半夏（洗、浣用）二升 人参三两 白蜜一升
右三味，以水一斗二升，和蜜扬之二百四十遍，煮药取一升半，温服一升，余分再服
。
『千金方』云：大半夏汤治胃反不受食，食入即吐。『外台方』云：大半夏汤治呕心
下痞□者。
【集解】
高世栻曰：朝食暮吐，宿谷不化，名曰胃反；胃反但吐不呕，然吐不离乎呕，故曰：
胃反呕吐者，用半夏助燥气以消谷，人参补元气以安胃，白蜜入水扬之，使甘味散于
水中，水得蜜而和缓，蜜得水而淡渗，庶胃反平而呕吐愈。李升玺曰：呕家不宜甘味
，此用白蜜何也？不知此胃反自属脾虚，经所谓甘味入脾，归其所喜是也。况君以半
夏，味辛而止呕，佐以人参温气而补中，胃反自立止矣。
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胃反，吐而渴欲饮水者，茯苓泽泻汤主之。
【注】
胃反吐而不渴者，寒也。渴欲饮水者，饮也。故以茯苓泽泻汤，补阳利水也。
茯苓半筋 泽泻四两 甘草二两 桂枝二两 白术三两 生姜四两
右六味，以水一斗，煮取三升，内泽泻，再煮取二升半，温服八合，日三服。
『外台方』云：茯苓泽泻汤，治消渴胃反脉绝。
【集解】
李□曰：吐而渴者，津液亡而胃虚燥也。饮水则水停心下，茯苓、泽泻，降气行饮，
白术补生津，此五苓散原方之义也。然胃反因脾气虚逆，故加生姜散逆，甘草和脾。
又五芩散治外有微热，故用桂枝。此胃反无表热，而亦用之者，桂枝非一于攻表药也
，乃彻上彻下，达表里，为通行津液，和阳散水之剂也。
尤怡曰：茯苓泽泻汤，治吐未已，而渴欲饮水者，以吐未已，知邪未去，则宜桂枝、
甘姜散邪气，茯苓、泽泻消水气也。
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哕逆者，橘皮竹茹汤主之。
【注】
哕即干呕也，因其有哕哕之声，而无他物，故不曰干呕，而曰哕逆，属气上逆为病也
。上逆之气，得出上窍，皆能作声，故肺虚气上逆，则作欬，气从喉出而有欬逆之声
，若为邪所阻，则为喘满，故无声也。胃虚气上逆，则作哕，气从咽出而有哕逆之声
，若与物凝结，则为痞痛，故无声也，是知气病也明矣。然邪气所凑，正气必虚，故
用橘皮、竹茹、生姜以清邪气，人参、甘草、大枣，以补正气，则上逆之气自可顺矣
。
Banxia (washed and rinsed) 2 sheng, Renshen 3 liang, Baimi (white honey) 1 sheng.
The above three ingredients are decocted with 12 dou of water mixed with honey, stirred and splashed two hundred and forty times. The decoction is reduced to obtain 1.5 sheng. Take 1 sheng warm; the remainder is divided into two doses for subsequent administration.
*Qianjin Fang* states: Banxia Decoction (Dabanchang Tang) treats Wei Fan (gastric reflux), characterized by the inability to retain food and immediate vomiting after ingestion. *Waitai Mi Yao Fang* states: Banxia Decoction (Dabanchang Tang) treats patients with vomiting and epigastric fullness/stuffiness.
