人参泽兰叶汤
产后口鼻黑而衄，胃绝肺败药难医，参兰丹膝生熟地，童便多冲冀万一。
【注】产后恶露不下，虚火载血上行，溢出鼻窍，不循经脉，变黑色见于口鼻，为热
极反兼水化，故曰胃绝肺败，药难医也，或用人参泽兰叶汤，即人参、泽兰叶、丹皮、牛
膝、生地、熟地煎汤，多冲童便饮之，间有得生者，然亦希冀于万一者耳。
产后痢名产子痢，饮食生冷暑寒干，里急后重有余病，日久滑脱不足看，赤黄稠粘多是热，清彻鸭溏
定属寒，寒热温清调补涩，虚实新久要详参。
【注】产后痢者，名产子痢。多因饮食不调、贪食生冷，或起居不慎，冲寒受暑所致
若腹中痛，里急后重者，属有余之证；若日久虚寒滑脱者，属不足之证。痢色黄赤稠粘，
多属于热；清稀澄彻如鸭粪者，则属于寒。治之之法∶热者清之，寒者温之，冷热不和者
调之，虚者补之，实者泻之。虚实新久之间宜细心详参也。
槐连四物汤 芍药汤 真人养脏汤
热痢槐连四物效；冷热有余芍药汤，芍药芩连归木草，枳桂坠槟痛大黄；虚寒滑脱参术桂，芍药呵
蔻广木香，甘草粟壳名养脏；日久十全大补良。
【注】热者清之，故热痢宜槐连四物汤，即四物汤加槐花、黄连，以清热而坚肠也。冷
热不和者调之，故宜芍药汤，即白芍药、黄芩、黄连、当归、木香、甘草、肉桂、槟榔；
坠者倍加槟榔，痛加生大黄也。若虚寒滑脱，则宜温补而固涩之，宜真人养脏汤，即人参、
白术、白芍药、肉桂、肉豆蔻、诃子、木香、甘草、罂粟壳同煎服也。若日久不止，气血
大虚，宜十全大补汤补之。
四物汤、十全大补汤（方俱见首卷）
人参败毒散 香连丸 加味四物汤
有表痢用败毒散，羌独枳桔共柴前，参苓芎草姜葱引；暑湿成痢用香连；血渗大肠成血痢，四物
胶榆余贼添。
【注】外感风寒成痢者，宜人参败毒散，即羌活、独活、枳壳、桔梗、柴胡、前胡、人
参、茯苓、川芎、甘草，姜、葱引也。若因暑湿致痢，宜香连丸，即黄连、木香为丸也。
若败血渗入大肠成血痢者，宜四物加阿胶、地榆、血余、乌 鱼骨服之。
四物汤（方见首卷）
Ren Shen Ze Lan Ye Tang (Ginseng and Eupatorium Decoction)
Postpartum epistaxis accompanied by blackening of the mouth and nose indicates exhaustion of Stomach Qi and failure of Lung Qi, a condition difficult to treat with medicine. The formula consists of Ren Shen (Ginseng), Ze Lan Ye (Eupatorium Leaf), Dan Pi (Moutan Cortex), Niu Xi (Achyranthes Root), Sheng Di Huang (Rehmannia Root, raw), and Shu Di Huang (Rehmannia Root, prepared). It is decocted in water and taken with a large amount of Tong Bian (Child's Urine), hoping for a slim chance of survival.
[Annotation] When Lochia (postpartum discharge) fails to descend after childbirth, Deficient Fire carries blood upward, causing it to overflow from the nasal cavity without following the meridians. The blood turns black and appears at the mouth and nose. This occurs because extreme Heat transforms into Water-like symptoms; thus, it is termed "Stomach Exhaustion and Lung Failure," making it difficult to treat with medicine. Alternatively, Ren Shen Ze Lan Ye Tang may be used, composed of Ren Shen (Ginseng), Ze Lan Ye (Eupatorium Leaf), Dan Pi (Moutan Cortex), Niu Xi (Achyranthes Root), Sheng Di Huang (Rehmannia Root, raw), and Shu Di Huang (Rehmannia Root, prepared). It is decocted and taken with abundant Tong Bian (Child's Urine). Occasionally, patients may survive, but this is merely a hope for one in ten thousand chances.
Chan Zi Li (Postpartum Dysentery)
Postpartum dysentery is named Chan Zi Li (Postpartum Dysentery). It is often caused by dietary irregularities, consumption of cold/raw foods, or exposure to summer-heat and cold due to improper living habits. Tenesmus (Li Ji Hou Zhong) belongs to Excess syndromes; prolonged slippage and incontinence belong to Deficiency syndromes. Stool that is red-yellow, thick, and sticky is mostly due to Heat; clear, watery stool resembling duck feces definitely belongs to Cold. Treatment involves regulating, tonifying, and astringing according to Cold, Heat, Excess, and Deficiency. One must carefully analyze the Excess/Deficiency and the newness or chronicity of the disease.
[Annotation] Postpartum dysentery is called Chan Zi Li (Postpartum Dysentery). It is mostly caused by dietary imbalance, greed for cold/raw foods, or careless daily life leading to exposure to cold or summer-heat. If there is abdominal pain and tenesmus, it belongs to an Excess syndrome; if it persists for a long time with cold deficiency and slippage, it belongs to a Deficiency syndrome. Dysentery that is yellow-red, thick, and sticky mostly belongs to Heat; clear, thin, and transparent stool like duck feces belongs to Cold. The treatment method: Clear the Heat, warm the Cold, harmonize mixed Cold and Heat, tonify Deficiency, and drain Excess. Careful analysis is required regarding Excess/Deficiency and whether the condition is new or chronic.
