人之胃腑，为水谷之海，而水谷之精，化为血气，荣润脏腑。产后劳伤脏腑，寒邪易乘，入于肠胃，则
气逆呕吐而不食也。初产，宜加减生化汤。七日外，宜温胃丁香散。如咳嗽、呕逆、怔忡、目眩，用石莲散。
《秘书》云∶产后胃气不和，呕吐不止，全不纳谷，初产香砂生化汤。块痛止，加味香砂生化汤。又云∶当
分二证，立三方。如七日内块痛未除，当重块，安胃行血汤佐以温胃药。如七日内曾服生化汤三四帖，血
块不痛，呕不纳谷，当服加减六和汤，又和中汤，此二方选用。如产后呕止，或服三方而胃和呕止痛止，但
血气不足食少，宜补中和胃汤。冯氏仿立斋治法云∶饮食过多，六君子加楂、曲。兼劳役，补中汤。饮食停滞，
人参养胃汤。脾胃气虚，六君子。胃气虚寒，加炮姜、煨木香。寒水侮土，益黄散。肝木侮土，六君子加升、
柴。呕吐泄泻，手足俱冷，肚腹作痛，乃阳气虚寒，急用附子理中汤。
此内有命门火衰，不能生土而呕吐，用八味丸一论，恐非救急之务，故摘出。密斋遵郭稽中治云∶有败血散
于脾胃，脾受则不能运化津液而成腹胀，胃受则不能受水谷而生呕逆。若以寻常治胀呕之剂，则药不对证，
反增其病，用抵圣汤。若产后伤食，呕吐胀满，用六君子汤为主，加随证药治之。予谓冯氏偏于补气，
密斋用抵圣一论，泥于败血，临证者，似宜斟酌。一产妇朝吐痰，夜发热，昼夜无寐，或用清痰降火，
肌体日瘦，饮食日少，前证愈甚。盖早间吐痰，脾气虚也。夜间发热，肝血虚也。昼夜无寐，脾血耗也。遂
用六君子汤，加味逍遥散，加味归脾汤，以次调理而痊。
加减生化汤 治产后呕逆不食。
川芎（一钱） 当归（四钱） 炮姜 砂仁（各四分） 炙草（五分）
姜一片，水煎服。
温胃丁香散 治产后七日外，患呕逆不食。
人参（一钱） 当归 白术（土炒。各二钱） 藿香 前胡 炮姜 丁香 陈皮 炙草（各四分）
姜一片，水煎服。
石莲散 治产后咳嗽，呕逆，怔忡，目眩。
石莲子（一两五钱，去壳） 茯苓（一两） 丁香（五钱）
共为细末，米饮调送，每服三钱。
香砂生化汤 治产后块痛未除，气逆呕吐。
当归（四钱） 川芎（一钱） 制半夏（八分） 桃仁（十粒，去皮尖） 炙姜 藿香 砂仁（
各四分） 陈皮（三分） 炙草（五分）
生姜一片，水煎服。
加味香砂生化汤 治产后块痛已除，呕逆不止。
当归（二钱） 川芎 白术（土炒。各一钱） 制夏（八分） 陈皮（三分） 前胡 砂仁 藿
香炮姜（各四分） 炙草（五分）
生姜一片，水煎服。
安胃行血汤 治产后七日内，块痛未除，呕吐不止，全不纳谷。
人参 川芎（各一钱） 当归（四钱，酒洗） 桃仁（十粒，去皮尖） 砂仁 藿香 炙草（各四分）
生姜一片，水煎服。一方无桃仁。有汗，不可用姜。
加减六和汤 治产后七日内，曾服生化汤三四帖，今血块不痛，但呕不止，不纳谷。
人参 川芎 茯苓（各一钱） 当归（二钱） 山药（一钱五分，炒） 藿香 陈皮（各三分）
白豆蔻 炙草（各四分）
姜一片，水煎服。呕止，减豆蔻。一方有炮姜四分。
和中汤
人参 当归 茯苓（各一钱） 白术（一钱五分，土炒） 扁豆（二钱） 丁香 藿香 陈皮（各
三分） 炙草（四分）
姜一片，水煎服。呕吐止，去丁香。受寒，加吴萸一二分。
补中和胃汤 治产后呕吐，服前三方而胃和、呕止、块痛止，但气血不足食少者。
人参 白术（土炒） 当归 扁豆（各二钱） 茯苓（一钱） 山药（一钱五分） 炮姜 陈
皮炙草（各四分）
水煎服。
益黄散 治脾胃虚寒，水反来侮，以致呕吐不食，或肚腹作痛，或大便不实，手足逆冷等证。
陈皮（一两） 青皮 诃子肉（煨） 炙草（各五钱） 丁香（二钱）
上为散，每服二三钱，水煎服。或黑糖调服一钱。益黄不用补益中州，反用青橘二皮辟除陈气，其
旨最微。此方原为婴儿久泻连绵不已，乳食积滞于内，故需二皮专理肝脾宿荫，即兼诃子以兜涩下脱，
丁香以温理中州，甘草以和脾气，深得泻中寓补之法，非洞达斯义，难与言至治也。
抵圣汤 治产后败血积于脾胃，腹胀呕逆。
人参 制夏 泽兰 陈皮 赤芍（各二钱） 炙草（一钱）
火焙生姜三片，水煎服。恶露过多者，去泽兰、赤芍，倍加陈皮、生姜。予谓陈皮用二钱过，当用一钱足矣。
六君子汤 补中益气汤 人参养胃汤（俱见上卷诸痛门。） 附子理中汤（见上卷疟门，附枳
实理中汤下。）
The human stomach is the sea of water and grain; the essence derived from water and grain transforms into blood and qi, nourishing and moistening the zang-fu organs. Postpartum, labor and fatigue damage the zang-fu organs, making them susceptible to invasion by cold pathogens. Once these pathogens enter the intestines and stomach, they cause rebellious qi, vomiting, and an inability to eat. Immediately after childbirth, Jiajian Shenghua Tang (Modified Birth-Invigorating Decoction) is appropriate. After seven days, Wenwei Dingxiang San (Stomach-Warming Clove Powder) is appropriate. If symptoms such as cough, retching, palpitations (Zhengchong), and dizziness occur, Shilian San (Stone Lotus Seed Powder) should be used.
