凡杂症之痢，皆由暑湿之积邪，或挟食积所致。伤于气分则痢白，伤于血分则痢赤，气血俱伤
赤白兼下。至产后患此，则有不同，治法亦异，盖多有中气虚而停积也。如产后七日内
外，患赤白痢疾后重频并，最为难治。欲调气行血而推荡痢邪，犹虑产后之元气方虚；欲滋荣益气而
大补产虚，又恐反助痢初之邪盛。其行不损元，补不助邪，惟生化汤去干姜，加以木香、茯苓（名香
苓生化汤）为善，以其能消恶露，兼行痢滞也。如痢在七日之外，可酌加芍、连、莲、朴等药；如伤
面食、谷食泻痢，先服生化汤加炒神曲，块痛止，服六君子加麦芽一撮，或神曲一钱；如伤肉食泻痢，
先服生化汤加山楂、砂仁，块痛止，服六君子汤加山楂四、五枚，砂仁四分，炒神曲一钱；如半月外
患赤痢后重，归芍连壳饮；如脾气虚弱泻痢，四肢浮肿，宜六君子汤加木香、肉果（面煨），合五皮
散；如泻痢黄色，乃脾土正气虚耳，宜补中益气汤加木香四分、肉果一枚（煨）；如胃气虚弱泻痢，
完谷不化，当温助胃气，及产后泻痢日久后重者，并宜服加味六君子汤。大凡产后赤痢，去血多，姜、
砂、木香之类不可多用，热则血愈行。倘血痢日久不止者，血虚也，宜四物汤加荆芥、人参。凡诸
症兼呕吐，皆宜加藿香五分，痰加制半夏八分。兼小便短涩，引加灯心三十寸，且灯心利水而不伤阴，
况产后津液已亏，兼之泻痢伤阴，复伤津液，小便理宜短少，故止用灯心足矣，不可用利水伤阴之药
也。如胎前下痢，产后不止，伏龙肝汤丸治之。又有白头翁加甘草阿胶汤，治产后痢不止。冯氏云∶
产后腹痛泻痢，若非外因所伤，乃属肾气亏损，阳虚不能生土，阴虚不能闭藏耳，必用四神、八味补
肾。倘误投分利导水之剂，是益其虚。但泻痢之症，非脾即肾，如病在肾，所谓补脾不如补肾；如
病在脾，自又补肾不如补脾也。
香苓生化汤 治产后七日内，患赤白痢。
川芎（二钱） 当归（五钱） 炙草（五分） 桃仁（十粒） 茯苓（一钱） 陈皮（四分） 木香（一分）
归芍连壳饮 治产后半月外，患赤痢后重。
川芎（一钱半） 当归（三钱） 白芍（酒炒） 茯苓（各一钱） 黄连（六分，姜汁炒）
枳壳（五分，麦炒） 甘草（四分） 木香（三分）
五皮散 治产后风湿伤脾，气血凝滞，以致面目虚浮，四肢肿胀，气喘。
陈皮 桑皮 姜皮 茯苓皮 大腹皮（黑豆水制净，各一钱）
伏龙肝汤丸 治胎前下痢，产后不止，及元气大虚，瘀积小腹结痛，不胜攻击者。
山楂肉（一两，炮黑） 黑糖（二两，熬枯）
二味，一半为丸，一半为末，用伏龙肝二两煎汤代水，煎前末二钱，送前丸二钱，日三夜二服，
一昼夜令尽。气虚，加人参二、三钱，驾驭之；虚热，加炮姜、肉桂、茯苓炙甘草；兼感风寒，加
葱白、香豉；膈气不舒，磨沉香数匙调服。
凡是非产后的普通痢疾，都是由暑湿之邪积聚，或者夹杂食积所导致。病邪损伤气分则排出白色脓液，损伤血分则排出红色血液，气血同时受损则赤白脓血混杂而下。到了产后患上此病，情况就有所不同，治疗方法也各异，因为产后大多是因为中气虚弱而导致积滞停留。比如在产后七日内外，出现赤白痢疾、里急后重且频繁发作的情况，是最难治疗的。想要调理气机、运行血脉以推荡排出痢疾邪气，又担心产后元气刚刚虚弱；想要滋养营血、益气以大补产后虚损，又恐怕反而助长痢疾初起时的邪气亢盛。只有那种行气不损伤元气、补益不助长邪气的方子，才是最好的，即使用生化汤去掉干姜，加入木香、茯苓（名为香苓生化汤）最为适宜，因为它既能消除恶露，又能通行痢疾的积滞。如果痢疾发生在七日之后，可以酌情加入芍药、黄连、莲子、厚朴等药物；如果是食用面食、谷食导致的泻痢，先服用生化汤加炒神曲，待块状疼痛停止后，再服用六君子汤加一撮麦芽，或者一钱神曲；如果是食用肉食导致的泻痢，先服用生化汤加山楂、砂仁，待块状疼痛停止后，再服用六君子汤加四到五枚山楂、四分砂仁、一钱炒神曲；如果在半月之后患赤痢且伴有里急后重，使用归芍连壳饮；如果是脾气虚弱导致的泻痢，四肢浮肿，适宜使用六君子汤加木香、肉豆蔻（面粉煨制），配合五皮散；如果泻痢颜色发黄，这是脾土正气虚弱的表现，适宜使用补中益气汤加四分木香、一枚肉豆蔻（煨制）；如果是胃气虚弱导致的泻痢，完谷不化，应当温补助益胃气，以及产后泻痢日久且伴有里急后重的情况，都适宜服用加味六君子汤。大凡产后赤痢，由于失血较多，生姜、砂仁、木香这类辛热走窜的药物不可多用，因为热性会使血液运行更加迅疾。如果血痢日久不止，属于血虚，适宜使用四物汤加荆芥、人参。凡是各种症状兼有呕吐的，都适宜加五分藿香；有痰的加八分制半夏。兼有小便短少涩滞的，引经药加三十寸灯心草，而且灯心草利水而不伤阴，何况产后津液已经亏损，再加上泻痢损伤阴液，再次耗伤津液，小便理应短少，所以只用灯心草就够了，不可使用那些利水而伤阴的药物。如果是怀孕期间下痢，产后仍然不止，用伏龙肝汤丸治疗。又有白头翁加甘草阿胶汤，用于治疗产后痢疾不止。冯氏说：产后腹痛伴泻痢，如果不是外因所伤，就是属于肾气亏损，阳虚不能生发脾土，阴虚不能固摄闭藏，必须使用四神丸、八味丸补肾。如果误投分利导水的药剂，是增加其虚损。但是泻痢这种病症，不是脾病就是肾病，如果病在肾，所谓补脾不如补肾；如果病在脾，自然又是补肾不如补脾。
香苓生化汤 治疗产后七日内，患赤白痢。
川芎（二钱） 当归（五钱） 炙甘草（五分） 桃仁（十粒） 茯苓（一钱） 陈皮（四分） 木香（一分）
归芍连壳饮 治疗产后半月外，患赤痢且伴有里急后重。
川芎（一钱半） 当归（三钱） 白芍（酒炒） 茯苓（各一钱） 黄连（六分，姜汁炒）
枳壳（五分，麦麸炒） 甘草（四分） 木香（三分）
五皮散 治疗产后风湿伤脾，气血凝滞，以致面目虚浮，四肢肿胀，气喘。
陈皮 桑白皮 生姜皮 茯苓皮 大腹皮（黑豆水制净，各一钱）
伏龙肝汤丸 治疗胎前下痢，产后不止，以及元气大虚，瘀积小腹结痛，不能耐受攻伐者。
山楂肉（一两，炮黑） 黑糖（二两，熬枯）
以上两味药，一半制成丸剂，一半研为末，用伏龙肝二两煎汤代替水，煎煮前面的药末二钱，送服前面的丸剂二钱，白天三次夜间两次服用，一昼夜内服完。气虚的，加人参二、三钱，以驾驭药力；虚热的，加炮姜、肉桂、茯苓、炙甘草；兼感风寒的，加葱白、香豉；胸膈气机不畅的，磨沉香数匙调服。
