呕吐痰饮，不纳饮食，状犹翻胃，投燥脾胃等药，疾愈增剧，意欲饮水，此虽胃中冷，而胃口有热也。（《澹寮》）
寒呕，中脘停寒饮食，喜辛热物，入口即吐出，宜二陈汤加丁香十粒，或理中汤加枳实半钱。不效则温中汤，
甚则附子理中汤或丁附汤，并须冷服。盖冷遇冷则相入，庶不吐出。（《要诀》）
胃虚呕吐。恶食不思食，兼寒者恶寒，或食久还吐，或朝食暮吐，暮食朝吐，脉迟而微涩，此皆虚寒者也，
宜藿香安胃汤（用藿香、丁香、人参、橘红）、理中汤，甚者丁香煮散（系辛温群队方）温补。（《医统》）
脉沉紧，四肢逆冷，或兼腹痛而吐者，属寒。卒然而起，或过食生冷，或误服寒药所致，宜温中理胃。（《六要》）
人有胃寒呕吐不纳药者，此阴盛格阳病也，家秘加减理中汤一服。（《保命歌括》）
热呕 病者胃中挟热烦躁，聚结涎沫，食入即吐，名曰热呕。或因胃热伏暑，及伤寒伏热不解，湿疸之
类，皆热之所为也。（《三因》）
如胃热而呕吐者，宜用小柴胡汤、芦根汤、竹茹散、槐花散。（《妇人良方》）
凡进热药愈增者，当于热（原作寒）呕中求，热呕宜二陈汤，加黄连一钱。（《要诀》）
胃中郁热，饮食积滞而呕者，则恶食恶寒，烦闷膈满，或渴喜凉，闻食则吐，服药亦吐，脉洪大而数，此皆
实热者也，宜竹茹汤、麦门冬汤（即《广济》方）清之。若食积多者，用二陈加神曲、麦芽、黄连，保和丸之类
消导。（《医统》）
脉弦数或洪滑，口干面赤，喜冷恶热，烦躁引饮而吐者，属火，宜清胃降火。（《六要》）
呕吐属胃火者，必面赤，小便短赤或涩，大便多燥，口苦或干渴，忌同胃实，宜同胃实。（《本草经疏》）
外感邪入而呕者，胃阳被郁而上冲也，治宜辛散，生姜所必用也。不因外感而内热胃火上冲者，治宜清降，
石膏所必用也。痰湿郁滞成热上逆者，陈皮、半夏、茯苓所必用也。食郁气滞而上逆者，枳实、麦芽等所必用也。
二便热结，下不通而反于上者，大黄、滑石等所必用也。此治实热之例也。若夫胃气虚衰不运，郁热而呕者，则推
扬胃气。寒冷不运，压火而呕者，则温中散寒。胸中虚热，久不食而呕者，但得五谷之阴以和之，则立止（按∶
胸中虚热云云，本出《准绳》）。此治虚热之例也。（《医碥》）
金宅少妇，宦门女也，素任性，每多胸胁痛及呕吐等证，随调随愈。后前证复作，而呕吐更甚，病及两日，
甚至厥脱不省如垂绝者。再后延予至。予因诊之，见其脉乱数甚，而且烦热躁扰，莫堪名状。意非阳明之火，
何以急剧若此。乃问其欲冷水否，彼即点首。遂与以半钟，惟此不吐，且犹有不足之状。乃复与一钟，稍觉安
静。因以太清饮（用知母、石斛、木通、石膏）投之，及药下咽，即酣睡半日，不复呕矣。自后凡见呕吐，其
有声势涌猛，脉见洪数，证多烦热者，皆以此法愈之，是又不可不知也。（《景岳》）（节录）
痰呕 病者素盛今瘦，肠中沥沥有声，食入即呕，食与饮并出，名曰痰呕。或因气郁涎结于胃口，或因酒
食甜冷聚饮之所为也。（《三因》）
如痰盛呕吐者，宜《局方》半夏茯苓汤、二陈汤。（《妇人良方》）
有痰饮，粥药到咽即吐，人皆谓其翻胃，非也。此乃痰气结在咽膈之间，宜先以姜苏汤下灵砂丹，俟药可进，
则以顺气之药继之。又有中脘伏痰，遇冷即发，俗谓之冷痫，或服新法半夏汤，或挝脾汤（用麻油、 香、良姜、
甘草）。外有热痰而呕者，宜小半夏茯苓汤，加竹茹如钱大。若呕痰而或致厥者，乃寒痰迷闷，谓之痰厥，宜姜附
汤，以生附代熟附。（《要诀》）
胃中有痰饮者，呕吐痰沫，痞满怔忡，法宜消痰逐饮。痰有寒热，宜分治之。（《保命歌括》）
脉滑或沉伏或弦实，虽吐，口不渴，属痰。（《六要》）
食呕 病者胸腹胀闷，四肢厥冷，恶闻食臭，食入即呕，朝食暮吐，暮食朝吐，名曰食呕。此由饮食伤脾，
宿谷不化
之所为也。（《三因》）
食呕多因七情而得，有外感邪气，并饮食不节而生。大概治以理中为先，二陈汤加枳实一钱，或加南星七分，
沉香、木香各四分亦好，或只服枳南汤。（方缺）或导痰汤。（《要诀》）
右关脉弦滑而疾，症兼噫酸饱闷而吐者，属食积，虽吐犹当以盐汤探吐之。（《六要》）
血呕 病者心下满，食入即呕，血随气出，名曰血呕。此由瘀蓄冷血，聚积胃口之所为也。（《三因》）
一中年人，中脘作痛，食已则吐，面紫霜色，两关脉涩，涩乃血病也。因跌仆后，中脘即痛。投以生新推陈
血剂，吐片血碗许而愈。（《丹溪》）
气呕（子时吐） 病者心膈胀满，气逆于胸间，食入即呕，呕尽却快，名曰气呕。胃者足阳明，合荣于足。
今随气上逆，结于胃口，故生呕病也。（《三因》）
气呕，胸满膈胀，关格不通，不食常饱，食则常气逆而吐，此因盛怒中饮食而然。宜二陈汤加枳实、木香各半
钱，或吴茱萸汤，不效则丁沉透膈汤及五膈宽中汤。（《要诀》）（按∶《得效》曰∶藿香正气散，治气呕大效。）
怒中饮食呕吐，胸满膈胀，关格不通，二陈加青皮、木香。未效，丁、沉、木香、砂仁、浓朴、神曲。更不效者，
瘀血也，当从蓄血例治。有一等肝火逆证，亦呕而不食，但所呕者，或酸水，或苦水，或青蓝水，惟大小便不秘（按∶
《医贯评》曰∶亦有乍秘乍泄者），亦能作心痛，此是火郁木郁之候，木郁达之，火郁发之，须用萸、连浓煎，
细细呷之，再服逍遥散。（《医通》）（按∶后段本出《医贯》。）
脉弦急出寸口，呕吐酸水或绿水，属肝火逆上，抑青丸
主之，或以二陈汤，吴茱萸炒黄连、柴胡，妙。（《六要》）
妇女多郁，或食际着恼，郁而不运，浊气上攻作呕，宜舒郁。（同上）
周慎斋治一人，饮食如常，每遇子时即吐，大便秘。询其人必有苦虑忧思，脾气郁结，故幽门不通。宜扶脾开
窍为主，用人参、白术，以苍术拌炒茯苓，各一钱，炙甘草五分，附子煮乌药三分，水煎服。（《医通》）
蛔动 又有呕吐诸药不效，又别无前项痰气等证，乃蛔在胸膈作呕，见药则动，动则不纳药，药出而蛔
不出。虽非吐蛔之比，亦宜用吐蛔药，或于治呕药中，入炒川椒十粒，蛔见椒则头伏故也。（《要诀》）
脉乍大乍小，时常呕清水，胃口时痛时止，得食则愈，饥则甚者，属虫积。面上必自有白斑点，或吐出虫，
呕而流涎，脉平，即非火与痰，是虫积也。（《六要》）
酒毒 脉弦细而滑，或浮洪而数，症见面赤口干，头痛恶心，懊 烦躁，呕吐不宁者，酒毒也，宜凉以
折之。（《六要》）
人有酒后呕吐者，此从饮冶，宜葛花解酲汤主之。（《保命歌括》）
注车注船 无问男子女人，乘车船则心闷乱，头痛吐逆，谓之注车注船，特由质性自然，非关宿挟病也。
（《病源论》）
注船大吐，渴饮水者即死，童便饮之最妙。（《丹溪》）
中毒 凡中毒而吐者，当察其所中者何物。盖中热毒而吐者，宜解以苦寒之剂。中阴寒之毒而吐泻不止者，
宜解以温热之剂。若因吐泻而脾胃致虚者，非大加温补不可。此证有中寒毒吐泻治按在后，当并阅之。（《景岳》）
（案∶寒
毒新按系食蘑菇大吐泻，医以黄连、黑豆之属连进之而病益甚，乃投参、术、甘、姜、附、茯之类，又加熟地，
二十余剂而复。曰∶蘑菇必产于深坑枯井，或沉寒极阴之处，其得阴气之最甚，解毒适所以助毒，兹用姜附，非
所以解寒毒乎。）
干呕 干呕者，胃气逆故也。但呕而欲吐，吐而无所出，故谓之干呕。（《病源》）
干呕者，有声无痰，然不似哕声之浊恶而长也。宜橘红煎汤，入姜汁、白蜜少许、细细呷之，胃虚加人参，胃
寒加炮姜。胃虚浊气上逆，吴茱萸汤。（《医通》）
吐清水 吐清水证有五因∶有因湿，因痰饮，因寒，因宿食，因虫。明知恣食生冷瓜果而作者，为寒湿
也。胸膈间漉漉有声者，痰饮也。饮食后而吐清水者，宿食也。但犯寒而作者，胃寒也。心腹时痛而作，亦吐
清黄水者，虫也。宜类辨而治之。（《医统》）
是证忽作，清水如从齿缝中出，源源而来，吐至碗许，感受之由，种种不同，因寒因湿因虫，痰饮食积，因醉
饱房劳者居多，治亦小异。诸方与吐酸参用，皆宜戒浓味。（《简明医彀》）
不时清水上溢或吐出，用苍术陈壁土炒，茯苓、滑石、白术、陈皮煎服。（《六要》）
