呕吐哕 皆属胃 呕字从沤，沤者水也，口中出水而无食也。吐字从土，土者食也，口
中吐食而无水也。呕吐者，水与食并出也。哕者，口中有秽味也，又谓之干呕，口中有秽味
，未有不干呕也。呃逆者，气冲有声，声短而频也。其病皆属于胃。
二陈加 时医贵 二陈汤倍生姜，安胃降逆药也。寒加丁香、砂仁；若热，加黄连、鲜
竹茹、石斛之类。
玉函经 难仿佛 寒热攻补，一定不移。
小柴胡 少阳谓 寒热往来而呕者，属少阳也。
吴茱萸 平酸味 吴茱萸汤治阳明食谷欲呕者，又治少阴症吐利、手足逆冷、烦躁欲死
者，又治干呕吐涎沫者。此症呕吐，多有酸味。
食已吐 胃热沸 食已即吐，其人胃素有热，食复入，两热相冲，不得停留。
黄草汤 下其气 大黄甘草汤治食已即吐。《金匮》云∶欲吐者不可下之。又云∶食已
即吐者，大黄甘草汤下之。何也?曰∶病在上而欲吐，宜因而越之。若逆之使下，则必愦乱
益甚。若既吐矣，吐而不已，是有升无降，当逆折之。
食不入 火堪畏 王太仆云∶食不得入，是有火也。
黄连汤 为经纬 喻嘉言用进退黄连汤，柯韵伯用干姜黄连黄芩人参汤，推之泻心汤亦
可借用，以此数汤为经纬。
若呃逆 代赭汇 代赭旋覆汤治噫气，即治呃逆。若久病呃逆，为胃气将绝，用人参一
两，干姜、附子各三钱，丁香、柿蒂各一钱，可救十中之一。
Vomiting, retching (Hui), and belching all pertain to the Stomach.
The character "Ou" (Vomit) derives from "Ou" (soak/bubble), where "Ou" means water; it refers to spitting out clear fluid without food.
The character "Tu" (Eject/Vomit) derives from "Tu" (Earth), where "Earth" represents food; it refers to ejecting food without fluid.
"Ou Tu" (Vomiting) implies that both water and food are expelled together.
"Hui" (Retch/Convulsive hiccup) refers to a foul odor in the mouth, also known as dry heaves; whenever there is a foul odor in the mouth, dry heaves invariably occur.
"E Ni" (Hiccup) refers to air rushing up producing sound, characterized by short and frequent noises.
The pathology of these conditions all belongs to the Stomach.
Er Chen Tang with added Ginger: Contemporary physicians value this approach.
Using Er Chen Tang (Two-Aged Peel Decoction) with doubled fresh ginger is a formula that stabilizes the Stomach and directs rebellious Qi downward.
If the pattern is Cold, add Ding Xiang (Clove) and Sha Ren (Amomum Fruit); if Heat, add Huang Lian (Coptis Rhizome), Xian Zhu Ru (Fresh Bamboo Shavings), Shi Hu (Dendrobium Stem), and similar herbs.
The principles of the *Yu Han Jing* are difficult to approximate:
For Cold patterns use warming methods, for Heat patterns use clearing methods, for Excess patterns use purging methods, and for Deficiency patterns use tonifying methods; these principles remain fixed and unchanging.
Xiao Chai Hu Tang corresponds to Shaoyang:
When alternating chills and fever occur accompanied by vomiting, the condition pertains to Shaoyang disease (disease resulting from pathogenic invasion of the Shaoyang channel).
Wu Zhu Yu Tang neutralizes sourness:
Wu Zhu Yu Tang (Evodia Decoction) treats cases of Yangming disease where one desires to vomit after eating grain; it also treats Shaoyin disease (disease resulting from pathogenic invasion of the Shaoyin channel) presenting with vomiting, diarrhea, cold extremities, and severe restlessness desiring death; and it treats dry heaves with expulsion of saliva. In such vomiting cases, a sour taste is often present.
Vomiting immediately after eating indicates boiling Stomach Heat:
Vomiting immediately after finishing a meal indicates that the patient has pre-existing heat in the Stomach; when new food enters, the two heats clash, preventing retention.
Da Huang Gan Cao Tang directs Qi downward:
Da Huang Gan Cao Tang (Rhubarb and Licorice Decoction) treats vomiting immediately after eating. The *Jin Gui Yao Lue* states: "Those who desire to vomit should not be treated with purgatives." It further states: "Those who vomit immediately after eating should be treated with Da Huang Gan Cao Tang to purge." Why? The answer is: When the pathogen is in the upper jiao and vomiting is desired, one should follow the trend and induce emesis. If one opposes this by forcing downward movement, the confusion will worsen significantly. If vomiting has already occurred but continues incessantly, this indicates rising without descending; one must oppose this trend to subdue it.
Inability to ingest food reveals Fire, which is to be feared:
Wang Bing (Grand Master Wang) stated: "Inability to take in food is due to the presence of Fire."
Huang Lian Tang serves as the warp and weft [guiding principle]:
Yu Jiayan used Jin Tui Huang Lian Tang (Advance-Retreat Coptis Decoction), Ke Yunbo used Gan Jiang Huang Lian Huang Qin Ren Shen Tang (Dried Ginger, Coptis, Scutellaria, and Ginseng Decoction); extending this logic, the Xin Xie Tang (Drain the Epigastrium Decoctions) can also be borrowed, using these several formulas as guiding principles.
Regarding E Ni (Hiccup), Dai Zhe (Magnetite) converges:
Dai Zhe Xuan Fu Tang (Magnetite and Inula Decoction) treats eructation, which is synonymous with treating hiccup. If hiccup persists in chronic illness, it indicates that Stomach Qi is about to exhaust; use Ren Shen (Ginseng Root) 1 liang, Gan Jiang (Dried Ginger) and Fu Zi (Prepared Aconite Root) each 3 qian, Ding Xiang (Clove) and Shi Di (Persimmon Calyx) each 1 qian; this may save one in ten patients.