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(See the section on Phlegm-Fluids)

Vomiting with the pathology located above the diaphragm, followed by a desire for water, indicates that the disease is resolving; in such cases, provide water promptly. If the patient continues to desire water, Zhu Ling San (Polyporus Powder) is the primary treatment.

[Annotation]
This passage elaborates on the preceding clause regarding vomiting caused by fluid retention, clarifying its treatment. After vomiting, the fluids of the upper diaphragm are damaged. If the patient desires water, providing it immediately will result in the cessation of vomiting if the pathogen has departed and the Stomach Qi has harmonized, leading to natural recovery. However, if the patient desires water but continues to vomit after drinking, it indicates that the pathogen remains and fluid retention persists. Zhu Ling San (Polyporus Powder) is prescribed to promote urination and stop vomiting.

[Collected Annotations]
Cheng Lin stated: The previous chapter mentioned that vomiting followed by thirst indicates an impending resolution. Similarly, vomiting with pathology above the diaphragm followed by a desire for water also signifies resolution, consistent with the aforementioned syndrome. Therefore, water should be provided promptly to harmonize the Stomach. However, patients desiring water may drink greedily once they obtain it. If the Stomach lacks sufficient heat to transform the ingested water, it may lead to new pathological conditions. Thus, for those desiring water, Zhu Ling San (Polyporus Powder) is used to dissipate fluid retention.

Wei Litong stated: Vomiting with pathology above the diaphragm followed by a desire for water is a sign of impending resolution, aligning with the principle in the Treatise on Cold Damage that "vomiting followed by thirst indicates resolution." Promptly providing water replenishes the fluids damaged by vomiting. Conversely, if a patient desires water before vomiting occurs, it corresponds to the syndrome of "thirst followed by vomiting," indicating fluid retention in the epigastrium. This requires treating Branch Fluids (Zhi Yin), after which the thirst will resolve. Zhu Ling San (Polyporus Powder) promotes urination and strengthens the Spleen Earth to treat dampness; by addressing the thirst, it simultaneously treats the upward rebellious vomiting.

Zhu Ling (Polyporus), Fu Ling (Poria), Bai Zhu (Atractylodis Macrocephalae Rhizoma) in equal parts.
These three herbs are pulverized into a powder. Take one fangcun bi (a square-inch measure) with warm water, administered three times daily.

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Vomiting accompanied by fever is primarily treated with Xiao Chai Hu Tang (Minor Bupleurum Decoction).

[Annotation]
Vomiting accompanied by abdominal fullness indicates interior excess; Da Chai Hu Tang (Major Bupleurum Decoction) is prescribed to purge the interior and stop vomiting. In contrast, vomiting accompanied by fever indicates exterior involvement; Xiao Chai Hu Tang (Minor Bupleurum Decoction) is prescribed to harmonize the exterior and interior and stop vomiting.

[Collected Annotations]
Cheng Lin stated: The Classics state: "Vomiting with fever indicates that the Chai Hu Tang syndrome is present." Typically, patients who vomit do not necessarily have fever; however, since fever belongs to the Shaoyang (Half-Exterior, Half-Interior) stage, Xiao Chai Hu Tang (Minor Bupleurum Decoction) is given to harmonize the condition.
Li [Name Missing] stated: Fever in cold damage is a Exterior Syndrome. However, when pathogens attempt to invade the Interior, the Interior Qi rejects them, causing rebellion and vomiting. This constitutes a Half-Exterior, Half-Interior syndrome. Xiao Chai Hu Tang (Minor Bupleurum Decoction) is a formula for treating Half-Exterior, Half-Interior syndromes through harmonization.