呕清水者，多气虚，六君子汤加赤石脂。（《必读》）
呕苦 邪在胆经，木善上乘于胃，吐则逆而胆汁上溢，所以呕苦也。宜吴茱萸、黄连、茯苓、泽泻、生姜。
邪在胆，逆在胃，胆液泄则口苦，小柴胡汤。胃气逆则呕苦，吴茱萸汤。（《医通》）
渴热不可遽治 呕吐津液既去，其口必渴，不可因渴而遽以为热。（《要诀》）
大凡治病，当识本末。假令呕吐痰涎，胃虚不食，以致发热。若与凉剂退热，则胃气愈虚，热愈不退。惟先
以助胃止吐为本，其热自退。纵热不退，但得胃气已正，亦可旋与解热之药。（《医彀》）
死证 大痛色如青菜叶者死。（《要诀》）（按∶《原病集》作吐如青菜汁者死。）
浑身作胀者，不治。（《大还》）
面色青，指甲黑，中痛不止，肢厥不回，其凶可知也。（《金鉴》）
至于呕吐，不纳饮食，或为滑泄，肌肉瘦极。眼胞浮肿，脉独弦实，是为脾败，百不救一。（《医读》）
定吐诸法 凡服汤呕逆不入腹者，先以甘草三两，水三升，煮取二升，服之得吐，但服之不吐益佳。消
息定，然后服余汤，即流利更不吐也。凡呕者多食生姜，此是呕家圣药。（《千金》）（按∶《资生经》曰∶有此
疾者，早上宜多用生姜泡汤取，或煨或生嚼，或取自然汁入酒服，皆效。）
大凡治呕，多是饮药难服。于此方中（按∶此方即丁香饮，治寒呕，用丁香、半夏、橘红、干姜，更加减治诸
呕）选宜用者，研为细末，姜汁为丸尤妙，或间服镇坠丹砂亦好，审而用之，不可苟也。（《续易简方脉论》）
呕家诸药不效，日久胃虚不纳谷，用长流水，和伏龙肝澄清，炒陈米煮汤，饮一二杯，以安胃气，殊效。（《六
要》）（按∶此本于《正传》，引在后。）
呕吐难纳药者，必徐徐一匙而进，不可太急也。（《统旨》）（按∶此本于《伤寒蕴要》。）
予按为医者临延医病，贵能体贴病情，能用心法。大凡呕吐不纳药食者，最难治疗。盖药入即吐，安能有功。又切
不可强灌胃口，愈吐愈翻，万不能止。予之治此颇多，先将姜汤和黄土作二泥丸，塞其两鼻，使之不闻药气。然
后用对证之药煎好，斟出澄清，冷热得中，止服一口。即停之半时之久，再服一口。又停之良久，服二口。停之
少顷，则任服不吐矣。斯时胃口已安，焉能作吐。愚人不知，明见其吐药不纳，偏以整杯整碗强灌之，则一吐倾
囊而出，又何药力之可恃乎。此等之法，不但幼科可用，即方脉亦当识此。倘临证不体病情，全无心法，即如呕
吐一证，虽能识病，虽能用药，其如不纳何哉。（《幼幼集成》）
呕吐药，忌栝蒌、杏仁、桃仁、萝卜子、山栀，皆要作吐（《医通》曰∶一切有油之物，皆犯胃作吐）。凡药
带香药行散不妨。（《丹溪》）（按∶此说无类可附，姑录于此。）
温中方法《备急》疗吐逆，水米不下，干姜甘草汤方。
干姜（二分炮） 甘草（一分炙）
上二味切，以水二合，煎取一合，去滓顿服则定。少间与粥，则不呕，神验。（《外台》）
《延年》甘草饮，主脾肾疼气乘心，痛闷吐利，四肢逆冷或烦疼方。
甘草（二两炙） 人参（二两） 干姜（四两） 浓朴（二两炙） 白术（二两）
上五味切，以水五升，煮取一升五合，去滓分温三、四服，如人行八、九里。（同上）又许仁则积冷在胃，
呕逆不下食，人参等七味丸，于本方去甘草、干姜，加生姜屑、细辛、橘皮、桂心为末，蜜和为丸，如梧子，饮下
之，初服十丸，日二，加至二十丸。
一方，白术散，治呕吐，用白术、人参各一两，半夏一两半，茯苓、干姜、甘草各半两，姜、枣煎。
治呕逆恶心者，于治中汤中（按∶系理中汤四味各一两，加橘红二两）更加丁香半两，半夏一两，名丁香温中
汤，每服加生姜十片煎服。（同上）加味理中汤，治痰浮于上，呕吐不已，加半夏、丁香，酌量用，每服四钱，
水煎不拘时热服，再入生姜亦可。（《得效》）
半夏茯苓饮子，治痰饮呕吐。
半夏（二两） 附子 赤茯苓 白术 人参 黄橘皮 丁香（各一分）
上为细末，空心姜煎五钱。（《鸡峰》）（按∶此系《千金》大半夏汤变方，宜参《水饮》。）
治脾胃虚寒，痰饮留滞，呕吐不止，济急散方。
附子（一枚切下盖取出肉纳丁香在内） 丁香（四十九枚）
Vomiting of phlegm-fluids, inability to accept food and drink, resembling Fanwei (reversal stomach), after administering drugs that dry the spleen and stomach, the disease worsens. The patient desires to drink water. This indicates cold in the Stomach but heat at the gastric opening. (From *Danliao*)
Cold vomiting, caused by retention of cold food and drink in the Zhongwan (CV12) area, with a preference for pungent and hot substances; if vomited immediately upon ingestion, Erchen Tang (Two-Cured Decoction) plus ten cloves (Dingxiang) is suitable, or Lizhong Tang (Regulate the Middle Decoction) plus half a qian of Zhishi. If ineffective, Wenzhong Tang (Warm the Middle Decoction) should be used. In severe cases, Fuzi Lizhong Tang (Aconite Regulate the Middle Decoction) or Dingfu Tang (Cloves and Aconite Decoction) are indicated. All must be taken cold. Because cold meets cold, they penetrate each other, preventing vomiting. (From *Yaojue*)
Stomach deficiency vomiting. Aversion to food and lack of appetite; if accompanied by cold, there is aversion to cold. Food may remain for a long time before being vomited, or morning food may be vomited in the evening, evening food in the morning. The pulse is slow and slightly choppy. These are all deficiency-cold patterns. Huoxiang Angwei Tang (Agastache Stomach-Anchoring Decoction, composed of Huoxiang, Dingxiang, Renshen, Juhong) or Lizhong Tang (Regulate the Middle Decoction) are suitable. For severe cases, Dingzhi San (Cloves Powder, a formula consisting of acrid-warm herbs) is used for warming and tonifying. (From *Yitong*)
