【呕吐苦水之症】表无外邪，但呕苦水，或白睛黄绿，或胁肋胀痛，长太息，此胆胃两
家内伤呕苦之症。
【呕吐苦水之因】恼怒伤于肝胆，怫逆升生之令，贼乘中土，则胃家呕苦水；或饮食填
满太仓，少阳升发之气不舒，则胃家亦呕苦水。
【呕吐苦水之脉】多见弦数。左关弦数，肝胆之热；右关弦数，肠胃有结；弦而带滑，痰火合杂。
【呕吐苦水之治】虚者，人参小柴胡汤。实者，家秘清胆汤。挟食者，干葛平胃散。夹
痰者，合二陈汤。热甚者，加山栀、川连、竹茹。
人参小柴胡汤
人参 柴胡 半夏 黄芩 陈皮 甘草
家秘清胆汤 治胆邪乘胃，呕苦吐酸。
柴胡 黄芩 半夏 陈皮 竹茹 甘草 浓朴
加生姜。
家秘以干葛清胃汤，治阳明经呕吐；以柴胡清胆汤，治少阳经呕吐。今立此方，兼治胆
干葛平胃散 即平胃散加干葛。
有痰合二陈汤。
【呕吐酸水之症】身冒外寒，即发热呕吐酸水，甚则酸水浸其心，不任苦楚，吐出酸水
，令上下牙关酸涩不能合，此外邪吐酸水症也。
【呕吐酸水之因】平时郁结，水饮不化，外被风寒所束，上升之气，郁而成积，积之既
久，湿能生热，湿甚木荣，肝气太盛，遂成木火之化，而吞酸吐酸之症作矣。
【呕吐酸水之脉】脉多带弦，弦紧主寒，弦数主热，沉弦主里，弦涩郁结。
【呕吐酸水之治】脉弦迟者，以大辛热之味治之，草蔻丸、姜桂大顺饮、连理汤，或用
风药以
宣扬之。此症本热标寒，不宜骤进苦寒，以酸水浸牙折齿，故用辛热辛散，若但呕而微有酸
味，脉又见弦数者，只宜防葛平胃散、家秘神术汤。热甚者，加栀、连。
草蔻 益智仁 青皮 神曲 麦芽 陈皮 苍术 浓朴 甘草
姜桂大顺饮
干姜 肉桂 杏仁 甘草
连理汤
人参 白术 干姜 炙甘草 黄连
防葛平胃散 家秘治胃风欲吐。
防风 葛根 苍术 浓朴 广皮 甘草
家秘神术汤 家秘治风湿呕吐。
苍术 防风 石膏 干葛 浓朴 广皮
[Symptoms of Vomiting Bitter Fluid] There is no external pathogenic factor on the body surface, but only vomiting of bitter fluid occurs. The whites of the eyes may appear yellowish-green, or there may be distending pain in the hypochondrium accompanied by frequent long sighs. This is a syndrome of vomiting bitter fluid caused by internal injury to the Gallbladder and Stomach.
[Etiology of Vomiting Bitter Fluid] Anger injures the Liver and Gallbladder, causing the ascending and dispersing function of Wood Qi to become rebellious. The Liver (Wood) overacts upon the Spleen and Stomach (Earth/Middle Jiao), leading the Stomach to vomit bitter fluid; or excessive food intake fills the Tai Cang (Stomach), causing the ascending and dispersing Qi of the Shaoyang (Gallbladder) to fail to flow freely, which also leads the Stomach to vomit bitter fluid.
[Pulse of Vomiting Bitter Fluid] The pulse is mostly Xian-Shu (Wiry-Rapid). A Xian-Shu pulse at the Left Guan position indicates Heat in the Liver and Gallbladder; a Xian-Shu pulse at the Right Guan position indicates accumulation in the Intestines and Stomach; a pulse that is Xian and Slippery indicates a mixture of Phlegm and Fire.
[Treatment of Vomiting Bitter Fluid] For deficiency patterns, use Renshen Xiao Chai Hu Tang (Ginseng Minor Bupleurum Decoction). For excess patterns, use Ji Mi Qing Dan Tang (Secret Family Clear Gallbladder Decoction). If complicated by food stagnation, use Gan Ge Ping Wei San (Pueraria Pingwei Powder). If complicated by Phlegm, combine with Er Chen Tang (Two-Aged Decoction). If Heat is severe, add Zhi Zi (Gardenia Fruit), Chuan Lian (Szechwan Chinaberry Seed, note: text says Chuan Lian usually implies Huang Lian in some contexts or specific local usage, but strictly Chuan Lian is Szechwan Chinaberry; however, standard clearing heat often uses Huang Lian. Given "Chuan Lian" is written, I will translate as Szechwan Chinaberry Seed, though contextually it might be a typo for Huang Lian or specific herb. Wait, looking at common formulas, Chuan Lian Zi is used for liver fire. But later it mentions "Zhi, Lian". Let's stick to literal: Chuan Lian). *Correction*: In many TCM texts, "Chuan Lian" refers to *Meliae Toosendan Fructus* (Chuan Lian Zi). However, in the context of "Heat severe", Huang Lian is more common. But I must translate what is written. "Chuan Lian" = *Meliae Toosendan Fructus*. "Zhu Ru" = Bamboo Shavings.
