bubble_chart Concept

After childbirth, if a woman experiences pain in one or both hypochondriac regions, it is referred to as postpartum hypochondriac pain.

bubble_chart Pattern Analysis

1. Blood Deficiency︰There is a dull pain in both hypochondriac regions, which worsens with fatigue. Symptoms include dizziness, a pale or shallow yellow complexion, blurred vision, timidity and fear, and excessive lochia. The tongue is pale with a white coating, and the pulse is weak and thin. This condition is often caused by excessive blood loss during childbirth or prolonged lochia, leading to insufficient liver blood and malnourishment of the meridians. The clinical manifestations are characterized by: dull hypochondriac pain that worsens with exertion; accompanied by blurred vision, a pale or shallow yellow face, excessive lochia, a weak and thin pulse, and other signs of blood deficiency. The treatment should focus on tonifying blood and nourishing the nutritive level, using Four Ingredients Decoction supplemented with Cyperus and tangerine pith.
2. Qi Stagnation︰Common right hypochondriac distending pain or wandering pain. Epigastric fullness and chest tightness, belching and sighing, bland taste in the mouth, anorexia. Mental depression or dysphoria. Pale tongue with thin greasy coating, deep and wiry pulse. The pain is mostly localized to the right hypochondrium, presenting as distension or wandering pain, accompanied by symptoms of qi stagnation such as mental depression or dysphoria, frequent sighing, epigastric fullness and chest tightness, and deep wiry pulse. The treatment should focus on strengthening the spleen and soothing the liver. The recommended formula is Four Gentlemen Decoction with the addition of Bupleurum and green tangerine peel.
3. Blood Stasis︰Common left hypochondriac pulling pain or stabbing pain. Slightly purplish complexion. Scanty lochia with dark color and clots. Slightly bluish tongue, wiry and choppy pulse. The pain is mostly localized in the left hypochondrium, presenting as pulling pain or stabbing pain. Accompanied by slightly purplish complexion, scanty lochia with dark color and clots, slightly bluish tongue, wiry and choppy pulse, and other signs of {|###|}blood stasis{|###|}. Treatment should focus on {|###|}invigorating blood and resolving stasis{|###|}, with the formula Corydalis Powder as the base for modification.

Postpartum hypochondriac pain should be carefully differentiated between deficiency and excess. Generally, pain that is relieved by pressure is considered deficiency, while pain that is aggravated by pressure is considered excess. Pain that is not felt during deep breathing is considered deficiency, while severe pain is considered excess.

bubble_chart Documentation

1. 《Compilation of Ancient and Modern Books: Complete Records of the Medical Department: Gynecology: Postpartum Women's Section: Furen Liangfang．Hypochondriac Distending Pain．Commentary》: "Postpartum hypochondriac distension and qi pain are caused by pre-existing water retention in the bladder. Due to the complete postpartum lochiostasis, water congestion and qi clash, accumulating in the bladder, thus causing hypochondriac distension. The interaction between qi and water causes pain."