胃反自是一种病，故前人必与呕吐为别，今亦区而列之，然要在与前门参看。
脉候 小弱而涩，胃反。（《脉经》）
寸紧尺涩，其人胸满不能食而吐。吐止者，为下之，故不能食。设言未止者，此为胃反，故尺为之微涩也。
（同上）
其脉紧而弦，紧则为寒，弦则为虚，虚寒相搏，故食已即吐，名为胃反。（《病源论》）
其脉浮缓者生，沉涩者逆。（《奇效》）
反胃之脉，沉细散乱，不成条道，沉浮则有，中按则无，必死不治。更参面色，不欲黄白，亦不欲纯白，皆
恶候也。（《准绳》）
翻胃初起之脉，滑数有力有神者，可治；若脉多沉涩而弦急者，不治，此由脾胃之元气已绝，不能营运转
输以传导耳。（《百问》）
源由证治诸说 荣卫俱虚，其血气不足，停水积饮在胃脘则脏冷，脏冷则脾不磨，脾不磨则宿谷不化，
其气逆而成胃反也，则朝食暮吐，暮食朝吐，心下牢大如杯，往往寒热，甚者食已即吐。（《病源论》）
夫反胃者，为食物呕吐，胃不受食，言胃口翻也。则有因饮酒过伤所致，则有因忧悒怏蓄怒，肠结胃翻所
致；则有宿滞痼癖，积聚冷痰，久不全除，致成兹疾；则有热毒壅隔，胃口闭塞，不下饮食。女人皆由血气所为，
男子多因冷惫所致（按∶《得效》曰∶女人得之，多由血气虚损，男子得之，多因下元冷惫）。大凡呕哕饮食
所为，病根既若异同，医疗固宜审密，其中有才食便吐，有食久乃翻，不可一概用方，切在子细体候也。（《圣
惠》）
五种翻胃∶第一停饮，早辰吃物，日午吐出，心痛头疼，又吐酸水者是也。第二膈气，吃物随手吐出，而小
便赤，腹肚气膨，坐卧不安，上暖下冷者是也。第三结肠，登混如羊粪，吐出似藏坏鸡子，大小便急涩疼痛者
是也（按∶《卫生家宝》曰∶结肠翻胃，饮食入腹，经宿则吐，食粒不化者，是此证）。第四呕逆，吐酸水，有
顽痰，心头燥者是也。第五膈宿（膈当隔），今日吃物，来日吐出，心 腹膨迷闷者是也。（《经验秘方》）
有食罢即吐，有朝食暮吐，暮食朝吐，所吐酸臭可畏，或吐黄水。凡有斯疾，乃是脾败，惟当速疗，迟则发
烦渴，大便秘，水饮纤悉不得入口，不旋踵毙矣。（《得效》）
翻胃者，朝食暮吐，暮食朝吐也。□则由七情气郁而生涎，及饮食生冷，喜啖炙 ，饥饱不时，伤损脾胃。
脾之中州，不能磨化水谷。胃之下口，不能宣达于阑门泌别之。所以致气复回升，引食而反。治之之法，须当运化
水谷为先，导泄胃之下口，使气得下达，随引水谷下透于小肠，则上不吐矣。（《活法秘方》）
如朝食暮吐，暮食朝吐，或食下须臾即吐者，此胃可容受而脾不能传送也；或大小肠秘结不通，食反而上奔
也。（《丹溪》）
翻胃之病，所以重于呕吐者，呕吐食入即吐，翻胃则或一日半日，食复翻上，不化如故。腹中非不欲食，食
不肯留。胃气不温，不能消食，食既不消，不为糟粕而入大肠，必随气逆上，从口而出。故翻胃人，胸膈多为冷
气所痞。二陈汤加丁香十粒，枳壳半钱；或治中汤，加枳壳，砂仁各半钱，半夏一钱，入米与生姜同煎。若胃寒
甚，服药而翻者，宜附子粳米汤，加丁香十粒，砂仁半钱；大便秘者，更加枳壳半钱。隧道久不通，名结肠翻胃，
半硫丸尤宜。病重百药无效，势危笃者，宜桂香青金散（按∶盖即桂香散）以坠之。（《要诀》）
治反胃之法，当辨其新久及所致之因。或以酷饮无度，伤于酒湿；或以纵食生冷，败其真阳；或因七情忧郁，
竭其中气。总之无非内伤之甚，致损胃气而然。故凡治此者，必宜以扶助正气，健脾养胃为主。但新病者，胃气犹
未尽坏，若果饮食未消，则当兼去其滞；若有逆气未调，则当兼解其
郁。若病稍久或气体禀弱之辈，则当专用温补，不可标本杂进，妄行峻利开导、消食化痰等剂，以致重伤胃气，
必致不起也。（《景岳》）
虚在上焦，微寒呕恶者，惟姜汤为最佳，或橘皮汤亦可。虚在中焦而食入反出者，宜五君子煎（即理中汤
加茯苓）、理中汤之类主之。虚在下焦而朝食暮吐，或食入久而反出者，其责在下，除非补命门以扶脾土之母，
则火无以化，土无以生，亦犹釜底无薪，不能腐熟水谷，终无济也，宜六味回阳饮（方见伤寒）或人参附子理阴煎
（用熟地、当归、炙甘、干姜）或右归饮（系肾气丸去苓、泽、牡，加枸杞、甘草、杜仲）之类主之。此屡用之
妙法，不可忽也。（《景岳》）
