妊娠泄泻，有风寒暑湿之外感，饮食生冷之内伤。病发一时，察其所因。如胃风，加味理中、加味治
中、四苓、不换金正气、胃苓等方，对证而治之即愈。然又有由脾肾二脏虚者，不可不知。夫血统于脾，
血拥胎元，则脾阴虚而食不运化，脾主健运，下焦壅滞而清气难舒，于是水谷难消而作泻。或因胎系于肾，
胎窃其气以拥护，而肾气既弱，命门火衰，不能上蒸脾土，此皆妊娠泄泻之由也。如脾虚内伤，用加味六
君子汤，随所因而加之。命门火衰，加益智以助之。至于妊娠久泻，元气下陷，发热作渴，肢体倦怠，用
补中益气汤。密斋治妊娠泄泻，以补中安胎为主，用加味四君子汤，如久泻大渴者，人参白术散主之，甚效。
胃风汤 治风冷乘虚入客肠胃，米谷不下，泄泻注下，及肠胃湿毒，下如豆汁，或下瘀血，或
下如鱼脑，日夜无度。
人参 白术（土炒） 茯苓 当归 川芎 芍药（炒） 肉桂（各等分）
入粟米一撮，水煎服。如腹痛加木香。此方治泻久气血两虚诚妙。然肉桂非久虚脏冷者断不可用。
其曰胃风，取其益胃而升举也。方中肉桂犯胎忌用，如不得已，或炒用，或易桂炭。如胃苓汤中肉桂，亦
不可不审用。
加味理中汤 治妊娠脐下阴冷洞泻。
人参 白术（土炒） 白芍 茯苓 干姜 黄连 木香 藿香叶 诃子肉 肉豆蔻（面煨） 甘草（各一钱）
生姜三片，大枣二枚，水二钟，煎一钟，饥时服。
加味治中汤 治饮食过多，脾胃之气不足运化而作泻。
人参 白术（土炒） 炮姜 甘草（各一钱） 陈皮 青皮（各七分） 砂仁（五分）
水煎服。
四苓散（附五苓散。） 治伏暑烦渴泻水。
白术（土炒） 猪苓 泽泻 茯苓
各等分为末，米饮调下。此方加肉桂，即五苓散。
不换金正气散 治妊妇伤湿泄泻。
苍术（制） 浓朴（姜汁制） 陈皮 藿香 制半夏（各一钱） 甘草（五分）
姜、枣为引，水煎服。
胃苓汤 治脾湿太过，胃气不和，腹痛泄泻，水谷不化，阴阳不分，此平胃散与五苓散合方也。
苍术（制） 浓朴（姜汁制） 陈皮 白术（土炒） 茯苓 猪苓 泽泻（各一钱） 官桂
炙草（各五分）
姜三片，枣二枚，水煎食远服。方中有桂，孕妇忌用，或易服不换金正气散更妥。
加味六君子汤
人参（随宜） 白术（一钱或一钱五分，土炒） 茯苓（一钱） 陈皮（八分） 制半夏（一钱）
炙草（五分）
生姜引，水煎服。米食所伤，加谷芽。面食所伤，加麦芽。肉食所伤，加山楂。如肝木侮土，兼寒热作
呕，加柴胡、生姜。若兼呕吐腹痛，手足逆冷，乃寒水侮土，加姜、桂。若泄泻黄色，乃脾土本色，加
木香、煨肉果。若作呕不食，腹痛恶寒，乃脾土虚寒，加木香、姜、桂。
密斋加味四君子汤 治妊娠泄泻，补中安胎为主。
人参 白术（土炒） 茯苓（各一钱） 炙草（八分）
水煎服。妊娠泄泻，加炒白芍一钱，更分寒热治之。如发热而渴者为热，加条芩一钱。不渴者为寒，加
炒黑干姜五分，并用乌梅一个为引，水煎食前服。如渴泻日久不止者，加酒炒白芍、诃子肉、炒干姜、
乌梅二个，去核。水煎食前服。或服人参白术散亦妙。
人参白术散 治久泻大渴者。
人参 白术（土炒） 茯苓 炙草（各一钱） 藿香 木香 干姜（各五分）
水煎，频频与之，以代汤水效。
补中益气汤（见本卷诸痛门。）
妊娠期间发生泄泻，既有风寒暑湿等外感邪气侵袭，也有饮食生冷造成的内伤。病症突发时，需审查其致病原因。如果是胃风所致，可选用加味理中汤、加味治中汤、四苓散、不换金正气散、胃苓汤等方剂，对症施治即可痊愈。然而，又有因脾肾两脏虚弱导致的泄泻，这一点不可不知。血液由脾所统摄，若血聚以供养胎元，则会导致脾阴虚而食物无法运化；脾主健运，若下焦壅滞导致清气难以舒展，于是水谷难以消化而发生泄泻。或者因为胎系于肾，胎儿窃取母体之气以自保，导致肾气虚弱，命门火衰，不能上蒸温煦脾土，这些都是妊娠泄泻的成因。若是脾虚兼有内伤，使用加味六君子汤，根据具体病因加减药物。若是命门火衰，加入益智仁以助阳。至于妊娠期间长期泄泻，导致元气下陷，出现发热口渴、肢体倦怠的症状，应使用补中益气汤。密斋治疗妊娠泄泻，以补中安胎为主，使用加味四君子汤；如果是久泻且大渴的患者，用人参白术散主治，效果很好。
胃风汤：治疗风冷乘虚侵入肠胃，导致米谷不下、泄泻如水注下，以及肠胃湿毒，大便如豆汁状，或下瘀血，或下如鱼脑状之物，日夜无度。
配方：人参、白术（土炒）、茯苓、当归、川芎、芍药（炒）、肉桂（各等分）。
用法：加入粟米一撮，水煎服。如果腹痛，加入木香。此方治疗久泻导致的气血两虚确实巧妙。然而，肉桂对于非久病脏冷的患者绝对不可使用。名为“胃风”，是取其益胃并升举清阳之意。方中的肉桂对胎儿有禁忌，如果不得已使用，可炒用，或改用桂炭。如胃苓汤中的肉桂，也不可不审慎使用。
加味理中汤：治疗妊娠期间脐下阴冷、洞泄（严重的水样腹泻）。
配方：人参、白术（土炒）、白芍、茯苓、干姜、黄连、木香、藿香叶、诃子肉、肉豆蔻（面煨）、甘草（各一钱）。
用法：生姜三片，大枣二枚，水两钟，煎至一钟，饥饿时服用。
加味治中汤：治疗饮食过多，脾胃之气不足，运化无力而导致的泄泻。
配方：人参、白术（土炒）、炮姜、甘草（各一钱），陈皮、青皮（各七分），砂仁（五分）。
用法：水煎服。
四苓散（附五苓散）：治疗伏暑引起的烦渴、泄泻如水。
配方：白术（土炒）、猪苓、泽泻、茯苓。
用法：各等分为末，用米饮调服。此方加入肉桂，即为五苓散。
不换金正气散：治疗孕妇伤湿引起的泄泻。
配方：苍术（制）、浓朴（姜汁制）、陈皮、藿香、制半夏（各一钱），甘草（五分）。
用法：姜、枣为引，水煎服。
胃苓汤：治疗脾湿太过，胃气不和，腹痛泄泻，水谷不化，阴阳不分。这是平胃散与五苓散的合方。
配方：苍术（制）、浓朴（姜汁制）、陈皮、白术（土炒）、茯苓、猪苓、泽泻（各一钱），官桂、炙草（各五分）。