The *Mishu* records: "When postpartum stomach qi is disharmonious, with incessant vomiting and complete inability to accept food, Xiangsha Shenghua Tang (Aucklandia and Amomum Birth-Invigorating Decoction) is used for initial postpartum cases. Once blood stasis pain ceases, Jiawei Xiangsha Shenghua Tang (Augmented Aucklandia and Amomum Birth-Invigorating Decoction) is used." It further states: "Two syndromes should be distinguished, and three formulas established. If within seven days the blood stasis pain remains, heavy emphasis should be placed on resolving stasis and calming the stomach using Anwei Xingxue Tang (Stomach-Calming and Blood-Circulating Decoction), assisted by stomach-warming herbs. If within seven days, three or four doses of Shenghua Tang have been taken, but the blood stasis does not hurt and vomiting/inability to eat persists, Jiahuan Liuhe Tang (Modified Six-Harmony Decoction) or Hezhong Tang (Middle-Harmonizing Decoction) should be administered, selecting one of these two formulas. If postpartum vomiting stops, or if after taking the aforementioned three formulas the stomach harmonizes, vomiting stops, and stasis pain ceases, but there is insufficient blood and qi leading to poor appetite, Buzhong Hewei Tang (Tonify-Middle and Harmonize-Stomach Decoction) is appropriate."
Feng Shi imitated the treatment methods of Xue Lizhai: For excessive food intake, use Liujunzi Tang (Six-Gentlemen Decoction) with Hawthorn (Shanzha) and Medicated Leaven (Qu). For cases complicated by overwork, use Buzhong Yiqi Tang (Tonify-the-Middle and Boost-Qi Decoction). For food stagnation, use Renshen Yangwei Tang (Ginseng Stomach-Nourishing Decoction). For spleen and stomach qi deficiency, use Liujunzi Tang. For stomach qi deficiency and cold, add Paojiang (Prepared Ginger) and Weimu Xiang (Baked Costus Root). When cold water insults earth (spleen), use Yihuang San (Benefit Yellow Powder). When liver wood insults earth, use Liujunzi Tang with Shengma (Cimicifugae Rhizoma) and Chaihu (Bupleuri Radix). For vomiting and diarrhea with cold extremities and abdominal pain, indicating yang qi deficiency and cold, Fuzi Lizhong Tang (Aconite Regulate-the-Middle Decoction) must be used urgently.
Regarding the theory that failure of the Mingmen fire (Gate of Life) to generate earth causes vomiting, the reference to Bawei Wan (Eight-Ingredient Pill) is excluded here, as it is likely not a matter for emergency rescue. Miyi Zhai followed Guo Jizhong’s treatment view: If lochia (bainxue) scatters into the spleen and stomach, the spleen suffers and cannot transform fluids, leading to abdominal distension; the stomach suffers and cannot receive water and grain, leading to vomiting and retching. Using ordinary remedies for distension and vomiting will mismatch the syndrome and worsen the condition; instead, Disheng Tang (Respect-Sage Decoction) should be used. If postpartum food injury causes vomiting and distension, Liujunzi Tang (Six-Gentlemen Decoction) should be the primary formula, modified according to symptoms. I consider Feng Shi’s approach biased toward tonifying qi, while Miyi Zhai’s reliance on Disheng Tang is too rigidly focused on blood stasis; clinicians should exercise discretion.
