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。）
凡出现呃逆症状的，都是由于气机逆乱所致。这种气从胃中发出，向上冲撞贲门，从而发出“吃忒”的声音。其病因有：胃气虚寒的；有中气极度虚弱，导致冲脉和任脉之火直接侵犯清窍而上逆的；有饮水过多，水液停聚而引发气逆的；有大便和小便闭塞，下焦气机不通导致气上逆的；还有胃气衰竭的。至于产后出现的呃逆，属于胃虚气寒的证候。有一种说法认为呃逆（呃噫）是胃气所生，适宜用加味理中汤主治。《医通》中说：产后气血都虚弱，风冷之气与正气相搏结导致气逆上行，这是胃气虚寒到了极点，是最为凶险的征象，应在理中汤中加入丁香。古方将丁香、豆蔻、伏龙肝研成粉末，用桃仁、吴茱萸煎汤调服一钱匙，如人行走五里的时间后再服一次。如果无效，急忙投用人参、附子，拖延则无法救治。《尊生》治疗吃忒说：用令人惊奇的事情，或者费力寻找某事的方法，出其不意地惊吓患者，使其思维中断，呃逆即可停止。又创立了羌附汤来治疗此症。冯氏说：如果是中气大虚，下焦阴火上冲而导致呃逆的，应当使用桂枝、附子、干姜之类的药物。
加味理中汤
人参 白术（土炒。各一钱） 柿蒂（二钱） 丁香 炮姜（各五分） 陈皮 炙甘草（各八分）
用水煎服。如果有热象，去掉丁香，加入竹茹二钱。如果身体极度虚弱消瘦，饮食减少且呃逆不止的，是胃气衰竭的表现，难以治疗。
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）
用水煎煮，热服后立即痊愈。
产后有因为败血进入脾胃，导致腹胀呕吐的，已经在呕吐门中论述过了。然而妇女因分娩，脾胃大多虚弱，饮食最容易停滞而产生胀闷感。如果在生产结束后，随即服用生化汤，消除旧的瘀血并生成新的血液，瘀块既然消除，就立即大补气血，使脾胃健运，自然就没有中气虚弱导致的胀满证候。产后的大率情况是因为伤食而错误地使用消导药，因为气郁而错误地专门使用顺气散，或者因为多吃冷物导致恶露停滞，或者因为血虚导致大便燥结而错误使用泻下药使得胀满更严重。这仅仅是知道伤食应当消导，气郁应当顺气，恶露应当攻逐，便结应当通下，却不知道消耗越多，胃气越受损，胀满闷塞反而增加，气机不能升降，积滞郁结久了兼变成膨胀。如果再专门使用攻伐消导的药物，不死不休罢了。哪里知道在补剂中加入消导药，则脾气强健而所伤的食积消散。在养血剂中加入逐瘀药，则恶露自行排出而大便濡润也能通畅。再考证《纲目》中说：饮食停滞于脾，用六君子汤加浓朴一钱。如果饮食损伤于胃，宜用六君子汤来补益。又说：凡是停滞于脾，没有比节制饮食更好的，自愈为善。《尊生》也用加减六君子汤治疗它。《秘书》立有治胀方，以及养生化滞汤两个方子，治疗产后胀证，都不敢专门使用消导法，前人的考虑对产后的顾虑很深啊。《医通》说：胎前孕妇服用安胎药过多，或者正产半产后，经过一两个月恶露未净，这不是败血的情况，适宜疏导气机行血，如果使用止涩、截断的方法就错了。又说：饱闷且恶露不行，多因为血逆，适宜以行瘀为主。如果有瘀块上升，饱闷想吐的，用二陈汤加生姜、肉桂、香附、炮山楂、蓬术。如果瘀块不散，积久变得更坚硬，用琥珀黑龙丹。我认为审察得知饱闷，确实是因为恶露不行导致的。如果是初产，仍然适宜服用生化汤，瘀血去除而饱闷自然解除，可以不需要借助二陈汤、炮山楂、蓬术，恐怕产后体虚者难以承受这些药物。
治胀方 治疗产后腹胀。
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）
用水煎服。
养生化滞汤 治疗产后大便不通，误服大黄等药，导致形成鼓胀。
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 炙甘草（各三分）
用水煎服。如果胀满很严重，再加人参二三钱。常用来治疗误用大黄较多的人，服用人参、当归达到半斤以上，大便才通畅，肿胀逐渐消退。
加减六君子汤 治疗产后腹胀。
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） 炙甘草（五分）
用水煎服。
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.)