7.产后痢名产子痢, 饮食生冷暑寒干, 里急后重有余病, 日久滑脱
不足看. 赤黄稠粘多是热, 清彻鸭溏定属寒, 寒热温清调补涩, 虚实
新久要详参.
【注】产后痢者, 名产子痢. 多因饮食不调, 贪食生冷, 或起居不慎
,冲寒受暑所致. 若腹中?? 痛, 里急后重者, 属有余之证; 若日久
虚寒滑脱者, 属不足之证. 痢色黄赤稠粘, 多属于热; 清稀澄彻如鸭
粪,则属于寒. 治之之法: 热者清之, 寒者温之, 冷热不和者调之,
虚者补之, 实者泻之, 虚实新久之间, 宜细心详参也.
槐连四物汤 芍药汤 真人养藏汤
8.热痢槐连四物效, 冷热有余芍药汤, 芍药芩连归木草, 枳桂坠槟
痛大黄. 虚寒滑脱参术桂, 芍药诃寇广木香, 甘草粟壳名养脏, 日久
十全大补汤.
【注】热者清之, 故热痢宜槐连四物汤, 即四物汤加槐花, 黄连, 以
清热而坚肠也. 冷热不和者调之, 故宜芍药汤, 即白芍药, 黄芩, 黄
连,当归, 木草, 甘草, 肉桂, 槟榔. 坠者倍加槟榔, 痛加生大黄也
.若虚寒滑脱, 则宜温补而固涩之, 宜真人养脏汤, 即人参, 白术,
白芍药, 肉桂, 肉豆蔻, 诃子, 木香, 甘草, 罂粟壳, 同煎服也. 若
日久不止, 气血大虚, 宜十全大补汤补之.
四物汤 十全大补汤 方俱见首卷
人参败毒散 香连丸 加味四物汤
9.有表痢用败毒散, 羌独枳梗共柴前, 参苓芎草姜葱引; 暑湿成痢
用香连, 血渗大肠成血痢, 四物胶榆余□添.
【注】外感风寒成痢者, 宜人参败毒散, 即羌活, 独活, 枳壳, 桔梗
,柴胡, 前胡, 人参, 茯苓, 川芎, 甘草, 姜, 葱引也. 若因暑湿致
痢,宜香连丸, 即黄连, 木香, 为丸也. 若败血渗入大肠成血痢者,
宜四物加阿胶, 地榆, 血余, 乌□鱼骨服之.
四物汤方见首卷
7. 产后痢疾称为“产子痢”，多因饮食生冷、暑热或寒邪干扰所致。若出现里急后重（腹痛窘迫，时时欲泻，肛门重坠），属于有余（实证）的病证；若病程日久，出现滑脱不禁（大便失禁或久泻不止），则属于不足（虚证）的范畴。痢下赤黄色且稠粘，大多属于热证；痢下清稀澄澈如鸭粪状，则定属寒证。治疗时应根据寒、热、温、清、调、补、涩等不同治法进行调理，对于虚实夹杂以及新病久病的情况，需要仔细辨证参详。
【注】产后痢疾，名为产子痢。多因饮食不调，贪食生冷食物，或者起居不慎，受风寒侵袭或中暑所致。如果腹中疼痛，伴有里急后重症状，属于有余（实证）的证候；如果病程日久，表现为虚寒且滑脱不禁，属于不足（虚证）的证候。痢疾颜色黄赤且稠粘，多归属于热证；痢下清稀澄澈如同鸭粪，则归属于寒证。治疗的方法：热证用清热法，寒证用温里法，寒热错杂者用调和法，虚证用补益法，实证用泻实法，在虚实、新病与久病的辨别上，应当细心详细参详。
8. 热痢使用槐连四物汤疗效显著，冷热不和及实证可用芍药汤。芍药汤由白芍、黄芩、黄连、当归、木香、甘草组成，枳壳、肉桂、槟榔用于行气导滞，痛甚加生大黄以通腑泄热。虚寒滑脱证用人参、白术、肉桂温补，配合芍药、诃子、肉豆蔻、广木香固涩止泻，加上甘草和罂粟壳即名为真人养脏汤；若病程日久，可用十全大补汤。
【注】热证应当清热，所以热痢适宜用槐连四物汤，即在四物汤基础上加入槐花、黄连，用以清热并坚固肠道。冷热不和者应当调和，所以适宜用芍药汤，即由白芍药、黄芩、黄连、当归、木香、甘草、肉桂、槟榔组成。“坠”指倍加槟榔以增强行气导滞之力，“痛”指加生大黄以缓解疼痛。如果是虚寒滑脱，则适宜用温补兼固涩的方法，适宜用真人养脏汤，即由人参、白术、白芍药、肉桂、肉豆蔻、诃子、木香、甘草、罂粟壳共同煎服。如果病程日久不止，气血严重亏虚，适宜用十全大补汤来补益。
9. 若有表证（外感症状）的痢疾，使用人参败毒散，由羌活、独活、枳壳、桔梗、柴胡、前胡、人参、茯苓、川芎、甘草组成，生姜、葱白为引；若是暑湿引起的痢疾，使用香连丸；若败血渗入大肠形成血痢，可在四物汤基础上加入阿胶、地榆、血余炭等药物加减治疗。
【注】外感风寒导致痢疾者，适宜用人参败毒散，即由羌活、独活、枳壳、桔梗、柴胡、前胡、人参、茯苓、川芎、甘草组成，生姜、葱白作为药引。如果因暑湿导致痢疾，适宜用香连丸，即由黄连、木香制成丸剂。如果是瘀血渗入大肠形成血痢者，适宜用四物汤加入阿胶、地榆、血余炭、乌贼骨服用。
四物汤方剂见本书首卷
