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Qin Jingming recorded: Two mothers suffered from Taiyin disease. After three days, the condition did not resolve, and they experienced vomiting, nausea, and counterflow qi. Their pulses were not floating. Banliu Wan (Half-Sulfur Pill) was administered for two or three doses, but the symptoms persisted. Huangqi Jianzhong Tang (Astragalus Decoction to Build the Middle) was then given, and the pulse became extremely tight. There were no exterior or interior signs, yet there was intense heat in the chest, thirst, and a desire to drink water. Everyone said it was a Yang syndrome and that the patient wanted water, but I instead administered warming herbs such as Shengjiang (Fresh Ginger) and Fuzi (Prepared Aconite Root). The tight pulse subsequently became deep and fine, indicating that Yang qi had not yet generated. Therefore, Guizhi (Cinnamon Twig), Fuzi (Prepared Aconite Root), Ganjiang (Dried Ginger), and Wutou (Aconite Root Lateralis Preparata) were made into wine pills. One hundred pills were taken at a time, continuously administered over two days, totaling more than ten doses. The patient's body became hot, and they were restless and irritable, desiring to sweat. The aforementioned pills were continued, and thick clothing was used to cover them. Only then did the Yang pulse emerge, followed by profuse sweating. The next day, urination and defecation finally resumed, and a basin full of dark red, liver-like blood clots was discharged. Weifeng Tang (Stomach Wind Decoction) with added Guizhi (Cinnamon Twig) and Fuzi (Prepared Aconite Root) was administered for three doses, stopping the bleeding. The severity of their cold pathogen was thus; such cases are rarely seen in the world.

In Shaoyin syndrome, if there is dryness in the mouth and tongue accompanied by thirst, and both the Cun (inch) and Chi (cubit) pulses are deep and slow, Sini Tang (Frigid Extremities Decoction) should be used. If the pulse is deep and rapid, Dachengqi Tang (Major Order the Golden Decoction) should be used. In Shaoyin syndrome, if there is dryness in the mouth and tongue with thirst, coolness on the body surface, and a deep, fine, and deficient pulse, Xiexin Tang (Drain the Epigastrium Decoction) is the primary formula. This distinguishes the use of medicines for tangible pathogens versus intangible heat.

Renshen Tang (Ginseng Decoction): Treats Shanghan (Cold Damage) after seven or eight days, where sweating leads to mental restlessness, dryness, and thirst.
Ingredients: Renshen (Ginseng Radix et Rhizoma), Huangqin (Scutellariae Radix), Chaihu (Bupleuri Radix), Gegen (Puerariae Lobatae Radix) (each 1 liang); Shanzhi (Gardeniae Fructus), Zhigancao (Prepared Licorice Root) (each 0.5 liang). Grind these into coarse powder. Take 5 qian per dose, decoct with Shengjiang (Fresh Ginger) and Dazao (Jujubae Fructus), and take warm.

Li Dongyuan recorded: For Yangdu syndrome (Yang Toxin) with燥热 (dry-heat) significantly exceeding normal levels and extreme thirst, Heinu Wan (Black Slave Pill) is the primary formula (see Yangdu section). For Fengwen (Wind-Warmth) with extreme thirst, Gualou Tang (Trichosanthes Root Decoction) is suitable (see Fengwen section). For Zhongshu (Summerheat) with latent heat that fails to heal after repeated treatments, resulting in persistent thirst, Jiuzheng Huanglian Wan (Wine-Steamed Coptis Pill) is the primary formula (see Zhongshu section).

Pulse Diagnosis: In Rebing (Heat Disease) affecting the Kidney, causing thirst, dry mouth, scorched tongue, yellow-red complexion, and an unceasing desire to drink day and night, accompanied by abdominal distension and fullness without aversion to drinking, and eyes lacking luster, this is a death sign and is incurable.

