〔大〕夫妊娠大小便不通，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〕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。亚卿李蒲汀侧室，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。主政王天成之内，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
遥散加车前子而瘥。
《短剧》疗妊娠子淋，大小便并不利，气急，已服猪苓散不瘥，宜服甘遂散下之。
甘遂散方
用泰山赤皮甘遂（二两）
上一味为末，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。（《经心录》同。此药太峻，不可轻用。）
猪苓散 疗妊娠小便涩痛，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，服前药。
葵子汤 （《古今录验》二方。）治妊娠得病六七日以上，身热入脏，大小便不利，安胎除热。
葵子（二升） 滑石（四两，碎）
上以水五升，煮取一升，去滓尽服，须臾当下，便愈。
又方 葵子（一合） 川朴硝（二两） 每服三钱，水煎温服。
治妊娠大小便不通，心腹胀满妨闷，不欲饮食，手足烦热。
槟榔 赤茯苓 大腹皮 木通 郁李仁（去皮尖） 北五味（各一两） 桑寄生
甘草 苦梗（各半两）
上为粗末，每服三钱，水一盏，煎至六分，温服。
治妊娠大小便不通，热闭心膈，腹胁胀闷，妨害饮食。
大黄 木通 槟榔（各一两） 枳壳（七钱半） 大腹子（三枚） 诃子（四个，去核，半生半煨）
上为末，以童便一盏，葱白二寸，同煎至六分，调下二钱。
当归散 治胎前诸疾，或因怒中气冲子脏或冲脬脉，腹急肚胀，腰腹时疼，不思饮
食，四肢浮肿，气急时喘，大便忽难，小便忽涩，产门忽肿。
当归（一两） 赤茯苓 枳壳 白芍药 川芎（各二两） 川白姜（炮） 木香（煨） 粉草（各半两）
上 咀，每服三大钱，水一盏半，生姜三片，煎至八分，去滓无时温服。如禀受气
弱及南人，枳壳减半。如气实及北人，于内加分两服之。或连日大便秘涩，加蜜同煎。
初虞世治妊娠大便秘涩方。
枳壳（三两） 防风（二两） 炙草（一两）
上为细末，沸汤点服一二钱，空心日三。
又治虚羸大便秘方。
枳壳（制） 阿胶（炒，各等分）
上为细末，炼蜜和剂，杵二三千下，丸如梧子大，别研滑石末为衣。温汤下二十丸，
半日来未通，再服三十丸，止于五十丸。
又方
车前子（一两） 大黄（炒，半两）
上为细末，每服三钱，空心蜜汤调下。
大腹皮汤 治妊妇大小便不通。
枳壳 大腹皮 赤茯苓（各一两） 甘草（二钱）
上为末，葱白汤调下二钱。
《补遗》局方八正散 治妊妇心经蕴热，脏腑秘结，大肠不通，小便赤涩癃闭。（见杂病
淋。）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，其它亦宜审订而用之。仍味薛氏之说，而参之以杂病诸方法，庶无误也。
【大】妊娠期间出现大小便不通，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据此用药治疗。
【薛】上述证候如果是大肠血燥，使用四物汤（Four-Item Decoction）加入条芩、桃仁。如果是大肠气滞，使用紫苏饮（Perilla Infusion）加入杏仁、条芩。如果是肠胃气虚，使用六君子汤（Six-Gentlemen Decoction）加入紫苏、杏仁。如果是肝脾蕴热，使用龙胆泻肝汤（Gentian Liver-Draining Decoction）。如果是心肝虚热，使用加味逍遥散（Modified Free and Easy Wanderer Powder）加入车前子。亚卿李蒲汀的侧室，妊娠期间大小便不利，有人使用降火理气的药剂，导致元气反而虚弱，肝脉弦急，脾脉迟滞，观察其面色，青黄无光泽。我说：这是由郁怒所致，以加味归脾汤（Modified Gui Pi Decoction）为主方，佐以加味逍遥散而痊愈。主政王天成的妻子，妊娠期间患痢疾，病愈后二便不通，其家世代行医，自行使用清热药剂无效。我诊察其脉象浮大而涩，这是气血虚弱的表现。早晨服用八珍汤（Eight-Treasure Decoction）加入桃仁、杏仁，晚上服用加味逍遥散加入车前子而康复。
