郭稽中曰∶产后腹满闷，呕吐不定者何。答曰∶败血散于脾胃，脾受之则不能运化精微
而成腹胀，胃受之则不能受纳水谷而生吐逆，医者不识，若以寻常治胀止吐药治之，病与药
不相于，更伤正气，疾愈难治，但服抵圣汤则愈。（稽中之言虽泥于败血，而其方亦加参，立
齐之言纯于补气，似近于偏，临症似宜斟酌）
薛氏曰∶前证若败血伤于脾胃，宜用前方；若饮食停于脾，宜用六君加浓朴；若饮食
伤于胃，宜用六君子汤。大凡损其脾者，当节其饮食为善。（节饮食者，损谷自愈之理）
一产妇患前证，或用抵当汤（抵当汤太峻，似非产后所宜，即参用之，亦不得已也。如
下后重坠，即不用抵当，亦宜升补），败血已下，前证益甚，小腹重坠，似欲去后。余谓此脾
气虚而下陷，用补中益气汤加炮姜温补脾气，重坠如故，又用六君子汤而安。
抵圣汤 治产后腹胀满闷，呕吐不定，盖败血入于脾胃，而脾不能运化，故胃不能纳谷
（是法家语，简当），以致呕吐腹胀等症。（薛氏曰∶此方最宜用。此方亦稳当，即半夏能破血，
立斋曰最宜，以其有和胃益气之物也）
赤芍药 半夏（汤泡） 泽兰叶 陈皮（去白） 人参（各一钱） 甘草（炙，五分）
上作一服，加生姜三片，水煎温服。恶露过多者，去泽兰赤芍药，倍加陈皮生姜。
香砂养胃汤 治产后呕吐，饮食不下，腹胀者，此败血攻于脾胃之间，日久成反胃之
症。（败血日久成反胃者，理实有之，而古方六丁丸可治，此方不能治瘀血也）
半夏（一钱） 白术 陈皮 茯苓 浓朴 香附子（各八分） 人参 藿香 砂仁 槟榔
草果（各五分） 甘草（四分）
上锉，加生姜三片，乌梅一个，水煎服。（与人参养胃汤少有差别，而香附槟榔砂仁白
术皆得治法之要）
加味六君子汤 治饮食停滞于脾，以致腹胀呕吐。
人参 白术 茯苓 甘草（炙，减半） 陈皮（去白） 半夏（汤泡七次） 浓朴（姜制，各一钱）
上锉，加生姜三片，水煎服。（此立斋方也，如果有饮食停滞者，不妨另为加减）
加味平胃散 治产后腹胀。（以平胃加人参，总是虑产后气虚之故；却为医家作一法眼）
浓朴（姜炒） 苍术（米泔浸，炒） 陈皮 甘草（炙） 人参（各一钱）
上锉，水煎服。
紫金丹 治产后冲胀，胸中有物，状如噎气。
代赭石 磋砺石（各等分）
上为细末，醋糊丸如桐子大，每服三五十丸，酒下。胸中痛，加当归，汤下，久服治血癖。
（丹溪云∶上升之气自肝出。产后肝血虚而肝气盛，以是冲上作胀，用代赭者，镇子气之上
逆也，醋丸更妙，磋砺石即磨刀石，亦为肝而设）
又方（此兼血胀）
代赭石（一两） 桃仁（三钱，炒，去皮尖） 大黄（半两）
上为末，薄荷水打糊丸如桐子大，每服三五十丸，温水下，无时。
白圣散 治产后腹大坚满，喘不能卧。（此治水法，惟有余者可服，曰治喘者，因水逆
而上喘也，水下则喘自止矣）
樟柳根（三两） 大戟（一两半） 甘遂（一两，炒）
上为极细末，每服二三钱，热汤调下，取大便宜利为度，此主水气之圣药也。（此药峻
利，不可轻用）
郭稽中说：产后腹部胀满闷塞，呕吐不定的原因是什么？回答说：这是败血（指瘀血）散乱于脾胃所致。脾受到邪气影响，则不能运化精微物质，从而形成腹胀；胃受到邪气影响，则不能受纳水谷，从而产生呕吐逆气。医生如果不了解这一点，若用通常治疗腹胀和止吐的药物来治疗，药不对症，反而会损伤正气，使疾病更加难以治愈。只要服用抵圣汤即可痊愈。（郭稽中的言论虽然拘泥于“败血”这一观点，但其方剂中也加入了人参，薛立斋的言论纯粹侧重于补气，似乎有些偏颇，临证时应当斟酌处理。）
薛氏说：上述症状如果是败血损伤了脾胃，适宜使用前面的方剂（指抵圣汤）；如果是饮食停滞在脾，适宜使用六君子汤加浓朴；如果是饮食损伤了胃，适宜使用六君子汤。大凡损伤脾气的情况，应当节制饮食为好。（节制饮食，符合减少谷物摄入以自愈的道理。）
有一位产妇患上述症状，有人使用了抵当汤（注：抵当汤药性过于峻猛，似乎不适合产后使用，即使参用，也是迫不得已的情况。如下腹有重坠感，即不使用抵当汤，也应当采用升提补益的方法）。服药后瘀血虽已排出，但前述症状反而加重，小腹重坠，感觉想要解大便。我认为这是脾气虚弱而下陷所致，于是使用补中益气汤加炮姜来温补脾气。服药后重坠感依旧，又改用六君子汤才安定下来。
抵圣汤：治疗产后腹胀满闷，呕吐不定。这是因为败血进入脾胃，脾不能运化，导致胃不能受纳食物（这是法家风格的语言，简洁恰当），从而引起呕吐、腹胀等症状。（薛氏说：此方最适宜使用。此方也很稳妥，即便半夏能破血，薛立斋认为最适宜，是因为其中含有和胃益气的药物。）
赤芍药、半夏（开水烫过）、泽兰叶、陈皮（去白）、人参（各一钱）、甘草（炙，五分）。
