阳明胃络从头走。气上逆行须便呕。少阳呕苦小柴胡。胸中有热黄连候。小停心下
茯苓甘。先呕后渴五苓散。汗后虚烦竹叶汤。栀子豆豉尤堪啖。
有物无声谓之呕。即海藏东垣所谓干呕是也。然干呕症亦不同。有因太阳自汗而干
呕者
。桂枝汤主之。有因水气在表而干呕者。小青龙汤主之。有因水气在里而干呕者。十枣汤主
之。有因少阴下利而干呕者。姜附汤主之。有因厥阴吐沫而干呕者。吴茱萸汤主之。大抵干
呕与呕吐不同。宜分别治之。
小青龙汤桂麻草。半夏细辛芍药炒。干姜五味可同煎。水停心下斯方好。十枣汤中用大
枣。
芫花大戟甘遂好。干呕胁痛宜煎服。伏饮停痰医莫少。吴茱萸汤人参枣。重用生姜温胃好。
阳明寒呕少阴利。厥阴能解痛皆保。
火邪劫夺或惊狂。迫汗烧针更走阳。烦躁不安何药治。柴胡龙骨可煎尝。
火邪惊狂者。医家用火熏熨迫汗。及烧针灼艾而然也。其人亡阳躁卧起不安。宜柴
胡加龙骨牡蛎汤主之。盖柴胡龙骨牡蛎能除烦敛气而镇惊也。
胃冷仍加重汗出。因成蛔厥吐长虫。病源本属厥阴症。宜用乌梅与理中。
蛔厥者。病在厥阴也。蛔入上膈则痛。须臾复止。得食则呕。而又烦。蛔闻食臭复
出也
。此为脏寒当自吐蛔。与乌梅温脏安蛔。亦有胃冷吐蛔者。此因发汗所致。病在阳明也。宜
用理中汤加炒川椒五粒。槟榔五分。吞乌梅丸。盖乌梅丸于辛酸入肝药中微加苦寒。纳上逆
之阳邪。而顺之使下也。名曰安蛔。实是安胃。故病主久利。见阴阳不相顺接。而下利之症
。皆可以此方括之也。
乌梅丸用细辛桂。人参附子椒姜继。黄连黄柏及当归。温脏安蛔寒厥剂。
The stomach meridian of the Yangming channel descends from the head. When Qi rebels upward, vomiting occurs. Vomiting associated with bitter taste in Shaoyang disease is treated with Xiao Chai Hu Tang (Minor Bupleurum Decoction). Heat in the chest is treated with formulas containing Huang Lian (Coptidis Rhizoma). Fluid retention under the heart (epigastrium) is treated with Fu Ling Gan Cao Tang (Poria and Licorice Decoction). Vomiting followed by thirst is treated with Wu Ling San (Five-Ingredient Powder with Poria). Restlessness after sweating is treated with Zhu Ye Shi Gao Tang (Bamboo Leaf and Gypsum Decoction); Zhi Zi Chi Tang (Gardenia and Fermented Soybean Decoction) is also highly suitable.
Vomiting with sound and matter is called "Ou" (vomiting). This is what Haicang (Zhang Yuansu) and Dongyuan (Li Gao) referred to as "Gan Ou" (dry heaving). However, symptoms of dry heaving vary. Dry heaving due to spontaneous sweating in Taiyang disease is primarily treated with Gui Zhi Tang (Cinnamon Twig Decoction). Dry heaving due to fluid retention in the exterior is primarily treated with Xiao Qing Long Tang (Minor Blue-Green Dragon Decoction). Dry heaving due to fluid retention in the interior is primarily treated with Shi Zao Tang (Ten Jujube Decoction). Dry heaving associated with diarrhea in Shaoyin disease is primarily treated with Jiang Fu Tang (Ginger and Aconite Decoction). Dry heaving associated with drooling in Jueyin disease is primarily treated with Wu Zhu Yu Tang (Evodia Decoction). Generally, dry heaving differs from vomiting and should be treated differently.
