凡病呃逆者，乃逆气使然。盖此气从胃中出，上冲贲门吃忒而作声也。有胃气
虚寒者；有中气大虚，冲任之火直犯清道而上者；有饮水过多，水停而逆者；有大小便闭，下焦不通其
气上逆者；有胃绝者。至于产后呃逆，乃胃虚气寒证也。有云呃噫者，胃气所生，宜加味理中汤主之。《医通》
云∶产后气血俱虚，风冷搏气而逆上，乃胃气虚寒之极，最为恶候，理中加丁香。古方以丁香、豆蔻、
伏龙肝为末，用桃仁、吴萸煎汤调下一钱匙，如人行五里再服。未应，急投参、附，迟则不救。《尊生》治吃忒
云∶以可异事，或费滋索事，出其不意扣之，令其思维立止。又立羌附汤以治之。冯氏云∶如中气大虚，
下焦阴火上冲而致呃逆者，当用桂、附、干姜之类。
加味理中汤
人参 白术（土炒。各一钱） 干柿蒂（二钱） 丁香 炮姜（各五分） 陈皮 炙草（各八分）
水煎服。有热，去丁香，加竹茹二钱。如虚羸太甚，饮食减少呃逆者，胃绝也，难治。
羌附汤
羌活 制附子 小茴香（各五分） 木香 生姜（各二分五厘） 食盐（一捻）
水煎，热服立愈。
理中汤（见上卷痢门。）
产后有因败血入于脾胃，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，因气郁而误专顺散，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，积郁之久兼成膨胀。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。逐瘀佐于养血剂中，则恶露自行而大便濡润亦通。再考之《纲目》内云∶饮
食停于脾，六君子汤加浓朴一钱。若饮食伤于胃，宜六君子汤以补之。又云∶大凡停于脾，莫妙节其饮
食，自愈为善。《尊生》亦用加减六君子汤治之。《秘书》立有治胀方，并养生化滞汤二方，治产后胀证，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（一钱五分） 川芎（七分） 陈皮（四分
）甘草（三分）
水煎服。
养生化滞汤 治产后大便不通，误服大黄等药，致成鼓胀。
人参 茯苓 川芎 白芍（炒。各一钱） 当归（四钱） 桃仁（十粒，去皮尖） 肉苁蓉（一钱五
分，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）
水煎服。如胀甚，再加人参二三钱。常治误用大黄多者，服参、归至半斤以上，大便方通，肿胀渐退。
加减六君子汤 治产后腹胀。
人参 白术（土炒） 茯苓（各一钱） 陈皮（六分） 浓朴（八分，制） 砂仁 炮姜（各四
分） 炙草（五分）
水煎服。
生化汤（见本卷生化汤论后。） 六君子汤（见上卷诸痛门。） 二陈汤（见上卷子烦
门。） 琥珀黑龙丹（见中卷催生门。）
For all cases of hiccups (E Ni), they are caused by rebellious Qi. This Qi originates from the Stomach, rushes upward to strike the cardia (Bumen), and produces the "hiccup" sound. Etiologies include: deficiency-cold of Stomach Qi; extreme deficiency of Middle Qi causing fire from the Chong and Ren vessels to directly invade the clear orifices and rebel upward; excessive water intake leading to fluid retention and subsequent Qi rebellion; obstruction of both urination and defecation causing lower Jiao Qi blockage and upward rebellion; and exhaustion of Stomach Qi. As for postpartum hiccups, it is a syndrome of Stomach deficiency and cold Qi. Some state that hiccups (E Yi) arise from Stomach Qi, and should be treated primarily with Modified Lizhong Decoction (Jiawei Lizhong Tang). *YiTong* states: Postpartum, both Qi and Blood are deficient; wind-cold combats with Qi causing it to rebel upward, which is an extreme case of Stomach deficiency-cold and represents a dire prognosis. Add Dingxiang (Caryophylli Flos) to Lizhong Decoction. Ancient formulas grind Dingxiang (Caryophylli Flos), Doukou (Amomi Fructus Rotundus), and Fulonggan (Caosinis Lapis) into powder, mix with one qian spoonful using decoction of Taoren (Persicae Semen) and Wuzhuyu (Evodiae Fructus), taken again after the time it takes a person to walk five li. If ineffective, urgently administer Renshen (Ginseng Radix et Rhizoma) and Fuzi (Aconiti Lateralis Radix Praeparata); delay means no rescue. *Zunsheng* treats hiccups by using surprising events or laborious tasks to startle the patient unexpectedly, interrupting their thought process, which stops the hiccups immediately. It also establishes Qiangfu Decoction (Qiangfu Tang) for treatment. Feng Shi states: For hiccups caused by extreme Middle Qi deficiency with Yin fire from the lower Jiao rushing up, use herbs such as Guizhi (Cinnamomi Ramulus), Fuzi (Aconiti Lateralis Radix Praeparata), and Ganjiang (Zingiberis Rhizoma).
