薛立斋曰∶有妇妊娠久痢，用消导理气之剂，腹内重坠，胎气不安。又用阿胶、艾叶之类不应，此腹重坠，
下元气虚也。胎动不安，内热盛也。用补中汤而安，又用六君子汤全愈。
薛立斋曰∶妊娠痢下黄水，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，须补脾肺。若黄而兼黑，是水反侮土，必温补脾肾。若黄而兼赤，乃心母益
子，但补中益气汤。若肠胃虚弱，风邪客之，用胃风汤。或脾气不安，急补脾胃自安。凡安胎之药，当临病制宜，
不必拘用阿胶、艾叶之类。
慎斋按∶以上四条，序胎前有痢疾证也。胎前痢，亦有暑邪湿热外感致病，不可专主饮食生冷为患。但妊娠
痢疾，本于脾胃不和，因而气血受病。气伤则白，血伤则赤，若守河间之法降气，后重自除，行血便脓自止。不
知胎前之气果可降乎？气降则胎下坠。胎前之血果可行乎？血行则胎必堕。莫若多用木香以调气，多用当归以
养血。此二药，乃为胎前痢疾妙剂，再以四物倍白术、黄芩。丹溪所谓先托住正气，以固其胎，而后顺气和
血，佐以消积导滞，此治妊痢之要法也。
《大全》曰∶饮食过度，触冒风冷，阴阳不和，清浊相干，谓之霍乱。其间，或先吐，或腹痛吐痢，是因
于热也。若头痛体疼，发热，是挟风邪也。若风折皮肤，则气不宣通，风热上冲为头痛。若风入肠胃，则泄痢
呕吐，甚则手足逆冷，此阳气暴竭，谓之四逆。妊娠患之，多致伤胎。
立斋按∶前证若因内伤饮食，外感风寒，用藿香正气散。若因饮食停滞，用平胃散。若果脾胃顿伤，阳气
虚寒，手足逆冷者，须用温补之剂。治当详审。母使动胎也。
薛立斋说：有一位妇女在妊娠期间患久痢，使用了消食导滞、理气的药物后，腹部有沉重下坠感，导致胎气不安。后来又用了阿胶、艾叶等安胎药却不见效。这种腹内重坠感，是因为下元之气虚弱所致。胎动不安，是由于体内热盛。使用补中益气汤后胎气得以安定，随后服用六君子汤完全痊愈。
薛立斋说：妊娠期间痢疾排出黄水，是脾土亏损、真气下陷的表现，应当升提补益中气。如果大便黄色兼青色，是肝木克制脾土，适宜平抑肝木、补益脾气。如果大便黄色兼白色，是子脏（脾）令母脏（肺）虚损，必须补益脾肺。如果大便黄色兼黑色，是水气反侮脾土，必须温补脾肾。如果大便黄色兼红色，是心母资助子脏（脾），只需服用补中益气汤。如果肠胃虚弱，风邪客居其中，使用胃风汤。或者脾气不安急迫，紧急补益脾胃自然安宁。凡是安胎的药物，应当根据病情灵活制宜，不必拘泥于使用阿胶、艾叶之类的药物。
慎斋按语：以上四条，叙述了胎前患痢疾的证候。胎前的痢疾，也有因暑邪湿热外感而致病的，不能专门归咎于饮食生冷为害。但是妊娠痢疾，根本原因在于脾胃不和，进而导致气血受病。气受伤则便白，血受伤则便赤。如果死守刘河间降气的方法，后重感自然会消除，行血化脓的症状自然会停止。却不知道胎前的气果真是可以降的吗？气一旦下降，胎儿就会下坠。胎前的血果真是可以行的吗？血一旦运行，胎儿必定流产。不如多用木香来调气，多用当归来养血。这两味药，是治疗胎前痢疾的妙剂，再加上四物汤加倍白术、黄芩。丹溪所说的先托住正气以固护胎儿，然后顺气和血，佐以消积导滞，这是治疗妊娠痢疾的关键方法。
《妇人大全良方》说：饮食过度，触犯风冷，导致阴阳不和，清浊之气相互干扰，称为霍乱。在此期间，有的先呕吐，有的腹痛并吐泻，这是因于热邪。如果头痛身体疼痛、发热，是挟带风邪。如果风邪束缚皮肤，则气机不宣通，风热上冲头部导致头痛。如果风邪进入肠胃，则出现泄泻痢疾和呕吐，严重时手足逆冷，这是阳气突然衰竭，称为四逆证。孕妇患上此病，多会导致伤胎。
立斋按语：上述病症，如果是因内伤饮食、外感风寒引起的，使用藿香正气散。如果是因饮食停滞引起的，使用平胃散。如果确实是脾胃骤然受损，阳气虚寒，出现手足逆冷的，必须使用温补的药物。治疗应当详细审察，以免扰动胎儿。
Xue Lizhai stated: There was a woman who suffered from chronic dysentery during pregnancy. After using agents for digestion promotion and qi regulation, she experienced a heavy bearing-down sensation in the abdomen, leading to unsettled fetal qi. Subsequently, using substances such as Ejiao (Donkey-hide Gelatin) and Aiye (Mugwort Leaf) proved ineffective. This abdominal heaviness and bearing-down sensation is due to deficiency of the Qi of the lower origin. The unsettled fetus is caused by excessive internal heat. The condition was stabilized using Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction), and complete recovery was achieved with Liujunzi Tang (Six Gentlemen Decoction).
