论曰。吐有三。气积寒也。皆从三焦论之。上焦在胃口。上通于天气。主纳而不出。中焦在中脘。上通天
气。下通地气。主腐熟水谷。下焦在脐下。下通地气。主出而不纳。是故上焦吐者。皆从于气。气者天之阳也。
其脉浮而洪。其证食已暴吐。渴欲饮水。大便燥结。气上冲而胸发痛。其治当降气和中。中焦吐者。皆从于积。
有阴有阳。食与气相假为积而痛。其脉浮而
弱。其证或先痛而后吐。或先吐而后痛。治法当以毒药去其积。槟榔木香行其气。下焦吐者。皆从于寒。地道
也。其脉沉而迟。其证朝食暮吐。暮食朝吐。小便清利。大便秘而不通。治法当以毒药。通其闭塞。温其寒气。
大便渐通。复以中焦药和之。不令大便秘结而自愈也。
治上焦气热上冲。食已暴吐。脉浮而洪。宜先和中。桔梗汤。
桔梗（一两半） 半夏曲（二两） 陈皮（一两去白） 枳实（一两麸炒） 白茯苓（一两去皮） 白术
（一两半） 浓朴（一两姜制炒香）
上 咀。每服一两。水一盏。煎至七分。取清温服。调木香散二钱。隔夜空腹食前服之。三服之后。气渐
下。吐渐止。然后去木香散。加芍药二两。黄 一两半。每料中扣算。加上件分两。根据前服之。病愈则已。如
大便燥结。食不尽下。以大承气汤去硝微下之。少利为度。再服前药补之。如大便复结。又根据前再微下之。
木香散
木香 槟榔（各等分）
上为细末。煎药调服。
治暴吐者。上焦气热所冲也。经曰。诸呕吐酸。暴注下迫。皆属于火。脉洪而浮者。荆黄汤主之。
荆芥穗（一两） 人参（五钱） 甘草（二钱半） 大黄（三钱）
上为粗末。都作一服。水二盏。煎至一盏。去滓调槟榔散二钱。空心服。
槟榔散
槟榔（二钱） 木香（一钱半） 轻粉（少许）
上为细末。用前药调服。如为丸亦可。用水浸蒸饼为丸。如小豆大。每服二十丸。食后服。
治上焦吐。头发痛有汗脉弦。青镇丸主之。
柴胡（二两去苗） 黄芩（七钱半） 甘草（半两） 半夏（汤洗半两） 青黛（二钱半） 人参（半两）
上为细末。姜汁浸蒸饼为丸。如桐子大。每服五十丸。生姜汤下食后服。
白术汤 治胃中虚损。及痰而吐者。
半夏曲（半两） 白术（一钱） 槟榔（二钱半） 木香（一钱） 甘草（一钱） 茯苓（二钱）
上六味。同为细末。每服二钱。煎生姜汤调下。食前。
吐而食不下。脉弦者。肝盛于脾。而吐乃由脾胃之虚。宜治风安脾之药。
金花丸
半夏（汤洗一两） 槟榔（二钱） 雄黄（一钱半）
上为细末。姜汁浸蒸饼为丸。如桐子大。小儿另丸。生姜汤下。从少至多。渐次服之。以吐止为度。羁绊
于脾。故饮食自下。
紫沉丸 治中焦吐食。由食积为寒气相假。故吐而痛。宜服之。
半夏曲（三钱） 乌梅（二钱去核） 代赭石（三钱） 杏仁（一钱去皮尖） 丁香（二钱） 缩砂仁（三钱）
沉香（一钱） 槟榔（二钱） 木香（一钱） 陈皮（五钱） 白豆蔻（半钱） 白术（一钱） 巴豆霜（半钱
另研）
上为细末。入巴豆霜令匀。醋糊为丸。如黍米大。每服五十丸。食后生姜汤下吐愈则止。小儿另丸。治
小儿食积吐食。亦大妙。
一法。治翻胃吐食。用橘皮一个。浸少时去白。裹生姜一块。面裹纸封。烧令熟去面。外生姜为三番。并
橘皮煎汤。下紫沉丸一百丸。一日二服。得大便通至不吐则止。此主治寒。积气皆可。
治呕吐腹中痛者。是有积也。胃强而干呕。有声无物。脾强而吐食。持实击强。是以腹中痛。当以木香白
术散和之。
木香白术散
木香（一钱） 白术（半两） 半夏曲（一两） 槟榔（二钱） 茯苓（半两） 甘草（四钱）
上为细末。浓煎芍药生姜汤。调下一二钱。有积而痛。手按之愈痛。无积者。按之不痛。
治下焦吐食。朝食暮吐。暮食朝吐。大便不通。宜附子丸。
附子炮（五钱） 巴豆霜（一钱） 砒（半钱研细）
上同研极细。熔黄蜡为丸。如桐子大。每服一二丸。冷水送下。利则为度。后更服紫沉丸。常服不令再闭。
浓朴丸 主反胃吐逆。饮食噎塞。气上冲心。腹中诸疾。加法在后。乌头减半更妙。
浓朴（二两半） 黄连（二两半） 紫菀（去苗土） 吴茱萸（汤洗七次） 菖蒲 柴胡（去苗） 桔梗
皂角（去皮弦子炙） 茯苓（去皮） 官桂（刮） 干姜（炮各二两） 人参（二两） 川乌头（炮裂去皮脐二
两半） 蜀椒（二两去目闭口者微炒出汗）
上为细末。入巴豆霜一两和匀。炼蜜和为丸。如桐子大。每服三丸。渐次加。至以利为度。生姜汤下食后
临卧服。此药治疗。与局方温白丸同。及治处暑以后秋冬间。脏腑下利大效。春夏再加黄连二两。秋冬再加浓
朴二两。
治风痫病。不能愈者。从浓朴丸。根据春秋加添外。又于每料中。加人参菖蒲茯苓各一两半。
上根据前法和剂服饵。治反胃。又大便不通者。是肠胜胃也。服局方中半硫丸。
硫黄（明净好者研令极
细用柳木槌子绞过） 半夏（汤洗七次焙干为末各等分） 一二百丸。如大便秘。用后药。
附子（半两） 巴豆（二枚） 砒（一豆许）
上为极细末。生姜糊为丸。如绿豆大。每服一丸。白汤下。
