论曰诸病吐之而愈者，邪在胸中也，伤寒大法，谓四日以上，若入阴经，其传未深，邪
气高而里实，客于胸膈，下之则动胃，发之则亡阳，唯宜吐而出之，然亦不必拘此，凡寒邪
热毒，痰实在胸中者，及有宿食在胃脘者，皆当吐之，但诊其脉寸口或浮、或滑、或数、或
紧，与诸部不同者，其证心胸痞满，郁郁而痛，不能息，多涎唾，饮食入则欲吐，吐复不能
出，或手足厥冷，反心下满而烦，饥不能食，吐下后心中懊 者是也，内经所谓其高者因而
越之，即其法也。
治胸有寒，病如桂枝证，头不痛，项不强，寸脉微浮，胸中痞硬，气上冲喉咽不得息，
当吐之。瓜蒂散方
瓜蒂（熬） 赤小豆（各一分）
上二味，各捣筛，再和匀，每服一钱匕，豉一合，汤七合，先渍之，须臾煮作稀糜，去
滓取汁，调散放温顿服，不吐少少加之，快吐为度（诸亡血虚家不可与）
治伤寒三四日胸中痰壅，憎寒壮热、头痛。撩膈汤方
桃枝（一握东引者取梢）柳枝（一握取梢） 甘草（一分生用） 乌梅（去核三枚） 山
栀子仁
（一分）
上五味，各细锉，同用浆水一大盏半，煎至一盏去滓，空心分为二服，相次再服，取吐
为度。
服前撩膈汤吐后，头痛壮热未退，即服此。三物汤方
薄荷（一握锉） 人参（半两锉） 生姜（切一分）
上三味，用水一大盏，煎至半盏，去滓空心温服，晚再服。
治伤寒四日，毒瓦斯入胃，喉中闭闷。吐痰散方
瓜蒂（微炒） 赤小豆 丁香（各一分）
上三味，捣罗为散，每服一钱匕，空心温水调下，当吐下后，便可煮葱豉粥补之。
治温病胸中满闷。取吐方
猪胆（三枚） 苦酒（二合）
上二味，同搅匀，绵滤过顿服，未吐再服。
治伤寒四日以上呕逆，苦参散吐方
苦参
上一味为细散，每服三钱匕，温酒五合，调服之，即吐。
治伤寒四日后，太阴初受。常山汤吐之方
常山 鳖甲（去裙 醋炙） 石膏（碎） 柴胡（去苗） 知母（焙） 甘草（生锉各
半两）
上六味，粗捣筛，每服三钱匕，水一盏，入竹叶七片，同煎至半盏，去滓温服，当吐涎
沫，后却服和气汤药。
治伤寒出汗后，心胸妨闷，烦热未退。人参汤吐方
人参（半两） 灯心（一小束） 枳壳（去瓤麸炒一分） 大腹皮（一枚锉） 茶末（二
钱） 生
甘草（半两）
上六味，除茶末外，各细锉，用淡浆水二大盏，煎至一盏，去滓下茶末搅匀，分温二服，
以纸捻子于咽喉中取吐为度。
Commentary states: Various diseases are cured by inducing vomiting because the pathogenic factor is located in the chest. The general principle of treating cold damage (Shanghan) holds that if the disease has lasted for four or more days and the pathogen has entered the Yin meridians, but the transmission has not yet gone deep, the pathogenic qi is high in position and there is interior excess. If the pathogen lodges in the chest and diaphragm, using purgation will disturb the Stomach Qi, while using diaphoresis may lead to the loss of Yang Qi. Therefore, it is appropriate to use emesis to expel the pathogen. However, one should not rigidly adhere to this rule. In cases where cold pathogens, heat toxins, phlegm-dampness firmly lodged in the chest, or retained food in the epigastrium are present, emesis should be employed. Upon pulse diagnosis, if the Cun (inch) position at the wrist shows a floating (Fu), slippery (Hua), rapid (Shu), or tight (Jin) pulse, differing from other positions, and symptoms include chest and heart oppression and fullness, depression with pain, dyspnea, excessive salivation, nausea upon swallowing food, inability to vomit despite the urge, cold extremities, apparent fullness below the heart accompanied by irritability, hunger without appetite, or mental restlessness (Ao Nao) after vomiting or purging, these conditions are suitable for treatment. As stated in the *Neijing* (Inner Canon): "Where the pathogen is high, induce vomiting to expel it." This refers to this method.
To treat cold pathogen in the chest, presenting with symptoms resembling Gui Zhi Tang Syndrome (Cinnamon Twig Decoction Syndrome), but without headache or stiffness of the neck, with a slightly floating pulse at the Cun position, chest oppression and hardness, upward rushing of Qi to the throat causing dyspnea, emesis should be induced. Guadi San (Melon Seed Powder) Formula:
Guadi (Cucumeris Fructus, processed by frying), Chixiaodou (Vigna angularis, each 1 fen).
