产后大便不通，因去血过多，大肠干涸，或血虚火燥干涸，不可计其日期，饮食数多，用药
通之润之，必待腹满觉胀，目欲去而不能者，乃结在直肠，宜用猪胆汁润之。若服苦参药润
通，反伤中焦元气，或愈加难通，或通而泻不能止，必成败症。若属血虚火燥，用加味逍遥
散。气血俱虚，八珍汤。慎不可用麻子、杏仁、枳壳之类。
治验
一产妇大便不通七日矣，饮食如常，腹中如故。余曰∶饮食所入，虽倍常数，腹不满胀，用
八珍加桃杏二仁。至二十一日，腹满，欲去，用猪胆汁润之，先去干粪五七块，后皆常粪而安。
一产妇大便八日不通，用通利之药，中脘作痛，饮食甚少，或云∶通则不痛，痛则不通。乃
用蜜导之，大便不禁，吃逆不食。余曰∶此脾肾复伤，用六君加吴茱、肉果、骨脂、五味数
剂，喜其年壮，不然，多致不起。
产后寒热，因气血虚弱，或脾胃亏损，乃不足之症。经云∶阴虚则发热，阳虚则恶寒。若兼
大便不通，尤属气血虚弱，切不可用发表降火。若寸口脉微，名阳气不足，阴气上入于阳中
则恶寒，用补中益气汤。尺部脉弱，名阴气不足，阳气下陷于阴中则发热，用六味地黄丸。
大抵阴不足，阳往从之，则阳内陷而发热；阳不足，阴往从之，则阴上入而恶寒。此阴阳不
归其分，以致寒热交争，故恶寒而发热也，当用八珍汤。若病后四肢发热，或形气倦怠，此
元气未复，湿热乘之故耳，宜补中益气汤。若肌热大渴引饮，目赤面红，此血虚发热，用当
归补血汤，若认为寒则误矣。
治验
一产妇恶寒发热，用十全大补加炮姜治之而愈。但饮食不甘，肢体倦怠，用补中益气而安。
又饮食后犯怒，恶寒发热，抽搐切牙，难候其脉，视其面色，青中隐黄，欲按其腹，以手护
之，此肝木侮脾土，饮食停滞而作，用六君加木香一剂而安。
一产妇恶寒发热，余欲用八珍加炮姜治之，其家知医，以为风寒，用小柴胡汤。余曰∶寒热
不时，乃气血虚。不信，仍服一剂，汗出不止，谵语不绝，烦热作渴，肢体抽搐，余用十全
大补，二剂益甚，脉洪大，重按如无，仍以前汤加附子，四剂稍缓，数剂而安。
产后大便不通，是因为失血过多，导致大肠干涸；或者是血虚伴有内火燥热导致干涸。这种情况不能单纯计算病程天数，如果饮食量较多，用药进行通下或润肠治疗，必须等到患者感到腹部胀满、有便意却排不出时，才判断为粪便结在直肠，此时适宜使用猪胆汁来润肠通便。如果服用苦参等药物来润通，反而会损伤中焦的元气，或者导致更加难以排便，或者虽然通了但腹泻无法停止，最终必定演变为败症（危重难治之症）。如果属于血虚火燥证型，使用加味逍遥散。如果是气血俱虚，使用八珍汤。千万不可使用麻子、杏仁、枳壳这类药物。
医案：
有一位产妇大便不通已有七天，饮食正常，腹部没有不适感。我说：“饮食摄入即使超过平常倍数，腹部也不胀满，这是气血不足，用八珍汤加上桃仁、杏仁。”到了第二十天，出现腹部胀满，有便意，于是用猪胆汁润肠通便，先排出干硬的粪块五七块，随后排出正常粪便而痊愈。
另一位产妇大便八天不通，使用了通利药物后，中脘穴部位疼痛，饮食很少。有人说：“通则不痛，痛则不通。”于是使用蜜导法（蜂蜜栓）通便，结果导致大便失禁，呃逆且无法进食。我说：“这是脾肾再次受到损伤，使用六君子汤加入吴茱萸、肉豆蔻、补骨脂、五味子，服用数剂，庆幸她年纪轻壮，否则大多会导致死亡。”
产后寒热，是由于气血虚弱，或者脾胃亏损，属于虚损类病症。《内经》说：“阴虚则发热，阳虚则恶寒。”如果兼有大便不通，更属于气血虚弱，千万不可使用发表解表或降火清热的药物。如果寸口脉微，名为阳气不足，阴气上入于阳分则表现为恶寒，使用补中益气汤。尺部脉弱，名为阴气不足，阳气下陷于阴分则表现为发热，使用六味地黄丸。大抵来说，阴不足，阳就会往从它，导致阳气内陷而发热；阳不足，阴就会往从它，导致阴气上入而恶寒。这是因为阴阳不能各守其位，导致寒热交争，所以出现恶寒发热的症状，应当使用八珍汤。如果在病后四肢发热，或者形体气息倦怠，这是元气尚未恢复，湿热乘虚侵袭所致，适宜使用补中益气汤。如果出现肌肤发热、大渴引饮、眼睛发红、面色红润，这是血虚发热，使用当归补血汤，如果误认为是寒证就错了。
医案：
一位产妇恶寒发热，我用十全大补汤加入炮姜治疗而痊愈。但她饮食无味，肢体倦怠，使用补中益气汤后安宁。
又有一位产妇在饮食后发怒，出现恶寒发热、抽搐咬牙，难以诊察脉搏，观察她的面色，青色中隐现黄色，想要按压腹部时，她用手护住腹部，这是肝木克制脾土，因饮食停滞引起，使用六君子汤加入木香，一剂后安宁。
