郭稽中曰∶产后大便秘涩者何。答曰∶产卧水血俱下，胃虚竭，津液不足，是以大便
秘涩不通也，若过五六日，腹中闷胀者，此乃燥屎在脏腑，以其干涩，未能出耳，宜服麻仁
丸以津润之。若误以为有热，投之寒药，则阳消阴长，变证百出，性命危矣。
薛氏曰∶前证因去血过多，大肠干涸，不可计其日期，饮食数多，而用药通之，必待腹
满觉胀，欲去不能者，乃结在直肠，宜用猪胆汁润之。若服苦寒疏通之剂，反伤中气，或愈
加难通，或通而不止，或成痞证也。若去血过多者，用十全大补汤；若血虚火燥者，用加味
四物汤；气血俱虚者，用八珍汤。虽数日不通，饮食如常，腹中如故，仍用八珍加桃仁、杏仁
治之，若泥其日期，饮食数多而通之，则误矣。
一产妇大便不通七日矣，饮食如常，腹中如故（非善守善察者不能），余曰∶饮食所入，
虽倍常数，腹不满胀。用八珍加桃仁杏仁，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，或用通利之药，中脘胀痛，饮食甚少，或云∶通则不痛，痛则不
通。乃用蜜导之，大便不禁，呃逆不食。余曰∶此脾肾复伤，用六君加吴茱萸肉果骨脂五味
数剂，喜其年壮而愈，不然多致不起。
一产妇大便秘结，小腹胀痛，用大黄等药，致吐泻不食，腹痛胸痞，余用六君子加木
香、炮姜，治之而愈。
一妇人大便秘涩，诸药不应，苦不可言，令饮人乳而安。
李氏曰∶产后大便闭者，芎归汤加防风、枳壳、甘草，秘涩者，麻子仁丸或苏麻粥。盖产
后去血多则郁冒，郁冒则汗多，汗多则大便闭，皆血虚也。
调导散 治妇人产前产后大便不通。
当归 川芎 防风（用防风者，将欲降之，必先升之也） 枳壳（各四钱） 甘草（炙，二钱）
上 咀，每服一两，用生姜三片，枣一枚，水煎，温服，忌动风物。
麻仁丸 治产后去血过多，津液枯竭，不能转送，大便闭涩。
大麻仁（研如泥） 枳壳（面炒） 人参（各一两） 大黄（半两）
上为末，炼蜜丸如桐子大，每服二十丸，空心温酒米饮任下，未通，渐加丸数，不可太
过。评曰∶产后不得利，利者百无一生，去血过多，脏燥大便秘涩，则固当滑之，大黄似难轻
用，唯葱涎调腊茶为丸，复以腊茶下之，必通。（亦是良法。产后固不可轻用大黄，然大肠秘
结不通，或恶露点滴不出，不得大黄以宣利之，势必不通，但利后即当以参、 、白术、甘
草及芎、归等药大剂调补之，不然，元气下脱，后将不可救矣）
滋肠五仁丸 治产后血气虚损，大肠闭涩，传道艰难。
杏仁（去皮，面炒） 桃仁（如上制，各一两） 柏子仁（五钱） 松子仁（一钱半） 郁李仁（一钱，
面炒） 橘红（四两，为末）（以橘红为君者，和气润下也）
一方加当归梢五钱。
上五仁另研为膏，合橘皮末和匀再研，炼蜜丸如桐子大，每服三十丸，加至五六十丸，
食前清米饮下。
阿胶枳壳丸 治产后大便秘涩。
阿胶 枳壳（各等分）
上为末，炼蜜丸如桐子大，滑石末为衣，温水下二十丸，未通再服。
麻苏粥 妇人产后有三种疾，郁冒则多汗，汗多则大便秘，故难以用药，惟麻子苏子
粥最为稳当。
苏子 大麻子（各半合，洗净）
上研极细，用水再研，取汁一盏，分二次，煮粥啜下。
本事方云∶此粥不惟产后可服，大抵老人诸虚风秘，皆宜服之。尝有一人，母年八十四，
忽尔腹痛头疼，恶心不食，召医数十，议皆用补脾进食治风清利头目等药，数日虽愈，全不
入食，其家忧惶，余辩说前药皆误矣，此证正是老人风秘，脏腑壅滞，聚于胸中，则腹胀恶
心，不思饮食，又上至于颠，则头痛神不清也，若脏腑流畅，诸疾悉去矣。予命作此粥，两啜
而气泄，先下结粪如胡桃者十余枚，后渐得通利，不用药而自愈矣。
兵部手集方 治产后秘结不通，膨满气急，坐卧俱难。
用大麦 炒黄为末，酒下一合，神效。（用大麦自有心得）
郭稽中说：产后大便秘涩的原因是什么？回答说：分娩后卧床休息，水和血液同时流失，导致胃气虚弱枯竭，津液不足，因此大便秘结不通。如果过了五六天，腹部感到闷胀，这是燥屎停留在脏腑中，因为粪便干燥涩滞，所以无法排出，适宜服用麻仁丸来滋润肠道。如果误认为是体内有热，而使用寒凉药物，就会导致阳气消减、阴气增长，从而引发各种变证，危及生命。
薛氏说：上述症状是因为失血过多，导致大肠干涸，不能单纯计算天数，即使饮食较多，也不能随意用药通便。必须等到腹部满胀、感觉想排便却排不出时，这才说明粪便结在直肠，适宜用猪胆汁来润肠。如果服用苦寒的疏通药剂，反而会损伤中焦脾胃之气，可能导致更加难以排便，或者排便不止，或者形成痞证。如果是失血过多的情况，使用十全大补汤；如果是血虚伴有火燥的情况，使用加味四物汤；如果是气血都虚的情况，使用八珍汤。虽然几天不通便，但饮食正常，腹部也没有不适，仍然使用八珍汤加入桃仁、杏仁治疗。如果拘泥于天数，饮食较多就强行通便，那就是错误的。
