〔大〕夫产后小便数者，乃气虚不能制故也。
〔薛〕前证若因稳婆不慎，以致胞损而小便淋沥者。用八珍汤以补气血。若因膀胱
气虚而小便频数，当补脾肺。若膀胱阴虚而小便淋沥，须补肺肾。一产妇小便频数，时
复寒战，乃属脾肺虚弱。用补中益气汤加山茱、山药为主，佐以桑螵蛸散而愈。后患发
热晡热，盗汗自汗，月水不调，用加味逍遥散而安。一产妇患前证，吐痰发热，日晡
作渴，此膀胱阴虚。用补中益气汤，以六味丸而愈。又患痢后小便频数，手足俱冷，属
阳气虚寒，用前汤及八味丸而瘳。
桑螵蛸散 （《千金》）治产后小便数及遗尿。
桑螵蛸（三十枚，煨） 鹿茸（酥炙） 黄 （各三两） 牡蛎（煨） 人参 浓朴
赤石脂（各二两）
上为末，空心粥饮调下二钱。（《外台》无浓朴、石脂，有甘草、生姜。）
栝蒌汤 （《集验》）疗产后小便数兼渴。
桑螵蛸 甘草（并炙） 黄连 生姜（各二两） 栝蒌根（三两） 人参（三两） 大枣（五十枚）
上细切，用水七升，煮二升半，分三服。忌猪肉、冷水。
《补遗》疗产后小便数，或遗尿。益智仁（为末，）米饮调服。
〔陈〕妇人产蓐产理不顺，致伤膀胱，遗尿无时。
〔丹〕尝见收生者不谨，损破产妇尿脬，致病淋沥，遂成废疾。一日有徐妇年壮难产
得此，因思肌肉破伤在外者，宜可补完，胞虽在腹，恐亦可治。遂诊其脉虚甚，予曰∶难
产之由，多是气虚，产后血气尤虚，试与峻补。因以参、 为君，芎、归为臣，桃仁、陈
皮、黄 、茯苓为佐，煎以猪、羊胞中汤，极饥时饮之。但剂小率用一两，至一月而安。盖
令气血骤长，其胞自完，恐稍缓亦难成功矣。
〔乔町〕妇人产后尿不禁，面微浮，略发热于午后，此膀胱为坐婆所伤。
黄 归身尾 芍药（各一钱半） 白术（一钱） 人参 陈皮（各五分） 甘草（炙，少许）
上水煎，热服之。
〔薛〕前证若脾肺阳虚，用补中益气汤。若肝肾阴虚，用六味地黄丸。若肝肾之气虚
寒，用八味地黄丸。一产妇小便不禁，二年不愈，面色或青赤、或黄白，此肝脾气虚
血热，用加味逍遥散为主，渐愈，佐以六味地黄丸而痊。后因怒，小便自遗，大便不实，
左目顿紧，面色顿赤，仍用前散，佐以六君子汤，以清肝火，生肝血，培脾土而痊。
《广济》疗产后小便不禁。
鸡尾毛烧存性，酒调下一匕，日三服。
《千金》治产后遗尿不知出。
白薇 芍药（各等分）
为末，酒服方寸匕，日三。
又方
桑螵蛸（半两，炒） 龙骨（一两）
上为末，食前粥饮调下二钱。
固脬散 治妇人临产时伤手脬破，小便不禁。
黄丝绢（自然黄者，染黄者不用。三尺，以炭灰汁煮极烂，以清水洗去灰，令净，
入黄蜡半两，蜜一两，白茅根二钱，马屁勃末二钱）
上用水二升，再煎至一盏，空心顿服。服时饮气服之，不得作声，如作声无效。
补遗补脬饮 治产后伤动脬破，终日不小便，但淋湿不干。
生丝绢（黄色者，一尺） 白牡丹根皮木 白芨（各一钱）
用水一碗，煎至绢烂如饧服之，勿作声，作声无效。
鸡内金散 治产后溺床失禁。
以鸡 一具，并肠，洗、烧为末，酒调服方寸匕。
〔薛〕前述证候如果是因接生婆不慎操作，导致膀胱（胞）受损而出现小便淋漓不尽的，应使用八珍汤来补益气血。如果是因膀胱气虚导致小便频繁，应当补益脾肺。如果是因膀胱阴虚导致小便淋漓，必须补益肺肾。有一位产妇小便频繁，时常伴有寒战，这属于脾肺虚弱。以补中益气汤加山茱萸、山药为主药，佐以桑螵蛸散治疗而痊愈。后来患者出现发热、傍晚潮热、盗汗和自汗，月经不调，使用加味逍遥散而安定。另一位产妇患上述证候，呕吐痰涎并发热，傍晚时分口渴，这是膀胱阴虚。使用补中益气汤配合六味丸治疗而痊愈。又有一位患者在痢疾后出现小便频繁，手足俱冷，属于阳气虚寒，使用前汤（指补中益气汤）及八味丸而病愈。
