典藏书目

Postpartum diarrhea cannot be treated in the same manner as general miscellaneous diseases. Generally, it is caused by deficiency of Middle Qi (Middle Jiao Qi), leading to dysfunction of transportation and transformation, involving Qi deficiency, food stagnation, and dampness. Qi deficiency should be tonified, food stagnation should be resolved, and dampness should be dried. However, if lochia (postpartum vaginal discharge) has not yet cleared, it is difficult to immediately use harsh tonification, strong resolution, or urgent drying methods. One should first administer Lianzi Shenghua Decoction (Lotus Seed Decoction for Generating New Blood) for three doses to resolve stasis and generate new blood. The formula contains Lotus Seed (Nelumbinis Semen) and Poria (Poria) to tonify the Spleen and promote urination, simultaneously treating the diarrhea. Once the old blood is resolved and new blood generated, then Jianpi Lishui Shenghua Decoction (Spleen-Strengthening and Water-Draining Decoction for Generating New Blood) can be used. Depending on the syndrome, herbs that tonify Qi, resolve food, transform accumulation, or dry dampness and separate clear from turbid are added appropriately. This avoids errors such as causing stagnation or worsening deficiency with deficiency-inducing treatments. After ten days postpartum, treatment may follow the principles for general miscellaneous diseases, but one must still assess the patient's deficiency or excess before treating.

If there is abdominal pain with watery diarrhea, borborygmus (intestinal rumbling), and undigested rice or drinks, this is Cold Diarrhea; treat with warming methods. If stool is yellow and the anus is painful, this is Heat Diarrhea; treat with clearing methods. If excessive food intake damages the Spleen/Stomach, accompanied by belching with a smell like rotten eggs, this is Food Stagnation; treat with resolving methods. If food intake is reduced, with borborygmus and abdominal urgency after eating, feeling relief only after passing all ingested food, this is Spleen Deficiency with Food Stagnation; treat by tonifying the Spleen while resolving stagnation. Zhu Danxi stated: In cases of postpartum deficient diarrhea accompanied by blurred vision and inability to recognize people, this is a critical condition; rescue with Shenling Zhufu Tang (Ginseng, Poria, Atractylodes, and Aconite Decoction). Another scenario involves prolonged diarrhea during pregnancy that continues postpartum, leading to Qi collapse. In such cases, temporarily administer Shenling Shenghua Decoction (Ginseng, Poria, and Shenghua Decoction) to support deficiency, adjusting based on the presence or absence of mass-related pain. For diarrhea combined with heat, avoid using Scutellariae Radix (Huangqin), Coptidis Rhizoma (Huanglian), Gardeniae Fructus (Zhizi), and Phellodendri Cortex (Huangbai). For diarrhea combined with phlegm, avoid using Pinelliae Rhizoma (Banxia) and Zingiberis Rhizoma Recens (Shengjiang). If diarrhea is accompanied by thirst, use Shenmai Yin (Ginseng and Ophiopogon Drink) to restore body fluids. For persistent postpartum Spleen-diarrhea, Shenling Lianzi Yin (Ginseng, Poria, and Lotus Seed Drink) is effective.

