产后七日内外，患赤白痢后重频并，最为难治。欲调气行血，推荡利邪，虑伤产后之元气；欲滋荣益气，
大补产虚，又助邪。利之初盛，其行不损元，补不助邪，惟生化汤去干姜，加木香运气，则并治而不悖也。
再服加味香连丸，以候一二日，视病势加减，可保无虑。若患褐色后重频并，丹溪
《纂要》中自有论方。其产妇素浓，及一月可用推荡之方，与芩、连寒性之药。若产妇素弱，虽产后一月，
未可用峻剂行积。再噤口痢，摘刊奇方中，自有方治，慎勿用古方浓朴、枳壳。以治产痢用香连代之。
加减生化汤方 治产妇七日内外，患赤白痢后重频并。
川芎（二钱） 甘草（四分） 当归（四钱） 桃仁（十粒） 茯苓（一钱） 陈皮（五分） 木香（三分）
水二钟，煎六分，去渣，送香连丸三十粒。
如产后曾服生化汤，产妇精神，可服芩、连、芍药之
类。至大黄等药决不可用。其加味香连丸，其摘刊方中。产后血痢久不愈，属阴虚。宜四物汤加参。
产后半月外，患赤痢后重，可服加连生化汤。
川芎（一钱五分） 当归（三钱） 白芍（一钱，酒炒） 黄连（六分，姜汁炒） 枳壳（五分） 甘草
（四分） 茯苓（一钱） 木香（三分）
水煎服。
产后泻痢已论立方，大率因初产气血暴竭，必用生化汤加减，未曾论产后泻痢，多由饮食伤脾而得，故
重出。余意及治症十方。凡产必先服生化汤行块痛止，可服后方。
一、产痢黄色乃脾土真气虚，宜服加味补中益气汤加木香、肉果。
二、久泻元气下陷，大便不禁，肛门如脱，宜服六君子加木香、肉果、干姜。
三、伤面食，宜服六君子加麦芽，停谷六君子加神曲。
四、停食肉，宜服六君子加山楂四个、砂仁四分、神曲一钱（炒）。
五、胃气虚弱泻痢，完谷不化，宜温助胃气，服六君子加肉果一个、木香四分。
六、胃气虚，脾气弱，四肢浮肿，宜服补中益气加五皮散。陈、桑、姜，苓、腹等皮各一钱。
七、诸症兼呕吐，宜加藿香五分，痰加半夏八分。
八、诸症兼小便短涩，加茯苓一钱，泽泻五分，灯心三十根。
九、泻久不止，加莲子十枚。
十、赤痢去血多，姜炒木香之类不可多用，热则血愈行。血痢久不愈，用人参五钱，香连丸一钱，同为末下。
产后胃气不和，呕吐不止，全不纳谷，分两症，立□□生活命丹而更耗，百试百验，又误而致膨胀□仍
用大补益气之剂，而不致夭折，十救八九，治者无以为过，姑先用人参一二钱，送锅焦粉。
乞遵丹溪医案方以救绝谷。
误用益气汤，治产后中气不足，中满或嗳气虚饱，及误服耗气顺气药，致成膨胀危急症。
产后七日内外，出现赤白痢疾、里急后重且频繁发作，是最难治疗的病症。想要调理气机、行血化瘀，推荡排出病邪，但担心损伤产后元气；想要滋养营血、益气补虚，大补产后的虚弱，又担心助长病邪。在痢疾初起盛发之时，使用既能利邪又不损元气、既补虚又不助邪的方法，只有用生化汤去掉干姜，加入木香以运行气机，才能兼顾治疗而不违背原则。再服用加味香连丸，观察一两天，根据病情轻重增减药量，就可以保证没有忧虑。如果患褐色痢疾、里急后重频繁发作，丹溪《纂要》中自有论述和方剂。对于体质肥胖的产妇，以及产后一个月可用的推荡攻下之方，可以使用黄芩、黄连等寒性药物。如果产妇平时体弱，即使产后一个月，也不可用峻猛的药剂来行积导滞。另外关于噤口痢，在摘刊奇方中自有方治，千万不要用古方中的厚朴、枳壳。治疗产后痢疾应用香连丸代替。
加减生化汤方：治疗产妇七日内外，患赤白痢疾、里急后重频繁发作。
川芎（二钱） 甘草（四分） 当归（四钱） 桃仁（十粒） 茯苓（一钱） 陈皮（五分） 木香（三分）
用水两钟，煎至六分，去渣，送服香连丸三十粒。
如果产后曾服用过生化汤，产妇精神尚可，可以服用黄芩、黄连、芍药之类的药物。至于大黄等药物绝对不可使用。其加味香连丸，在其摘刊方中记载。产后血痢久不愈，属于阴虚。适宜用四物汤加人参。
产后半月外，患赤痢、里急后重，可服用加连生化汤。
川芎（一钱五分） 当归（三钱） 白芍（一钱，酒炒） 黄连（六分，姜汁炒） 枳壳（五分） 甘草（四分） 茯苓（一钱） 木香（三分）
水煎服。
产后泻痢已经论述并立了方子，大抵是因为初产时气血突然枯竭，必须用生化汤加减，此前未曾论述产后泻痢多由饮食伤脾所致，所以再次列出。我的意见及治疗症状十方如下。凡是生产后必须先服用生化汤以消除块状疼痛，之后可服用后方。
一、产后痢疾呈黄色，是脾土真气虚弱，适宜服用加味补中益气汤加木香、肉豆蔻。
二、久泻导致元气下陷，大便失禁，肛门感觉如脱出，适宜服用六君子汤加木香、肉豆蔻、干姜。
三、伤于面食，适宜服用六君子汤加麦芽；停滞谷物，适宜服用六君子汤加神曲。
四、停滞肉食，适宜服用六君子汤加山楂四个、砂仁四分、神曲一钱（炒）。
五、胃气虚弱导致的泻痢，完谷不化，适宜温补胃气，服用六君子汤加肉豆蔻一个、木香四分。
六、胃气虚，脾气弱，四肢浮肿，适宜服用补中益气汤加五皮散。陈皮、桑白皮、生姜皮、茯苓皮、大腹皮各一钱。
七、诸症兼有呕吐，适宜加藿香五分，有痰加半夏八分。
八、诸症兼有小便短少涩痛，加茯苓一钱，泽泻五分，灯心草三十根。
九、泻久不止，加莲子十枚。
十、赤痢失血多，姜炒木香之类不可多用，因为热则血行加速。血痢久不愈，用人参五钱，香连丸一钱，同为粉末冲服。
产后胃气不和，呕吐不止，完全不能进食，分为两种症状，创立□□生活命丹更加耗损，百试百验，又因误治导致膨胀□仍用大补益气的药剂，而不致夭折，十救八九，医者这样做没有过错，姑且先用人参一二钱，送服锅焦粉。
请求遵照丹溪医案方剂以救治绝食。
误用益气汤，治疗产后中气不足，中满或嗳气虚饱，以及误服耗气顺气药，导致形成膨胀危急症。