反胃系真火式微，胃寒脾弱，不能消谷，朝食暮吐，暮食朝吐，或一两时而吐，或积至一日一夜，腹中胀闷
不可忍而复吐。虽曰脾胃虚寒，然致病之由，必有积滞于内。《千金》治反胃初起，用《金匮》茯苓泽泻汤，去白
术，换干姜，加人参、橘皮、大黄、青竹茹，得利去大黄，为胃虚反胃、下喉便吐之主方。若吐出原物酸臭不化，
此饮食入胃，既抵胃之下脘，复返而出也，宜理中汤为主，甚则加丁、附、川连（按∶此本出《沙篆》）。食物
之后，冷涎不已，随即反出，或心腹觉疼，藿香安胃散，或六君子汤加丁香、藿香。咽喉阻塞，胸膈满闷，暂用
香、砂、枳、朴以开其结滞，然通气药过多，中气因而不运，异功散加香、砂，使气旺自能运化。胃反上气，食即
吐出，属热者，《千金》用芦根、茅根等煎服；不应，加竹茹、生姜。反胃而胸中嘈杂不宁，或作或止，其人懊 ，
面上有白点者，作虫积治之。（《医通》）
翻胃不甚剧者，但视其所食之物犹未尽者是也，宜用温药如木香、桂心、生姜之类以温其脾，加半夏、黄连、
人参、茯苓煎服。翻胃甚者，所食之物吐尽者是也，其胃大寒，必用热药如煨熟附子、丁香、干姜之类，加姜炒
黄连、人参、茯苓、苏子、沉香、白豆蔻煎服。（《医镜》）
反胃属胃气虚，忌破气、升。苦寒、甘、热燥，宜补气降气、和胃、清热、酸敛以制肝。（《本草经疏》）
反胃，用伏龙肝水煎药以补土，糯米汁以泽脾，代储以镇逆，乌铅以抑肝。（《汇补》）
火衰证（宜参前条景岳说） 反胃火衰，不能生土，其脉沉迟，宜八味丸，减熟地，加沉香、砂仁。
（《沙篆》）（《医通》作八味丸加丁、沉，间进黑锡丹。）
石顽治汤伯干子，年及三旬，患呕吐经年，每食后半日许，吐出原物，全不秽腐，大便二三日一行，仍不燥结，
渴不喜饮，小便时白时黄。屡用六君子、附子理中、六味丸皆罔效，日濒于危，逮后延余诊之。其两关尺弦细而
沉，两寸皆涩而大，此肾脏真阳大亏，不能温养脾土之故，遂以崔氏八味丸与之。或谓附子已经服过二枚，六
味亦曾服过，恐八味亦不能克效也。余曰∶不然。此证本属肾虚，反以姜、附、白术伐其肾水，转耗真阴，至于
六味虽曰补肾，而阴药性滞，无阳则阴无以生，必于水中补火，斯为合法。服之不终剂而愈。（《医通》）
大便秘结 反胃证，多有大便闭结者，此其上出，固因下之不通也；然下之不通，又何非上气之不化乎。
盖脾胃气虚，然后治节不行而无以生血，血涸于下，所以结闭不行，此真阴枯槁证也。必使血气渐充，脏腑渐润，
方是救本之治。若徒为目前计而推之逐之，则虽见暂通，而真阴愈竭矣。（《景岳》）
有阳虚不能统运，呕逆便秘，用人参、大黄、附子攻之，即真气竭者，不可救。（《医通》）
死证 反胃症沫大吐者多死，予目击十数人矣。（《赤水》）
凡反胃而致大吐白沫如鸡子清者，是肺胃俱亡，矢如羊粪，则大肠血槁，即大补气血，终亦必亡而已。
（《医通》）
温中诸方 《万全方》疗脾，饮食吐逆，水谷不化，此为胃反，半夏饮子方。
制半夏（八分） 浓朴（炙） 人参 白术 生姜（切） 枣（各六分） 粳米（两合） 橘皮（四分）
上八味细切，以水二大升，煎取一升，去滓分温四服。空肚服二服。（《外台》）《叶氏》翻胃汤，治反胃
呕吐，胸膈不快，食即经宿吐出酸臭（石大夫方），于本方去半夏、粳米，加茯苓、吴茱萸。
李绛《兵部手集方》，疗反胃，呕吐无常，粥饮入口即吐，困弱无力，垂死者，以上党人参二大两拍破，
水一大升，煮取四合，热顿服日再，兼以人参汁煮粥与啖。李直方司勋徐郎中，于汉南患反胃，两月余诸方不
瘥，遂与此方，当时便定，瘥后十余日发入京。绛每与名医持论此药，难可为俦也。（《本草图经》）
治反胃，吐酸水，人参粥方。
人参（为末半两） 生姜（取汁半升）
上二味，以水二升，煮取一升，入粟米一合，煮为稀粥，觉饥即食之。（《圣济》）（按∶前门有参粟汤，
即是类方。又《千金》有捣粟米作面，水和丸烂煮，内醋中吞之方，宜参。）
《斗门方》治翻胃，用附子一个最大者，坐于砖上，四
面着火渐逼，淬入生姜自然汁中，又根据前火逼干，复淬之，约生姜汁可尽半碗许，捣罗为末，用粟米饮下一钱，