Xiao Qing Long Tang consists of Gui Zhi (Cinnamomi Ramulus), Ma Huang (Ephedrae Herba), Gan Cao (Glycyrrhizae Radix et Rhizoma), Ban Xia (Pinelliae Rhizoma Praeparatum cum Zingibere et Alumine), Xi Xin (Asari Radix et Rhizoma), fried Shao Yao (Paeoniae Radix Alba), Gan Jiang (Zingiberis Rhizoma), and Wu Wei Zi (Schisandrae Fructus), which are decocted together. This formula is effective for fluid retention in the epigastrium. Shi Zao Tang uses Da Zao (Jujubae Fructus) combined with Yuan Hua (Genkwa Flos), Da Ji (Euphorbiae Pekinensis Radix), and Gan Sui (Kansui Radix). It is suitable for dry heaving with hypochondriac pain and is indispensable for treating latent fluid retention and phlegm. Wu Zhu Yu Tang contains Ren Shen (Ginseng Radix et Rhizoma) and Da Zao, with a heavy use of Sheng Jiang (Zingiberis Rhizoma Recens) to warm the stomach effectively. It resolves pain and preserves healthy Qi for cold vomiting in Yangming, diarrhea in Shaoyin, and disorders in Jueyin.
Fire pathogen depletion or convulsive fright. Forced sweating and moxibustion cause Yang to escape. What medicine treats restlessness? Chai Hu Jia Long Gu Mu Li Tang (Bupleurum Decoction plus Dragon Bone and Oyster Shell) can be decocted and taken.
Fire pathogen-induced convulsive fright results from physicians using fire fumigation, fire ironing to force sweating, and burning needles or moxibustion. The patient exhibits loss of Yang, agitation, and restlessness in lying down or sitting up. It is primarily treated with Chai Hu Jia Long Gu Mu Li Tang. This is because Chai Hu (Bupleuri Radix), Long Gu (Fossilia Ossis Mastodi), and Mu Li (Ostrea Concha) can relieve irritability, consolidate Qi, and calm fright.
Cold stomach exacerbated by excessive sweating leads to Ascaris syncope (Hui Jue), with expulsion of long worms. The pathology originates in Jueyin disease; Wumei Wan (Mume Pill) and Lizhong Tang (Regulate the Middle Decoction) are indicated.
Ascaris syncope involves Jueyin pathology. When ascarides enter the upper diaphragm, pain occurs, ceasing momentarily. Eating induces vomiting and vexation, as the ascarides return upon smelling food. This indicates cold in the zang organs causing spontaneous expulsion of ascarides; Wumei Wan is given to warm the zang and pacify ascarides. There are also cases of vomiting ascarides due to cold stomach caused by sweating, involving Yangming pathology. Lizhong Tang is used with five grains of chao Chuan Jiao (Sichuan Pepper) and 0.5 fen of Bing Lang (Arecae Semen), swallowed with Wumei Wan. Wumei Wan adds slight bitter-cold herbs to acrid-sour liver-entering drugs to accommodate rebellious Yang pathogens and guide them downward. Named "pacifying ascarides," it essentially "calms the stomach." Thus, it mainly treats chronic dysentery and conditions where Yin and Yang fail to connect smoothly, presenting with diarrhea; such cases can all be managed by this formula.
Wumei Wan contains Xi Xin (Asari Radix et Rhizoma), Gui Zhi (Cinnamomi Ramulus), Ren Shen (Ginseng Radix et Rhizoma), Fu Zi (Aconiti Lateralis Radix Praeparata), Jiao (Zanthoxyli Pericarpium), Gan Jiang (Zingiberis Rhizoma), Huang Lian (Coptidis Rhizoma), Huang Bai (Phellodendri Cortex), and Dang Gui (Angelicae Sinensis Radix). It is a formula for warming the zang, pacifying ascarides, and treating cold syncope.