有一位产妇大便不通七天了，饮食如常，腹部没有异常（这不是善于观察和诊察的人所不能做到的）。我说：饮食摄入虽然超过平常倍数，但腹部并不满胀。使用八珍汤加入桃仁、杏仁，到了第二十天，腹部满胀想要排便，使用猪胆汁润肠，先排出干硬粪块五七块，之后都是正常粪便，身体安适。
另一位产妇大便八天不通，有人使用通利药物，导致中脘部胀痛，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），导致大便失禁，呃逆且不能进食。我说：这是脾肾再次受伤，使用六君子汤加入吴茱萸、肉豆蔻、骨碎补、五味子等药数剂，庆幸她年轻力壮而痊愈，否则大多会导致死亡。
还有一位产妇大便秘结，小腹胀痛，使用大黄等药物，导致呕吐腹泻、不能进食、腹痛胸闷，我使用六君子汤加入木香、炮姜，治愈了她。
又有一位妇人，大便秘涩，各种药物无效，痛苦不堪，让她喝人乳而安定下来。
李氏说：产后大便闭结的，用芎归汤加入防风、枳壳、甘草；大便秘涩的，用麻子仁丸或苏麻粥。大概产后失血多会导致郁冒，郁冒则汗多，汗多则大便闭结，这都是血虚所致。
调导散：治疗妇女产前产后大便不通。
当归、川芎、防风（使用防风的原因是，想要下降必先升提）、枳壳（各四钱）、甘草（炙，二钱）。
以上药材切碎，每次服用一两，用生姜三片、大枣一枚，水煎煮，温服，忌食动风之物。
麻仁丸：治疗产后失血过多，津液枯竭，传导无力，大便闭涩。
大麻仁（研成泥状）、枳壳（面粉炒）、人参（各一两）、大黄（半两）。
以上研为细末，炼蜜制成梧桐子大小的丸药，每次服用二十丸，空腹时用温酒或米饮送下，若未通，逐渐增加丸数，不可过量。评论说：产后不宜轻易泻下，泻下者百无一活。因失血过多，脏腑干燥，大便秘涩，确实应当滑润肠道，大黄似乎难以轻易使用。唯有用葱汁调和腊茶制成丸药，再用腊茶送下，必然通畅。（这也是好方法。产后固然不可轻用大黄，但如果大肠秘结不通，或恶露点滴不出，不用大黄宣通泻下，势必不通，但在泻下之后应当立即用参、[此处原文缺字，推测为芪]、白术、甘草及芎、归等药大剂量调补，不然元气下脱，后来就无法挽救了）
滋肠五仁丸：治疗产后气血虚损，大肠闭涩，传导艰难。
杏仁（去皮，面粉炒）、桃仁（如上法制，各一两）、柏子仁（五钱）、松子仁（一钱半）、郁李仁（一钱，面粉炒）、橘红（四两，研为末）（以橘红为君药，是为了调和气息并润下）。
一方中加入当归梢五钱。
以上五种仁另研成膏，与陈皮末混合再研匀，炼蜜制成梧桐子大小的丸药，每次服用三十丸，加至五六十丸，饭前用清米饮送下。
阿胶枳壳丸：治疗产后大便秘涩。
阿胶、枳壳（各等分）。
以上研为细末，炼蜜制成梧桐子大小的丸药，以滑石末为衣，温水送服二十丸，若未通再服。
麻苏粥：妇人产后有三种疾病，郁冒则多汗，汗多则大便秘结，所以难以用药，只有麻子苏子粥最为稳妥。
苏子、大麻子（各半合，洗净）。
以上研磨极细，用水再次研磨，取汁一盏，分两次煮粥食用。
《本事方》说：此粥不仅产后可服，大体上老人各种虚证和风秘，都适宜服用。曾经有一人，母亲八十四岁，忽然腹痛头疼，恶心不想吃东西，召集几十位医生，议论都用补脾进食、治风、清利头目等药物，几天后虽好转，但完全不能进食，家人担忧惶恐。我辨析说前面的药都错了，此证正是老人的风秘，脏腑壅滞，聚于胸中，则腹胀恶心，不思饮食，又上至于头顶，则头痛神志不清。如果脏腑流畅，各种疾病都会去除。我命令制作此粥，喝了两顿后气机泄降，先排出像胡桃一样的干硬粪块十余枚，之后逐渐通畅，不用药而自愈。
Guo Jizhong said: What is the cause of constipation and dryness of stool after childbirth? The answer is: After delivery, while lying in bed, both water (body fluids) and blood are discharged. This leads to deficiency and exhaustion of Stomach Qi, and insufficiency of Jin-Ye (Body Fluids), resulting in constipation and difficulty in defecation. If five or