桑螵蛸散（出自《千金方》）：治疗产后小便频数及遗尿。
药材：桑螵蛸（三十枚，煨制）、鹿茸（用酥炙烤）、黄芪（各三两）、牡蛎（煨制）、人参、厚朴、赤石脂（各二两）。
制法与用法：以上药物研为细末，空腹时用米粥汁调服二钱。（注：《外台秘要》中无厚朴、赤石脂，有甘草、生姜。）
栝蒌汤（出自《集验方》）：治疗产后小便频数兼有口渴。
药材：桑螵蛸、甘草（均炙烤）、黄连、生姜（各二两）、栝蒌根（三两）、人参（三两）、大枣（五十枚）。
制法与用法：以上药物切碎，用水七升，煮取二升半，分三次服用。忌食猪肉、冷水。
《补遗》：治疗产后小便频数，或遗尿。益智仁（研为细末），用米饮调服。
〔陈〕妇人在产褥期因产理不顺，导致损伤膀胱，出现随时遗尿的症状。
〔丹〕我曾见到接生者不谨慎，损伤了产妇的膀胱，导致疾病表现为小便淋漓，最终成为废疾。有一天有位徐姓妇女，年轻但难产得了此病，我想到肌肉在外部的破损尚可修补完整，膀胱虽然在腹内，恐怕也可以治疗。于是诊察其脉象非常虚弱，我说：“难产的原因，多是气虚，产后气血更加虚弱，试着给予峻猛的补益。”因此以人参、黄芪为君药，川芎、当归为臣药，桃仁、陈皮、黄芪、茯苓为佐药，用猪、羊膀胱中的汤液煎药，在极度饥饿时饮用。虽然剂量较小，通常只用一两，但坚持一个月后病情安定。这是因为让气血迅速增长，膀胱自然修复，恐怕如果稍显缓慢也难以成功。
〔乔町〕妇人产后小便不禁，面部轻微浮肿，午后略有发热，这是膀胱被坐婆（接生婆）所伤。
处方：黄芪、当归身尾、芍药（各一钱半）、白术（一钱）、人参、陈皮（各五分）、甘草（炙，少许）。
制法与用法：以上药物用水煎煮，热服。
〔薛〕前述证候如果是脾肺阳虚，使用补中益气汤。如果是肝肾阴虚，使用六味地黄丸。如果是肝肾之气虚寒，使用八味地黄丸。一位产妇小便不禁，两年未愈，面色有时青赤、有时黄白，这是肝脾气虚血热，以加味逍遥散为主药，逐渐痊愈，佐以六味地黄丸而康复。后来因为发怒，出现小便自遗，大便不成形，左眼突然紧绷，面色突然变红，仍用前散（加味逍遥散），佐以六君子汤，以清肝火，生肝血，培补脾土而痊愈。
《广济方》：治疗产后小便不禁。
方法：鸡尾毛烧至存性，用酒调服一匕，每日三次。
《千金方》：治疗产后遗尿不知排出。
药材：白薇、芍药（各等分）。
制法与用法：研为细末，用酒送服方寸匕，每日三次。
又一方：
药材：桑螵蛸（半两，炒制）、龙骨（一两）。
制法与用法：以上研为细末，饭前用米粥汁调服二钱。
固脬散：治疗妇人临产时手部损伤膀胱破裂，小便不禁。
药材：黄丝绢（自然的黄色，染色的不用。三尺，用炭灰汁煮至极烂，用清水洗去灰，令其洁净，加入黄蜡半两、蜜一两、白茅根二钱、马屁勃末二钱）。
制法与用法：以上用水二升，再煎至一盏，空腹顿服。服药时要屏住呼吸服用，不能出声，如果出声则无效。
补遗补脬饮：治疗产后伤动膀胱破裂，整天不小便，只是淋湿不干。
药材：生丝绢（黄色的，一尺）、白牡丹根皮木、白芨（各一钱）。
制法与用法：用水一碗，煎至丝绢烂如饴糖状时服用，不要出声，出声则无效。
[Da] Postpartum frequent urination is caused by Qi deficiency failing to control and retain urine.
