产后泄泻，不可与杂证同治。大率中气虚弱，传化失职所致，气虚、食积、与湿也。气虚宜补，食积
宜消，湿宜燥之。然恶露未除，又难以骤补、峻消、急燥，当先用莲子生化汤三剂，化旧生新。方中且有
莲子、茯苓补脾利水，兼治其泻。候旧化新生，然后用健脾利水生化汤，或补气或消食，或化积或燥湿分
利，因证加入对证之药，始无滞涩虚虚之失。至产后旬日外，方可与杂证同论，然犹宜量人虚实而治也。如
痛下清水，腹鸣，米饮不化者，以寒泻温之。如粪色黄，肛门痛，以热泻清之。如饮食过多伤脾，嗳气味
如败卵，以食积消之。如饮食减少，食下腹鸣腹急，尽下所食之物方觉畅快，以脾虚食积补而消之。丹
溪云∶如产后虚泻，眼昏不识人，危证，用参苓术附汤救之。又有胎前久泻，产后不止，以致虚脱，须从
权服参苓生化汤以扶虚，仍分块痛、不痛，加减而治。凡泻兼热，切勿用芩、连、栀、柏。
兼痰，切勿用半夏、生姜。如泻渴，参麦饮以回津液。如产后脾泻不止，参苓莲子饮妙。夫完谷不化者，
因产时劳倦伤脾，而转输稽迟也。夫水谷入胃，游溢精气，散归于脾，脾气散精，上归于肺，而调通水道，
乃能致气滋脏以养人。今因产劳倦脾伤，以致冲和之气不能化，而物完出焉，病名飧泄。又饮食太过，
脾胃受伤，亦致完谷不化，俗呼为水谷痢也。然产方三日内，血块未散，患此脾败胃弱之证，未可遽加 、
术，且服加味生化汤。内有益智、砂仁少温其气，俟块消散，服参苓大补生化汤。如胃气虚，泻利黄色，
用补中益气汤加木香治之。若久泻痢虚者，参香散。如久泻元气下陷，大便不禁，肛门如脱，宜加味六君
子汤。若见完谷不化，色白如糜，此脾胃大虚，元气虚脱之候，十有九死，惟猛进温补之剂，庶可挽回。
即有烦躁发热面赤，脉来数大，皆虚火上炎之故，当并进桂、附、人参、甘草、干姜、芩、术之类，伏
龙肝煎汤代水煎服，仍得收功。若小便混浊如泔，或大便中有白沫如肠垢者，乃元气下陷之故，并宜补中
益气加桂、苓、炮姜升举之。或泻臭水不止，加蕲艾、香附、吴茱萸。若兼瘀结不通，腹胀喘急，虽神
丹亦无济也。如大便不知为
遗屎，补中益气汤加肉苁蓉、故纸。
莲子生化汤 治产后血块未消泄泻。
川芎 茯苓（各二钱） 当归（四钱。一方一钱，黄土炒） 炮姜（四分） 桃仁（十粒，去皮
尖） 炙草（五分） 莲肉（十枚，去心）
水煎服。一方无桃仁。
健脾利水生化汤
川芎 当归（黄土炒。各一钱） 白术（二钱，土炒） 泽泻（八分） 干姜（四分，炮） 陈
皮炙草（各五分） 肉果（一枚，煨） 人参（三钱） 茯苓（一钱五分）
一方无茯苓。寒泻，加砂仁八分，炮干姜八分。热泻，加炒黄连五分。泻水腹痛，米饮不化，加砂仁
六分，山楂、麦芽。泻有酸嗳臭气，系食积，加神曲八分，砂仁八分，山楂、麦芽。少食不安，泻即觉
安快者，亦以食积论。脾气虚久泻，加升麻。泻水多而腹不痛者，有湿，加制苍术一钱，以燥之。诸
泻方中，须加莲子十枚。
参苓术附汤 丹溪治产后虚泻，眼昏不识人，危证，用此方救之。
人参（七钱） 白术（三钱，土炒） 茯苓 附子（制。各一钱）
水煎服。
参苓生化汤 治胎前久泻，产后不止。
人参 当归（各二钱） 干姜（炮） 炙草（各五分） 诃子皮 川芎 山药（炒。各一钱）
肉果（一个，面裹煨） 茯苓（一钱五分） 莲子（七粒） 糯米（一大撮）
水煎服。虚甚，加人参三四钱。如七日内外，块痛不止，减参、肉果、诃子以除痛。血块不痛，加
土炒白术二钱，陈皮三分。
参苓莲子饮 治产后脾泄不止，并治年久不止脾泄之证。
人参 白术（土炒。各二钱） 白芍（八分，炒） 当归（一钱五分） 白茯苓 山药（各一钱）
升麻 陈皮（各三分） 炙草（四分） 莲子（十二粒，去心）
姜二片，水三钟煎服，取药内莲子送药。甚者腹疼，加炒黑干姜五分。虚甚，加人参三四钱。
加味生化汤 治产后脾虚，三日内血块未消，完谷不化，胎前素弱者，非胃苓能治，此方主之。
川芎 益智仁 砂仁（各一钱） 当归（四钱，土炒） 炮姜（四分） 炙草（五分） 茯苓（
一钱五分） 桃仁（十粒，去皮尖）
水煎服。
参苓大补生化汤 治产后血块痛止，可服此以补之，完谷自化矣。
人参 白术（土炒。各二钱） 川芎 当归 益智仁 白芍（炒） 茯苓（各一钱） 干姜（四分，
炮） 肉果（一个，面煨） 炙草（五分） 莲子（八枚，去心）
水煎服。泻而腹痛，加砂仁八分。泻水多，加泽泻、木通各八分。渴，加去心麦冬、五味子。寒，倍
炮姜，加木香四分。食积黄色，以神曲、麦芽、山楂、砂仁择一二味加入。
参香散 治久泻痢虚者。
人参 木香（各二钱） 肉蔻 茯苓 扁豆（各四钱） 陈皮 粟壳（各一钱）
为末，米饮下。
加味六君子汤 凡产后泻久，胃气虚弱，完谷不化，宜温助胃气也。
人参 茯苓 半夏（制。各一钱） 白术（二钱，土炒） 陈皮 炙草（各八分） 肉果（一枚。
面煨熟，去
面） 木香（三四分）
水煎服。一方有炙干姜四分。
参麦饮（见本卷晕厥门。） 补中益气汤（见上卷诸痛门。）
Postpartum diarrhea cannot be treated in the same manner as general miscellaneous diseases. Generally, it is caused by deficiency of Middle Qi (Middle Jiao Qi), leading to dysfunction of transportation and transformation, involving Qi deficiency, food stagnation, and dampness. Qi deficiency should be tonified, food stagnation should be resolved, and dampness should be dried. However, if lochia (postpartum vaginal discharge) has not yet cleared, it is difficult to immediately use harsh tonification, strong resolution, or urgent drying methods. One should first administer Lianzi