Pulse is deep and tight, limbs are cold, or accompanied by abdominal pain and vomiting; this belongs to cold. Sudden onset, possibly due to excessive consumption of raw/cold foods or mistaken administration of cold medicines. Treatment should warm the middle and regulate the Stomach. (From *Liuyao*)
Some people suffer from vomiting due to Stomach cold and cannot retain medicine. This is Yin excess repelling Yang. One dose of the secret modified Lizhong Tang (Regulate the Middle Decoction) is effective. (From *Baoming Gekuo*)
Heat vomiting. The patient is irritable due to heat in the Stomach, with accumulated saliva and foam; food is vomited immediately upon ingestion. This is called Heat Vomiting. It may be caused by Stomach heat combined with summer-heat, unresolved latent heat from Cold Damage, or conditions like damp-jaundice. All are caused by heat. (From *Sanyin*)
If vomiting is due to Stomach heat, Xiaochaihu Tang (Minor Bupleurum Decoction), Lugeng Tang (Reed Rhizome Decoction), Zhuru San (Bamboo Shavings Powder), or Huaihua San (Sophora Flower Powder) are suitable. (From *Furen Liangfang*)
If symptoms worsen after taking hot medicines, seek treatment within the category of Heat Vomiting (original text says Cold, corrected here). For Heat Vomiting, Erchen Tang (Two-Cured Decoction) plus one qian of Huanglian is suitable. (From *Yaojue*)
If vomiting is due to stagnant heat in the Stomach and food stagnation, there is aversion to food and cold, irritability and chest fullness, thirst with preference for cool drinks, vomiting at the smell of food or even medicine. The pulse is surging and rapid. These are excess-heat patterns. Zhuru Tang (Bamboo Shavings Decoction) or Maimendong Tang (Ophiopogon Decoction, i.e., from *Guangji*) are used to clear heat. If food stagnation is heavy, Erchen Tang (Two-Cured Decoction) plus Shenqu, Maiya, and Huanglian, or Baohe Wan (Preserve Harmony Pill) are used for digestion. (From *Yitong*)
Pulse is wiry-rapid or surging-slippery; dry mouth, red face, preference for cold and aversion to heat, irritability with drinking and vomiting. This belongs to Fire. Clear the Stomach and descend Fire. (From *Liuyao*)
Vomiting due to Stomach Fire must present with a red face, short dark or difficult urination, dry stool, bitter or dry mouth. Do not treat it as Stomach Excess; treat it similarly to Stomach Excess (Note: Text implies distinguishing or applying similar principles). (From *Bencao Jingshu*)
When external pathogens invade causing vomiting, Stomach Yang is constrained and rushes upward. Treatment should use acrid dispersants; Shengjiang (Fresh Ginger) is essential. When internal heat and Stomach Fire rush upward without external pathogen, treatment should clear and descend; Shigao (Gypsum) is essential. When phlegm-dampness stagnates and transforms into heat rushing upward, Chenpi (Tangerine Peel), Banxia (Pinellia), and Fuling (Poria) are essential. When food stagnation and Qi constraint rush upward, Zhishi (Immature Bitter Orange) and Maiya (Malt) are essential. When heat binds the bowels/bladder, lower blockage causes reverse upward flow; Dahuang (Rhubarb) and Huashi (Talc) are essential. These are examples for treating excess-heat. For Stomach Qi deficiency failing to transport, leading to stagnant heat and vomiting, promote Stomach Qi. For cold failing to transport, suppressing fire and causing vomiting, warm the middle and scatter cold. For empty-heat in the chest with prolonged anorexia and vomiting, nourish with the yin of grains to harmonize, and it will stop immediately (Note: Originates from *Zhunsheng*). These are examples for treating empty-heat. (From *Yiqie*)