"Complete digestion failure" (passage of undigested food in stool) occurs because labor fatigue injures Spleen Qi, delaying transport and transformation. When food and water enter the Stomach, their essence floats up and disperses to the Spleen; the Spleen scatters these essences upward to the Lung, which regulates water passages, thereby generating Qi and nourishing the Zang organs to sustain the human body. Now, due to labor-induced Spleen injury, the harmonious Qi fails to transform, resulting in the passage of undigested food. This disease is named Sun Xie (Sundown Diarrhea/Incomplete Digestion). Additionally, overeating damaging the Spleen/Stomach also causes complete digestion failure, commonly known as Shuigu Li (Water-Food Dysentery). However, within three days postpartum, when blood masses have not yet dispersed, suffering from this syndrome of Spleen failure and Stomach weakness, one should not hastily use Atractylodis Macrocephalae Rhizoma (Baizhu) etc., but instead take Jiawei Shenghua Tang (Modified Shenghua Decoction). It contains Yi Zhi Ren (Alpinia Oxyphylla Fruit) and Sha Ren (Amomum Villosum Fruit) to mildly warm and move Qi. Wait until the blood masses disperse, then take Shenling Dabu Shenghua Tang (Ginseng, Poria, and Great Tonification Shenghua Decoction). If Stomach Qi is deficient with yellow diarrhea, use Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) plus Mugwort (Muxiang). For chronic dysentery/diarrhea due to deficiency, use Shenxiang San (Ginseng and Aucklandia Powder). If chronic diarrhea leads to sinking of Yuan Qi (Primal Qi), incontinence of feces, and a sensation of anal prolapse, use Jiawei Liujunzi Tang (Modified Six Gentlemen Decoction). If complete digestion failure is seen with white, porridge-like stool, this indicates severe Spleen/Stomach deficiency and collapse of Yuan Qi, with nine out of ten cases being fatal. Only vigorous administration of warming and tonifying agents can potentially reverse the condition. Even if restlessness, fever, red face, and rapid, large pulses appear, these are due to Deficient Fire flaming upward. One should concurrently administer Cinnamomi Ramulus (Guizhi), Aconiti Lateralis Radix Praeparata (Fuzi), Ginseng Radix et Rhizoma (Renshen), Glycyrrhizae Radix et Rhizoma (Gancao), Zingiberis Rhizoma (Ganjiang), Scutellariae Radix (Huangqin), and Atractylodis Macrocephalae Rhizoma (Baizhu), decocted in water prepared from Fulonggan (Dragon's House Soil), which can still achieve success. If urine is turbid like rice washings, or white foam resembling intestinal mucus appears in stool, this is due to sinking of Yuan Qi; Bu Zhong Yi Qi Tang plus Guizhi, Poria, and Pao Jiang (Prepared Ginger) should be used to raise and lift. If foul-smelling watery diarrhea persists, add Qiai (Qiai Ye), Xiangfu (Cyperi Rhizoma), and Wuzhuyu (Evodiae Fructus). If accompanied by blood stasis obstruction, abdominal distension, and wheezing/urgency, even divine medicine will be of no help. If feces are passed involuntarily without awareness (Yi Shi), use Buzhong Yiqi Tang plus Roushengrong (Cistanche Deserticola) and Guzhi (Psoraleae Fructus).

Lianzi Shenghua Decoction: Treats postpartum diarrhea with unresolved blood masses.
Chuanxiong, Fuling (2 qian each), Danggui (4 qian; one prescription uses 1 qian fried with yellow earth), Paojiang (0.4 qian), Taoren (10 kernels, peeled and slit), Zhigancao (0.5 qian), Lianrou (10 pieces, heart removed).
Decoct in water and drink. One prescription excludes Taoren.

Jianpi Lishui Shenghua Decoction:
Chuanxiong, Danggui (fried with yellow earth, 1 qian each), Baizhu (2 qian, fried with earth), Zexie (0.8 qian), Ganjiang (0.4 qian, prepared), Chenpi, Zhigancao (0.5 qian each), Rouguo (1 piece, baked), Renshen (3 qian), Fuling (1.5 qian).
One prescription excludes Fuling. For Cold Diarrhea, add Sharen (0.8 qian) and Pao Ganjiang (0.8 qian). For Heat Diarrhea, add Chao Huanglian (0.5 qian). For watery diarrhea with abdominal pain and undigested food, add Sharen (0.6 qian), Shanzha, and Maiya. For diarrhea with sour, foul belching indicating food stagnation, add Shenqu (0.8 qian), Sharen (0.8 qian), Shanzha, and Maiya. For poor appetite with discomfort relieved by diarrhea, also consider food stagnation. For chronic Spleen-deficiency diarrhea, add Shengma. For profuse watery diarrhea without abdominal pain, indicating dampness, add Zhi Cangzhu (1 qian) to dry dampness. All diarrhea formulas must include 10 Lotus Seeds.