以上为一服量，加生姜三片，水煎，温服。如果恶露过多，去掉泽兰和赤芍药，加倍增加陈皮和生姜。
香砂养胃汤：治疗产后呕吐，饮食不下，腹胀。这是因为败血攻冲于脾胃之间，日久形成反胃的症状。（注：败血日久形成反胃，道理上确实存在，但古方中的六丁丸可以治疗，此方不能治疗瘀血。）
半夏（一钱）、白术、陈皮、茯苓、浓朴、香附子（各八分）、人参、藿香、砂仁、槟榔、草果（各五分）、甘草（四分）。
以上锉碎，加生姜三片，乌梅一个，水煎服。（与人参养胃汤略有差别，而香附、槟榔、砂仁、白术都抓住了治疗的要领。）
加味六君子汤：治疗饮食停滞在脾，导致腹胀呕吐。
人参、白术、茯苓、甘草（炙，减半）、陈皮（去白）、半夏（开水烫七次）、浓朴（姜制，各一钱）。
以上锉碎，加生姜三片，水煎服。（这是薛立斋的方子，如果有饮食停滞的情况，不妨另外进行加减。）
加味平胃散：治疗产后腹胀。（在平胃散中加入人参，总是考虑到产后气虚的缘故；这为医家提供了一个诊疗的眼目/思路。）
浓朴（姜炒）、苍术（米泔水浸泡，炒）、陈皮、甘草（炙）、人参（各一钱）。
以上锉碎，水煎服。
紫金丹：治疗产后冲气上逆导致的胀满，胸中有异物感，状如噎气。
代赭石、磋砺石（各等分）。
以上研为细末，醋糊制成梧桐子大小的丸药，每次服用三五十丸，酒送下。如果胸中痛，加当归，汤送下，久服可治疗血癖（体内积块）。
（朱丹溪说：上升的气自肝而出。产后肝血虚而肝气盛，因此冲气上逆导致胀满，使用代赭石是为了镇摄上逆之气，用醋制丸药更妙。磋砺石即磨刀石，也是为了调理肝脏而设。）
又一方（此方兼治血胀）：
代赭石（一两）、桃仁（三钱，炒，去皮尖）、大黄（半两）。
以上研为末，薄荷水打糊制成梧桐子大小的丸药，每次服用三五十丸，温水送下，不限时间。
白圣散：治疗产后腹部大而坚硬胀满，气喘不能卧。（这是治水的方法，只有实证者可以服用。所谓治疗气喘，是因为水气上逆导致气喘，水下行则气喘自然停止。）
樟柳根（三两）、大戟（一两半）、甘遂（一两，炒）。
以上研为极细末，每次服用二三钱，热开水调下，以大便利下为度。这是主治水气的圣药。（此药峻烈通利，不可轻易使用。）
Guo Jizhong stated: What is the cause of abdominal fullness and stifling sensation accompanied by irregular vomiting after childbirth? The answer is that this results from retained blood (stasis) dispersing into the Spleen and Stomach. When the Spleen is affected, it fails to transform and transport essence and nutrients, leading to abdominal distension; when the Stomach is affected, it fails to receive and digest food and fluids, resulting in vomiting and regurgitation. If physicians fail to recognize this and treat it with ordinary medicines for distension and vomiting, the medication will not address the root cause, further damaging the healthy Qi, making the disease more difficult to cure. However, administering Disheng Tang (Cinnamon Twig and Ginseng Decoction) will lead to recovery. (Although Guo's theory is somewhat rigid regarding "retained blood," his prescription includes Ren Shen [Ginseng Root]. Xue Li Zhai's approach focuses purely on tonifying Qi, which seems biased; clinical judgment should be exercised.)
