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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.)