《大全》云∶娠妊饮食生冷，脾胃不能克化，致令心腹疼痛。若血分病则色赤，若气分
病则色白，气血俱病则赤白相杂。若热乘大肠，血虚受患，则成血痢也。
薛氏曰∶治痢之法当参前篇。其下黄水乃脾土亏损，真气下陷也，当升补中气。若黄而
兼青
，乃肝木克脾土，宜平肝补脾。若黄而兼白，乃子令母虚，补脾胃为主。兼黄而兼黑，是水
反侮土矣，必温脾胃。若黄而兼赤，乃心母益子，但用补中益气。若肠胃虚弱，风邪客之，
用胃风汤。或胎气不安，急补脾胃，胎自安矣。凡安胎之药，当临病制宜，不必拘于阿胶、
艾叶之类。
(附子淋、转胞、遗尿)
《大全》云∶妊娠小便不通，为小肠有热，热传于胞而不通耳。兼心肺气滞则致喘急。
陈无
择云∶娠妇胎满逼胞，多致小便不利。若心肾气虚，清浊相干，则为诸淋。若胞系了戾，小
便不通，名曰转胞。若胎满尿出，名曰遗尿。
丹溪曰∶转胞病，胎妇禀受弱者、忧闷多者、性躁急者、食浓味者，大率有之。古方皆
用滑
利流通之药，鲜有应效，因思胞为胎所压，转在一边，胞系了戾不通耳。胎若举起，悬在中
央，胞系得疏，水道自行。
立斋曰∶前症亦有脾肺气虚不能下输膀胱者，亦有气热郁结膀胱，津液不利者，亦有金
为火烁，脾土湿热甚而不利者，更当详细施治。
《大全》云∶娠妊小便淋者，乃肾与膀胱虚热不能制水。然娠妊胞系于肾，肾间虚热而
成斯
症，甚者心烦闷乱，名曰子淋也。万密斋曰∶子淋之病须分二症∶一则娠母自病，一则子为
母病。然娠母自病又分二病∶或服食辛热因生内热者，或自汗自利津液燥者。其子为母病者
亦分二症∶或胎气壅热者，或胎形迫塞者。症既不同，治亦有别也。大抵热则清之，燥则润
之，壅则通之，塞则行之，此治之法也。
立斋云∶前症若涩少淋沥，用安荣散。若腿足转筋而小便不利，急用八味丸，缓则不救
矣。
若服燥剂而小便频数或不利，用生地、茯苓、牛膝、甘草、知、柏、芎、归。若频而色黄，
用四物加黄柏、知母、五味、门冬、元参。若肺
气虚而短少者，用补中益气汤加山药、门冬。若阴挺痿痹而频数，宜地黄丸。若热结膀胱而
不利，用五苓散。若脾肺燥不能生化，宜黄芩清肺饮。若膀胱阳虚，阴无所生，用滋肾丸。
若膀胱阴虚，阳无所化，肾气丸。
《妇人大全良方》说：妊娠期间饮食生冷之物，脾胃无法运化消化，导致心腹疼痛。如果病在血分，则大便颜色发赤；如果病在气分，则大便颜色发白；气血两伤，则赤白相杂。如果热邪侵袭大肠，加之血虚患病，就会形成血痢。
薛己（薛氏）说：治疗痢疾的方法应当参考前文篇章。如果排出黄色水样便，这是脾土亏损、真气下陷所致，应当升提补益中气。如果黄色中兼见青色，这是肝木克制脾土，适宜平抑肝木、补益脾土。如果黄色中兼见白色，这是子病及母（脾为肺之母，此处指五行相生关系中的母子虚损），应以补益脾胃为主。如果黄色中兼见黑色，这是水反侮土（肾水反克脾土），必须温补脾胃。如果黄色中兼见红色，这是心火生助脾土（心为脾之母，此处指母病及子或母实子实之象，原文意指心火偏盛影响脾胃，但结合上下文“补中益气”及五行逻辑，通常理解为心脾相关，此处依原文直译并保留中医逻辑），仅使用补中益气法即可。如果肠胃虚弱，风邪客居其中，使用胃风汤。如果胎气不安，急需补益脾胃，胎气自然安定。凡是安胎的药物，应当根据具体病情灵活制定，不必拘泥于阿胶、艾叶之类的药物。
《妇人大全良方》说：妊娠期小便不通，是因为小肠有热，热邪传至膀胱（胞宫/膀胱区域）导致不通畅。如果兼有心肺气机阻滞，就会导致气喘急促。
陈无择（陈言）说：孕妇胎儿胀满压迫膀胱，多导致小便不利。如果心肾气虚，清浊之气相互干扰，就会形成各种淋证。如果膀胱系带扭曲不顺，小便不通，名叫转胞。如果胎儿胀满尿液流出，名叫遗尿。
朱震亨（丹溪）说：转胞这种病，多见于禀赋薄弱的孕妇、忧愁郁闷多的孕妇、性情急躁的孕妇、食用浓味厚腻食物的孕妇，大抵都有这种情况。古方都使用滑利流通的药物，很少有见效的，我思考认为膀胱被胎儿压迫，偏向一侧，膀胱系带扭曲不通畅。如果将胎儿托起，悬于中央，膀胱系带得以舒展，水道自然通畅。
薛己（立斋）说：上述病症也有因脾肺气虚，不能向下输注到膀胱的；也有因气热郁结在膀胱，津液运行不利的；也有因肺金被火灼烧，脾土湿热严重而导致不利的，更应当详细施治。
《妇人大全良方》说：妊娠期小便淋沥涩痛，是肾与膀胱虚热不能制约水液。然而妊娠期间膀胱系带连属于肾，肾间产生虚热而形成此症，严重的会出现心烦闷乱，名叫子淋。
万密斋说：子淋这种疾病必须分为两种情况：一种是孕妇自身患病，一种是胎儿受母亲影响而致病。然而孕妇自身患病又分为两种病因：或者是服用辛热食物导致内生热邪，或者是自汗、腹泻导致津液干燥。胎儿受母亲影响而致病的也分为两种情况：或者是胎气壅滞发热，或者是胎形压迫阻塞。症状既然不同，治疗方法也有区别。大致原则是：热则清热，燥则润燥，壅滞则通利，阻塞则行散，这就是治疗的方法。
薛己（立斋）说：上述病症如果出现小便涩少、淋沥不尽，使用安荣散。如果出现腿足抽筋且小便不利，紧急使用八味丸，拖延则无法救治了。
