朱丹溪曰∶有收生不谨，损破产妇尿脬，致病淋沥，用猪羊胞煎汤入药，参、 为君，归、地为佐，桃仁、
陈皮、茯苓为使，于极饥时饮之，令气血骤长，其胞自完，稍缓亦难成功也。
薛立斋曰∶稳婆不慎，致胞损而小便淋沥者，八珍汤补气血。若因膀胱气虚，小便
频数，当补脾肺。若膀胱阴虚，小便淋沥，须补肺肾，方用补中汤，加山茱、山药为主，佐以桑螵蛸散。
慎斋按∶以上六条，序产后小便有数，有不禁遗尿，有淋沥之证也。经云，肾主二便，开窍二阴，小便不
禁，淋沥，前阴病也。产后气血大虚，有伤脏腑，非肺气虚而不能约制，为遗尿，为不禁，即肾气竭，而多
有虚热移于膀胱，为沥为淋。总以补养气血，加升提固涩之剂为主。若用渗利疏导，是重虚也，戒之。
《大全》曰∶产后小便出血，因血气虚而热乘之，血得热则流散，渗于胞内，故血随小便出。有产妇尿血，
面黄胁胀，少食，此肝木乘脾土也。用加味逍遥散、补中汤，兼服而愈。
薛立斋曰∶产后便血，或饮食起居，或六淫七情，致元气亏损，阳络外伤。治法，若因膏粱积热，加味清胃
散；因醇酒湿毒，葛花解醒汤；怒动肝火，六君子加芎、归、芍药、柴胡；因郁结伤脾，加味归脾汤；思虑
伤心，妙香散；大肠风热，四物加柏叶、荆、防、枳壳、槐花；大肠血热，四物加芩、连；肠胃虚弱，六君子
加升、柴；肠胃虚寒，六君子加肉果、木香；因元气下陷，补中汤加茯苓、半夏；胃气虚弱，六君子加升麻；
血虚，四物加升麻；气血虚，八珍加升、柴温补。
慎斋按∶以上二条，序产后有二便下血之证也。产后既亡血，而大小二便复有下血之患，此非寻常火热，渗
于膀胱，归于大肠，可例治也。非血虚即气脱。心主血，脾统血。心气虚则小肠不能制而血流，脾气弱则大肠
无移荫而血下。故二便出血，当责之心脾二经为病。若《大全》竟以热论，立斋一条，分
因杂出，详证配方，未免胶柱，似难责效。立斋之书，补元阴元阳，动以滋化源立论，开发后人，有功来学不
少。但每让辄以方配，某病用某方，似欲后人按图索骥，刻舟求剑矣。善读立斋之书者，不知以予言为河汉否
也。
陈良甫说：妇人分娩过程不顺利，导致膀胱受损，出现随时遗尿的症状。
朱丹溪说：有因接生不够谨慎，损伤了产妇的尿脬（膀胱），导致病证表现为小便淋漓不尽。治疗可用猪羊胞（猪或羊的膀胱）煎汤送服药物，以人参、[白术]为君药，当归、熟地为佐药，桃仁、陈皮、茯苓为使药，在极度饥饿时服用，使气血迅速生长，其胞自然修复，如果用药稍缓也难以成功。
薛立斋说：稳婆（接生婆）不慎，导致胞受损而小便淋漓不尽的，用八珍汤补益气血。若因膀胱气虚，小便频数，应当补益脾肺。若膀胱阴虚，小便淋漓不尽，必须补益肺肾，方剂用补中益气汤，以山茱萸、山药为主药，佐以桑螵蛸散。
慎斋按语：以上六条，叙述了产后小便有次数多、有不禁遗尿、有淋沥不尽的病证。《内经》说，肾主管大小便，开窍于前后二阴，小便不禁、淋沥，属于前阴疾病。产后气血大虚，有伤及脏腑，如果不是肺气虚而不能约制，导致遗尿、不禁，就是肾气衰竭，而多有虚热移入膀胱，导致沥出、淋证。总的治疗原则是以补养气血，加入升提固涩的药物为主。如果使用渗湿利导的方法，是加重虚损，务必戒除。
《妇人大全良方》说：产后小便出血，是因为血气虚弱而热邪乘虚而入，血得热则流动散乱，渗入胞内，所以血液随小便排出。有的产妇尿血，面色黄、胁肋胀满、食欲少，这是肝木克制脾土所致。使用加味逍遥散、补中益气汤，兼服而痊愈。
薛立斋说：产后大便出血，或因饮食起居失调，或因六淫七情，导致元气亏损，阳络外伤。治疗方法：若因膏粱厚味积热，用加味清胃散；因醇酒湿毒，用葛花解醒汤；因怒动肝火，用六君子汤加川芎、当归、芍药、柴胡；因郁结伤脾，用加味归脾汤；因思虑伤心，用妙香散；因大肠风热，用四物汤加侧柏叶、荆芥、防风、枳壳、槐花；因大肠血热，用四物汤加黄芩、黄连；因肠胃虚弱，用六君子汤加升麻、柴胡；因肠胃虚寒，用六君子汤加肉豆蔻、木香；因元气下陷，用补中益气汤加茯苓、半夏；因胃气虚弱，用六君子汤加升麻；因血虚，用四物汤加升麻；因气血两虚，用八珍汤加升麻、柴胡温补。
慎斋按语：以上两条，叙述了产后有二便下血的病证。产后既然已经亡血，而大小便又有下血的隐患，这并非寻常火热之邪，渗入膀胱，归于大肠，可以常规治疗。不是血虚就是气脱。心主血，脾统血。心气虚则小肠不能制约而血流，脾气弱则大肠无遮蔽而血下。所以二便出血，应当责之于心脾二经的疾病。如果《大全》竟以热论治，薛立斋的一条，分述病因杂出，详细辨证配方，未免拘泥固执，似乎难以见效。薛立斋的书，补元阴元阳，动不动就以滋生化之源立论，启发后人，对后学功劳不少。但他每每让方配药，某病用某方，似乎想让后人按图索骥，刻舟求剑了。善于读薛立斋书的人，不知道是否把我的话当作胡说八道呢？
Chen Liangfu stated: When a woman's labor process is not smooth, it may cause injury to the bladder (bladder), resulting in involuntary urination at any time.