Consider a puerpera who vomited phlegm in the morning, had fever at night, and could not sleep day or night. Someone used herbs to clear phlegm and descend fire, resulting in daily emaciation, reduced food intake, and worsening of previous symptoms. The morning phlegm vomiting indicates spleen qi deficiency. The night fever indicates liver blood deficiency. The day-and-night insomnia indicates consumption of spleen blood. Subsequently, Liujunzi Tang (Six-Gentlemen Decoction), Jiawei Xiaoyao San (Augmented Free and Easy Wanderer Powder), and Jiawei Guipi Tang (Augmented Heart-Spleen Tonifying Decoction) were used sequentially for regulation, leading to recovery.
Jiajian Shenghua Tang (Modified Birth-Invigorating Decoction): Treats postpartum vomiting, retching, and inability to eat.
Chuanxiong (1 qian) Danggui (4 qian) Paojiang (Prepared Ginger) Sharen (Amomi Fructus, each 4 fen) Zhigancao (Honey-fried Licorice, 5 fen).
One slice of fresh ginger, decocted in water and taken orally.
Wenwei Dingxiang San (Stomach-Warming Clove Powder): Treats postpartum vomiting, retching, and inability to eat after seven days.
Renshen (Ginseng Radix et Rhizoma, 1 qian) Danggui (Angelicae Sinensis Radix) Baizhu (Atractylodis Macrocephalae Rhizoma, soil-fried, each 2 qian) Huoxiang (Agastaches Herba) Qianhu (Peucedani Radix) Paojiang (Prepared Ginger) Dingxiang (Eugeniae Flos) Chenpi (Citri Reticulatae Pericarpium) Zhigancao (Honey-fried Licorice, each 4 fen).
One slice of fresh ginger, decocted in water and taken orally.
Shilian San (Stone Lotus Seed Powder): Treats postpartum cough, vomiting, retching, palpitations, and dizziness.
Shilianzi (Nelumbinis Semen, 1.5 liang, shell removed) Fuling (Poria, 1 liang) Dingxiang (Eugeniae Flos, 5 qian).
Grind into fine powder, mix with rice water for administration, 3 qian per dose.
Xiangsha Shenghua Tang (Aucklandia and Amomum Birth-Invigorating Decoction): Treats postpartum persistent blood stasis pain with rebellious qi and vomiting.
Danggui (Angelicae Sinensis Radix, 4 qian) Chuanxiong (Ligusticum Chuanxiong Rhizoma, 1 qian) Zhibanxia (Pinelliae Tuber prepared, 8 fen) Taoren (Persicae Semen, 10 grains, skin and tip removed) Zhijiang (Honey-fried Ginger) Huoxiang (Agastaches Herba) Sharen (Amomi Fructus, each 4 fen) Chenpi (Citri Reticulatae Pericarpium, 3 fen) Zhigancao (Honey-fried Licorice, 5 fen).
One slice of fresh ginger, decocted in water and taken orally.
Jiawei Xiangsha Shenghua Tang (Augmented Aucklandia and Amomum Birth-Invigorating Decoction): Treats postpartum cessation of blood stasis pain but persistent vomiting and retching.
Danggui (Angelicae Sinensis Radix, 2 qian) Chuanxiong (Ligusticum Chuanxiong Rhizoma) Baizhu (Atractylodis Macrocephalae Rhizoma, soil-fried, each 1 qian) Zhixia (Pinelliae Tuber prepared, 8 fen) Chenpi (Citri Reticulatae Pericarpium, 3 fen) Qianhu (Peucedani Radix) Sharen (Amomi Fructus) Huoxiang (Agastaches Herba) Paojiang (Prepared Ginger, each 4 fen) Zhigancao (Honey-fried Licorice, 5 fen).
One slice of fresh ginger, decocted in water and taken orally.
Anwei Xingxue Tang (Stomach-Calming and Blood-Circulating Decoction): Treats postpartum cases within seven days where blood stasis pain persists, vomiting is incessant, and no food is accepted.
Renshen (Ginseng Radix et Rhizoma) Chuanxiong (Ligusticum Chuanxiong Rhizoma, each 1 qian) Danggui (Angelicae Sinensis Radix, wine-washed, 4 qian) Taoren (Persicae Semen, 10 grains, skin and tip removed) Sharen (Amomi Fructus) Huoxiang (Agastaches Herba) Zhigancao (Honey-fried Licorice, each 4 fen).
One slice of fresh ginger, decocted in water and taken orally. Another version excludes Taoren. Do not use ginger if sweating is present.