不过三服瘥。（《本草》）（《本事》名附子散。）治患痼冷反胃，呕哕不下食方。附子三分，生姜一升，水入
二合。上切附子如豆许大，入姜汁中，煎令汁尽，更入蜜一合，捣一千杵，丸如梧桐子大，不计时候，以生姜汤
下二十丸，渐加至三十丸。（《圣惠》）
治翻胃呕吐，黄附丸。
附子（炮去皮脐尖）
上为末糊丸，如梧桐子大，以大黄为衣，每服十丸，温水下。（《家宝》）
附子五苓散，治翻胃吐食。
大附子（一只取空入五苓散在内炮熟）
上为细末，用姜汤下，何元寿方。（《朱氏》）
尤，脉缓右关弦，知饥恶食，食入即吐，肢浮便溏，溺少不渴饮，此胃阳衰微，开合之机已废，老年噎格
反胃，乃大症也。
人参 茯苓 淡附子 淡干姜 炒粳米 姜汁（《临证指南》）
茱萸丸，孙生传曰∶年深膈气翻胃，饮食之物至晚皆吐出，悉皆生存不化，膈上常有痰涎，时时呕血，胸中
多酸水，吐清水无时，日渐羸，腹中痛楚，时复冷滑，或即闭结，候状不可尽述。自患此疾六年，日可吐及五、
七度，百方无验。因遇此法，服及两月，诸疾悉瘥。
吴茱萸（三分瓦上出油） 胡椒 人参 当归（各五钱） 甘草（半两，一半生，一半纸裹五、七重，醋浸令
透，火内慢煨，干又浸，如此七遍。） 半夏（一两，用姜四两研汁，入砂罐子内，用姜汁、并
水煮，候破，看存二分白心，取半夏研为膏子。） 白矾（半两炒干存性一分）
上为末，半夏膏丸，如稍硬，添姜汁，丸如梧桐子大，每服七丸，桑柳条各三十茎，银器内煎汤吞下，日
三服。忌诸毒物，惟可食油猪胰脾软饭。此孙生自叙如此。（《苏沈》）
治翻胃，丁香一两为末，炼卤梅取肉，以丁香末为膏，含化即愈。（《袖珍》）（又有生姜、荞麦面、丁香方，
当阅。）
清中诸方 治胃反，食即吐出，上气方。
芦根 茅根（各二两细切）
上二味以水四升，煮取二升，顿服之，得下良。（《千金》）
包（六十），胸脘痞闷嗳逆，三四日必呕吐粘腻或黄绿水液，此属反胃，六旬之年，是亦重病。
川连 半夏 枳实 郁金 竹茹 姜汁（《临证指南》）
疏里诸方 华佗治胃反，胃反为病，朝食暮吐，心下坚如杯升，往来寒热，吐逆不下食，此为关上寒
所作，将成肺痿，治之方。
真珠 雄黄 丹砂（各三两） 朴硝（五两） 干姜（十累）
上五味末之蜜丸，先食服，如梧子三丸。若小烦者，饮水即解，然无所忌，神良无比。一方用桂心一两。
（《千金》）
大黄汤，治冷涎翻胃，其候欲发时先流冷涎，次则吐食，此乃劳证，治之不早，死在旦夕。
大黄（一两，生姜自然汁半茶盏，炙大黄令干，又淬姜汁中，如此淬尽，切焙为末。）
上每服二钱，陈米一撮，葱白二茎，水一大盏，煎至七分，先食葱白，次服其药，不十日去根。（《本事续集》）
半夏生姜大黄汤，治旦食暮吐，暮食朝吐，此下焦病。
半夏 大黄（各二两） 生姜（一两半）
水五升，煮取三升，分温再服。（《必读》）
治胸膈不快，酒食所伤，渐成翻胃，自令干呕。
丁香 巴豆 乌梅（各二十个完全好者）
上三味皆不去油谷并核，捣三五千百杵成膏，入早米饭一两，同捣又二千杵，令极匀细，众手丸如○大，
慢火焙干，净纸承，顿地上出火毒，每服五丸或七丸，茶酒熟水任下。如呕吐酸水，心腹气痛，膨胀者，橘皮
甘草汤下。（《本事续集》）（按∶此本《鸡峰》五百罗汉丸，今去胡椒、缩砂，彼曰消食化气。《三因》五百
丸，于罗汉丸去胡椒。）
翻胃平胃散，平胃散多加 砂，姜为末沸汤点服，当吐出恶物一块，黑色如石，屡验。（《必用全书》）
（按∶磨积方仅止此，仍不别设其类，敢列于斯。）
收涩镇坠诸方 治反胃病吐后，令永瘥，赤石脂丸方。
赤石脂（一斤好腻无砂者）
Geng Fan (Recurrent Vomiting) is a distinct disease entity. Therefore, predecessors necessarily distinguished it from general vomiting (Ou Tu). It is now categorized separately, but the key lies in cross-referencing with the preceding section.