The young wife of the Jin family, a daughter of an official, was naturally willful and often suffered from chest/hypochondriac pain and vomiting, resolving quickly with treatment. Later, symptoms recurred severely, lasting two days, leading to syncope and unconsciousness. I was summoned. Her pulse was chaotic and very rapid; she was irritable and feverish beyond description. I reasoned this must be Mingyang (Yangming) Fire. I asked if she wanted cold water; she nodded. I gave her half a cup; she did not vomit it and seemed unsatisfied. I gave another cup; she felt slightly calm. I then administered Taiqing Yin (Clear Heaven Drink, composed of Zhimu, Shihu, Mutong, Shigao). After swallowing, she slept soundly for half a day, and vomiting ceased. Since then, whenever I encountered vomiting with vigorous sound, surging-rapid pulse, and irritability/fever, I cured them with this method. This is important to know. (Excerpt from *Jingyue*)
Phlegm Vomiting. The patient was formerly robust but is now emaciated; borborygmus is audible in the intestines; food is vomited immediately upon ingestion, along with fluids. This is Phlegm Vomiting. It may be caused by Qi constraint binding saliva at the gastric opening, or by accumulation of wine, sweets, and cold drinks. (From *Sanyin*)
For heavy phlegm vomiting, Banxia Fuling Tang (Pinellia and Poria Decoction) from *Ju Fang* or Erchen Tang (Two-Cured Decoction) are suitable. (From *Furen Liangfang*)
Patients with phlegm-fluids vomit porridge and medicine immediately upon reaching the throat. People call this Fanwei (Reversal Stomach), but it is incorrect. This is phlegm-Qi knotted between the throat and diaphragm. First administer Lingsha Dan (Spirit Sand Pill) with Jiangsu Tang (Ginger and Perilla Decoction). Once medicine can be retained, follow with Qi-regulating drugs. Another type is latent phlegm in Zhongwan (CV12), triggered by cold, commonly called Lengxian (Cold Epilepsy). Treat with Xinfa Banxia Tang (New Method Pinellia Decoction) or Zhuapi Tang (Beating Spleen Decoction, composed of Sesame Oil, Xiang, Liangjiang, Gancao). For external heat-phlegm vomiting, Xiaobanxia Fuling Tang (Minor Pinellia and Poria Decoction) plus Zhuru (Bamboo Shavings) the size of a coin is suitable. If vomiting phlegm leads to syncope, it is Cold-Phlegm confusing the mind, called Tanjue (Phlegm Syncope). Treat with Jiangfu Tang (Ginger and Aconite Decoction), using raw Fuzi instead of processed. (From *Yaojue*)
Phlegm-fluids in the Stomach cause vomiting of phlegm-foam, fullness, and palpitations. The method is to resolve phlegm and drive out fluids. Phlegm has cold and heat types; treat accordingly. (From *Baoming Gekuo*)
