（附论）
夫妊娠大小便不通者。因脏腑气实而生于热。热者。随停之处则成病也。若热结于大肠。
则大便不通。结于小肠。则小便不通。若大小肠俱为热所结。故烦满而大小便皆不通也。又
云。小肠有热。热入于内脬。热结甚者。令小便不通。则心胁小腹气涩而喘急也。陈无择云。
妊娠胎满逼胞。多致小便不利者。或心肾气不足。不能使胞冷。清浊相干。为诸淋病。致小
便不通。名曰转胞。又胎满尿出不知时。名曰遗尿。治之各有方。
方
槟榔散 治妊娠大小便不通。心腹胀满妨闷。不欲饮食。手足烦热。
槟榔 赤茯苓 大腹皮 木通 郁李仁 北五味（各一两） 桑寄生 甘草 苦梗（各
一两） 上为粗末。每服三钱。水一盏。煎至六分。温服。一方无五味子。
归凉节命散 治妊娠恣情饮酒。或食生果、鱼、羊、鸡、面、毒物。致令百节酸痛
。大小腑秘涩。面赤。口苦心烦。腹胀。
栀子汤 治妊娠大小便不通。脐腹胀痛。
栀子仁（一两半） 石膏（四两） 黄芩（一两半） 泽泻（二两） 柴胡（一两半） 赤
芍药（二两） 葳蕤（一两半） 车前草（切半两） 上粗捣筛。每服四钱匕。水一盏半。
淡竹叶十片。同煎
柴胡通塞汤 治妊娠大小便不通。下焦热结。
柴胡 黄芩 陈橘皮 泽泻 羚羊角（各三两） 栀子仁（一两） 石膏（一两） 大
黄（锉炒一两） 上粗捣筛。每服四钱匕。水一盏。入生地黄一分。拍破。豉半分。同煎至
七分去滓。食前温服。
治妊娠大小便不通。热闭。心膈腹胁妨闷。妨害饮食。
大黄 木通 槟榔（各一两） 枳壳（三分） 大腹皮（二枚） 诃黎勒（四个半生半
煨） 上为末。以童子小便一盏。葱白二寸。同煎至六分。调下二钱。不拘时候。
车前子汤 治妊娠大小便俱不通。
车前子（五两） 木通（四两） 黄芩（二两） 郁李仁（二两半） 大黄（二两） 上
粗捣筛。每服四钱匕。水一盏半。煎至八分去滓。食前温服。
大腹皮散 治妊娠大小便秘涩。浮肿。
枳壳 大腹皮 甘草 赤茯苓（各等分） 上为细末。每服二钱。浓煎葱白汤下。不拘
时候。
冬葵根汤 治妊娠大小便不通。七八日以上。腹胀烦闷。
冬葵根（干者一握洗冬即用子） 车前草（一两干者切） 木通（细锉三两） 大黄（锉
炒半两） 上粗捣筛。每服五钱。水一盏半。煎至八分去滓。食前温服。
茅根汤 治妊娠大小便不通。结闷气急。胀满欲死。
茅根（碎锉） 滑石 车前子（微炒） 大黄（锉碎微炒各一两半） 上粗捣筛。每服
四钱。水一盏半。煎至八分去滓。食前温服。
木通汤 治妊娠大小便不通。下部胀满。坐卧不安。
木通（锉碎二两） 滑石（三两） 大麻仁（一两） 大黄（锉碎生用二两） 上粗捣
筛。每服四钱。水一盏半。煎至七分去滓。空心温服。
榆白皮汤 治妊娠大小便不通。
榆白皮（细锉一两半） 桂（去粗皮一两锉碎） 甘草（一两半炙） 滑石（三两） 上
粗捣筛。每服四钱。水一盏半。煎至七分去滓。食前温服。
冬葵子汤 治妊娠大小便不通。
冬葵子（二两微炒） 大黄（一两锉炒） 上粗捣筛。每服三钱。水一盏。煎至七分去
滓。食前温服。
冬葵根汁方 治妊娠大小便不通。
生冬葵根（洗二斤细切烂捣生细布捩取汁三合） 生姜（四两洗切烂研生细布绞取汁半
合）
上和令匀。分三服。空心日一服。未利再服。又未利。尽三服。
治妊娠小便不通。脐下妨闷。虚羸。大便秘。
车前子（一两） 大黄（半两） 上为细末。每服三钱。空心蜜调下。
葵子汤 治妊娠得病六七日以上。身热入脏。大小便不利。安胎除热。
用葵子研为末。酒调下。
治妇人双身大小便不利。
用八正散大作剂料。去滑石。加葵菜子煎服。经曰膀胱不利为癃者。小便闭而不通也。
如正八散加木香。取效更捷。经曰膀胱气化则能出焉。然后五苓散三五服则愈也。
治妊娠大小便不通。
用猪脂如半鸡子大。碎切。以酒半升暖令沸。投猪膏内更煎一两沸。分三服。食前温服。
未通再服。
治妊娠大小便不利方。
用甘遂煨令黄。捣细罗为散。每服不计时候。以水调下一钱匕。
治大小便赤涩。
大腹皮 枳壳 甘草（各一钱） 赤茯苓（三钱） 锉作三服。水一盏半。煎一盏。将
郁李
仁二钱半去皮尖。同煎五七沸。空心连服。通为度。如不通。必是大腑热秘。可服后药。
枳壳（一钱） 大黄（二钱） 甘草（一钱） 三味为细末。作三服。浓煎葱白汤调下。
虽通
小便复涩胀。烦热。不得睡卧。而反倚息。心胞系戾。不得溺者。病名转胎。可服八味丸。
治妊娠大腑秘热。非时腰痛。行履不得方。
杏仁 桔梗 升麻 枳壳 前胡（各一分） 大腹皮（一两） 上为细末每服二钱水一
盏二
分。煎三四服。食后临卧徐徐去滓服。
治妊娠小便不利。大腑热。小便时水道中疼痛不可忍方。