Zhu Danxi stated: There are cases where careless midwifery damages the urinary bladder of the parturient woman, causing symptoms of dribbling urine. Treatment can involve decocting pig or sheep bladders and using the broth to administer medicine. Ren Shen (Ginseng) and [Bai Zhu (Atractylodes Rhizome)] serve as the sovereign drugs; Dang Gui (Angelica Sinensis) and Shu Di Huang (Prepared Rehmannia Root) serve as minister drugs; Tao Ren (Peach Kernel), Chen Pi (Tangerine Peel), and Fu Ling (Poria) serve as envoy drugs. It should be taken when extremely hungry to rapidly generate Qi and Blood, allowing the bladder to repair itself naturally; if the treatment is delayed, success will be difficult to achieve.
Xue Lizhai stated: If a midwife is careless, causing damage to the bladder with dribbling urine, Ba Zhen Tang (Eight-Treasure Decoction) should be used to tonify Qi and Blood. If frequent urination is due to deficiency of Qi in the bladder, the Spleen and Lung should be tonified. If dribbling urine is due to Yin deficiency of the bladder, the Lung and Kidney must be tonified. The formula used is Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), with Shan Zhu Yu (Cornus Fruit) and Shan Yao (Dioscorea Rhizome) as the main drugs, assisted by Sang Piao Xiao San (Mantis Egg-case Powder).
Shenzhai commented: The above six sections describe postpartum urinary conditions characterized by frequency, incontinence, and dribbling. The Classic states that the Kidney governs the two lower orifices and opens into the anterior and posterior yin openings. Incontinence and dribbling of urine are diseases of the anterior yin. Postpartum, Qi and Blood are severely deficient, and internal organs may be injured. If it is not Lung Qi deficiency failing to exert control, leading to enuresis and incontinence, then it is Kidney Qi exhaustion, often accompanied by deficient heat transferring to the bladder, causing dribbling and strangury. The general treatment principle is to nourish Qi and Blood and add herbs that lift and secure/astringe. Using diuretic and draining methods would further deplete deficiency; this must be avoided.