Within seven days before or after childbirth, suffering from dysentery with red and white discharge accompanied by frequent tenesmus is the most difficult to treat. If one attempts to regulate Qi and promote blood circulation to push out pathogens, there is a fear of damaging the primordial Qi postpartum; if one attempts to nourish blood and replenish Qi to greatly tonify postpartum deficiency, there is a fear of aiding the pathogens. In the initial vigorous stage of dysentery, the method that benefits without damaging primordial Qi and tonifies without aiding pathogens is only Shenghua Tang (Life-Birth Decoction) with dried ginger removed and Muxiang (Aucklandiae Radix) added to move Qi, thereby treating both aspects without contradiction. Subsequently, Jiawei Xianglian Wan (Modified Coptis and Costus Pill) should be taken for one or two days, adjusting according to the severity of the disease, ensuring no worries. If suffering from brown dysentery with frequent tenesmus, Danxi's *Zuanyao* contains its own discussion and formulas. For constitutionally robust parturients, or those at one month postpartum where purgative methods are applicable, cold-natured herbs such as Huangqin (Scutellariae Radix) and Lianzi (Coptidis Rhizoma) may be used. However, for parturients who are constitutionally weak, even at one month postpartum, harsh agents for moving stagnation should not be used. Regarding Jin Kou Li (Dysentery with inability to swallow food), treatments are found in the collected miraculous formulas; strictly avoid using ancient formulas containing Houpo (Magnoliae Officinalis Cortex) and Zhike (Aurantii Fructus). Instead, use Xianglian Wan (Costus and Coptis Pill) to treat postpartum dysentery.
Modified Shenghua Tang Formula: Treats parturients within seven days before or after childbirth suffering from red and white dysentery with frequent tenesmus.
Chuanxiong (Ligustici Chuanxiong Rhizoma) (2 qian) Gancao (Glycyrrhizae Radix et Rhizoma) (4 fen) Danggui (Angelicae Sinensis Radix) (4 qian) Taoren (Persicae Semen) (10 grains) Fuling (Poria) (1 qian) Chenpi (Citri Reticulatae Pericarpium) (5 fen) Muxiang (Aucklandiae Radix) (3 fen)
Boil in two zhong of water until reduced to six fen, remove dregs, and take with thirty pills of Xianglian Wan.
If Shenghua Tang has been taken postpartum and the parturient's spirit is adequate, herbs such as Huangqin (Scutellariae Radix), Lianzi (Coptidis Rhizoma), and Shaoyao (Paeoniae Radix) may be taken. Da Huang (Rhei Radix et Rhizoma) and similar drugs must absolutely not be used. The formula for Jiawei Xianglian Wan (Modified Coptis and Costus Pill) is recorded in the collected formulas. Postpartum bloody dysentery that persists for a long time belongs to Yin deficiency. Siwu Tang (Four Substances Decoction) with Renshen (Ginseng Radix et Rhizoma) added is appropriate.