7. Dysentery occurring after childbirth is called "postpartum dysentery" (Chan Zi Li). It is often caused by dietary intake of raw and cold foods, or interference from summer-heat or cold pathogens. If symptoms include tenesmus (Li Ji Hou Zhong - urgent need to defecate with a feeling of incomplete evacuation and heaviness in the anus), it belongs to an excess (Shi Zheng) syndrome; if the disease persists for a long time leading to incontinence or chronic diarrhea without control (Hua Tuo), it belongs to a deficiency (Xu Zheng) category. Dysentery that is red-yellow, thick, and sticky mostly indicates a heat syndrome; dysentery that is clear, thin, and watery like duck feces definitely indicates a cold syndrome. Treatment should be adjusted according to methods such as clearing heat, warming cold, harmonizing, tonifying, and astringing. The conditions of excess vs. deficiency, and acute vs. chronic onset, must be carefully differentiated and analyzed.
[Annotation] Postpartum dysentery, named Chan Zi Li, is mostly caused by irregular diet, craving for raw and cold foods, or careless living habits leading to exposure to wind-cold or summer-heat. If there is abdominal pain accompanied by tenesmus, it belongs to an excess syndrome; if the disease has lasted for a long time presenting with deficiency-cold and incontinence, it belongs to a deficiency syndrome. Yellow-red and thick/sticky dysentery color mostly belongs to heat syndrome; clear, thin, and watery dysentery resembling duck feces belongs to cold syndrome. The treatment principles are: clear heat for heat syndromes, warm interior for cold syndromes, harmonize for mixed cold-heat patterns, tonify for deficiency syndromes, and drain/excess for excess syndromes. One must carefully analyze the nuances between excess/deficiency and new/chronic diseases.
