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[Da] When women experience vomiting, it is caused by pathogenic factors and cold in the Spleen and Stomach, leading to dysfunction in the digestion of food and fluids. The Stomach is the sea of water and grain; if its Qi mechanism is disordered, wind-cold pathogens may invade. Cold clashing with the Stomach causes Stomach Qi to rebel upward, resulting in vomiting. This disease of vomiting is not solely due to deficiency-cold of the Spleen and Stomach; there are also cases of vomiting due to Stomach heat, cases where the body of the Stomach is cold but the cardia (Stomach opening) is hot, cases due to excessive phlegm, and cases due to blood deficiency. The Classics state: "Without Yin, there is vomiting," referring to this situation. Therefore, medication cannot be applied uniformly. For vomiting due to Stomach cold, it is appropriate to use *Renshen Dingxiang San* (Ginseng and Clove Powder) or *Lizhong Wan* (Regulate the Middle Pill) from the *Jufang* (Prescriptions of the Bureau), as well as *Banxia Wan* (Pinellia Pill) and *Renshen Qiwei Wan* (Seven-Ingredient Ginseng Pill) by Xu Renze. For vomiting due to Stomach heat, it is appropriate to use *Xiao Chaihu Tang* (Minor Bupleurum Decoction), *Lugen Tang* (Reed Rhizome Decoction), *Zhuru Tang* (Bamboo Shavings Decoction), or *Huaihua San* (Sophora Flower Powder). For vomiting due to cold in the Stomach body and heat at the cardia, it is appropriate to use *Huoxiang Zhengqi San* (Agastache Powder to Rectify the Qi) from the *Jufang*, combined with decocted fresh ginger and jujubes, taken when cool to stop vomiting. For vomiting due to excessive phlegm, it is appropriate to use *Banxia Tang* (Pinellia Decoction), *Fuling Tang* (Poria Decoction), or *Erchen Tang* (Two-Aged Decoction) from the *Jufang*. For nausea and vomiting associated with pregnancy (*Ezu*), *Fuling Wan* (Poria Pill) can be used concurrently, which has its own specialized treatment. For vomiting due to blood failing to return to its source (blood deficiency and loss of containment), use *Shiquan Dabu Tang* (Comprehensive Great Tonifying Decoction—used for deficiency consumptive diseases in miscellaneous disorders), adding Chenpi (Tangerine Peel), Banxia (Pinellia), Huoxiang (Patchouli), fresh ginger, and jujubes, decocted and taken. For vomiting accompanied by *Hongxiangjiao* (Beriberi/Leg Qi), there is a specialized treatment, so it is not discussed here to avoid confusion.