Pulse is slippery, deep-hidden, or wiry-solid. Although vomiting occurs, there is no thirst. This belongs to Phlegm. (From *Liuyao*)
Food Vomiting. Chest and abdomen are distended and stuffy; limbs are cold; aversion to the smell of food; food is vomited immediately upon ingestion; morning food vomited in evening, evening food in morning. This is Food Vomiting. Caused by diet injuring the Spleen and undigested grain. (From *Sanyin*)
Food vomiting is often due to Seven Emotions, external pathogens, or irregular diet. Generally, treat first with Lizhong Tang (Regulate the Middle Decoction). Erchen Tang (Two-Cured Decoction) plus one qian Zhishi, or seven fen Nanxing, four fen Chenxiang and Mugui, is good. Or only Zhinan Tang (Immature Bitter Orange and Pinellia Decoction - name missing) or Daotan Tang (Guide Out Phlegm Decoction). (From *Yaojue*)
Right Guan pulse is wiry-slippery and rapid; symptoms include belching, sour regurgitation, fullness, and vomiting. This belongs to Food Stagnation. Even if vomiting occurs, probe vomiting with salt water is still appropriate. (From *Liuyao*)
Blood Vomiting. Lower epigastrium is full; food is vomited immediately upon ingestion; blood exits with Qi. This is Blood Vomiting. Caused by stasis of cold blood accumulating at the gastric opening. (From *Sanyin*)
A middle-aged man had Zhongwan (CV12) pain and vomiting after eating. His face was purple-frost colored; both Guan pulses were choppy (indicating Blood disease). He had fallen previously, causing immediate Zhongwan pain. Administered a blood-generating and stasis-resolving agent. He vomited a bowl-full of bloody pieces and recovered. (From *Danxi*)
Qi Vomiting (Vomiting at Zi Hour). Chest and diaphragm are full/distended; Qi rebels in the chest; food is vomited immediately upon ingestion; feeling relieved after vomiting. This is Qi Vomiting. The Stomach belongs to Foot-Yangming, merging with Ying at the foot. Now Qi rebels upward, knotting at the gastric opening, causing vomiting. (From *Sanyin*)
Qi Vomiting: Chest fullness, diaphragmatic distension, Guan-Ge obstruction (blockage), constant feeling of fullness without eating, Qi rebellion and vomiting after eating. Caused by eating while extremely angry. Erchen Tang (Two-Cured Decoction) plus half a qian Zhishi and Mugui is suitable, or Wuzhuyu Tang (Evodia Decoction). If ineffective, Dingchen Touge Tang (Cloves and Amber Throat-Penetrating Decoction) and Wuge Kuanzhong Tang (Five Diaphragms Midsection-Widening Decoction). (From *Yaojue*) (Note: *Defu* states Huoxiang Zhengqi San (Agastache Rectify Qi Powder) is highly effective for Qi Vomiting.)
Vomiting from eating while angry, chest/diaphragm fullness, Guan-Ge obstruction: Erchen Tang (Two-Cured Decoction) plus Qingpi and Mugui. If ineffective, add Dingxiang, Chenxiang, Mugui, Sharen, Houpo, Shenqu. If still ineffective, it is Blood Stasis; treat according to Accumulated Blood protocols. Some Liver-Fire rebellion cases also vomit without eating; vomit may be sour, bitter, or green/blue fluid. Bowels/bladder are not constipated (Note: *Yiguan Ping* notes intermittent constipation/diarrhea). Can cause Heart pain. This is Fire-Stagnation and Wood-Stagnation. Wood-stagnation requires dispersion; Fire-stagnation requires venting. Use Yuandan (Evodia) and Huanglian decocted strongly, sipped slowly, followed by Xiaoyao San (Free and Easy Wanderer Powder). (From *Yitong*) (Note: Latter part originates from *Yiguan*.)
