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[Da] During pregnancy, the obstruction of both urination and defecation is caused by heat in the Zang-Fu organs. If there is heat in the Large Intestine, defecation will be obstructed; if there is heat in the Small Intestine, urination will be difficult; if there is heat in both the Large and Small Intestines, both urination and defecation will be obstructed. One should further investigate the etiology and prescribe medication accordingly.

[Xue] In the aforementioned conditions, if it is due to blood dryness in the Large Intestine, use Siwu Tang (Four-Item Decoction) with added Huangqin (Scutellariae Radix, Baical Skullcap Root) and Taoren (Persicae Semen). If it is due to Qi stagnation in the Large Intestine, use Zisu Yin (Perilla Infusion) with added Xingren (Armeniacae Semen Amarum) and Huangqin. If it is due to Qi deficiency in the Stomach and Intestines, use Liujunzi Tang (Six-Gentlemen Decoction) with added Zisu (Perillae Folium) and Xingren. If it is due to latent heat in the Liver and Spleen, use Longdan Xiegan Tang (Gentian Liver-Draining Decoction). If it is due to deficient heat in the Heart and Liver, use Jiawei Xiaoyao San (Modified Free-and-Easy Wanderer Powder) with added Cheqianzi (Plantaginis Semen). The concubine of Vice Minister Li Puting suffered from difficulty in urination and defecation during pregnancy. Others administered herbs to clear fire and regulate Qi, which instead depleted her Yuan Qi. Her Liver pulse was wiry and tense, and her Spleen pulse was slow and sluggish. Upon observing her complexion, it appeared greenish-yellow and lusterless. I said: "This is caused by depression and anger." I used Jiawei Guipi Tang (Modified Return-to-Spleen Powder) as the main formula, assisted by Jiawei Xiaoyao San, resulting in recovery. The wife of Director Wang Tiancheng suffered from dysentery during pregnancy. After recovery, she experienced obstruction of both urination and defecation. Her family were physicians for generations, and they self-administered heat-clearing herbs without effect. I palpated her pulse as floating, large, and choppy, indicating a deficiency of Qi and Blood. In the morning, she took Bazhen Tang (Eight-Treasure Decoction) with added Taoren and Xingren; in the evening, she took Jiawei Xiaoyao San with added Cheqianzi, leading to cure.

*Dujuan* records the treatment of *Zilin* (dysuria during pregnancy) where both urination and defecation are obstructed, accompanied by shortness of breath. Since Zhuling San (Polyporus Powder) failed to cure, Gansui San (Kansui Powder) should be used to purge.
Formula for Gansui San
Use Taishan Chipi Gansui (2 liang).
Grind the above single herb into powder. Mix with 2 he of white honey and take one pill-sized dose (size of a bean). If one feels vexation in the epigastrium and experiences slight purging, take once daily. After purging, resume taking Zhuling San. If no purging occurs, take twice daily, gradually increasing to half qian, stopping when mild laxation is achieved. (Same as *Jingxin Lu*. This medicine is too harsh and should not be used lightly.)

Zhuling San treats painful and difficult urination during pregnancy and also addresses fetal edema (*Taishui*).
Zhuling (5 liang, peeled). Grind into powder. Mix with hot water and take one cun-bi (square-inch measure), increasing to two cun-bi. Take three times daily and twice at night. If ineffective, switch to purgatives and take the previous medicines.

Kuizi Tang (Two formulas from *Gujin Luyan*) treats pregnancy illness lasting more than six or seven days, where pathogenic heat enters the Zang organs, causing obstruction of urination and defecation. It calms the fetus and clears heat.
Dongkuizi (2 sheng) Huashi (4 liang, crushed).
Boil the above in 5 sheng of water until reduced to 1 sheng. Strain and drink completely. Purging should occur shortly after, and the condition will resolve.

Another Formula: Dongkuizi (1 he) Puxiao (2 liang). Take 3 qian per dose, decoct in water and take warm.

Treats obstruction of urination and defecation during pregnancy, with fullness and oppression in the heart and abdomen, loss of appetite, and vexatious heat in the hands and feet.
Bolang (Arecae Semen) Chi Fuling (Red Polyporus) Dafupi (Tangeris Pericarpium) Mutong (Akebiae Caulis) Yuliren (Pruni Semen) Bei Wuwei (Schisandrae Fructus) Sangjisheng (Taxilli Herba) Gancao (Licorice Root) Kugeng (Platycodonis Radix) [Each 1 liang except Sangjisheng, Gancao, Kugeng which are 0.5 liang].
Grind into coarse powder. Take 3 qian per dose, decoct in 1 cup of water until reduced to 60%, and take warm.

Treats obstruction of urination and defecation during pregnancy, with heat closing the heart and diaphragm, abdominal and hypochondriac distension and oppression, interfering with eating.
Dahuang (Rhei Radix et Rhizoma) Mutong Bolang [Each 1 liang] Zhike (Aurantii Fructus) Dafuzi (Tangeris Pericarpium) Hezi (Chebulae Fructus) [Grind into fine powder. Decoct with 1 cup of child's urine and 2 cun of scallion white until reduced to 60%. Mix and take 2 qian.]

Danggui San treats various pre-partum disorders, such as Qi rushing to the uterus or Chong and Ren vessels due to anger, causing abdominal urgency and distension, intermittent lower back and abdominal pain, anorexia, edema of the four limbs, shortness of breath with wheezing, sudden difficulty in defecation, sudden difficulty in urination, and sudden swelling of the birth canal.
Danggui (1 liang) Chi Fuling Zhike Baishao Chuanxiong [Each 2 liang] Chuan Baijiang (Pounded) Muxiang (Stewed) Fengcao (Licorice Root) [Each 0.5 liang].
Chop coarsely. Take 3 da qian per dose, decoct in 1.5 cups of water with 3 slices of fresh ginger until reduced to 80%. Strain and take warm at any time. For those with weak constitution or Southerners, reduce Zhike by half. For those with excess Qi or Northerners, increase the dosage within the formula. If constipation persists for several days, add honey and decoct together.

Chu Yushi's formula for treating constipation during pregnancy.
Zhike (3 liang) Fangfeng (2 liang) Zhigancao (1 liang).
Grind into fine powder. Take 1-2 qian with boiling water, three times daily on an empty stomach.

Another formula for treating constipation due to emaciation and deficiency.
Zhike (Processed) Ejiao (Fried) [Equal parts].
Grind into fine powder. Mix with refined honey, pound 2,000-3,000 times, and form pills the size of mulberry seeds. Coat with powdered Huashi. Take 20 pills with warm water. If no bowel movement after half a day, take another 30 pills, up to a maximum of 50 pills.

Another Formula: Cheqianzi (1 liang) Dahuang (Fried, 0.5 liang).
Grind into fine powder. Take 3 qian per dose with honey water on an empty stomach.

Dafupi Tang treats obstruction of urination and defecation in pregnant women.
Zhike Dafupi Chi Fuling [Each 1 liang] Gancao (2 qian).
Grind into powder. Take 2 qian mixed with scallion white water.

*Buyi* Ju Fang Bazen San treats heat accumulation in the Heart Meridian in pregnant women, organ constipation, Large Intestine obstruction, and red, scanty, or obstructed urination. (See Miscellaneous Diseases: Lin Syndrome.) The above formulas recorded by Chen Liangfu are preserved here. Adding Gansui and Puxiao is only for severe excess patterns in critical conditions, out of necessity; do not use lightly. Other formulas should also be carefully reviewed before use. Following Master Xue's advice and referencing miscellaneous disease methods ensures accuracy.