《短剧》记载治疗妊娠子淋（妊娠期小便淋沥涩痛），大小便均不利，气急，已经服用猪苓散（Polyporus Powder）未见效，适宜服用甘遂散（Kansui Powder）攻下。
甘遂散方
使用泰山赤皮甘遂（二两）
将以上一味药研为细末，用白蜜二合调和，每次服用如豆大一粒，感到心下烦闷，轻微腹泻的，每日服用一次。泻下之后，再服用猪苓散。若不能泻下，每日两次，逐渐增加至半钱，以轻微通利为度。（与《经心录》相同。此药过于峻猛，不可轻易使用。）
猪苓散 治疗妊娠小便涩痛，兼治胎水（妊娠期水肿）。
猪苓（五两，去皮） 研为细末，用开水调服一方寸匕，可增至二方寸匕，每日三次，夜间两次。若未见效，适宜改用攻下药，服用前面的药物。
葵子汤 （出自《古今录验》两个方子。）治疗妊娠患病六七天以上，邪热入脏，大小便不利，安胎除热。
冬葵子（二升） 滑石（四两，捣碎）
以上用水五升，煮取一升，去渣尽服，不久应泻下，病即愈。
又一方 冬葵子（一合） 川朴硝（二两） 每次服用三钱，水煎温服。
治疗妊娠大小便不通，心腹胀满憋闷，不想饮食，手足烦热。
槟榔 赤茯苓 大腹皮 木通 郁李仁（去皮尖） 北五味子（各一两） 桑寄生 甘草 桔梗（各半两）
以上为粗末，每次服用三钱，水一盏，煎至六分，温服。
治疗妊娠大小便不通，热闭心膈，腹胁胀闷，妨害饮食。
大黄 木通 槟榔（各一两） 枳壳（七钱半） 大腹子（三枚） 诃子（四个，去核，半生半煨）
以上为细末，用童子尿一盏，葱白二寸，同煎至六分，调服二钱。
当归散 治疗产前诸疾，或因愤怒中气冲犯子宫或冲任脉，腹部拘急肚胀，腰腹时常疼痛，不思饮食，四肢浮肿，气急时喘，大便忽然困难，小便忽然涩滞，产门忽然肿胀。
当归（一两） 赤茯苓 枳壳 白芍药 川芎（各二两） 川白姜（炮制） 木香（煨制） 粉草（各半两）
以上切碎，每次服用三大钱，水一盏半，生姜三片，煎至八分，去渣随时温服。如果禀赋气弱及南方人，枳壳减半。如果气实及北方人，在其中增加分量服用。或者连续几天大便秘涩，加蜂蜜同煎。
初虞世治疗妊娠大便秘涩方。
枳壳（三两） 防风（二两） 炙甘草（一两）
以上为细末，用沸水冲服一二钱，空腹每日三次。
又治疗虚羸大便秘结方。
枳壳（制） 阿胶（炒，各等分）
以上为细末，炼蜜和剂，杵捣二三千下，丸如梧桐子大，另研滑石末为衣。温水送下二十丸，半天未通，再服三十丸，最多止于五十丸。
又一方
车前子（一两） 大黄（炒，半两）
以上为细末，每次服用三钱，空腹蜜汤调下。
大腹皮汤 治疗妊妇大小便不通。
枳壳 大腹皮 赤茯苓（各一两） 甘草（二钱）
以上为末，葱白汤调服二钱。
《补遗》局方八正散 治疗妊妇心经蕴热，脏腑秘结，大肠不通，小便赤涩癃闭。（见杂病淋。）以上陈良甫氏所录诸方，今并存之。纳入甘遂、朴硝，非到实证危重，不得已而为之，不可轻用，其他也适宜审慎订正后使用。仍品味薛氏的说法，并参考杂病诸方法，才没有错误。
[Da] During pregnancy, the obstruction of both urination and defecation 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 there is heat in both the Large and Small Intestines, both urination and defecation will be obstructed. One should further investigate the etiology and prescribe medication accordingly.