Shenling Zhufu Tang: Zhu Danxi used this to rescue critical postpartum deficient diarrhea with blurred vision and inability to recognize people.
Renshen (7 qian), Baizhu (3 qian, fried with earth), Fuling, Fuzhi (prepared, 1 qian each).
Decoct in water and drink.

Shenling Shenghua Decoction: Treats prolonged diarrhea during pregnancy continuing postpartum.
Renshen, Danggui (2 qian each), Ganjiang (prepared), Zhigancao (0.5 qian each), Heqipi, Chuanxiong, Shanyao (fried, 1 qian each), Rouguo (1 piece, wrapped in flour and baked), Fuling (1.5 qian), Lianzi (7 grains), Nuomi (a large pinch).
Decoct in water and drink. For severe deficiency, add 3-4 qian of Renshen. If within seven days, mass-pain persists, reduce Renshen, Rouguo, and Heqipi to relieve pain. If blood masses are painless, add Baizhu fried with earth (2 qian) and Chenpi (0.3 qian).

Shenling Lianzi Yin: Treats persistent postpartum Spleen-diarrhea and long-standing Spleen-diarrhea.
Renshen, Baizhu (fried with earth, 2 qian each), Baishao (0.8 qian, fried), Danggui (1.5 qian), Bai Fuling, Shanyao (1 qian each), Shengma, Chenpi (0.3 qian each), Zhigancao (0.4 qian), Lianzi (12 grains, heart removed).
Add 2 slices of Ginger, decoct in 3 zhong of water. Take the medicine with the Lotus Seeds from the decoction. For severe abdominal pain, add Chao Hei Ganjiang (0.5 qian). For severe deficiency, add 3-4 qian of Renshen.

Jiawei Shenghua Tang: Treats postpartum Spleen deficiency, unresolved blood masses within three days, complete digestion failure, and constitutional weakness prior to pregnancy. Not suitable for Weiling Tang; this formula is primary.
Chuanxiong, Yizhiren, Sharen (1 qian each), Danggui (4 qian, fried with earth), Paojiang (0.4 qian), Zhigancao (0.5 qian), Fuling (1.5 qian), Taoren (10 kernels, peeled and slit).
Decoct in water and drink.

Shenling Dabu Shenghua Decoction: Treats postpartum state after blood-mass pain ceases; take this to tonify, and complete digestion will normalize.
Renshen, Baizhu (fried with earth, 2 qian each), Chuanxiong, Danggui, Yizhiren, Baishao (fried), Fuling (1 qian each), Ganjiang (0.4 qian, prepared), Rouguo (1 piece, flour-baked), Zhigancao (0.5 qian), Lianzi (8 pieces, heart removed).
Decoct in water and drink. For diarrhea with abdominal pain, add Sharen (0.8 qian). For profuse watery diarrhea, add Zexie and Mutong (0.8 qian each). For thirst, add Qu Xin Maidong and Wuweizi. For cold, double Pao Jiang and add Muxiang (0.4 qian). For food-stagnation yellow stool, choose 1-2 of Shenqu, Maiya, Shanzha, Sharen to add.

Shenxiang San: Treats chronic diarrhea/dysentery due to deficiency.
Renshen, Muxiang (2 qian each), Roubdou, Fuling, Bidou (4 qian each), Chenpi, Suske (1 qian each).
Grind into powder, take with rice water.

Jiawei Liujunzi Tang: For prolonged postpartum diarrhea with weak Stomach Qi and complete digestion failure; appropriate to warm and assist Stomach Qi.
Renshen, Fuling, Banxia (prepared, 1 qian each), Baizhu (2 qian, fried with earth), Chenpi, Zhigancao (0.8 qian each), Rouguo (1 piece, baked熟 in flour, remove flour), Muxiang (0.3-0.4 qian).
Decoct in water and drink. One prescription includes Zhi Ganjiang (0.4 qian).

Shenmai Yin (See Syncope Section in this volume). Buzhong Yiqi Tang (See Pain Sections in previous volume).