产后腰痛者，由肾位系胞，腰为肾府，产则劳伤肾气，损动胞络，或虚未平复，而风冷乘之，二
者皆致腰痛。若寒冷邪气，连滞背脊，痛久未已，后忽有孕，必致损动，宜养荣壮肾汤主之。如产后
日久腰痛，济阴大造丸治之。如恶露方行，忽断绝不来，腰中重痛，下注两股，痛如锥刺入骨，此血滞经
络，不即通之，必作痈疽。《医通》用调经散加陵鲤甲，或琥珀地黄丸亦宜。切勿误用五积散等辛温之药。盖
五积之治瘀血作痛，以苍术为君，麻黄为臣，浓朴枳壳为使，虽有归芍之补血，仅及苍术三分之一，不思
产后之妇，即有寒邪，血气未充，似难发汗，不过借药性温和，可以推陈致新，岂可用麻黄之悍，苍术之燥
散，虚而又虚，祸不旋踵矣。
养荣壮肾汤 治产后腰痛，属劳伤或风寒所乘。
当归（二钱） 独活 桂心 川芎 杜仲（盐水制断丝） 续断（制，取净肉） 桑寄生（各八分，
取真桑树上者） 防风（四分）
生姜三片，煎服。如服二帖后疼痛不止，肾虚也。加熟地三钱再服。失血过多
者，加当归二钱，蜜炙黄 、酒炒白芍各一钱五分。
局方调经散 治产后败血，乘虚停积于五脏，循经流入于四肢，留滞日深，腐坏如水，渐致身体面
目浮肿。或因产败血上干于心，心不受触，致心烦躁，卧起不安，如见鬼神，言语颠倒，并宜服之。
赤芍 没药（别研） 琥珀（别研） 桂心 当归（各一钱） 细辛（去苗） 麝香（别研。各五分）
上为末，和匀，每服一钱，温酒入生姜少许服。一方每服五分，以痛止为度。
琥珀地黄丸 治产后恶露未净，胸腹痛，小便不利。
琥珀（别研） 延胡（同糯米炒，去米） 当归（各一两） 蒲黄（四两，生半、炒半） 干生地（
八两） 生姜（一斤）
上将地黄咀碎，酒浸。生姜切片，各捣取汁留滓。无油杓中，用姜汁炒地黄滓，地黄汁炒姜滓，各
干为末。忌犯铁器，炼白蜜为丸，弹子大。每服一丸，空心，当归煎汤调服。
济阴大造丸（见上卷补益门。）
产后腰痛，是因为肾脏的位置与胞宫相连，腰部是肾脏的外府。分娩时劳损并伤害了肾气，损伤了胞宫的络脉；或者身体虚弱尚未恢复，风冷邪气趁机侵袭，这两种情况都会导致腰痛。如果是寒冷邪气滞留于背部脊柱，疼痛日久不愈，后来忽然再次怀孕，必定会导致损伤，适宜用养荣壮肾汤主治。如果是产后时间已久仍出现腰痛，可用济阴大造丸治疗。如果恶露刚刚排出，忽然中断不来，腰部沉重疼痛，痛感向下放射至双腿，疼痛像锥子刺入骨头一样，这是血瘀阻滞经络所致，如果不立即疏通，必然发展为痈疽。《医通》主张使用调经散加陵鲤甲，或者琥珀地黄丸也适宜。千万不要误用五积散等辛温的药物。因为五积散治疗瘀血作痛，以苍术为君药，麻黄为臣药，厚朴、枳壳为使药，虽然有当归、白芍来补血，但用量仅占苍术的三分之一。没考虑到产后妇女即使有寒邪，气血也未充盈，似乎难以发汗，只是借药物温和的性质，可以推陈出新，怎么能使用麻黄的猛烈和苍术的燥散呢？这样会使虚弱的体质更加虚弱，灾祸很快就会降临。
养荣壮肾汤：治疗产后腰痛，属于劳累损伤或风寒侵袭所致。
当归（二钱） 独活 桂心 川芎 杜仲（用盐水制断丝） 续断（炮制，取净肉） 桑寄生（各八分，取真桑树上的） 防风（四分）
生姜三片，煎服。如果服用两帖后疼痛不止，说明是肾虚。加入熟地黄三钱再服。失血过多者，加入当归二钱，蜜炙黄芪、酒炒白芍各一钱五分。
局方调经散：治疗产后败血，乘虚停积在五脏，顺着经络流入四肢，停留日久加深，腐败坏乱如水，逐渐导致身体面目浮肿。或者因产后败血上扰于心，心脏不能承受触动，导致心中烦躁，卧起不安，如见鬼神，言语颠倒，都适宜服用此药。
赤芍 没药（单独研磨） 琥珀（单独研磨） 桂心 当归（各一钱） 细辛（去苗） 麝香（单独研磨。各五分）
以上药材研为细末，混合均匀，每次服用一钱，用温酒调入少许生姜服用。另一法每服五分，以疼痛停止为限度。
琥珀地黄丸：治疗产后恶露未净，胸腹部疼痛，小便不利。
琥珀（单独研磨） 延胡索（同糯米炒，去米） 当归（各一两） 蒲黄（四两，生用一半、炒用一半） 干生地（八两） 生姜（一斤）
先将地黄切碎，用酒浸泡。生姜切片，分别捣碎取汁并保留药渣。在无油的勺中，用姜汁炒地黄渣，用地黄汁炒姜渣，各自炒干后研为细末。忌讳接触铁器，炼白蜜制成丸药，大小如弹子。每次服用一丸，空腹时，用当归煎汤送服。
济阴大造丸（见上卷补益门）。
Lower back pain after childbirth is caused by the fact that the Kidney's position is connected to the Bao (uterus), and the waist is the mansion of the Kidney. Childbirth labors and injures Kidney Qi, damaging the collaterals of the Bao; or if the body is deficient and has not yet recovered, Wind-Cold pathogenic factors take advantage of this to invade. Both conditions result in lower back pain. If Cold-Damp pathogenic factors linger in the spine, causing chronic pain that does not resolve, and pregnancy occurs suddenly later, it will inevitably cause damage; Yangrong Zhuangshen Decoction (Nourishing the Blood and Strengthening the Kidney Decoction) should be used as the primary treatment. For lower back pain persisting long after childbirth, Jiyin Dazao Wan (Jiyin Great Creation Pill) is indicated. If lochia (postpartum discharge) begins but then suddenly stops, accompanied by heavy pain in the waist radiating down to both thighs, with pain feeling like a awl piercing into the bone, this is due to blood stasis blocking the collaterals. If not treated immediately to unblock them, it will inevitably develop into a carbuncle or ulcer. *Yitong* suggests using Tiaojing San (Regulating Menses Powder) plus Lingli Jia (Shell of Lingli turtle), or Hupo Dihuang Wan (Amber and Rehmannia Pill) is also suitable. Do not mistakenly use Wuji San (Five Accumulations Powder) or other acrid-warm medications. This is because Wuji San treats pain caused by blood stasis, using