Xue Lizhai stated: Dysentery with yellow discharge during pregnancy indicates damage to Spleen Earth and sinking of True Qi; it should be treated by raising and tonifying Middle Qi. If the discharge is yellow mixed with green, it indicates Liver Wood overacting on Spleen Earth, requiring soothing the Liver and tonifying the Spleen. If yellow mixed with white, it indicates the daughter organ (Spleen) deficiency affecting the mother organ (Lung), requiring tonification of the Spleen and Lung. If yellow mixed with black, it indicates Water counter-acting upon Earth, requiring warming and tonification of the Spleen and Kidney. If yellow mixed with red, it indicates Heart Mother benefiting the Son (Spleen), requiring only Buzhong Yiqi Tang. If the Intestines and Stomach are weak with Wind pathogen lodging within, Weifeng Tang (Stomach Wind Decoction) should be used. Or if Spleen Qi is urgently unsettled, urgently tonifying the Spleen and Stomach will bring peace. Any herbs for calming the fetus should be adapted to the specific disease condition; one should not rigidly rely on Ejiao or Aiye.
Shenzhen noted: The above four cases describe dysentery occurring before delivery. Dysentery during pregnancy can also be caused by external contraction of Summerheat pathogenic damp-heat, and should not be exclusively attributed to damage from cold and raw food. However, dysentery in pregnancy fundamentally stems from disharmony between the Spleen and Stomach, which subsequently affects Qi and Blood. Injury to Qi results in white discharge; injury to Blood results in red discharge. If one strictly adheres to Liu Hejian’s method of descending Qi, the tenesmus will naturally cease, and bloody pus will stop. However, one must ask: Can Qi really be descended during pregnancy? Descending Qi causes the fetus to drop. Can Blood really be moved during pregnancy? Moving Blood causes miscarriage. It is better to use more Muxiang (Aucklandiae Radix) to regulate Qi and more Danggui (Angelicae Sinensis Radix) to nourish Blood. These two herbs are excellent agents for treating dysentery in pregnancy. Combined with Siwu Tang (Four Substances Decoction) with doubled Baizhu (Atractylodis Macrocephalae Rhizoma) and Huangqin (Scutellariae Radix), this follows Danxi’s principle: first support the Righteous Qi to secure the fetus, then harmonize Qi and Blood, assisting with resolving accumulation and guiding out stagnation. This is the essential method for treating pregnancy dysentery.
The Daquan (Great Compendium) states: Excessive eating combined with exposure to Wind-Cold leads to disharmony of Yin and Yang and interference between Clear and Turbid Qi, termed Huoluan (Cholera-like disorder). In this condition, some vomit first, while others experience abdominal pain followed by vomiting and diarrhea, indicating Heat etiology. If accompanied by headache, body ache, and fever, it indicates concurrent Wind pathogen. If Wind constrains the skin, Qi mechanism fails to circulate freely, and Wind-Heat rushes upward causing headache. If Wind enters the Intestines and Stomach, it causes diarrhea, dysentery, and vomiting; in severe cases, cold extremities occur, indicating sudden exhaustion of Yang Qi, termed Sini (Four Coldness). When pregnant women suffer from this, it often damages the fetus.
Lizhai noted: For the aforementioned conditions, if caused by internal dietary injury and external Wind-Cold contraction, Huoxiang Zhengqi San (Agastache Powder to Rectify the Qi) should be used. If caused by food stagnation, Pingwei San (Calm the Stomach Powder) should be used. If there is indeed sudden damage to the Spleen and Stomach with Yang Qi deficiency and Cold, manifesting as cold extremities, warming and tonifying agents are required. Treatment must be carefully examined to avoid disturbing the fetus.