More than half a month postpartum, suffering from red dysentery with tenesmus, Jialian Shenghua Tang (Added Coptis Shenghua Decoction) may be taken.
Chuanxiong (Ligustici Chuanxiong Rhizoma) (1.5 qian) Danggui (Angelicae Sinensis Radix) (3 qian) Baishao (Paeoniae Radix Alba) (1 qian, stir-fried with wine) Lianzi (Coptidis Rhizoma) (6 fen, stir-fried with ginger juice) Zhike (Aurantii Fructus) (5 fen) Gancao (Glycyrrhizae Radix et Rhizoma) (4 fen) Fuling (Poria) (1 qian) Muxiang (Aucklandiae Radix) (3 fen)
Decoct in water and take orally.
Postpartum diarrhea and dysentery have already been discussed with established formulas, generally because sudden depletion of Qi and Blood occurs immediately after childbirth, requiring modified Shenghua Tang. Previously, it was not discussed that postpartum diarrhea and dysentery often result from dietary injury to the Spleen, hence they are repeated here. My opinion and ten formulas for treating symptoms are as follows. After childbirth, one must first take Shenghua Tang to eliminate mass-related pain, after which the following formulas may be taken.
1. Yellow postpartum dysentery indicates deficiency of True Qi in the Spleen Earth; Jiawei Buzhong Yiqi Tang (Modified Tonify the Middle and Augment the Qi Decoction) with Muxiang (Aucklandiae Radix) and Rougu (Myristicae Semen) is appropriate.
2. Prolonged diarrhea causing sinking of Primordial Qi, incontinence of stool, and a sensation of anal prolapse; Liu Junzi Tang (Six Gentlemen Decoction) with Muxiang (Aucklandiae Radix), Rougu (Myristicae Semen), and Ganjiang (Zingiberis Rhizoma) is appropriate.
3. Injury from wheat products; Liu Junzi Tang (Six Gentlemen Decoction) with Maiya (Hordei Fructus Germinatus) is appropriate. Stagnation of grains; Liu Junzi Tang (Six Gentlemen Decoction) with Shenqu (Massae Fermentatae Medicamentosa) is appropriate.
4. Stagnation of meat; Liu Junzi Tang (Six Gentlemen Decoction) with four Shanzha (Crataegi Fructus), 4 fen Sharen (Amomi Fructus), and 1 qian Shenqu (Massae Fermentatae Medicamentosa, stir-fried) is appropriate.
5. Diarrhea and dysentery due to weak Stomach Qi with undigested food in stool; warm and assist Stomach Qi by taking Liu Junzi Tang (Six Gentlemen Decoction) with one Rougu (Myristicae Semen) and 4 fen Muxiang (Aucklandiae Radix).
6. Weak Stomach Qi and weak Spleen Qi with edema of the four limbs; Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Wupi San (Five Peel Powder) is appropriate. Each peel—Chenpi (Citri Reticulatae Pericarpium), Sangbaipi (Mori Cortex), Jiangpi (Zingiberis Rhizoma Recens Pericarpium), Fulingpi (Poria Peridium), and Fupipi (Trogopterori Faeces Pericarpium)—should be 1 qian.
7. For all conditions accompanied by vomiting, add Huoxiang (Agastaches Herba) 5 fen; for phlegm, add Banxia (Pinelliae Rhizoma) 8 fen.
8. For all conditions accompanied by scanty and dysuric urine, add Fuling (Poria) 1 qian, Zexie (Alismatis Rhizoma) 5 fen, and Dengxincao (Junci Medullia) 30 roots.
9. For prolonged diarrhea that does not stop, add Shi Zi Lianren (Nelumbinis Semen) 10 pieces.
10. For red dysentery with excessive blood loss, do not use too much Ginger-processed Muxiang (Aucklandiae Radix), as heat accelerates blood flow. For persistent bloody dysentery, use 5 qian Renshen (Ginseng Radix et Rhizoma) and 1 qian Xianglian Wan (Costus and Coptis Pill), ground together into powder and taken orally.
Postpartum disharmony of Stomach Qi with incessant vomiting and complete inability to ingest food involves two symptom patterns. [Name obscured] Life-Saving Pill causes further consumption but is effective in hundred trials. Mismanagement leading to distension [obscured]; still using major Qi-tonifying agents prevents premature death, saving eight or nine out of ten cases; the practitioner commits no fault. Initially, use 1-2 qian Renshen (Ginseng Radix et Rhizoma) taken with Guojiao Fen (Charred Rice Powder).
Request to follow Danxi's medical case formulas to save those unable to eat.
Misuse of Yiqi Tang (Qi-Tonifying Decoction) to treat insufficient Middle Qi postpartum, abdominal fullness, or false satiety with belching, and misuse of Qi-consuming and Qi-regulating medicines, leading to critical distension.