Huailian Siwu Decoction Shaoyao Tang Zhenren Yangzang Tang
8. Huailian Siwu Decoction is effective for heat dysentery; Shaoyao Tang is used for mixed cold-heat and excess conditions. Shaoyao Tang consists of Bai Shao (Radix Paeoniae Alba), Huang Qin (Scutellariae Radix), Huang Lian (Coptidis Rhizoma), Dang Gui (Angelicae Sinensis Radix), Mu Xiang (Aucklandiae Radix), and Gan Cao (Glycyrrhizae Radix et Rhizoma); Zhi Ke (Aurantii Fructus), Rou Gui (Cinnamomi Cortex), and Bing Lang (Arecae Semen) are used to promote qi movement and guide stagnation downward; Sheng Da Huang (Rhei Radix et Rhizoma) is added for severe pain to purge heat and unblock the bowels. For deficiency-cold with incontinence, Ren Shen (Ginseng Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), and Rou Gui are used for warming and tonifying, combined with Bai Shao, He Zi (Terminalia Chebulae Fructus), Rou Dou Kou (Myristicae Semen), and Guang Mu Xiang for astringing and stopping diarrhea. Adding Gan Cao and Ying Su Qiao (Papaveris Capsicum) constitutes Zhenren Yangzang Tang. If the condition persists for a long time, Shiquan Dabu Tang may be used.
[Annotation] Since heat syndromes require clearing, heat dysentery is suitable for Huailian Siwu Decoction, which is Siwu Tang plus Huai Hua (Sophorae Flos) and Huang Lian, to clear heat and strengthen the intestines. For mixed cold-heat patterns requiring harmonization, Shaoyao Tang is suitable, composed of Bai Shao Yao, Huang Qin, Huang Lian, Dang Gui, Mu Xiang, Gan Cao, Rou Gui, and Bing Lang. "Zhuì" (descending/purging) implies increasing the dosage of Bing Lang to enhance the guiding of stagnation; "Tòng" (pain) implies adding Sheng Da Huang to relieve pain. If deficiency-cold with incontinence occurs, warming, tonifying, and astringing methods are appropriate, using Zhenren Yangzang Tang, composed of Ren Shen, Bai Zhu, Bai Shao Yao, Rou Gui, Rou Dou Kou, He Zi, Mu Xiang, Gan Cao, and Ying Su Qiao decocted together. If the disease persists for a long time causing severe deficiency of qi and blood, Shiquan Dabu Tang is suitable for tonification.
Siwu Tang Shiquan Dabu Tang Formulas are found in the first volume.
Renshen Baidu San Xianglian Wan Jiawei Siwu Tang
9. For dysentery accompanied by exterior syndromes, Renshen Baidu San is used, consisting of Qiang Huo, Du Huo, Zhi Ke, Jie Geng, Chai Hu, Qian Hu, Ren Shen, Fu Ling, Chuan Xiong, and Gan Cao, with Sheng Jiang (Zingiberis Rhizoma Recens) and Cong Bai (Allii Fistulosii Bulbus) as guides. For dysentery caused by summer-heat and dampness, Xianglian Wan is used. If stagnant blood infiltrates the large intestine forming bloody dysentery, Siwu Tang can be modified by adding E Jiao (Colla Corii Asini), Di Yu (Sanguisorbae Radix), Xue Yu Tan (Spuma Sanguinis Humanis), etc.
[Annotation] For dysentery caused by external contraction of wind-cold, Renshen Baidu San is suitable, composed of Qiang Huo, Du Huo, Zhi Ke, Jie Geng, Chai Hu, Qian Hu, Ren Shen, Fu Ling, Chuan Xiong, and Gan Cao, with Sheng Jiang and Cong Bai as guides. If dysentery is caused by summer-heat and dampness, Xianglian Wan is suitable, composed of Huang Lian and Mu Xiang made into pills. If stagnant blood infiltrates the large intestine resulting in bloody dysentery, Siwu Tang added with E Jiao, Di Yu, Xue Yu Tan, and Wu Zei Gu (Sepiae Endoconcha) is suitable for administration.
Siwu Tang formula is found in the first volume.