Library

[Xue Ji] In *Bingji* (Pathogenesis), it is stated: There are three types of vomiting: Qi, Accumulation, and Cold. All should be discussed from the perspective of the Sanjiao (Triple Burner). Vomiting originating in the Upper Jiao stems from Qi; Qi belongs to the Yang of Heaven. Its pulse is floating and surging. Food is vomited violently immediately after eating, accompanied by thirst and a desire to drink water, dry and constipated stool, Qi rushing upward to the chest causing pain. The treatment principle is usually to descend Qi and harmonize the Middle Jiao. Vomiting originating in the Middle Jiao stems from Accumulation, which can be Yin or Yang. Food and Qi intertwine to form an accumulation causing pain. Its pulse is floating but deep upon pressing (Ni). Symptoms may involve pain preceding vomiting or vomiting preceding pain. The treatment principle is to use mildly toxic drugs to remove the accumulation, using Areca Seed (Binglang) and Costus Root (Muxiang) to move Qi. Vomiting originating in the Lower Jiao stems from Cold, reflecting the Way of Earth. Its pulse is deep and slow. Symptoms include morning food vomited in the evening, or evening food vomited in the morning, clear urine, and severe constipation. The treatment principle is to use drugs to unblock constipation and warm away cold Qi. Once stool gradually becomes unblocked, use medicines for the Middle Jiao to harmonize it, preventing re-constipation, and the disease will heal spontaneously. Wang Taipu said: Food unable to enter indicates Fire; food entering and then being vomited out indicates lack of Fire. Furthermore, *Faming* states: "Ye" (Dysphagia/Choking) is governed by the Six Fu-organs, belonging to Yang and Qi. "Se" (Obstruction) is governed by the Five Zang-organs, belonging to Yin and Blood. Both conditions arise from latent Fire hidden within Yin. Mr. Liu Zongnong said: If caused by dysfunction of Sanjiao transmission and transformation, it primarily involves Qi. If caused by Blood deficiency leading to dryness and atrophy of the stomach lining, it primarily involves Blood. "Se" implies blockage like filling. Thus, *Faming* provides the example of Tongyou Decoction for treating obstruction of the pylorus and dysphagia. Generally, Yang cannot transform without Yin; if Yin loses its position and Yang lies dormant within, transmission and transformation remain unchanged but reverse direction upwards. Therefore, previous symptoms may result from diet, lifestyle, or Seven Emotions damaging the Spleen and Stomach, causing Phlegm-fluid retention and failure of Middle Qi to circulate. The primary formula should be Buzhong Yiqi Tang (see Miscellaneous Diseases: Fatigue). If constrained accumulation damages the Spleen, use Guipi Tang (see Miscellaneous Diseases: Forgetfulness) with added Magnolia Bark (Zhike) and Platycodon Root (Jiegeng). If anger damages the Liver, use Xiaochaihu Tang (see Shaoyang Syndrome of Cold Damage) with added Gardenia (Shanzhi), Poria (Fuling), Ginseng (Renshen), and Atractylodes Macrocephala Rhizome (Baizhu). For Spleen Qi deficiency, use Liujunzi Tang (see Miscellaneous Diseases: Consumption) with added Gardenia and Magnolia Bark. For simultaneous Qi and Blood deficiency, use Bazhen Tang (i.e., Zabing Bayiwu Tang) with added Gardenia and Pinellia Tuber (Banxia). If chest and diaphragm stuffiness occurs after using Qi-moving drugs, use Liujunzi Tang with Chuanxiong Rhizome (Xiong) and Angelica Sinensis Radix (Gui). If excessive use of aromatic-drying agents leads to dry stool, use Siwu Tang (General Treatment) with added Ginseng and Atractylodes Macrocephala Rhizome. If food cannot enter, use Liujunzi Tang with Gardenia, Evodia Fruit (Wuzhuyu), and Processed Coptis Rhizome (Zhi Huanglian). If food enters and is vomited back, use Liujunzi Tang with Processed Ginger (Paojiang), White Cardamom Seed (Baidoukou), Coptis Rhizome, and Processed Evodia Fruit. If food is vomited due to Phlegm stagnation, use Liujunzi Tang with Magnolia Bark and Platycodon Root. If appetite is poor, stool is loose, chest/diaphragm is stuffy, acid regurgitation and belching of rotten food occur, and food fails to digest, this is Spleen-Stomach Deficiency-Cold. Use Dongyuan's Buzhen Wan or Bawei Wan (see Miscellaneous Diseases: Consumption). If feverish irritability, aversion to wind-cold, fear of hot food in the abdomen, or cold hands and feet with chest fullness and abdominal distension occur, this is True Cold inside with False Heat outside. Use Shenxiao Fuzi Wan (this section) or Bawei Wan. Generally, vomiting with good appetite and preference for cold drinks indicates Fire. Vomiting with poor appetite and preference for hot drinks indicates lack of Fire. One must examine the cause and treat accordingly.

