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The *Classic* (Huangdi Neijing) states: All rebellious qi rushing upward belongs to Fire; all vomiting and acid regurgitation belong to Heat. It also states: When Cold pathogen lodges in the Stomach and Intestines, causing Jue-Ni (rebellious counterflow) to rush upward, pain and vomiting occur. Vomiting occurs because the Qi of the Yangming Stomach, which should descend smoothly, instead rebels and ascends. The etiologies include Heat, Cold, and Food Retention. However, there are cases where excessive feeding leads to overflow, further damaging the deficient Stomach Qi, gradually resulting in this condition.

That which involves both sound and matter, occurring upon opening the mouth, is termed "Ou" (Vomit). That which involves matter but no sound is termed "Tu" (Regurgitate). That which involves sound but no matter is termed "Yueh" (Hiccups/Retching). There is also "Yi Ru" (Spilling Milk), where milk flows out naturally, resembling water shooting from an eaves trough. "Ye" (Choking/Stagnation) refers to rebellious Qi stagnating and obstructing the upper and lower chest. "Yueh" results from deficiency in the Diaphragm and Cold in the Stomach; although sound is produced, no matter exits. Its manifestations vary. For instance, in newborns, it may arise from latent Phlegm in the mother transmitted via fetal Qi, or from unclean oral wiping leading to toxic fluids, or from dietary mishaps combined with fright and anger injuring Stomach Qi, causing aversion to food, stomach pain, and vomiting. If red lines appear behind the ears and the cheeks are red-purple, accompanied by coarse breathing and vomiting, this is a sign that smallpox/rashes are about to erupt. If the body is emaciated, spirit is exhausted, movements are involuntary and ceaseless, and there is no desire for milk or food, this is Deficient Vomiting due to weak Stomach Qi unable to digest and accept nourishment. If the face is cyan and lips pale, with clear saliva mixed with milk, preferring warmth and fearing cold, with cold limbs, this is Cold Vomiting. If there is Excess Fire in the Stomach, yellow bitter fluid is vomited, accompanied by chest restlessness. If the pathogen enters the Liver via the Jueyin channel, sourness and rebellion occur, with irritability and frequent crying, constituting Heat Vomiting. If coughing, rapid breathing, vomiting of clear fluid, and chest oppression occur, this is Phlegm Vomiting due to Cold pathogen in the Stomach and stubborn Phlegm transforming into Heat. If undigested food causes sour and foul regurgitation, aversion to food, lack of thirst, stomach pain, and tidal fever, this is Food Injury and Cold Damage. If thick yellow phlegm and saliva cause belching and vomiting, these are signs of inflammatory Heat. If the face is pale, hands are dry/scorched, or white spots appear on the face, lips are red or purple, and the infant becomes comatose after vomiting, with intermittent stomach pain and vomiting of clear fluid, this is Worm Vomiting. If lips are black, crying is frequent, and milk is vomited with phlegm, this indicates Spleen injury. If the body is feverish, coughing with rattling phlegm, night-time restlessness, nasal cyanosis, and milk vomiting occur, this is External Wind injuring the Lung. If fever occurs morning and evening, the Shan Gen (root of the nose) is cyan, and vomiting prevents sleep, this is Fright Vomiting.

The treatment of vomiting must distinguish between new/old onset and Cold/Heat patterns. For initial vomiting, guiding and purging methods should be used to facilitate downward Qi movement. For chronic vomiting, one must guard against Wind generated by Stomach deficiency; thus, supporting Stomach Qi is paramount. If vomiting persists, mild ant-emetics may be used, but excessive purging must be avoided to prevent severe depletion of Stomach Qi. Only in cases of Wind disorders and Phlegm-complexed vomiting should stopping vomiting not be done hastily; otherwise, Wind has no fixed location, external Wind may invade, and Phlegm-Heat may generate, inevitably leading to Convulsive disorders. Other initial vomiting cases and those caused by improper feeding should be regulated and treated. If Yi Ru persists, it becomes Tu; if Tu persists, it becomes dry retching; if dry retching persists, it becomes Yueh. At this stage, Stomach Qi is severely depleted, and Spirit is fading. If vomiting continues, becoming increasingly severe with sunken or swollen fontanelles, exposed blue veins, frequent vomiting without eating, coma with blocked speech, panting with upper heat, or frequent vomiting of foul-smelling fluid, these are death omens. Additionally, constant spitting of saliva is often due to declining and cold Kidney Qi, failing to store fluids to moisten the Heart and Lungs, eventually leading to yellow emaciation; decoctions of Rehmannia (Di Huang) are suitable. Cases due to declining and cold Stomach Qi failing to transport fluids require warming and tonifying Stomach Qi. Cases of Heat accumulation in the Heart and Spleen, as stated in the Classic: "Flaccid tongue with drooling belongs to Heat," require clearing and purging. Whether involving the Kidney, Stomach, or Spleen, and whether Deficient, Cold, or Heat, differentiation is typically made through observation of complexion and pulse.