**Pulse Patterns**
A pulse that is small, weak, and choppy indicates Geng Fan (Recurrent Vomiting). (*Mai Jing*)
A tight pulse at the Cun position and a choppy pulse at the Chi position indicate chest fullness, inability to eat, and vomiting. If the vomiting stops, it is due to improper purgation, leading to an inability to eat. If the vomiting does not stop, this is Geng Fan (Recurrent Vomiting), hence the Chi pulse appears slightly choppy.
*(Ibid.)*
A pulse that is tight and wiry: tight indicates Cold, wiry indicates Deficiency. The binding of Deficiency and Cold results in vomiting immediately after eating, named Geng Fan (Recurrent Vomiting). (*Zhu Bing Yuan Hou Lun*)
A floating and moderate pulse suggests a favorable prognosis; a deep and choppy pulse suggests an unfavorable prognosis. (*Qi Xiao Liang Fang*)
The pulse of Fan Wei (Inverted Stomach) is deep, fine, scattered, and disorganized, lacking clear channels. It can be felt at light and heavy pressure but disappears at moderate pressure. This is a terminal condition, incurable. Referencing the complexion, neither yellowish-white nor pure white is desirable; both are ominous signs. (*Yi Xue Gang Mu*)
At the onset of Fan Wei (Inverted Stomach), a slippery, rapid, forceful, and spirited pulse is treatable. If the pulse is mostly deep, choppy, wiry, and urgent, it is untreatable. This is because the primordial Qi of the Spleen and Stomach has exhausted, failing to circulate, transform, and transport. (*Bai Wen Da Yi Chao*)
**Etiology, Symptoms, and Treatment Theories**
When Ying and Wei are both deficient, and Qi and Blood are insufficient, retained water and accumulated fluids in the Epigastrium cause Zang Cold. Zang Cold leads to Spleen failure in digestion. Spleen failure causes undigested food to remain, causing Qi rebellion and resulting in Geng Fan (Recurrent Vomiting). Thus, food eaten in the morning is vomited in the evening, and food eaten in the evening is vomited in the morning. The area below the heart feels hard and large like a cup, often accompanied by alternating cold and heat. In severe cases, vomiting occurs immediately after eating. (*Zhu Bing Yuan Hou Lun*)
Fan Wei (Inverted Stomach) refers to food vomiting where the Stomach rejects food, implying the stomach opening flips. Causes include excessive alcohol consumption damaging the body; sorrow, depression, and anger causing intestinal knotting and stomach flipping; lingering food stagnation, stubborn masses, accumulated cold phlegm, long unremoved, leading to this disease; or heat toxins blocking the passage, closing the stomach opening, preventing food intake. Women suffer from this mostly due to Blood and Qi issues, while men suffer mostly due to lower Yuan Cold and exhaustion. Generally, vomiting and hiccups relate to diet. Since root causes vary, medical treatment must be meticulous. Some vomit immediately after eating; others vomit after a long time. One cannot use a single formula for all; careful observation is essential. (*Tai Ping Sheng Hui Fang*)
Five types of Fan Wei (Inverted Stomach):
1. **Retained Fluids**: Eat in the morning, vomit at noon, with heart pain, headache, and sour water vomiting.
2. **Diaphragm Qi**: Vomit immediately after eating, red urine, abdominal bloating, restlessness day and night, upper body warm, lower body cold.
3. **Colon Knotting**: Stool like sheep dung, vomit resembling rotten eggs, urgent and painful urination and defecation.
4. **Rebellious Vomiting**: Sour water vomiting, stubborn phlegm, dry heart mind.
5. **Diaphragm Retention**: Food eaten today vomited tomorrow, with heart and abdominal bloating and confusion. (*Jing Yan Mi Fang*)
Some vomit immediately after eating; some exhibit morning-eating-evening-vomiting or evening-eating-morning-vomiting. The vomitus is fearfully sour and foul, or yellow water. Any such disease indicates Spleen collapse. Rapid treatment is necessary; delay leads to vexation, thirst, constipation, inability to ingest even sips of water, and death shortly thereafter. (*De Xiao Fang*)
Fan Wei (Inverted Stomach) is characterized by morning-eating-evening-vomiting or evening-eating-morning-vomiting. It arises from Qi stagnation due to Seven Emotions generating phlegm, as well as dietary raw/cold foods, preference for roasted/fried foods, irregular meals, damaging the Spleen and Stomach. The Spleen, residing in the Central Region, fails to grind and transform water and grain. The lower opening of the Stomach fails to transmit to the Lan Men (Gate of Separation) for clarification. Thus, Qi rebels upward, pulling food back up. Treatment must prioritize transforming water and grain, draining the lower Stomach opening, allowing Qi to descend, guiding water and grain into the Small Intestine, thereby stopping upper vomiting. (*Huo Fa Mi Fang*)
