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The syndrome of vomiting is primarily categorized into three types: Cold, Heat, and Deficiency. Cold presents with a slow pulse (Chi Mai), Heat with a rapid pulse (Shu Mai), and Deficiency with a deficient pulse (Xu Mai); thus, the pulse allows for differentiation of the symptoms. The easiest to treat is Cold. The Yangming channel is the site for digesting grains and favors warmth while disliking cold. Once cold invades internally, causing conflict between pathogenic factors and healthy qi, food is vomited immediately upon ingestion, and retching occurs even without eating. Although herbs such as Banxia (Pinelliae Rhizoma), Dingxiang (Caryophylli Flos), Baikou (Amomi Fructus Rotundus), and Sharen (Amomi Fructus) are recorded in materia medica as specific anti-emetics and are effective, they are not as swift as a bowl of Shengjiang Tang (Fresh Ginger Decoction). This aligns with the *Neijing* stating: "When cold qi lodges in the stomach and intestines, rebellious qi rises upward, causing pain and vomiting."

The most prone to misdiagnosis and mistreatment is Heat. (Cold-cooling and drying-hot herbs have pros and cons. Zhu Danxi advocated nourishing Kidney Water to clear damp-heat, which supplemented previous theories; however, blind followers abused cold-cooling agents. Those who died from excessive cold-cooling were victims of poor scholarship, not Zhu Danxi's fault. Ming dynasty scholars, attempting to correct the弊端 of cold-cooling, often made extreme remarks. Over two centuries, the trend shifted from cold-cooling to drying-hot fire. Deaths from drying-hot agents exceeded those from cold-cooling by tenfold. When encountering such cases, some advocate heat therapy, citing various texts as proof, yet fail to recognize that the syndrome may actually be Heat.) If Cold persists, it stagnates and transforms into Heat. If physicians fail to recognize this Heat and continue treating it as Cold with acrid-warm herbs, vomiting and heat will intensify reciprocally. Although Maidong (Ophiopogonis Radix) and Lugen (Phragmitis Rhizoma) are documented to stop vomiting, their use is sometimes overlooked, let alone the use of Shigao (Gypsum Fibrosum), which is extremely cold and cooling. (Empirical Formula: Shigao, Maidong, Jingmi (Oryzae Semen), Zhigancao (Glycyrrhizae Radix et Rhizoma Preparata)). Shigao is a premier herb for stopping vomiting. While not explicitly detailed in some materia medica, its efficacy is supported by the *Neijing*: "All rebellious upward rushing belongs to Fire; all vomiting of acid water, sudden diarrhea with tenesmus, belongs to Heat."

The easiest to treat is Deficiency. Treatment should not focus solely on the Stomach but also address the Spleen. The Spleen possesses the stillness of Kun (Earth) and the vigorous movement of Qian (Heaven). Deficiency leads to failed transportation and transformation, causing rebellious qi and vomiting. Regulating the Spleen and Stomach is a superior strategy. Lizhong Tang (Atractylodis Macrocephalae Rhizoma, Ginseng Radix, Zingiberis Rhizoma, Aconiti Lateralis Radix Praeparata, Glycyrrhizae Radix et Rhizoma Preparata, Jujubae Fructus) and Liujunzi Tang (Ginseng Radix, Atractylodis Macrocephalae Rhizoma, Pinelliae Rhizoma Preparatum, Poria, Citri Reticulatae Pericarpium, Glycyrrhizae Radix et Rhizoma Preparata) are both effective. The *Neijing* states: "The Foot-Taiyin Spleen channel runs alongside the pharynx and connects to the root of the tongue. When moved [pathologically], it causes stiffness of the tongue root and vomiting after eating."

Vomiting is a superficial disease, whereas Yige (Dysphagia/Regurgitation) is a deep-seated disease, making them easy to distinguish. Vomiting has an acute onset; Yige has a gradual onset. Vomiting occurs immediately after eating or involves retching when empty; Yige involves regurgitation only after food enters, with no retching when empty. Vomiting may present with external signs of Cold, Heat, or Deficiency; Yige patients appear normal even when not eating. Vomiting affects all ages; Yige is mostly seen in the elderly. Pulses in Vomiting can be Slow, Rapid, or Deficient; the pulse in Yige is Slow. Medical texts often conflate Vomiting and Yige, using formulas for Yige that are essentially for Vomiting, leading to confusion.

In Hunan, an old physician claimed to cure several cases of Yige. His prescription was Fuzi Lizhong Tang, and his diagnosed symptoms were actually Spleen Deficiency Vomiting. Another old physician claimed similar success with Huanglian Banxia Tang, which treated Stomach Heat Vomiting. As the proverb says: "Medicine cures fake diseases, people acquire fake names," referring to these two physicians. For elderly individuals with Qi obstruction and occasional vomiting, one should not generalize it as simple Vomiting nor hastily diagnose Yige, as it may stem from insufficient fluids and Qi deficiency hindering transport. Ancient people carved doves on canes to wish the elderly freedom from choking, illustrating this point. For pregnant women with vomiting, Banxia is not contraindicated and can calm the fetus, as detailed in *Zhunsuo*. Additionally, women whose menstruation (Tian Gui) is disrupted by Wind-Cold, leading to blood stasis in the Lung channel, may experience immediate vomiting after eating for over a year. Standard anti-emetic treatments for Cold or Heat fail here. Only with Jiegeng (Platycodonis Radix) and Honghua (Carthami Flos) to remove stasis and generate new blood does recovery occur in a few doses. This is another aspect that must be understood.