14.产后去血亡津液, 胃燥肠枯大胃难, 饮食如常无所苦, 不须妄下
损真元, 量其虚实通利导, 血旺津回听自然.
【注】产后去血过伤其津液, 多致胃燥肠枯, 故令大便秘结. 若饮食
如常, 无胀满之苦者, 不宜轻下, 反伤元气. 惟宜量其虚实, 用诸导
法,待血旺津回, 大便自然顺利也.
加味四物汤
15.产后淋闭腹胀痛, 热邪挟血渗胞中, 四物蒲瞿桃仁膝, 滑石甘草
木香通.
【注】产后热邪挟瘀血流渗胞中, 多令小便淋闭, 宜四物汤加蒲黄,
瞿麦, 桃仁, 牛膝, 滑石, 甘草梢, 木香, 木通治之.
四物汤 方见首卷
黄耆当归散 加味地黄汤
16.产后小便数且白, 肾虚不固自遗尿. 因产伤胞多淋沥, 频数补中
益气宜. 胞伤黄耆当归治, 参耆术芍草当归, 不禁六味加桂附, 益智
螵蛸补骨脂.
【注】产后气虚下陷, 多令小便频数而色白. 肾虚不固, 小便自遗.
因产时稳婆不慎, 伤其胞脬, 多致小便淋沥. 气虚频数者, 宜补中益
气汤升举之. 伤胞淋沥者, 宜黄耆当归散补之, 其方即黄耆, 当归 ,
人参, 白术, 白芍, 甘草也, 引用猪草胞同煮服. 肾虚遗尿不禁者,
宜六味地黄汤加肉桂, 附子, 名桂附地黄汤, 更加益智仁, 桑螵蛸,
补骨脂治之.
补中益气汤 六味地黄汤 方俱见首卷
14. 产后失血导致津液耗伤，胃中干燥、肠道枯涩，大便难以排出。如果饮食正常且没有痛苦感，就不需要随意使用攻下法损伤真元之气，应根据患者虚实情况，采用通便导滞的方法，待气血旺盛、津液恢复后，大便自然会通畅。
【注】产后失血过多会严重损伤津液，多导致胃燥肠枯，从而引起大便秘结。若饮食如常，没有胀满痛苦的，不宜轻易使用泻下法，否则会反伤元气。只应当衡量其虚实状况，采用各种导便方法，等待血液充盈、津液回复，大便自然顺利排出。
加味四物汤
15. 产后小便淋沥闭塞、腹部胀痛，是热邪挟带瘀血渗入胞宫所致。可用四物汤加入蒲黄、瞿麦、桃仁、牛膝、滑石、甘草、木香来通利治疗。
【注】产后热邪挟带瘀血流渗进入胞宫，多导致小便淋沥闭塞，适宜用四物汤加入蒲黄、瞿麦、桃仁、牛膝、滑石、甘草梢、木香、木通来治疗。
四物汤 方剂见首卷
黄耆当归散 加味地黄汤
16. 产后小便频数且颜色清白，是肾虚不固导致尿液自遗。因分娩损伤胞宫多致小便淋沥不尽，对于频数症状宜用补中益气汤治疗。胞宫损伤可用黄耆当归散治疗，该方由人参、黄耆、白术、白芍、甘草、当归组成；对于不禁（失禁）症状，在六味地黄汤基础上加入肉桂、附子，再加益智仁、桑螵蛸、补骨脂治疗。
【注】产后气虚下陷，多导致小便频数且颜色发白。肾虚不固，导致小便自遗。因分娩时接生婆不慎，损伤了胞脬，多导致小便淋沥不尽。气虚导致频数的，宜用补中益气汤升提举陷。损伤胞宫导致淋沥的，宜用黄耆当归散补益，该方即黄耆、当归、人参、白术、白芍、甘草，引用猪胞同煮服用。肾虚导致遗尿不禁的，宜用六味地黄汤加入肉桂、附子，名为桂附地黄汤，再加入益智仁、桑螵蛸、补骨脂治疗。
补中益气汤 六味地黄汤 方剂均见首卷
14. Postpartum blood loss leads to the depletion of body fluids, causing dryness in the Stomach and withering of the intestines, making defecation difficult. If diet remains normal without discomfort, one should not recklessly use purgative methods that damage True Yuan Qi (Vital Energy). Instead, based on the patient's deficiency or excess, guiding methods for bowel movement should be employed. Once blood volume recovers and body fluids return, defecation will naturally become smooth.
