产后有因败血流入于脾胃，腹胀呕吐者，已于呕吐门中论之矣。然妇人因产，脾胃多虚，饮食
最易停滞而生胀闷，若产毕，随服生化汤消其旧瘀而生其新血，瘀块既消，便大补气血，使脾胃
健运，自无中虚胀满之证。其产后大率因伤食，而误用消导，因气郁而误专顺气，或因多食冷物，
而停滞恶露，或因血虚大便燥结，误下而愈胀。此盖止知伤食当消，气郁当顺，恶露当攻，便结
当下，不知消耗愈多，胃气大损，满闷益增，气不升降，积郁之久，兼成臌胀。若再专
用攻消，不死不休矣。岂知消导佐于补剂内，则脾强而所伤之食消气散；逐瘀佐以养血剂中，则恶
露自行而大便濡润亦通。《秘书》立有治胀方，并养生化滞汤二方，治产后胀症，均未敢专于消导，
前人之虑产深矣。《医通》云∶胎前孕妇服安胎药过多，或正产、半产后，经一两月恶露未净，
此非败血之比，宜导气行血，若用止截误矣。又云∶饱闷恶露不行，多因血逆，宜行瘀为主，如
有块上升，饱闷欲吐者，二陈汤加姜、桂、香附、炮楂、蓬术；块不散，积久愈坚，琥珀黑龙丹。
予谓∶审知饱闷，实因恶露不行所致。若初产，仍宜服生化汤，瘀去而饱闷自开，可无藉乎二陈、炮
楂、蓬术，恐产虚者难当耳。
治胀方 治产后腹胀。
人参（二钱） 白术（土炒） 当归（各三钱） 茯苓（一钱半） 川芎（七分） 陈皮（四
分） 甘草（三分）
养生化滞汤 治产后大便不通，误服大黄等药，致成膨胀。
人参 茯苓 川芎 白芍（炒，各一钱） 当归（四钱） 桃仁（十粒） 肉苁蓉（一钱半，
酒洗去泥甲） 大腹皮（五分，黑豆水制净） 陈皮（四分） 制香附 炙草（各三分）
Postpartum cases involving敗血 (bad blood/stasis) flowing into the Spleen and Stomach, causing abdominal distension and vomiting, have already been discussed in the chapter on Vomiting. However, women often have deficient Spleen and Stomach Qi after childbirth, making food stagnation prone to occur and generate distension and fullness. If, after delivery, Shenghua Tang (Life-Birth Decoction) is taken immediately to resolve old stasis and generate new blood, and once the clots are resolved, substantial tonification of Qi and Blood is administered to strengthen Spleen and Stomach transportation, then symptoms of middle-Jiao deficiency with distension will naturally be absent.
Most postpartum conditions arise from food injury, yet incorrect use of digestive-promoting methods occurs; or from Qi stagnation, yet exclusive use of Qi-regulating methods occurs; or from excessive consumption of cold foods, leading to retention of lochia; or from Blood deficiency causing dry stool constipation, where incorrect purgative treatment exacerbates the distension. These situations only recognize that food injury requires digestion promotion, Qi stagnation requires regulation, lochia requires expulsion, and constipation requires purging, without realizing that excessive depletion severely damages Stomach Qi, thereby increasing fullness and distension. With failure of Qi ascending and descending, prolonged accumulation eventually transforms into鼓胀 (drum-like distension). If one continues to exclusively use attacking and resolving methods, death is inevitable. How can it be known that adding digestive promoters to tonic formulas strengthens the Spleen, allowing injured food to dissipate; and adding blood-activating herbs to blood-nourishing formulas allows lochia to pass naturally while moistening the intestines to relieve constipation? *Fu Ke Mi Shu* (Secrets of Gynecology) established two formulas for treating distension: Zhi Zhang Fang (Distension-Curing Formula) and Yang Sheng Hua Zhi Tang (Nourish-Life Resolve-Stasis Decoction). In treating postpartum distension, these formulas dare not rely solely on digestive promotion, demonstrating the profound caution of predecessors regarding postpartum care.
*Yi Tong* states: If a pregnant woman takes too many fetal-anchoring medicines, or if lochia remains unclean for one or two months after normal delivery or miscarriage, this is not comparable to bad blood stasis; one should guide Qi and move Blood. Using hemostatic or astringent methods would be an error. It also states: Fullness and inability to pass lochia are often due to reversed Blood flow; the primary treatment should be moving stasis. If there are masses rising upward, causing fullness and nausea, use Er Chen Tang (Two-Cured Decoction) plus Sheng Jiang (Fresh Ginger), Rou Gui (Cinnamon Bark), Xiang Fu (Cyperus Rhizome), Pao Zha (Fried Hawthorn Fruit), and Peng Zhu (Curcuma Zedoaria Rhizome); if the mass does not disperse and becomes harder over time, use Hu Po Hei Long Dan (Amber Black Dragon Pill).
I assert: Upon careful examination, fullness is indeed caused by the failure of lochia to pass. In initial postpartum cases, Shenghua Tang (Life-Birth Decoction) is still appropriate; once stasis is removed, fullness naturally resolves, eliminating the need for Er Chen Tang, Fried Hawthorn, or Curcuma Zedoaria, which might be too harsh for postpartum deficiency.
Zhi Zhang Fang (Distension-Curing Formula): Treats postpartum abdominal distension.
Ren Shen (Ginseng Radix et Rhizoma) (2 qian), Bai Zhu (Atractylodis Macrocephalae Rhizoma, stir-fried with earth) (3 qian each with Dang Gui), Dang Gui (Angelicae Sinensis Radix) (3 qian each), Fu Ling (Poria) (1.5 qian), Chuan Xiong (Ligusticum Chuanxiong Rhizoma) (0.7 fen), Chen Pi (Citri Reticulatae Pericarpium) (0.4 fen), Gan Cao (Glycyrrhizae Radix et Rhizoma) (0.3 fen).
Yang Sheng Hua Zhi Tang (Nourish-Life Resolve-Stasis Decoction): Treats postpartum constipation resulting from distension caused by the erroneous use of Da Huang (Rhei Radix et Rhizoma) and other purgatives.
Ren Shen (Ginseng Radix et Rhizoma), Fu Ling (Poria), Chuan Xiong (Ligusticum Chuanxiong Rhizoma), Bai Shao (Paeoniae Radix Alba, stir-fried) (1 qian each), Dang Gui (Angelicae Sinensis Radix) (4 qian), Tao Ren (Persicae Semen) (10 kernels), Rou Cong Rong (Cistanche Deserticolae Caulis) (1.5 qian, washed with wine to remove mud and scales), Da Fu Pi (Arecae Pericarpium) (0.5 fen, processed with black bean water), Chen Pi (Citri Reticulatae Pericarpium) (0.4 fen), Zhi Xiang Fu (Cyperi Rhizoma, processed), Zhi Gan Cao (Glycyrrhizae Radix et Rhizoma, honey-fried) (0.3 fen each).