大全云∶产后大小便不通者，本肠胃挟热，因产后血水俱下，津液燥竭，肠胃痞涩，热
气内结于肠胃，故令大小便不通也。
薛氏尝治一妇大小便不通，诸药不应，将危矣，令饮牛乳，一日稍通，三日而痊。人乳尤
善。
通气散 治产后大小便不通。（通气）
陈皮 苏叶 枳壳（麸炒） 木通（各等分）
上锉散，每服四钱，水煎，温服，立通。
桃仁散 治膀胱气滞血涩，大小便闭。（通血）
桃仁 葵子 滑石 槟榔（各等分）
上为细末，每服二钱，空心葱白汤调下。
枳壳丸 治产后大小便涩滞。（通气凉血润肠）
木香（一钱） 枳壳（麸炒） 麻仁（炒黄） 大黄（各
一两）
上为末，炼蜜丸如桐子大，每服三十丸，温水送下，食后如饮食不化，亦宜服之。
一方 治产后大小便不利，下血。
车前子 黄芩 蒲黄 牡蛎 生地黄 芍药（各一两五钱）
上为细末，空心米饮调服方寸匕，忌面蒜。（凉大小肠血，而又止血者也，则牡蛎之
涩，与别药不同）
密钥匙散 治产后大小便不通，腹胀等证。
滑石 蒲黄（各等分）
上为细末，酒调下二钱。
薛氏曰∶产后遗屎，若脾肾虚弱，用还少丹，仍以补中益气汤为主，虚寒加肉豆蔻、补
骨脂，或四神丸，若脾肾虚寒，用八味丸兼四神丸，仍佐以前二方。按产后遗屎，乃肾气不
固，宜五味子散主之。（夫肾开窍于二阴，而大便者，血之道，肾主之，故立斋集方，皆以脾肾
为治，以命门兼之者，土恶湿也）
一产妇大便不实，饮食少思，五更或清晨遗屎，此中气虚寒，脾肾不足，用补中益气送
四神丸而痊。（非大有见者，不能主此方）
一产妇小便出粪，名大小肠交，乃气血俱虚，失行常道，先用六君子二剂，又用五苓散
一剂而痊。寻常肠交亦可用。
补遗方 疗产后遗屎不知，亦治遗尿。（以下二方，乃自良所集，各取其义也）
白蔹 芍药（各七分）
上为末，酒调服方寸匕。
集验方 疗产后遗屎，亦治男子。
枯矾 牡蛎（ ，各等分）
上为末，酒调服方寸匕，日三服。
加味补中益气汤 治脾肾虚寒，大便不禁。（此加法火土相生之理，然非原方所加，以
此推之能以无法观法，斯为妙法）
黄 人参 白术 甘草（炙，各一钱） 当归 陈皮（各七分） 升麻 柴胡（各三分） 肉豆蔻
补骨脂（各五分）
上锉一剂，水煎服。
还少丹 治脾肾虚弱遗粪。
肉苁蓉（本草以肉苁蓉善动大便，人皆忌之，今治遗粪，而立斋反以为用，岂立斋为一
代名医，而反不知耶，以用所当用，则不忌耳）
远志（去心） 茴香 巴戟 干山药 枸杞子 熟地黄 石菖蒲 山茱萸（去核） 牛膝 杜仲（去皮，
姜制） 楮实子 五味子 白茯苓（各三两）
上为末，用枣肉百枚同炼蜜丸如桐子大，每服五七十丸，空心温酒或盐汤下，日三服。
四神丸 治脾肾虚弱，大便不实，或五更作泻。
破故纸 吴茱萸（炒，各四两） 肉豆蔻（生用） 五味子（各一两）
上为末，用大红枣四十九枚，生姜四两切碎，同枣用水煮熟，去姜，取枣肉和药，丸桐子
大，每服五十丸，空心盐汤下。
五味子散 治肾泄。
五味子（二两） 吴茱萸（半两）
上炒香熟，研为细末，每服二钱，陈米饮调下。
广济方 治产后遗粪，亦治男子。
取故燕窝中草烧为末，以酒调下半盏。
According to *Da Quan*: Postpartum obstruction of urination and defecation is caused by heat in the intestines and stomach. Since blood and fluids are lost during childbirth, body fluids become dry and exhausted, leading to stagnation and astringency in the intestines and stomach. Heat qi knots internally within the intestines and stomach, thus causing the obstruction of both urine and feces.