葶苈子 麦门冬 知母 柴胡 茯苓 芎 升麻 枳壳 杏仁（各一分） 冬葵子（三
铢） 上细杵罗为末。每服二钱。水一盏煎取九分。食后。临卧。去滓吃。大腑热。服后方。
麦门冬 升麻 大黄 杏仁（各一分） 大腹皮（一两） 上细杵罗为末。每服三钱。
水一
盏二分。煎取一盏。食后临卧徐徐去滓吃。
治妊娠通身瘙痒。渐次面目浑身四肢俱肿。心躁不安。大小腑秘热。宜服此方。吃
此药了。小便通尽平复如故。更不须吃后面方。若尚余数分。小便未通。即吃后面通小
肠方。
黄芩 山栀 杏仁 前胡 升麻 知母 桔梗 大黄 枳壳 葶苈（各等分） 上细杵
罗
为末。每二钱水一盏。葱白三枚。同煎四五沸。泻出去滓。温和食后吃。
(Attached Discussion)
When a pregnant woman experiences obstruction of both urination and defecation, it is caused by the excessiveness of Qi in the Zang-Fu organs generating internal heat. The pathogenic heat forms disease manifestations according to where it stagnates. If heat binds in the Large Intestine (Da Chang), defecation becomes obstructed; if it binds in the Small Intestine (Xiao Chang), urination becomes obstructed. If both intestines are bound by heat, symptoms include mental restlessness and fullness, with both urination and defecation obstructed. It is also stated that heat in the Small Intestine enters the bladder (Nei Pao); when heat binding is severe, it causes urinary obstruction, leading to Qi stagnation in the heart, hypochondrium, and lower abdomen, accompanied by panting. Chen Wuyue said that during pregnancy, the expanding fetus compresses the uterus (Bao), often causing difficult urination. This may be due to insufficiency of Heart and Kidney Qi, failing to keep the uterus cool, resulting in the interference of clear and turbid Qi, manifesting as various strangury syndromes (Lin Bing) and urinary obstruction, termed "Zhuan Bao" (displacement of the bladder/uterus). Furthermore, if the expanding fetus causes involuntary leakage of urine, it is termed "Yi Niao" (enuresis). Each condition has its specific treatment formulas.
Formulas:
Binglang San (Areca Nut Powder): Treats urinary and fecal obstruction in pregnancy, accompanied by chest and abdominal distension and stifling sensation, loss of appetite, and vexatious heat in the hands and feet.