Pulse wiry-tight extending past Cun Kou; vomiting sour or green fluid. Belongs to Liver-Fire rebelling upward. Yiqing Wan (Suppress Green Pill) is primary. Alternatively, Erchen Tang (Two-Cured Decoction) with Yuandan stir-fried Huanglian and Chaihu is excellent. (From *Liuyao*)
Women often have Qi constraint. If angered during meals, constraint fails to transport, turbid Qi attacks upward causing vomiting. Soothe the constraint. (Same source)
Zhou Shenzhen treated a man who ate normally but vomited every Zi hour, with constipation. Inquiry revealed mental distress/worry, Spleen Qi constraint, blocking Youmen (ST21). Primary treatment: Support Spleen and open orifices. Renshen, Baizhu, Cangzhu stir-fried with Fuling (each 1 qian), Zhi Gancao (0.5 qian), Fuzi boiled with Wuyao (0.3 qian). Decoct in water. (From *Yitong*)
Roundworm Movement. Vomiting unresponsive to various medicines, without preceding phlegm/Qi symptoms. Roundworms in chest/diaphragm cause vomiting; they move upon seeing medicine, refusing intake. Medicine is vomited, worms remain. Though not expelling worms, use worm-expelling methods. Add ten fried Chuanjiao (Sichuan Pepper) to anti-vomit formulas; roundworms subdue upon seeing pepper. (From *Yaojue*)
Pulse fluctuates large/small; frequent vomiting of clear fluid; gastric pain comes and goes; improves with eating, worsens on hunger. Belongs to Parasite Accumulation. White spots on face, or expulsion of worms, salivation. Pulse is peaceful. Not Fire or Phlegm, but Parasites. (From *Liuyao*)
Alcohol Toxicity. Pulse wiry-thin-slippery or floating-surging-rapid. Symptoms: red face, dry mouth, headache, nausea, restlessness/irritability, continuous vomiting. This is Alcohol Toxicity. Cool to subdue. (From *Liuyao*)
Vomiting after drinking alcohol stems from beverage processing. Gegen Jieying Tang (Kudzu Relieve Intoxication Decoction) is primary. (From *Baoming Gekuo*)
Motion Sickness (Zhuche/Zhuchuan). Regardless of gender, riding car/boat causes chest oppression/confusion, headache, vomiting/reversal. Called Motion Sickness. Due to natural constitution, not pre-existing disease. (From *Bingyuan Lun*)
Severe vomiting from boat motion, thirsty for water: fatal. Drinking Tongbian (Child's Urine) is best. (From *Danxi*)
Poisoning. For vomiting due to poisoning, identify the toxin. Heat-toxin vomiting: resolve with bitter-cold agents. Yin-Cold-toxin vomiting/diarrhea: resolve with warm-hot agents. If vomiting/diarrhea causes Spleen/Stomach deficiency, strong warming/tonification is required. See later case for Cold-Toxin vomiting/diarrhea. (From *Jingyue*) (Case: New analysis of Cold-Toxin: Severe vomiting/diarrhea after eating mushrooms. Doctor continued黄连 (Huanglian) and Black Beans, worsening condition. Then administered Renshen, Baizhu, Gancao, Ganjiang, Fuzi, Fuling, plus Shudi. Over 20 doses, recovered. Reason: Mushrooms grow in deep pits/wells, extreme Yin/Cold. Detoxifying aids poison. Using Jiang/Fuji warms Cold-Toxin.)