six days pass and the abdomen feels distended and stifling, this indicates that dry feces are retained within the Zang-Fu organs. Because the feces are dry and astringent, they cannot be expelled. It is appropriate to administer Mahuan Wan (Hemp Seed Pill) to moisten the intestines. If mistakenly treated as having internal Heat by administering cold-natured medicines, Yang will decline and Yin will grow, leading to various complicated syndromes and endangering life.
Xue said: The aforementioned symptoms are caused by excessive blood loss, leading to dryness of the Large Intestine. One should not rely solely on the number of days passed. Even if food intake is high, one should not arbitrarily use purgatives. One must wait until the abdomen feels full and distended, with the urge to defecate but inability to do so; only then can it be determined that the feces are impacted in the rectum. In such cases, pig bile is suitable for lubricating the intestines. If bitter-cold purgative agents are taken, they will damage the Qi of the Middle Jiao (Spleen and Stomach). This may result in increased difficulty in defecation, uncontrolled diarrhea, or the formation of Pi Syndrome (abdominal masses/distension). For cases of excessive blood loss, Shiquan Dabu Tang (Decoction for Complete Great Tonification) should be used. For cases of Blood Deficiency with Fire Dryness, Jiawei Siwu Tang (Modified Four Substances Decoction) should be used. For cases of both Qi and Blood Deficiency, Bazhen Tang (Eight Treasures Decoction) should be used. Even if there is no bowel movement for several days, provided that appetite remains normal and the abdomen feels unchanged, Bazhen Tang added with Tao Ren (Peach Kernel) and Xing Ren (Apricot Kernel) should still be used. If one rigidly adheres to the number of days and uses purgatives merely because food intake is high, it would be an error.