Xue Ji once treated a woman suffering from postpartum obstruction of urination and defecation. After various medicines failed to work, her condition became critical. Xue Ji instructed her to drink cow's milk. Her symptoms improved slightly after one day, and she recovered completely after three days. Human milk is even more effective.
*Tongqi San* (Ventilation Powder): Treats postpartum obstruction of urination and defecation. (Action: Ventilation)
Chenpi (Tangerine Peel), Suye (Perilla Leaf), Zhike (Bitter Orange, stir-fried with bran), Mutong (Akebia Stem) (equal parts).
Crush these into a powder. Take 4 qian per dose, decoct in water, and take warm. It promotes immediate unobstruction.
*Taoren San* (Peach Kernel Powder): Treats postpartum closure of urination and defecation due to Qi stagnation and blood stasis in the bladder. (Action: Promoting Blood Circulation)
Taoren (Peach Kernel), Kuizi (Okra Seed), Huashi (Talcum), Binglang (Areca Seed) (equal parts).
Grind into a fine powder. Take 2 qian per dose, mixed with Congbai Tang (Scallia White Decoction) on an empty stomach.
*Zhike Wan* (Bitter Orange Pill): Treats postpartum sluggishness of urination and defecation. (Actions: Ventilation, Cooling Blood, Moistening Intestines)
Muxiang (Costus Root, 1 qian), Zhike (Bitter Orange, stir-fried with bran), Mahren (Hemp Seed, stir-fried until yellow), Dahuang (Rhubarb Root) (1 liang each).
Grind into powder. Mix with refined honey to make pills the size of paulownia seeds. Take 30 pills per dose with warm water. If food digestion is poor after meals, this medicine is also suitable.
Another Prescription: Treats postpartum difficulty in urination and defecation accompanied by bleeding.
Cheqianzi (Plantago Seed), Huangqin (Scutellaria Root), Puhuang (Lygodium Spore), Muli (Oyster Shell), Shengdihuang (Rehmannia Root), Shaoyao (Peony Root) (1.5 liang each).
Grind into a fine powder. Take one fangcun bi (a measure roughly equivalent to a tablespoon) mixed with rice water on an empty stomach. Avoid wheat noodles and garlic. (This formula cools the blood of the large and small intestines and stops bleeding; the astringent property of Oyster Shell differs from other herbs.)
*Miyao San* (Secret Key Powder): Treats postpartum obstruction of urination and defecation, abdominal distension, and other symptoms.
Huashi (Talcum), Puhuang (Lygodium Spore) (equal parts).
Grind into a fine powder. Take 2 qian mixed with wine.
Xue Ji stated: For postpartum involuntary defecation due to Spleen and Kidney deficiency, use *Huanshao Dan* (Restore Youth Pill), primarily relying on *Buzhong Yiqi Tang* (Decoction for Supplementing the Middle and Augmenting Qi). If there is deficiency-cold, add Roudoukou (Nutmeg) and Buguzhi (Psoralea Fruit), or use *Sishen Wan* (Four Spirits Pill). If there is Spleen-Kidney deficiency-cold, use *Bawei Wan* (Eight-Ingredient Pill) combined with *Sishen Wan*, assisted by the previous two formulas. Regarding postpartum involuntary defecation, it is caused by insecurity of Kidney Qi, so *Wuweizi San* (Schisandra Powder) should be used as the main treatment. (The Kidney opens into the two yin orifices, and defecation is the pathway of blood, governed by the Kidney. Therefore, Lizhai collected formulas focusing on treating the Spleen and Kidney, incorporating the Mingmen [Gate of Life], because Earth dislikes dampness.)
One postpartum patient had loose stools, poor appetite, and involuntary defecation at dawn or early morning. This was due to deficiency-cold of the Middle Qi and insufficiency of the Spleen and Kidney. She recovered using *Buzhong Yiqi Tang* administered with *Sishen Wan*. (Only those with profound insight can prescribe this formula.)
