凡产后舌燥咽干而渴，兼小便不利，由产后亡血或汗多所致，内亡津液也。夫日用水谷，胃纳而脾
运，肺散至精至清之气，为津为液，清肃下行膀胱而为小便。其气通心，受火色化为营身之血。值产亡血
而又汗多，加之产后气虚，不能为胃行
其津液，则是生化之气不运，渗泄之令不行。所以上无津液流通，而有咽燥干渴之证。下气不升，而有小
便不通。虽通而亦短少之候，勿作淋秘，轻用渗利，使气益虚，病益甚。治法必当助脾益肺，升举气血，则
气化流行。阴升阳降，斯水入经而为血为津，谷入胃而长气行脉，自然津液充而便利调匀矣。初产生化汤
多服数剂，如汗多亡津液，须加人参于内，使血生而津足。若无块痛，六君子倍参、 ，或服生津止渴益水
饮。渴甚，兼服参麦饮。如产后口干少力，宜生津益液汤。有用四君子汤，加车前一钱，桂心五分。若认咽
干口燥为火，而用芩、连、栀、柏以降之；认小便秘涩为水滞，而用五苓等剂以通之。不特非其治法，更患
愈通愈竭变生他证矣。《尊生》云∶小便不通，金匮肾气丸可加减用之。予谓当用加味肾气丸为是。若
兼口渴，用生津止渴益水饮。渴甚，兼生脉饮。密斋云∶如恶露不来，败血闭涩水渎，小便不通，其证则小
腹胀满刺痛，乍寒乍热，烦闷不宁，用加味五苓主之。予谓初产，自当用生化汤则瘀行便利矣。可无事乎五
苓也。如产过五七日，而恶露亦自宜渐少而止矣，又何必事乎五苓也？况产后最禁发汗、利水，予焉敢轻产，
而用五苓以竭其阴乎？世有治小便不通，用炒盐加麝少许，填脐中，外用葱白十余茎作一
束，切如半指浓，置盐麝上，将艾灸之，觉热气入腹难忍方止，小便即通。此惟气闭者宜之，若产后气虚
源涸，与夫热结膀胱者，皆不可用。
生津止渴益水饮 治产后口渴，小便不利。
人参 生地 麦冬（去心。各二钱） 黄 （一钱五分，蜜炙） 五味子（十粒） 当归（三钱，酒
浸） 茯苓（八分） 升麻 炙草（各四分） 葛根（一钱）
水煎服。如汗多，加麻黄根一钱，炒枣仁一钱，浮小麦一撮。大便日久不通，加酒洗苁蓉一钱五分。渴
甚，用参麦饮代茶饮之，不可疑而不用。凡一切降火利便药，断不可用。
生津益液汤 治产后口干少力。
人参（随宜） 麦冬（一钱二分，去心） 茯苓 栝蒌根（各一钱） 甘草（八分） 小麦（一撮）
竹叶（十片）
枣二枚，水煎服。如大渴，加芦根。
加味五苓散 治产后恶露不行，小便不通。
猪苓 泽泻 白术（土炒） 茯苓 桂心（各一钱） 桃仁（去皮尖） 红花（各二钱）
水煎服。此方予未敢用，姑录之以备参考耳。
生化汤（见本卷生化汤论后。） 六君子汤（见上卷诸痛门。） 参麦饮（见本卷
晕厥门。） 四君子汤（见上卷胎逆上逼门。） 加味肾气丸（见上卷诸痛门，附六味地黄汤下。）
凡是在产后出现舌面干燥、咽喉干渴，并且兼有小便不通畅或短少的症状，这是由于产后失血过多或者汗出过多，导致体内津液亏损的缘故。人每天摄入的水谷食物，由胃受纳而脾运化，肺将精微清肃之气散布全身，化为津和液，向下输注到膀胱形成小便。其中部分气机通于心，受心火之色变化而成为滋养身体的血液。正值产后失血，又加上汗出过多，加之产后元气虚弱，不能帮助胃运行津液，因此生化之气无法运转，渗泄的功能不能正常行使。所以上部没有津液流通，出现咽喉干燥、口渴的症状；下部气机不升，导致小便不通。即使有排尿，也是短少的表现，不要将其当作淋证或癃秘，轻易使用渗湿利水的药物，以免使正气更加虚弱，病情加重。治疗法则必须应当补益脾气、增益肺气，升举气血，使得气化功能流行。阴气上升，阳气下降，这样水液进入经脉化为血和津，谷物进入胃部生成气并运行于脉中，自然津液充盈，大小便调匀了。初产之后多服用几剂生化汤，如果汗多导致津液亏损，必须在方中加入人参，使血液生成而津液充足。如果没有瘀血块引起的疼痛，可以使用六君子汤并重用人参、白术，或者服用生津止渴益水饮。如果口渴严重，兼服参麦饮。如果是产后口干且乏力，适宜服用生津益液汤。有人使用四君子汤，加入车前子一钱，桂心五分。如果把咽干口燥认为是火邪，而用黄芩、黄连、栀子、黄柏来降火；把小便秘涩认为是水湿停滞，而用五苓散等方剂来通利。这不仅不是正确的治法，反而会导致越通利越枯竭，变生其他病症。《尊生》书中说：小便不通，金匮肾气丸可以加减使用。我认为应当使用加味肾气丸才是正确的。如果兼有口渴，使用生津止渴益水饮。如果口渴严重，兼服生脉饮。密斋说：如果恶露不来，败血闭塞水道，导致小便不通，其症状是小腹胀满刺痛，忽冷忽热，烦闷不安，使用加味五苓散主治。我认为初产之时，自然应当使用生化汤则瘀血行而便利自通了。哪里用得着五苓散呢？如果过了五七天，恶露也自然会逐渐减少而停止，又何必再用五苓散呢？况且产后最禁忌发汗、利水，我怎么敢轻率地给产妇使用五苓散来竭尽她的阴液呢？世间有治疗小便不通的方法，用炒盐加少许麝香，填入肚脐中，外用葱白十余茎扎成一束，切得如半指厚，放在盐麝之上，用艾灸它，感觉到热气进入腹部难以忍受时才停止，小便随即通畅。这种方法只适合气机闭塞者，如果是产后气虚源流枯竭，或者热结膀胱者，都不可使用。
生津止渴益水饮 治疗产后口渴，小便不利。
人参、生地、麦冬（去心，各二钱）、黄芪（一钱五分，蜜炙）、五味子（十粒）、当归（三钱，酒浸）、茯苓（八分）、升麻、炙甘草（各四分）、葛根（一钱）。
用水煎服。如果汗多，加麻黄根一钱，炒酸枣仁一钱，浮小麦一撮。大便日久不通，加酒洗肉苁蓉一钱五分。口渴严重，用参麦饮代替茶水饮用，不要怀疑而不使用。凡是所有降火利便的药物，绝对不可使用。
生津益液汤 治疗产后口干少力。
人参（随宜用量）、麦冬（一钱二分，去心）、茯苓、栝蒌根（各一钱）、甘草（八分）、小麦（一撮）、竹叶（十片）。
大枣二枚，用水煎服。如果大渴，加芦根。
加味五苓散 治疗产后恶露不行，小便不通。
猪苓、泽泻、白术（土炒）、茯苓、桂心（各一钱）、桃仁（去皮尖）、红花（各二钱）。
用水煎服。此方我不敢使用，暂且记录以备参考而已。
生化汤（见本卷生化汤论后。） 六君子汤（见上卷诸痛门。） 参麦饮（见本卷晕厥门。） 四君子汤（见上卷胎逆上逼门。） 加味肾气丸（见上卷诸痛门，附六味地黄汤下。）