It is stated that there are three types of vomiting: those caused by Qi accumulation and those caused by cold. These can all be discussed in terms of the San Jiao (Triple Burner). The Upper Jiao is located above the stomach opening, connecting upward to Heaven Qi (natural clear Qi), and its main function is to receive and not expel. The Middle Jiao is located at the Zhongwan point, connecting upward to Heaven Qi and downward to Earth Qi (nutritive essence from food and water), and its main function is to rot and ripen food and drink. The Lower Jiao is located below the navel, connecting downward to Earth Qi, and its main function is to expel and not receive. Therefore, vomiting originating from the Upper Jiao is always due to Qi disorders. Qi belongs to the Yang of Heaven. Its pulse is floating and surging. Symptoms include violent vomiting immediately after eating, thirst with desire to drink water, dry and constipated stool, Qi rushing upward causing chest pain. Treatment should focus on descending Qi and harmonizing the middle. Vomiting originating from the Middle Jiao is always due to accumulation. There are Yin and Yang patterns; food and Qi interact to form accumulations causing pain. Its pulse is floating and weak. Symptoms may present as pain followed by vomiting, or vomiting followed by pain. Treatment methods should use toxic drugs to remove the accumulation, using Areca Seed (Binglang) and Costus Root (Muxiang) to move Qi. Vomiting originating from the Lower Jiao is always due to cold, which represents the Earthly path (Yin cold). Its pulse is deep and slow. Symptoms include vomiting food eaten in the morning in the evening, and food eaten in the evening in the morning, clear and profuse urination, and constipation with no bowel movement. Treatment should use drugs to unblock obstructions and warm away cold Qi. Once the stool gradually becomes loose, use medicines for the Middle Jiao to harmonize, preventing constipation again, and the disease will heal itself.