Ingredients: Areca Seed (Binglang), Red Poria (Chi Fuling), Betel Nut Peel (Dafupi), Akebia Stem (Mutong), Apricot Kernel (Yuliren), Northern Schisandra Berry (Bei Wuwei Zi) (each 1 liang), Eucommia Bark (Sangjisheng), Licorice Root (Gancao), Platycodon Root (Kugeng/Jiegeng) (each 1 liang). Grind the above ingredients into coarse powder. Take 3 qian per dose, decoct with one sheng of water until reduced to 0.6 sheng, and take warm. Another version excludes Schisandra Berry.
Guiliang Jieming San (Return Cool Life-Saving Powder): Treats conditions caused by excessive alcohol consumption or ingestion of raw fruits, fish, mutton, chicken, wheat products, and toxic foods during pregnancy, leading to soreness and pain in all joints, constipation and difficult urination, red face, bitter taste in the mouth, mental restlessness, and abdominal distension.
(Note: The original text lists the formula name and indications but omits the ingredient list, proceeding directly to the next formula.)
Zhizi Tang (Gardenia Decoction): Treats urinary and fecal obstruction in pregnancy, with distending pain around the umbilicus and abdomen.
Ingredients: Gardenia Fruit (Zhizi Ren) (1.5 liang), Gypsum (Shigao), Scutellaria Root (Huangqin) (each 1.5 liang), Alisma Rhizome (Zexie) (2 liang), Bupleurum Root (Chaihu), Red Peony Root (Chishaoyao) (each 2 liang), Polygonatum Rhizome (Weirui/Yuzhu), Plantago Herb (Cheqiancao) (cut, 0.5 liang). Coarsely crush and sieve the above ingredients. Take 4 qian-bi per dose, decoct with 1.5 sheng of water and ten slices of light bamboo leaf (Danzhuye) together.
Chaihu Tong Sai Tang (Bupleurum Unblocking Decoction): Treats urinary and fecal obstruction in pregnancy due to heat binding in the Lower Jiao (Lower Burner).
Ingredients: Bupleurum Root (Chaihu), Scutellaria Root (Huangqin), Dried Tangerine Peel (Chenju Pi), Alisma Rhizome (Zexie), Antelope Horn (Lingyangjiao) (each 3 liang), Gardenia Fruit (Zhizi Ren) (1 liang), Gypsum (Shigao) (1 liang), Rhubarb (Dahuang) (crushed and stir-fried, 1 liang). Coarsely crush and sieve the above ingredients. Take 4 qian-bi per dose, decoct with 1 sheng of water, adding one fen of Fresh Rehmannia Root (Sheng Dihuang, crushed), and 0.5 fen of Fermented Soybean (Chi). Decoct until reduced to 0.7 sheng, strain, and take warm before meals.
Treats urinary and fecal obstruction in pregnancy due to heat closure, causing stifling sensation in the chest, diaphragm, abdomen, and hypochondrium, interfering with eating.
Ingredients: Rhubarb (Dahuang), Akebia Stem (Mutong), Areca Seed (Binglang) (each 1 liang), Aurantium Fruit (Zhiqiao), Betel Nut Peel (Dafupi) (2 pieces), Chebula Fruit (Helile/Hewulei) (4.5 pieces, half raw, half roasted). Grind into fine powder. Decoct with one sheng of child's urine and two cun of green onion white (Congbai) until reduced to 0.6 sheng. Mix with 2 qian of powder and take at any time.
Cheqianzi Tang (Plantago Seed Decoction): Treats complete obstruction of both urination and defecation in pregnancy.
Ingredients: Plantago Seed (Cheqianzi) (5 liang), Akebia Stem (Mutong) (4 liang), Scutellaria Root (Huangqin) (2 liang), Apricot Kernel (Yuliren) (2.5 liang), Rhubarb (Dahuang) (2 liang). Coarsely crush and sieve. Take 4 qian-bi per dose, decoct with 1.5 sheng of water until reduced to 0.8 sheng, strain, and take warm before meals.
Dafupi San (Betel Nut Peel Powder): Treats constipation and difficult urination in pregnancy with edema.
Ingredients: Aurantium Fruit (Zhiqiao), Betel Nut Peel (Dafupi), Licorice Root (Gancao), Red Poria (Chi Fuling) (equal parts). Grind into fine powder. Take 2 qian per dose, swallow with strong decoction of green onion white (Congbai) water, at any time.
Dongkuigen Tang (Malva Root Decoction): Treats urinary and fecal obstruction in pregnancy lasting seven to eight days or more, with abdominal distension and mental restlessness.