[Xue] In the aforementioned conditions, if it is due to blood dryness in the Large Intestine, use Siwu Tang (Four-Item Decoction) with added Huangqin (Scutellariae Radix, Baical Skullcap Root) and Taoren (Persicae Semen). If it is due to Qi stagnation in the Large Intestine, use Zisu Yin (Perilla Infusion) with added Xingren (Armeniacae Semen Amarum) and Huangqin. If it is due to Qi deficiency in the Stomach and Intestines, use Liujunzi Tang (Six-Gentlemen Decoction) with added Zisu (Perillae Folium) and Xingren. If it is due to latent heat in the Liver and Spleen, use Longdan Xiegan Tang (Gentian Liver-Draining Decoction). If it is due to deficient heat in the Heart and Liver, use Jiawei Xiaoyao San (Modified Free-and-Easy Wanderer Powder) with added Cheqianzi (Plantaginis Semen). The concubine of Vice Minister Li Puting suffered from difficulty in urination and defecation during pregnancy. Others administered herbs to clear fire and regulate Qi, which instead depleted her Yuan Qi. Her Liver pulse was wiry and tense, and her Spleen pulse was slow and sluggish. Upon observing her complexion, it appeared greenish-yellow and lusterless. I said: "This is caused by depression and anger." I used Jiawei Guipi Tang (Modified Return-to-Spleen Powder) as the main formula, assisted by Jiawei Xiaoyao San, resulting in recovery. The wife of Director Wang Tiancheng suffered from dysentery during pregnancy. After recovery, she experienced obstruction of both urination and defecation. Her family were physicians for generations, and they self-administered heat-clearing herbs without effect. I palpated her pulse as floating, large, and choppy, indicating a deficiency of Qi and Blood. In the morning, she took Bazhen Tang (Eight-Treasure Decoction) with added Taoren and Xingren; in the evening, she took Jiawei Xiaoyao San with added Cheqianzi, leading to cure.
*Dujuan* records the treatment of *Zilin* (dysuria during pregnancy) where both urination and defecation are obstructed, accompanied by shortness of breath. Since Zhuling San (Polyporus Powder) failed to cure, Gansui San (Kansui Powder) should be used to purge.
Formula for Gansui San
Use Taishan Chipi Gansui (2 liang).
Grind the above single herb into powder. Mix with 2 he of white honey and take one pill-sized dose (size of a bean). If one feels vexation in the epigastrium and experiences slight purging, take once daily. After purging, resume taking Zhuling San. If no purging occurs, take twice daily, gradually increasing to half qian, stopping when mild laxation is achieved. (Same as *Jingxin Lu*. This medicine is too harsh and should not be used lightly.)
Zhuling San treats painful and difficult urination during pregnancy and also addresses fetal edema (*Taishui*).
Zhuling (5 liang, peeled). Grind into powder. Mix with hot water and take one cun-bi (square-inch measure), increasing to two cun-bi. Take three times daily and twice at night. If ineffective, switch to purgatives and take the previous medicines.
Kuizi Tang (Two formulas from *Gujin Luyan*) treats pregnancy illness lasting more than six or seven days, where pathogenic heat enters the Zang organs, causing obstruction of urination and defecation. It calms the fetus and clears heat.
Dongkuizi (2 sheng) Huashi (4 liang, crushed).
Boil the above in 5 sheng of water until reduced to 1 sheng. Strain and drink completely. Purging should occur shortly after, and the condition will resolve.