For treating Qi heat in the Upper Jiao rushing upward, causing violent vomiting after eating, with a floating and surging pulse, it is appropriate to first harmonize the middle. Use Jiegeng Tang (Platycodon Decoction).
Jie Geng (Platycodonis Radix, 1 liang 5 qian) Ban Xia Qu (Prepared Pinellia Fermented, 2 liang) Chen Pi (Aurantii Pericarpium, 1 liang, white part removed) Zhi Shi (Immature Bitter Orange Fruit, 1 liang, bran-fried) Bai Fu Ling (Poria, 1 liang, skin removed) Bai Zhu (Atractylodis Macrocephalae Rhizoma, 1 liang 5 qian) Hou Po (Magnoliae Officinalis Cortex, 1 liang, ginger-processed and fried until fragrant).
Crush the herbs. Take 1 liang per dose, add 1 zhan of water, decoct to 0.7 zhan, take the clear liquid warm. Mix with 2 qian of Muxiang San (Costus Powder). Take on an empty stomach overnight before meals. After three doses, Qi will gradually descend and vomiting will stop. Then remove Muxiang San, add 2 liang of Shaoyao (Peony Root) and 1 liang 5 qian of Huang Qin (Scutellariae Radix), calculate proportionally into the above formula, and administer as before. Stop when cured. If stool is dry and hard, and food does not pass down, use Dachengqi Tang (Major Order the Qi Decoction) without Mang Xiao (Mirabilite) to gently purge, stopping when slight laxation occurs. Then take the previous tonifying medicine. If stool becomes hard again, gently purge again according to the previous method.
Muxiang San (Costus Powder)
Mu Xiang (Costi Radix) Bing Lang (Arecae Semen) (equal parts).
Grind into fine powder, mix with decoction to take.
To treat sudden vomiting caused by Upper Jiao Qi heat rushing upward: The Classic states, "All vomiting and acid regurgitation, sudden diarrhea with tenesmus, belong to Fire." For a surging and floating pulse, use Jinghuang Tang (Schizonepeta and Rhubarb Decoction).
Jing Jie Sui (Schizonepetae Spica, 1 liang) Ren Shen (Ginseng Radix et Rhizoma, 5 qian) Gan Cao (Licorice Radix et Rhizoma, 2 qian 5 fen) Da Huang (Rhei Radix et Rhizoma, 3 qian).
Grind into coarse powder. Prepare as one dose. Add 2 zhan of water, decoct to 1 zhan, strain, mix with 2 qian of Binglang San (Areca Powder). Take on an empty stomach.
Binglang San (Areca Powder)
Bing Lang (Arecae Semen, 2 qian) Mu Xiang (Costi Radix, 1 qian 5 fen) Qing Fen (Calomelas, a little).
Grind into fine powder, mix with the previous decoction to take. Can also be made into pills: soak steamed wheat cake in water, make pills like small beans, take 20 pills after meals.
For treating Upper Jiao vomiting accompanied by headache, sweating, and a string-taut pulse, use Qingzhen Wan (Blue Calming Pill).
Chai Hu (Bupleuri Radix, 2 liang, radix removed) Huang Qin (Scutellariae Radix, 7 qian 5 fen) Gan Cao (Licorice Radix et Rhizoma, 0.5 liang) Ban Xia (Pinelliae Rhizoma, 0.5 liang, washed in hot water) Qing Dai (Indigo Naturalis, 2 qian 5 fen) Ren Shen (Ginseng Radix et Rhizoma, 0.5 liang).
