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[Xue Ji] In the *Bingji* (Pathogenesis), it is stated: There are three types of vomiting: Qi, Accumulation, and Cold. All should be discussed from the perspective of the Sanjiao (Triple Burner). Vomiting originating from the Upper Jiao stems from Qi; Qi belongs to the Yang of Heaven. Its pulse is floating and surging (Hong). Food is vomited violently immediately after eating, accompanied by thirst and desire for water, dry and constipated stool, Qi rushing upward to the chest causing pain. The treatment principle is usually to descend Qi and harmonize the Middle Jiao. Vomiting originating from the Middle Jiao stems from Accumulation, which can be Yin or Yang. Food and Qi interact to form an accumulation causing pain. Its pulse is floating but deep upon pressing (Ni). Symptoms may involve pain preceding vomiting or vomiting preceding pain. Treatment should employ slightly toxic drugs to remove the accumulation, using Areca Seed (Binglang) and Costus Root (Muxiang) to move Qi. Vomiting originating from the Lower Jiao stems from Cold, which follows the way of Earth (Yin). Its pulse is deep and slow. Symptoms include morning food vomited in the evening, or evening food vomited in the morning, clear urine, and severe constipation with no passage. Treatment should use toxic drugs to unblock impaction and warm away cold Qi. Once stool gradually passes, medications for the Middle Jiao should be used to harmonize, preventing re-constipation, leading to spontaneous recovery. Wang Taipou said: "Food unable to enter indicates Fire; food entering and then coming out indicates lack of Fire." Furthermore, the *Faming* states: "Ye" (Dysphagia/Choking) is governed by the Six Fu-organs, belonging to Yang and Qi. "Se" (Obstruction) is governed by the Five Zang-organs, belonging to Yin and Blood. Both arise from Fire hidden within Yin. Mr. Liu Zongnong said: If caused by dysfunction of Sanjiao transmission and transformation, it primarily concerns Qi. If caused by Blood deficiency leading to dryness and atrophy of the stomach cavity, it primarily concerns Blood. "Se" implies blockage like filling. Thus, the *Faming* provides the example of Tongyou Tang (Unblocking the幽 Pass Decoction) for treating obstruction of the幽门 (Pylorus) and dysphagia. Generally, Yang cannot transform without Yin; if Yin loses its position and Yang hides within it, transmission becomes abnormal and reverses upward. Therefore, previous symptoms may result from diet, lifestyle, and Seven Emotions damaging the Spleen and Stomach, causing Phlegm-fluid retention and failure of Middle Qi movement. The primary formula should be Buzhong Yiqi Tang (from Miscellaneous Diseases: Fatigue and Weakness). If constrained depression damages the Spleen, use Guipi Tang (from Miscellaneous Diseases: Forgetfulness) plus Magnolia Bark (Zhiqiao) and Platycodon Root (Jiegeng). If anger damages the Liver, use Xiaochaihu Tang (from Shaoyang Syndrome in Cold Damage) plus Gardenia (Zhizi), Poria (Fuling), Ginseng (Renshen), and Atractylodes Macrocephala (Baizhu). For Spleen Qi deficiency, use Liujunzi Tang (from Miscellaneous Diseases: Consumption and Weakness) plus Zhizi and Zhiqiao. For dual deficiency of Qi and Blood, use Bazhen Tang (i.e., Babawu Tang from Miscellaneous Diseases) plus Zhizi and Pinellia (Banxia). If Qi-moving drugs cause chest and diaphragm fullness, use Liujunzi Tang plus Ligusticum Chuanxiong (Xiong) and Angelica Sinensis (Gui). If overuse of aromatic-dry agents causes dry constipation, use Siwu Tang (General Formula) plus Renshen and Baizhu. If food cannot enter, use Liujunzi Tang plus Zhizi, Evodia (Wuzhuyu), and Processed Coptis (Huanglian). If food enters and is regurgitated, use Liujunzi Tang plus Roasted Ginger (Paojiang), Cardamom (Baidoukou), Huanglian, and Processed Wuzhuyu. If Phlegm stagnation causes food regurgitation, use Liujunzi Tang plus Zhiqiao and Jiegeng. If appetite is poor, stool is loose, chest/diaphragm is full, acid regurgitation and belching of rotten food occur, and food is not digested, this is Spleen-Stomach Deficiency-Cold. Use Dongyuan's Bizhen Wan or Bawei Wan (from Miscellaneous Diseases: Consumption and Weakness). If fever and irritability occur, body aversion to wind-cold, abdominal aversion to hot food, or cold hands and feet with chest/full abdomen, this is True Cold inside with False Heat outside. Use Shenxiao Fuzi Wan (this section) or Bawei Wan. Generally, vomiting with good appetite and preference for cold drinks indicates Fire. Vomiting with poor appetite and preference for hot drinks indicates lack of Fire. One must examine the cause and treat accordingly.