Dry Vomiting. Dry vomiting is due to Stomach Qi rebellion. Wanting to vomit but nothing comes out. (From *Bingyuan*)
Dry vomiting has sound but no phlegm, unlike the harsh/long sound of Hiccups. Ju Hong decocted in water, with少许 Jiangzhi (Ginger Juice) and Baimi (White Honey), sipped slowly. For Stomach deficiency, add Renshen. For Stomach cold, add Paojiang (Processed Ginger). Stomach deficiency with turbid Qi rebellion: Wuzhuyu Tang (Evodia Decoction). (From *Yitong*)
Vomiting Clear Fluid has five causes: Dampness, Phlegm-Fluids, Cold, Retained Food, Parasites. Known excessive raw/cold fruit/veg intake indicates Cold-Dampness. Borborygmus in chest/diaphragm indicates Phlegm-Fluids. Vomiting clear fluid after eating indicates Retained Food. Onset after cold exposure indicates Stomach Cold. Abdominal pain with clear/yellow fluid indicates Parasites. Differentiate and treat accordingly. (From *Yitong*)
Sudden onset, clear fluid flowing from teeth, pouring out, filling a bowl. Causes vary: Cold, Damp, Parasites, Phlegm, Food Stagnation, overindulgence in food/alcohol/sex. Treatment varies slightly. Refer to formulas for Sour Vomiting. Avoid rich flavors. (From *Jianming Yigou*)
Occasional overflow/vomiting of clear fluid: Cangzhu stir-fried with Chenbitsi (Old Wall Earth), Fuling, Huashi, Baizhu, Chenpi decocted. (From *Liuyao*)
Vomiting clear fluid is mostly Qi deficiency. Liu Junzi Tang (Six Gentlemen Decoction) plus Chishizhi. (From *Bidu*)
Vomiting Bitter Fluid. Pathogen in Gallbladder channel; Wood overacts on Stomach. Rebellion causes bile overflow, hence bitter taste. Wu Zhu Yu, Huang Lian, Fu Ling, Ze Xie, Sheng Jiang. Pathogen in Gallbladder, rebellion in Stomach; bile leakage causes bitter mouth. Xiaochaihu Tang (Minor Bupleurum Decoction). Stomach Qi rebellion causes bitter vomiting. Wuzhuyu Tang (Evodia Decoction). (From *Yitong*)
Thirst/Heat: Do not treat hastily. After vomiting fluids, mouth becomes thirsty. Do not assume Heat solely based on thirst. (From *Yaojue*)
Generally, understand root and branch. Example: Vomiting phlegm, Stomach deficiency/anorexia leading to fever. Cooling herbs for fever further weaken Stomach Qi, failing to reduce fever. Prioritize supporting Stomach and stopping vomiting; fever subsides. If fever persists, once Stomach Qi is restored, administer cooling herbs. (From *Yigou*)
Death Signs. Severe pain, color like vegetable leaves: Death. (From *Yaojue*) (Note: *Yuanbing Ji* says vomiting like vegetable juice is death.)
Generalized distension: Incurable. (From *Dahuan*)
Blue face, black nails, unceasing mid-abdominal pain, irreversible limb cold: Fatal. (From *Jinjian*)
Vomiting, inability to eat, or diarrhea, extreme emaciation. Eyelid edema, pulse wiry-solid alone: Spleen failure. One in a hundred survives. (From *Yidu*)
Methods to Stop Vomiting. If decoctions are vomited immediately: Boil 3 liang Gancao (Licorice) in 3 sheng water to 2 sheng. Take. If it induces vomiting, better if it doesn't. Wait for stability, then take remaining decoction; it will pass smoothly. Ginger is the holy herb for vomiters. (From *Qianjin*) (Note: *Zisheng Jing* says: Morning ginger tea, roasted, chewed raw, or juice in wine is effective.)