[Xue] Mr. Dongyuan stated: In the aforementioned conditions, if old cold pathogens and newly ingested food enter the Stomach together, the new and old pathogens attack each other, causing Qi to conflict and rebel, emerging again from the Stomach, thus forming *Yue* (hiccups/regurgitation). He further stated: The Stomach forms *Yue* due to rebellious Qi. Vomiting, spitting, and *Yue* all belong to the Stomach, differing only according to the abundance or scarcity of Qi and Blood. Vomiting belongs to the Yangming channel; Yangming has abundant Qi and Blood, so there is both sound and material expelled, indicating that both Qi and Blood are diseased. Zhang Zhongjing said: "When there is much vomiting, even if there are Yangming signs, one must be cautious and absolutely avoid purgation." Sun Simiao said: "Those who vomit frequently should take fresh ginger often, as it is the holy medicine for vomiting." Rebellious Qi must be dispersed; therefore, fresh ginger is the primary herb. Spitting (expelling without sound) belongs to the Taiyang channel; Taiyang has abundant Blood but scarce Qi, so there is material expelled but no sound, indicating a Blood disease. For immediate vomiting after eating, *Chenpi* (Tangerine Peel, white part removed) is used as the primary herb. *Yue* (hiccups/regurgitation with sound but no material) belongs to the Shaoyang channel; Shaoyang has abundant Qi but scarce Blood, so there is sound but no material expelled, indicating a Qi disease, treated primarily with ginger-processed Banxia. If the Spleen and Stomach are weak, with cold pathogens lodging or dietary injury, use *Liujunzi Tang* (Six-Gentlemen Decoction), Dingxiang (Clove), Huoxiang (Patchouli), fresh ginger, etc. If there is heat in the Stomach and phlegm above the diaphragm, use *Erchen Tang* (Two-Aged Decoction), Shanzhi (Gardenia), Huanglian (Coptis), fresh ginger. If chronic illness leads to Stomach deficiency, with vomiting and inability to accept food, use fresh ginger, Renshen (Ginseng), Baizhu (Atractylodes), Huangqi (Astragalus), Xiangfu (Cyperus), etc. There are also cases of phlegm obstruction in the middle Jiao preventing food descent, cases of Qi rebellion causing vomiting, cases of Qi stagnation at the cardia, cases of food stasis between the Heart and Lungs regurgitating upward, and cases of fire and phlegm at the cardia causing vomiting. If vomiting is severe like pouring water, and the patient is thirsty and desires water, death ensues; drinking child's urine is most excellent. The previous discussion stated: For vomiting due to blood failing to return to its source, use *Shiquan Dabu Tang*; this truly expounds upon what predecessors had not yet revealed. I have used this method frequently with success. (This discussion differs slightly from Wang Andao's *Suhui Ji*; reference is advised.) My late mother, after eating, heard external words that displeased her, leading to vomiting of sour fluid, internal heat, thirst, and a preference for cold water. Her Qi-kou pulse was large and chaotic, and her complexion was greenish-red. This indicated Liver-Spleen constrained fire. Medication administered entered the mouth but was immediately vomited. On the third day, she vomited undigested food; on the seventh day, sour yellow fluid; on the eleventh day, bitter fluid. The pulse remained surging and large, and she still preferred cold drinks. A small amount of Huanglian (Coptis) decoction, cooled, was given. By the twentieth day, Baizhu (Atractylodes) and Fuling (Poria) were added; on the twenty-fifth day, Chenpi (Tangerine Peel); on the thirty-seventh day, Danggui (Angelica) and Zhi Gancao (Honey-fried Licorice). By the sixtieth day, she could consume half a cup of rice drink, gradually advancing to thin congee, and recovered through regulation. Shen Jiwen, a student of the local academy, had a mother suffering from Spleen deficiency with central fullness, phlegm-cough, and fever. After eating wet noodles and cold tea, she experienced acid regurgitation, vomiting, and anorexia. She mistakenly took Qin (Scutellaria), Lian (Coptis), and Qingpi (Aurantium peel), which exacerbated her chills, fever, dry mouth, uncontrollable salivation, and vomiting upon smelling food. Upon consultation, I said: "The Spleen controls saliva; this is Spleen deficiency failing to constrain fluids." I intended to use *Renshen Anwei San* (Ginseng Powder to Pacify the Stomach), but was swayed by public opinion to treat it as Stomach excess fire and food stasis. The condition worsened daily. Suddenly desiring winter melon, she ate a piece the size of a fingernail, triggering continuous violent vomiting of sour fluid. Continuing the previous medicines made it worse. Upon re-examination, her spirit was depleted, pulse was faint and near extinction, and she was near death. Only her eyeballs moved. I said: "Cold pervades the interior; it should be treated with acrid-hot herbs, but medicine cannot be retained." Urgently, salt, Aiye (Mugwort leaf), and Fuzi (Aconite) were stir-fried hot and applied to the umbilicus and abdomen to scatter cold and restore Yang. I also breathed air into her mouth to supplement her Qi, and applied a hot cake of Fuzi to the umbilicus. After about an hour, her spirit slightly revived. Renshen (Ginseng), Baizhu (Atractylodes), and Fuzi (Aconite) were powdered, mixed with Chenpi (Tangerine Peel) paste, and formed into pills the size of millet grains. Five to seven grains were placed in the mouth and swallowed with saliva, stopping the vomiting immediately. After two days, the dose increased to ten grains, and symptoms receded slightly, though salivation continued. After five days, one or two spoonfuls of the previous decoction were gradually taken, restoring some Stomach Qi, and she began craving congee drink. Subsequently, Renshen (Ginseng) and Baizhu (Atractylodes) were used to warm and tonify the Spleen and Stomach. After more than fifty doses, she recovered.

