《金匮要略》曰∶新产妇人有三病，三者大便难，何谓也？曰∶亡津液胃燥，故大便难。
《圣济总录》曰∶大肠者，传导之官，变化出焉。产后津液减耗，胃中枯燥，润养不足，糟粕壅滞，故令大
便难，或致不通。盖新产之人喜病者，由去血过多，内亡津液故也。
薛立斋曰∶产后大便不通，因去血过多，大肠干涸，或血虚火燥，不可计日期，饮食数多，用药通润之，必
待胀满，觉胀自欲去，不能去，乃结在直肠，宜胆导之。若服苦寒药通之，反伤中焦元气，或愈难通，或通而
泻不止，必成败证。若血虚火燥，加味逍遥散。气血俱虚八珍汤，慎不可用麻仁、杏仁、枳壳之类。
郭稽中曰∶产后大便秘涩者何？答曰∶产后水血俱下，肠胃虚竭，津液不足，是以大便秘涩不通。若过五
六日闷胀者，此燥屎在脏腑，干涩未能出耳，宜麻仁丸以润之。若误以为有热，投寒药，则阳消阴长，变证百
出矣。
单养贤曰∶产后大便日久不通，因血少肠燥故也。宜多服生化汤，则血旺气顺，传化如常，自无燥涩之患。
切不可用硝、黄峻利之剂，以亡阴血，致中气虚而便秘愈甚，遂成胀满者有之。
陈无择曰∶产后不得利，利者百无一生。去血过多，脏燥，大便秘涩，固当滑之，大黄似难轻用，唯葱涎
调腊茶为丸，复以腊茶下之。
慎斋按∶以上六条，序产后有大便秘结之证也。产后水血俱下，则大肠燥涩，便闭不通，《金匮》、《圣济》
均主津液内亡，立斋主血虚火燥，自是元气内乏受病，故戒不可以苦寒峻利，再伤气血，渐致不救也。
《金匮要略》说：刚生产完的产妇有三种病，其中一种是排便困难，这是什么原因呢？回答说：是因为流失了津液导致胃中干燥，所以大便困难。
《圣济总录》说：大肠是负责传导的器官，负责将变化后的糟粕排出体外。产后津液减少耗损，胃中干枯燥热，滋润滋养的功能不足，导致食物残渣壅滞，因此造成大便困难，甚至导致不通畅。大概新生产的妇女容易患病，是因为失血过多，体内津液亡失的缘故。
薛立斋说：产后大便不通，是因为失血过多，大肠干涸，或者是血虚导致内火燥热，不能计算日子，饮食数量较多，用药进行通便润肠，一定要等到腹部胀满，感觉有便意却排不出来，这是因为粪便结在直肠，适宜使用胆导法（如猪胆汁灌肠）。如果服用苦寒药物来通下，反而损伤中焦的元气，或者更加难以通畅，或者通畅后腹泻不止，必然会导致败证（危重病症）。如果是血虚火燥，使用加味逍遥散。如果是气血俱虚，使用八珍汤，千万不要使用麻仁、杏仁、枳壳之类的药物。
郭稽中说：产后大便秘结涩滞是什么原因？回答说：产后水和血一起下行，肠胃虚弱枯竭，津液不足，因此大便干结涩滞不通。如果过了五六天感到闷胀，这是燥屎在脏腑中，因为干涩而未能排出，适宜用麻仁丸来润肠通便。如果错误地认为是有热邪，投用寒凉药物，就会导致阳气消减、阴气增长，变生各种证候。
单养贤说：产后大便长久不通，是因为血液少、肠道干燥的缘故。适宜多服用生化汤，这样血液旺盛、气机顺畅，传导消化功能恢复正常，自然就没有燥涩的隐患。千万不可使用芒硝、大黄等峻猛利下的药剂，以免亡失阴血，导致中气虚弱而使便秘更加严重，进而出现胀满的情况。
陈无择说：产后不得随意使用泻下法，一旦误用泻下法，百人中难有一人生还。失血过多，脏腑干燥，大便干结涩滞，固然应当使用滑利之法，但大黄似乎难以轻易使用，只能用葱汁调和腊月茶做成丸药，再用腊茶送服。
慎斋按语：以上六条，叙述了产后有大便秘结的证候。产后水和血一起下行，则大肠干燥涩滞，便秘不通，《金匮要略》和《圣济总录》都主张是津液在内亡失，薛立斋主张是血虚火燥，这自然是元气内部匮乏而致病，所以告诫不可以使用苦寒峻猛的药物，再次伤害气血，逐渐导致无法救治。
The *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) states: There are three diseases in women who have just given birth, one of which is difficulty in defecation. What does this mean? It is said that the loss of body fluids and dryness of the stomach cause difficulty in defecation.
