声物俱有曰呕，无声有物曰吐。有声无物曰干呕。其症有
三，有寒、有热、有食积。
寒吐者，吐时少而出物多，此胃受寒也。以理中丸治之，或用
胃苓丸，以煨姜汤送下。寒吐，食不化，恶食。
热吐者，吐时多而出物少，此胃有热也。以二陈汤加黄连、
煨姜治之。热吐，食化，不恶食。
食积吐者，要分三焦，明白俱恶食。如食即吐者，此积在上
焦胃口也，宜用淡盐汤吞一小盅，后以鹅翎毛扫喉中，令其吐尽
旧积。后以二陈汤加干姜(煨)、神曲(炒)、麦芽(炒)、砂仁治
之。如食入之时而吐者，此积在中焦，下口过小肠上口处也，先
以丁香脾积丸通去旧积，后以二陈汤加消导药治之。如早食晚吐，
晚食早吐者，此积在下焦，小肠下口过大肠上口处也，先以丁香
脾积丸下之，后以二陈汤加消导药治之。
神曲、麦芽(炒)、砂仁、香附子之类。
如呕吐久而诸药不纳者，此胃口壮火，关格之病，用理中
汤，以童便。猪胆汁同炒，煎服即安。
如呕吐蛔虫者，以理中丸加乌梅一个，附子一小片，黄柏，
川椒一服，即愈。
凡呕吐后瘦弱者，只以集圣丸谓之。
此药桂热，所以治寒。
人参、甘草(炙)，干姜(炒)、白术。水一盅煎
服。若为丸，共为末，炼蜜临时为丸，滚水送下。
如诸吐不纳药者，此阴盛拒阳也，必加童便，猪胆汁者，取童
便味酸咸性寒，胆汁味苦性寒，以和理中汤服，则阴体渐消，阳
性乃发。故(内经)曰："伏其所主。先其所因"之谓也。
Vomiting accompanied by sound and ejection of matter is termed "Ou" (vomiting with sound). Vomiting with matter but without sound is termed "Tu" (vomiting without sound). Sound without ejection of matter is termed "Gan Ou" (dry heaving). There are three types of symptoms: cold, heat, and food stagnation.
In cold vomiting, there is little sound but much ejection of matter; this is due to the stomach receiving cold pathogenic factors. It is treated with Lizhong Wan (Regulate the Middle Pill), or alternatively, Weiling Wan (Stomach and Lingzhi Pill), administered with decoction of baked ginger. Cold vomiting is characterized by undigested food and aversion to eating.
In heat vomiting, there is much sound but little ejection of matter; this is due to heat in the stomach. It is treated with Erchen Tang (Two-Cured Decoction) added with Huanglian (Coptis Rhizome) and baked ginger. Heat vomiting is characterized by digested food and no aversion to eating.
For vomiting caused by food stagnation, one must distinguish the location within the Three Jiaos (San Jiao, Triple Burner); patients invariably exhibit aversion to eating. If vomiting occurs immediately after eating, the stagnation is in the Upper Jiao at the stomach opening. It is appropriate to drink a small cup of light salt water, then stimulate the throat with a goose feather to induce complete expulsion of the old stagnation. Subsequently, treat with Erchen Tang (Two-Cured Decoction) added with Ganjiang (Dried Ginger, baked), Shenqu (Medicated Leaven, fried), Maiya (Sprouted Hordeum, fried), and Sharen (Amomum Fruit). If vomiting occurs shortly after eating, the stagnation is in the Middle Jiao, located between the lower opening of the stomach and the upper opening of the small intestine. First, use Dingxiang Pi Ji Wan (Clove Spleen Stagnation Pill) to clear the old stagnation, then treat with Erchen Tang (Two-Cured Decoction) added with digestive aids. If morning food is vomited in the evening, or evening food in the morning, the stagnation is in the Lower Jiao, located between the lower opening of the small intestine and the upper opening of the large intestine. First, purge with Dingxiang Pi Ji Wan (Clove Spleen Stagnation Pill), then treat with Erchen Tang (Two-Cured Decoction) added with digestive aids.
Common digestive aids include Shenqu (Medicated Leaven), Maiya (Sprouted Hordeum, fried), Sharen (Amomum Fruit), Xiangfuzi (Cyperi Rhizoma), etc.
If vomiting persists for a long time and all medicines are rejected, this indicates vigorous fire in the stomach opening, a condition known as "Guan Ge" (Obstruction and Reversal). Use Lizhong Tang (Regulate the Middle Decoction), stir-frying the herbs with Tongbian (Child's Urine) and Zhudanshu (Pig Gallbladder Bile), then decoct and administer to achieve relief.
For vomiting of roundworms, use Lizhong Wan (Regulate the Middle Pill) added with one Wumei (Mume Fruit), a small slice of Fuzi (Aconite Lateral Root Preparata), Huangbai (Phellodendron Bark), and Chuanjiao (Sichuan Pepper). One dose will result in recovery.
For those who become emaciated and weak after vomiting, only Jisheng Wan (Accumulated Sage Pill) should be used.
This medicine is warm in nature, thus it treats cold conditions.
The formula consists of Renshen (Ginseng Radix et Rhizoma), Gancao (Licorice Root, honey-fried), Ganjiang (Zingiberis Rhizoma, stir-fried), and Baizhu (Atractylodis Macrocephalae Rhizoma). Decoct one cup of water and take orally. If making pills, grind all ingredients into powder, mix with refined honey to form pills just before use, and swallow with boiling water.
If various types of vomiting prevent the intake of medicine, this is due to extreme Yin rejecting Yang. One must add Tongbian (Child's Urine) and Zhudanshu (Pig Gallbladder Bile). Taking advantage of the sour and salty flavor and cold nature of child's urine, and the bitter flavor and cold nature of pig gallbladder bile, to harmonize with Lizhong Tang (Regulate the Middle Decoction), the Yin pathogen gradually dissipates, and the Yang nature emerges. Thus, the *Neijing* (Inner Canon) states: "Subdue that which dominates, first address its cause." This refers to this principle.