Library

The causes of vomiting are numerous and difficult to list comprehensively. They include Cold Vomiting, Heat Vomiting, Accumulation Vomiting, Vomiting due to Wind-Cold with Cough, and Milk Injury Vomiting. While the act of vomiting is similar, the accompanying symptoms differ. These are described below.

Cold Vomiting: Undigested milk curds appear in vomit; there is frequent vomiting but small volume expelled. The pulse is deep and faint (Chen Wei). The complexion is pale, eyes are sluggish, breath is weak, spirit is lethargic, and sweat appears on the forehead. This is caused by Wind-Cold invading the Stomach, consumption of raw/cold foods, or damage from retained old milk, leading to a deficiency of Stomach Qi that fails to retain food. Treatment should warm the Stomach, dispel Wind, and eliminate cold stagnation. Use Danggui San (Angelica Powder), water-boiled Ginger (Shui Wei Jiang), and Chenpi (Tangerine Peel) decocted for administration. Alternatively, intermittently administer Chonghe Yin (Harmonizing Drink), Lizhong Tang (Regulate the Middle Decoction), Jiangju Tang (Ginger and Citrus Decoction), or Dingtu Yin (Vomiting-Stopping Drink). If these remedies fail, use Shenxiang Yin (Ginseng and Aquilaria Drink).

Heat Vomiting: The face is red, lips are crimson. There are few episodes of vomiting but large volumes expelled. The milk has digested and turned yellow. The whole body feels very hot. This may be due to Summerheat-Qi lingering in the Stomach or consumption of hot-natured foods. The child’s spirit is not dull but rather irritable and restless. This is Heat Vomiting. Treatment should resolve heat toxicity. Use Dashun Yin (Great Harmony Drink), administered with warm boiled water on an empty stomach. It can also be combined with Wuling San (Five-Ingredient Powder with Poria), Xiaochaihu Tang (Minor Bupleurum Decoction), taken slowly with Ginger Juice, or treated primarily with Xiangru San (Elsholtzia Powder). If hot medicines were mistakenly administered, first give Moudou Yin (Mung Bean Drink) to detoxify, followed by anti-emetic agents.

Accumulation Vomiting: Eyelids are puffy, facial complexion is slightly yellow. Feet are cold while the abdomen is hot. Symptoms are lighter during the day and heavier at night. In older children, the pulse is deep and slow (Chen Huan), indicating cold stagnation in the Spleen, resulting in vomiting of yellow, sour fluid or clear phlegm. If the pulse is excess and slippery (Shi Hua), it indicates injury from food accumulation, with vomiting of sour/foul odor or undigested food. In younger children, it manifests as undigested milk. Initially, use Wuling San (Five-Ingredient Powder with Poria) and Ginger Juice, mixed with warm water to harmonize. Subsequently, treat primarily with Wuxi Wan (Black Rhinoceros Horn Pill). For the youngest infants, administer Sanleng San (Curcuma Longa Powder) or Huapi Wan (Mass-Dissolving Pill).

Vomiting due to Wind-Cold with Cough: Heat may generate Wind, or Wind may generate Phlegm. Phlegm knots in the chest, causing Lung Qi to flow irregularly. Continuous coughing leads to vomiting mixed with phlegm; this is called Cough-Vomiting. When Phlegm is obstructive and acute, it is an Excess pattern. Treatment should dispel Wind and transform Phlegm. First administer Qingfei Yin (Lung-Clearing Drink), followed by Xiaochaihu Tang (Minor Bupleurum Decoction). If chronic cough leads to Lung Deficiency, where Earth (Spleen) fails to generate Metal (Lung), the face becomes pale and lips dry. With dry cough and dry retching without phlegm, warming and tonification is superior. Use Fuling Nongpu Tang (Poria and Magnolia Bark Decoction), Xingxing San (Awakening Powder), or Ruyi Gao (As-Desired Ointment).

Milk Injury Vomiting: Vomiting occurs immediately after feeding or after a short pause. This is due to unregulated breastfeeding, weak Spleen Qi, and inability to transport and transform milk. It is like a small vessel overflowing when full. Treatment requires regulating milk intake and administering Sanleng San (Curcuma Longa Powder).

For all types of persistent vomiting, the general principle is to regulate breastfeeding and gradually medicate to restore stability. "Regulating" implies moderation: feed only three to five times a day. Avoid overfeeding during each session; vomiting will naturally decrease. Intermittent feeding of thin rice gruel can also harmonize the Stomach and stop vomiting. Many who do not understand this principle seek rapid results through medication, often stopping breastfeeding for two or three days. This leads to severe hunger and further Stomach deficiency, causing incessant crying and triggering other pathologies. Food is life for humans, and infants cannot survive without milk; thus, complete cessation is inadvisable. Milk is blood; blood belongs to Yin and is cold in nature. Excessive vomiting weakens the Stomach, hence the need for regulation. Physicians must understand this. Nursing mothers should also take herbs to harmonize Qi and Blood and regulate the Spleen and Stomach.