Renshen Xiao Chai Hu Tang
Renshen (Ginseng Root), Chai Hu (Bupleurum Root), Ban Xia (Pinellia Rhizome), Huang Qin (Scutellaria Root), Chen Pi (Citrus Reticulata Peel), Gan Cao (Licorice Root).
Ji Mi Qing Dan Tang Treats Gallbladder Pathogen invading the Stomach, vomiting bitter fluid and acid regurgitation.
Chai Hu (Bupleurum Root), Huang Qin (Scutellaria Root), Ban Xia (Pinellia Rhizome), Chen Pi (Citrus Reticulata Peel), Zhu Ru (Bamboo Shavings), Gan Cao (Licorice Root), Hou Po (Magnolia Bark).
Add Sheng Jiang (Fresh Ginger).
The Secret Family uses Gan Ge Qing Wei Tang (Pueraria Clear Stomach Decoction) to treat Yangming Channel vomiting; and Chai Hu Qing Dan Tang (Bupleurum Clear Gallbladder Decoction) to treat Shaoyang Channel vomiting. Now this formula is established to jointly treat Gallbladder... [Text fragment] ... Gan Ge Ping Wei San is simply Ping Wei San plus Gan Ge (Pueraria Root).
If there is Phlegm, combine with Er Chen Tang.
[Symptoms of Vomiting Acid Fluid] When the body is exposed to external Cold, fever and vomiting of acid fluid occur immediately. Severe cases involve acid fluid soaking the Heart region, causing unbearable suffering. After vomiting acid fluid, the upper and lower teeth feel sour and astringent, making it difficult to close the jaw. This is an external pathogen-induced syndrome of vomiting acid fluid.
[Etiology of Vomiting Acid Fluid] Chronic emotional depression causes water fluids to fail to transform. Externally bound by Wind-Cold, the ascending Qi becomes stagnant and forms accumulations. Over time, Dampness generates Heat. Excessive Dampness nourishes Wood (Liver), causing Liver Qi to become overly vigorous. This transforms into Wood-Fire pathology, resulting in symptoms of acid regurgitation and vomiting acid fluid.
[Pulse of Vomiting Acid Fluid] The pulse mostly presents a Xian (Wiry) quality. Xian-Jin (Wiry-Tight) indicates Cold; Xian-Shu (Wiry-Rapid) indicates Heat; Chen-Xian (Deep-Wiry) indicates Interior involvement; Xian-Se (Wiry-Choppy) indicates Qi stagnation.
[Treatment of Vomiting Acid Fluid] For a Xian-Chi (Wiry-Slow) pulse, treat with major Acrid-Hot substances, such as Cao Kou Wan (Cardamom Pill), Jiang Gui Da Shun Yin (Ginger and Cinnamon Great Smooth Drink), or Lian Li Tang (Coptis and Licorice Combined Decoction). Alternatively, use Wind-dispelling herbs to promote diffusion. This syndrome is fundamentally Heat with superficial Cold; therefore, Bitter-Cold herbs should not be administered abruptly, as acid fluid can erode teeth. Thus, Acrid-Hot and Acrid-Dispersing methods are used. If there is only vomiting with a slight sour taste and the pulse is Xian-Shu (Wiry-Rapid), only Fang Ge Ping Wei San (Saposhnikovia-Pueraria Pingwei Powder) and Ji Mi Shen Shu Tang (Secret Family Divine Atractylodes Decoction) are suitable. If Heat is severe, add Zhi Zi (Gardenia Fruit) and Lian (Coptis Rhizome).
Cao Kou Wan Composition: Cao Kou (Black Cardamom), Yi Zhi Ren (Alpinia Oxyphylla Fruit), Qing Pi (Amarant Citrus Peel), Shen Qu (Medicated Leaven), Mai Ya (Barley Sprout), Chen Pi (Citrus Reticulata Peel), Cang Zhu (Atractylodes Lancea Rhizome), Hou Po (Magnolia Bark), Gan Cao (Licorice Root).
Jiang Gui Da Shun Yin
Gan Jiang (Dried Ginger), Rou Gui (Cinnamon Bark), Xing Ren (Apricot Seed), Gan Cao (Licorice Root).
Lian Li Tang
Renshen (Ginseng Root), Bai Zhu (Atractylodes Macrocephala Rhizome), Gan Jiang (Dried Ginger), Zhi Gan Cao (Honey-fried Licorice Root), Huang Lian (Coptis Rhizome).
Fang Ge Ping Wei San The Secret Family treats Stomach Wind desiring to vomit.
Fang Feng (Saposhnikovia Root), Ge Gen (Pueraria Root), Cang Zhu (Atractylodes Lancea Rhizome), Hou Po (Magnolia Bark), Guang Pi (Citrus Peel), Gan Cao (Licorice Root).
Ji Mi Shen Shu Tang The Secret Family treats Wind-Dampness vomiting.
Cang Zhu (Atractylodes Lancea Rhizome), Fang Feng (Saposhnikovia Root), Shi Gao (Gypsum Fibrosum), Gan Ge (Pueraria Root), Hou Po (Magnolia Bark), Guang Pi (Citrus Peel).