Treating vomiting is hard due to difficulty retaining medicine. Select suitable ingredients from this formula (Dingxiang Yin, for Cold Vomiting: Dingxiang, Banxia, Juhong, Ganjiang), grind to powder, form pills with Ginger Juice. Or intermittently take Zhenzhen Dansha (Cinnabar Sedative). Be prudent. (From *Xu Yijian Fangmai Lun*)
If all medicines fail for vomiting, long-term Stomach deficiency prevents grain intake: Use Changliushui (Long-flowing Water), clarify Fulonggan (Dragon’s House Soil), boil fried aged rice in it. Drink 1-2 cups to calm Stomach Qi. Highly effective. (From *Liuyao*) (Note: From *Zhengzhuan*.)
For difficult medicine retention, advance slowly, one spoon at a time, not too fast. (From *Tongzhi*) (Note: From *Shanghan Yunyao*.)
My Comment: Physicians must empathize with the condition. Vomiting with non-retention is hardest to treat. Medicine vomited immediately cannot work. Never force-feed; it increases vomiting. I have treated many: Make mud balls from Ginger Soup and Yellow Earth, plug nostrils to block smell. Decoct correct medicine, clarify, ensure moderate temperature. Give one mouthful. Wait half an hour. Another mouthful. Wait longer. Two mouthfuls. Wait briefly. Then take freely without vomiting. Stomach is calmed. Fools force-feed whole bowls; everything is expelled. This method applies to pediatrics and general practice. Without understanding condition/method, diagnosis and prescription are useless for non-retention. (From *Youyou Jicheng*)
Anti-vomit medicines: Avoid Gualou, Xingren, Taoren, Luobozhi, Shanzhi (all induce vomiting). (Note: *Yitong* says all oily substances offend Stomach and cause vomiting.) Fragrant/dispersing herbs are acceptable. (From *Danxi*) (Note: No category fits, recorded here.)
Warming Middle Methods. *Beiji* treats reversal vomiting, inability to take water/grain: Ganjiang Gancao Tang (Dried Ginger and Licorice Decoction).
Ganjiang (2 parts, fried) Gancao (1 part, honey-fried)
Chop, boil in 2 he water to 1 he. Strain, take at once. Calms. Eat congee later. Miraculous. (From *Waitai*)
*Yannian* Gancao Yin (Licorice Drink): Treats Spleen/Kidney pain Qi attacking Heart, painful oppression, vomiting/diarrhea, limb cold or irritant pain.
Gancao (2 liang, honey-fried) Renshen (2 liang) Ganjiang (4 liang) Houpo (2 liang, honey-fried) Baizhu (2 liang)
Chop, boil in 5 sheng water to 1.5 sheng. Strain, divide into 3-4 warm doses. Walk 8-9 li between doses. (Same source)
Also Xu Renze’s Accumulated Cold in Stomach, vomiting/reversal, unable to eat: Renshen etc. 7-ingredient Pills. Remove Gancao/Ganjiang from base, add Shengjiang, Xixin, Ju Pi, Guixin. Grind, honey-pill, walnut size. Take with water. Start 10 pills, bidaily, increase to 20.
Another Formula: Baizhu San (Atractylodes Powder) for vomiting: Baizhu, Renshen (1 liang each), Banxia (1.5 liang), Fuling, Ganjiang, Gancao (0.5 liang each). Decoct with Ginger/Jujube.
For vomiting/nausea: Add Dingxiang (0.5 liang), Banxia (1 liang) to Zhizhong Tang (Regulate Middle Decoction - Lizhong Tang 4 herbs 1 liang each + Juhong 2 liang). Name: Dingxiang Wenzhong Tang. Add 10 slices Ginger per dose. (Same source)
Modified Lizhong Tang for floating phlegm/unceasing vomiting: Add Banxia, Dingxiang. Dosage: 4 qian per dose, decoct, take hot anytime. Add Ginger. (From *Defu*)
Banxia Fuling Yinzi (Pinellia Poria Drink) for Phlegm-Fluid Vomiting.
Banxia (2 liang) Fuzi Chifubing Baizhu Renshen Huang Jupi Dingxiang (1 fen each)
Grind fine. Decoct 5 qian in Ginger water on empty stomach. (From *Jifeng*) (Note: Variation of *Qianjin* Banxia Banxia Tang. See Water-Fluids.)
Treat Spleen/Stomach Deficiency-Cold, Phlegm-Fluid retention, unceasing vomiting: Jiji San (Urgent Relief Powder).
Fuzi (1 piece, cut lid, remove meat, insert Dingxiang inside) Dingxiang (49 pieces)