大全云∶妊娠大小便不通，由脏腑之热所致。若大肠热，则大便不通；小肠热，则小便不
利；大小肠俱热，则大小便俱不通，更推其因而药之。
薛氏曰∶前证若大肠血燥，用四物汤加条芩、桃仁；大肠气滞，用紫苏饮加杏仁、条芩；
肠胃气虚，用六君子加紫苏、杏仁；肝脾蕴热，用龙胆泻肝汤；心肝虚热，用加味逍遥散加车前子。
亚卿李浦汀侧室妊娠，大小便不利，或用降火理气之剂，元气反虚，肝脉弦急，脾脉迟
滞，视其面色，青黄不泽。余曰∶此郁怒所致也。用加味归脾汤为主，佐以加味逍遥散而安。
主政王在成之内妊娠，痢疾愈后，二便不通，其家世医，自用清热之剂，未效。余诊其
脉，浮大而涩，此气血虚也，朝用八珍汤加桃仁、杏仁，夕用加味逍遥加车前子而痊。
大腹皮散 治妊娠大小便不通。
大腹皮 赤茯苓 枳壳（麸炒，各一两） 甘草（炙，二钱）
上为细末，每服二钱，浓煎葱白汤调下。一方锉作散，入郁李仁去皮尖一钱半，水煎，空心连服，以通为度，如不
通，必六腑热
秘，用枳壳炒一钱半，大黄炮二钱，甘草炙一钱，研为细末，作三服，浓煎葱白汤调下。
当归散 治妊娠因怒，肚腹胀痛，四肢浮肿，气急作喘，大便难，小便涩，产门肿。
当归（五分） 赤茯苓 枳壳（麸炒） 白芍药 川芎（各一钱） 白姜（炮） 木香（煨）
粉草（各三分）
上用姜，水煎服。气弱，枳壳减半。大便秘，加蜜同煎。
一方 治妊娠小便不通，腹胁痞闷，不思饮食。
大黄 木通 槟榔（各一两） 枳壳（麸炒，七钱半） 诃黎勒（四个，去核，半生半煨）
大腹子（三枚）
上为末，用童便一盏，葱白二寸，煎六分，调服二钱。
一方 治妊娠风气，大便秘涩。
枳壳（麸炒，三两） 防风（二两） 甘草（炙，一两）
上为末，每一二钱，空心用白滚汤调服，日三次。
又方
车前子（一两） 大黄（半两，炒）
上为末，每服三钱，汤调服。
又方 治虚羸大便秘。
枳壳（制） 阿胶（炒，各等分）
上为细末，炼蜜和剂，杵二三千下，丸如桐子大，别研滑石末为衣，（研滑石末妙）温汤
下二十丸，半日来未通，再服三十丸，止于五十丸。
葵子汤 治妊娠得病六七日以上，身热入脏，大小便不利，安胎除热。（此利窍除热药也）
葵子（二升） 滑石（四两，碎）
上以水五升煮取一升，去渣尽服，须臾当下便愈。
又方
葵子（一合） 川朴硝（一两）（朴硝非妊娠所宜，用者须慎）
上每服三钱，水煎温服。
猪苓散 治妊娠小便涩痛，兼治胎水。
猪苓五两去皮为末，白汤调方寸匕，加至二匕，日三夜二。不瘥，宜转下之，服后药。
甘遂散 治妊娠子淋，大小便并不利，气急，已服猪苓散不瘥，宜服此下之。
用泰山赤皮甘遂二两为末，以白蜜二合和服，如豆大一粒。觉心下烦，得微下者，日一
服，下之后，还服猪苓散，不得下，日两服，渐加至半钱，以微利为度。（此药太峻，不可轻用。）
上陈良甫氏所录诸方，今并存之，纳甘遂、朴硝，非至实至危，不得已而为之，不可轻
用。其他亦宜审订用之，仍味薛氏之说，而参之以杂病诸方，庶无误也。
《大全》说：妊娠期间大小便不通，是由脏腑有热所致。如果大肠有热，则大便不通；小肠有热，则小便不利；大小肠都有热，则大小便都不通，应当进一步推究病因并用药治疗。
薛氏（薛己）说：上述病症如果是大肠血燥，用四物汤加黄芩、桃仁；大肠气滞，用紫苏饮加杏仁、黄芩；肠胃气虚，用六君子汤加紫苏、杏仁；肝脾蕴热，用龙胆泻肝汤；心肝虚热，用加味逍遥散加车前子。
亚卿李浦汀的侧室怀孕时，大小便不利，有人使用降火理气的药剂，导致元气反而虚弱，脉象表现为肝脉弦急，脾脉迟滞，观察其面色，呈现青黄色且无光泽。我说：这是由郁怒所致。以加味归脾汤为主方，佐以加味逍遥散而痊愈。
主政王在成的内人怀孕，痢疾痊愈后，大小便不通，其家族世代行医，自行使用清热药剂，无效。我诊察其脉象，浮大而涩，这是气血虚的表现，早晨服用八珍汤加桃仁、杏仁，晚上服用加味逍遥散加车前子而痊愈。
