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Vomiting is caused by Stomach Fire. When Stomach Fire rushes upward, it causes vomiting and an inability to swallow food. Coughing with reverse flow of Qi (Ke Ni) is caused by Lung Fire. When Lung Fire rushes upward, it causes incessant coughing and reverse flow of Qi. The *Classic* states: Vomiting indicates that pathogenic factors are excessive in the upper jiao. By following the Qi mechanism and clearing the fire, the symptoms will cease spontaneously. One must absolutely avoid using ginger juice. If there is phlegm in the diaphragm or meridians, emesis (induced vomiting) is necessary, as emesis also contains the meaning of dispersing outward. This corresponds to what the *Classic* says: "For those high up, use the method of making them vomit out" (*Yin Qi Gao Zhe Yin Er Yue Zhi*).

For persistent vomiting, administer decoction of Puerariae Radix (Gegen). However, this cannot descend Qi or resolve phlegm. For persistent dry heaving and hiccups, administer decoction of Loquat Leaf (Pipaye), which can stop phlegm-cough and Ke Ni.

Thirst accompanied by frequent drinking is called Upper Xiao (Wasting-Thirst), attributed to Lung Heat, where Heart Fire transfers heat to the Lung. Excessive eating with easy hunger is called Middle Xiao, attributed to Stomach Heat. Thirst accompanied by frequent urination and the presence of fatty substances in urine is called Lower Xiao, attributed to Kidney Heat and deficiency of Kidney Water.

The human body relies on Stomach Qi as its foundation; without food intake, Stomach Qi will inevitably be damaged. This situation arises from excess-heat obstruction. In later stages, heavy use of Gypsum (Shigao) is employed to clear Stomach Fire. If constipation occurs, Rhubarb (Dahuang) must be added. There is no need to worry about excessive coldness, nor about purgatives damaging the Stomach. The *Classic* states: "Among all things, the desire to eat is paramount." The *Classic* also states: "Those who can digest grain prosper; those who cannot digest grain perish." One should understand the various reasons for not eating. Some cases involve heat pathogens invading the Stomach causing anorexia; others involve Stomach deficiency with fire closure causing anorexia. This latter case is undoubtedly not due to Stomach deficiency. Anorexia due to Stomach deficiency presents with a quiet body; anorexia due to Stomach heat presents with irritability and external heat sensation. Additionally, overeating, or phlegm stagnation with Qi constraint, or cold pathogens blocking and generating Stomach heat, all lead to anorexia. It must be noted that overeating can cause the Spleen to fail to transform grains, resulting in fullness and distension.

Heat-toxins invade the Heart. As the Heart is the Sovereign Lord, if suddenly bound by Wind pathogens, sweat cannot be released. The Large and Small Intestines become stagnant, preventing internal circulation of pathogens. Consequently, Heart Fire becomes extremely hyperactive. Metal (Lung) is controlled by Fire and cannot level Wood (Liver). Wood moves and generates Wind to invade Earth (Spleen). Thus, vomiting food is accompanied by eye twitching, cyanotic complexion, head shaking, chaotic Qi, and confusion of spirit, leading to convulsions (Jing Chu). The *Classic* states: When Wood evil is excessive and injures Earth, one should use dispersing methods combined with promoting urination, allowing internal and external toxins to be dispersed separately, so that convulsions will settle naturally. For dispersing, use Decoction for Disinfecting (Xiaodu Yin) plus Saposhnikoviae Radix (Fangfeng), Sichuan Notopterygium Root (Chuan Qiang), Prepared Aconite Lateralis Radix Preparata (Wei Tianma - *Note: Context suggests Tianma/Gastrodia, likely typo in source or specific preparation, usually Gastrodiae Rhizoma*), Uncaria Ramulus cum Uncis (Gouteng), Akebia Caulis (Mutong), Polygonum Aviculare (Xiaocao), Licorice Root (Gancao), Citrus Reticulata Pericarpium (Chenpi), and Green Tangerine Peel (Qingpi). In later stages, add Rheum Palmatum (Dahuang), Ophiopogon Tuber (Maidong), Bupleuri Radix (Chaihu), Gardenia Fruit (Shanzhi), or use Clearing and Resolving Decoction (Qingjie San). Ingredients include Saposhnikoviae Radix (Fangfeng), Schizonepeta Spike (Jingjie), Cicada Slough (Chanyi), Platycodon Root (Jiegeng), Peucedani Radix (Qianhu), Ligusticum Chuanxiong Rhizome (Chuanxiong), Cimicifugae Rhizoma (Shengma), Scutellaria Root (Huangqin), Akebia Caulis (Mutong), Ardisia Crenata Root (Dali), and Forsythia Fruit (Lianqiao). The treatment principle should focus on pacifying Liver Wood and promoting urination. Purging the Liver eliminates wind; promoting urination clears Heart heat. This condition arises because Heart Fire is blazing, Metal is controlled and cannot restrain Wood, leading to a struggle between Fire and Wind, disturbing the Spirit. When pathogenic fire recedes and healthy Qi flourishes, the Heart and Liver calm, and convulsions subside. Treating convulsions should prioritize unblocking joints, rather than treating solely as fright. One must clear vexatious heat and calm the spirit. The beneficial approach is to disperse wind, resolve food stagnation, and vent toxins.