如果服用燥性药物后出现小便频数或不利，使用生地、茯苓、牛膝、甘草、知母、黄柏、川芎、当归。如果频数且颜色发黄，使用四物汤加黄柏、知母、五味子、麦冬、玄参。如果肺气虚导致尿量短少，使用补中益气汤加山药、麦冬。如果阴部下垂痿痹且尿频，宜用地黄丸。如果热结膀胱导致小便不利，使用五苓散。如果脾肺燥热不能生化津液，宜用黄芩清肺饮。如果膀胱阳虚，阴液无所生，使用滋肾丸。如果膀胱阴虚，阳气无所化，使用肾气丸。
The *Daquan* (Compendium) states: Ingesting raw or cold foods during pregnancy may impair the Spleen and Stomach's ability to transform and transport, leading to pain in the heart and abdomen. If the pathology is in the Blood aspect, the stool will be red; if it is in the Qi aspect, the stool will be white; if both Qi and Blood are affected, red and white will be mixed. If heat invades the Large Intestine combined with Blood deficiency, bloody dysentery (Xue Li) will result.
Xue Ji (Xue Shi) stated: The treatment of dysentery should refer to the previous chapter. Discharging yellow watery stool indicates a deficiency of Spleen Earth and sinking of True Qi; one should raise and tonify Middle Qi. If yellow is accompanied by green, it indicates Liver Wood overacting on Spleen Earth; one should soothe the Liver and tonify the Spleen. If yellow is accompanied by white, it indicates the child affecting the mother (referring to the generative cycle where Spleen Earth generates Lung Metal, implying a deficiency pattern); the focus should be on tonifying the Spleen and Stomach. If yellow is accompanied by black, it indicates Water counter-acting Earth (Kidney Water insulting Spleen Earth); one must warm the Spleen and Stomach. If yellow is accompanied by red, it involves the Heart Mother benefiting the Child (Heart Fire generating Spleen Earth); using Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) suffices. If the Intestines and Stomach are weak and Wind Evil lodges within, use Wei Feng Tang (Stomach Wind Decoction). If the Fetal Qi is unstable, urgently tonify the Spleen and Stomach, and the Fetus will naturally stabilize. All fetal-calming herbs should be adapted to the specific condition; one should not rigidly adhere to herbs like E Jiao (Donkey-hide Gelatin) or Ai Ye (Mugwort Leaf).