A postpartum woman had not had a bowel movement for seven days. Her diet was normal, and her abdomen felt unchanged (this requires keen observation and discernment). I stated: Although food intake exceeds the usual amount, the abdomen is not distended. I prescribed Bazhen Tang added with Tao Ren and Xing Ren. By the twentieth day, when abdominal distension occurred and she felt the urge to defecate, I used pig bile to lubricate the bowels. She first passed five to seven pieces of dry feces, followed by normal stools, and her condition stabilized.
Another postpartum woman had not had a bowel movement for eight days. Someone administered purgative medicines, causing distending pain in the Zhongwan (CV12) region and reduced food intake. Some argued, "If there is free flow, there is no pain; if there is pain, there is no free flow." Consequently, honey suppositories were used, leading to involuntary defecation, hiccups, and inability to eat. I stated: This is a secondary injury to the Spleen and Kidney. I prescribed Liujun Zi Tang (Six Gentlemen Decoction) added with Wuzhuyu (Evodia Fruit), Roudoukou (Nutmeg), Gusuibu (Drynaria Rhizome), and Wuweizi (Schisandra Berry) over several doses. Fortunately, she was young and vigorous, and she recovered; otherwise, it likely would have been fatal.
Another postpartum woman suffered from constipation and lower abdominal distending pain. After using Rhubarb (Dahuang) and other medicines, she developed vomiting, diarrhea, anorexia, abdominal pain, and chest oppression. I treated her with Liujun Zi Tang added with Muxiang (Aucklandia Root) and Paojiang (Prepared Ginger), which cured her.
Another woman suffered from severe constipation and dryness, to which various medicines failed to respond, causing unbearable suffering. I instructed her to drink human milk, which brought relief.
Li said: For postpartum fecal impaction, Xionggui Tang (Ligusticum and Angelica Decoction) added with Fangfeng (Saposhnikovia Root), Zhike (Bitter Orange), and Gancao (Licorice Root) should be used. For constipation and dryness, Maziren Wan (Hemp Seed Pill) or Susu Zhou (Perilla and Hemp Seed Porridge) should be used. Generally, excessive blood loss after childbirth leads to Yu Mao (Depression and Vertigo); Yu Mao causes profuse sweating; profuse sweating leads to constipation. All these stem from Blood Deficiency.
Tiaodao San (Regulating and Guiding Powder): Treats constipation in women before and after childbirth.
Danggui (Angelica Sinensis Radix), Chuanxiong (Ligusticum Chuanxiong Rhizoma), Fangfeng (Saposhnikovia Divaricata Radix [Note: Fangfeng is used because to descend, one must first ascend]), Zhike (Aurantii Fructus) (each 4 qian), Gancao (Glycyrrhizae Radix et Rhizoma, prepared with honey) (2 qian).
Crush the herbs. Take 1 liang per dose, with three slices of fresh ginger and one jujube. Decoct in water and take warm. Avoid foods that stir wind.
Mahuan Wan (Hemp Seed Pill): Treats constipation and dryness due to excessive blood loss after childbirth, depletion of Jin-Ye (Body Fluids), and failure of transportation and transformation.
Dama Ren (Cannabis Sativa Semen), Zhike (Aurantii Fructus, stir-fried with flour), Renshen (Panax Ginseng Radix et Rhizoma) (each 1 liang), Dahuang (Rhei Radix et Rhizoma) (0.5 liang).
