天津张姓妇年二十六岁，流产之后胃脘满闷，不能进食。
病因 孕已四月，自觉胃口满闷，倩人以手为之下推，因用力下推至脐，遂至流产。
证候 流产之后，忽觉气血上涌充塞胃口，三日之间分毫不能进
食。动则作喘，头目眩晕，心中怔忡，脉象微弱，两尺无根。
诊断 此证因流产后下焦暴虚，肾气不能固摄冲气，遂因之上冲。夫冲脉原上隶阳明胃府，
其气上冲胃气即不能下降（胃气以息息下行为顺），是以胃中胀满，不能进食。治此等证者，若用
开破之药开之，胀满去而其人或至于虚脱。宜投以峻补之剂，更用重镇之药辅之以引之下行，则
上之郁开而下焦之虚亦即受此补剂之培养矣。
处方 大潞参（四钱） 生赭石（一两轧细） 生怀山药（一两） 熟怀地黄（一两）
玄参（八钱） 净萸肉（八钱） 紫苏子（三钱炒捣） 生麦芽（三钱）
共煎汤一大盅，分两次温服下。
方解 按方中用生麦芽，非取其化食消胀也。诚以人之肝气宜升，胃气宜降，凡用重剂降胃，
必须少用升肝之药佐之，以防其肝气不舒。麦芽生用原善舒肝，况其性能补益胃中酸
汁，兼为化食消胀之妙品乎。
效果 将药煎服一剂，胃中豁然顿开，能进饮食，又连服两剂，喘与怔忡皆愈。
A twenty-six-year-old woman surnamed Zhang from Tianjin experienced fullness and stifling sensation in the epigastrium (upper abdomen) and inability to eat after a miscarriage.
Etiology She had been pregnant for four months and felt fullness and stifling at the stomach opening. She asked someone to push downwards with their hand; due to excessive force applied down to the umbilicus, it resulted in miscarriage.
Symptoms After the miscarriage, she suddenly felt Qi and Blood surging upward and obstructing the stomach opening. For three days, she could not consume any food. Movement induced panting, dizziness, palpitations (Zhen Tong), a faint pulse, and rootless pulses at both Chi positions.
Diagnosis This condition arises because the Lower Jiao (Lower Burner) became severely deficient after the miscarriage, causing Kidney Qi to fail in securing Chong Mai (Penetrating Vessel) Qi, leading to its upward rebellion. The Chong Mai originally attaches to the Yangming Stomach Fu organ. When Chong Qi rebels upward, Stomach Qi cannot descend (the physiological norm of Stomach Qi is downward movement). Consequently, there is distension in the stomach and an inability to eat. In treating such conditions, if one uses drugs that open and break stagnation, although the distension may be relieved, the patient might suffer from collapse due to deficiency. It is appropriate to administer potent tonifying agents, assisted by heavy sedatives to guide the Qi downward. Thus, the upper stagnation will be resolved, and the deficiency in the Lower Jiao will be nourished by the tonifying agent.
Prescription Da Lu Shen (Radix Codonopsis Pilosae, 4 qian), Sheng Zhe Shi (Hematitum, 1 liang, crushed), Sheng Huai Shan Yao (Rhizoma Dioscoreae Hypoglaucae, 1 liang), Shu Huai Di Huang (Radix Rehmanniae Preparata, 1 liang), Xuan Shen (Radix Scrophulariae, 8 qian), Jing Yu Rou (Fructus Corni Officinalis, 8 qian), Zi Su Zi (Fructus Perillae, 3 qian, stir-fried and crushed), Sheng Mai Ya (Fructus Hordei Germinatus, 3 qian).
Decoct together in a large cup of water, divide into two doses, and take warm.
Formula Analysis: The use of Sheng Mai Ya (Fructus Hordei Germinatus) in this formula is not primarily for digesting food or reducing distension. Indeed, Liver Qi should ascend, while Stomach Qi should descend. Whenever heavy agents are used to direct Stomach Qi downward, a small amount of herbs that ascend Liver Qi must be added as assistants to prevent the stagnation of Liver Qi. Raw Mai Ya is naturally good at soothing the Liver. Moreover, its properties can replenish sour juices in the Stomach and serve as an excellent remedy for digestion and reducing distension.
Outcome: After taking one dose of the decoction, the epigastric fullness was instantly relieved, and she was able to eat. After taking two more consecutive doses, the panting and palpitations were completely cured.