The *Shengji Zonglu* (General Records of the Sage's Relief) states: The large intestine is the official responsible for conduction, where transformation occurs. After childbirth, body fluids are reduced and consumed, leading to dryness and aridity in the stomach. Due to insufficient moistening and nourishment, waste accumulates and stagnates, causing difficulty in defecation or even obstruction. Generally, women who have just given birth are prone to illness due to excessive blood loss and the subsequent internal loss of body fluids.
Xue Lizhai stated: Difficulty in defecation after childbirth is caused by excessive blood loss leading to dryness of the large intestine, or by blood deficiency with fire-induced dryness. One should not wait for a specific number of days; if dietary intake is high, use medications to promote bowel movement and moisten the intestines. However, one must wait until abdominal distension occurs and the urge to defecate is felt but cannot be expelled. This indicates feces impacted in the rectum, suitable for treatment with bile suppositories (Dan Dao). If bitter-cold herbs are used to purge, it will damage the Yuan Qi (Original Qi) of the middle jiao, potentially making passage more difficult or causing unceasing diarrhea after passage, inevitably leading to a critical condition. For blood deficiency with fire dryness, Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) is indicated. For combined qi and blood deficiency, Bazhen Tang (Eight Treasures Decoction) is indicated. One must strictly avoid using herbs such as Hemp Seed (Hempseed), Apricot Kernel, and Aurantium Fructus (Bitter Orange).
Guo Jizhong asked: What causes constipation and dryness of stool after childbirth? He answered: After childbirth, water and blood descend together, leaving the intestines and stomach weak and depleted, with insufficient body fluids, resulting in dry, hard, and obstructed stools. If闷胀 (stifling distension) occurs after five or six days, this indicates dry feces retained in the zang-fu organs, unable to pass due to dryness and roughness. Mahuang Wan (Hempseed Pill) should be used to moisten. If mistakenly treated as having heat and cold-natured drugs are administered, yang will decline and yin will grow, leading to myriad complications.
Shan Yangxian stated: Prolonged inability to defecate after childbirth is due to blood deficiency and intestinal dryness. It is appropriate to take Shenghua Tang (Invigorate Blood Decoction) frequently, so that blood becomes abundant and qi flows smoothly, restoring normal digestion and transportation, thereby avoiding dryness and roughness. One must absolutely avoid using harsh purgatives like Mirabilite (Natrii Sulfas) and Rhubarb (Rhubarb Root and Rhizome), which can deplete yin-blood, weaken middle qi, and exacerbate constipation, potentially leading to distension.
Chen Wuzhe stated: Diarrhea/purging should not be induced after childbirth; if induced, fewer than one in a hundred survives. Excessive blood loss leads to organ dryness and constipation. While lubricating methods are indeed necessary, Dahuang (Rhubarb Root and Rhizome) should not be used lightly. Instead, onion juice mixed with wax tea (Lacha) pills, taken with wax tea wash-down, is recommended.
Shenzhen's Commentary: The above six passages describe the syndrome of severe constipation after childbirth. Since water and blood descend together after childbirth, the large intestine becomes dry and rough, leading to constipation. Both the *Jingui Yaolue* and *Shengji Zonglu* attribute this to the internal loss of body fluids. Xue Lizhai attributes it to blood deficiency with fire dryness. In all cases, the underlying pathology is a deficiency of internal Yuan Qi (Original Qi). Therefore, it is warned against using bitter-cold and harsh purgative agents, which would further damage qi and blood, gradually leading to an incurable state.