Huai Lian Si Wu Tang (Sophora and Coptis Four Substances Decoction), Shao Yao Tang (Peony Decoction), Zhen Ren Yang Zang Tang (True Human Nourishing the Viscera Decoction)
For Heat dysentery, Huai Lian Si Wu Tang (Sophora and Coptis Four Substances Decoction) is effective; for mixed Cold-Heat with Excess, Shao Yao Tang (Peony Decoction) is used, containing Shao Yao (Peony Root), Qin Lian (Coptis and Scutellaria), Gui Mu Cao (Angelica, Aucklandia, Licorice), Zhi Gui Bin Tong Da Huang (Aucklandia, Cinnamon, Areca Nut, Pain-relieving Rhubarb); for Cold-deficiency with slippage, use Ren Shen, Zhu Gui, Shao Yao, Ke Kou Guang Mu Xiang, Gan Cao Su Ke (Ginseng, Atractylodes, Cinnamon, Peony, Tsaoko, Litsea, Licorice, Poppy Shell) as Zhen Ren Yang Zang Tang (True Human Nourishing the Viscera Decoction); for chronic cases, Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) is beneficial.
[Annotation] Since Heat should be cleared, Heat dysentery is suitable for Huai Lian Si Wu Tang (Sophora and Coptis Four Substances Decoction), which is Si Wu Tang (Four Substances Decoction) plus Huai Hua (Sophora Flower) and Huang Lian (Coptis Rhizome), to clear Heat and strengthen the intestines. For mixed Cold and Heat, harmonization is needed, so Shao Yao Tang (Peony Decoction) is suitable, consisting of Bai Shao Yao (White Peony Root), Huang Qin (Scutellaria Root), Huang Lian (Coptis Rhizome), Dang Gui (Angelica Sinensis), Mu Xiang (Aucklandia Root), Gan Cao (Licorice Root), Rou Gui (Cinnamon Bark), Bing Lang (Areca Seed); increase Bing Lang (Areca Seed) for heaviness/sinking sensation, and add Sheng Da Huang (Raw Rhubarb) for pain. If it is Cold-deficiency with slippage, warming, tonifying, and astringing are appropriate; Zhen Ren Yang Zang Tang (True Human Nourishing the Viscera Decoction) is suitable, comprising Ren Shen (Ginseng), Bai Zhu (Atractylodes Macrocephala), Bai Shao Yao (White Peony Root), Rou Gui (Cinnamon Bark), Rou Dou Kou (Myristica Seed), He Zi (Chebula Fruit), Mu Xiang (Aucklandia Root), Gan Cao (Licorice Root), Ying Su Ke (Poppy Shell), decocted together. If it persists for a long time with severe Qi and Blood deficiency, Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) should be used to tonify.
Si Wu Tang (Four Substances Decoction) and Shi Quan Da Bu Tang (Comprehensive Great Tonifying Decoction) (Formulas are in Volume 1).
Ren Shen Bai Du San (Ginseng Detoxifying Powder), Xiang Lian Wan (Aucklandia and Coptis Pill), Jia Wei Si Wu Tang (Modified Four Substances Decoction)
For dysentery with exterior symptoms, use Ren Shen Bai Du San (Ginseng Detoxifying Powder), containing Qiang Du Zhi Jie Gong Chai Qian (Notopterygium, Angelica Pubescens, Aucklandia, Platycodon, Bupleurum, Peucedanum), Ren Shen (Ginseng), Fu Ling (Poria), Xiong Cao Jiang Cong Yin (Ligusticum, Licorice, Ginger, Scallion as guides); for dysentery caused by Summer-heat and Dampness, use Xiang Lian Wan (Aucklandia and Coptis Pill); for blood seeping into the Large Intestine forming bloody dysentery, use Si Wu Tang (Four Substances Decoction) plus E Jiao (Donkey-hide Gelatin), Di Yu (Sanguisorba Root), and other herbs to eliminate pathogens.
[Annotation] For dysentery caused by external contraction of Wind-Cold, Ren Shen Bai Du San (Ginseng Detoxifying Powder) is suitable, consisting of Qiang Huo (Notopterygium Rhizome), Du Huo (Angelica Pubescens), Zhi Ke (Aurantium Fruit), Jie Geng (Platycodon Root), Chai Hu (Bupleurum Root), Qian Hu (Peucedanum Root), Ren Shen (Ginseng), Fu Ling (Poria), Chuan Xiong (Ligusticum Chuanxiong), Gan Cao (Licorice Root), guided by Jiang (Ginger) and Cong (Scallion). If dysentery is caused by Summer-heat and Dampness, Xiang Lian Wan (Aucklandia and Coptis Pill) is suitable, made of Huang Lian (Coptis Rhizome) and Mu Xiang (Aucklandia Root) as pills. If defeated blood seeps into the Large Intestine forming bloody dysentery, Si Wu Tang (Four Substances Decoction) plus E Jiao (Donkey-hide Gelatin), Di Yu (Sanguisorba Officinalis Root), Xue Yu (Hair Charcoal), and Ou Gu (Cuttlefish Bone) should be taken.
Si Wu Tang (Four Substances Decoction) (Formula is in Volume 1).