大腹皮散：治疗妊娠期间大小便不通。
大腹皮、赤茯苓、枳壳（麸炒，各一两）、甘草（炙，二钱）。
以上药物研为细末，每次服用二钱，用浓煎的葱白汤调服。另一方法将药锉成散剂，加入去皮尖的郁李仁一钱半，用水煎煮，空腹连服，以通畅为度。如果不通，必定是六腑热秘，可用炒枳壳一钱半、炮大黄二钱、炙甘草一钱，研为细末，分三次服用，用浓煎的葱白汤调服。
当归散：治疗妊娠因愤怒引起的肚腹胀痛、四肢浮肿、气急作喘、大便难、小便涩、产门肿。
当归（五分）、赤茯苓、枳壳（麸炒）、白芍药、川芎（各一钱）、白姜（炮）、木香（煨）、粉草（各三分）。
以上药物用生姜和水煎服。气弱者，枳壳减半。大便秘结者，加蜂蜜同煎。
另一方：治疗妊娠小便不通，腹胁痞闷，不思饮食。
大黄、木通、槟榔（各一两）、枳壳（麸炒，七钱半）、诃黎勒（四个，去核，半生半煨）、大腹子（三枚）。
以上药物研为末，用童子尿一盏、葱白二寸，煎至六分，调服二钱。
另一方：治疗妊娠风气，大便秘涩。
枳壳（麸炒，三两）、防风（二两）、甘草（炙，一两）。
以上药物研为末，每次一二钱，空腹用白开水调服，每日三次。
又一方：
车前子（一两）、大黄（半两，炒）。
以上药物研为末，每次服用三钱，用汤水调服。
又一方：治疗身体虚弱消瘦导致的大便秘结。
枳壳（制）、阿胶（炒，各等分）。
以上药物研为细末，用炼蜜和药，捣杵二三千下，制成如梧桐子大小的丸药，另研滑石末作为包衣，用温开水送服二十丸，半天后仍未通畅，再服三十丸，最多不超过五十丸。
葵子汤：治疗妊娠患病六七天以上，身热入脏，大小便不利，安胎除热。（这是利窍除热的药物）
葵子（二升）、滑石（四两，碎）。
以上药物用水五升煮取一升，去渣尽服，不久即可通便痊愈。
又一方：
葵子（一合）、川朴硝（一两）（朴硝不适合孕妇使用，使用者须谨慎）。
以上药物每次服用三钱，用水煎煮温服。
猪苓散：治疗妊娠小便涩痛，兼治胎水。
猪苓五两，去皮研为末，用白开水调服方寸匕，可加至二匕，每日三次，夜间两次。若不愈，宜采用攻下法，服用后面的药物。
甘遂散：治疗妊娠子淋，大小便都不利，气急，已服用猪苓散未愈，宜服用此药攻下。
用泰山赤皮甘遂二两研为末，用白蜜二合调和服用，如豆大一粒。若感觉心下烦闷，轻微腹泻的，每日服用一次，泻下之后，再服用猪苓散，若仍不能下，每日两次，逐渐加量至半钱，以轻微腹泻为度。（此药过于峻猛，不可轻易使用。）
以上是陈良甫先生所收录的各种方剂，现在一并保存。加入甘遂、朴硝的药物，若非实证危证，不得已而为之，不可轻易使用。其他方剂也应当审慎订正后使用，同时参考薛氏的说法，并结合杂病诸方，这样才能避免错误。
The *Daquan* states: Inability to urinate or defecate during pregnancy is caused by heat in the zang-fu organs. If there is heat in the Large Intestine, defecation will be obstructed; if there is heat in the Small Intestine, urination will be difficult; if both intestines have heat, both urination and defecation will be obstructed. One should further investigate the etiology and prescribe medication accordingly.