Xue Shi said: For the aforementioned symptoms, if they are caused by retained blood injuring the Spleen and Stomach, the previous formula (Disheng Tang) should be used; if food stagnation is in the Spleen, Liu Jun Zi Tang (Six Gentlemen Decoction) added with Hou Po (Magnolia Bark) is appropriate; if food injury is in the Stomach, Liu Jun Zi Tang (Six Gentlemen Decoction) alone is suitable. Generally, when the Spleen is damaged, regulating diet is beneficial. (Regulating diet aligns with the principle of reducing grain intake to facilitate self-healing.)
A postpartum patient suffered from these symptoms. Someone administered Didang Tang (Ephedra and Rhubarb Decoction). (Note: Didang Tang is too harsh and generally unsuitable for postpartum conditions; even if used, it should be a last resort. If there is a sensation of heaviness and bearing down below, Sheng Bu [lifting and tonifying] methods should be employed instead of Didang Tang.) After administration, although the lochia was expelled, the preceding symptoms worsened, with severe heaviness in the lower abdomen and a sensation of needing to defecate. I reasoned this was due to deficiency and sinking of Spleen Qi. Therefore, I prescribed Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction) with Pao Jiang (Prepared Ginger) to warm and tonify Spleen Qi. The heaviness persisted, so I subsequently used Liu Jun Zi Tang (Six Gentlemen Decoction), which resolved the condition.
Disheng Tang (Cinnamon Twig and Ginseng Decoction): Treats postpartum abdominal fullness, stifling sensation, and irregular vomiting. This occurs because retained blood enters the Spleen and Stomach; the Spleen fails to transform, causing the Stomach to fail to receive food, leading to vomiting and abdominal distension. (Xue Shi commented: This formula is highly suitable. It is also safe; although Ban Xia [Pinellia Tuber] can break blood stasis, Xue Li Zhai deemed it most appropriate because it contains herbs that harmonize the Stomach and tonify Qi.)
Ingredients: Chi Shao Yao (Red Peony Root), Ban Xia (Pinellia Tuber, prepared with boiling water), Ze Lan Ye (Herba Lycopi), Chen Pi (Pericarpium Citri Reticulatae, white pith removed), Ren Shen (Radix Ginseng) — each 1 qian; Zhi Gan Cao (Honey-fried Licorice Root) — 0.5 qian.
Prepare as one dose. Add three slices of fresh ginger, decoct in water, and take warm. If lochia flow is excessive, remove Ze Lan Ye and Chi Shao Yao, and double the dosage of Chen Pi and fresh ginger.
Xiang Sha Yang Wei Tang (Amomum and Aucklandia Decoction for Nourishing the Stomach): Treats postpartum vomiting, inability to eat, and abdominal distension. This is caused by retained blood attacking between the Spleen and Stomach, eventually leading to reverse reflux over time. (Note: While retained blood causing reverse reflux over time is theoretically possible, the ancient formula Liu Ding Wan [Six Yin Pill] is indicated for this, whereas this formula does not treat blood stasis.)