The Da Quan (Great Compendium) stated: Postpartum hematuria occurs because Qi and Blood are deficient, allowing Heat pathogens to invade. Blood becomes agitated by Heat and flows erratically, seeping into the uterus/bladder, thus blood exits with urine. Some parturient women presenting with hematuria, sallow complexion, hypochondriac distension, and poor appetite suffer from Liver Wood overacting on Spleen Earth. Jia Wei Xiao Yao San (Modified Free and Easy Wanderer Powder) and Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction) should be administered concurrently for recovery.
Xue Lizhai stated: Postpartum hematochezia (blood in stool) may result from improper diet and lifestyle or from Six Excesses and Seven Emotions, causing depletion of Yuan Qi and external injury to Yang collaterals. Treatment methods vary by etiology: if caused by accumulation of heat from rich foods, use Jia Wei Qing Wei San (Modified Stomach-Clearing Powder); if caused by damp-toxin from alcohol, use Ge Hua Jie Xing Tang (Ardisia Japonica Decoction to Resolve Intoxication); if caused by anger stirring Liver Fire, use Liu Jun Zi Tang (Six-Gentlemen Decoction) plus Chuan Xiong (Sichuan Lovage Rhizome), Dang Gui, Bai Shao (White Peony Root), and Chai Hu (Bupleurum Root); if caused by constraint injuring the Spleen, use Jia Wei Gui Pi Tang (Modified Restore the Spleen Decoction); if caused by overthinking injuring the Heart, use Miao Xiang San (Miraculous Incense Powder); if caused by Wind-Heat in the Large Intestine, use Si Wu Tang (Four-Substance Decoction) plus Ce Bai Ye (Biota Tops), Jing Jie (Schizonepeta), Fang Feng (Saposhnikovia Root), Zhi Ke (Bitter Orange), and Huai Hua (Sophora Flower); if caused by Blood-Heat in the Large Intestine, use Si Wu Tang plus Huang Qin (Scutellaria Root) and Lian Zi (Lotus Plumule)/Lian Qiao (Forsythia) [Note: Text says Qin, Lian]; if caused by Spleen-Stomach weakness, use Liu Jun Zi Tang plus Sheng Ma (Cimicifuga Rhizome) and Chai Hu; if caused by Spleen-Stomach deficiency-cold, use Liu Jun Zi Tang plus Rou Dou Kou (Nutmeg) and Mu Xiang (Aucklandia Root); if caused by sinking of Yuan Qi, use Bu Zhong Yi Qi Tang plus Fu Ling and Ban Xia (Pinellia Tuber); if caused by weak Stomach Qi, use Liu Jun Zi Tang plus Sheng Ma; if caused by Blood deficiency, use Si Wu Tang plus Sheng Ma; if caused by Qi and Blood deficiency, use Ba Zhen Tang plus Sheng Ma and Chai Hu for warm tonification.
Shenzhai commented: The above two sections describe postpartum bleeding from both bowels. Since postpartum hemorrhage has already depleted blood, the occurrence of bleeding from both upper and lower orifices is not a case of ordinary Heat pathogens seeping into the bladder or returning to the Large Intestine that can be treated conventionally. It is either Blood deficiency or Qi collapse. The Heart governs Blood, and the Spleen controls Blood. If Heart Qi is deficient, the Small Intestine cannot restrain flow, leading to bleeding; if Spleen Qi is weak, the Large Intestine lacks support, leading to downward bleeding. Therefore, bleeding from both orifices should be attributed to pathology in the Heart and Spleen meridians. If the *Da Quan* attributes it solely to Heat, and Xue Lizhai’s section lists mixed etiologies with detailed syndrome differentiation and formulas, it may be too rigid and difficult to achieve efficacy. Xue Lizhai’s works focus on tonifying Original Yin and Original Yang, often establishing theories based on nourishing the source of transformation and generation, which has greatly benefited later scholars. However, his tendency to match specific formulas to specific diseases seems to encourage practitioners to follow maps blindly or mark boats to find swords. Those who read Xue Lizhai’s books well—do they consider my words to be nonsense?