〔大〕产后痢疾者，由产劳伤，脏腑不足，日月未满，虚乏未复，或劳动太早，或
误食生冷，若行起太早，则外伤风冷，乘虚入于肠胃，若误食生冷难化之物，伤于脾胃，
皆令洞泄水泻，甚者变为痢也。若血渗入大肠则为血痢，难治，世谓之产子痢也。得冷
则白，或如鱼脑，得热则赤黄，或为骤血。若冷热相搏，则下痢赤白，或脓血相杂。若下
痢青色，则极冷也。若饮食不进，便利无常，日夜无度。产后本虚，更加久痢不止，无力
瘦乏，愈见羸弱，谓之虚羸下痢。又有产后气宇不顺，而下痢赤白，谓之气痢。治之之
法，热则凉之，冷则温之，冷热相搏则调之，滑者涩之，虚羸者补之，水谷不分者当利小
便。若产妇性情执着，不能宽解，须当顺其气，未有不安者也。
〔薛〕前证白属气分，而赤属血分也。其论详见泻利。一产妇食鸡子，腹中作痛，
面色青黄，服平胃、二陈，更下痢腹胀。用流气饮子，又小腹一块不时上攻，饮食愈少。
此脾胃虚寒，肝木克侮所致。用补中益气加木香、吴茱渐愈。又用八珍大补，兼服调理
寻愈。一妇产后痢未至月满，因食冷物及酒，冷热与血攻击，滞下纯血，缠坠极痛，其
脉大无力，口干，用黄芩芍药汤三服而安。
〔熊〕治产后赤白痢证 用四君子汤加黄 、粟壳神效。
〔云〕救急散 治产后赤白痢，腹中绞痛。
芍药 阿胶 艾叶 熟地黄（各一两） 甘草 当归（各三两）
上 咀，水煎分二服，空心饮。
〔大〕当归芍药散 治妊娠腹中绞痛，心下急痛，及疗产后血晕，崩中久痢。（方见血崩。）
疗妊娠血痢 用阿胶二两，以酒一升半，煮一升，顿服。
产后诸痢 煮薤白食之。又方，羊肾脂炒薤白，空心食之，甚佳。
〔经〕治产后、胎前痢疾 败龟甲一枚，米醋炙研为末，醋汤调下。（丹溪云∶龟甲大补阴，
治劳倦。）
〔丹〕妇人患堕胎后膈满食少，痢不止，脉虚，左手尤甚。
滑石 白芍药（炒） 苍术（各五钱） 白术（二钱五分） 诃子（二钱，煨） 干姜（四钱）
茯苓（一钱）
上为细末，调下保和丸四五十粒。
〔云〕产后血痢，脐腹疼痛 四物汤加槐花、黄连、御米壳等药。
黄连丸 治产后赤白痢，腹中搅痛不可忍。
黄连（四两） 阿胶 蒲黄 栀子仁（各一两） 当归（二两半） 黄芩 黄柏（各二两）
上为末，炼蜜丸如桐子大。每服六七十丸，米饮吞下，日三夜一。
〔仲〕产后下痢虚极， 白头翁加甘草阿胶汤主之。（《脉经》作热痢重下，新产虚极者。）
白头翁 阿胶（各二两） 黄连 黄柏 秦皮（各三两） 甘草（二两）
上以水七升，煮取二升半，纳胶令消尽，温分三服。妇人临产痢疾。
山栀不拘多少，烧灰为细末，空心温熟水调下一钱，甚者不过五服。
产后血痢，小便不通，脐腹疼痛。
用生马齿苋捣汁二大合，煎一沸，下蜜一合调，顿服。
〔梅〕治产后血泄不禁，余血作痛兼块。
桂心、干姜等分为末，空心酒调服方寸匕。
〔大〕疗产后痢，日五十行者，取木里蛀虫粪屑炒黄，急以水沃之，令稠稀得所，服
之即瘥。
〔圣〕治产后诸痢方。取苍耳叶捣汁、半盏，日三四，温服。
〔渴〕产后下痢作渴者，水谷之精，化为血气津液，以养脏腑，脏腑虚燥，故痢而渴。若
引饮则难止，反溢水气，脾胃既虚，不能克水，水自流溢，浸渍皮肤，则令人肿。但止
其渴，痢则自瘥。
〔薛〕前证若渴而不喜冷冻饮料，属胃气虚，不能生津液，宜用七味白术散。夜间发热口
渴，属肾水弱而不能润，宜用六味丸，并佐以益气汤，以滋化源。一产妇泻痢，发热
作渴，吐痰，肌体消瘦，饮食少思，或胸膈痞闷，或小腹胀坠，年余矣。余以为脾肾之
泻，朝用二神丸，夕用六君子，三月余而痊。
一产妇患前证，形体倦怠，饮食不进，与死为邻，此脾胃俱虚也。用四神丸、十全大
补汤而愈。
《必效》疗产后痢而渴饮无度数。
麦门冬（三两） 乌梅（二十个）
细锉，水一升，煮取七合，细呷。
《经效》疗产后久痢，津液涸，渴不止。
龙骨（十二分） 浓朴 茯苓 黄 麦门冬 人参（各八分） 生姜（六分） 大枣（十四个，并
细锉）
上以水一大升，煮取七合，空心分两服。
疗产后痢，日久津液枯竭，四肢浮肿，口干舌燥。《古今录验》
冬瓜（一枚） 黄泥糊浓五寸，煨烂熟，去皮，绞汁服之瘥。
《补遗》人参白术散，治产后痢，津液竭，渴不止。（方见胎前霍乱。）