Grind into fine powder, moisten with ginger juice, soak steamed wheat cake, make pills like paulownia seeds. Take 50 pills per dose, swallow with ginger soup after meals.
Baizhu Tang (Atractylodes Macrocephala Decoction) treats deficiency damage in the Stomach and vomiting due to phlegm.
Ban Xia Qu (Prepared Pinellia Fermented, 0.5 liang) Bai Zhu (Atractylodis Macrocephalae Rhizoma, 1 qian) Bing Lang (Arecae Semen, 2 qian 5 fen) Mu Xiang (Costi Radix, 1 qian) Gan Cao (Licorice Radix et Rhizoma, 1 qian) Fu Ling (Poria, 2 qian).
The above six ingredients, grind together into fine powder. Take 2 qian per dose, mix with ginger soup to swallow, before meals.
Vomiting with inability to eat, with a string-taut pulse, indicates Liver excess over Spleen, while vomiting arises from Spleen-Stomach deficiency. It is appropriate to use wind-dispelling and Spleen-stabilizing medicines.
Jinhua Wan (Golden Flower Pill)
Ban Xia (Pinelliae Rhizoma, 1 liang, washed in hot water) Bing Lang (Arecae Semen, 2 qian) Xiong Huang (Realgar, 1 qian 5 fen).
Grind into fine powder, moisten with ginger juice, soak steamed wheat cake, make pills like paulownia seeds. Children's pills separately, swallow with ginger soup. Start with small amounts and increase gradually, taking sequentially until vomiting stops. This is because pathogens bind to the Spleen, causing food to come up from below.
Zichen Wan (Purple Amber Pill) treats Middle Jiao vomiting of food, caused by food accumulation interacting with cold Qi, resulting in vomiting and pain. It is appropriate to take this.
Ban Xia Qu (Prepared Pinellia Fermented, 3 qian) Wu Mei (Mume Fructus, 2 qian, pit removed) Dai Zhe Shi (Hematitum, 3 qian) Xing Ren (Armeniacae Semen Amarum, 1 qian, skin and tip removed) Ding Xiang (Caryophylli Flos, 2 qian) Suo Sha Ren (Amomi Fructus Rotundus, 3 qian) Chen Xiang (Aquilariae Lignum Resinatum, 1 qian) Bing Lang (Arecae Semen, 2 qian) Mu Xiang (Costi Radix, 1 qian) Chen Pi (Aurantii Pericarpium, 5 qian) Bai Dou Kou (Cardamomi Fructus, 0.5 qian) Bai Zhu (Atractylodis Macrocephalae Rhizoma, 1 qian) Ba Dou Shuang (Crotonis Fructus Pulvis, 0.5 qian, ground separately).
Grind into fine powder, mix evenly with Ba Dou Shuang. Make pills with vinegar paste like millet grains. Take 50 pills per dose, swallow with ginger soup after meals. Stop when vomiting cures. Children's pills separately; very effective for children's food accumulation vomiting.
Another method for treating fanwei (rebellious stomach vomiting): Soak one tangerine peel briefly, remove white pith, wrap a piece of ginger inside. Wrap in dough/paper, bake until cooked, remove dough. Slice ginger into three parts. Decoct ginger and tangerine peel together. Swallow 100 Zichen Wan pills with the soup. Take twice daily. Stop when bowels open and vomiting ceases. This mainly treats cold; suitable for accumulated Qi as well.
For treating vomiting with abdominal pain, this indicates accumulation. Strong Stomach Qi causes dry heaving (sound but no matter); strong Spleen Qi causes vomiting of food. Excess attacking strength causes abdominal pain. Harmonize with Muxiang Baizhu San (Costus and Atractylodes Powder).
Muxiang Baizhu San (Costus and Atractylodes Powder)
Mu Xiang (Costi Radix, 1 qian) Bai Zhu (Atractylodis Macrocephalae Rhizoma, 0.5 liang) Ban Xia Qu (Prepared Pinellia Fermented, 1 liang) Bing Lang (Arecae Semen, 2 qian) Fu Ling (Poria, 0.5 liang) Gan Cao (Licorice Radix et Rhizoma, 4 qian).