[Collected Commentaries]
Gao Shishi stated: When morning intake is vomited in the evening, and undigested food remains, it is named Wei Fan (gastric reflux); Wei Fan involves vomiting without retching, yet vomiting is inherently linked to the mechanism of retching. Therefore, for treating Wei Fan and vomiting, Banxia is used to assist drying qi to digest grains, Renshen is used to tonify primordial qi to stabilize the stomach, and Baimi (white honey) is added to water and stirred vigorously so that its sweet flavor disperses in the water. Water becomes mild when combined with honey, and honey becomes light and penetrating when combined with water. Thus, Wei Fan is pacified, and vomiting ceases. Li Shengxi stated: Patients prone to vomiting should generally avoid sweet flavors. Why use Baimi here? It is unknown that this type of Wei Fan belongs to Spleen deficiency. As the classics state, "sweet flavor enters the Spleen," which accords with what the Spleen prefers. Moreover, with Banxia as the sovereign herb, its pungent flavor stops vomiting, assisted by Renshen to warm qi and tonify the middle, causing Wei Fan to cease spontaneously.
@@@
When Wei Fan (gastric reflux) presents with vomiting and thirst desire to drink water, Fuling Zexie Tang (Poria and Alisma Decoction) is the primary treatment.
[Annotation]
Wei Fan with vomiting but no thirst indicates cold. Thirst desire to drink water indicates fluid retention. Therefore, Fuling Zexie Tang is used to tonify yang and promote diuresis.
Fuling 0.5 jin, Zexie 4 liang, Gancao 2 liang, Guizhi 2 liang, Baizhu 3 liang, Shengjiang 4 liang.
The above six ingredients are decocted with 10 dou of water until 3 sheng remain. Then add Zexie and continue decocting until 2.5 sheng remain. Take 8 ge warm, three times a day.
*Waitai Mi Yao Fang* states: Fuling Zexie Tang treats Xiao Ke (wasting-thirst) and Wei Fan with absent pulse.
[Collected Commentaries]
Li [Name obscured] stated: Vomiting accompanied by thirst indicates loss of body fluids and dryness due to Stomach deficiency. Drinking water leads to fluid stagnation in the heart region. Fuling and Zexie descend qi and move fluids, while Baizhu tonifies qi and generates fluids; this aligns with the principle of the original Wuling San (Five-Ingredient Powder with Poria). However, since Wei Fan arises from deficient and rebellious Spleen qi, Shengjiang is added to scatter rebellion, and Gancao harmonizes the Spleen. Furthermore, Wuling San is used when there is slight external heat, hence the use of Guizhi. Although this case of Wei Fan lacks exterior heat, Guizhi is still used because Guizhi is not merely an exterior-releasing agent; it penetrates from top to bottom, connects interior and exterior, promotes the circulation of body fluids, harmonizes yang, and dissipates water.
You Yi stated: Fuling Zexie Tang treats cases where vomiting has not yet ceased, accompanied by thirst and desire to drink. Since vomiting persists, it indicates pathogenic factors have not been expelled; thus, Guizhi and Ganjiang (dried ginger) are suitable to scatter pathogenic qi, while Fuling and Zexie eliminate fluid accumulation.
@@@
For Suo Ni (hiccups/belching with upward reversal), Jupi Zhuru Tang (Tangerine Peel and Bamboo Shavings Decoction) is the primary treatment.
[Annotation]
Suo refers to dry heaving. Because it produces a "suo suo" sound without expelling other substances, it is termed Suo Ni rather than Gan Ou (dry heaving). It belongs to diseases caused by upward reversal of qi. Qi reversing upward and exiting through upper orifices can produce sound. For instance, Lung deficiency with upward reversing qi causes coughing; qi exiting the throat produces coughing sounds. If obstructed by pathogens, it becomes panting and fullness, resulting in no sound. Stomach deficiency with upward reversing qi causes Suo; qi exiting the pharynx produces Suo sounds. If condensed with tangible matter, it becomes distension and pain, resulting in no sound. Thus, it is clear this is a disease of qi. Wherever pathogenic factors gather, righteous qi must be deficient. Therefore, Jupi, Zhuru, and Shengjiang are used to clear pathogenic qi, while Renshen, Gancao, and Dazao are used to tonify righteous qi, allowing the upward-reversing qi to naturally descend smoothly.