呕吐反胃，浮滑者昌。弦数紧涩，结肠者亡。
呕吐有声有物，反出于胃，上焦之病也。（宜仲景大半夏汤、生姜半夏汤、二陈汤之类。）上焦，
则脉应浮。有物，则脉应滑。浮滑为阳，饮食之能纳能运而不反者，阳之力也。故
云∶浮滑者昌。若得弦数紧涩之脉，则逆矣。盖弦状阴敛，阳运衰微。又弦为肝木
之脉。呕吐属胃，胃者土也。木来乘土，土将夺矣。《金匮要略》云∶脉弦者虚也，
胃气无余。亦惧胃土虚而见肝木之脉也。（宜平肝补脾，如四君子汤、六君子汤加防风白芍之类。）数则
为热，热当消谷。而反吐谷者，乃知数为虚数。虚则不运，数则气促，呕吐不止，
胃将由此而败。《金匮要略》云∶阳气微，膈气虚，脉乃数。（宜补中兼清虚热，如六君子汤加竹
茹、生姜、茱萸、制黄连之类。紧则为寒，寒则无阳以运，故上出而呕吐。宜温中散寒，如理中汤、
藿香安胃散之类。）涩脉枯涩，吐亡津液之所致也。《金匮要略》所谓朝食暮吐，暮食朝吐，
宿谷不化，名曰胃反。脉紧而涩，其病难治者是也。（宜补气而生津，如四君子汤加黄 、五味子
之类。）夫胃为水谷之海，若再加大肠秘结，是全无阴液而水谷之海枯矣。水谷之海
枯而能生者，未之有也。（反胃，粪如羊屎者不治。）
Vomiting with sound and regurgitation of food from the stomach is a disease of the Upper Jiao (Upper Burner). (Appropriate formulas include Zhang Zhongjing's Banxia Tang Major, Shengjiang Banxia Tang, or Erchen Tang.) When the pathology is in the Upper Jiao, the pulse should be Floating. When there is regurgitated matter, the pulse should be Slippery. A Floating-Slippery pulse indicates Yang; the ability to ingest and transport food without regurgitation is due to the power of Yang. Hence it is said: "Floating and Slippery indicates prosperity." If a Wiry, Rapid, Tight, or Choppy pulse is obtained, it indicates an adverse prognosis. This is because a Wiry pulse shape signifies Yin constriction and declining Yang transportation. Furthermore, the Wiry pulse corresponds to the Liver Wood. Vomiting involves the Stomach, which belongs to Earth. When Wood overacts on Earth, Earth's Qi will be depleted. The *Jingui Yaolue* states: "A Wiry pulse indicates deficiency; there is no surplus of Stomach Qi." This reflects the fear that weak Stomach Earth manifests as a Liver Wood pulse. (Treatment should soothe the Liver and tonify the Spleen, such as Sijunzi Tang or Liujunzi Tang added with Fangfeng and Baishao.) A Rapid pulse indicates Heat, which should digest grain. However, if grain is vomited undigested, this Rapid pulse indicates Deficiency-Rapid. Deficiency leads to failure of transportation; Rapidness leads to shortness of breath. Unceasing vomiting will cause the Stomach Qi to fail. The *Jingui Yaolue* states: "When Yang Qi is minute and Diaphragm Qi is deficient, the pulse becomes Rapid." (Treatment should tonify while clearing Deficient Heat, such as Liujunzi Tang added with Zhuru, Shengjiang, Zhuyu, and Zhi Huanglian.) A Tight pulse indicates Cold; Cold lacks Yang to facilitate transportation, causing upward expulsion and vomiting. Treatment should warm the Middle and dispel Cold, such as Lizhong Tang or Huoxiang Anwei San.) A Choppy pulse is withered and rough, caused by the loss of Body Fluids due to vomiting. The *Jingui Yaolue* describes "morning eating evening vomiting, evening eating morning vomiting, undigested old grain" as Wei Fan (Stomantic Reflux). A Tight and Choppy pulse indicates a difficult-to-treat condition. (Treatment should tonify Qi and generate fluids, such as Sijunzi Tang added with Huangqi and Wuweizi.) The Stomach is the Sea of Water and Grain. If accompanied by constipation of the Large Intestine, it means a complete lack of Yin fluids, leading to the desiccation of the Sea of Water and Grain. There has never been a case where life can be sustained after the Sea of Water and Grain is exhausted. (If the patient with Wei Fan passes stool like sheep dung, it is incurable.)