Cheng Wuji discussed: "Ou" (vomiting) involves the simultaneous expulsion of sound and matter. It is commonly misidentified as "Yue" (hiccups/retching). Although "Yue" and "Gan Ou" (dry retching) differ in character, they share the same pronunciation and meaning. "Tu" (spitting up/vomiting) refers only to the expulsion of matter without sound; hence, there is "Gan Ou" (dry retching) but no "Gan Tu" (dry spitting). Regarding vomiting, some cases are attributed to heat, others to cold. However, cases of "Tu" (spitting up) are generally considered due to deficiency-cold. Vomiting can also result from retained fluids or pus in the stomach region, which must be clearly distinguished.
For vomiting accompanied by fever, Xiaochaihu Tang (Minor Bupleurum Decoction) is indicated (details see Xiaochaihu Tang section). For continuous vomiting, epigastric urgency, and mild irritability, this indicates pathogenic heat causing vomiting, treated with Dachengqi Tang (Major Order the Golden Decoction). For dry retching due to cold-fluid retention above the diaphragm, emesis is contraindicated; warming is required. For dry retching with salivary discharge and headache, Wuzhuyu Tang (Evodia Fruit Decoction) is indicated, treating vomiting caused by cold pathogen. Vomiting followed by thirst indicates the disease is resolving. Thirst followed by vomiting indicates water retention in the epigastrium, belonging to fluid-retention syndromes. For vomiting due to retained fluids, if there is abscess-pus in the stomach, treatment is unnecessary as it will resolve spontaneously when the pus is exhausted.
Generally, in Shanghan, when exterior pathogens attempt to transmit inward, rebellious Qi in the interior causes vomiting. Thus, half-exterior-half-interior syndromes often mention vomiting. After three days of Shanghan, if the Three Yang meridians are exhausted and the Three Yin meridians should receive the pathogen, but the patient can eat and does not vomit, it indicates the Three Yin meridians are not affected. This confirms that transmission of pathogens inward inevitably leads to vomiting. In the case of Ganjiang Fuzi Tang (Dried Ginger and Prepared Aconite Decoction), the absence of vomiting and thirst indicates no heat in the interior. In the case of Shizao Tang (Ten Jujubes Decoction), dry retching, shortness of breath, sweating, and absence of aversion to cold indicate that the exterior is resolved but the interior is not harmonized. From this, it is clear that vomiting is often due to interior heat.
For patients with chronic vomiting, rebellious Qi must be dispersed, and phlegm-fluids must be purged. *Qianjin Fang* states that ginger is the sacred herb for vomiting, intended to disperse rebellious Qi. *Jinkui Yaolue* states that Pinellia is used for vomiting to remove water; once the water is removed, vomiting stops, aiming to purge phlegm-fluids. Even if there are Yangming signs, excessive vomiting contraindicates purgation because the Qi is rebellious and has not yet consolidated into excess. If vomiting is accompanied by a weak pulse, frequent urination, slight fever, and cold extremities, the prognosis is difficult, indicating severe deficiency-cold. Physicians must examine the deficiency or excess of the pathogen and the favorable or unfavorable course of the disease before prescribing medication.

