〔大〕产后遍身疼痛者何？答曰∶产后百节开张，血脉流散，遇气弱则经络肉分之
间，血多留滞，累日不散，则骨节不利，筋脉急引，故腰背不得转侧，手足不能动摇，身
热头痛也。若医以为伤寒治之，则汗出而筋脉动惕，手足厥冷，变生他病，但服趁痛散
除之。
〔薛〕前证若以手按而痛甚，是血滞也。用四物、炮姜、红花、桃仁、泽兰，补而散
之。若按而痛稍缓，此是血虚也。用四物、炮姜、人参、白术，补而养之。 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，六脉洪大如无，用
补中益气加炮姜、半夏，一剂顿退二三，又剂寝食甘美，但背强而痛，用八珍散大补汤
调理而安。一产妇遍身头项作痛，恶寒拘急，脉浮紧，此风寒之证也。用五积散一剂，
汗出而愈。但倦怠发热，此邪气去而真气虚也，用八珍汤调补而痊。一妇六月产后多
汗，人倦不敢袒被，故汗出被里，冷则浸渍，得风湿疼痛，遂以羌活续断汤数服而愈。
趁痛散 （《云岐》）治产后气弱血滞，遍身疼痛，及身热头疼。
牛膝 当归 桂心 白术 黄 独活 生姜（各半两） 甘草 薤白（各二钱半）
上 咀，每服半两，水参盏，煎至一盏半，去渣，食前服。
陈无择评曰∶趁痛散不特治产后气弱血滞，兼能治太阳经感风头疼，腰背痛，自汗
发热。若其感寒伤食，忧恐惊怒，皆致身疼发热头痛，况有蓐劳，诸证尤甚，趁痛散皆
不能疗。不若五积散入醋煎用却不妨。
五积散加酒煎，治感寒头痛身疼，方见伤寒门。恐与四物各半服之稳当。加桃仁煎，
治腰痛，逐败血，去风湿。
〔大〕治产后遍身青肿疼痛，及众疾。
牛膝 大麦 （各等分）
上为细末，以新瓦罐子中填一重麦 ，一重牛膝，如此填满，用盐泥固济，火 过赤，
放冷，研为散。但是产后诸疾，热酒调二钱下。
活血丹 苍术四物各半汤（并见杂病身痛。）
乌金散，治产后骨节四肢疼痛。（见后狂言谵语。）
【大】产后出现全身疼痛的原因是什么？回答说：产后全身关节松弛张开，血脉运行散乱，如果遇到气虚，则在经络和肌肉腠理之间，血液容易多处留滞，多日不散，就会导致骨节活动不利，筋脉拘急牵引，因此腰背不能翻身侧转，手足不能随意运动，并伴有身体发热、头痛等症状。如果医生误认为是伤寒来治疗，使用发汗法，会导致出汗后筋脉跳动抽搐，手足冰冷，从而变生其他疾病。此时只需服用趁痛散即可消除病症。
【薛】上述症状如果用手按压时疼痛加剧，这是血瘀阻滞的表现。应使用四物汤（补血调经方）、炮姜、红花、桃仁、泽兰，以补益兼消散瘀血的方法治疗。如果按压时疼痛稍缓，这是血虚的表现。应使用四物汤、炮姜、人参、白术，以补益滋养的方法治疗。有一位产妇身体和腹部作痛，发热且食欲不振，烦躁不安无法入睡，盗汗且胁肋疼痛，服用了发散解表及祛瘀血的药物后，不时出现神志昏沉迷糊的症状，六脉洪大但按之空虚无力。使用补中益气汤加入炮姜、半夏，服用一剂后症状退去二三分，再服用一剂后睡眠和饮食恢复正常，只是背部僵硬疼痛，随后用八珍散大补汤调理而痊愈。另一位产妇全身及头颈部疼痛，恶寒且肢体拘急，脉象浮紧，这是风寒的证候。使用五积散一剂，出汗后痊愈。但之后出现倦怠和发热，这是邪气已去而真气虚弱所致，使用八珍汤调补而康复。还有一位妇女在六月产后出汗过多，身体疲倦不敢掀开被子，导致汗水浸渍被内，受冷后浸渍肌肤，引发风湿疼痛，于是服用羌活续断汤数剂而痊愈。
趁痛散（出自《云岐子脉诀》）：治疗产后气弱血滞引起的全身疼痛，以及身体发热、头痛。
配方：牛膝、当归、桂心、白术、黄芪、独活、生姜（各半两）；甘草、薤白（各二钱半）。
制法与用法：将药材切碎，每次取半两，加水一盏，煎煮至一盏半，滤去药渣，饭前温服。
陈无择评论说：趁痛散不仅治疗产后气弱血滞，还能治疗太阳经受风引起的头痛、腰背痛、自汗发热。如果是感受寒邪或伤食，或因忧恐惊怒导致的身疼发热头痛，况且有蓐劳（产后虚损），各种症状尤其严重，趁痛散都不能治愈。不如使用五积散加醋煎服反而有效。
五积散加酒煎煮，治疗感寒引起的头痛身疼，方剂见伤寒门。恐怕与四物汤各半合服更为稳妥。加入桃仁煎煮，治疗腰痛，驱逐败血，去除风湿。
【大】治疗产后全身青肿疼痛，以及多种杂病。
配方：牛膝、大麦（各等分）。
制法与用法：将药材研为细末，在新瓦罐中一层层填入大麦和牛膝，填满后用盐泥密封固定，用火煅烧至通红，放凉后研成散剂。凡是产后各种疾病，用热酒调服二钱。
[Da] What is the cause of generalized body pain after childbirth? The answer is: After childbirth, all joints and apertures are open, and blood vessels run scattered. If Qi is weak, blood tends to stagnate in the meridians and muscle layers for many days without dispersing. This leads to impaired joint mobility and acute tension in tendons and collaterals, resulting in an inability to turn or bend the waist and back, immobility of the hands and feet, along with fever and headache. If physicians mistakenly treat this as Taiyang Cold Damage (Shanghan) and induce sweating, it will cause twitching of tendons and collaterals after sweating, coldness of the hands and feet, and generate other pathological changes. In such cases, one should simply administer Chentong San (Urging Pain-Relieving Powder) to resolve the condition.