Grind into powder, mix with refined honey to form pills the size of paulownia seeds. Take 20 pills per dose on an empty stomach with warm wine or rice gruel. If unrelieved, gradually increase the number of pills, but do not exceed the limit. Commentary: Purging is contraindicated after childbirth; those who purge rarely survive. Due to excessive blood loss and dryness of the Zang-Fu, constipation occurs, and lubrication is indeed indicated. However, Dahuang (Rhubarb) should not be used lightly. A better method is to mix scallion juice with La Cha (aged tea) to form pills, and take them down with aged tea, which ensures passage. (This is also a good method. While Dahuang should not be used lightly postpartum, if the Large Intestine is severely constipated or lochia does not exit, Dahuang is necessary to promote free flow. However, immediately after purging, large doses of tonics such as Renshen, [missing character, likely Huangqi], Baizhu, Gancao, Chuanxiong, and Danggui must be used to restore Yuan Qi (Primal Qi). Otherwise, collapse of Yuan Qi will occur, making recovery impossible.)
Zichang Wuren Wan (Intestine-Nourishing Five Seeds Pill): Treats constipation and difficult defecation due to Qi and Blood deficiency after childbirth.
Xing Ren (Armeniacae Semen Amarum, peeled and stir-fried with flour), Tao Ren (Persicae Semen, prepared as above) (each 1 liang), Baizi Ren (Platycladi Semen), Songzi Ren (Pinus Massoniana Semen), Yuliren (Pruni Semen) (stir-fried with flour) (1 qian), Juhong (Citri Reticulatae Pericarpium Rubrum) (4 liang, ground into powder) [Juhong is the sovereign herb to harmonize Qi and promote downward movement].
One variation adds Danggui Shao (Angelica Sinensis Radix tip) (5 qian).
Grind the five seeds separately into a paste, mix with Citrus powder, and grind again. Mix with refined honey to form pills the size of paulownia seeds. Take 30 pills per dose, increasing to 50-60 pills, before meals with clear rice gruel.
Ejiao Zhike Wan (Donkey-Hide Gelatin and Bitter Orange Pill): Treats postpartum constipation.
Ejiao (Colla Corii Asini), Zhike (Aurantii Fructus) (equal parts).
Grind into powder, mix with refined honey to form pills the size of paulownia seeds. Coat with Talcum Powder. Take 20 pills with warm water. Repeat if unrelieved.
Mazu Zhou (Hemp Seed and Perilla Porridge): Postpartum women may suffer from three conditions: Yu Mao (Depression/Vertigo) leads to sweating; sweating leads to constipation. Therefore, medication is difficult to use. Mazu Zhou is the safest option.
Suzi (Perillae Fructus), Dama Ren (Cannabis Sativa Semen) (each half he, washed clean).
Grind extremely finely, add water, grind again, and extract one cup of juice. Divide into two portions and cook into porridge to consume.
Ben Shi Fang states: This porridge is suitable not only for postpartum women but also generally for elderly patients with various deficiencies and Wind Constipation. Once, a patient's mother, aged 84, suddenly suffered from abdominal pain, headache, nausea, and anorexia. Dozens of doctors were summoned, all prescribing spleen-tonifying, appetite-stimulating, wind-dispelling, and head-clearing herbs. Although she improved after several days, she could not eat at all. Her family was anxious. I analyzed that previous prescriptions were incorrect. This case was precisely Wind Constipation in the elderly, with stagnation in the Zang-Fu accumulating in the chest, causing abdominal distension, nausea, and anorexia, and rising to the vertex, causing headache and mental cloudiness. If the Zang-Fu become smooth and flowing, all diseases will resolve. I ordered the preparation of this porridge. After two servings, Qi descended, and she first passed more than ten hard fecal pellets resembling walnuts, followed by gradual regularity. She healed without further medication.
Bingbu Shouji Fang (Ministry of War Manual Formula): Treats postpartum constipation with bloating, fullness, and shortness of breath, making sitting and lying difficult.
Use Da Mai (Hordei Fructus Germinatus), stir-fried until yellow and ground into powder. Take one he with wine. Effect is miraculous. (Using Da Mai reflects personal insight.)