Taiyang disease (whether fever has appeared or not, there must be aversion to cold, body pain, vomiting, counterflow, and tight pulses on both Yin and Yang positions) is named Shanghan. Mahuang Tang (Ephedra Decoction) is indicated.
If Taiyang disease persists beyond its designated period for more than ten days, and after being incorrectly purged two or three times, the Chaihu syndrome remains after four or five days, administer Xiaochaihu Tang (Minor Bupleurum Decoction) first. If vomiting continues, epigastric urgency, and mild irritability persist, indicating the disease is unresolved, administer Dachengqi Tang (Major Order the Golden Decoction) to purge, which will cure it. (Note: Although Zhang Zhongjing stated that excessive vomiting with Yangming signs contraindicates purgation, if latent heat in Yangming steams the clear pathways causing vomiting and irritability, bitter-cold direct draining is necessary; thus, Dachengqi Tang is used.)
In Shanghan, if fever persists despite sweating, with epigastric stiffness/fullness, vomiting, diarrhea, and lower abdominal fullness, Dachengqi Tang (Major Order the Golden Decoction) is indicated.
If Taiyang disease persists beyond its period for more than ten days, with a sensation of warmth in the epigastrium urging vomiting, chest pain, loose stools, mild abdominal fullness, and irritability: if the patient previously underwent extreme emesis or purgation, Tiaowei Chengqi Tang (Regulate the Waistline Order the Golden Decoction) is given; otherwise, it is contraindicated. If there is only a desire to vomit, chest pain, and loose stools, this is not a Chaihu syndrome; the vomiting indicates previous extreme emesis/purgation. (Cheng Wuji notes: Warmth in the epigastrium urging vomiting, irritability, and chest pain suggest heat pathogens in the chest. Loose stools and abdominal fullness suggest heat has moved to the stomach. If no emesis/purgation occurred, it is merely transmitted pathogen, treatable with Chaihu Tang. If emesis/purgation damaged Stomach Qi, allowing pathogen to enter as excess, Tiaowei Chengqi Tang is needed to purge Stomach heat. The text likely has missing characters regarding "vomiting".)
For vomiting with fever, Xiaochaihu Tang (Minor Bupleurum Decoction) is indicated.
After six or seven days of Shanghan, with slight fever and aversion to cold, limb pain, slight vomiting, sub-epigastric constraint, and unresolved exterior signs, Chaihu Jia Guizhi Tang (Bupleurum plus Cinnamon Twig Decoction) is indicated.
In combined Taiyang and Yangming diseases, without diarrhea but with vomiting, Gegen Banxia Tang (Pueraria and Pinellia Decoction) is indicated. (*Huoren Shu* states: Headache, body heat, muscle pain, eye pain, nasal dryness, and floating-long pulse confirm this.)
Gegen Banxia Tang Formula: Gegen (Puerariae Lobatae Radix), Banxia (Pinelliae Rhizoma Preparatum) (each 2 qian); Mahuang (Ephedrae Herba), Shengjiang (Zingiberis Rhizoma Recens) (each 1.5 qian); Gancao (Licorice Root), Shaoyao (Paeoniae Radix Alba), Guizhi (Cinnamomi Ramulus) (each 1 qian); Dazao (Jujubae Fructus) (12 pieces, split). Cut ingredients. Decoct in 1 dou of water. First boil Mahuang and Gegen, reduce by 2 sheng, skim white foam, add remaining herbs, boil to obtain 3 sheng. Take 1 sheng warm, cover to induce slight sweating.

Yangming disease: Shanghan with fever, no sweating, vomiting, inability to eat, but instead profuse sweating indicates transformation into Yangming. Dachengqi Tang (Major Order the Golden Decoction) is indicated.
Desire to vomit upon eating food belongs to Yangming; Wuzhuyu Tang (Evodia Fruit Decoction) is indicated. If symptoms worsen after taking the decoction, it belongs to the Upper Jiao; Gegen Banxia Tang (Pueraria and Pinellia Decoction) is indicated.
Excessive vomiting in Shanghan, even with Yangming signs, contraindicates purgation. Huangqin Shengjiang Banxia Tang (Scutellaria, Fresh Ginger, and Pinellia Decoction) or Xiaochaihu Tang (Minor Bupleurum Decoction) are indicated. (*Huoren Shu* uses Jiegeng Tang).
In Yangming disease, with hardness/fullness under the hypochondrium, constipation, vomiting, and a white coating on the tongue, Xiaochaihu Tang (Minor Bupleurum Decoction) may be given.
In Yangming (Warm) disease, with absence of sweating but free urination, followed by vomiting, cough, and cold extremities after two or three days, severe headache will occur. (Alternatively, Zhenwu Tang (True Warrior Decoction) minus Fuling (Poria) may be used.)