Xue (Xue Ji) stated: For the aforementioned conditions, if it is dryness of blood in the Large Intestine, use Siwu Tang (Four Substances Decoction) with Huangqin (Scutellariae Radix) and Taoren (Persicae Semen); if it is qi stagnation in the Large Intestine, use Zisu Yin (Perilla Leaf Infusion) with Xingren (Armeniacae Semen Amarum) and Huangqin; if there is qi deficiency in the Stomach and Intestines, use Liujunzi Tang (Six Gentlemen Decoction) with Zisu (Perillae Folium) and Xingren; if there is latent heat in the Liver and Spleen, use Longdan Xiegan Tang (Gentian Liver-Draining Decoction); if there is deficient heat in the Heart and Liver, use Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder) with Cheqianzi (Plantaginis Semen).
The concubine of Vice Minister Li Puting suffered from difficulty in urination and defecation during pregnancy. After using herbs to clear fire and regulate qi, her Yuanqi (Primary Qi) became deficient. Her Liver pulse was wiry and urgent, and her Spleen pulse was slow and sluggish. Her complexion appeared greenish-yellow and lusterless. I said: This was caused by depression and anger. She recovered after being treated primarily with Jiawei Guipi Tang (Modified Restore the Spleen Decoction), assisted by Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder).
The wife of Director Wang Zaicheng suffered from inability to pass urine and stool after recovering from dysentery during pregnancy. As a family of physicians, they self-administered heat-clearing herbs without effect. Upon examining her pulse, which was floating, large, and choppy, I diagnosed it as deficiency of Qi and Blood. She recovered after taking Bazhen Tang (Eight Treasures Decoction) with Taoren and Xingren in the morning, and Jiawei Xiaoyao San with Cheqianzi in the evening.
Dafupi San (Areca Peel Powder): Treats inability to urinate or defecate during pregnancy.
Dafupi (Arecae Pericarpium), Chifuling (Poria cum Ramo et Ligno Pinus), Zhike (Aurantii Fructus Immaturus, stir-bran fried, each 1 liang), Gancao (Licorizae Radix et Rhizoma, honey-fried, 2 qian).
Grind the above into fine powder. Take 2 qian each time, mixed with strong decoction of Congbai (Allii Fistulosi Bulbus). Another method: crush into powder, add Quli Ren (Pruni Semen, peeled and pitted, 1.5 qian), decoct in water, take on an empty stomach continuously until passage is achieved. If unrelieved, it is likely constipation due to heat in the Six Fu organs. Use Zhike (stir-fried, 1.5 qian), Dahuang (Rhei Radix et Rhizoma, processed, 2 qian), and Gancao (honey-fried, 1 qian), grind into fine powder, divide into three doses, and take with strong decoction of Congbai.
Danggui San (Angelica Sinensis Powder): Treats abdominal distension and pain, edema of the four limbs, shortness of breath with wheezing, difficulty in defecation, astringency in urination, and swelling of the vaginal opening during pregnancy due to anger.