Cangzhu (Atractylodis Rhizoma) as the sovereign herb, Mahuang (Ephedrae Herba) as the minister herb, Houpo (Magnoliae Officinalis Cortex) and Zhike (Aurantii Fructus Immaturus) as the envoy herbs. Although Danggui (Angelicae Sinensis Radix) and Baishao (Paeoniae Radix Alba) are included to nourish blood, their dosage is only one-third of that of Cangzhu. One fails to consider that postpartum women, even if they have cold pathogenic factors, have insufficient Qi and Blood, making sweating therapy difficult. The mild nature of these drugs merely helps to eliminate the old and generate the new. How can one use the fierce nature of Mahuang and the drying-dispersing nature of Cangzhu? Doing so would make the already deficient constitution even more deficient, and disaster would follow swiftly.
Yangrong Zhuangshen Decoction: Treats lower back pain after childbirth, attributed to labor injury or invasion of Wind-Cold.
Danggui (2 qian) Duhuo Guixin Chuanxiong Duzhong (prepared with salt water until fibers break) Xuduan (processed, taking only the clean flesh) Sangjisheng (each 8 fen, taken from authentic mulberry trees) Fangfeng (4 fen)
Add three slices of Shengjiang (Fresh Ginger), decoct and take orally. If pain persists after two doses, it indicates Kidney deficiency. Add Shudi (Prepared Rehmanniae Radix) 3 qian and take again. For those with excessive blood loss, add Danggui 2 qian, Mi Zhi Huangqi (Honey-fried Astragali Radix) and Jiu Chao Baishao (Wine-fried Paeoniae Radix Alba) each 1.5 qian.
Ju Fang Tiaojing San: Treats postpartum "bad blood" (stagnant blood) that takes advantage of deficiency to accumulate in the five zang organs, flows along the meridians into the four limbs, lingers deeply, becomes corrupt and fluid-like, gradually leading to edema of the body and face. Or, due to postpartum stagnant blood disturbing the Heart, which cannot tolerate the disturbance, resulting in mental restlessness, anxiety about lying down or rising, hallucinations (seeing ghosts/spirits), and disordered speech. All these conditions are suitable for this medication.
Chishao Moyao (separately ground) Hupo (separately ground) Guixin Danggui (each 1 qian) Xixin (remove seedlings) Shexiang (separately ground. Each 5 fen)
Grind all above into powder, mix evenly. Take 1 qian per dose, administered with warm wine and a little Shengjiang. Another method suggests taking 5 fen per dose, stopping when pain ceases.
Hupo Dihuang Wan: Treats postpartum incomplete expulsion of lochia, chest and abdominal pain, and dysuria.
Hupo (separately ground) Yanhusuo (stir-fried with glutinous rice, remove rice) Danggui (each 1 liang) Puhuang (4 liang, half raw, half stir-fried) Gan Shengdi (8 liang) Shengjiang (1 jin)
First, chop the Dihuang (Rehmanniae Radix) and soak in wine. Slice Shengjiang, crush separately to extract juice while retaining the dregs. In a non-oily spoon, stir-fry Dihuang dregs with Shengjiang juice, and stir-fry Shengjiang dregs with Dihuang juice, until dry, then grind into powder. Avoid contact with iron vessels. Refine white honey to form pills, size of a bullet. Take one pill per dose, on an empty stomach, washed down with decoction of Danggui.
Jiyin Dazao Wan (See Volume I, Tonification Section).