Shaoyang disease: Vomiting with alternating chills and fever, and fullness/hardness in the chest and hypochondrium, suggests Xiaochaihu Tang (Minor Bupleurum Decoction). If accompanied by diarrhea, it is a combined Taiyang and Shaoyang syndrome, treated with Huangqin Banxia Shengjiang Tang (Scutellaria, Pinellia, and Fresh Ginger Decoction). (Discussion on alternating chills/fever and diarrhea: Taiyang-Yangming combined diarrhea is exterior, treated with Gegen Tang (Pueraria Decoction) to induce sweating. Yangming-Shaoyang combined diarrhea is interior, treated with Chengqi Tang (Order the Golden Decoctions) to purge. This Taiyang-Shaoyang combined diarrhea is half-exterior-half-interior, unsuitable for sweating or purging; thus, Huangqin Tang (Scutellaria Decoction) is used to harmonize. Vomiting indicates rebellious Stomach Qi, so Banxia and Shengjiang are added to disperse rebellious Qi.)
After five or six days of Shanghan, with vomiting and fever, if Chaihu syndrome criteria are met but incorrect purgation was performed, and Chaihu syndrome persists, administer Xiaochaihu Tang (Minor Bupleurum Decoction) again.
When blood is weak and Qi exhausted, pores open, and pathogens enter to struggle with healthy Qi, knotting in the hypochondrium, leading to alternating chills/fever, silence, and loss of appetite, connected organs cause pain. Pathogens high, pain low, causing vomiting. Xiaochaihu Tang (Minor Bupleurum Decoction) is indicated. (If pathogens are external and Yang cannot govern the interior, Qi descends without ascending, causing diarrhea without vomiting. If interior Qi rebels upward without descending, causing vomiting without diarrhea, Xiaochaihu Tang resolves half-exterior-half-interior pathogens.)
Thirst with drinking followed by vomiting contraindicates Xiaochaihu Tang. (*Huoren Shu* states: Treat water between the diaphragm with Chifuling Tang (Red Poria Decoction), see later.)

Taiyin disease: The Taiyin syndrome is characterized by abdominal fullness, vomiting, inability to eat, worsening spontaneous diarrhea, occasional spontaneous abdominal pain. Purging will cause hardness below the chest.

Shaoyin disease: Diarrhea for six or seven days, cough, vomiting, thirst, mental irritability, and insomnia are treated with Zhuling Tang (Polyporus Decoction).
Shaoyin disease with diarrhea, faint and choppy pulses, vomiting, sweating, frequent bowel movements but small amounts, requires warming the upper part and moxibustion.
Shaoyin disease persisting for two to three days, progressing to four or five days with abdominal pain, difficulty urinating, heavy/painful limbs, and spontaneous diarrhea indicates water Qi. If accompanied by cough, free urination, diarrhea, or vomiting, Zhenwu Tang (True Warrior Decoction) minus Fuzi (Prepared Aconite Root) plus Shengjiang (Fresh Ginger) is indicated.

Jueyin disease: In Shanghan with slight heat and mild cold extremities (cold fingertips), silence, loss of appetite, irritability, and free pale urine after several days indicates heat elimination. Desire to eat indicates recovery. If cold extremities are accompanied by vomiting and chest/hypochondriac irritability, hematochezia will follow. Huangqin Shaoyao Tang (Scutellaria and Peony Decoction) or Didang Tang (Should-Reach Decoction) are indicated.
Vomiting with weak pulse, free urination, slight fever, and cold extremities is difficult to treat; Sini Tang (Frigid Extremities Decoction) is indicated.
Shanghan originally involving cold-dysfunction, incorrectly treated with emesis/purgation by physicians, leading to cold rejection and further vomiting/diarrhea, where food is vomited immediately upon entry, is treated with Ganjiang Huanglian Huangqin Renshen Tang (Dried Ginger, Coptis, Scutellaria, and Ginseng Decoction). (Pathogen transmits to exterior, but original condition was cold-dysfunction. Incorrect emesis/purgation damages Zheng Qi, causing internal cold rejection. Classic says: Rejection causes vomiting. Food vomited immediately is cold rejection. Further emesis/purgation causes double deficiency and death. This decoction opens cold rejection. Zhao Sizhen notes: Zhang Zhongjing's intent is to warm the interior with Ganjiang, use Huanglian/Huangqin as counter-agents, and tonify Zheng Qi with Renshen. Some argue Chi pulse delay indicates Stomach deficiency-cold, but rapid pulse can also indicate Stomach deficiency-cold with false heat. Physicians must distinguish based on pulse and syndrome.)
Hui Jue (Roundworm Cold Extremities) involves vomiting roundworms. If the patient is quiet but occasionally irritable, it is due to Zang cold causing roundworms to ascend to the diaphragm. Eating triggers vomiting and irritability as roundworms smell food and emerge. Patient will vomit roundworms spontaneously. Wumei Wan (Mume Pill) is indicated.

