论曰∶呕吐者，由清浊不分，中焦气痞。若心下牢大如杯，或时寒时热，朝食则暮吐，
暮食则朝吐，关脉弦紧，弦则为虚，紧则为寒，虚寒相搏，此名为格，与关格同也，是谓反
胃，青金丹、朴附丸主之。
青金丹
硫黄 水银 木香（末）
上将硫黄水银二味同研，令不见水银星子为度，合木香再研，用生姜汁煮糊为丸，如梧
桐子大。米饮下三粒，食后服。
朴附丸
浓朴（去皮，锉作小块子） 附子（炮，去皮脐，锉作小块子，各一两） 生姜（八两，
去
皮取汁）
上将二味，以姜汁同煮，尽汁为度，焙干为末，酒煮和丸，如梧桐子大。米饮下三粒，
食前服。
若心中温温常欲呕，闻食吐酸，由宿寒在胃，不能运水谷，中腕成痰，其关弦，脉小而
短，白术丸、大半夏汤主之。
白术丸
白术（三两） 半夏（汤洗七遍，二两） 橘皮（洗） 干姜（各三两） 丁香（一两）
上为细末，姜汁煮糊为丸，如梧桐子大。姜汤下三十丸，食前服。史氏《指南方》无橘
皮。
大半夏汤
半夏（一升） 人参（一两） 白蜜
上为末。每服三钱，水一盏，煎至半盏，加白蜜少许，食前服。
若心上汪洋嘈烦，头目时痛，胸中不利，或呕胆汁，大便或利或秘，喜渴，此中脘伏痰
旋复丸主之。
旋复花丸（见前热证门。）
若心下虚满，不入饮食，时时欲呕，呕无所出， 短气，由他病瘥后，复为寒邪伤气
气寒则不能食，胃无谷气以养，其脉微弱，大藿香散主之。
大藿香散
藿香叶 人参 茯苓 桔梗 木香 桂（取心） 白术（各半两） 半夏（汤洗七遍，
为末
半两，姜汁和成饼子，阴干） 枇杷叶（十片，刷去毛）
上为末。每服三大钱，水一盏，炒姜丝一分，与药同煎至七分，去滓，食前温服。刘孟
容《琐碎录》名藿香汤。
若心下烦，不喜热物，得热即呕，喜渴，由胃受邪热，胃热则气浊，阴阳浑乱，其脉虚
数，或细而疾，竹茹汤主之。
竹茹汤
竹茹 橘皮 甘草 半夏 赤茯苓 麦冬 人参 枇杷叶
上加姜枣煎，胃寒去竹茹麦冬，加丁香，实火去人参。
若心下闷乱，呕吐不止，卧起不安，手足躁扰，水浆不下，由冷热不和，邪正相干，清
浊不分，阴阳错乱，喜冷者因热，恶冷者因寒，名曰霍乱。其脉弦大者，寒也，大理中汤、
半硫丸主之。其脉数疾者，热也，小藿香散、青金散主之。
大理中汤（方缺。）
半硫丸
半夏（汤洗七遍，焙，为末） 硫黄（研，等分）
上研细，生姜汁煮糊为丸。米饮下三十丸。
小藿香散
丁香 枇杷叶（去毛） 干葛 赤茯苓 藿香叶 甘草（各等分）
上为末。每服三钱，水一盏，生姜三片，同煎至一盏，去滓温服。
青金散（方缺。）
若卒然呕吐，胸中痞闷，气不下行，由饮食过伤，胸气滞而不转，胃中为浊，逆行则吐
其脉沉疾，金汁丸主之。
金汁丸（方缺。）
若痛而呕者，此寒气客于肠胃，肠胃得寒则聚沫，聚沫则痛，痛则气逆，逆则津液反出
而呕，其脉紧细而滑，粳米汤主之。
粳米汤
附子（炮，去皮脐，切片子，半两） 半夏（汤浸七遍，切片子，二两半） 甘草（炙，
锉
碎，一两） 陈粳米（二两半）
上拌和，分作十二服。每服用水三盏，姜十片，同煎至一盏，去滓温服。
若因呕而哕者，吴茱萸丸主之。
吴茱萸丸
吴茱萸（炒，一两） 橘皮（洗，二两） 附子（炮，去皮脐，半两）
上为细末，白面糊为丸，如梧桐子大。饮下二十粒，食前服。
Commentary states: Vomiting arises from the failure of clear and turbid qi to separate, resulting in qi stagnation and obstruction in the middle jiao. If there is a hardness below the heart like a cup, alternating chills and fever, regurgitation of morning food in the evening or evening food in the morning, with a wiry and tight pulse at the Guan position; the wiry pulse indicates deficiency, and the tight pulse indicates cold. The interplay of deficiency and cold is termed "Ge" (blocking), which is identical to "Guan Ge" (obstruction and blocking). This is referred to as Fan Wei (reverse stomach/retrograde vomiting), treated with Qing Jin Dan and Pu Fu Wan.