The above two ingredients are each pounded and sifted, then mixed evenly. Take 1 qianbi (approx. 3-5g) of the powder per dose, combined with 1 he (approx. 20ml) of Xiangchi (Prepared Soybean, Fabae Preparata) and 7 he (approx. 140ml) of water. Soak the Xiangchi briefly, then boil into a thin porridge. Strain to obtain the decoction, mix with the powder, and take warm in one dose. If vomiting does not occur, increase the dose slightly; stop when vigorous vomiting is achieved. (Contraindicated in patients with blood loss or deficiency constitution.)
To treat phlegm obstruction in the chest following three to four days of Shanghan, accompanied by aversion to cold with high fever and headache. Liaoge Tang (Diaphragm-Lifting Decoction) Formula:
Tao zhi (Peach twig, apical part of branches growing eastward, one handful), Liu zhi (Willow twig, apical part, one handful), Gancao (Licorice Root, 1 fen, raw), Wumei (Mume Fruit, pitted, three pieces), Shanzhizi Ren (Gardenia Seed, 1 fen).
The above five ingredients are finely chopped and decocted together with 1.5 da zhan (approx. 300ml) of Jiangshui (Sour rice water) until reduced to 1 da zhan (approx. 200ml). Strain and divide into two doses taken on an empty stomach, administered sequentially. Stop when vomiting occurs.
After inducing vomiting with the preceding Liaoge Tang, if headache and high fever persist, administer this formula immediately. Sanwu Tang (Three-Ingredient Decoction) Formula:
Bohe (Mint Herb, one handful, chopped), Renshen (Ginseng Root, half liang, chopped), Shengjiang (Fresh Ginger Rhizome, 1 fen, sliced).
The above three ingredients are decocted in 1 da zhan (approx. 200ml) of water until reduced to half a zhan (approx. 100ml). Strain and take warm on an empty stomach; repeat the dose in the evening.
To treat toxic vapors entering the Stomach after four days of Shanghan, causing throat closure and stuffiness. Tutan San (Phlegm-Vomiting Powder) Formula:
Guadi (Cucumeris Fructus, lightly fried), Chixiaodou (Vigna angularis), Dingxiang (Clove, each 1 fen).
The above three ingredients are pounded and sifted into a powder. Take 1 qianbi (approx. 3-5g) per dose, mixed with warm water on an empty stomach. Vomiting and purging should follow; afterwards, prepare Congchi Zhou (Scallion and Soybean Porridge) to nourish the body.
To treat chest fullness and stuffiness in Warm Disease (Wenbing). Emetic Formula:
Zhudan (Pig Gallbladder, three pieces), Kujiu (Vinegar, 2 he).
Mix the above two ingredients thoroughly, filter through silk cloth, and take in one dose. If vomiting does not occur, administer again.
To treat retching occurring after four or more days of Shanghan. Kushen San (Sophora Root Powder) Emetic Formula:
Kushen (Sophora Root).
Grind the single ingredient into a fine powder. Take 3 qianbi (approx. 9-15g) per dose, mixed with 5 he (approx. 100ml) of warm wine. Vomiting will ensue.
To treat the initial invasion of the Taiyin Meridian after four days of Shanghan. Changshan Tang (Dichroa Root Decoction) Emetic Formula:
Changshan (Dichroa Root), Biejia (Turtle Shell, skirt removed, vinegar-fried), Shigao (Gypsum Fibrosum, crushed), Chaihu (Bupleurum Root, radix removed), Zhimu (Anemarrhena Rhizome, dried), Gancao (Licorice Root, raw, chopped, each half liang).
The above six ingredients are coarsely pounded and sifted. Take 3 qianbi (approx. 9-15g) per dose, with 1 zhan (approx. 200ml) of water and seven leaves of Zhuye (Bamboo Leaf), decocted until reduced to half a zhan (approx. 100ml). Strain and take warm. Saliva and froth should be vomited out; afterwards, administer harmonizing Qi medicines.
To treat chest and heart oppression and lingering irritability and heat after sweating in Shanghan. Renshen Tang (Ginseng Decoction) Emetic Formula:
Renshen (Ginseng Root, half liang), Dengxin (Juncus Medulla, small bundle), Zhike (Aurantii Fructus, pulp removed, bran-fried, 1 fen), Dafupi (Arecae Pericarpium, one piece, chopped), Chamofen (Tea powder, 2 qian), Sheng Gancao (Raw Licorice Root, half liang).
Except for the tea powder, finely chop the above six ingredients. Decoct in 2 da zhan (approx. 400ml) of light Jiangshui (Sour rice water) until reduced to 1 da zhan (approx. 200ml). Strain, add the tea powder, and mix well. Divide into two warm doses. Induce vomiting by stimulating the throat with a paper wick until vomiting occurs.