Thirst: Thirst followed by vomiting indicates water retention in the epigastrium, belonging to fluid-retention syndromes (*Huoren Shu*: Chifuling Tang). Vomiting followed by thirst indicates resolution (*Jinkui*: If vomiting patient desires water, give it promptly).

Diarrhea: Vomiting with diarrhea involving cold-heat indicates Yang syndrome, treated with Huangqin Tang (Scutellaria Decoction) or Dachengqi Tang (Major Order the Golden Decoction). Absence of heat indicates Yin syndrome, treated with Zhuling Tang (Polyporus Decoction) or Zhenwu Tang (True Warrior Decoction).

Irritability: Vomiting with mental irritability after sweating/emesis/purgation is treated with Zhizi Shengjiang Chi Tang (Gardenia, Fresh Ginger, and Fermented Soybean Decoction). If no prior sweating/emesis/purgation, accompanied by cough and thirst, Zhuling Tang (Polyporus Decoction) is suitable.

Patients with vomiting due to abscess-pus do not require specific treatment; it resolves when the pus is exhausted.
Vomiting after taking Guizhi Tang occurs in habitual wine drinkers.

Dai Yuanli discussed: Even if Yangming syndrome presents obvious indications for purgation, excessive vomiting suggests the pathogen is still in the Upper Jiao, and purgation should not be rushed. Xiaochaihu Tang (Minor Bupleurum Decoction) is appropriate. If Taiyang syndrome exists without combining with Shaoyang/Yangming, presenting with vomiting/diarrhea, suspect pre-existing phlegm-fluid stagnation in the diaphragm. Erchen Tang (Two-Cured Decoction) should stabilize the condition first. Once vomiting subsides, gradually administer Taiyang meridian-resolving herbs. Vomiting followed by thirst suggests Zhuling Tang (Polyporus Decoction). Thirst followed by vomiting suggests treating water in the diaphragm with Xiao Banxia Fuling Tang (Minor Pinellia and Polyporus Decoction). Thirst with immediate vomiting upon drinking, followed by renewed thirst, is named Shui Ni (Water Counterflow), caused by Heart meridian heat affecting Small Intestine function. Wuling San (Five-Ling Powder) is indicated. In Shaoyin, non-thirsty vomiting or dry retching is treated with Lizhong Tang (Regulate the Middle Decoction) minus Baizhu (Atractylodes Macrocephala Rhizome) plus Shengjiang (Fresh Ginger). Vomiting with salivary discharge is treated with Wuzhuyu Tang (Evodia Fruit Decoction).
In Taiyin and Jueyin, vomiting may occur. Taiyin is treated with Lizhong Tang (Regulate the Middle Decoction); Jueyin with Sini Tang (Frigid Extremities Decoction), both with added Shengjiang (Fresh Ginger). These Yin syndromes are Yin within Yin, requiring hot agents. When Yang enters Yin, it causes diarrhea rather than vomiting. Vomiting is upper and near exterior; Yang entering deeply causes diarrhea.
After recovery from Yang syndrome, new-onset vomiting without other causes indicates residual heat in the Stomach. Zhuyegeshao Tang (Bamboo Leaf and Scallop Shell Decoction) or JuPi Zhuru Tang (Tangerine Peel and Bamboo Shaving Decoction) are indicated.
Generally, vomiting arising from Taiyang indicates combined syndrome, suggesting the disease is moving inward. Not pure Taiyang. Recall a case: Initial Taiyang syndrome with persistent vomiting failed to respond to warming agents. Knowing Taiyang exterior was resolved, cooling agents were required. Vomiting in Taiyang implies combination with Yangming or Shaoyang, indicating heat; warming agents were incorrect.
Another case: Initial Taiyang syndrome with vomiting affected a whole family similarly. Yangwei Tang (Stomach-Nourishing Decoction) worked instantly. This was epidemic Qi, classified as Shanghan mixed disease, not strictly following classic Shanghan rules.