Modified Lizhong Decoction (Jiawei Lizhong Tang)
Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma stir-fried with earth, each 1 qian), Shidi (Diospyri Fructus, 2 qian), Dingxiang (Caryophylli Flos), Paojiang (Zingiberis Rhizoma Praeparatum, each 0.5 fen), Chenpi (Citri Reticulatae Pericarpium, Zhi Cao (Glycyrrhizae Radix et Rhizoma Praeparatum, each 0.8 fen).
Decoct in water and take orally. If there is heat, remove Dingxiang (Caryophylli Flos) and add Zhuru (Bambusae Caulis in Taeniam, 2 qian). If the body is extremely emaciated, food intake is reduced, and hiccups persist, this indicates exhaustion of Stomach Qi, which is difficult to treat.
Qiangfu Decoction (Qiangfu Tang)
Qianghuo (Notopterygii Rhizoma et Radix), Zhi Fuzi (Aconiti Lateralis Radix Praeparata), Xiaohuixiang (Foeniculi Fructus, each 0.5 fen), Muxiang (Aucklandiae Radix), Shengjiang (Zingiberis Rhizoma Recens, each 0.25 fen), Yanshi (Sal, a pinch).
Decoct in water, take hot, and cure will follow immediately.
Lizhong Decoction (See Li Disease Section in Upper Volume.)
Postpartum cases due to failed blood entering the Spleen and Stomach, causing abdominal distension and vomiting, have already been discussed in the Vomiting Section. However, women often have deficient Spleen and Stomach after childbirth, making dietary stagnation prone to occur and generate bloating and fullness. After delivery, if Shenghua Decoction (Shenghua Tang) is taken immediately to eliminate old stasis and generate new blood, once the stasis clots are resolved, major tonification of Qi and Blood should be administered to strengthen Spleen and Stomach transport, naturally preventing middle-deficiency bloating syndromes. Generally, postpartum issues arise from misusing digestive agents for food stagnation, exclusively using Qi-regulating powders for Qi depression, or consuming too many cold foods causing lochia stagnation, or using purgatives erroneously for dry stool due to Blood deficiency, thereby worsening distension. These practitioners only know that food stagnation requires digestion, Qi depression requires regulation, lochia requires expulsion, and constipation requires purging, not realizing that excessive consumption damages Stomach Qi further, increasing fullness and oppression, preventing Qi ascent and descent, and long-term accumulation leads to distension. If one continues to use only attacking and digesting methods, death is inevitable. One must understand that adding digestive agents to tonics strengthens the Spleen and dissipates damaged food Qi. Adding blood-activating agents to blood-nourishing formulas allows lochia to pass naturally and moistens the intestines to relieve constipation. Consulting *Bencao Gangmu*: For food stagnation in the Spleen, use Liu Junzi Decoction (Liujunzi Tang) plus Houpo (Magnoliae Officinalis Cortex, 1 qian). For food injury to the Stomach, use Liu Junzi Decoction (Liujunzi Tang) to tonify. It also states: For stagnation in the Spleen, nothing is better than regulating diet for self-healing. *Zunsheng* also uses Modified Liu Junzi Decoction (Jiawei Liujunzi Tang). *Mishu* has established Zhizhang Fang (Zhizhang Formula) and Yangsheng Huazhi Tang (Yangsheng Huazhi Decoction) for postpartum distension, neither daring to rely solely on digestion, showing ancestors' deep concern for postpartum conditions. *YiTong* states: Pregnant women taking too many fetal-anchoring medicines, or half-months postpartum with lochia remaining unclean for one to two months, this is not failed blood; regulate Qi and move Blood is appropriate, using astringents or blockers is erroneous. It also states: Fullness and lochia obstruction are often due to Blood rebellion; prioritize moving stasis. If stasis clots rise causing fullness and nausea, use Erchen Decoction (Erchen Tang) plus Shengjiang (Zingiberis Rhizoma Recens), Rougui (Cinnamomi Cortex), Xiangfu (Cyperi Rhizoma), Paozha (Ziziphi Spinosae Semen Praeparatum), and Pengze (Curcumae Rhizoma). If clots do not disperse and harden over time, use Hupo Heilong Dan (Hupo Heilong Pill). I argue that if fullness is confirmed to be caused by lochia obstruction, for initial postpartum cases, Shenghua Decoction (Shenghua Tang) should still be used; once stasis is removed, fullness resolves naturally, without needing Erchen Decoction (Erchen Tang), Paozha (Ziziphi Spinosae Semen Praeparatum), or Pengze (Curcumae Rhizoma), lest postpartum deficiency patients cannot tolerate them.