【大】产后痢疾，是由于分娩时劳力损伤，导致脏腑功能虚弱，产期未满，身体虚乏尚未恢复。如果过早劳动，或误食生冷食物；若过早起身活动，则外受风冷之邪，乘虚侵入肠胃；若误食难以消化的生冷之物，则损伤脾胃。这些情况都会导致腹泻如水，严重时演变为痢疾。如果血液渗入大肠，则形成血痢，难以治疗，世人称之为“产子痢”。感受寒邪则下白痢，状如鱼脑；感受热邪则下赤黄痢，或为暴注下血。若冷热之邪相互搏结，则下痢赤白相间，或脓血混杂。若下痢青色，说明寒气极重。若饮食不进，排便无规律，日夜无度。产妇本身体质虚弱，再加上久痢不止，导致无力、消瘦乏力，日益羸弱，这称为“虚羸下痢”。又有产后气机不畅而下痢赤白的，称为“气痢”。治疗方法是：热证用凉法，寒证用温法，冷热相搏用调和法，滑脱不禁用固涩法，虚羸者用补益法，水谷不分者当利小便。若产妇性情执着，不能宽心解郁，应当顺其气机，没有不安稳的。
【薛】上述症状中，白痢属于气分病变，赤痢属于血分病变。详细论述见“泻利”篇。一位产妇食用鸡蛋后，腹中疼痛，面色青黄，服用平胃散和二陈汤后，反而出现下痢和腹胀。改用流气饮子后，小腹又有一块状物不时上攻，饮食更加减少。这是脾胃虚寒，肝木克伐脾土所致。使用补中益气汤加木香、吴茱萸，逐渐痊愈。后又用八珍汤大补气血，兼服调理药物，最终痊愈。另一位产妇产后痢疾未满月，因食用冷物及饮酒，冷热与血气相互攻击，导致纯血下痢，里急后重，疼痛剧烈，脉象大而无力，口干，服用黄芩芍药汤三剂而安。
【熊】治疗产后赤白痢证，使用四君子汤加黄芪、罂粟壳，效果神效。
【云】救急散，治疗产后赤白痢，腹中绞痛。
组成：芍药、阿胶、艾叶、熟地黄（各一两）；甘草、当归（各三两）。
制法：切碎，加水煎煮，分两次服用，空腹温服。
【大】当归芍药散，治疗妊娠腹中绞痛，心下急痛，以及治疗产后血晕、崩漏日久导致的痢疾。（方剂见“血崩”篇。）
治疗妊娠血痢：使用阿胶二两，以酒一升半，煮取一升，一次性服用。
产后各种痢疾：煮薤白食用。另一方法，将羊肾脂炒薤白，空腹食用，效果很好。
【经】治疗产后、胎前痢疾：败龟甲一枚，用米醋炙烤后研为粉末，醋汤调服。（丹溪说：龟甲大补阴精，治疗劳倦。）
【丹】妇人患堕胎后，胸膈满闷，食少，痢疾不止，脉象虚弱，左手脉尤甚。
组成：滑石、白芍药（炒）、苍术（各五钱）；白术（二钱五分）；诃子（二钱，煨）；干姜（四钱）；茯苓（一钱）。
制法：研为细末，送服保和丸四五十粒。
【云】产后血痢，脐腹疼痛：四物汤加槐花、黄连、御米壳等药。
黄连丸，治疗产后赤白痢，腹中搅痛不可忍受。
组成：黄连（四两）；阿胶、蒲黄、栀子仁（各一两）；当归（二两半）；黄芩、黄柏（各二两）。
制法：研为粉末，炼蜜为丸，如梧桐子大。每次服用六七十丸，米饮送下，每日三次，夜间一次。
【仲】产后下痢，正气极度虚弱，用白头翁加甘草阿胶汤主治。（《脉经》作热痢重下，新产虚极者。）
组成：白头翁、阿胶（各二两）；黄连、黄柏、秦皮（各三两）；甘草（二两）。
制法：用水七升，煮取二升半，加入阿胶使其溶化尽，温服，分三次服用。适用于妇人临产时的痢疾。
山栀不拘多少，烧灰为细末，空腹用温熟水调服一钱，严重者不超过五服。
产后血痢，小便不通，脐腹疼痛。
用生马齿苋捣汁两大合，煎沸一次，加入蜂蜜一合调和，一次性服用。
【梅】治疗产后血泄不禁，余血作痛兼有积块。
桂心、干姜等分为末，空腹用酒调服一方寸匕。
【大】治疗产后痢疾，一天腹泻五十次者，取木头里的蛀虫粪屑炒黄，立即用水冲服，调节稠稀适度，服用后即愈。
【圣】治疗产后各种痢疾的方子。取苍耳叶捣汁半盏，每日三四次，温服。
【渴】产后下痢伴有口渴的，是因为水谷的精微物质化为血气津液以滋养脏腑，脏腑虚燥，所以既下痢又口渴。如果大量饮水则难止，反而溢出水气，脾胃既已虚弱，不能制约水湿，水湿自流溢，浸渍皮肤，则令人浮肿。只要止住其渴，痢疾自然痊愈。
【薛】上述症状若口渴但不喜冷饮，属于胃气虚，不能生津液，宜用七味白术散。夜间发热口渴，属于肾水弱而不能滋润，宜用六味丸，并佐以益气汤，以滋生化之源。一位产妇泻痢，发热口渴，吐痰，肌体消瘦，饮食少思，有时胸膈痞闷，或小腹胀坠，病程一年多了。我认为这是脾肾之泻，早晨服用二神丸，晚上服用六君子汤，三月多而痊愈。
另一位产妇患前述症状，形体倦怠，饮食不进，濒临死亡，这是脾胃俱虚。用四神丸、十全大补汤而愈。
《必效方》治疗产后痢疾且口渴饮水无度。
组成：麦门冬（三两）；乌梅（二十个）。
制法：细切，用水一升，煮取七合，细细呷服。
《经效方》治疗产后久痢，津液枯竭，口渴不止。
组成：龙骨（十二分）；浓朴、茯苓、黄芪、麦门冬、人参（各八分）；生姜（六分）；大枣（十四个，并细切）。
制法：用水一大升，煮取七合，空腹分两次服用。
治疗产后痢疾，日久津液枯竭，四肢浮肿，口干舌燥。（出自《古今录验》）
冬瓜（一枚），用黄泥包裹厚五寸，煨烂熟，去皮，绞汁服用即愈。
