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Diarrhea during pregnancy may result from external contraction of wind-cold, summer-heat, and dampness, or internal injury caused by consuming raw and cold food. When the disease manifests suddenly, one must examine its etiology. If it is due to Stomach Wind (Wei Feng), formulas such as Jiawei Lizhong Tang (Modified Cinnamon Twig and Atractylodes Macrocephala Decoction), Jiawei Zhizhong Tang (Modified Regulating the Middle Decoction), Siling San (Four-Ingredient Powder for Draining Dampness), Buhuanjin Zhengqi San (Non-Exchanging Golden Earth Harmonizing Qi Powder), and Weiling Tang (Stomach and Bladder Decoction) should be selected according to the syndrome for treatment, which will lead to recovery. However, diarrhea caused by deficiency of the Spleen and Kidney organs must not be overlooked. Blood is governed by the Spleen; when blood congregates to nourish the fetal origin, it leads to Yin deficiency of the Spleen and failure of food transformation. The Spleen governs healthy transportation; if stagnation in the Lower Jiao prevents the clear Qi from diffusing smoothly, water and grain fail to digest, resulting in diarrhea. Alternatively, since the fetus is anchored to the Kidney, the fetus may borrow Qi for protection, weakening Kidney Qi and causing decline of the Fire of the Gate of Vitality (Mingmen). This fire fails to steam and warm the Spleen Earth from above, which are all causes of diarrhea during pregnancy. For Spleen deficiency with internal injury, Jiawei Liujunzi Tang (Modified Six-Gentleman Decoction) is used, with modifications based on the specific cause. For decline of the Fire of the Gate of Vitality, Yizhi Ren (Alpinia Oxyphylla Fruit) is added to assist Yang. In cases of prolonged diarrhea during pregnancy leading to sinking of Yuan Qi (Original Qi), accompanied by fever, thirst, and limb fatigue, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) should be employed. Mi Zhai treated diarrhea during pregnancy primarily by tonifying the Middle and calming the fetus using Jiawei Sijunzi Tang (Modified Four-Gentleman Decoction); for patients with prolonged diarrhea and severe thirst, Renshen Baizhu San (Ginseng and Atractylodes Macrocephala Powder) was prescribed with excellent results.

Weifeng Tang treats wind-cold invading the intestines and stomach due to deficiency, causing inability to retain rice and grain, profuse watery diarrhea, and intestinal-stomach damp-toxin, resulting in stools resembling bean curd dregs, dark blood, or fish brain matter, occurring day and night without limit.
Ingredients: Renshen (Ginseng Root), Baizhu (Atractylodes Macrocephala Rhizome, stir-fried with soil), Fuling (Poria), Danggui (Angelica Sinensis Root), Chuanxiong (Ligusticum Chuanxiong Rhizome), Shaoyao (Peony Root, stir-fried), Rougui (Cinnamon Bark) (all in equal proportions).
Usage: Add a pinch of Setaria Italica Grain, decoct in water and take orally. If abdominal pain occurs, add Muxiang (Aucklandiae Radix). This formula is truly ingenious for treating Qi and Blood deficiency caused by prolonged diarrhea. However, Rougui is absolutely contraindicated for those without chronic cold in the viscera. The name "Stomach Wind" implies benefiting the Stomach and lifting the clear Yang. Rougui in this formula is contraindicated for the fetus; if unavoidable, it may be stir-fried or replaced with Guitan (Charred Cinnamon Bark). Similarly, Rougui in Weiling Tang must be used with caution.

Jiawei Lizhong Tang treats cold sensation below the umbilicus and severe watery diarrhea during pregnancy.
Ingredients: Renshen, Baizhu (stir-fried with soil), Baishao (White Peony Root), Fuling, Ganjiang (Dried Ginger), Huanglian (Coptis Rhizome), Muxiang, Huoxiangye (Agastache Leaf), Hezirou (Chebula Fruit Flesh), Roudoukou (Nutmeg, baked in flour), Gancao (Licorice Root) (each 1 qian).
Usage: Three slices of Shengjiang (Fresh Ginger), two dates, decoct in two zhong of water until one zhong remains; take when hungry.

Jiawei Zhizhong Tang treats diarrhea caused by excessive food intake leading to insufficient Qi of the Spleen and Stomach and impaired transportation.
Ingredients: Renshen, Baizhu (stir-fried with soil), Paojiang (Prepared Ginger), Gancao (each 1 qian); Chenpi (Tangerine Peel), Qingpi (Green Tangerine Peel) (each 0.7 qian); Sharen (Amomum Fruit) (0.5 qian).
Usage: Decoct in water and take orally.