Zhizhang Formula (Zhizhang Fang) Treats postpartum abdominal distension.
Renshen (Ginseng Radix et Rhizoma, 2 qian), Baizhu (Atractylodis Macrocephalae Rhizoma stir-fried with earth), Danggui (Angelicae Sinensis Radix, each 3 qian), Fuling (Poria, 1.5 qian), Chuanxiong (Ligustici Chuanxiong Rhizoma, 0.7 fen), Chenpi (Citri Reticulatae Pericarpium, 0.4 fen), Gancao (Glycyrrhizae Radix et Rhizoma, 0.3 fen).
Decoct in water and take orally.
Yangsheng Huazhi Decoction (Yangsheng Huazhi Tang) Treats postpartum constipation resulting from drum-like distension due to erroneous use of Dahuang (Rhei Radix et Rhizoma) etc.
Renshen (Ginseng Radix et Rhizoma), Fuling (Poria), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baishao (Paeoniae Radix Alba stir-fried, each 1 qian), Danggui (Angelicae Sinensis Radix, 4 qian), Taoren (Persicae Semen, 10 grains, skin and tip removed), Roushourong (Cistanches Herba, 1.5 qian, washed with wine to remove mud and scales), Dafupi (Arecae Pericarpium, 0.5 fen, processed with black soybean water), Chenpi (Citri Reticulatae Pericarpium, 0.4 fen), Zhi Xiangfu (Cyperi Rhizoma processed), Zhi Cao (Glycyrrhizae Radix et Rhizoma Praeparatum, each 0.3 fen).
Decoct in water and take orally. If distension is severe, add Renshen (Ginseng Radix et Rhizoma) 2-3 qian. Commonly used for those who misused Dahuang (Rhei Radix et Rhizoma) excessively; taking Renshen (Ginseng Radix et Rhizoma) and Danggui (Angelicae Sinensis Radix) totaling over half jin usually results in bowel movement and gradual reduction of swelling.
Modified Liu Junzi Decoction (Jiawei Liujunzi Tang) Treats postpartum abdominal distension.
Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma stir-fried with earth), Fuling (Poria, each 1 qian), Chenpi (Citri Reticulatae Pericarpium, 0.6 fen), Houpo (Magnoliae Officinalis Cortex processed, 0.8 fen), Sharen (Amomi Fructus), Paojiang (Zingiberis Rhizoma Praeparatum, each 0.4 fen), Zhi Cao (Glycyrrhizae Radix et Rhizoma Praeparatum, 0.5 fen).
Decoct in water and take orally.
Shenghua Decoction (Shenghua Tang) (See Shenghua Tang Discussion in this Volume.)
Liujunzi Decoction (Liujunzi Tang) (See Various Pain Section in Upper Volume.)
Erchen Decoction (Erchen Tang) (See Child Restlessness Section in Upper Volume.)
Hupo Heilong Pill (Hupo Heilong Dan) (See Labor Induction Section in Middle Volume.)