治呕吐，因胃气上逆，胆火上冲者。
生赭石（六钱，细轧） 青黛（二钱） 清半夏（三钱） 生杭芍（四钱） 龙胆草（三钱） 吴茱萸（一钱）
生姜（二钱） 野台参（二钱）
治胃气上逆，冲气上冲，以致呕吐不止，闻药气则呕吐益甚，诸药皆不能下咽者。
生山药（一两，轧细） 清半夏（一两）
上二味，先将半夏用微温之水淘洗数次，不使分毫有矾味。用煮菜小锅（勿用药瓶）煎取清汤约两杯半，
去渣调入山药细末，再煎两三沸，其粥即成，和白沙糖食之。若上焦有热者，以柿霜代沙糖，凉者用粥送服干
姜细末半钱许。
吐后口舌干燥，思饮水者热也。吐后口舌湿润，不思饮水者凉也。若呕吐既久，伤其津液，虽有凉者亦可
作渴，又当细审其脉，滑疾为热，弦迟为凉。滑而无力，为上盛下虚，上则热而下或凉。弦而有力，为冲胃气
逆，脉似热却非真热。又当问其所饮食
者，消化与否，所呕吐者，改味与否，细心询问体验，自能辨其凉热虚实不误也。
从来呕吐之证，多因胃气冲气，并而上逆。半夏为降胃安冲之主药，故《金匮》治呕吐，有大小半夏汤。
特是呕者，最忌矾味，而今之坊间鬻者，虽清半夏亦有矾，故必将矾味洗净，而后以治呕吐，不至同于抱薪救
火也。其多用至一两者，诚以半夏味本辛辣，因坊间治法太过，辣味全消，又经数次淘洗，其力愈减，必额外
多用之，始能成降逆止呕之功也。而必与山药作粥者，凡呕吐之人，饮汤则易吐，食粥则借其稠粘留滞之力，
可以略存胃腑，以待药力之施行。且山药，在上大能补肺生津，则多用半夏，不虑其燥，在下大能补肾敛冲，
则冲气得养，自安其位。且与半夏皆无药味，故用于呕吐甚剧，不能服药者尤宜也。
有因“胆倒”而呕吐不止者，《续名医类案》载∶许宣治一儿十岁，从戏台倒跌而下，呕吐苦水，绿如菜
汁。许曰∶此“胆倒”也，胆汁倾尽则死矣。方用温胆汤，加枣仁、代赭石，正其胆腑。可名正胆汤，一服吐
止。按∶此证甚奇异，附载于此，以备参考。
Treats vomiting caused by rebellious Stomach Qi and upward rushing of Gallbladder Fire.
Sheng Zhe Shi (Hematitum, six qian, finely ground) Qing Dai (Indigo Naturalis, two qian) Qing Ban Xia (Pinelliae Rhizoma Preparatum, three qian) Sheng Hang Shao (Paeoniae Radix Alba, four qian) Long Dan Cao (Gentianae Radix, three qian) Wu Zhu Yu (Evodiae Fructus, one qian)
Sheng Jiang (Zingiberis Rhizoma Recens, two qian) Ye Tai Shen (Codonopsis Radix, two qian)
Treats persistent vomiting due to rebellious Stomach Qi and rushing Chong Qi, where the smell of medicine exacerbates vomiting, making it impossible to swallow any medication.
Sheng Shan Yao (Dioscoreae Rhizoma, one liang, finely ground) Qing Ban Xia (Pinelliae Rhizoma Preparatum, one liang)
For the above two ingredients, first wash Pinelliae Rhizoma Preparatum several times with slightly warm water until no alum taste remains. Use a small pot for cooking vegetables (do not use a medicinal decoction pot) to decoct until approximately two and a half cups of clear liquid remain.
Remove the dregs, mix in the fine powder of Dioscoreae Rhizoma, boil for two or three more boils, and the gruel is ready. Consume it mixed with white rock sugar. If there is heat in the Upper Jiao, substitute persimmon frost for rock sugar; if cold, take half a qian of dried Ginger Rhizome powder with the gruel.
Dryness of the mouth and tongue after vomiting, with a desire to drink water, indicates Heat. Moisture of the mouth and tongue after vomiting, without a desire to drink, indicates Cold. If vomiting has persisted for a long time, damaging body fluids, even a Cold pattern may present with thirst. In such cases, carefully examine the pulse: slippery and rapid indicates Heat, wiry and slow indicates Cold. Slippery but weak indicates excess above and deficiency below, with heat above and possible cold below. Wiry but forceful indicates rebellious Stomach and Chong Qi; although the pulse resembles Heat, it is not true Heat. One must also inquire about their diet: whether food is digested, and whether vomitus has an altered taste. Careful inquiry and observation will naturally allow differentiation of Cold, Heat, Excess, and Deficiency without error.
Historically, most cases of vomiting are due to the simultaneous rebellion of Stomach Qi and Chong Qi. Pinellia is the principal herb for descending Stomach Qi and calming Chong Qi; thus, *Jin Gui Yao Lue* treats vomiting with Da Ban Xia Tang and Xiao Ban Xia Tang.
However, vomiting strictly forbids the taste of alum. Currently, even commercially available prepared Pinellia contains alum. Therefore, the alum taste must be thoroughly washed away before treating vomiting, otherwise it would be like adding fuel to the fire. The reason for using up to one liang is that Pinellia is originally pungent and spicy. Due to excessive processing by manufacturers, its pungency is completely lost, and after multiple washings, its efficacy is further reduced. Extra dosage is necessary to achieve the effect of descending rebellion and stopping vomiting. The reason for combining it with Yam in a gruel is that patients who vomit easily reject liquids. The viscosity and retention power of the gruel help it stay in the Stomach longer, allowing the medicinal effects to act. Furthermore, Yam strongly tonifies Lung Yin and generates fluids when acting on the Upper Jiao, so the drying nature of Pinellia is not a concern. When acting on the Lower Jiao, it strongly tonifies Kidney Essence and secures Chong Qi, nourishing Chong Qi so it returns to its proper position. Moreover, both have no strong medicinal taste, making this combination particularly suitable for severe vomiting where oral medication cannot be retained.
There are cases of persistent vomiting due to "Gallbladder Reversal" (Dan Dao). *Xu Ming Yi Lei An* records: Xu Xuanzhi treated a ten-year-old boy who fell backward from a stage, vomiting bitter green fluid resembling vegetable juice. Xu said, "This is 'Gallbladder Reversal'; if all bile is exhausted, death ensues." The prescription was Wen Dan Tang (Warm the Gallbladder Decoction), added with Suan Zao Ren (Ziziphi Spinosae Semen) and Zhe Shi (Hematitum), to rectify the Gallbladder organ. It can be named Zheng Dan Tang (Rectify the Gallbladder Decoction). After one dose, vomiting stopped. Note: This case is very peculiar and is recorded here for reference.