一位产妇恶寒发热，我想用八珍汤加入炮姜治疗，但其家属懂医理，认为是风寒，使用了小柴胡汤。我说：“寒热发作无定时，是气血虚弱。”家属不信，仍服了一剂，导致汗出不止，胡言乱语，烦躁发热口渴，肢体抽搐。我改用十全大补汤，服用两剂后病情加重，脉象洪大但重按无力，仍然用前汤加入附子，服用四剂后稍见缓解，再服数剂后痊愈。
Postpartum constipation arises from excessive blood loss, leading to dryness of the Large Intestine (大肠), or from blood deficiency with internal fire causing dryness. One should not merely count the days since onset. If dietary intake is heavy, using purgative or moistening medications requires waiting until the patient feels abdominal fullness and a tenesmus-like urge but cannot defecate; only then is it determined that feces are impacted in the rectum, at which point Pig Bile (猪胆汁) is suitable for moistening the intestines. If one takes bitter herbs like Sophora Flavescens Root (苦参) to promote lubrication, it will instead damage the Yuan Qi (Original Qi) of the Middle Jiao (中焦), potentially making defecation even more difficult, or causing unceasing diarrhea after initial passage, inevitably leading to a fatal condition. If the pattern is blood deficiency with fire dryness, use Modified Xiao Yao San (加味逍遥散). If both Qi and Blood are deficient, use Ba Zhen Tang (Eight Treasures Decoction). One must strictly avoid using seeds like Hemp Seed (麻子), Apricot Kernel (杏仁), or Aurantium Fruit (枳壳).
Clinical Case 1:
A postpartum woman had been unable to defecate for seven days. Her diet was normal, and her abdomen felt unchanged. I said, "Although food intake may exceed the usual amount, the absence of abdominal distension indicates deficiency. Use Ba Zhen Tang plus Peach Kernel (桃仁) and Apricot Kernel (杏仁)." By the twenty-first day, she experienced abdominal fullness and an urge to defecate. I used Pig Bile (猪胆汁) to moisten the intestines. She first passed five to seven pieces of hard stool, followed by normal stools, and recovered.
