Library

[Da] When women experience vomiting, it is caused by pathogenic factors and cold in the Spleen and Stomach, leading to dysfunction in the digestion and absorption of food and fluids. The Stomach is the sea of water and grain; when its Qi mechanism is disordered, wind-cold pathogens may invade. Cold clashing with Stomach Qi causes Stomach Qi to rebel upward, resulting in vomiting. Vomiting is not solely due to deficiency-cold of the Spleen and Stomach; there are also cases caused by Stomach heat, cases where the middle Jiao (Stomach body) is cold but the upper orifice (cardia/pylorus area) is hot, cases dominated by phlegm-dampness, and cases due to blood deficiency. The Classics state: "Absence of Yin leads to vomiting." Therefore, medication cannot be applied uniformly. For vomiting due to Stomach cold, one should use *Renshen Dingxiang San* (Ginseng and Clove Powder) or *Lizhong Wan* (Regulate the Middle Pill) from the *Taiping Huimin Heji Jufang*, as well as *Banxia Wan* (Pinellia Pill) or *Renshen Qiwei Wan* (Seven-Ingredient Ginseng Pill) by Xu Renze. For vomiting due to Stomach heat, *Xiaochaihu Tang* (Minor Bupleurum Decoction), *Lugen Tang* (Reed Rhizome Decoction), *Zhuru Tang* (Bamboo Shavings Decoction), or *Huaihua San* (Sophora Flower Powder) are suitable. For vomiting due to cold in the Stomach body and heat at the orifice, *Huoxiang Zhengqi San* (Patchouli and Qi-Regulating Powder) from the *Heji Jufang*, decocted with fresh ginger and jujube, taken cold, will stop the vomiting. For vomiting due to excessive phlegm, *Banxia Tang* (Pinellia Decoction), *Fuling Tang* (Poria Decoction), or *Erchen Tang* (Two-Aged Decoction) from the *Heji Jufang* are appropriate. For nausea and vomiting during pregnancy (*Ezu*), *Fuling Wan* (Poria Pill) can be used concurrently, following specific protocols. For vomiting due to blood failing to return to its vessels, use *Shiquan Dabu Tang* (Comprehensive Great Tonifying Decoction, indicated for deficiency-consumption in miscellaneous diseases) added with Chenpi (Tangerine Peel), Banxia (Pinellia), Huoxiang (Patchouli), ginger, and jujube. Cases of vomiting associated with *Jiaogixing* (Beriberi/Leg Swelling) have their own specialized treatments and are not discussed here.