用法：姜三片，枣二枚，水煎，饭后服用。方中含有桂，孕妇忌用，或改服不换金正气散更为妥当。
加味六君子汤：
配方：人参（随宜）、白术（一钱或一钱五分，土炒）、茯苓（一钱）、陈皮（八分）、制半夏（一钱）、炙草（五分）。
用法：生姜为引，水煎服。米食所伤，加谷芽；面食所伤，加麦芽；肉食所伤，加山楂。如果肝木侮土，兼有寒热作呕，加柴胡、生姜。如果兼有呕吐腹痛、手足逆冷，这是寒水侮土，加姜、桂。如果泄泻黄色，这是脾土本色，加木香、煨肉果。如果作呕不食、腹痛恶寒，这是脾土虚寒，加木香、姜、桂。
密斋加味四君子汤：治疗妊娠泄泻，以补中安胎为主。
配方：人参、白术（土炒）、茯苓（各一钱），炙草（八分）。
用法：水煎服。妊娠泄泻，加炒白芍一钱，进一步区分寒热进行治疗。如果发热而渴，属于热证，加条芩一钱。如果不渴，属于寒证，加炒黑干姜五分，并用乌梅一个为引，水煎，饭前服用。如果渴泻日久不止者，加酒炒白芍、诃子肉、炒干姜、去核乌梅二个，水煎，饭前服用。或者服用人参白术散也很好。
人参白术散：治疗久泻且大渴的患者。
配方：人参、白术（土炒）、茯苓、炙草（各一钱），藿香、木香、干姜（各五分）。
用法：水煎，频频给予饮用，以此代替汤水，效果良好。
补中益气汤（见本卷诸痛门）。
Diarrhea during pregnancy may result from external contraction of wind-cold, summer-heat, and dampness, or internal injury caused by consuming raw and cold food. When the disease manifests suddenly, one must examine its etiology. If it is due to Stomach Wind (Wei Feng), formulas such as Jiawei Lizhong Tang (Modified Cinnamon Twig and Atractylodes Macrocephala Decoction), Jiawei Zhizhong Tang (Modified Regulating the Middle Decoction), Siling San (Four-Ingredient Powder for Draining Dampness), Buhuanjin Zhengqi San (Non-Exchanging Golden Earth Harmonizing Qi Powder), and Weiling Tang (Stomach and Bladder Decoction) should be selected according to the syndrome for treatment, which will lead to recovery. However, diarrhea caused by deficiency of the Spleen and Kidney organs must not be overlooked. Blood is governed by the Spleen; when blood congregates to nourish the fetal origin, it leads to Yin deficiency of the Spleen and failure of food transformation. The Spleen governs healthy transportation; if stagnation in the Lower Jiao prevents the clear Qi from diffusing smoothly, water and grain fail to digest, resulting in diarrhea. Alternatively, since the fetus is anchored to the Kidney, the fetus may borrow Qi for protection, weakening Kidney Qi and causing decline of the Fire of the Gate of Vitality (Mingmen). This fire fails to steam and warm the Spleen Earth from above, which are all causes of diarrhea during pregnancy. For Spleen deficiency with internal injury, Jiawei Liujunzi Tang (Modified Six-Gentleman Decoction) is used, with modifications based on the specific cause. For decline of the Fire of the Gate of Vitality, Yizhi Ren (Alpinia Oxyphylla Fruit) is added to assist Yang. In cases of prolonged diarrhea during pregnancy leading to sinking of Yuan Qi (Original Qi), accompanied by fever, thirst, and limb fatigue, Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) should be employed. Mi Zhai treated diarrhea during pregnancy primarily by tonifying the Middle and calming the fetus using Jiawei Sijunzi Tang (Modified Four-Gentleman Decoction); for patients with prolonged diarrhea and severe thirst, Renshen Baizhu San (Ginseng and Atractylodes Macrocephala Powder) was prescribed with excellent results.
Weifeng Tang treats wind-cold invading the intestines and stomach due to deficiency, causing inability to retain rice and grain, profuse watery diarrhea, and intestinal-stomach damp-toxin, resulting in stools resembling bean curd dregs, dark blood, or fish brain matter, occurring day and night without limit.
Ingredients: Renshen (Ginseng Root), Baizhu (Atractylodes Macrocephala Rhizome, stir-fried with soil), Fuling (Poria), Danggui (Angelica Sinensis Root), Chuanxiong (Ligusticum Chuanxiong Rhizome), Shaoyao (Peony Root, stir-fried), Rougui (Cinnamon Bark) (all in equal proportions).
Usage: Add a pinch of Setaria Italica Grain, decoct in water and take orally. If abdominal pain occurs, add Muxiang (Aucklandiae Radix). This formula is truly ingenious for treating Qi and Blood deficiency caused by prolonged diarrhea. However, Rougui is absolutely contraindicated for those without chronic cold in the viscera. The name "Stomach Wind" implies benefiting the Stomach and lifting the clear Yang. Rougui in this formula is contraindicated for the fetus; if unavoidable, it may be stir-fried or replaced with Guitan (Charred Cinnamon Bark). Similarly, Rougui in Weiling Tang must be used with caution.
Jiawei Lizhong Tang treats cold sensation below the umbilicus and severe watery diarrhea during pregnancy.
Ingredients: Renshen, Baizhu (stir-fried with soil), Baishao (White Peony Root), Fuling, Ganjiang (Dried Ginger), Huanglian (Coptis Rhizome), Muxiang, Huoxiangye (Agastache Leaf), Hezirou (Chebula Fruit Flesh), Roudoukou (Nutmeg, baked in flour), Gancao (Licorice Root) (each 1 qian).
Usage: Three slices of Shengjiang (Fresh Ginger), two dates, decoct in two zhong of water until one zhong remains; take when hungry.
Jiawei Zhizhong Tang treats diarrhea caused by excessive food intake leading to insufficient Qi of the Spleen and Stomach and impaired transportation.