Shenghua Decoction (Lotus Seed Decoction for Generating New Blood) for three doses to resolve stasis and generate new blood. The formula contains Lotus Seed (Nelumbinis Semen) and Poria (Poria) to tonify the Spleen and promote urination, simultaneously treating the diarrhea. Once the old blood is resolved and new blood generated, then Jianpi Lishui Shenghua Decoction (Spleen-Strengthening and Water-Draining Decoction for Generating New Blood) can be used. Depending on the syndrome, herbs that tonify Qi, resolve food, transform accumulation, or dry dampness and separate clear from turbid are added appropriately. This avoids errors such as causing stagnation or worsening deficiency with deficiency-inducing treatments. After ten days postpartum, treatment may follow the principles for general miscellaneous diseases, but one must still assess the patient's deficiency or excess before treating.
If there is abdominal pain with watery diarrhea, borborygmus (intestinal rumbling), and undigested rice or drinks, this is Cold Diarrhea; treat with warming methods. If stool is yellow and the anus is painful, this is Heat Diarrhea; treat with clearing methods. If excessive food intake damages the Spleen/Stomach, accompanied by belching with a smell like rotten eggs, this is Food Stagnation; treat with resolving methods. If food intake is reduced, with borborygmus and abdominal urgency after eating, feeling relief only after passing all ingested food, this is Spleen Deficiency with Food Stagnation; treat by tonifying the Spleen while resolving stagnation. Zhu Danxi stated: In cases of postpartum deficient diarrhea accompanied by blurred vision and inability to recognize people, this is a critical condition; rescue with Shenling Zhufu Tang (Ginseng, Poria, Atractylodes, and Aconite Decoction). Another scenario involves prolonged diarrhea during pregnancy that continues postpartum, leading to Qi collapse. In such cases, temporarily administer Shenling Shenghua Decoction (Ginseng, Poria, and Shenghua Decoction) to support deficiency, adjusting based on the presence or absence of mass-related pain. For diarrhea combined with heat, avoid using Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), Gardeniae Fructus (Zhizi), and Phellodendri Cortex (Huangbai). For diarrhea combined with phlegm, avoid using Pinelliae Rhizoma (Banxia) and Zingiberis Rhizoma Recens (Shengjiang). If diarrhea is accompanied by thirst, use Shenmai Yin (Ginseng and Ophiopogon Drink) to restore body fluids. For persistent postpartum Spleen-diarrhea, Shenling Lianzi Yin (Ginseng, Poria, and Lotus Seed Drink) is effective.