[Xue] Master Dongyuan stated: In the aforementioned conditions, old cold pathogens and newly ingested food enter the Stomach together. The new and old pathogens attack each other, causing Qi to rebel and exit from the Stomach, resulting in hiccups (*Yue*). Treatment involves tonifying the Hand-Taiyin Lung Meridian and draining the Foot-Shaoyin Kidney Meridian. He also said: Hiccups result from rebellious Stomach Qi. Vomiting, spitting, and hiccups all belong to the Stomach, differing only in the quantity of Qi and Blood involved. Vomiting belongs to the Yangming channel, which has abundant Qi and Blood; thus, it presents with both sound and material, indicating disease in both Qi and Blood. Zhang Zhongjing said: "In frequent vomiting, even if Yangming symptoms exist, one must strictly avoid purgatives." Sun Simiao said: "Those who vomit often should take fresh ginger, as it is the holy medicine for vomiting." Rebellious Qi must be dispersed, so fresh ginger is the primary herb. Spitting (without sound) belongs to the Taiyang channel, which has abundant Blood but little Qi; thus, it presents with material but no sound, indicating Blood disease. For immediate vomiting after eating, Chennopii (Citrus Peel, white part removed) is the primary herb. Hiccups belong to the Shaoyang channel, which has abundant Qi but little Blood; thus, it presents with sound but no material, indicating Qi disease. Jiang-processed Banxia is the primary herb. If the Spleen and Stomach are weak, invaded by cold pathogens, or damaged by diet, use *Liujunzi Tang* (Six-Gentlemen Decoction), Dingxiang (Clove), Huoxiang (Patchouli), ginger, etc. If there is heat in the Stomach and phlegm above the diaphragm, use *Erchen Tang* (Two-Aged Decoction), Shanzhi (Gardenia), Huanglian (Coptis), and ginger. If chronic illness leads to Stomach deficiency, with vomiting and inability to retain food, use ginger, Renshen (Ginseng), Baizhu (Atractylodes), Huangqi (Astragalus), Xiangfu (Cyperus), etc. There are also cases of phlegm obstruction in the middle Jiao preventing food intake, rebellious Qi causing vomiting, Qi stagnation at the Stomach orifice, food retention between the Heart and Lungs causing regurgitation, and fire-phlegm at the Stomach orifice causing vomiting. If vomiting is profuse like a pouring ship, accompanied by thirst for water, death ensues; drinking child's urine is most effective. The previous discussion mentioned using *Shiquan Dabu Tang* for vomiting due to blood failing to return to its vessels, which indeed elucidates insights previously unexpressed. I have used this method frequently with success. (This discussion differs slightly from Wang Andao's *Suhui Ji*; comparison is recommended.) My late mother, after eating, heard words that offended her, leading to vomiting of sour fluid, internal heat, thirst, and a preference for cold water. Her Qi-kou pulse was large and chaotic, and her complexion was greenish-red. This was Liver-Spleen depressed fire. Medication entered the mouth but was immediately vomited. On the third day, she vomited undigested food; on the seventh day, sour-yellow fluid; on the eleventh day, bitter fluid. The pulse remained surging and large, and she still preferred cold drinks. A small amount of cooled Huanglian (Coptis) decoction was given. By the twentieth day, Baizhu (Atractylodes) and Fuling (Poria) were added. By the twenty-fifth day, Chenpi (Tangerine Peel) was added. By the thirty-seventh day, Danggui (Angelica) and Zhi Gancao (Honey-fried Licorice) were added. By the sixtieth day, she could consume half a cup of rice drink, gradually advancing to thin congee, and recovered through regulation. The mother of Shen Jiwen, a government student, suffered from Spleen deficiency causing abdominal fullness, phlegm-cough, and fever. After eating wet noodles and cold tea, she experienced acid regurgitation, vomiting, and anorexia. She mistakenly took Huangqin (Scutellaria), Huanglian (Coptis), and Qingpi (Aurantium Peel), worsening her chills, fever, dry mouth, and uncontrollable salivation. She vomited upon smelling food for several days. Upon consultation, I stated: "The Spleen controls saliva; this is Spleen deficiency failing to constrain fluids." I intended to use *Renshen Anwei San* (Ginseng Stomach-Calming Powder), but was swayed by others' opinions to treat it as Stomach meridian excess-fire and food retention. The condition worsened daily. Suddenly craving winter melon, she ate a piece the size of a fingernail, triggering incessant vomiting of sour fluid. Continuing the previous medication exacerbated the condition. Upon re-examination, her spirit was depleted, and her pulse was faint, nearing death. Only her eyeballs moved. I stated: "Cold flooding internally requires acrid-hot treatment, but medicine cannot be retained." I urgently applied salt, Aiye (Mugwort Leaf), and Fuzi (Aconite Root) heated and pressed to the umbilical-abdominal region to dissipate cold and restore Yang. I also used breath-to-mouth resuscitation and applied a hot Fuzi cake to the navel. After about an hour, her spirit slightly revived. I powdered Renshen (Ginseng), Baizhu (Atractylodes), and Fuzi (Aconite Root), mixed with Chenpi (Tangerine Peel) paste into pills the size of millet grains. Placing five to seven pills in the mouth allowed them to be swallowed with saliva, stopping vomiting. After two days, the dose increased to ten pills, and symptoms subsided somewhat, though salivation persisted. After five days, gradually taking one or two spoons of the previous decoction restored some Stomach Qi, and she desired congee. Subsequently, tonifying the Spleen and Stomach with Renshen and Baizhu for over fifty doses led to recovery.