[Da] Dysentery occurring postpartum is caused by labor injury during childbirth, leading to insufficiency of the Zang-Fu organs. Before the confinement period is complete, the body remains deficient and has not yet recovered. If one engages in labor too early or mistakenly consumes raw and cold foods, or rises and moves about too soon, external wind-cold pathogens may invade the intestines and stomach via the deficiency. Mistakenly consuming hard-to-digest raw and cold items damages the Spleen and Stomach. All these conditions lead to watery diarrhea, which in severe cases transforms into dysentery. If blood seeps into the Large Intestine, it becomes bloody dysentery (Xue Li), which is difficult to treat and is commonly known as "childbirth dysentery" (Chan Zi Li). Contracting cold results in white dysentery, resembling fish brains; contracting heat results in red-yellow dysentery, or sudden profuse bleeding. If cold and heat pathogens contend with each other, the discharge is mixed red and white, or pus and blood are intermingled. Green discharge indicates extreme cold. If there is no appetite, bowel movements are irregular, and occur day and night without limit, combined with the mother's inherent deficiency and prolonged dysentery causing weakness and emaciation, this is called "deficiency-emaciation dysentery" (Xu Lei Xia Li). Another type, where Qi mechanism is obstructed postpartum leading to red and white dysentery, is called "Qi dysentery" (Qi Li). The treatment principles are: for heat patterns, use cooling methods; for cold patterns, use warming methods; for contending cold and heat, use harmonizing methods; for sliding/loose discharges, use astringent methods; for deficiency-emaciation, use tonifying methods; for inability to distinguish water and grain, promote urination. If the parturient woman is stubborn-minded and cannot relax, her Qi must be smoothed, and she will surely stabilize.