Siling San (with Wuling San attached) treats restive summer-heat causing irritability, thirst, and watery diarrhea.
Ingredients: Baizhu (stir-fried with soil), Zhuling (Polyporus), Zexie (Alisma Rhizome), Fuling.
Usage: Grind into powder in equal proportions; mix with rice drink and take orally. Adding Rougui to this formula creates Wuling San (Five-Ingredient Powder with Cinnamon).

Buhuanjin Zhengqi San treats dampness-injury diarrhea in pregnant women.
Ingredients: Cangzhu (Atractylodis Rhizoma, processed), Nongpu (Magnolia Bark, processed with ginger juice), Chenpi, Huoxiang, Banxia (Pinellia Tuber, processed) (each 1 qian); Gancao (0.5 qian).
Usage: Use Fresh Ginger and dates as guides; decoct in water and take orally.

Weiling Tang treats excessive Spleen dampness, disharmony of Stomach Qi, abdominal pain, diarrhea, indigestion of water and grain, and confusion of Yin and Yang. It is a combined formula of Pingwei San (Stomach-Pacifying Powder) and Wuling San.
Ingredients: Cangzhu, Nongpu, Chenpi, Baizhu (stir-fried with soil), Fuling, Zhuling, Zexie (each 1 qian); Guangui (Official Cinnamon Bark), Zhigancao (Honey-fried Licorice Root) (each 0.5 qian).
Usage: Three slices of Fresh Ginger, two dates; decoct in water and take well after meals. Since the formula contains Gui (Cinnamon), it is contraindicated for pregnant women; alternatively, Buhuanjin Zhengqi San is more appropriate.

Jiawei Liujunzi Tang:
Ingredients: Renshen (dose as appropriate), Baizhu (1 qian or 1.5 qian, stir-fried with soil), Fuling (1 qian), Chenpi (0.8 qian), Banxia (1 qian), Zhigancao (0.5 qian).
Usage: Use Fresh Ginger as a guide; decoct in water and take orally. For injury from rice, add Guya (Sprouted Rice); for injury from wheat, add Maiya (Sprouted Barley); for injury from meat, add Shanzha (Hawthorn Fruit). If Liver Wood insults Spleen Earth, accompanied by alternating chills and fever with vomiting, add Chaihu (Bupleurum Root) and Fresh Ginger. If accompanied by vomiting, abdominal pain, and cold limbs (Cold Water insulting Spleen Earth), add Ginger and Cinnamon. If stool is yellow (the true color of Spleen Earth), add Muxiang and Wei Rouguo (Baked Myristica Seed). If vomiting and anorexia occur with abdominal pain and aversion to cold (Spleen Earth deficiency-cold), add Muxiang, Ginger, and Cinnamon.

Mi Zhai's Jiawei Sijunzi Tang treats diarrhea during pregnancy, focusing on tonifying the Middle and calming the fetus.
Ingredients: Renshen, Baizhu (stir-fried with soil), Fuling (each 1 qian), Zhigancao (0.8 qian).
Usage: Decoct in water and take orally. For pregnancy diarrhea, add 1 qian of Chao Baishao (Stir-fried White Peony Root) to further differentiate between cold and heat syndromes. If there is fever and thirst, it is a heat syndrome; add 1 qian of Tiao Qin (Scutellaria Baicalensis Root). If there is no thirst, it is a cold syndrome; add 0.5 qian of Chao Hei Ganjiang (Stir-fried Blackened Dried Ginger), using one Wu Mei (Chinese Plum) as a guide; decoct in water and take before meals. For prolonged diarrhea with thirst that does not cease, add Jiuchao Baishao (Wine-stir-fried White Peony Root), Hezirou, Chao Ganjiang, and two pitted Wu Meis; decoct in water and take before meals. Alternatively, Renshen Baizhu San is also effective.

Renshen Baizhu San treats prolonged diarrhea with severe thirst.
Ingredients: Renshen, Baizhu (stir-fried with soil), Fuling, Zhigancao (each 1 qian), Huoxiang, Muxiang, Ganjiang (each 0.5 qian).
Usage: Decoct in water; administer frequently to replace soups and fluids, which yields good effects.

Buzhong Yiqi Tang (see the section on various pains in this volume).