[Sun] A thirty-five-year-old woman without children feared her husband would take another wife, leading to Qi depression. Her menses had ceased for three months. She suffered from abdominal pain and nausea. All physicians diagnosed pregnancy. Her husband, knowing some medicine, rejoiced and administered fetal-calming, Qi-regulating, and pain-relieving herbs. After thirty to fifty doses, there was no effect, and suffering increased. Every Wei and Shen hours (1:00 PM - 5:00 PM), she experienced chills and fever. Abdominal masses, like marbles, numbering twenty to thirty, churned painfully. Movement produced gurgling water sounds. Extreme pain caused vomiting of five to six bowls of sour fluid. After vomiting, the masses subsided, chills/fever ceased, and pain stopped, repeating the next day. Treating it as malaria worsened the condition. Upon my pulse diagnosis, the left hand was wiry with a choppy Chi position; the right hand was soggy and weak, becoming slippery upon heavy pressure, with the Chi position matching the left. Menses had been absent for five months. I stated: "This is a depression syndrome. How can a choppy pulse indicate pregnancy? If it were pregnancy, the previous medicines would have worked." Her husband realized his error. I prescribed *Erchen Tang* (Two-Aged Decoction) added with Xiangfu (Cyperus), Shanzhi (Gardenia), Fuxiong (Ligusticum), Yuanhu (Corydalis), Danggui (Angelica), Honghua (Safflower). Pain ceased upon administration. Four doses were effective, but pain recurred upon cessation. One month of regulation failed to cure the root. Taking the pulse records to my master, Mr. Huang Gutan, he instructed me: "This is a depressed-fire syndrome originating in the Liver and Gallbladder. The Liver governs planning; the Gallbladder governs decision-making. Lack of resolution leads to depression. Depression causes Wood to flourish. Flourishing Wood insults the Spleen. Spleen injury prevents transformation of essence and generation of Qi and Blood, hence amenorrhea. Lung Metal loses nourishment from its mother (Liver), losing its descending function. Wood, lacking fear, insults what it cannot overcome (Metal), rushing up to disturb the clear orifices, causing vomiting. Symptoms subside after vomiting because Wood rises and Fire extinguishes." I formulated a prescription: Huangqi (Astragalus) 5 qian, Chaihu (Bupleurum) 3 qian, Baishao (White Peony) 2 qian, Gancao (Licorice) 1 qian, Chenpi (Tangerine Peel), Beimu (Fritillaria), Zhishi (Immature Bitter Orange) each 0.5 qian, Ginger 3 slices. After one dose, chills/fever ceased. After two doses, pain decreased, vomiting stopped, and water sounds disappeared. No recurrence for seven days. The husband exclaimed: "How miraculous!" He urged me to consult the Master again. The Master said: "Chills and fever belong to the Shaoyang Gallbladder. Sour vomiting belongs to the Jueyin Liver. Abdominal pain and churning masses indicate fire stirring water, like boiling soup. Frequent vomiting injures Lung Metal further. Thus, Huangqi tonifies Lung Metal as the Sovereign herb to control Liver Wood. Chaihu drains Liver Wood as the Minister herb to ascend Gallbladder Fire. The Classics say: 'For Wood depression, achieve flow.' Flow means unblocking. Wood naturally ascends; depression prevents this. Chaihu ascends the clear Qi of Gallbladder and Liver, breaking depression to restore normalcy. It also says: 'Excess is reduced by what it fears.' Draining refers to tonifying Lung to control Liver. It also says: 'To drain the Liver, soothe its center,' using Gancao to soothe the center as the Assistant. It also says: 'For the main aspect of Wood, drain with sour,' using Baishao to drain Wood within the Spleen as the Minister. Chronic illness generates depression; long-term depression generates phlegm. Beimu, Chenpi, and Zhishi open depression and expel phlegm as the Envoy. Then Metal is correct, Wood is balanced, Earth is secure, leading to rapid recovery. Previous formulas used Shanzhi and Huanglian, which are descending herbs. With blazing fire, how can slight cold suppress it? Thus, the Classics say: 'Light cases are treated directly; heavy cases follow their nature and ascend.' Understanding this principle is essential in treating diseases."

*Yizhi Zi San* (Alpinia Oxyphylla Powder) treats women with chronic Spleen-Stomach deficiency and weak Qi, frequent vomiting, complete anorexia, and limb weakness.
Ingredients: Yizhiren (Alpinia Oxyphylla Fruit) 1 liang, Fuzi (Processed Aconite Root), Suosharen (Amomum Fruit), Dingxiang (Clove), Nongpo (Magnolia Bark), Huangqi (Astragalus Root), Baizhu (Atractylodes Macrocephala Rhizome), Bai Fuling (Poria), Chenpi (Tangerine Peel), Chuanxiong (Ligusticum Chuanxiong Rhizome), Liangjiang (Galangal Rhizome), Huoxiangye (Patchouli Leaf), Danggui (Angelica Sinensis Root) [each 7.5 qian]; Renshen (Ginseng Root), Guixin (Cinnamon Twig) [each 0.5 liang].
Preparation: Coarsely crush. Take 3 qian per dose, with 3 slices of ginger and 1 jujube, in 1 sheng of water, decoct to 0.7 sheng. Strain and take warm at any time.

*Dingxiang San* (Clove Powder) treats women with deficiency-cold of the Zang-Fu, weak Spleen-Stomach Qi, vomiting after eating, and indigestion of food and fluids.
Ingredients: Dingxiang (Clove), Baizhu (Atractylodes Macrocephala Rhizome), Suosharen (Amomum Fruit), Caoguoren (Tsaoko Cardamom Seed), Ju Pi (Tangerine Peel) [each 7.5 qian]; Danggui (Angelica Sinensis Root), Baidoukou (White Cardamom Seed), Huoxiangye (Patchouli Leaf), Shenqu (Medicated Leaven), Hezipi (Persimmon Sepal), Gancao (Licorice Root) [each 0.5 liang]; Renshen (Ginseng Root) 1 liang.
Preparation: Grind to fine powder. Take 2-3 qian per dose, mixed with ginger-jujube decoction.