[Xue] If pressing on the affected area exacerbates the pain in the aforementioned symptoms, it indicates Blood stasis. Use Siwu Tang (Four Substances Decoction), Paojiang (Charred Ginger), Honghua (Safflower), Taoren (Peach Kernel), and Zelan (Eupatorium), employing a method of tonifying while dissipating stasis. If pressing on the area relieves the pain slightly, it indicates Blood deficiency. Use Siwu Tang, Paojiang, Renshen (Ginseng), and Baizhu (Atractylodes Macrocephala Rhizome), employing a method of tonifying and nourishing.
One postpartum woman suffered from abdominal and bodily pain, fever, loss of appetite, irritability, insomnia, night sweats, and hypochondriac pain. After taking herbs for releasing the exterior and dispelling blood stasis, she frequently experienced mental confusion. Her six pulses were surging yet empty upon pressure. She was treated with Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Paojiang and Banxia (Pinellia Tuber). After one dose, symptoms improved by two or three degrees; after another dose, her sleep and appetite returned to normal. However, she still had a stiff and painful back, which was resolved using Bazhen San (Eight Treasures Powder) and Dabu Tang (Great Tonifying Decoction) for regulation.
Another postpartum woman suffered from generalized pain in the body, head, and neck, aversion to cold, and stiffness, with a floating and tight pulse. This is a pattern of Wind-Cold. She was treated with Wuji San (Five Accumulations Powder); after one dose, sweating occurred and she recovered. Subsequently, she experienced fatigue and low-grade fever, indicating that the pathogenic factor had departed but True Qi was deficient. She was treated with Bazhen Tang (Eight Treasures Decoction) for regulation and tonification, leading to recovery.
A woman who gave birth in the sixth month sweated excessively. Due to physical exhaustion, she dared not uncover herself, causing sweat to soak into the bedding. The cold moisture penetrated the skin, leading to Wind-Damp pain. She was cured after several doses of Qianghuo Xuduan Tang (Notopterygium and Dipsacus Decoction).
Chentong San (from *Yunqi*) treats generalized body pain due to postpartum Qi weakness and Blood stasis, as well as fever and headache.
Ingredients: Huainiu (Achyranthes Root), Danggui (Angelica Sinensis), Guixin (Cinnamon Twig), Baizhu (Atractylodes Macrocephala Rhizome), Huangqi (Astragalus Root), Duhuo (Angelica Pubescens Root), Shengjiang (Fresh Ginger) (each 0.5 liang); Gancao (Licorice Root), Xiebai (Allium Macrostemon Bulb) (each 2.5 qian).
Preparation and Administration: Coarsely crush the herbs. Take 0.5 liang per dose, add one cup of water, decoct until one and a half cups remain, strain, and take warm before meals.
Chen Wuyue commented: Chentong San not only treats postpartum Qi weakness and Blood stasis but also treats headache, lower back pain, spontaneous sweating, and fever caused by Wind affecting the Taiyang Meridian. However, if the body pain, fever, and headache are caused by Cold invasion, food retention, or emotional disturbances like worry, fear, shock, or anger, especially when complicated by Rudao (postpartum consumptive disease), Chentong San cannot cure them. It is better to use Wuji San (Five Accumulations Powder) decocted with vinegar.
Wuji San decocted with wine treats headache and body pain due to Cold invasion (see Shanghan section). It may be prudent to take half of this formula and half of Siwu Tang together. Adding Taoren (Peach Kernel) treats lower back pain, expels lochia, and removes Wind-Damp.
[Da] Treats generalized cyanosis and swelling with pain after childbirth, as well as various miscellaneous diseases.
Ingredients: Huainiu (Achyranthes Root), Damai (Barley) (equal parts).
Preparation and Administration: Grind into fine powder. Layer barley and Huainiu in a new clay pot, sealing it with salt mud. Calcine over fire until red hot, cool down, and grind into powder. For any postpartum disease, mix 2 qian with hot wine and ingest.
Huoxue Dan (Blood Invigorating Elixir), Cangzhu Siwu Gemban Tang (Half Cangzhu Half Siwu Tang) (both see Miscellaneous Diseases: Body Pain section).
Wujin San (Black Gold Powder) treats bone and joint pain in the limbs after childbirth (see subsequent section on delirium and manic speech).