[Xue] In the aforementioned symptoms, white discharge belongs to the Qi level, while red discharge belongs to the Blood level. Detailed discussions can be found under "Diarrhea and Dysentery." A parturient woman ate eggs and suffered abdominal pain with a greenish-yellow complexion. After taking Ping Wei San and Er Chen Tang, she developed dysentery and abdominal distension. Switching to Liu Qi Yin Zi caused a mass in the lower abdomen to attack upwards intermittently, and food intake decreased further. This was due to Spleen-Stomach deficiency-cold and Liver Wood overacting on Earth. She gradually improved using Bu Zhong Yi Qi Tang added with Mu Xiang and Wu Zhu Yu. Subsequently, Ba Zhen Tang was used for major tonification, along with regulatory herbs, leading to recovery. Another parturient had dysentery before the confinement month ended. Due to eating cold items and drinking alcohol, cold and heat attacked the blood, resulting in pure bloody dysentery with severe tenesmus and pain. Her pulse was large but forceless, and she had dry mouth. Three doses of Huang Qin Shao Yao Tang brought relief.
[Xiong] To treat postpartum red and white dysentery, Si Jun Zi Tang added with Huang Qi and Yu Mi Ke (Poppy Shell) yields miraculous effects.
[Yun] Jiu Ji San treats postpartum red and white dysentery with colicky abdominal pain.
Ingredients: Bai Shao, E Jiao, Ai Ye, Shu Di Huang (each 1 liang); Gan Cao, Dang Gui (each 3 liang).
Preparation: Coarsely crush, decoct in water, divide into two doses, take warm on an empty stomach.
[Da] Dang Gui Shao Yao San treats colicky abdominal pain during pregnancy, urgent pain below the heart, and also treats postpartum blood vertigo and chronic dysentery following metrorrhagia. (Formula see "Metrorrhagia".)
To treat bloody dysentery during pregnancy: Use 2 liang of E Jiao, decoct in 1.5 sheng of wine until reduced to 1 sheng, take all at once.
For various postpartum dysenteries: Boil and eat Xie Bai (Allium macrostemon). Another method: Stir-fry Xie Bai with Sheep Kidney Fat, eat on an empty stomach; very effective.
[Jing] Treat dysentery during postpartum and antepartum periods: Take one Bie Jia (Tortoise Shell), roast with rice vinegar, grind to powder, mix with vinegar water and swallow. (Danxi said: Bie Jia greatly tonifies Yin, treating fatigue from overwork.)
[Dan] A woman, after spontaneous abortion, suffered chest fullness, poor appetite, and incessant dysentery with a weak pulse, especially on the left hand.
Ingredients: Hua Shi, Chao Bai Shao Yao, Cang Zhu (each 5 qian); Bai Zhu (2.5 qian); He Zi (2 qian, roasted); Gan Jiang (4 qian); Fu Ling (1 qian).
Preparation: Grind to fine powder, take with 40-50 pills of Bao He Wan.
[Yun] For postpartum bloody dysentery with umbilical and abdominal pain: Si Wu Tang added with Huai Hua, Huang Lian, and Yu Mi Qiao.
Huang Lian Wan treats postpartum red and white dysentery with unbearable twisting abdominal pain.
Ingredients: Huang Lian (4 liang); E Jiao, Pu Huang, Zhi Zi Ren (each 1 liang); Dang Gui (2.5 liang); Huang Qin, Huang Bo (each 2 liang).
Preparation: Grind to powder, make pills with refined honey the size of paulownia seeds. Take 60-70 pills per dose, swallowed with rice water, three times daily and once at night.
