to break Qi, harmonize Blood, warm and tonify, and suppress rebellion, failing to realize that when Yin and Yang are knotted, tonification is useless and attack worsens the knot. Suppressing methods only inhibit vital Yang and obstruct pathogens. Only the method of 'communication' can open Yang entering Yin and connect upper and lower, allowing Yin to govern below and Yang above, leaving the Tai Xu (Great Void) cavity clear, thus resolving chest pain." Ren Shen (3 qian) and Cinnamomi Ramulus (Rougui, 1 qian) were combined with Zhang Zhongjing's Huang Lian Tang (Coptis Decoction). Pain decreased after one dose and vanished after two to three doses. Jia Gui Li Zhong Tang (Modified Cinnamon and Ginger Decoction to Regulate the Middle) was then administered, curing the patient after several doses.
Note: This syndrome is Xiong Bi (Chest Bi), hence included in the Tong Bi (Painful Bi) section.
Miao Zhongchun treated Lady Wang Shanchang, who suffered from postpartum leg pain, inability to walk or stand, progressive anorexia, and extreme exhaustion. Diagnosis indicated insufficient Spleen Yin. Since the Spleen governs the four limbs, Yin insufficiency manifested in the lower body. Previous medications were drying and bitter, failing to nourish Yin. Dendrobii Caulis (Shihu), Chaenomelis Fructus (Mugua), Achyranthis Bidentatae Radix (Niuxi), Paeoniae Radix Alba (Baishao), and Ziziphi Spinosae Semen (Suanzaoren) were used as principal herbs; Rehmanniae Radix (Shengdi), Lycii Fructus (Gouqi), Poria (Fuling), and Phellodendri Cortex (Huangbai) as assistant herbs; Licorice Root (Gancao) and Plantaginis Seed (Cheqianzi) as guide herbs. Improvement was seen after one dose, and she could rise after four doses.
Lai Tianpei treated the wife of Pan Luduan, approximately forty years old, suffering from numbness and pain in the head, body, hands, and feet. Postpartum exposure to Wind, combined with overwork, allowed Wind to enter the collaterals, forming Tong Feng (Gout-like Syndrome). History confirmed onset after childbirth last year. Angelicae Sinensis Radix (Guishen) and Carthami Flos (Honghua) nourished Blood; Uncariae Ramulus cum Uncis (Gouteng) and Gentianae Macrophyllae Radix (Qinjiao) unblocked collaterals; Scutellariae Radix (Huangqin) and Lonicerae Japonicae Flos (Yinhua) cleared Heat; Notopterygii Rhizoma et Radix (Qianghuo) traversed all joints; Chuanxiong Rhizoma (Chuanxiong) addressed headache; Acori Tatarinowii Rhizoma (Changpu) benefited the intestines and reduced fullness; Licorice Root (Gancao) alleviated pain; Zingiberis Pericarpium (Jiangpi) reached the skin and opened interstices. Headache resolved and abdominal distension decreased after two doses, but fever and body pain persisted, along with mental agitation and insomnia. The pulse became slightly harmonious. Exterior symptoms had retreated, but interior Heat remained. Formula was changed to include Shengdi, Danggui, Baishao, Bupleuri Radix (Chaihu), Corticis Lycii (Digupi), Dipsaci Radix (Xuduan), Gouteng, Massae Fermentatae Medicinalis (Banxia Qu), Aurantii Fructus Immaturus (Zhike), Suanzaoren, and Nelumbinis Plumula (Jianlian). All symptoms resolved after two doses. However, swelling and pain in the inner knees required a cane. This indicated Wind entering the Three Yin meridians, signaling impending recovery. The previous formula was modified by removing Chaihu, Digupi, Banxia Qu, and Zhike, adding Moutan Cortex (Danpi), Red Peony Root (Chishao), Honghua, Weilingxian, Sinomenii Caulis (Qingfengteng), Fangji, Niuxi, Acanthopanacis Cortex (Wujiapi), and Gancao. Cure was achieved after three to four doses.
Xue Lizhai treated a postpartum woman in June who sweated excessively and felt fatigued, fearing to uncover herself. Sweat accumulated under the covers, cooling and soaking the body, leading to Wind-Damp invasion and body pain. Qianghuo Xuduan Tang (Notopterygium and Dipsacus Decoction) was administered, curing her after several doses. (Not selected.)