Clinical Case 2:
Another postpartum woman had not defecated for eight days. After taking purgative medicines, she experienced pain in the Zhongwan region (中脘) and had very little appetite. Some argued, "If there is free flow, there is no pain; if there is pain, there is obstruction." Consequently, Honey Suppositories (蜜导) were used, resulting in fecal incontinence, hiccups, and inability to eat. I stated, "This is further injury to the Spleen and Kidney. Use Liu Jun Zi Tang (Six Gentlemen Decoction) added with Evodia Fruit (吴茱), Nutmeg (肉果), Psoralea Fruit (骨脂), and Schisandra Berry (五味子). Fortunately, she was young and strong; otherwise, this would likely have proven fatal."
Postpartum alternating chills and fever results from Qi and Blood deficiency or Spleen and Stomach impairment, constituting a deficiency syndrome. The Classic states: "Yin deficiency leads to fever; Yang deficiency leads to aversion to cold." If accompanied by constipation, it particularly points to Qi and Blood deficiency. One must absolutely avoid using diaphoretic (sweat-inducing) or heat-clearing/descending methods. If the Cun (Inch) pulse is faint, it is named Yang Qi deficiency; when Yin Qi enters the Yang aspect, it causes aversion to cold, treated with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction). If the Chi (Cubit) pulse is weak, it is named Yin Qi deficiency; when Yang Qi sinks into the Yin aspect, it causes fever, treated with Liu Wei Di Huang Wan (Six-Ingredient Pill with Rehmannia). Generally, when Yin is insufficient, Yang follows it inward, causing Yang to sink internally and resulting in fever; when Yang is insufficient, Yin follows it upward, causing Yin to rise and resulting in aversion to cold. This failure of Yin and Yang to remain in their proper positions leads to a struggle between cold and heat, manifesting as chills and fever, which should be treated with Ba Zhen Tang (Eight Treasures Decoction). If limbs feel hot after illness, or if there is fatigue and lassitude of form and Qi, this is due to incomplete recovery of Yuan Qi (Original Qi) with damp-heat taking advantage of the weakness; Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) is appropriate. If there is skin heat, intense thirst with desire to drink, red eyes, and ruddy complexion, this is fever due to Blood deficiency, treated with Dang Gui Bu Xue Tang (Angelica Tonifying the Blood Decoction); mistaking this for a cold pattern would be an error.
Clinical Case 3:
A postpartum woman presented with chills and fever. I treated her with Shi Quan Da Bu Tang (Great Tonifying Decoction for Ten Powers) added with Prepared Ginger (炮姜), resulting in recovery. However, she had poor appetite and limb fatigue, which resolved after treatment with Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction).
Clinical Case 4:
Another postpartum woman became angry after eating, presenting with chills, fever, convulsions, and teeth grinding. It was difficult to palpate her pulse. Observing her facial color, which showed blue with hidden yellow, and noting that she protected her abdomen when I attempted to press it, I diagnosed Liver Wood overacting on Spleen Earth due to food stagnation. Treatment with Liu Jun Zi Tang (Six Gentlemen Decoction) added with Aucklandia Root (木香) resulted in relief after one dose.
Clinical Case 5:
A postpartum woman presented with chills and fever. I intended to treat her with Ba Zhen Tang (Eight Treasures Decoction) added with Prepared Ginger (炮姜). Her family, who were knowledgeable in medicine, believed it was Wind-Cold and administered Xiao Chai Hu Tang (Minor Bupleurum Decoction). I stated, "The irregular timing of chills and fever indicates Qi and Blood deficiency." They did not believe me and continued with one dose. This led to continuous sweating, delirious speech, irritability, heat sensation, thirst, and limb convulsions. I switched to Shi Quan Da Bu Tang (Great Tonifying Decoction for Ten Powers). After two doses, the condition worsened, and the pulse became flooding (Hong) but empty upon deep pressure. I retained the previous formula but added Aconite Root (附子). After four doses, symptoms slightly eased, and after several more doses, she recovered.