Ingredients: Malva Root (Dongkuigen) (one handful of dried root, washed; use seeds in winter), Plantago Herb (Cheqiancao) (1 liang, dried and cut), Akebia Stem (Mutong) (finely crushed 3 liang), Rhubarb (Dahuang) (crushed and stir-fried, 0.5 liang). Coarsely crush and sieve. Take 5 qian per dose, decoct with 1.5 sheng of water until reduced to 0.8 sheng, strain, and take warm before meals.
Maogen Tang (Imperata Root Decoction): Treats urinary and fecal obstruction in pregnancy with heat binding, stifling sensation, rapid breathing, and severe distension.
Ingredients: Imperata Root (Maogen) (crushed), Talcum (Huashi), Plantago Seed (Cheqianzi) (lightly fried), Rhubarb (Dahuang) (crushed and lightly fried, each 1.5 liang). Coarsely crush and sieve. Take 4 qian per dose, decoct with 1.5 sheng of water until reduced to 0.8 sheng, strain, and take warm before meals.
Mutong Tang (Akebia Stem Decoction): Treats urinary and fecal obstruction in pregnancy with lower body distension and restlessness in sitting or lying down.
Ingredients: Akebia Stem (Mutong) (crushed 2 liang), Talcum (Huashi) (3 liang), Hemp Seed (Damaoren/Huomaren) (1 liang), Rhubarb (Dahuang) (crushed, raw, 2 liang). Coarsely crush and sieve. Take 4 qian per dose, decoct with 1.5 sheng of water until reduced to 0.7 sheng, strain, and take warm on an empty stomach.
Yubaipi Tang (Ulmus Bark Decoction): Treats urinary and fecal obstruction in pregnancy.
Ingredients: Ulmus Bark (Yubaipi) (finely crushed 1.5 liang), Cinnamon Twig (Gui, bark removed, 1 liang, crushed), Licorice Root (Gancao) (1.5 liang, honey-fried), Talcum (Huashi) (3 liang). Coarsely crush and sieve. Take 4 qian per dose, decoct with 1.5 sheng of water until reduced to 0.7 sheng, strain, and take warm before meals.
Dongkuizi Tang (Malva Seed Decoction): Treats urinary and fecal obstruction in pregnancy.
Ingredients: Malva Seed (Dongkuizi) (2 liang, lightly fried), Rhubarb (Dahuang) (1 liang, crushed and stir-fried). Coarsely crush and sieve. Take 3 qian per dose, decoct with 1 sheng of water until reduced to 0.7 sheng, strain, and take warm before meals.
Dongkuigen Zhi Fang (Malva Root Juice Formula): Treats urinary and fecal obstruction in pregnancy.
Ingredients: Raw Malva Root (Washed 2 jin, finely chopped, pounded, juice extracted through raw fine cloth, 3 he), Ginger (Washed 4 liang, chopped, pounded, juice extracted through raw fine cloth, 0.5 he).
Mix the juices evenly. Divide into three doses. Take one dose on an empty stomach daily. If bowel movement is not achieved, take another dose. If still not achieved, finish all three doses.
Treats urinary obstruction in pregnancy with stifling sensation below the umbilicus, emaciation, and fecal constipation.
Ingredients: Plantago Seed (Cheqianzi) (1 liang), Rhubarb (Dahuang) (0.5 liang). Grind into fine powder. Take 3 qian per dose, mix with honey water and take on an empty stomach.
Kuizi Tang (Malva Seed Decoction): Treats pregnancy illness lasting six to seven days or more, with fever entering the Zang organs, difficult urination and defecation. It calms the fetus and clears heat.
Usage: Grind Malva Seeds into powder, mix with wine, and take.
Treats difficult urination and defecation in pregnant women.
Usage: Use Bazheng San (Eight-Ingredient Powder for Rectifying Urination) in large dosage, remove Talcum (Huashi), add Malva Seeds (Kuicai Zi), decoct and take. The Classics state: "Obstruction of the Bladder is called Long," meaning urinary retention. Adding Costus Root (Muxiang) to Zheng Bazheng San accelerates efficacy. The Classics state: "Bladder Qi transformation allows excretion." Subsequently, taking three to five doses of Wuling San (Five-Ingredient Powder with Poria) leads to recovery.