[Xue] If the aforementioned syndrome is due to careless midwifery causing damage to the bladder (urinary bladder), resulting in dribbling urine, use Bazhen Tang (Eight Treasure Decoction) to tonify Qi and Blood. If frequent urination is due to Qi deficiency of the urinary bladder, tonify the Spleen and Lung. If dribbling urine is due to Yin deficiency of the urinary bladder, tonify the Lung and Kidney. One postpartum patient had frequent urination with occasional chills, belonging to Spleen and Lung deficiency. Use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Cornus Fructus (Shanzhuyu) and Dioscoreae Rhizoma (Shanyao) as main herbs, assisted by Sangpiaoxiao San (Mantis Egg-case Powder) for recovery. Later, she suffered from fever, afternoon tidal fever, night sweats, and spontaneous sweating, with irregular menstruation; she was stabilized using Jiawei Xiaoyao San (Modified Free and Easy Wanderer Powder). Another postpartum patient suffered from the aforementioned syndrome, vomiting phlegm with fever, and thirst in the late afternoon, indicating Yin deficiency of the urinary bladder. She was cured using Buzhong Yiqi Tang combined with Liuwei Wan (Six-Ingredient Pill with Rehmannia). Another patient experienced frequent urination after dysentery, with cold hands and feet, indicating Yang Qi deficiency and cold; she recovered using the aforementioned decoction (Buzhong Yiqi Tang) and Bawei Wan (Eight-Ingredient Pill with Rehmannia).
Sangpiaoxiao San (from *Qianjin Fang*): Treats postpartum frequent urination and enuresis.
Herbs: Sangpiaoxiao (Mantis Egg-case, 30 pieces, roasted), Lurong (Deer Antler, prepared with butter), Huangqi (Astragali Radix, each 3 liang), Muli (Oyster Shell, roasted), Renshen (Ginseng Radix), Houpo (Magnoliae Officinalis Cortex), Chishizhi (Red Halloysite, each 2 liang).
Preparation and Administration: Grind into powder, take 2 qian mixed with rice water on an empty stomach. (Note: *Waitai Miyao* excludes Houpo and Chishizhi, adding Gancao and Shengjiang.)
Gualou Tang (from *Jiyan Fang*): Treats postpartum frequent urination accompanied by thirst.
Herbs: Sangpiaoxiao (Mantis Egg-case), Gancao (Licorice Root, both roasted), Huanglian (Coptidis Rhizoma), Shengjiang (Fresh Ginger, each 2 liang), Gualougen (Trichosanthis Radix, 3 liang), Renshen (Ginseng Radix, 3 liang), Dazao (Jujubae Fructus, 50 pieces).
Preparation and Administration: Cut finely, boil 7 sheng of water until reduced to 2.5 sheng, divide into three doses. Avoid pork and cold water.
*Buyi*: Treats postpartum frequent urination or enuresis. Yizhiren (Alpiniae Oxyphyllae Fructus) ground into powder, taken with rice water.
[Chen] Women during the puerperium may suffer from improper delivery mechanics, injuring the urinary bladder, leading to involuntary urination at any time.
[Dan] I have observed that careless midwives can damage a parturient's urinary bladder, causing dribbling urine which becomes a chronic disability. Once, a young woman named Xu suffered from this due to difficult labor. I reasoned that external muscle tears can be repaired, so perhaps an internal bladder tear could also be treated. Her pulse was very deficient. I stated, "Difficult labor is often due to Qi deficiency; postpartum Qi and Blood are even more deficient. Let us try strong tonification." Thus, Renshen (Ginseng Radix) and Huangqi (Astragali Radix) were used as Sovereign herbs, Xiong (Angelicae Sinensis Radix var. dulcis) and Danggui (Angelicae Sinensis Radix) as Minister herbs, Taoren (Persicae Semen), Chenpi (Citri Reticulatae Pericarpium), Huangqi (Astragali Radix), and Fuling (Poria) as Assistant herbs. The decoction was prepared using broth from pig or sheep bladders, administered when extremely hungry. Although the dose was small, typically only 1 liang, she stabilized after one month. This allowed Qi and Blood to grow rapidly, allowing the bladder to heal naturally; slower progress might have failed.