A woman suffered from the above symptoms, with chest and abdominal stuffiness, feeling slightly relieved after defecation or passing gas. I said: This belongs to Spleen Qi constraint and deficiency; regulation and tonification are best. She did not believe me, used Erchen Tang, Immature Bitter Orange (Zhishi), and Coptis Rhizome instead, with no effect; then used aromatic-drying Qi-breaking agents, worsening the symptoms and further depleting her form and Qi. I used Jiawei Guipi Tang (i.e., this formula with added Bupleurum Root (Chaihu) and Gardenia), regulating and treating for half a year until recovery. Another woman suffered from the above symptoms, with chest and hypochondriac distension, lower abdominal discomfort, occasional pain, and scanty, difficult urination. I said: This is Liver Fire and Blood deficiency. Clear Liver Fire, generate Liver Blood, nourish Spleen Earth, and generate Lung Metal. She considered my words pedantic, took Qi-promoting and Phlegm-resolving agents instead, worsening the condition and bringing forth numerous deficiency syndromes. I used Jiawei Xiaoyao San (see Menstrual Disorders) and Jiawei Guipi Tang concurrently, and she recovered soon. Another woman vomited copious phlegm, had constantly cold hands and feet, and poor appetite. I said: This is Liver-Spleen constraint and anger, combined with Declining Fire of the Gate of Vitality (Mingmen). She did not believe me, took Phlegm-resolving and Qi-promoting agents, increasing abdominal distension, then took harsh diuretic and purgative agents. I said: This is incorrect treatment; it will surely turn into Spleen-deficiency edema. Urgently take Jin Gui Jian Shenqi Wan, perhaps there is hope. She did not believe me, took Chenxiang Huaqi pills instead, indeed developed edema and died.

Bai San treats women's Fanwei (Reverse Flow of Stomach) and vomiting. *Qianjin Yi Fang* states: It is not only for women; men may also take it. A dose of one jin or more is excellent.
White Kaolin (Boil one sheng of rice vinegar, heat the earth until red, immerse in vinegar until cool, repeat immersion until vinegar is dry, take one liang and grind.)
Dried Ginger (Processed, two qian and half)
Grind into fine powder. Take one qian per dose, mixed with rice drink. For severe cases, take two qian.

Baizhi San treats women's Fanwei and vomiting.
Take one liang of Angelica Dahurica Root (Baizhi), slice it, stir-fry on tile until yellow, grind into fine powder. Take twenty slices of pig blood, soak in boiling water seven times, dip the blood slices in the medicine powder and eat seven slices. Reserve remaining powder for next use.

Taicang Wan treats Spleen-Stomach weakness, inability to eat, and Fanwei vomiting.
White Cardamom Seed (Suandoukou) and Amomum Fruit (Suosharen) (each two liang), Clove (Dingxiang) (one liang), Stored Grain Rice (Chencangmi) (one sheng, stir-fry with yellow loess until rice turns red, remove loess).
Grind into fine powder. Make pills the size of wutong seeds using ginger juice. Take 60-70 pills per dose after meals, washed down with light ginger soup.

Qingjin Dan treats vomiting and Fanwei etc. Take thirty pills per dose, swallowed with decoction of Fresh Ginger and Tangerine Peel (Chenpi). (Formula seen in previous Vomiting section.)

Wuling San treats Fanwei with thirst, add Pinellia Tuber (Banxia). Take four qian per dose, decoct with five slices of fresh ginger, take warm. (Formula seen in Cold Damage Thirst section.)

Dongyuan Buzhen Wan
Cistanche Stem (Roucongrong) (soaked in wine, baked), Trigonella Foenum-graecum Seed (Huluba) (stir-fried), Prepared Aconite Root (Fuzi) (processed, peeled), Activated Halloysite (Yangqishi) (calcined), Nutmeg (Roudoukou) (baked in flour wrapper), Dodder Seed (Tusizi) (cleanly washed, soaked in wine and steamed), Prepared Sichuan Aconite Root (Chuanwu) (processed, peeled), Agarwood (Chenxiang), Schisandra Fruit (Wuweizi) (each five qian), Deer Antler Lu Rong (Lu Rong) (soaked in wine, fried), Morinda Officinalis Root (Baji) (decored), Calcined Stalactite Powder (Zhongru Fen) (each one liang).
Grind into fine powder. Treat two pairs of sheep kidneys as food, boil with scallion, pepper, and wine, mash, add wine, make paste pills the size of wutong seeds. Take seventy pills per dose when empty stomach, washed down with rice drink or salt water as desired.

Shenxiao Fuzi Wan treats Spleen-Kidney Deficiency-Cold, vomiting, or Fanwei and Ge Ye (Diaphragmatic Obstruction).
Black Aconite Root (Hei Fuzi) weighing one liang, four qian, five qian, upright with flat base and round tip, one piece. Process in ash fire until skin cracks, soak in fresh ginger juice, dry, process again, soak again, dry and process again. Use half a bowl of ginger juice completely. Then peel and remove navel, grind to powder. Mix with Ginseng Paste to make pills the size of millet grains. Swallow several pills with saliva. When Stomach Qi recovers slightly and food intake improves, administer warming and tonifying agents.