Treats urinary and fecal obstruction in pregnancy.
Usage: Take pork fat the size of half a chicken egg, chop finely, warm half a sheng of wine until boiling, pour into the pork fat, boil once or twice more. Divide into three doses, take warm before meals. If unrelieved, take again.
Formula for difficult urination and defecation in pregnancy.
Usage: Rove Kansui Root (Gansui) until yellow, grind into fine powder. Take 1 qian-bi mixed with water at any time.
Treats reddish and astringent urination and defecation.
Ingredients: Betel Nut Peel (Dafupi), Aurantium Fruit (Zhiqiao), Licorice Root (Gancao) (each 1 qian), Red Poria (Chi Fuling) (3 qian). Cut into three doses, decoct with 1.5 sheng of water until reduced to 1 sheng. Add 2.5 qian of peeled and split Apricot Kernels (Yuliren), decoct for five to seven boils. Take on an empty stomach continuously until passage is achieved. If still obstructed, it is likely Heat Constipation of the Large Intestine; use the following formula.
Following Formula Ingredients: Aurantium Fruit (Zhiqiao) (1 qian), Rhubarb (Dahuang) (2 qian), Licorice Root (Gancao) (1 qian). Grind into fine powder, divide into three doses, mix with strong decoction of green onion white (Congbai) water.
Even if urination is patent, if astringency and distension recur, accompanied by vexatious heat, insomnia, orthopnea, and distortion of the Pericardium system preventing urination, this disease is named "Zhuan Tai" (note: context suggests severe urinary retention similar to Zhuan Bao). Ba Wei Wan (Eight-Ingredient Pill) may be taken.
Formula for Heat Constipation of the Large Intestine in pregnancy, non-menstrual lower back pain, and difficulty walking.
Ingredients: Apricot Kernel (Xingren), Platycodon Root (Jiegeng), Cimicifuga Rhizome (Shengma), Aurantium Fruit (Zhiqiao), Peucedanum Root (Qianhu) (each 1 fen), Betel Nut Peel (Dafupi) (1 liang). Grind into fine powder. Take 2 qian per dose, decoct with 1.2 sheng of water. Divide into three or four doses. Strain slowly and take after meals and before bed.
Formula for difficult urination in pregnancy, Heat of the Large Intestine, and unbearable pain in the urethra during urination.
Ingredients: Lepidium Seed (Tinglizi), Ophiopogon Tuber (Maimendong), Anemarrhena Rhizome (Zhimu), Bupleurum Root (Chaihu), Poria (Fuling), Ligusticum Rhizome (Xiong), Cimicifuga Rhizome (Shengma), Aurantium Fruit (Zhiqiao), Apricot Kernel (Xingren) (each 1 fen), Malva Seed (Dongkuizi) (3 zhu). Grind into fine powder. Take 2 qian per dose, decoct with 1 sheng of water until reduced to 0.9 sheng. Strain and take after meals and before bed. For Heat of the Large Intestine, use the following formula.
Following Formula Ingredients: Ophiopogon Tuber (Maimendong), Cimicifuga Rhizome (Shengma), Rhubarb (Dahuang), Apricot Kernel (Xingren) (each 1 fen), Betel Nut Peel (Dafupi) (1 liang). Grind into fine powder. Take 3 qian per dose, decoct with 1.2 sheng of water until reduced to 1 sheng. Strain slowly and take after meals and before bed.
Treats generalized pruritus in pregnancy, gradually progressing to edema of the face, whole body, and limbs, mental restlessness, and Heat Constipation of both intestines. Take this formula. After taking this medicine, urination will become patent, and the body will return to normal, eliminating the need for subsequent formulas. If a small amount remains unpassed and urination is not fully patent, use the following formula to benefit the Small Intestine.
Ingredients: Scutellaria Root (Huangqin), Gardenia Fruit (Shanzhi), Apricot Kernel (Xingren), Peucedanum Root (Qianhu), Cimicifuga Rhizome (Shengma), Anemarrhena Rhizome (Zhimu), Platycodon Root (Jiegeng), Rhubarb (Dahuang), Aurantium Fruit (Zhiqiao), Lepidium Seed (Tingli) (equal parts). Grind into fine powder. Take 2 qian per dose, decoct with 1 sheng of water and three stalks of green onion white (Congbai) for four to five boils. Strain and take warm after meals.