Wu Kun discussed: Initial vomiting, retching clear fluid, or vomiting food indicates cold damaging the Stomach. If aversion to cold, stiffness, no fever yet, with vomiting/food regurgitation, use Jiajian Huoxiang Zhengqi San (Modified Evodia and Magnolia Decoction) or Renshen Yangwei Tang (Ginseng Stomach-Nourishing Decoction). If fever has appeared, use Shiwei Xiong Su Fa San (Ten-Ingredient Cyperus and Perilla Dispelling Decoction) or Gegen Tang (Pueraria Decoction) plus Shengjiang/Banxia. If spontaneous sweating, avoid sweating methods; use Zhengqi San minus Zisu (Perilla Leaf) to harmonize.
Fever, bitter taste, string-taut-rapid pulse with vomiting; mental irritability with vomiting; hypochondriac fullness with vomiting; alternating chills/fever with vomiting; afternoon tidal fever with vomiting—all belong to Shaoyang. Treat with Xiaochaihu Tang (Minor Bupleurum Decoction) doubling Banxia and Shengjiang. If heat decreases and mouth is dry, add Gegen and Gualougen (Trichosanthes Root). If irritable, add Jiangzhi Chuhuanglian (Ginger-juiced Fried Coptis). If epigastric fullness, add Zhishi (Immature Bitter Orange). If tidal fever, interior excess, constipation, continuous vomiting, and epigastric irritability, use Dachengqi Tang (Major Order the Golden Decoction) to purge.
Differentiate four types of vomiting: Stomach heat (string-taut-rapid pulse, bitter taste, irritability/thirst); Stomach cold (string-taut-slow pulse, cold extremities, anorexia); Water Qi (thirst before vomiting, abdominal fullness, palpitations); Pus/Blood (foul odor in throat, rushing upward, no irritability). Pus/blood vomiting resolves spontaneously.
Taiyin abdominal fullness, vomiting food, inability to eat, or abdominal pain with vomiting and deep pulse: Lizhong Tang (Regulate the Middle Decoction) plus Banxia, Chenpi, Huoxiang, Houpo, Shengjiang. Add Fuzi for severe cold.
Shaoyin: Food vomited immediately upon entry, epigastric warmth urging vomiting but inability to spit, cold hands/feet, deep-fine pulse: Sini Tang (Frigid Extremities Decoction) plus Banxia, Shengjiang, Chenpi.
Jueyin: Vomiting saliva, cold extremities, deep-micro pulse: Wuzhuyu Sini Tang (Evodia and Frigid Extremities Decoction) plus Banxia, Shengjiang, Chenpi.

Dry retching/desire to vomit:
Taiyang Wind Strike: Floating-yang and deficient-yin pulses. Yang-floating causes spontaneous heat; Yin-deficient causes spontaneous sweating. Aversion to cold/wind, slight fever, nasal congestion, and dry retching are treated with Guizhi Tang (Cinnamon Twig Decoction).
Shanghan with unresolved exterior and fluid retention in the heart region: Dry retching, fever, cough, thirst, diarrhea, choking, difficulty urinating, lower abdominal fullness, or asthma are treated with Xiao Qinglong Tang (Minor Green Dragon Decoction).

Zhang Yuansu discussed: Question: Both Xiao Qinglong Tang and Xiaochaihu Tang treat vomiting with sweating, appearing similar in exterior/interior patterns. Why the difference? Answer: In Shanghan with unresolved exterior and mild interior heat, thirst with inability to drink much indicates insufficient interior heat to transform fluids, leading to fluid retention. Cold-water pathology requires warm-hot agents to disperse fluid via sweating; thus, Xiao Qinglong Tang is used. Originally, there was no interior syndrome, only cold-water induced. Conversely, Xiaochaihu Tang treats Shanghan fever where heat transmits to the half-exterior-half-interior, attacking internally. Although both involve exterior/interior issues, the cold-heat nature differs, justifying the use of Ginger/Cinnamon vs. Bupleurua/Poria.