Qing Jin Dan (Green Gold Pill)
Sulfur (Liu Huang, 硫黄); Mercury (Shui Yin, 水银); Costus Root Powder (Mu Xiang Mo, 木香末)
First, grind Sulfur and Mercury together until no mercury particles are visible. Mix in the Costus Root powder and grind again. Use ginger juice to make a paste for pills, sized like Sophora japonica seeds. Take three pills with rice water after meals.
Pu Fu Wan (Magnolia Bark and Aconite Pill)
Bark of Magnolia officinalis (Nou Pi, 厚朴, peeled and chopped into small pieces); Prepared Aconite Root (Pao Fu Zi, 炮附子, prepared, peeled, navel removed, chopped into small pieces, each 1 liang); Fresh Ginger (Sheng Jiang, 生姜, 8 liang, peeled for juice)
Boil the two herbs above in ginger juice until the juice is completely absorbed. Dry by baking, grind into powder, and mix with wine paste to form pills sized like Sophora japonica seeds. Take three pills with rice water before meals.
If there is a constant feeling of nausea below the heart, acid regurgitation upon smelling food, it is due to chronic cold retained in the stomach, failing to transform water and grain, leading to phlegm formation in the Zhong Wan region. The Guan pulse is wiry, and the pulse is small and short. Treat with Bai Zhu Wan and Da Ban Xia Tang.
Bai Zhu Wan (Atractylodes Macrocephala Pill)
Rhizoma Atractylodis Macrocephalae (Bai Zhu, 白术, 3 liang); Pinellia Tuber (Ban Xia, 半夏, washed seven times in decoction, 2 liang); Dried Tangerine Peel (Ju Pi, 橘皮, washed); Dried Ginger (Gan Jiang, 干姜, each 3 liang); Flower Bud of Eugenia caryophyllata (Ding Xiang, 丁香, 1 liang)
Grind all into fine powder. Use ginger juice to make a paste for pills, sized like Sophora japonica seeds. Take thirty pills with ginger decoction before meals. Shi's *Zhi Nan Fang* omits Tangerine Peel.
Da Ban Xia Tang (Large Pinellia Decoction)
Pinellia Tuber (Ban Xia, 半夏, 1 sheng); Ginseng Radix et Rhizoma (Ren Shen, 人参, 1 liang); White Honey (Bai Mi, 白蜜)
Grind into powder. Take 3 qian per dose. Add one cup of water, boil to half a cup, add a little white honey, and take before meals.
If there is a warm,嘈杂 (gurgling/uncomfortable) sensation below the heart, frequent headache, chest discomfort, vomiting of bile, irregular bowel movements (either loose or constipated), and thirst, this is due to latent phlegm in the Zhong Wan region. Treat with Xuan Fu Wan.
Xuan Fu Hua Wan (Inula Flower Pill) (See previous section on Heat Syndromes.)
If there is fullness and emptiness below the heart, inability to eat, frequent urge to vomit but nothing comes out, and shortness of breath, it is because after recovery from another illness, the body was re-injured by cold pathogen damaging the qi. Cold qi cannot digest food; without grain qi to nourish the stomach, the pulse becomes weak. Treat with Da Huo Xiang San.
Da Huo Xiang San (Large Agastache Powder)
Leaf of Agastache rugosa (Huo Xiang Ye, 藿香叶); Ginseng Radix et Rhizoma (Ren Shen, 人参); Poria (Fu Ling, 茯苓); Platycodon Root (Jie Geng, 桔梗); Costus Root (Mu Xiang, 木香); Cinnamon Twig (Gui Xin, 桂心, taken from the center); Rhizoma Atractylodis Macrocephalae (Bai Zhu, 白术, each 0.5 liang); Pinellia Tuber (Ban Xia, 半夏, washed seven times in decoction, ground to 0.5 liang, mixed with ginger juice into cakes, dried in shade); Leaf of Loquat (Pi Pa Ye, 枇杷叶, ten leaves, brushed to remove hairs)
Grind all into powder. Take 3 da qian per dose. Add one cup of water and 1 fen of stir-fried ginger shreds. Boil together to 0.7 cups, strain, and take warm before meals. Liu Mengrong's *Suo Sui Lu* names this Huo Xiang Tang.