If morning-eating-evening-vomiting or immediate post-prandial vomiting occurs, the Stomach can receive but the Spleen cannot transport. Or, if Large and Small Intestines are blocked, food rebels upward. (*Dan Xi Xin Fa*)
Fan Wei (Inverted Stomach) is more severe than Ou Tu (Vomiting). Ou Tu involves immediate vomiting upon ingestion; Fan Wei involves food remaining for half a day before being thrown up again, undigested as before. The abdomen desires food, but food does not stay. Stomach Qi is not warm, failing to digest food. Undigested food does not become waste entering the Large Intestine but rebels upward via Qi, exiting the mouth. Thus, patients with Fan Wei often have Cold Qi obstructing the Chest and Diaphragm. Use Er Chen Tang plus 10 Cardamomi Fructus (Ding Xiang) and 0.5 qian of Aurantii Fructus (Zhi Ke); or Zhi Zhong Tang plus 0.5 qian each of Aurantii Fructus (Zhi Ke) and Amomi Fructus Rotundus (Sha Ren), and 1 qian of Pinelliae Rhizoma (Ban Xia), decocted with rice and Zingiberis Rhizoma Recens (Sheng Jiang). If Stomach Cold is severe and vomiting persists after medication, use Fuzi Jingmi Tang plus 10 Cardamomi Fructus (Ding Xiang) and 0.5 qian of Amomi Fructus Rotundus (Sha Ren). If constipated, add 0.5 qian of Aurantii Fructus (Zhi Ke). For long-term blockage named Colon Knotting Fan Wei, Ban Liu Wan is especially suitable. For critical cases unresponsive to hundreds of medicines, Gui Xiang Qing Jin San (likely Gui Xiang San) should be used to suppress rebellion. (*Ji Sheng Ba Cui*)
Treatment of Fan Wei (Inverted Stomach) must distinguish between new/old onset and etiology. Causes include excessive drinking injuring Yang with dampness; indulging in raw/cold foods destroying True Yang; or Seven Emotions depressing and exhausting Middle Qi. Essentially, these are severe internal injuries damaging Stomach Qi. Treatment must primarily support Righteous Qi, strengthen the Spleen, and nourish the Stomach. For new diseases, Stomach Qi is not fully ruined; if food is undigested, resolve stagnation; if rebellious Qi is unregulated, resolve depression. For chronic cases or constitutionally weak individuals, use only warming tonification. Do not mix treating root and branch, nor recklessly use harsh purgatives, digestive aids, or phlegm-resolving agents, which would severely damage Stomach Qi and lead to death. (*Jing Yue Quan Shu*)
Deficiency in the Upper Jiao with mild Cold and nausea/vomiting: Ginger Decoction is best; Tangerine Peel Decoction is also acceptable. Deficiency in the Middle Jiao with food rejection: Wu Jun Zi Jian (Li Zhong Tang plus Poria) or Li Zhong Tang. Deficiency in the Lower Jiao with morning-eating-evening-vomiting or delayed rejection: The fault lies in the Lower Jiao. Unless Ming Men Fire is supplemented to support the Mother of Spleen Earth, fire cannot transform, and earth cannot generate. Like a pot without fuel, it cannot cook food. Use Liu Wei Hui Yang Yin or Ren Shen Fu Zi Li Yin Jian (Prepared Rehmannia Root, Angelica Sinensis Root, Honey-fried Licorice Root, Dried Ginger) or You Gui Yin (Shen Qi Wan minus Alisma, Poria, Oyster Shell, plus Goji Berry, Licorice Root, Eucommia Bark). These are proven effective methods; do not neglect them. (*Jing Yue Quan Shu*)
Fan Wei (Recurrent Vomiting) stems from declining True Fire, Cold Stomach, and Weak Spleen, unable to digest grains. Morning-eating-evening-vomiting or evening-eating-morning-vomiting, or vomiting after 1-2 hours, or accumulation over a day/night with unbearable abdominal distension before vomiting. Although attributed to Spleen-Stomach Deficiency Cold, there must be internal stagnation. *Qian Jin Fang* treats early Fan Wei using Fu Ling Ze Xie Tang from *Jin Gui Yao Lue*, removing Atractylodis Macrocephalae Rhizoma (Bai Zhu), substituting with Dried Ginger (Gan Jiang), adding Ginseng Radix (Ren Shen), Citri Reticulatae Pericarpium (Chen Pi), Rheum Palmatum Radix et Rhizoma (Da Huang), and Bambusae Caulis Recens (Qing Zhu Ru). After bowel movement, remove Da Huang. This is the main formula for Stomach Deficiency Fan Wei with immediate regurgitation. If vomitus is sour, foul, and undigested, indicating food reached the lower Stomach and returned, use Li Zhong Tang as primary, adding Cardamomi Fructus (Ding Xiang), Aconiti Lateralis Radix Preparata (Fu Zi), and Coptidis Rhizoma (Huang Lian) for severe cases. If cold saliva follows food and is immediately rejected, or heart/abdominal pain occurs, use Huo Xiang An Wei San or Liu Jun Zi Tang plus Cardamomi Fructus (Ding Xiang) and Agastegher Herba (Huo Xiang). For throat obstruction and chest fullness, temporarily use Agastegher Herba (Xiang Ru), Amomi Fructus Rotundus (Sha Ren), Aurantii Fructus (Zhi Ke), and Immature Bitter Orange (Zhi Shi) to open blockages. However, excessive Qi-moving drugs impair Middle Qi; use Yi Gong San plus Agastegher Herba (Xiang Ru) and Amomi Fructus Rotundus (Sha Ren) to boost Qi for natural transformation. For Fan Wei with rebellious Qi and immediate vomiting due to Heat, *Qian Jin Fang* uses Phragmitis Rhizoma (Lu Gen) and Imperatae Rhizoma (Mao Gen) decoction; if ineffective, add Bambusae Caulis Recens (Zhu Ru) and Zingiberis Rhizoma Recens (Sheng Jiang). For Fan Wei with epigastric discomfort, intermittent symptoms, mental restlessness, and white spots on the face, treat as Parasite Accumulation. (*Yi Tong*)