[Annotation] Excessive blood loss postpartum severely damages body fluids, often leading to stomach dryness and intestinal withering, thus causing constipation. If dietary intake is normal and there is no suffering from distension and fullness, gentle purgatives should not be used lightly, as they may counterproductively damage Yuan Qi. One should only assess the condition's deficiency or excess and employ various guiding methods for defecation. Wait for blood to flourish and fluids to recover, and stool will pass smoothly naturally.
Jiawei Siwu Tang (Modified Four Substances Decoction)
15. Postpartum strangury and urinary retention accompanied by abdominal distension and pain are caused by heat pathogens carrying blood stasis infiltrating the uterus. Siwu Tang (Four Substances Decoction) can be modified by adding Puhuang (Polygoni Typhonii Pollen), Qumai (Dianthi Herba), Taoren (Persicae Semen), Niuxi (Achyranthis Bidentatae Radix), Huashi (Talcum), Gancao (Glycyrrhizae Radix et Rhizoma), Muxiang (Aucklandiae Radix), and Mutong (Akebiae Caulis) to promote urination.
[Annotation] Heat pathogens carrying blood stasis infiltrating the uterus postpartum often cause strangury and urinary retention. It is suitable to treat this with Siwu Tang (Four Substances Decoction) added with Puhuang (Polygoni Typhonii Pollen), Qumai (Dianthi Herba), Taoren (Persicae Semen), Niuxi (Achyranthis Bidentatae Radix), Huashi (Talcum), Gancao Jiao (the tip of Glycyrrhizae Radix et Rhizoma), Muxiang (Aucklandiae Radix), and Mutong (Akebiae Caulis).
Siwu Tang (Four Substances Decoction) Formula is seen in the first volume.
Huangqi Danggui San (Astragalus and Angelica Powder) & Jiawei Dihuang Tang (Modified Rehmannia Decoction)
16. Frequent urination with clear white urine postpartum indicates Kidney deficiency failing to secure, leading to spontaneous enuresis. Due to uterine injury during childbirth, frequent dribbling occurs; for frequency, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is appropriate. Uterine injury can be treated with Huangqi Danggui San (Astragalus and Angelica Powder); this formula consists of Renshen (Ginseng Radix), Huangqi (Astragali Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Baishao (Paeoniae Radix Alba), Gancao (Glycyrrhizae Radix et Rhizoma), and Danggui (Angelicae Sinensis Radix). For incontinence, Liuwei Dihuang Tang (Six-Ingredient Rehmannia Pill/Decoction) is modified with Rougui (Cinnamomi Cortex) and Fuzi (Aconiti Lateralis Radix Praeparata), named Guifu Dihuang Tang (Cinnamon and Aconite Rehmannia Decoction), further adding Yizhiren (Biondae Semen), Sangpiaoxiao (Mantis Ootheca), and Buguzhi (Psoraleae Fructus) for treatment.
[Annotation] Postpartum Qi deficiency sinking downward often causes frequent urination with pale color. Kidney deficiency failing to secure leads to spontaneous enuresis. If the bladder is injured due to careless midwifery during childbirth, it often results in urinary dribbling. For frequency caused by Qi deficiency, Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) should be used to lift and raise. For dribbling caused by bladder injury, Huangqi Danggui San (Astragalus and Angelica Powder) should be used to tonify; this formula consists of Huangqi (Astragali Radix), Danggui (Angelicae Sinensis Radix), Renshen (Ginseng Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Baishao (Paeoniae Radix Alba), and Gancao (Glycyrrhizae Radix et Rhizoma), taken after boiling together with pig bladder. For incontinence caused by Kidney deficiency, Liuwei Dihuang Tang (Six-Ingredient Rehmannia Decoction) added with Rougui (Cinnamomi Cortex) and Fuzi (Aconiti Lateralis Radix Praeparata), named Guifu Dihuang Tang (Cinnamon and Aconite Rehmannia Decoction), further treating with Yizhiren (Biondae Semen), Sangpiaoxiao (Mantis Ootheca), and Buguzhi (Psoraleae Fructus).
Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) and Liuwei Dihuang Tang (Six-Ingredient Rehmannia Decoction) formulas are both seen in the first volume.