"Complete digestion failure" (passage of undigested food in stool) occurs because labor fatigue injures Spleen Qi, delaying transport and transformation. When food and water enter the Stomach, their essence floats up and disperses to the Spleen; the Spleen scatters these essences upward to the Lung, which regulates water passages, thereby generating Qi and nourishing the Zang organs to sustain the human body. Now, due to labor-induced Spleen injury, the harmonious Qi fails to transform, resulting in the passage of undigested food. This disease is named Sun Xie (Sundown Diarrhea/Incomplete Digestion). Additionally, overeating damaging the Spleen/Stomach also causes complete digestion failure, commonly known as Shuigu Li (Water-Food Dysentery). However, within three days postpartum, when blood masses have not yet dispersed, suffering from this syndrome of Spleen failure and Stomach weakness, one should not hastily use Atractylodis Macrocephalae Rhizoma (Baizhu) etc., but instead take Jiawei Shenghua Tang (Modified Shenghua Decoction). It contains Yi Zhi Ren (Alpinia Oxyphylla Fruit) and Sha Ren (Amomum Villosum Fruit) to mildly warm and move Qi. Wait until the blood masses disperse, then take Shenling Dabu Shenghua Tang (Ginseng, Poria, and Great Tonification Shenghua Decoction). If Stomach Qi is deficient with yellow diarrhea, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Mugwort (Muxiang). For chronic dysentery/diarrhea due to deficiency, use Shenxiang San (Ginseng and Aucklandia Powder). If chronic diarrhea leads to sinking of Yuan Qi (Primal Qi), incontinence of feces, and a sensation of anal prolapse, use Jiawei Liujunzi Tang (Modified Six Gentlemen Decoction). If complete digestion failure is seen with white, porridge-like stool, this indicates severe Spleen/Stomach deficiency and collapse of Yuan Qi, with nine out of ten cases being fatal. Only vigorous administration of warming and tonifying agents can potentially reverse the condition. Even if restlessness, fever, red face, and rapid, large pulses appear, these are due to Deficient Fire flaming upward. One should concurrently administer Cinnamomi Ramulus (Guizhi), Aconiti Lateralis Radix Praeparata (Fuzi), Ginseng Radix et Rhizoma (Renshen), Glycyrrhizae Radix et Rhizoma (Gancao), Zingiberis Rhizoma (Ganjiang), Scutellariae Radix (Huangqin), and Atractylodis Macrocephalae Rhizoma (Baizhu), decocted in water prepared from Fulonggan (Dragon's House Soil), which can still achieve success. If urine is turbid like rice washings, or white foam resembling intestinal mucus appears in stool, this is due to sinking of Yuan Qi; Bu Zhong Yi Qi Tang plus Guizhi, Poria, and Pao Jiang (Prepared Ginger) should be used to raise and lift. If foul-smelling watery diarrhea persists, add Qiai (Qiai Ye), Xiangfu (Cyperi Rhizoma), and Wuzhuyu (Evodiae Fructus). If accompanied by blood stasis obstruction, abdominal distension, and wheezing/urgency, even divine medicine will be of no help. If feces are passed involuntarily without awareness (Yi Shi), use Buzhong Yiqi Tang plus Roushengrong (Cistanche Deserticola) and Guzhi (Psoraleae Fructus).
Lianzi Shenghua Decoction: Treats postpartum diarrhea with unresolved blood masses.
Chuanxiong, Fuling (2 qian each), Danggui (4 qian; one prescription uses 1 qian fried with yellow earth), Paojiang (0.4 qian), Taoren (10 kernels, peeled and slit), Zhigancao (0.5 qian), Lianrou (10 pieces, heart removed).
Decoct in water and drink. One prescription excludes Taoren.
Jianpi Lishui Shenghua Decoction:
Chuanxiong, Danggui (fried with yellow earth, 1 qian each), Baizhu (2 qian, fried with earth), Zexie (0.8 qian), Ganjiang (0.4 qian, prepared), Chenpi, Zhigancao (0.5 qian each), Rouguo (1 piece, baked), Renshen (3 qian), Fuling (1.5 qian).