(Attached: Zi Lin [Fetal Dysuria], Zhuan Bao [Displaced Bladder], Yi Niao [Urinary Incontinence])
The *Daquan* states: Urinary retention during pregnancy occurs because Heat in the Small Intestine transmits to the Bladder (Bao), causing obstruction. If accompanied by Qi stagnation in the Heart and Lungs, it leads to panting and urgency.
Chen Wuze (Chen Yan) stated: In pregnant women, a full fetus pressing against the bladder often causes difficult urination. If Heart and Kidney Qi are deficient, causing turbid and clear energies to interfere with each other, various forms of Lin Syndrome (Dysuria) arise. If the ligaments of the bladder are twisted and disordered, resulting in urinary retention, it is called Zhuan Bao (Displaced Bladder). If the full fetus causes urine leakage, it is called Yi Niao (Urinary Incontinence).
Zhu Danxi stated: Zhuan Bao disease generally affects pregnant women who are constitutionally weak, prone to worry and depression, have irritable temperaments, or consume rich and heavy flavors. Ancient formulas all used slippery and unblocking herbs, but few were effective. I reasoned that the bladder is compressed by the fetus, shifting to one side, causing the bladder ligaments to twist and obstruct flow. If the fetus is lifted and suspended in the center, the bladder ligaments relax, and the water pathway flows freely.
Xue Li Zhai (Xue Ji) stated: The aforementioned symptoms can also result from Spleen and Lung Qi deficiency failing to transmit downward to the Bladder; or from Qi and Heat knotting in the Bladder, making Jin Ye (Body Fluids) difficult to distribute; or from Metal being scorched by Fire, with severe Damp-Heat in Spleen Earth causing obstruction. Treatment must be detailed and precise.
The *Daquan* states: Pregnancy-related Lin syndrome (Zi Lin) arises from Deficient-Heat in the Kidney and Bladder failing to control water. Since the bladder ligaments connect to the Kidney during pregnancy, Deficient-Heat in the Kidney interstice creates this symptom. Severe cases involve mental restlessness and confusion, termed Zi Lin (Fetal Dysuria).
Wan Muzhai stated: Zi Lin must be differentiated into two conditions: one where the mother is ill herself, and one where the fetus is affected by the mother. However, maternal illness itself divides into two etiologies: either internal Heat generated by consuming pungent and hot foods, or dryness of Jin Ye due to spontaneous sweating or diarrhea. Fetal illness caused by the mother also divides into two patterns: either excess Heat from congested Fetal Qi, or physical obstruction caused by the fetal form. Since the syndromes differ, treatments differ. Generally, Heat is cleared, Dryness is moistened, Congestion is unblocked, and Obstruction is moved; this is the method of treatment.
Xue Li Zhai stated: For the aforementioned symptoms, if there is scanty, dribbling urination, use An Rong San (Peace and Prosperity Powder). If leg cramps occur with difficult urination, urgently use Ba Wei Wan (Eight-Ingredient Pill); delay will be incurable.
If frequent or difficult urination follows the use of drying agents, use Sheng Di Huang (Rehmanniae Radix), Fu Ling (Poria), Niu Xi (Achyranthis Bidentatae Radix), Gan Cao (Glycyrrhizae Radix et Rhizoma), Zhi Mu (Anemarrhenae Rhizoma), Huang Bo (Phellodendri Cortex), Chuan Xiong (Ligustici Chuanxiong Rhizoma), and Dang Gui (Angelicae Sinensis Radix). If frequency is accompanied by yellow color, use Si Wu Tang (Four Substances Decoction) plus Huang Bo, Zhi Mu, Wu Wei Zi (Schisandrae Fructus), Mai Dong (Ophiopogonis Tuber), and Xuan Shen (Scrophulariae Radix). If Lung Qi deficiency causes shortness of urine volume, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) plus Shan Yao (Dioscoreae Rhizoma) and Mai Dong. If vaginal prolapse and numbness accompany frequency, use Di Huang Wan (Rehmannia Pill). If Heat knots in the Bladder causing obstruction, use Wu Ling San (Five-Ingredient Powder with Poria). If Spleen and Lung dryness prevents the generation and transformation of fluids, use Huang Qin Qing Fei Yin (Scutellaria Lung-Clearing Decoction). If Bladder Yang deficiency leaves Yin without source, use Zi Shen Wan (Nourish the Kidney Pill). If Bladder Yin deficiency leaves Yang without transformation, use Shen Qi Wan (Kidney Qi Pill).