*Zhuru Tang* (Bamboo Shavings Decoction) treats Stomach heat vomiting.
Ingredients: Gange (Kudzu Root) 3 liang; Banxia (Pinellia Tuber) washed seven times in boiling water, with 0.5 zhan of ginger juice and 1 sheng of fermented grain water, boiled until half evaporated, retaining 7.5 qian; Gancao (Licorice Root) 7.5 qian.
Preparation: Coarsely crush. Take 5 qian per dose, with 2 sheng of water, 3 slices of ginger, bamboo shavings the size of an egg, and 1 jujube. Decoct to 1 sheng. Strain and take warm.

Scholar Xu stated: Those with Stomach heat have hot palms and soles. During the Zhenghe era, a clan relative suffered from Shanghan (Cold Damage). After sweating, his body cooled, but days later he suddenly vomited, unable to retain medicine or food. Physicians used Dingxiang, Huoxiang, and Shihuang (Talcum), but vomiting occurred immediately upon swallowing. I stated: "This is residual heat remaining in the Stomach after sweating. Sun Zhao's Zhuru Tang is precisely indicated." I prepared the medicine, and he recovered instantly.

*Liangfang Huaihua San* (Good Formula Sophora Flower Powder)
Ingredients: Saojiao (Gleditsia Sinensis Fruit), Baifan (Alum), Huaihua (Sophora Flower, stir-fried until yellow-black), Gancao (Licorice Root) [equal parts].
Preparation: Grind to fine powder. Mix with hot water and take 2 qian.

*Xu Xueshi Banxia Wan* (Scholar Xu's Pinellia Pill) treats accumulation of cold in the Stomach, retching, and inability to eat.
Ingredients: Banxia (Pinellia Tuber, 1 sheng, authentic Xiongzhou variety, washed to remove slipperiness); Xiaomaiqu (Wheat Medicated Leaven, 1 sheng).
Preparation: Pound Banxia into powder. Mix with water and dough. Form pills the size of marbles. Boil in water until the dough is cooked. Initial dose: 4-5 pills, twice daily. Gradually increase to 14-15 pills. Cook and take immediately. Condition improves. Avoid mutton and maltose.

Furthermore, regarding the earlier Banxia Wan: although symptoms gradually improved, the root cause remained. To prepare more pills raised concerns about long-term toxicity. To abstain raised fears of disease progression. It is advisable to combine with *Renshen Qiwei Wan*.

*Renshen Qiwei Wan* (Seven-Ingredient Ginseng Pill)
Ingredients: Renshen (Ginseng Root), Baizhu (Atractylodes Macrocephala Rhizome) [each 5 liang]; Nongpo (Magnolia Bark, honey-fried), Xixin (Asarum Root) [each 4 liang]; Shengjiang (Fresh Ginger, minced) 8 liang; Ju Pi (Tangerine Peel) 3 liang; Guixin (Cinnamon Twig) 2 liang.
Preparation: Grind to fine powder. Mix with refined honey to form pills the size of paulownia seeds. Take 10 pills with water, gradually increasing to 20 pills. Can be alternated with Banxia Wan. Avoid peaches, plums, sparrow meat, raw scallions, and raw vegetables.

*Supplement* treats all vomiting in men and women. Remove Guizhi (Cinnamon Twig) from *Wuling San* (Five-Ingredient Powder with Poria), add Banxia powder equal to the amount of Guizhi. Take 1 qian per dose. Mix with fresh ginger juice to form a dough-like consistency. Wait half an hour. Then mix with a small cup of boiling water and take warm. (See *Wuling San* formula in *Shanghan Zhunsheng* under Thirst section.)

*Qingjin Dan* (Green Golden Pill) treats persistent vomiting of all types.
Ingredients: Liuhuang (Sulfur) 2 qian; Shuiyin (Mercury) 1 qian.
Preparation: Slowly melt in a crucible. Stir-fry with a wooden spatula until granular. Grind in a mortar until black and no stars visible. Use ginger juice paste to form pills the size of mung beans. Take 20-30 pills with rice drink.

*Renshen Anwei San* (Ginseng Stomach-Calming Powder) treats deficiency-heat of Spleen-Stomach, vomiting with diarrhea, or inability to ingest food.
Ingredients: Renshen (Ginseng Root) 1 qian; Huangqi (Astragalus Root, fried) 2 qian; Sheng Gancao (Raw Licorice Root), Zhi Gancao (Honey-fried Licorice Root) [each 0.5 qian]; Baishao (White Peony Root) 0.7 qian; Bai Fuling (Poria) 0.4 qian; Chenpi (Tangerine Peel) 0.3 qian; Huanglian (Coptis Rhizome, fried) 0.2 qian.
Preparation: Decoct in water and take.