[Sun] A thirty-five-year-old woman, barren, feared her husband taking another wife, leading to depression. Her menses had ceased for three months. She suffered abdominal pain and nausea. All physicians claimed she was pregnant. Her husband, knowing some medicine, rejoiced and treated her with fetal-calming, Qi-regulating, and pain-relieving herbs. After thirty to fifty doses with no effect, her suffering intensified. Every afternoon (Wei-Shen hours), she experienced chills and fever. Abdominal masses, like quail eggs, numbering twenty to thirty, churned painfully. Movement produced gurgling water sounds. Extreme pain caused vomiting of five to six bowls of sour fluid. After vomiting, the masses subsided, chills/fever ceased, and pain stopped, repeating the next day. Treated as malaria, the condition worsened. Upon my pulse diagnosis, the left hand was wiry with a choppy Chi position; the right hand was soggy and weak, but deep pressure revealed slippery pulses, similar to the left. Menses had been absent for five months. I said: "This is a constraint disorder. How can a choppy pulse indicate pregnancy? If it were pregnancy, the previous medicines would have worked." Her husband realized his error. I prescribed *Erchen Tang* (Two-Aged Decoction) plus Xiangfu (Cyperus), Shanzhi (Gardenia), Fuxiong (Ligusticum), Yuanhu (Corydalis), Danggui (Angelica), Honghua (Safflower), etc. Pain ceased with administration. Four consecutive doses were effective, but pain returned upon cessation. One month of regulation failed to cure the root. Taking the pulse records to my master, Mr. Huang Gutan, he instructed me: "This is a constrained fire disorder originating in the Liver and Gallbladder. The Liver governs planning; the Gallbladder governs decision-making. Lack of resolution leads to constraint. Constraint generates Wood hyperactivity. Wood hyperactivity overacts on Earth (Spleen). Spleen injury fails to transform fine essences into Qi and Blood, hence amenorrhea. Lung Metal loses nourishment from its mother (Wood), so descending functions fail. Wood, lacking fear, insults its conqueror (Metal), rushing up to disturb the clear orifices, causing vomiting. Symptoms reduce after vomiting because Wood ascends and Fire subsides." I formulated a prescription: Huangqi (Astragalus) 5 qian, Chaihu (Bupleurum) 3 qian, Baishao (White Peony Root) 2 qian, Gancao (Licorice) 1 qian, Chenpi (Tangerine Peel), Beimu (Fritillaria), Zhishi (Immature Bitter Orange) each 0.5 qian, Fresh Ginger 3 slices. After one dose, chills/fever ceased; after two doses, pain reduced, vomiting stopped, and water sounds disappeared. No recurrence for seven days. Her husband rejoiced: "How miraculous!" He urged me to consult the Master again. The Master said: "Chills and fever belong to Shaoyang Gallbladder. Sour vomiting belongs to Jueyin Liver. Painful abdominal masses churning is fire agitating water, like boiling soup in a pot. Excessive vomiting injures Lung Metal further. Thus, Huangqi (Astragalus) tonifies Lung Metal as the Sovereign herb to control Liver Wood. Chaihu (Bupleurum) drains Liver as the Minister herb to ascend Gallbladder Fire. The Classics say: 'For Wood constraint, achieve unimpeded flow.' 'Unimpeded' means thorough penetration. Wood nature tends to ascend; since constrained, it cannot, so Chaihu ascends the clear Qi of Gallbladder and Liver, breaking the constraint to restore normalcy. It also says: 'For excess, subdue it via its fear.' Draining refers to tonifying Lung to control Liver. It also says: 'To drain the Liver, soothe its center,' using Gancao (Licorice) to soothe the center as the Assistant. It also says: 'For the main treatment of Wood positions, use sour to drain.' Baishao (White Peony Root) drains Wood within the Spleen as the Minister. Chronic illness creates constraint; long-standing constraint generates phlegm. Beimu (Fritillaria), Chenpi (Tangerine Peel), and Zhishi (Immature Bitter Orange) open constraint and drive out phlegm as the Envoy. Then Metal is correct, Wood is balanced, Earth is peaceful, leading to rapid recovery. Previous formulas using Shanzhi (Gardenia) or Huanglian (Coptis) are descending herbs. With raging fire, how can slight cold herbs suppress it? Thus, the Classics say: 'For mild cases, treat directly; for heavy cases, follow its nature and ascend.' In treating any disease, one must understand this principle."