Any dysentery arising from miscellaneous diseases is caused by the accumulation of pathogenic factors of summerheat and dampness, or by food stagnation. When the pathogen injures the Qi level, white discharge occurs; when it injures the Blood level, red discharge occurs; when both Qi and Blood are injured, red and white discharges occur together. However, when this condition occurs postpartum, the situation differs, and the treatment methods vary, as there is often deficiency of Middle Qi leading to retention of stagnation. For instance, within seven days after delivery, if red and white dysentery with frequent tenesmus occurs, it is extremely difficult to treat. If one attempts to regulate Qi and move Blood to push out the dysenteric pathogens, one must worry that the postpartual Yuan Qi is just now deficient; if one attempts to nourish Ying (Nutritive) Blood and tonify Qi to greatly supplement postpartal deficiency, one fears it may instead assist the flourishing pathogens of early dysentery. The only approach that moves without damaging Yuan Qi and tonifies without assisting pathogens is best: using Shenghua Tang (Decoction for Generating Blood) minus Ganjiang (Dried Ginger), plus Muxiang (Aucklandiae Radix) and Fuling (Poria), named Xiangling Shenghua Tang (Aucklandia and Poria Decoction for Generating Blood). This is beneficial because it can eliminate lochia while simultaneously moving dysenteric stagnation. If dysentery occurs after seven days, Shaoyao (Paeoniae Radix), Lian (Coptidis Rhizoma - likely referring to Huanglian here contextually or Lotus seeds, but standard text implies Coptis for heat/dysentery, though "Lian" usually means Lotus, in dysentery context with Houpo, it often refers to Huanglian/Coptis or potentially Lianxu/Lotus Seed Plumule. Given "Houpo", Huanglian is common. However, strictly translating "Lian": Lianzi (Lotus Seed) or Huanglian. In classical texts, "Lian" alone often refers to Huanglian in dysentery formulas like Guipi Tang variants or similar. Let's stick to literal "Lian" -> Lotus Seed? No, for dysentery, it's likely Huanglian. But the text says "Lian". I will use Huanglian (Coptidis Rhizoma) as it fits the therapeutic logic of clearing heat/dampness in dysentery better than Lotus seed, but strictly "Lian" is ambiguous. Actually, looking at "Shenqu" later, these are specific herbs. "Lian" in dysentery often implies Huanglian. I will translate as Huanglian (Coptidis Rhizoma) for clinical accuracy in this context, or note ambiguity. Wait, "Lian" could be Lianxu (Lotus Plumule). But combined with Houpo, Huanglian is the classic pair. I will use Huanglian (Coptidis Rhizoma). ) , and Houpo (Magnoliae Officinalis Cortex) etc.; if diarrhea and dysentery result from consuming wheat/flour or grain foods, first take Shenghua Tang plus Chao Shenqu (Stir-fried Medicated Leaven); once cramping pain stops, take Liujunzi Tang (Six Gentlemen Decoction) plus a pinch of Maiya (Hordei Fructus Germinatus) or one qian of Shenqu; if resulting from meat consumption, first take Shenghua Tang plus Shanzha (Crataegi Fructus) and Sharen (Amomi Fructus); once pain stops, take Liujunzi Tang plus four or five pieces of Shanzha, four fen of Sharen, and one qian of stir-fried Shenqu; if red dysentery with tenesmus occurs after half a month, use Guishao Lianke Yin (Angelica, Peony, and Zhiqiao Decoction); if spleen Qi deficiency causes diarrhea and dysentery with edema of the four limbs, use Liujunzi Tang plus Muxiang and Rouguo (Arecae Semen, baked in flour), combined with Wupi San (Five Barks Powder); if stool is yellow, it indicates deficiency of Spleen Earth's righteous Qi, so use Buzhong Yiqi Tang (Decoction to Supplement the Middle and Augment the Qi) plus four fen of Muxiang and one Rouguo (baked); if Stomach Qi deficiency causes diarrhea and dysentery with undigested food in stool, warm and assist Stomach Qi should be applied; for postpartal diarrhea and dysentery lasting long with tenesmus, Jiawei Liujunzi Tang (Modified Six Gentlemen Decoction) is suitable. Generally, for postpartal red dysentery, due to significant blood loss, ginger, Sharen, and Muxiang should not be used excessively, as heat promotes blood flow further. If bloody dysentery persists for a long time, it is Blood deficiency, so use Siwu Tang (Four Substances Decoction) plus Jingjie (Schizonepetae Herba) and Renshen (Ginseng Radix et Rhizoma). For any symptoms accompanied by vomiting, add five fen Huoxiang (Agastaches Herba); for phlegm, add eight fen Zhibanxia (Pinelliae Rhizoma Preparatum). For short and scanty urination, add thirty cun of Dengxincao (Junci Medulla) as a guiding herb; Dengxincao promotes diuresis without damaging Yin. Moreover, postpartal fluids are already depleted, and diarrhea/dysentery further damages Yin and fluids, so urine should naturally be scanty; thus, Dengxincao suffices, and diuretics that damage Yin should not be used. If dysentery occurred during pregnancy and continues postpartum, Fulonggan Wan (Dragon's House Soil Pills) treats it. There is also Baitouweng Jia Gancao Ejiao Tang (Baitouweng Decoction with Licorice and Donkey-hide Gelatin) for treating persistent postpartal dysentery. Feng Shi stated: Postpartal abdominal pain with diarrhea and dysentery, if not caused by external pathogens, belongs to Kidney Qi deficiency. Yang deficiency fails to generate Spleen Earth, and Yin deficiency fails to secure and store; thus, Sishen Wan (Four Spirits Pill) and Bawei Wan (Eight Flavor Pill) must be used to tonify the Kidney. If misprescribed with draining and water-guiding agents, it increases deficiency. Dysentery and diarrhea are either Spleen or Kidney disorders. If the disease is in the Kidney, tonifying the Kidney is superior to tonifying the Spleen; if in the Spleen, tonifying the Spleen is superior to tonifying the Kidney.
Xiangling Shenghua Tang (Aucklandia and Poria Decoction for Generating Blood): Treats red and white dysentery within seven days postpartum.
Chuanxiong (2 qian) Danggui (5 qian) Zhigancao (5 fen) Taoren (10 grains) Fuling (1 qian) Chenpi (4 fen) Muxiang (1 fen)
Guishao Lianke Yin (Angelica, Peony, and Zhiqiao Decoction): Treats red dysentery with tenesmus after half a month postpartum.
Chuanxiong (1.5 qian) Danggui (3 qian) Baishao (wine-fried) Fuling (each 1 qian) Huanglian (6 fen, fried with ginger juice)
Zhiqiao (5 fen, wheat-bran fried) Gancao (4 fen) Muxiang (3 fen)
Wupi San (Five Barks Powder): Treats postpartal wind-damp injuring the Spleen, Qi and Blood stagnation, causing facial puffiness, limb swelling, and asthma.
Chenpi Sangbai Pi Jiangpi Fulingpi Dafupi (prepared clean with black soybean water, each 1 qian)
Fulonggan Wan (Dragon's House Soil Pills): Treats dysentery before delivery continuing after, and severe Yuan Qi deficiency with stasis accumulation causing lower abdominal binding pain, intolerant to aggressive attack.
Shanzha Rou (1 liang, charred) Heitang (2 liang, boiled until dry/crisp)
These two ingredients: half made into pills, half ground into powder. Use 2 liang of Fulonggan (Dragon's House Soil) decocted in water to replace water, decoct 2 qian of the powder, and take with 2 qian of the pills. Take three times during the day and twice at night, finishing within one day and night. For Qi deficiency, add 2-3 qian Renshen to control/manage; for deficiency heat, add Paojiang (Charred Ginger), Rougui (Cinnamomi Cortex), Fuling, and Zhigancao; for concurrent wind-cold, add Congbai (Scallion White) and Xiangchi (Fermented Soybean); for chest diaphragm Qi stagnation, grind Chenxiang (Aquilariae Lignum) and mix with several spoons to take.