For mild Fan Wei where food is not fully expelled, use warming herbs like Costus Root (Mu Xiang), Cinnamon Twig (Gui Xin), and Fresh Ginger (Sheng Jiang) to warm the Spleen, plus Pinelliae Rhizoma (Ban Xia), Coptidis Rhizoma (Huang Lian), Ginseng Radix (Ren Shen), and Poria (Fu Ling). For severe Fan Wei where all food is expelled, indicating extreme Stomach Cold, use hot herbs like Roasted Prepared Aconite Root (Wei Fu Zi), Cardamomi Fructus (Ding Xiang), and Dried Ginger (Gan Jiang), plus Ginger-fried Coptidis Rhizoma (Huang Lian), Ginseng Radix (Ren Shen), Poria (Fu Ling), Perillae Fructus (Su Zi), Aquilariae Lignum Resinatum (Chen Xiang), and White Cardamom Seed (Bai Dou Kou). (*Yi Jing*)
Fan Wei belongs to Stomach Qi Deficiency. Avoid Qi-breaking and ascending herbs. Bitter-cold, sweet, and hot-dry herbs are contraindicated. Instead, use Qi-tonifying, Qi-descending, Stomach-harmonizing, Heat-clearing, and Astringent herbs to subdue the Liver. (*Ben Cao Jing Su Shu*)
For Fan Wei, use Longgu (Fulong Gan) water to decoct herbs to tonify Earth, Rice Juice (Nuomi Zhi) to moisten the Spleen, Ochre (Daishi Zhi) to suppress rebellion, and Lead (Wu Qian) to restrain the Liver. (*Hui Bu*)
**Fire Decline Syndrome** (Refer to Jing Yue's previous discussion): Fan Wei due to Fire Decline, failing to generate Earth, with a deep and slow pulse. Use Ba Wei Wan, removing Prepared Rehmannia Root (Shu Di Huang), adding Aquilariae Lignum Resinatum (Chen Xiang) and Amomi Fructus Rotundus (Sha Ren). (*Sha Zhao*) (*Yi Tong* notes Ba Wei Wan plus Cardamomi Fructus (Ding Xiang) and Aquilariae Lignum Resinatum (Chen Xiang), intermittently administering Hei Xi Dan.)
Shi Wan treated the son of Tang Bokan, nearly thirty years old, suffering from vomiting for a year. About half a day after each meal, he vomited the original food, completely undigested. Bowel movements occurred every two to three days, not dry or hard. Thirsty but not desiring to drink. Urine varied between white and yellow. Repeated treatments with Liu Jun Zi Tang, Fu Zi Li Zhong Tang, and Liu Wei Wan were ineffective. He was critically ill daily. I was consulted later. His Guan and Chi pulses on both sides were wiry, fine, and deep; his Cun pulses were choppy and large. This indicated severe deficiency of Kidney True Yang, failing to warm and nourish Spleen Earth. I prescribed Cui Shi's Ba Wei Wan. Others argued that since he had already taken Fu Zi and Liu Wei Wan, Ba Wei Wan might not work. I replied: Incorrect. This case is fundamentally Kidney Deficiency. Using Ginger, Aconite, and Atractylodes previously damaged Kidney Water and consumed True Yin. Although Liu Wei Wan tonifies the Kidney, its Yin-nourishing properties are stagnant; without Yang, Yin cannot be generated. One must tonify Fire within Water. He recovered before finishing one course. (*Yi Tong*)
**Constipation**
Fan Wei cases often involve constipation. The upper expulsion is indeed due to lower blockage; however, the lower blockage is also due to the failure of upper Qi transformation. Spleen-Stomach Qi Deficiency leads to failed regulation and inability to generate Blood. Blood dries up below, causing blockage. This is a syndrome of True Yin Exhaustion. Treatment must gradually replenish Qi and Blood and moisten organs to address the root. Merely planning for the present and pushing/purging will temporarily relieve but further deplete True Yin. (*Jing Yue Quan Shu*)
Yang Deficiency failing to control and transport, with vomiting/reversal and constipation: Using Ginseng Radix (Ren Shen), Rheum Palmatum Radix et Rhizoma (Da Huang), and Aconiti Lateralis Radix Preparata (Fu Zi) to attack may be fatal if True Qi is exhausted. (*Yi Tong*)
**Terminal Syndromes**
Fan Wei with massive vomiting of foam often leads to death; I witnessed over ten such cases. (*Chi Shui Xuan Zhu*)
Fan Wei with massive vomiting of white foam like egg whites indicates Lung and Stomach exhaustion. Stool like sheep dung indicates Large Intestine Blood exhaustion. Even with massive Qi and Blood tonification, death is inevitable. (*Yi Tong*)
**Warm-Middle Formulas**
*Wan Quan Fang* treats Spleen/Stomach food rejection, water/grain indigestion, named Fan Wei, Ban Xia Yin Zi Formula.