*Yizhi Zi San* (Alpinia Oxyphylla Powder) treats women with long-standing Spleen-Stomach deficiency and weak Qi, frequent vomiting, complete anorexia, and limb weakness.
Yizhiren (Alpinia Oxyphylla Fruit) (1 liang), Fuzi (Prepared Aconite), Suosharen (Amomum Fructus), Dingxiang (Caryophylli Flos), Houpo (Magnoliae Officinalis Cortex), Huangqi (Astragali Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Baifuling (Poria Cum Mycelium), Chenpi (Citri Reticulatae Pericarpium), Chuanxiong (Ligustici Chuanxiong Rhizoma), Liangjiang (Alpiniae Katsumadai Rhizoma), Huoxiangye (Agastaches Pallidae Folium), Danggui (Angelicae Sinensis Radix) (each 7.5 qian), Renshen (Ginseng Radix et Rhizoma), Guixin (Cinnamomi Ramulus) (each 0.5 liang).
Crush the herbs. Take 3 qian per dose, with 3 slices of fresh ginger and 1 jujube, in 1 sheng of water, decoct to 0.7 sheng, strain, and take warm at any time.

*Dingxiang San* (Clove Powder) treats women with viscera deficiency-cold, weak Spleen-Stomach Qi, vomiting after eating, and indigestion of food and fluids.
Dingxiang (Caryophylli Flos), Baizhu (Atractylodis Macrocephalae Rhizoma), Suosharen (Amomum Fructus), Caoguoren (Tsaoko Fructus), Juapi (Citri Reticulatae Pericarpium) (each 7.5 qian), Danggui (Angelicae Sinensis Radix), Baidoukou (Amomi Rotundus Fructus), Huoxiangye (Agastaches Pallidae Folium), Shenqu (Massa Medicata Fermentata), Hezipi (Terminaliae Chebulae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma) (each 0.5 liang), Renshen (Ginseng Radix et Rhizoma) (1 liang).
Grind into fine powder. Take 2-3 qian per dose,調 with decocted ginger-jujube water.

*Zhuru Tang* (Bamboo Shavings Decoction) treats Stomach heat vomiting.
Gange (Puerariae Lobatae Radix) (3 liang), Banxia (Pinelliae Rhizoma) (washed 7 times in hot water, mixed with 0.5 zhan of ginger juice and 1 sheng of fermented grain water, boiled until volume halves, take 7.5 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (7.5 qian).
Crush. Take 5 qian per dose, with 2 sheng of water, 3 slices of fresh ginger, bamboo shavings the size of an egg, and 1 jujube. Decoct to 1 sheng, strain, and take warm.

Scholar Xu stated: Those with Stomach heat have hot palms and soles. During the Zhenghe era, a clan relative suffered from Shanghan (Cold Damage). After sweating, his body cooled, but days later he suddenly vomited, unable to retain medicine or food. Physicians used Dingxiang (Clove), Huoxiang (Patchouli), Huashi (Talcum), etc., but everything was vomited immediately. I said: "This is exactly residual heat after sweating lingering in the Stomach cavity. Sun Zhao's *Zhuru Tang* is precisely indicated." I urgently prepared the medicine, and he recovered instantly.

