《大全》云∶产后痢疾者,因行起太早,使冷风乘虚入于肠胃,或食生冷难化之物,伤
胃,皆令洞泄水泻,甚则变为痢。若血渗入肠则为血痢也,难治。世谓之产后痢也。得冷则
白,或如鱼脑,热则黄赤,或为骤血。若冷热相搏则下痢赤白,或脓血相杂。若下痢青色,
则极冷也。若饮食不进,便痢日夜无度,瘦之羸弱,谓之虚羸下痢。又有产后气血不顺而下
痢赤白,谓之气痢。治之之法,热则凉之,寒则温之,冷热相搏则调之。滑者涩之,虚羸者
补之,水谷不分者当利小便。若产妇情性热着,不能宽解,须当顺其气,未有不安者也。与
泄泻参看。
《大全》云∶妇人乳汁乃气血所化,其或不行者,由虚弱经络不调所致。或产后乳胀,
作者,此年少之人初经产乳,内有风热也。须服清理之药则乳行。若累经产而无乳者,亡津
液故也,须服滋阴之药以助之。或虽有乳而不多者,须服通经之药以通之,仍以羹 引之
。盖妇人之乳汁资以冲脉,冲与胃经通故也。按《三因方》云∶乳汁不行有二∶有血气盛而
壅闭不行,有血少气弱涩而不行者。虚当补之,盛当疏之(盛者当用通草、漏芦、土瓜根,
虚者当用炼成钟乳粉、猪蹄、鲫鱼之属)。薛氏曰∶若气血虚弱而不生化者,宜壮脾胃,怒
动肝胆而乳肿、乳汁不出者,宜清肝火。若夫屡产无乳或大便涩滞,当滋化源。未产前乳汁
自不出者,谓之乳泣。
乳头生小浅热疮,搔之黄汁出,浸淫渐大,百疗不瘥,动经年月,名为妒乳。若感外受
之邪
与气血相搏,即壮热大渴引饮,牢强掣痛,手不近是也。若夫不得于舅姑,忧怒郁遏,时日
累积,脾气清汨肝气横逆,遂成隐核如鳖棋子,不痛不痒,十数年后方为疮陷,名曰乳岩(
仲圭曰∶本病若在未成溃疡以前,以香附饼治之良效。方用香附细末一两,麝香二分,研匀
,以蒲公英二两,酒煎去渣,以酒调药,乘热敷患处,日数次。如已成溃疡者,应受外科之
治疗,特本症之病原既由肝脾抑郁而起,则怡情悦情又为至要。汤剂以逍遥散与归脾汤间服
。至于性情如何怡悦,则莫如披阅内典,以了解人生观为上策)。
The *Daquan* (Compendium of Great Health) states: Dysentery occurring postpartum is caused by rising and moving too early, allowing cold wind to enter the intestines and stomach due to deficiency, or by consuming raw, cold, and indigestible foods that damage the Stomach. All these conditions lead to profuse watery diarrhea, which may severe into dysentery. If blood seeps into the intestines, it becomes bloody dysentery, which is difficult to treat; this is commonly referred to as "postpartum dysentery." When affected by cold, the stool is white or resembles fish brains; when affected by heat, it is yellow-red or presents as sudden hemorrhage. If cold and heat pathogens contend with each other, red and white dysenteric stools are passed, or pus and blood are mixed. If green dysenteric stools are passed, it indicates extreme cold. If food intake ceases, accompanied by unceasing day-and-night diarrhea, leading to emaciation and weakness, it is termed "deficiency-emaciation dysentery" (Xu Lei Xia Li). Additionally, red and white dysentery caused by the stagnation of Qi and Blood postpartum is called "Qi dysentery" (Qi Li). The treatment principles are: for heat patterns, use cooling methods; for cold patterns, use warming methods; for contending cold and heat, use harmonizing methods; for slippery/uncontrolled discharge, use astringent methods; for deficiency-emaciation, use tonifying methods; for the inability to distinguish water and grain, promote diuresis. If the parturient has a hot temperament and cannot relax, her Qi mechanism must be smoothed, ensuring stability. This condition should be cross-referenced with the section on Diarrhea.
The *Daquan* further states: Women's milk is transformed from Qi and Blood. Its failure to flow is caused by physical weakness and disharmony of the meridians. If there is breast distension and pain with milk stasis after childbirth, this occurs in young women during their first lactation due to internal Wind-Heat. Medications that clear heat and regulate Qi should be administered to promote milk flow. If a woman who has given birth multiple times still lacks milk, it is due to the depletion of Body Fluids; nourishing Yin medications should be taken to assist. If milk exists but is scanty, medications that unblock the meridians should be used to facilitate flow, supplemented by soups or broths as guides. This is because women's milk originates from the Chong Mai (Penetrating Vessel), which connects with the Stomach Meridian. According to the *Sanyin Fang* (Formulas of Three Causes), there are two types of milk stasis: one where abundant Qi and Blood cause obstruction and blockage, and another where deficient Blood and weak Qi cause涩滞 (stagnation). Deficient patterns require tonification, while excess patterns require dispersion (for excess patterns, use Tongcao, Lulü, and Tugua Gen; for deficient patterns, use refined Zhongru Fen, pig trotters, and crucian carp). Xue Ji stated: For those whose Qi and Blood are weak and fail to transform milk, strengthen the Spleen and Stomach. For those whose anger moves Liver and Gallbladder fire, causing breast swelling and milk stasis, clear Liver Fire. For those lacking milk after multiple births or suffering from constipation, nourish the source of transformation. Milk flowing spontaneously before delivery is called "Ru Qi" (Milk Weeping).
Small superficial heat sores appearing on the nipple, oozing yellow fluid upon scratching, spreading gradually, resistant to all treatments, and persisting for years, are named "Du Ru" (Jealous Breast). If external pathogenic factors invade and contend with Qi and Blood, symptoms include high fever, intense thirst requiring drinking, firm rigidity, pulling pain, and tenderness such that the area cannot be touched. If distress arises from not being favored by parents-in-law, leading to accumulated sorrow and anger, causing Spleen Qi to become turbid and Liver Qi to flare horizontally, hidden nodules like turtle eggs form, painless and itchless, only ulcerating into sores after ten or more years; this is named "Ru Yan" (Breast Rock/Cancer). (Zhong Gui noted: Before ulceration forms, applying an Xiangfu cake is highly effective. The formula consists of 1 liang of fine Xiangfu powder and 2 fen of Shexiang, ground together. Two liang of Pugongying is decocted in wine, strained, and the wine is used to mix the medicine. Apply warm compresses to the affected area several times daily. If ulceration has already occurred, surgical treatment is required. Notably, since the etiology stems from Liver-Spleen depression, emotional regulation is paramount. Decoctions can alternate between Xiaoyao San and Guipi Tang. As for how to achieve emotional joy, reading Buddhist and Daoist classics to understand life philosophy is the best strategy.)