Jiahuan Liuhe Tang (Modified Six-Harmony Decoction): Treats postpartum cases within seven days where three or four doses of Shenghua Tang have been taken, blood stasis no longer hurts, but vomiting persists and no food is accepted.
Renshen (Ginseng Radix et Rhizoma) Chuanxiong (Ligusticum Chuanxiong Rhizoma) Fuling (Poria, each 1 qian) Danggui (Angelicae Sinensis Radix, 2 qian) Shanyao (Dioscoreae Rhizoma, stir-fried, 1.5 qian) Huoxiang (Agastaches Herba) Chenpi (Citri Reticulatae Pericarpium, each 3 fen) Baidoukou (Amomi Fructus Rotundus) Zhigancao (Honey-fried Licorice, each 4 fen).
One slice of fresh ginger, decocted in water and taken orally. Reduce Doukou when vomiting stops. Another version includes 4 fen of Paojiang.
Hezhong Tang (Middle-Harmonizing Decoction)
Renshen (Ginseng Radix et Rhizoma) Danggui (Angelicae Sinensis Radix) Fuling (Poria, each 1 qian) Baizhu (Atractylodis Macrocephalae Rhizoma, soil-fried, 1.5 qian) BianDou (Lablab Album Semen, 2 qian) Dingxiang (Eugeniae Flos) Huoxiang (Agastaches Herba) Chenpi (Citri Reticulatae Pericarpium, each 3 fen) Zhigancao (Honey-fried Licorice, 4 fen).
One slice of fresh ginger, decocted in water and taken orally. Remove Dingxiang when vomiting stops. If affected by cold, add Wuyu (Evodiae Fructus) 1-2 fen.
Buzhong Hewei Tang (Tonify-Middle and Harmonize-Stomach Decoction): Treats postpartum vomiting where, after taking the first three formulas, the stomach harmonizes, vomiting stops, and stasis pain ceases, but there is insufficient blood and qi leading to poor appetite.
Renshen (Ginseng Radix et Rhizoma) Baizhu (Atractylodis Macrocephalae Rhizoma, soil-fried) Danggui (Angelicae Sinensis Radix) BianDou (Lablab Album Semen, each 2 qian) Fuling (Poria, 1 qian) Shanyao (Dioscoreae Rhizoma, 1.5 qian) Paojiang (Prepared Ginger) Chenpi (Citri Reticulatae Pericarpium) Zhigancao (Honey-fried Licorice, each 4 fen).
Decoct in water and take orally.
Yihuang San (Benefit Yellow Powder): Treats spleen and stomach deficiency-cold, where cold water insults earth, causing vomiting, inability to eat, abdominal pain, loose stools, or cold extremities.
Chenpi (Citri Reticulatae Pericarpium, 1 liang) Qingpi (Citri Reticulatae Pericarpium Viride) Heziren (Myristicae Semen, roasted) Zhigancao (Honey-fried Licorice, each 5 qian) Dingxiang (Eugeniae Flos, 2 qian).
Grind into powder, take 2-3 qian per dose, decocted in water. Alternatively, mix with black sugar and take 1 qian. Yihuang San does not use tonification of the middle jiao; instead, it uses Qingpi and Ju Pi (orange peels) to dispel stale qi, a subtle intent. This formula was originally designed for infants with chronic diarrhea due to milk and food stagnation internally. Thus, the two peels specifically regulate liver and spleen old accumulations, combined with Hezi to secure downward leakage, Dingxiang to warm and regulate the middle jiao, and Gancao to harmonize spleen qi. It deeply embodies the method of embedding tonification within purgation. Without thorough understanding of this principle, one cannot discuss supreme treatment.
Disheng Tang (Respect-Sage Decoction): Treats postpartum accumulation of lochia in the spleen and stomach, causing abdominal distension and vomiting/retching.
Renshen (Ginseng Radix et Rhizoma) Zhixia (Pinelliae Tuber prepared) Zelan (Leonuri Herba) Chenpi (Citri Reticulatae Pericarpium) Chishao (Paeoniae Radix Rubra, each 2 qian) Zhigancao (Honey-fried Licorice, 1 qian).
Three slices of ginger baked over fire, decocted in water and taken orally. If lochia discharge is excessive, remove Zelan and Chishao, and double the dosage of Chenpi and Shengjiang. I consider 2 qian of Chenpi excessive; 1 qian is sufficient.
Liujunzi Tang (Six-Gentlemen Decoction), Buzhong Yiqi Tang (Tonify-the-Middle and Boost-Qi Decoction), Renshen Yangwei Tang (Ginseng Stomach-Nourishing Decoction) (All seen in Volume 1, Section on Various Pains.) Fuzi Lizhong Tang (Aconite Regulate-the-Middle Decoction) (Seen in Volume 1, Section on Malaria, under Zhishi Lizhong Tang.)