Ingredients: Renshen, Baizhu (stir-fried with soil), Paojiang (Prepared Ginger), Gancao (each 1 qian); Chenpi (Tangerine Peel), Qingpi (Green Tangerine Peel) (each 0.7 qian); Sharen (Amomum Fruit) (0.5 qian).
Usage: Decoct in water and take orally.
Siling San (with Wuling San attached) treats restive summer-heat causing irritability, thirst, and watery diarrhea.
Ingredients: Baizhu (stir-fried with soil), Zhuling (Polyporus), Zexie (Alisma Rhizome), Fuling.
Usage: Grind into powder in equal proportions; mix with rice drink and take orally. Adding Rougui to this formula creates Wuling San (Five-Ingredient Powder with Cinnamon).
Buhuanjin Zhengqi San treats dampness-injury diarrhea in pregnant women.
Ingredients: Cangzhu (Atractylodis Rhizoma, processed), Nongpu (Magnolia Bark, processed with ginger juice), Chenpi, Huoxiang, Banxia (Pinellia Tuber, processed) (each 1 qian); Gancao (0.5 qian).
Usage: Use Fresh Ginger and dates as guides; decoct in water and take orally.
Weiling Tang treats excessive Spleen dampness, disharmony of Stomach Qi, abdominal pain, diarrhea, indigestion of water and grain, and confusion of Yin and Yang. It is a combined formula of Pingwei San (Stomach-Pacifying Powder) and Wuling San.
Ingredients: Cangzhu, Nongpu, Chenpi, Baizhu (stir-fried with soil), Fuling, Zhuling, Zexie (each 1 qian); Guangui (Official Cinnamon Bark), Zhigancao (Honey-fried Licorice Root) (each 0.5 qian).
Usage: Three slices of Fresh Ginger, two dates; decoct in water and take well after meals. Since the formula contains Gui (Cinnamon), it is contraindicated for pregnant women; alternatively, Buhuanjin Zhengqi San is more appropriate.
Jiawei Liujunzi Tang:
Ingredients: Renshen (dose as appropriate), Baizhu (1 qian or 1.5 qian, stir-fried with soil), Fuling (1 qian), Chenpi (0.8 qian), Banxia (1 qian), Zhigancao (0.5 qian).
Usage: Use Fresh Ginger as a guide; decoct in water and take orally. For injury from rice, add Guya (Sprouted Rice); for injury from wheat, add Maiya (Sprouted Barley); for injury from meat, add Shanzha (Hawthorn Fruit). If Liver Wood insults Spleen Earth, accompanied by alternating chills and fever with vomiting, add Chaihu (Bupleurum Root) and Fresh Ginger. If accompanied by vomiting, abdominal pain, and cold limbs (Cold Water insulting Spleen Earth), add Ginger and Cinnamon. If stool is yellow (the true color of Spleen Earth), add Muxiang and Wei Rouguo (Baked Myristica Seed). If vomiting and anorexia occur with abdominal pain and aversion to cold (Spleen Earth deficiency-cold), add Muxiang, Ginger, and Cinnamon.
Mi Zhai's Jiawei Sijunzi Tang treats diarrhea during pregnancy, focusing on tonifying the Middle and calming the fetus.
Ingredients: Renshen, Baizhu (stir-fried with soil), Fuling (each 1 qian), Zhigancao (0.8 qian).
Usage: Decoct in water and take orally. For pregnancy diarrhea, add 1 qian of Chao Baishao (Stir-fried White Peony Root) to further differentiate between cold and heat syndromes. If there is fever and thirst, it is a heat syndrome; add 1 qian of Tiao Qin (Scutellaria Baicalensis Root). If there is no thirst, it is a cold syndrome; add 0.5 qian of Chao Hei Ganjiang (Stir-fried Blackened Dried Ginger), using one Wu Mei (Chinese Plum) as a guide; decoct in water and take before meals. For prolonged diarrhea with thirst that does not cease, add Jiuchao Baishao (Wine-stir-fried White Peony Root), Hezirou, Chao Ganjiang, and two pitted Wu Meis; decoct in water and take before meals. Alternatively, Renshen Baizhu San is also effective.
Renshen Baizhu San treats prolonged diarrhea with severe thirst.
Ingredients: Renshen, Baizhu (stir-fried with soil), Fuling, Zhigancao (each 1 qian), Huoxiang, Muxiang, Ganjiang (each 0.5 qian).
Usage: Decoct in water; administer frequently to replace soups and fluids, which yields good effects.
Buzhong Yiqi Tang (see the section on various pains in this volume).