One postpartum patient excreted feces through the urethra, a condition named "Jiaochang" (Intertwined Intestines). This was due to deficiency of both Qi and Blood, causing them to deviate from their normal pathways. She first took two doses of *Liujunzi Tang* (Six Gentlemen Decoction), followed by one dose of *Wuling San* (Five-Ingredient Powder with Poria), resulting in recovery. This method can also be used for ordinary cases of Jiaochang.
*Buyi Fang* (Supplementary Formulas): Treats postpartum unawareness of involuntary defecation, and also treats enuresis. (The following two formulas were collected by Liang Yi, each taking its meaning.)
Bailian (Belamcanda Rhizome), Shaoyao (Peony Root) (7 fen each).
Grind into powder. Take one fangcun bi mixed with wine.
*Jiyan Fang* (Verified Formula): Treats postpartum involuntary defecation, and also treats men.
Kufan (Alum), Muli (Oyster Shell, calcined) (equal parts).
Grind into powder. Take one fangcun bi mixed with wine, three times daily.
*Jiawei Buzhong Yiqi Tang* (Modified Decoction for Supplementing the Middle and Augmenting Qi): Treats Spleen-Kidney deficiency-cold with uncontrollable defecation. (This addition reflects the principle of Fire generating Earth. Although not added to the original formula, inferring from this shows that mastering methods beyond rigid forms constitutes a wonderful method.)
Huangqi (Astragalus Root), Ren Shen (Ginseng Root), Baizhu (Atractylodes Macrocephala Rhizome), Gancao (Licorice Root, honey-fried) (1 qian each), Danggui (Angelica Sinensis Root), Chenpi (Tangerine Peel) (7 fen each), Shengma (Cimicifuga Rhizome), Chaihu (Bupleurum Root) (3 fen each), Roudoukou (Nutmeg), Buguzhi (Psoralea Fruit) (5 fen each).
Cut into pieces for one dose. Decoct in water and take orally.
*Huanshao Dan* (Restore Youth Pill): Treats involuntary defecation due to Spleen-Kidney weakness.
(Roucongrong (Cistanche Stem) is recorded in Materia Medica as promoting bowel movements, so people generally avoid it. However, for treating involuntary defecation, Lizhai recommends its use. Is Lizhai, a renowned physician of his generation, unaware of this? No, when used appropriately, there is no need to avoid it.)
Roucongrong (Cistanche Stem), Yuanzhi (Polygala Root, heart removed), Huixiang (Fennel Fruit), Bajitian (Morinda Root), Ganshenyao (Dioscorea Rhizome dried), Gouqizi (Goji Berry), Shudihuang (Rehmannia Root, prepared), Shichangpu (Acorus Rhizome), Shanzhuyu (Cornus Fruit, pitted), Niuxi (Achyranthes Root), Duzhong (Eucommia Bark, skin removed, processed with ginger), Chushizi (Celtis Seed), Wuweizi (Schisandra Fruit), Bai Fuling (Poria) (3 liang each).
Grind into powder. Mix with pulp of 100 dates and refined honey to make pills the size of paulownia seeds. Take 50-70 pills per dose on an empty stomach with warm wine or salt water, three times daily.
*Sishen Wan* (Four Spirits Pill): Treats Spleen-Kidney deficiency with loose stools or diarrhea occurring at the fifth watch (early morning).
Poguzhi (Psoralea Fruit), Wuzhuyu (Evodia Fruit, stir-fried) (4 liang each), Roudoukou (Nutmeg, raw), Wuweizi (Schisandra Fruit) (1 liang each).
Grind into powder. Use 49 large red dates and 4 liang of sliced fresh ginger. Cook together in water until soft. Remove the ginger, mix the date pulp with the powder, and make pills the size of paulownia seeds. Take 50 pills per dose on an empty stomach with salt water.
*Wuweizi San* (Schisandra Powder): Treats Kidney diarrhea.
Wuweizi (Schisandra Fruit) (2 liang), Wuzhuyu (Evodia Fruit) (0.5 liang).
Stir-fry until fragrant and cooked, then grind into a fine powder. Take 2 qian per dose mixed with aged rice water.
*Guangji Fang* (Broad Salvation Formula): Treats postpartum involuntary defecation, and also treats men.
Burn the grass found in old swallow nests to ash. Take half a zhan (measure) mixed with wine.