A woman suffered from the above symptoms, with chest and abdominal fullness, feeling somewhat relieved after defecation or passing gas. I said: This belongs to Spleen Qi constraint and deficiency; regulation and tonification are best. She did not believe me and used Erchen Tang, Zhashi, and Huanglian, which was ineffective. Then she used aromatic-dry Qi-breaking agents, worsening the symptoms and further depleting her Form and Qi. I used Jiawei Guipi Tang (Guipi Tang plus Bupleurum [Chaihu] and Zhizi), regulating and treating for half a year until recovery. Another woman suffered from the above symptoms, with chest and hypochondriac distension, occasional lower abdominal discomfort or pain, and dribbling urine. I said: This is Liver Fire and Blood deficiency. One should clear Liver Fire, generate Liver Blood, nourish Spleen Earth, and generate Lung Metal. Deeming my advice pedantic, she took Qi-promoting and Phlegm-resolving agents instead, making the symptoms worse and triggering numerous deficiency signs. I used Jiawei Xiaoyao San (from Menstrual Disorders) and Jiawei Guipi Tang concurrently, and she recovered soon. Another woman vomited excessive phlegm, had cold hands and feet, and poor appetite. I said: This is Liver-Spleen constraint and anger, combined with Decline of Mingmen Fire. Disbelieving, she took phlegm-resolving and Qi-promoting agents, increasing abdominal distension, and then took harsh purgative agents. I said: This is incorrect treatment; it will surely turn into Spleen-deficiency edema. Urgently take Jin Gui's Jiashen Shenqi Wan, or there might be hope. Disbelieving, she took Chenxiang Huaqi pills instead, and indeed developed edema and died.

Bai San: Treats women's Fanwei (Reverse Stomach) and vomiting. Qianjin Yi Fang states: It treats men as well. A dose of one jin or more is excellent.
Bai E Tu (White Halloysite): Take one sheng of rice vinegar, heat the earth until red, immerse in vinegar until cool. Repeat immersion until vinegar is absorbed. Take one liang and grind finely.
Gan Jiang (Dried Ginger): Processed, two qian and half.
Grind both into fine powder. Take one qian each time, mixed with rice drink. For severe cases, take two qian.

Baizhi San: Treats women's Fanwei and vomiting.
Take one liang of Bai Zhi (Angelica Dahurica), slice it, stir-fry on a tile until yellow, and grind into fine powder. Take twenty slices of pig blood, soak in boiling water seven times. Dip the blood slices in the powder and eat seven slices. Reserve remaining powder for next use.

Tai Cang Wan: Treats Spleen-Stomach weakness, inability to eat, reverse vomiting.
Bai Dou Kou (Cardamom Fruit) and Suo Sha Ren (Amomum Fruit): Two liang each.
Ding Xiang (Clove): One liang.
Chen Cang Mi (Stored Rice): One sheng, stir-fried with yellow earth until red, discard earth.
Grind into powder. Make pills with ginger juice the size of wutong seeds. Take 60-70 pills after meals, washed down with light ginger soup.

Qing Jin Dan: Treats vomiting and Fanwei. Take thirty pills each time, swallowed with decoction of Sheng Jiang (Fresh Ginger) and Chen Pi (Tangerine Peel). (Formula see Vomiting section previously.)

Wu Ling San: Treats Fanwei with thirst. Add Ban Xia (Pinellia). Take four qian each time, decoct with five slices of Sheng Jiang, take warm. (Formula see Cold Damage Thirst section.)

Dongyuan Bizhen Wan
Rou Cong Rong (Cistanche): Wine-soaked, baked.
Hu Lu Ba (Trigonella Foenum-graecum): Stir-fried.
Fu Zi (Prepared Aconite): Processed, skin removed.
Yang Qi Shi (Leiolite): Calcined.
Rou Dou Kou (Nutmeg): Baked in flour paste.
Tu Si Zi (Cuscuta Seed): Cleaned, wine-soaked, steamed.
Chuan Wu (Processed Aconite): Processed, skin removed.
Chen Xiang (Agarwood).
Wu Wei Zi (Schisandra): Five qian each.
Lu Rong (Deer Antler Velvet): Wine-soaked, fried.
Ba Ji Tian (Morinda Root): Heart removed.
Zhong Ru Fen (Stalactite Powder): One liang each.
Grind into powder. Prepare two pairs of sheep kidneys according to culinary methods. Boil with scallion, pepper, and wine until soft. Mash, add wine, and make paste pills the size of wutong seeds. Take seventy pills on an empty stomach, washed down with rice drink or salt water as preferred.

Shenxiao Fuzi Wan: Treats Spleen-Kidney Deficiency-Cold, vomiting, or Fanwei and Ge Ye (Diaphragmatic Dysphagia).
Hei Fu Zi (Black Prepared Aconite): Weighing one liang, four qian, five qian. Shape should be upright, flat bottom, round tip. One piece. Process with ash fire until skin cracks. Immerse in fresh ginger juice, sun-dry. Process again, immerse again, sun-dry, process again. Continue until half a bowl of ginger juice is consumed. Remove skin and navel, grind to powder. Mix with Renshen Gao (Ginseng Paste) to make pills the size of millet grains. Take several pills each time, swallow with saliva. When Stomach Qi recovers slightly and intake improves, administer warming and tonifying agents.