Whenever postpartum dryness of the tongue and throat with thirst is accompanied by difficult or scanty urination, it is caused by blood loss or excessive sweating after childbirth, leading to a depletion of body fluids (Jin-Ye) internally. Daily intake of food and water is received by the Stomach and transported by the Spleen; the Lungs distribute the finest and clearest Qi throughout the body, transforming it into Jin and Ye, which descend clearly and turbidly to the Bladder to form urine. Part of this Qi connects to the Heart, where it takes on the color of Fire and transforms into Blood that nourishes the body. During childbirth, blood is lost, and if sweating is also excessive, compounded by postpartum Qi deficiency, the ability to assist the Stomach in transporting fluids is impaired. Consequently, the Qi of generation and transformation fails to move, and the command for seepage and excretion does not function properly. Thus, there is no circulation of fluids above, resulting in symptoms of dry throat and thirst; below, Qi fails to ascend, leading to urinary retention. Even if urination occurs, it is scanty. Do not mistake this for Lin syndrome (dysuria) or Long-Mi (urinary retention), nor lightly employ diuretic herbs, as this will further deplete Qi and exacerbate the condition. The treatment method must focus on strengthening the Spleen and benefiting the Lung, raising and supplementing Qi and Blood, so that Qi transformation circulates freely. With Yin ascending and Yang descending, water enters the meridians to become Blood and fluids, while grain enters the Stomach to generate Qi and flow through the vessels, naturally replenishing fluids and regulating bowel and bladder movements. After initial delivery, take several doses of Shenghua Tang. If excessive sweating has depleted fluids, Ginseng must be added to generate Blood and suffice fluids. If there are no masses or pain, Liu Jun Zi Tang should be used with increased amounts of Ren Shen (Ginseng) and Bai Zhu (Atractylodes Macrocephala Rhizome), or one may take Sheng Jin Zhi Ke Yi Shui Yin. For severe thirst, concurrently take Shen Mai Yin. For postpartum dry mouth and weakness, Sheng Jin Yi Ye Tang is appropriate. Some use Si Jun Zi Tang with added Che Qian Zi (Plantago Seed) and Gui Xin (Cinnamon Bark). If dry throat and mouth are mistaken for Fire, using Huang Qin (Scutellaria Root), Huang Lian (Coptis Rhizome), Zhi Zi (Gardenia Fruit), and Huang Bo (Phellodendron Bark) to purge heat; or if constipation is mistaken for Water stagnation, using Wu Ling San (Five-Ingredient Powder with Poria) to promote urination—this is not only incorrect treatment but also leads to greater depletion and other complications. *Zun Sheng* states: For urinary retention, Jin Kui Shen Qi Wan can be modified and used. I believe Jia Wei Shen Qi Wan is more appropriate. If accompanied by thirst, use Sheng Jin Zhi Ke Yi Shui Yin. For severe thirst, concurrently take Sheng Mai Yin. Mi Zhai says: If lochia does not come, and stagnant blood blocks the water passages causing urinary retention, with symptoms of lower abdominal distension and stabbing pain, alternating chills and fever, and restlessness, Jia Wei Wu Ling should be used. I argue that immediately after birth, Shenghua Tang should naturally be used so that stasis moves and urination becomes smooth; why resort to Wu Ling San? If five or seven days