If there is irritability below the heart, aversion to hot substances (vomiting upon exposure to heat), and thirst, it is due to the stomach receiving pathogenic heat. Stomach heat causes turbid qi, chaotic yin and yang. The pulse is deficient and rapid, or fine and fast. Treat with Zhu Ru Tang.
Zhu Ru Tang (Bamboo Shavings Decoction)
Bamboo Shavings (Zhu Ru, 竹茹); Dried Tangerine Peel (Ju Pi, 橘皮); Licorice Root (Gan Cao, 甘草); Pinellia Tuber (Ban Xia, 半夏); Red Poria (Chi Fu Ling, 赤茯苓); Ophiopogon Tuber (Mai Dong, 麦冬); Ginseng Radix et Rhizoma (Ren Shen, 人参); Leaf of Loquat (Pi Pa Ye, 枇杷叶)
Decoct with fresh ginger and jujube. For stomach cold, remove Bamboo Shavings and Ophiopogon Tuber, add Flower Bud of Eugenia caryophyllata. For excess fire, remove Ginseng Radix et Rhizoma.
If there is oppression and chaos below the heart, incessant vomiting, restlessness in lying down and rising, fidgeting of hands and feet, inability to take fluids, it is due to disharmony of cold and heat, conflict between pathogenic and righteous qi, failure of clear and turbid separation, and chaotic yin and yang. Preference for cold indicates heat; aversion to cold indicates cold. This is named Huo Luan (cholera-like syndrome). If the pulse is wiry and large, it is cold; treat with Da Li Zhong Tang and Ban Liu Wan. If the pulse is rapid and hurried, it is heat; treat with Xiao Huo Xiang San and Qing Jin San.
Da Li Zhong Tang (Great Spleen-Regulating Decoction) (Formula missing.)
Ban Liu Wan (Half-Sulfur Pill)
Pinellia Tuber (Ban Xia, 半夏, washed seven times in decoction, baked, ground); Sulfur (Liu Huang, 硫黄, ground, equal parts)
Grind finely. Use ginger juice to make a paste for pills. Take thirty pills with rice water.
Xiao Huo Xiang San (Small Agastache Powder)
Flower Bud of Eugenia caryophyllata (Ding Xiang, 丁香); Leaf of Loquat (Pi Pa Ye, 枇杷叶, de-haired); Kudzu Root (Gan Ge, 干葛); Red Poria (Chi Fu Ling, 赤茯苓); Leaf of Agastache rugosa (Huo Xiang Ye, 藿香叶); Licorice Root (Gan Cao, 甘草, equal parts)
Grind into powder. Take 3 qian per dose. Add one cup of water and three slices of fresh ginger. Boil to one cup, strain, and take warm.
Qing Jin San (Green-Gold Powder) (Formula missing.)
If sudden vomiting occurs with chest oppression and stagnant qi failing to descend, it is due to excessive dietary injury causing stagnation of chest qi and turbidity in the stomach. Rebellious qi leads to vomiting. The pulse is deep and rapid. Treat with Jin Zhi Wan.
Jin Zhi Wan (Gold Juice Pill) (Formula missing.)
If pain accompanies vomiting, it is because cold pathogen has invaded the intestines and stomach. Cold causes fluid condensation into foam; foam causes pain; pain causes rebellious qi; rebellious qi causes fluids to exit abnormally as vomiting. The pulse is tight, fine, and slippery. Treat with Jing Mi Tang.
Jing Mi Tang (Rice Decoction)
Prepared Aconite Root (Pao Fu Zi, 炮附子, prepared, peeled, navel removed, sliced, 0.5 liang); Pinellia Tuber (Ban Xia, 半夏, soaked in decoction seven times, sliced, 2.5 liang); Roasted Licorice Root (Zhi Gan Cao, 炙甘草, crushed, 1 liang); Aged Rice (Chen Jing Mi, 陈粳米, 2.5 liang)
Mix well and divide into twelve doses. For each dose, use three cups of water and ten slices of ginger. Boil to one cup, strain, and take warm.
If vomiting is followed by hiccups, treat with Wu Zhu Yu Wan.
Wu Zhu Yu Wan (Evodia Pill)
Fruit of Evodia rutaecarpa (Wu Zhu Yu, 吴茱萸, stir-fried, 1 liang); Dried Tangerine Peel (Ju Pi, 橘皮, washed, 2 liang); Prepared Aconite Root (Pao Fu Zi, 炮附子, prepared, peeled, navel removed, 0.5 liang)
Grind into fine powder. Use wheat flour paste to form pills sized like Sophora japonica seeds. Take twenty pills with drink before meals.