Gancao Xiexin Tang (Licorice Drain the Epigastrium Decoction): On the first day of Shanghan, if the pulse is quiet, no transmission; if prone to vomiting, irritability, and rapid pulse, transmission is occurring. Use Mahuang Tang (Ephedra Decoction) initially. Once exterior resolves, use Xiaochaihu Tang or Baihu Tang (White Tiger Decoction).
Shanghan with heat in the Chest and pathogenic Qi in the Stomach, abdominal pain, and desire to vomit:黄连汤 (Coptis Decoction).
Taiyang Wind Strike with diarrhea and vomiting: If exterior resolves, attack the interior. Sweating, periodic headache, epigastric hardness/fullness radiating to hypochondrium, dry retching, shortness of breath, sweating, no aversion to cold: Exterior resolved, interior unharmonized. Shizao Tang (Ten Jujubes Decoction) is indicated. (Zhang Yuansu note: Dry retching and hypochondriac pain appear in both Xiaochaihu and Shizao Tangs. One harmonizes, one attacks. Xiaochaihu is for half-exterior-half-interior with alternating chills/fever and dry retching; purgation is contraindicated. Shizao Tang is for resolved exterior (no chills/fever, sweating) with internal heat and latent fluid causing headache, epigastric hardness, dry retching, shortness of breath. Differentiate by presence of exterior signs: with exterior signs, use Chaihu Tang; without, use Shizao Tang. Zhang mentions headache in fluid retention to prevent students from fearing exterior involvement.)
Desire to vomit upon eating belongs to Yangming: Wuzhuyu Tang (Evodia Fruit Decoction). Worsening after intake indicates Upper Jiao rejection: Xiaochaihu Tang, Zhizi Chi Tang (Gardenia and Fermented Soybean Decoction), or Huangqin Tang (Scutellaria Decoction).
Shaoyin disease: Food vomited upon entry, urge to vomit but inability, cold hands/feet, string-taut-slow pulse at onset: Excess in Chest, do not purge, induce emesis. If cold-fluid above diaphragm causing dry retching, do not emetic; urgently warm with Sini Tang (Frigid Extremities Decoction).
Shaoyin disease: Unstopping diarrhea, cold extremities, absent pulse, dry retching, irritability: Baitong Jia Zhuchidan Tang (White Connective plus Pig Gallbladder Bile Decoction).
Shaoyin disease: Clear grain diarrhea, interior cold with exterior heat, cold extremities, micro pulse nearing extinction, no aversion to cold, flushed face, abdominal pain, dry retching, sore throat, or stopped diarrhea with absent pulse: Tongmai Sini Tang (Connect to Frigid Extremities Decoction).
Shaoyin disease: Urge to vomit but nothing comes, irritability, drowsiness. After five-six days, spontaneous diarrhea with thirst belongs to Shaoyin.
Taiyin disease: Micro-fine-deep pulse, desire to sleep, sweating without irritability, desire to vomit. Progressing to five-six days with spontaneous diarrhea, renewed irritability, and inability to sleep is fatal. Post-recovery, weakness, shortness of breath, and desire to vomit: Zhuyegeshao Tang (Bamboo Leaf and Scallop Shell Decoction).

Chifuling Tang (Red Poria Decoction): Treats Shanghan vomiting/retching, epigastric fullness, fluid retention in chest/diaphragm, dizziness, palpitations.
Ingredients: Chifuling (Red Poria), Renshen (Ginseng Radix et Rhizoma) (each 1 liang); Banxia (Pinelliae Rhizoma Preparatum, ginger-processed), Juhong (Citri Reticulatae Pericarpium Rubrum), Chuanxiong (Ligustici Chuanxiong Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 0.5 liang). Cut. Take 4 qian per dose with 5 slices of Shengjiang (Fresh Ginger), decoct in water.

Gegen Tang (Pueraria Decoction - Note: Formula content resembles a tonic/resolving fluid formula, possibly misnamed in source text relative to standard Mahuang-based Gegen Tang): Treats persistent dry retching in Shanghan.
Ingredients: Gegen (Puerariae Lobatae Radix), Renshen (Ginseng Radix et Rhizoma), Maidong (Ophiopogonis Radix, heart removed), Zhigancao (Prepared Licorice Root) (each 1 liang); Banxia (Pinelliae Rhizoma Preparatum, ginger-processed), Huangqi (Astragali Radix) (each 0.75 liang); Baifuling (White Poria), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 0.5 liang). Cut. Take 3 qian per dose with 3 slices of Shengjiang (Fresh Ginger) and 2 Jujubes, decoct together.