Ingredients: Ban Xia (Pinellia Tuber) — 1 qian; Bai Zhu (Atractylodes Macrocephala Rhizome), Chen Pi (Pericarpium Citri Reticulatae), Fu Ling (Poria), Hou Po (Magnolia Bark), Xiang Fu (Cyperus Rhizome) — each 0.8 fen; Ren Shen (Radix Ginseng), Huo Xiang (Patchouli Herb), Sha Ren (Amomum Fruit), Bing Lang (Areca Seed), Cao Guo (Tsaoko Fruit) — each 0.5 fen; Gan Cao (Licorice Root) — 0.4 fen.
Crush the ingredients. Add three slices of fresh ginger and one Chinese plum (Wu Mei), decoct in water, and take. (This differs slightly from Ren Shen Yang Wei Tang, but Xiang Fu, Bing Lang, Sha Ren, and Bai Zhu capture the essentials of treatment.)
Jia Wei Liu Jun Zi Tang (Modified Six Gentlemen Decoction): Treats abdominal distension and vomiting caused by food stagnation in the Spleen.
Ingredients: Ren Shen (Radix Ginseng), Bai Zhu (Atractylodes Macrocephala Rhizome), Fu Ling (Poria), Zhi Gan Cao (Honey-fried Licorice Root, halved dosage), Chen Pi (Pericarpium Citri Reticulatae, white pith removed), Ban Xia (Pinellia Tuber, boiled seven times), Hou Po (Magnolia Bark, processed with ginger juice) — each 1 qian.
Crush the ingredients. Add three slices of fresh ginger, decoct in water, and take. (This is Xue Li Zhai's formula. If food stagnation is present, modifications may be made as needed.)
Jia Wei Ping Wei San (Modified Flat Stomach Powder): Treats postpartum abdominal distension. (Adding Ren Shen [Ginseng Root] to Ping Wei San accounts for postpartum Qi deficiency; this provides a diagnostic perspective for physicians.)
Ingredients: Hou Po (Magnolia Bark, stir-fried with ginger), Cang Zhu (Atractylodes Lancea Rhizome, soaked in rice wash water and stir-fried), Chen Pi (Pericarpium Citri Reticulatae), Zhi Gan Cao (Honey-fried Licorice Root), Ren Shen (Radix Ginseng) — each 1 qian.
Crush the ingredients, decoct in water, and take.
Zijin Dan (Purple Gold Pill): Treats postpartum Chong vessel qi rebellion causing distension, with a foreign body sensation in the chest resembling globus hystericus.
Ingredients: Dai Zhe Shi (Hematitum) and Cuo Li Shi (Lapis Quinquelaterae) — equal parts.
Grind into fine powder. Make pills using vinegar paste, sized like paulownia seeds. Take 30–50 pills per dose with wine. If there is chest pain, add Dang Gui (Angelica Sinensis) and take with decoction. Long-term use treats blood masses (Xue Pi). (Zhu Danxi stated: Ascending Qi originates from the Liver. Postpartum Liver Blood deficiency leads to Liver Qi excess, causing ascending rebellion and distension. Dai Zhe Shi [Hematitum] is used to subdue rebellious Qi; vinegar-coated pills are superior. Cuo Li Shi [Lapis Quinquelaterae], i.e., whetstone, is also set for the Liver.)
Another Formula (for concurrent blood distension):
Ingredients: Dai Zhe Shi (Hematitum) — 1 liang; Tao Ren (Prunus Persica Seed), stir-fried, skin and tips removed — 3 qian; Da Huang (Rhei Radix et Rhizoma) — 0.5 liang.
Grind into powder. Make pills using mint water paste, sized like paulownia seeds. Take 30–50 pills per dose with warm water, at any time.
Bai Sheng San (White Holy Powder): Treats postpartum large, hard, and full abdominal distension with asthma preventing lying down. (This is a method for treating water retention, suitable only for excess patterns. The term "treating asthma" refers to asthma caused by water Qi rebelling upward; once water moves downward, the asthma stops.)
Ingredients: Zhang Liu Gen (Root Bark of Salix chaenomeloides) — 3 liang; Da Ji (Euphorbiae Pekinensis Radix) — 1.5 liang; Gan Sui (Kansui Radix), stir-fried — 1 liang.
Grind into an extremely fine powder. Take 2–3 qian per dose, mixed with hot water. The goal is profuse bowel movement. This is a holy medicine for treating water Qi. (Note: This medicine is harsh and purgative; do not use lightly.)