Prepared Pinelliae Rhizoma (Ban Xia) (8 fen), Processed Magnolia Bark (Niu Pi) (8 fen), Ginseng Radix (Ren Shen) (8 fen), Atractylodis Macrocephalae Rhizoma (Bai Zhu) (8 fen), Fresh Ginger (Sheng Jiang) (8 fen), Jujube (Zao) (8 fen), Coix Seed (Jing Mi) (2 he), Tangerine Peel (Ju Pi) (4 fen).
Finely cut the eight ingredients. Decoct in 2 sheng of water to obtain 1 sheng. Strain and divide into four warm doses. Take two doses on an empty stomach. (*Wai Tai Mi Yao*)
Ye Shi's Fan Wei Tang treats Fan Wei vomiting, chest/diaphragm discomfort, vomiting sour/foul food after overnight retention (Dr. Shi's Formula). Remove Ban Xia and Jing Mi from the base formula, add Poria (Fu Ling) and Evodiae Fructus (Wu Zhu Yu).
Li Jiang's *Bingbu Shouji Fang* treats Fan Wei, unpredictable vomiting, immediate vomiting of porridge/drinks, weakness, impending death. Use Shangdang Ginseng Radix (Ren Shen) 2 liang, cracked. Decoct in 1 sheng of water to obtain 4 he. Drink hot at once, twice daily. Also feed porridge cooked with Ginseng juice. Li Zhifang's Secretary Xu Langzhong suffered Fan Wei in Hannan for over two months, unresponsive to various formulas. Given this formula, he stabilized immediately and recovered, traveling to the capital ten days later. Li Jiang debated this medicine with famous physicians, finding few peers. (*Ben Cao Tu Jing*)
Treat Fan Wei with sour vomiting, Ren Shen Zhou Formula.
Ginseng Radix (Ren Shen) (half liang powder), Fresh Ginger (Sheng Jiang) (half sheng juice).
Decoct in 2 sheng of water to obtain 1 sheng. Add Coix Seed (Su Mi) 1 he. Cook into thin porridge. Eat when hungry. (*Sheng Ji Zong Lu*)
*Doumen Fang* treats Fan Wei. Use one large Fu Zi. Place on brick, apply fire around it gradually, quench in Fresh Ginger (Sheng Jiang) juice. Repeat until half a bowl of ginger juice is absorbed. Grind to powder. Take 1 qian with Coix Seed (Su Mi) drink. Cure within three doses. (*Ben Cao Gang Mu*) (*Ben Shi Fang* names it Fu Zi San.)
Treat stubborn Cold Fan Wei with no food intake. Fu Zi 3 fen, Fresh Ginger (Sheng Jiang) 1 sheng, Water 2 he. Cut Fu Zi into bean-sized pieces. Decoct in ginger juice until liquid is gone. Add Honey 1 he. Pound 1000 times. Pill like wutong seeds. Take 20 pills with Ginger Tea, increasing to 30. (*Tai Ping Sheng Hui Fang*)
Huang Fu Wan treats Fan Wei vomiting.
Prepared Aconiti Lateralis Radix (Fu Zi) (remove skin, umbilicus, tip).
Grind to powder, make pills with paste, size of wutong seeds. Coat with Rheum Palmatum Radix et Rhizoma (Da Huang). Take 10 pills with warm water. (*Wei Sheng Jia Bao Fang*)
Fu Zi Wu Ling San treats Fan Wei vomiting.
One large Fu Zi, hollowed out, filled with Wu Ling San, roasted熟.
Grind to fine powder. Take with Ginger Tea. He Yuanshou's Formula. (*Zhu Shi Ji Yan Fang*)
You (disciple of Ye Tianshi), pulse slow, right Guan wiry. Hungry but repulsed by food, immediate vomiting after eating, limb edema, loose stools, scanty urine, no thirst. This is Stomach Yang decline, opening/closing mechanism abolished. Elderly Yeger Fan Wei is a major illness.
Ginseng Radix (Ren Shen), Poria (Fu Ling), Light Aconiti Lateralis Radix (Dan Fu Zi), Light Dried Ginger (Dan Gan Jiang), Fried Coix Seed (Chao Jing Mi), Ginger Juice (Jiang Zhi). (*Lin Zheng Zhi Nan Yi An*)
Zhu Yu Wan, transmitted by Sun Sheng: Chronic Diaphragm Qi Fan Wei, food vomited at night, undigested. Phlegm-saliva above diaphragm, occasional hematemesis, sour water in chest, constant clear water vomiting, gradual emaciation, abdominal pain, cold/slipping sensations, or constipation. Symptoms endless. Six years duration, vomiting 5-7 times daily, hundred formulas failed. Met this method, took for two months, all diseases cured.
Evodiae Fructus (Wu Zhu Yu) (3 fen, heated on tile to release oil), Piper Longum Fruit (Hu Jiao), Ginseng Radix (Ren Shen), Angelica Sinensis Radix (Dang Gui) (each 5 qian), Glycyrrhizae Radix et Rhizoma (Gan Cao) (half liang, half raw, half wrapped in paper 5-7 layers, soaked in vinegar, slow-roasted, dried, soaked again, repeat 7 times), Pinelliae Rhizoma (Ban Xia) (1 liang, pounded with 4 liang Fresh Ginger (Sheng Jiang) juice, boiled in clay pot with ginger juice and water until broken, retain 2 parts white core, grind to paste), Alum (Bai Fan) (half liang, fried dry retaining nature 1 fen).
