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Postpartum dryness and constipation of the stool result from excessive blood loss during childbirth, leading to dryness in the Stomach (Stomach organ). The essence and nutrients fail to descend and distribute downward, causing food residue to accumulate and obstruct the bowels. Furthermore, the Large Intestine (Large Intestine organ) governs fluids. When a postpartum woman suffers from a massive loss of body fluids internally, the intestines become dry and lose their function of conduction and transformation, thus making defecation difficult. Frequent administration of Shenghua Tang (Decoction for Generating New Blood) will promote blood generation and smooth Qi flow, allowing the stool to naturally become moist and pass. Alternatively, Yangzheng Tongyou Tang (Decoction for Nourishing Righteousness and Unblocking the Obstruction) may also be taken. If there is no bowel movement but no discomfort or suffering, medication may not be necessary. Therefore, it is common for postpartum women to go three to five days, or even eight to nine days, before having a bowel movement; this is considered normal. Even if symptoms resembling Shaoyin (Lesser Yin) or Taiyin (Greater Yin) patterns of Cold Damage (Shanghan) appear—such as tidal fever with sweating, dry mouth with abdominal fullness, delirium with constipation, or indications that dry feces need to be purged—these are actually manifestations of deficiency due to exhaustion of Qi and Blood, presenting as false excess. One must be cautious not to adhere to biased methods or underestimate the postpartum state, nor should one recklessly prescribe the Three Chengqi Decoctions (San Chengqi Tang) for purging. In cases of difficulty due to Blood deficiency and Fire dryness, one should not wait based on the number of days passed. One must wait until there is abdominal fullness and a sensation of distension, where the patient desires to defecate but cannot. This indicates impaction in the rectum. It should be treated by moistening with Runchang Zhou (Moistening Intestines Porridge), which will allow natural passage. The *Quan Shu* advocates using Jichuan Jian (Jichuan Decoction) as the primary treatment. Caution: do not use enema methods (Daofa). If moistening fails to resolve the issue and the situation is urgent with no other options, use Mi Jian Dao (Honey Suppository Method). Boil honey until it becomes a brown paste, shape it into a date-like form after dipping in water, and insert it into the anus; the impacted stool will naturally dissolve and exit. Alternatively, sliced preserved melon or ginger can be shaped like honey dates and used similarly. This is merely an expedient measure. The Zhu Danzhi Bilian Dao (Pig Bile Enema) method must strictly be avoided; misusing bitter-cold substances often leads to hiccups. If bitter-cold purgatives are taken, they may damage the Yuan Qi (Original Qi) of the Middle Jiao (Middle Burner), resulting in either worsened impaction or unceasing diarrhea, turning the condition into a critical failure. *Yi Tong* states: For Blood deficiency with Fire dryness, use Siwu Tang (Four Substances Decoction) plus He Shou Wu (Polygoni Multiflori Radix Praeparata) to moisten and purge. Lizhai states: If blood loss was excessive, use Shiquan Dabu Tang (Ten Significant Tonifying Decoction). If both Qi and Blood are deficient, use Bazhen Tang (Eight Treasures Decoction). If there has been no bowel movement for several days, but diet remains normal and the abdomen feels unchanged, treat with Bazhen Tang plus Tao Ren (Persicae Semen) and Xing Ren (Armeniacae Semen). Feng Shi states: For difficult defecation, only regulating the Middle Jiao and nourishing Blood is appropriate. One must not solely use Huo Ma Ren (Cannabis Seed) and Zhi Ke (Aurantii Fructus), as this vainly depletes the generating Qi of the intestines and stomach without effect. Some practitioners have successfully treated long-standing constipation by administering large doses of Xiong Gui (Chuanxiong and Angelicae Sinensis Radix), totaling several jin, while concurrently taking Runchang Zhou. If both urine and stool are retained and lochia does not discharge, the formulas and discussions are found in the chapter on "Lochia Not Discharging."

Yangzheng Tongyou Tang treats postpartum dryness and constipation.
Chuanxiong (1 qian, or 1.5 qian, or 2 qian) Danggui (4 qian or 6 qian) Taoren (10 grains, skin and tip removed) Zhigancao (0.5 qian)
Chenpi (0.4 qian) Huorenm (1 qian or 1.5 qian, stir-fried) Rongshongrong (1 qian or 2 qian, washed with wine to remove mud and scales)
Decoct in water and take orally. One variation excludes Rongshongrong. If there is pain due to blood stasis masses, add Rougui (Cinnamomi Cortex) and Chao Yanhusuo (Stir-fried Corydalis Rhizoma) each 0.5 qian, and exclude Rongshongrong. If Qi deficiency with profuse sweating occurs, add Mi Zhi Huangqi (Honey-fried Astragali Radix) 1 qian and Renshen (Ginseng Radix et Rhizoma) 1-2 qian. One variation adds Mahuanggen (Ephedrae Radix et Rhizoma) 1 qian. For dryness and thirst, add Qu Xin Maidong (Ophiopogonis Radix with heart removed) 1.5 qian and Renshen 1-2 qian. One variation adds Wubeizi (Schisandrae Fructus) 7 grains. For abdominal fullness and solid stool, add Qu Xin Maidong 1 qian and Fu Chao Zhike (Bran-stir-fried Aurantii Fructus) 0.6 qian. For sweating, delirium, and solid stool, this indicates exhaustion of both Qi and Blood, decline of Shen (Spirit), and loss of control by the Heart (Heart organ). One should nourish Qi and calm the Spirit, adding Fushen (Poria with Wood), Chao Zaoren (Stir-fried Ziziphi Spinosomi Semen), Zhi Yuanzhi Rou (Prepared Polygalae Radix flesh), Zhi Huangqi, Baoren (Platycladi Semen), and Rongshongrong each 1 qian, and Renshen and Tu Chao Baizhu (Earth-stir-fried Atractylodis Macrocephalae Rhizoma) each 2 qian. Further consultation with the chapter on "Delirium and Hallucinations" is required.

Runchang Zhou treats long-standing postpartum constipation.
Zhima (Sesame seed, 1 sheng)
Grind into powder, mix with Jingmi (Oryza Sativa Var. Glutinosa, 2 he), cook and eat. Once the intestines are moistened, passage will occur.

Jichuan Jian is indicated for constipation due to deficiency and damage. Purgative drugs must absolutely not be used. If circumstances necessitate the use of unblocking agents, this decoction is primary.
This is a formula that achieves unblocking through tonification, which is most excellent.
Danggui (3-5 qian) Niuxi (2 qian, steamed) Rongshongrong (2-3 qian, washed with wine) Zexie (1.5 qian) Shengma (0.5-0.7 qian) Zhike (1 qian, bran-stir-fried. Exclude if deficiency is severe)
Decoct in 1.5 zhong of water until 0.7 zhong remains. Take before meals. If Qi deficient, adding Renshen is harmless. If Heat/Fire is present, add Jiu Chao Huangqin (Wine-stir-fried Scutellariae Radix). If Kidney (Kidney organ) deficient, add Shudi (Rehmanniae Radix Praeparata).

Shenghua Tang (See discussion on Shenghua Tang later in this volume.) Shiquan Dabu Tang (See chapter on "Fetal Malnutrition" in the previous volume.) Siwu Tang (See chapter on "Fetal Protection" in the previous volume.) Bazhen Tang (See chapter on "Various Pains" in the previous volume.)