One prescription excludes Fuling. For Cold Diarrhea, add Sharen (0.8 qian) and Pao Ganjiang (0.8 qian). For Heat Diarrhea, add Chao Huanglian (0.5 qian). For watery diarrhea with abdominal pain and undigested food, add Sharen (0.6 qian), Shanzha, and Maiya. For diarrhea with sour, foul belching indicating food stagnation, add Shenqu (0.8 qian), Sharen (0.8 qian), Shanzha, and Maiya. For poor appetite with discomfort relieved by diarrhea, also consider food stagnation. For chronic Spleen-deficiency diarrhea, add Shengma. For profuse watery diarrhea without abdominal pain, indicating dampness, add Zhi Cangzhu (1 qian) to dry dampness. All diarrhea formulas must include 10 Lotus Seeds.
Shenling Zhufu Tang: Zhu Danxi used this to rescue critical postpartum deficient diarrhea with blurred vision and inability to recognize people.
Renshen (7 qian), Baizhu (3 qian, fried with earth), Fuling, Fuzhi (prepared, 1 qian each).
Decoct in water and drink.
Shenling Shenghua Decoction: Treats prolonged diarrhea during pregnancy continuing postpartum.
Renshen, Danggui (2 qian each), Ganjiang (prepared), Zhigancao (0.5 qian each), Heqipi, Chuanxiong, Shanyao (fried, 1 qian each), Rouguo (1 piece, wrapped in flour and baked), Fuling (1.5 qian), Lianzi (7 grains), Nuomi (a large pinch).
Decoct in water and drink. For severe deficiency, add 3-4 qian of Renshen. If within seven days, mass-pain persists, reduce Renshen, Rouguo, and Heqipi to relieve pain. If blood masses are painless, add Baizhu fried with earth (2 qian) and Chenpi (0.3 qian).
Shenling Lianzi Yin: Treats persistent postpartum Spleen-diarrhea and long-standing Spleen-diarrhea.
Renshen, Baizhu (fried with earth, 2 qian each), Baishao (0.8 qian, fried), Danggui (1.5 qian), Bai Fuling, Shanyao (1 qian each), Shengma, Chenpi (0.3 qian each), Zhigancao (0.4 qian), Lianzi (12 grains, heart removed).
Add 2 slices of Ginger, decoct in 3 zhong of water. Take the medicine with the Lotus Seeds from the decoction. For severe abdominal pain, add Chao Hei Ganjiang (0.5 qian). For severe deficiency, add 3-4 qian of Renshen.
Jiawei Shenghua Tang: Treats postpartum Spleen deficiency, unresolved blood masses within three days, complete digestion failure, and constitutional weakness prior to pregnancy. Not suitable for Weiling Tang; this formula is primary.
Chuanxiong, Yizhiren, Sharen (1 qian each), Danggui (4 qian, fried with earth), Paojiang (0.4 qian), Zhigancao (0.5 qian), Fuling (1.5 qian), Taoren (10 kernels, peeled and slit).
Decoct in water and drink.
Shenling Dabu Shenghua Decoction: Treats postpartum state after blood-mass pain ceases; take this to tonify, and complete digestion will normalize.
Renshen, Baizhu (fried with earth, 2 qian each), Chuanxiong, Danggui, Yizhiren, Baishao (fried), Fuling (1 qian each), Ganjiang (0.4 qian, prepared), Rouguo (1 piece, flour-baked), Zhigancao (0.5 qian), Lianzi (8 pieces, heart removed).
Decoct in water and drink. For diarrhea with abdominal pain, add Sharen (0.8 qian). For profuse watery diarrhea, add Zexie and Mutong (0.8 qian each). For thirst, add Qu Xin Maidong and Wuweizi. For cold, double Pao Jiang and add Muxiang (0.4 qian). For food-stagnation yellow stool, choose 1-2 of Shenqu, Maiya, Shanzha, Sharen to add.
Shenxiang San: Treats chronic diarrhea/dysentery due to deficiency.
Renshen, Muxiang (2 qian each), Roubdou, Fuling, Bidou (4 qian each), Chenpi, Suske (1 qian each).
Grind into powder, take with rice water.
Jiawei Liujunzi Tang: For prolonged postpartum diarrhea with weak Stomach Qi and complete digestion failure; appropriate to warm and assist Stomach Qi.
Renshen, Fuling, Banxia (prepared, 1 qian each), Baizhu (2 qian, fried with earth), Chenpi, Zhigancao (0.8 qian each), Rouguo (1 piece, baked熟 in flour, remove flour), Muxiang (0.3-0.4 qian).
Decoct in water and drink. One prescription includes Zhi Ganjiang (0.4 qian).
Shenmai Yin (See Syncope Section in this volume). Buzhong Yiqi Tang (See Pain Sections in previous volume).