Danggui (Angelicae Sinensis Radix, 5 fen), Chifuling, Zhike (stir-bran fried), Baishao (Paeoniae Radix Alba), Chuanxiong (Ligustici Chuanxiong Rhizoma, each 1 qian), Baijiang (Zingiberis Rhizoma Processatum), Muxiang (Aucklandiae Radix, baked), Fencacao (Glycyrrhizae Radix et Rhizoma, each 3 fen).
Decoct the above with Shengjiang (Zingiberis Rhizoma Recens) and water. For weak Qi, reduce Zhike by half. For severe constipation, add Honey (Mifengmi) and decoct together.
Another prescription: Treats inability to urinate during pregnancy, with fullness and oppression in the abdomen and hypochondrium, and loss of appetite.
Dahuang, Mutong (Akebiae Caulis), Binglang (Arecae Semen, each 1 liang), Zhike (stir-bran fried, 7.5 qian), Helile (Terminaliae Chebulae Fructus, four pieces, pitted, half raw half baked), Dafuzi (Arecae Semen, three pieces).
Grind into powder. Take 2 qian, mixed with one cup of Tongbian (Child's Urine) and two cun of Congbai, decocted to six parts.
Another prescription: Treats wind-pathogen in pregnancy causing dry and difficult defecation.
Zhike (stir-bran fried, 3 liang), Fangfeng (Saposhnikoviae Radix, 2 liang), Gancao (honey-fried, 1 liang).
Grind into powder. Take 1-2 qian on an empty stomach with plain boiled water, three times daily.
Another prescription:
Cheqianzi (Plantaginis Semen, 1 liang), Dahuang (processed, half liang).
Grind into powder. Take 3 qian each time, mixed with warm water.
Another prescription: Treats severe constipation due to emaciation and deficiency.
Zhike (processed), Ejiao (Asini Corii Colla, stir-fried, equal parts).
Grind into fine powder, mix with refined honey, pound 2000-3000 times, form pills the size of paulownia seeds. Coat with Shiyan (Talcum Powder). Take 20 pills with warm water. If no relief after half a day, take another 30 pills, up to a maximum of 50 pills.
Kuizi Tang (Abelmosk Seed Decoction): Treats pregnancy illness lasting more than six or seven days, with body heat entering the zang organs, difficulty in urination and defecation. It calms the fetus and clears heat. (This is a formula for promoting diuresis and clearing heat.)
Kuizi (Abelmoschi Semen, 2 sheng), Huashi (Talcum, 4 liang, crushed).
Decoct in five sheng of water to obtain one sheng. Strain and drink completely. Bowel movement should occur shortly thereafter, leading to recovery.
Another prescription:
Kuizi (one he), Chuanponxiao (Natrii Sulfas, 1 liang) (Ponxiao is not suitable for pregnancy; users must exercise caution).
Take 3 qian each time, decocted in water and taken warm.
Zhuling San (Polyporus Powder): Treats painful and difficult urination during pregnancy, and also treats fetal fluid retention.
Grind Zhuling (Polyporus, 5 liang, peeled) into powder. Mix with warm water and take one fangcunbi (square-inch spoonful), increasing to two fangcunbi. Take three times daily and twice at night. If ineffective, proceed to purgation using the following medicine.
Gansui San (Kansui Root Powder): Treats Zilin (pregnancy strangury) where both urination and defecation are obstructed, accompanied by shortness of breath. If Zhuling San has failed, this purgative should be used.
Grind Gansui (Kansui Radix, sourced from Mount Tai, red bark, 2 liang) into powder. Mix with Erhe (two units of volume) of White Honey (Baimi) and take one pill the size of a bean. If heart discomfort is felt or slight diarrhea occurs, take once daily. After evacuation, resume Zhuling San. If still no evacuation, take twice daily, gradually increasing to half a qian. The goal is mild laxation. (This medicine is too harsh and should not be used lightly.)
The above prescriptions were recorded by Chen Liangfu. They are preserved here for reference. Formulas containing Gansui and Ponxiao should only be used when absolutely necessary for excess and critical conditions; they must not be used lightly. Other formulas should also be carefully reviewed before use. Reference Xue's theories and consult miscellaneous disease prescriptions to avoid errors.