have passed since delivery, lochia should naturally decrease and stop; why still use Wu Ling San? Moreover, postpartum patients are strictly forbidden from sweating or diuresis; how dare I lightly prescribe Wu Ling San to exhaust their Yin? There is a worldly remedy for urinary retention: fill the navel with fried salt mixed with a little Musk, place a bundle of over ten stalks of scallion white (cut to half-finger thickness) over the salt and musk, and moxa-burn it until the heat entering the abdomen is unbearable, at which point urination usually resumes. This is only suitable for cases of Qi obstruction; it cannot be used for postpartum Qi deficiency with exhausted sources, or Heat binding in the Bladder.
Sheng Jin Zhi Ke Yi Shui Yin treats postpartum thirst and difficult urination.
Ren Shen (Ginseng Radix et Rhizoma), Di Huang (Rehmanniae Radix), Mai Dong (Ophiopogonis Tuber) [decored, each 2 qian], Huang Qi (Astragali Radix) [1.5 qian, honey-fried], Wu Wei Zi (Schisandrae Fructus) [10 grains], Dang Gui (Angelicae Sinensis Radix) [3 qian, wine-soaked], Fu Ling (Poria) [8 fen], Sheng Ma (Cimicifugae Rhizoma), Zhi Gan Cao (Prepared Glycyrrhizae Radix et Rhizoma) [each 4 fen], Ge Gen (Puerariae Lobatae Radix) [1 qian].
Decoct in water and drink. If sweating is excessive, add Ma Huang Gen (Ephedrae Herba Caudex) 1 qian, Chao Zao Ren (Ziziphi Spinosae Semen) 1 qian, and Fu Xiao Mai (Tritici Levis Fructus) a pinch. If constipation persists for many days, add Jiu Xi Rou Cong Rong (Cynomorii Herba) washed in wine 1.5 qian. For severe thirst, use Shen Mai Yin as tea substitute; do not hesitate to use it. All herbs that purge fire and promote urination must absolutely not be used.
Sheng Jin Yi Ye Tang treats postpartum dry mouth and weakness.
Ren Shen (Ginseng Radix et Rhizoma) [as needed], Mai Dong (Ophiopogonis Tuber) [1.2 qian, decored], Fu Ling (Poria), Gua Lou Gen (Trichosanthis Radix) [each 1 qian], Gan Cao (Glycyrrhizae Radix et Rhizoma) [8 fen], Xiao Mai (Tritici Levis Fructus) [a pinch], Zhu Ye (Bambusae Folium) [10 leaves].
With two Jujubes, decoct in water and drink. For extreme thirst, add Lu Gen (Phragmitis Rhizoma).
Jia Wei Wu Ling San treats postpartum lochia retention and urinary obstruction.
Zhu Ling (Polyporus), Ze Xie (Alismatis Rhizoma), Bai Zhu (Atractylodis Macrocephalae Rhizoma) [soil-fried], Fu Ling (Poria), Gui Xin (Cinnamomi Cortex) [each 1 qian], Tao Ren (Persicae Semen), Hong Hua (Carthami Flos) [each 2 qian].
Decoct in water and drink. I dare not use this formula myself; I record it here merely for reference.
Shenghua Tang (see discussion of Shenghua Tang later in this volume.) Liu Jun Zi Tang (see Chapter on Various Pains in the Upper Volume.) Shen Mai Yin (see Chapter on Syncope in this volume.) Si Jun Zi Tang (see Chapter on Fetal Reversal Pressing Upward in the Upper Volume.) Jia Wei Shen Qi Wan (see Chapter on Various Pains in the Upper Volume, appended under Liu Wei Di Huang Tang.)