〔大〕产后大小便不通者,肠胃本挟于热,因产血水俱下,津液燥竭,肠胃痞涩,热
气结于肠胃,故令大小便不通也。
〔薛〕尝治一产妇大小便不通,诸药不应,将危矣。令饮牛乳,一日稍通,三日而
痊。人乳尤善。
桃花散 治膀胱气滞血涩,大小便秘。
桃仁 葵子 滑石 槟榔(各等分)
上为细末,每服二钱,空心葱白汤调下。
疗产后大小便不利,下血。
车前子 黄芩 蒲黄 牡蛎 生地黄 芍药(各一两五钱)
上为细末,空心米饮服方寸匕。忌面、蒜。
通气散,治产后大小便不通。亦可用封脐法。(见前杂证大便不通。)
〔心〕治妇人产后,忽小腹胀如蛊,大小便不通。气海、三里、关元、三阴交、阴
谷主之。
〔薛〕产后遗屎,若脾肾虚弱,用还少丹,仍以补中益气汤为主。虚寒加肉豆蔻、补
骨脂,或四神丸。若脾肾虚寒,用八味丸兼四神丸,仍佐以前二方。
按∶产后遗屎,乃肾气不固,宜五味子丸主之。(杂病泄泻。)
一产妇大便不实,饮食少思,或侵晨遗屎,此中气虚寒,脾肾不足,用补中益气送
四神丸而痊。一产妇小便出粪,名大小肠交。乃气血俱虚,失行常道,先用六君子汤
二剂,又用五苓散二剂而痊。寻常肠交,亦可用。
《广济》疗产后遗粪方。
取故燕窠中草,烧为末,以酒调下半盏。亦治男子。
《集验方》疗产后遗粪。亦治男子。
矾石(枯) 牡蛎( ,各等分)
上为末,酒服方寸匕,日三服。
《补遗》疗产后遗粪不知出时方。
白蔹 芍药(各等分,为末) 酒服方寸匕。
《补遗》治产后遗粪不知觉,可服固肠丸。(方见前杂症泄泻条。)
华佗云∶病患卧,遗屎不觉者死。
【大】产后出现大小便不通的情况,是因为产妇的肠胃原本就挟带有热邪,加上分娩时血液和津液同时流失,导致体内津液干枯枯竭,肠胃气机痞塞涩滞,热气结聚在肠胃之中,所以导致大小便无法排出。
【薛】曾经治疗一位产妇大小便不通,服用各种药物都没有效果,病情危急。让她饮用牛乳,一天后症状稍有好转并得以通畅,三天后痊愈。用人乳效果更好。
桃花散:治疗膀胱气机阻滞、血行涩滞导致的大小便秘结。
桃仁、葵子、滑石、槟榔(各等分)
以上药材研成细末,每次服用二钱,空腹时用葱白汤调服。
治疗产后大小便不利,伴有下血症状。
车前子、黄芩、蒲黄、牡蛎、生地黄、芍药(各一两五钱)
以上药材研成细末,空腹时用米饮送服方寸匕大小的药量。忌食面食、大蒜。
通气散:治疗产后大小便不通。也可以使用封脐法。(参见前面杂证大便不通章节。)
【心】治疗妇人产后,突然小腹胀大如蛊状,大小便不通。取气海穴、足三里穴、关元穴、三阴交穴、阴谷穴主治。
【薛】产后遗屎(大便失禁),如果是脾肾虚弱所致,使用还少丹,仍以补中益气汤为主方。若兼有虚寒症状,加用肉豆蔻、补骨脂,或者使用四神丸。若是脾肾虚寒,使用八味丸兼服四神丸,同时辅助以前提到的两个方剂。
按语:产后遗屎,是由于肾气不固所致,适宜用五味子丸主治。(参见杂病泄泻章节。)
有一位产妇大便不成形,饮食减少且没有食欲,有时清晨遗屎,这是中气虚寒,脾肾不足,使用补中益气汤送服四神丸而痊愈。
有一位产妇小便中排出粪便,名为大小肠交。这是由于气血俱虚,失去正常的运行规律,先用六君子汤两剂,又用五苓散两剂而痊愈。寻常的肠交症也可以使用此法。
《广济》记载的治疗产后遗粪的方子。
取旧燕巢中的草,烧成灰烬为末,用酒调服半盏。也可以治疗男子。
《集验方》治疗产后遗粪。也治疗男子。
矾石(枯矾)、牡蛎(煅,各等分)
以上研成细末,用酒送服方寸匕大小的药量,每日三次服用。
《补遗》记载的治疗产后遗粪不知何时排出的方子。
白蔹、芍药(各等分,研为细末),用酒送服方寸匕大小的药量。
《补遗》治疗产后遗粪不知觉,可以服用固肠丸。(方剂见前面杂症泄泻条目。)
华佗说:病人卧床,遗屎而不自知者,预后不良,主死。
[Da] Postpartum obstruction of both urination and defecation occurs because the intestines and stomach originally harbor heat pathogens. Due to the loss of blood and body fluids during childbirth, the body fluids become dry and exhausted. This leads to qi stagnation and涩 (astringency/stagnation) in the intestines and stomach, with heat qi knotting within them, thus causing the obstruction of both urination and defecation.