[Qiaoting] A postpartum woman with urinary incontinence, slight facial edema, and low-grade fever in the afternoon, indicates injury to the urinary bladder by the midwife.
Prescription: Huangqi (Astragali Radix), Danggui Shenyewei (Angelicae Sinensis Radix body and tail), Shaoyao (Paeoniae Radix, each 1.5 qian), Baizhu (Atractylodis Macrocephalae Rhizoma, 1 qian), Renshen (Ginseng Radix), Chenpi (Citri Reticulatae Pericarpium, each 0.5 qian), Gancao (Licorice Root, roasted, a little).
Preparation and Administration: Boil in water, take hot.
[Xue] If the aforementioned syndrome is due to Spleen and Lung Yang deficiency, use Buzhong Yiqi Tang. If due to Liver and Kidney Yin deficiency, use Liuwadihuang Wan (Six-Ingredient Pill with Rehmannia). If due to Liver and Kidney Qi deficiency and cold, use Baweidihuang Wan (Eight-Ingredient Pill with Rehmannia). A postpartum patient with urinary incontinence for two years, with complexion sometimes blue-red or yellow-white, indicated Liver and Spleen Qi deficiency with Blood heat. She gradually recovered using Jiawei Xiaoyao San as the main formula, assisted by Liuwadihuang Wan. Later, due to anger, she experienced spontaneous urination, loose stools, sudden tightness in the left eye, and flushed face. She again used the previous powder (Jiawei Xiaoyao San), assisted by Liujunzi Tang (Six Gentlemen Decoction), to clear Liver Fire, generate Liver Blood, and fortify Spleen Earth, achieving recovery.
*Guangji Fang*: Treats postpartum urinary incontinence.
Method: Burn chicken tail feathers until carbonized but retaining efficacy (cunxing), mix with wine, take one bi daily, three times a day.
*Qianjin Fang*: Treats postpartum enuresis where urine is not expelled consciously.
Herbs: Baiwei (Cynanchi Atrati Radix), Shaoyao (Paeoniae Radix, equal parts).
Preparation and Administration: Grind into powder, take one fangcunbi with wine, three times a day.
Another Formula:
Herbs: Sangpiaoxiao (Mantis Egg-case, half liang, stir-fried), Longgu (Fossilized Bones, 1 liang).
Preparation and Administration: Grind into powder, take 2 qian with rice water before meals.
Guopao San: Treats women whose bladder is ruptured by hand injury during childbirth, causing urinary incontinence.
Herbs: Huang sijuan (Yellow silk fabric, natural yellow only, not dyed. 3 chi, boiled thoroughly in charcoal ash juice, washed clean with clear water, then added with Huangla (Beeswax, half liang), Mi (Honey, 1 liang), Baimaogen (Imperatae Rhizoma, 2 qian), Mapibo mo (Endothelium Corneum Gigeriae Galli powder, 2 qian)).
Preparation and Administration: Boil in 2 sheng of water until reduced to 1 zhen, take all at once on an empty stomach. While taking, hold breath and do not make sound; if sound is made, it is ineffective.
Buyi BUPao Yin: Treats postpartum bladder rupture, inability to urinate for a whole day, only wetting without drying.
Herbs: Sheng sijuan (Raw silk fabric, yellow, 1 chi), Baidanpigenpi (Moutan Cortex), Baiji (Bletillae Rhizoma, each 1 qian).
Preparation and Administration: Boil in one bowl of water until silk dissolves like syrup, take. Do not make sound; if sound is made, it is ineffective.
Jineijin San: Treats postpartum bed-wetting/incontinence.
Method: Take one Jineijin (Endothelium Corneum Gigeriae Galli) along with the intestine, wash, burn into powder, take one fangcunbi mixed with wine.