Grind into fine powder. Decoct Shaoyao (Peony Root) and Sheng Jiang (Zingiberis Rhizoma Recens) thickly. Mix 1-2 qian with the decoction to take. Pain upon pressing indicates accumulation; no pain upon pressing indicates no accumulation.
For treating Lower Jiao vomiting of food, morning food vomited in evening, evening food vomited in morning, with constipation, use Fuzi Wan (Aconite Pill).
Fu Zi (Aconiti Lateralis Radix Praeparata, 5 qian, processed) Ba Dou Shuang (Crotonis Fructus Pulvis, 1 qian) Pi (Arsenicum, 0.5 qian, finely ground).
Grind together extremely finely. Melt yellow beeswax to make pills like paulownia seeds. Take 1-2 pills per dose, swallow with cold water. Stop when purged. Subsequently continue taking Zichen Wan to prevent re-obstruction.
Houpo Wan (Magnolia Bark Pill) mainly treats fanwei (rebellious vomiting), food dysphagia, Qi rushing to the heart, and various abdominal diseases. Dosage modifications follow. Using Wu Tou (Aconiti Radix) halved is even better.
Hou Po (Magnoliae Officinalis Cortex, 2.5 liang) Huang Lian (Coptidis Rhizoma, 2.5 liang) Zi Wan (Adenophorae Radix, radix and soil removed) Wu Zhu Yu (Evodiae Fructus, washed in hot water seven times) Chang Pu (Acori Tatarinowii Rhizoma) Chai Hu (Bupleuri Radix, radix removed) Jie Geng (Platycodonis Radix) Zao Jiao (Gleditsiae Sinensis Fructus, skin and strings removed, roasted) Fu Ling (Poria, skin removed) Guan Gui (Cinnamomi Cortex, scraped) Gan Jiang (Zingiberis Rhizoma, 2 liang each, processed) Ren Shen (Ginseng Radix et Rhizoma, 2 liang) Chuan Wu Tou (Aconiti Radix, processed, cracked, skin and umbilicus removed, 2.5 liang) Shu Jiao (Zanthoxyli Pericarpium, 2 liang, remove eyes and closed-mouth ones, lightly stir-fry to release moisture).
Grind into fine powder, mix evenly with 1 liang of Ba Dou Shuang. Blend with refined honey to make pills like paulownia seeds. Take 3 pills per dose, gradually increase until purged. Swallow with ginger soup after meals and before sleep. The therapeutic effect of this medicine is similar to Wenbai Wan (Warm White Pill) in the Bureau Formulary. It is also highly effective for intestinal diarrhea during autumn and winter after Chushu (End of Heat). In spring and summer, add 2 liang of Huang Lian; in autumn and winter, add 2 liang of Hou Po.
For treating Fengxian (wind epilepsy) that cannot be cured, refer to Houpo Wan. Besides seasonal additions in spring and autumn, add 1.5 liang each of Ren Shen, Chang Pu, and Fu Ling to each batch.
Prepare and administer according to the previous methods. For treating fanwei with constipation, this is Intestine overcoming Stomach. Take Banshu Wan (Half Sulfur Pill) from the Bureau Formulary.
Liu Huang (Sulfur, pure and good, ground extremely fine,絞 through willow wood pestle) Ban Xia (Pinelliae Rhizoma, washed in hot water seven times, dried and ground, equal parts). Make 100-200 pills. If severe constipation, use the following medicine:
Fu Zi (Aconiti Lateralis Radix Praeparata, 0.5 liang) Ba Dou (Crotonis Fructus, 2 seeds) Pi (Arsenicum, size of a soybean).
Grind into extremely fine powder. Make pills with ginger paste like mung bean sizes. Take 1 pill per dose, swallow with plain boiled water.