[Xue] I once treated a postpartum woman suffering from obstruction of both urination and defecation. Various medicines failed to produce any effect, and her condition was critical. I instructed her to drink cow's milk. After one day, her condition slightly improved and passage was restored; after three days, she recovered completely. Human breast milk is even more effective.
Taohua San (Peach Blossom Powder): Treats constipation of both urination and defecation caused by qi stagnation and blood stasis in the Bladder.
Tao Ren (Peach Seed), Kui Zi (Okra Seed), Hua Shi (Talcum), Bing Lang (Areca Seed) (equal parts).
Grind the above ingredients into a fine powder. Take 2 qian per dose, mixed with Scallion White Decoction on an empty stomach.
Treats postpartum difficulty in urination and defecation, accompanied by bleeding from the lower orifice.
Che Qian Zi (Plantago Seed), Huang Qin (Scutellaria Root), Pu Huang (Typha Pollen), Mu Li (Oyster Shell), Sheng Di Huang (Rehmannia Root), Shao Yao (Peony Root) (each 1 liang 5 qian).
Grind the above ingredients into a fine powder. Take a "fang cun bi" (a measure equivalent to a square inch spoonful) mixed with Rice Drink on an empty stomach. Avoid wheat products and garlic.
Tongqi San (Qi-Regulating Powder): Treats postpartum obstruction of both urination and defecation. The Umbilical Sealing Method can also be used. (See the section on Constipation in Miscellaneous Diseases.)
[Xin] Treats postpartum women who suddenly experience abdominal distension resembling a water belly (ascites/gu syndrome), with obstruction of both urination and defecation. Points Qihai (CV6), Zusanli (ST36), Guanyuan (CV4), Sanyinjiao (SP6), and YinGu (KI10) are indicated.
[Xue] Postpartum fecal incontinence due to Spleen and Kidney deficiency should be treated with Huanshao Dan (Return to Youth Pill), primarily using Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction). If there is deficiency-cold, add Rou Dou Kou (Nutmeg) and Bu Gu Zhi (Psoralea Fruit), or use Sishen Wan (Four Spirits Pill). If there is Spleen-Kidney deficiency-cold, use Bawei Wan (Eight-Ingredient Pill) combined with Sishen Wan, supplemented by the aforementioned two formulas.
Note: Postpartum fecal incontinence is caused by insecurity of Kidney Qi; Wuweizi Wan (Schisandra Berry Pill) is appropriate. (See Miscellaneous Diseases: Diarrhea.)
One postpartum patient had loose stools, poor appetite, and occasional morning fecal incontinence. This was due to deficiency-cold of the Middle Qi and insufficiency of the Spleen and Kidney. She recovered after taking Buzhong Yiqi Tang administered with Sishen Wan.
One postpartum patient excreted feces through the urethra, a condition named Da Xiao Chang Jiao (Intercourse of Large and Small Intestines). This resulted from joint deficiency of Qi and Blood and deviation from normal pathways. She first took Liujunzi Tang (Six Gentlemen Decoction) for two doses, followed by Wuling San (Five-Ingredient Powder with Poria) for two doses, and recovered. This method can also be applied to ordinary cases of intestinal crossing.
The Guangji text records a formula for treating postpartum fecal incontinence.
Take grass from old swallow nests, burn it to ash, mix with wine, and take half a cup. It can also treat men.
The Jiyan Fang records a treatment for postpartum fecal incontinence. It also treats men.
Fan Shi (Alumen, calcined), Mu Li (Oyster Shell, calcined) (equal parts).
Grind into powder. Take a fang cun bi mixed with wine, three times daily.
The Buyi text records a formula for treating postpartum fecal incontinence without awareness of its occurrence.
Bai Lian (Akebia Rhizome), Shao Yao (Peony Root) (equal parts, ground into powder). Take a fang cun bi mixed with wine.
The Buyi text states that for postpartum fecal incontinence without sensation, Guchang Wan (Intestine-Securing Pill) can be taken. (Formula see Miscellaneous Diseases: Diarrhea section.)
Hua Tuo said: If a patient lies in bed and has fecal incontinence without awareness, it indicates death.