Another Formula: Dongkuizi (1 he) Puxiao (2 liang). Take 3 qian per dose, decoct in water and take warm.
Treats obstruction of urination and defecation during pregnancy, with fullness and oppression in the heart and abdomen, loss of appetite, and vexatious heat in the hands and feet.
Bolang (Arecae Semen) Chi Fuling (Red Polyporus) Dafupi (Tangeris Pericarpium) Mutong (Akebiae Caulis) Yuliren (Pruni Semen) Bei Wuwei (Schisandrae Fructus) Sangjisheng (Taxilli Herba) Gancao (Licorice Root) Kugeng (Platycodonis Radix) [Each 1 liang except Sangjisheng, Gancao, Kugeng which are 0.5 liang].
Grind into coarse powder. Take 3 qian per dose, decoct in 1 cup of water until reduced to 60%, and take warm.
Treats obstruction of urination and defecation during pregnancy, with heat closing the heart and diaphragm, abdominal and hypochondriac distension and oppression, interfering with eating.
Dahuang (Rhei Radix et Rhizoma) Mutong Bolang [Each 1 liang] Zhike (Aurantii Fructus) Dafuzi (Tangeris Pericarpium) Hezi (Chebulae Fructus) [Grind into fine powder. Decoct with 1 cup of child's urine and 2 cun of scallion white until reduced to 60%. Mix and take 2 qian.]
Danggui San treats various pre-partum disorders, such as Qi rushing to the uterus or Chong and Ren vessels due to anger, causing abdominal urgency and distension, intermittent lower back and abdominal pain, anorexia, edema of the four limbs, shortness of breath with wheezing, sudden difficulty in defecation, sudden difficulty in urination, and sudden swelling of the birth canal.
Danggui (1 liang) Chi Fuling Zhike Baishao Chuanxiong [Each 2 liang] Chuan Baijiang (Pounded) Muxiang (Stewed) Fengcao (Licorice Root) [Each 0.5 liang].
Chop coarsely. Take 3 da qian per dose, decoct in 1.5 cups of water with 3 slices of fresh ginger until reduced to 80%. Strain and take warm at any time. For those with weak constitution or Southerners, reduce Zhike by half. For those with excess Qi or Northerners, increase the dosage within the formula. If constipation persists for several days, add honey and decoct together.
Chu Yushi's formula for treating constipation during pregnancy.
Zhike (3 liang) Fangfeng (2 liang) Zhigancao (1 liang).
Grind into fine powder. Take 1-2 qian with boiling water, three times daily on an empty stomach.
Another formula for treating constipation due to emaciation and deficiency.
Zhike (Processed) Ejiao (Fried) [Equal parts].
Grind into fine powder. Mix with refined honey, pound 2,000-3,000 times, and form pills the size of mulberry seeds. Coat with powdered Huashi. Take 20 pills with warm water. If no bowel movement after half a day, take another 30 pills, up to a maximum of 50 pills.
Another Formula: Cheqianzi (1 liang) Dahuang (Fried, 0.5 liang).
Grind into fine powder. Take 3 qian per dose with honey water on an empty stomach.
Dafupi Tang treats obstruction of urination and defecation in pregnant women.
Zhike Dafupi Chi Fuling [Each 1 liang] Gancao (2 qian).
Grind into powder. Take 2 qian mixed with scallion white water.
*Buyi* Ju Fang Bazen San treats heat accumulation in the Heart Meridian in pregnant women, organ constipation, Large Intestine obstruction, and red, scanty, or obstructed urination. (See Miscellaneous Diseases: Lin Syndrome.) The above formulas recorded by Chen Liangfu are preserved here. Adding Gansui and Puxiao is only for severe excess patterns in critical conditions, out of necessity; do not use lightly. Other formulas should also be carefully reviewed before use. Following Master Xue's advice and referencing miscellaneous disease methods ensures accuracy.