[Zhong] For postpartum dysentery with extreme deficiency, Bai Tou Weng Tang plus Gan Cao and E Jiao Decoction is indicated. (Mai Jing describes it as severe hot dysentery with heavy bearing-down sensation in newly delivered women with extreme deficiency.)
Ingredients: Bai Tou Weng, E Jiao (each 2 liang); Huang Lian, Huang Bo, Qin Pi (each 3 liang); Gan Cao (2 liang).
Preparation: Decoct in 7 sheng of water to obtain 2.5 sheng, add E Jiao and dissolve completely, take warm in three divided doses. Suitable for women suffering dysentery at the time of delivery.
Zhi Zi (Gardenia Fruit), any amount, burnt to ash and ground to fine powder. Take 1 qian mixed with warm cooked water on an empty stomach; severe cases require no more than five doses.
For postpartum bloody dysentery with urinary retention and umbilical/abdominal pain: Mash fresh Chi Xian Cao (Portulaca oleracea) to extract juice (two large he), boil once, add 1 he of honey, mix, and take all at once.
[Mei] Treat postpartum uncontrollable bloody discharge, pain from residual blood, and masses.
Gui Xin and Gan Jiang in equal parts, ground to powder. Take one fang cun bi (square-inch spoonful) mixed with wine on an empty stomach.
[Da] To treat postpartum dysentery with fifty stools per day: Collect excrement from wood-boring insects, stir-fry until yellow, immediately pour water over it to achieve appropriate consistency, and administer. It cures immediately.
[Sheng] Formula for various postpartum dysenteries: Extract juice from Cang Er Ye (Xanthium Leaf), half zhan, take warm three to four times daily.
[Ke] Postpartum dysentery accompanied by thirst occurs because the essence of food and drink fails to transform into Qi, Blood, and Body Fluids to nourish the Zang-Fu organs due to their deficiency and dryness. Thus, dysentery and thirst coexist. Excessive drinking is hard to stop and may cause water qi overflow. Since the Spleen and Stomach are deficient and cannot control water, water flows freely and soaks the skin, causing edema. One should only stop the thirst, and the dysentery will heal spontaneously.
[Xue] If the aforementioned symptom involves thirst without desire for cold drinks, it belongs to Stomach Qi deficiency failing to generate fluids; use Qi Wei Bai Zhu San. Nighttime fever and thirst belong to Kidney Water deficiency failing to moisten; use Liu Wei Wan, assisted by Yi Qi Tang to nourish the source of transformation. A parturient woman had diarrhea/dysentery, fever, thirst, expectoration, emaciation, poor appetite, occasional chest diaphragm stuffiness, or lower abdominal bearing-down sensation, lasting over a year. I diagnosed it as Spleen-Kidney diarrhea. Morning administration of Er Shen Wan and evening administration of Liu Jun Zi Zi led to recovery after three months.
Another parturient with similar symptoms showed physical fatigue, no appetite, and was near death; this was Spleen-Stomach dual deficiency. She recovered using Si Shen Wan and Shi Quan Da Bu Tang.
Bi Xiao Fang treats postpartum dysentery with excessive thirst and drinking.
Ingredients: Mai Men Dong (3 liang); Wu Mei (20 pieces).
Preparation: Finely chop, decoct in 1 sheng of water to obtain 7 he, sip slowly.
Jing Xiao Fang treats postpartum chronic dysentery with depleted fluids and unceasing thirst.
Ingredients: Long Gu (12 fen); Hou Po, Fu Ling, Huang Qi, Mai Men Dong, Ren Shen (each 8 fen); Sheng Jiang (6 fen); Da Zao (14 pieces, finely chopped).
Preparation: Decoct in 1 da sheng of water to obtain 7 he, divide into two doses, take on an empty stomach.
Treat postpartum dysentery where long duration depletes fluids, causing limb edema, dry mouth, and dry tongue. (From Jin Gu Lu Yan)
Dong Gua (Winter Melon, 1 piece): Coat thickly with yellow mud (5 cun), bake until soft and ripe, peel, extract juice, and drink. Cures the condition.
Bu Yi: Ren Shen Bai Zhu San treats postpartum dysentery with depleted fluids and unceasing thirst. (Formula see "Antepartum Cholera-like Disease".)