【呕吐酸水之症】食入即吐，其味酸馊，或两肋刺痛，或火冲于面，此内伤呕吐之症也
【呕吐酸水之因】恼怒忧郁，伤肝胆之气，木能生火，乘胃克脾，则饮食不能消化，停
积于胃，遂成酸水浸淫之患矣。
【呕吐酸水之脉】左关弦数，肝火为患。右关弦数，胃中有火。左关弦滑，胆涎沃胃。
右关弦滑，痰饮食滞。脉若濡缓，寒湿气滞。
【呕吐酸水之治】肝火乘胃者，柴葛平胃散。胃中有火，栀连平胃散、栀连二陈汤。痰
饮食滞，平胃二陈汤。若酸水浸牙折齿，草蔻丸、大顺饮，不用苦寒之药。
柴葛平胃散 家秘治胆火入胃，呕苦吐酸。
苍术 浓朴 陈皮 甘草 柴胡 干葛 黄连 山栀
八味等分为末。
栀连平胃散 见内伤呃。
栀连二陈汤 见外感呃。
平胃二陈汤 即苍朴二陈汤，见湿痰门。
草蔻丸 见吐酸。
大顺饮 见前吐酸。
胃有痰涎，则发吐呕，以上分别外感内伤，各立诸方治法，详且尽矣。然总其大纲，则
家秘正气散，实为治呕正法。
家秘正气散
藿香 浓朴 广皮 半夏 干葛 竹茹 麦芽 白茯苓
水煎。胃火旺，加川连，冲芦根汁。胃寒，加生姜。胃燥，加天花粉，冲竹沥、萝卜汁
秦子曰∶肿症在表者多，胀症在表者少。肿症肿于遍身，现于皮肤，在外不在内。胀症
胀于心腹，即《内经》所谓心腹满，旦食不能暮食也。是以其症当分，其治当别。然经络同者，
症形治法，亦无不同。例如外感之肿，与外感之胀，二者固自各异，至内伤五脏之肿，与内
伤五脏之胀，则形症治法，大抵相似。今分列前后，以备互相参考。
[Symptoms of Vomiting Acidic Water] Food is vomited immediately after ingestion, with a sour and rancid taste, or accompanied by stabbing pain in the hypochondrium, or a sensation of fire rushing to the face. This is a symptom of vomiting caused by internal injury (internal damage).
[Etiology of Vomiting Acidic Water] Anger and melancholy injure the Qi of the Liver and Gallbladder. Wood generates Fire, which overacts on the Stomach and suppresses the Spleen, leading to the inability to digest food. The food stagnates and accumulates in the Stomach, resulting in the affliction of acidic water overflowing.
[Pulse Diagnosis of Vomiting Acidic Water] A wiry and rapid pulse at the left Guan position indicates Liver Fire pathology. A wiry and rapid pulse at the right Guan position indicates Fire in the Stomach. A wiry and slippery pulse at the left Guan position indicates Gallbladder phlegm-fluid flooding into the Stomach. A wiry and slippery pulse at the right Guan position indicates Phlegm-dampness and food stagnation. If the pulse is soggy and slow, it indicates Cold-dampness and Qi stagnation.
[Treatment of Vomiting Acidic Water] For Liver Fire invading the Stomach, use Chai Ge Ping Wei San (Bupleurum and Pueraria Powder to Calm the Stomach). For Fire in the Stomach, use Zhi Lian Ping Wei San (Gardenia and Coptis Powder to Calm the Stomach) or Zhi Lian Er Chen Tang (Gardenia and Coptis Two-Chen Decoction). For Phlegm-dampness and food stagnation, use Ping Wei Er Chen Tang (Calm the Stomach and Two-Chen Decoction). If acidic water corrodes the teeth causing them to break, use Cao Kou Wan (Grass Cardamom Pill) or Da Shun Yin (Great Harmony Drink), and do not use bitter-cold herbs.
Chai Ge Ping Wei San: Family secret formula for treating Gallbladder Fire entering the Stomach, vomiting bitter fluid, and regurgitating acidic water.
Herbs: Cang Zhu (Atractylodis Rhizoma), Nong Po (Magnoliae Officinalis Cortex), Chen Pi (Citri Reticulatae Pericarpium), Gan Cao (Glycyrrhizae Radix et Rhizoma), Chai Hu (Bupleuri Radix), Gan Ge (Puerariae Lobatae Radix), Huang Lian (Coptidis Rhizoma), Shan Zhi (Gardeniae Fructus).
Grind the above eight ingredients into equal parts and make into powder.
Zhi Lian Ping Wei San: See "Internal Injury Hiccups".
Zhi Lian Er Chen Tang: See "External Contraction Hiccups".
Ping Wei Er Chen Tang: Also known as Cang Po Er Chen Tang, see "Phlegm-Dampness Section".
Cao Kou Wan: See "Regurgitation of Acidic Fluid".
Da Shun Yin: See previous section on "Regurgitation of Acidic Fluid".
When there is phlegm-fluid in the Stomach, vomiting occurs. The above sections distinguish between external contraction and internal injury, establishing various formulas and treatments in detail. However, summarizing the general principle, the Family Secret Zheng Qi San (Upright Qi Powder) is truly the orthodox method for treating vomiting.
Family Secret Zheng Qi San
Herbs: Huo Xiang (Agastaches Herba), Nong Po (Magnoliae Officinalis Cortex), Guang Pi (Citri Reticulatae Pericarpium), Ban Xia (Pinelliae Rhizoma), Gan Ge (Puerariae Lobatae Radix), Zhu Ru (Bambusae Caulis in Taenia), Mai Ya (Hordei Fructus Germinatus), Bai Fu Ling (Poria).
Decoct in water. If Stomach Fire is vigorous, add Chuan Lian (Coptidis Rhizoma) and mix with Lu Gen juice (Reed Rhizome Juice). If the Stomach is cold, add Sheng Jiang (Zingiberis Rhizoma Recens). If the Stomach is dry, add Tian Hua Fen (Trichosanthis Radix) and mix with Zhu Li (Bamboo Sap) and Luo Bo juice (Radish Juice).
Qin Zi said: Swelling syndromes are mostly exterior, while distension syndromes are rarely exterior. Swelling manifests all over the body and appears on the skin; it is external, not internal. Distension manifests in the heart and abdomen, which corresponds to what the *Nei Jing* (Inner Canon) calls "fullness in the heart and abdomen, where one cannot eat dinner if they ate breakfast." Therefore, these syndromes should be differentiated, and their treatments distinguished. However, when the meridians are the same, the syndrome presentation and treatment methods are also similar. For example, swelling due to external contraction and distension due to external contraction are naturally different. As for swelling due to internal injury of the Five Zang organs and distension due to internal injury of the Five Zang organs, the syndrome presentation and treatment principles are largely similar. They are listed separately here for mutual reference.