*Liangfang Huaihua San* (Good Prescriptions Sophora Flower Powder)
Zaojiao (Gleditsiae Sinensis Spina), Baifan (Alumen), Huaihua (Sophorae Flos) (stir-fried until yellow-black), Gancao (Glycyrrhizae Radix et Rhizoma) (equal parts).
Grind into fine powder. Take 2 qian,調 with boiling water.

*Xu Renze Banxia Wan* (Xu Renze Pinellia Pill) treats accumulation of cold in the Stomach, rebellious vomiting, and inability to eat.
Banxia (Pinelliae Rhizoma) (1 sheng, genuine from Xiongzhou, washed to remove slime), Xiaomaiqu (Triticum Vulgare Fermentatum) (1 sheng).
Pound Banxia into powder. Mix with water and flour, form pills the size of quail eggs. Boil in water until the flour is cooked; the medicine is ready. Initially swallow 4-5 pills, twice daily. Gradually increase to 14-15 pills. Cook and take immediately. When symptoms improve, preparing more is good. Avoid mutton and maltose.

Furthermore, based on the first half of the Banxia Pill formula, although gradual improvement occurs, the root cause remains. Wanting to prepare more of the previous pill, but fearing long-term toxicity, yet fearing non-treatment will let the disease spread, it is suitable to take *Renshen Qiwei Wan* (Seven-Ingredient Ginseng Pill).

*Renshen Qiwei Wan* (Seven-Ingredient Ginseng Pill)
Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 5 liang), Houpo (Magnoliae Officinalis Cortex) (roasted), Xixin (Asari Radix et Rhizoma) (each 4 liang), Shengjiang (Zingiberis Recens Rhizoma) (8 liang, powdered), Juapi (Citri Reticulatae Pericarpium) (3 liang), Guixin (Cinnamomi Ramulus) (2 liang).
Grind into fine powder. Form honey pills the size of sophora seeds. Take 10 pills with water, gradually increasing to 20 pills. Can also be alternated with Banxia Wan. Avoid peaches, plums, sparrow meat, raw scallions, and raw vegetables.

*Supplement* treats all vomiting in men and women. Remove Guizhi (Cinnamon Twig) from *Wuling San* (Five-Ingredient Poria Powder), add Banxia powder in equal amount to Guizhi. Take 1 qian per dose. Mix with fresh ginger juice to form a dough-like consistency. Wait half an hour. Then mix with a small cup of boiling water, stir, and take warm. (See *Wuling San* formula in *Shanghan Zhunsheng* under Thirst section.)

*Qingjin Dan* (Green Gold Pill) treats persistent vomiting of all types.
Liuhuang (Sulfur) (2 qian), Shuiyin (Mercurius) (1 qian).
Slowly melt in a crucible. Stir-fry with a wooden spatula until granular. Grind in a mortar until black and stars are invisible. Form pills the size of mung beans with ginger juice paste. Take 20-30 pills per dose with rice drink.

*Renshen Anwei San* (Ginseng Powder to Pacify the Stomach) treats Spleen-Stomach deficiency-heat, vomiting, diarrhea, or inability to ingest food.
Renshen (Ginseng Radix et Rhizoma) (1 qian), Huangqi (Astragali Radix) (roasted, 2 qian), Sheng Gancao (Raw Licorice), Zhi Gancao (Honey-fried Licorice) (each 0.5 qian), Baishao (Paeoniae Radix Alba) (0.7 qian), Baifuling (Poria Cum Mycelium) (0.4 qian), Chenpi (Citri Reticulatae Pericarpium) (0.3 qian), Huanglian (Coptidis Rhizoma) (roasted, 0.2 qian).
Decoct in water and take.