Grind to powder, pill with Ban Xia paste. If too hard, add ginger juice. Size of wutong seeds. Take 7 pills, decoct 30 mulberry twigs and 30 willow twigs in silver vessel. Swallow with decoction. Three times daily. Avoid toxic foods. Only eat oily pork pancreas/spleen soft rice. Sun Sheng's autobiography. (*Su Shen Liang Fang*)
Treat Fan Wei. Cardamomi Fructus (Ding Xiang) 1 liang powder. Refine plum salt, take flesh. Mix with Ding Xiang powder to make paste. Hold in mouth to dissolve. Cure. (*Xiu Zhen Fang*)
**Clear-Middle Formulas**
Treat Fan Wei, immediate vomiting, rebellious Qi.
Phragmitis Rhizoma (Lu Gen), Imperatae Rhizoma (Mao Gen) (each 2 liang, finely cut).
Decoct in 4 sheng water to obtain 2 sheng. Drink at once. Good if bowel movement occurs. (*Qian Jin Fang*)
Bao (60 years old), chest/epigastrium fullness, belching, vomiting sticky or yellow-green fluid every 3-4 days. This is Fan Wei. At sixty, it is a serious illness.
Coptidis Rhizoma (Chuan Lian), Pinelliae Rhizoma (Ban Xia), Immature Bitter Orange (Zhi Shi), Curcuma Aromatica Rhizome (Yu Jin), Bambusae Caulis Recens (Zhu Ru), Ginger Juice (Jiang Zhi). (*Lin Zheng Zhi Nan Yi An*)
**Drain-Interior Formulas**
Hua Tuo treats Fan Wei. Morning-eating-evening-vomiting, epigastrium hard like a cup, alternating cold/heat, vomiting/reversal, inability to eat. Caused by Cold at Guan position, progressing to Lung萎 (Fei Wei). Formula:
Pearl (Zhen Zhu), Realgar (Xiong Huang), Cinnabar (Dan Sha) (each 3 liang), Mirabilite (Piao Xiao) (5 liang), Dried Ginger (Gan Jiang) (10 lei).
Grind five ingredients, make honey pills. Take before meals, 3 pills size of wutong seeds. If slight discomfort, drink water to resolve. No restrictions. Extremely effective. Alternative: Cinnamon Twig (Gui Xin) 1 liang. (*Qian Jin Fang*)
Da Huang Tang treats Cold Saliva Fan Wei. Prodrome: cold saliva flow, then food vomiting. This is Labor Syndrome. Delayed treatment leads to death soon.
Rheum Palmatum Radix et Rhizoma (Da Huang) (1 liang, half tea cup Fresh Ginger (Sheng Jiang) juice. Roast Da Huang dry, quench in ginger juice, repeat until exhausted. Cut and roast to powder).
Take 2 qian per dose. With a pinch of aged rice, 2 scallion whites, 1 da cup water. Decoct to 70%. Eat scallions first, then medicine. Root removed in 10 days. (*Ben Shi Fu Ji*)
Ban Xia Sheng Jiang Da Huang Tang treats morning-eating-evening-vomiting. Lower Jiao disease.
Pinelliae Rhizoma (Ban Xia), Rheum Palmatum Radix et Rhizoma (Da Huang) (each 2 liang), Fresh Ginger (Sheng Jiang) (1.5 liang).
Decoct in 5 sheng water to obtain 3 sheng. Divide into two warm doses. (*Yi Du Bi Du*)
Treat chest/diaphragm discomfort, alcohol/food injury, gradual Fan Wei, spontaneous dry heaving.
Cardamomi Fructus (Ding Xiang), Crotonis Fructus (Ba Dou), Mume Fructus (Wu Mei) (each 20 whole good ones).
Do not remove oil/seeds/kernels from the three. Pound 3,000-5,000 times into paste. Add 1 liang morning rice, pound another 2,000 times until very fine. Roll into pills size of circles. Dry slowly over low fire. Place on clean paper, set on ground to remove fire toxicity. Take 5-7 pills with tea, wine, or warm water. If vomiting sour water, heart/abdominal pain, bloating, take with Ju Pi Gan Cao Tang. (*Ben Shi Fu Ji*) (Originally *Ji Feng Fang* Wu Bai Luo Han Wan, remove Hu Jiao and Suo Sha. *San Yin Fang* Wu Bai Wan removes Hu Jiao from Luo Han Wan.)
Fan Wei Ping Wei San: Ping Wei San plus extra Amomi Fructus Rotundus (Sha Ren). Grind with Ginger to powder. Point with boiling water. Should vomit a black stone-like evil mass. Proven effective. (*Bi Yong Quan Shu*)
**Astringent/Sedative Formulas**
Treat Fan Wei vomiting, prevent recurrence, Chi Shi Zhi Wan Formula.
Red Halloysite (Chi Shi Zhi) (1 jin, good quality, fine, no sand)