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Great vomiting syndromes are mostly caused by injury to the Stomach Qi (Stomach energy). However, there is a distinction between Yin and Yang patterns in such injuries. If vomiting is accompanied by sound or pain, it is a Yang pattern; if vomiting occurs without sound and the vomitus consists purely of clear water, or if food eaten today is completely vomited out tomorrow, this is a Yin pattern. If there is no abdominal pain, or if symptoms occur upon exposure to cold, these are invariably Yin patterns. If differentiation is unclear and medication is administered blindly, it will inevitably lead to death. I shall also transmit another method to distinguish between Yin and Yang: simply observe whether the tongue coating is slippery or dry. Generally speaking, Yang patterns involve thirst and a dry tongue, whereas Yin patterns involve no thirst and a slippery tongue. For the treatment of vomiting in Yang patterns, the formula named "Yin Huo Zhi Tu Tang" (Fire-Guiding Vomiting-Stop Decoction) is used. The brilliance of this formula lies in the use of Fu Ling (Poria) up to one liang. The upward rushing of Fire is due to the blockage of the Water pathways below; Fu Ling strengthens the Spleen and Stomach while promoting the downward flow of water, Huang Lian (Coptis Rhizome) clears Heart Fire, and the remaining herbs are harmonized properly. Naturally, the rebellious Fire will subside and Water will flow downward smoothly, preventing the occurrence of vomiting. As for vomiting caused by Yin deficiency, it is indeed difficult to treat and cannot be cured with a single dose like Yang-pattern vomiting. This is because Yin-deficiency vomiting stems from the deficiency of Ming Men Fire (Gate of Life Fire) in the Kidney. Once Kidney Fire declines, the Spleen lacks Fire nourishment, causing food to stagnate in the Spleen and create a world of Yin-Cold. Unable to transform at the lower level, it naturally surges upward, resulting in vomiting. The therapeutic method should be to warm and tonify the Ming Men Fire, allowing Fire to generate within Water, thereby enabling Earth to generate Fire internally. Use Ji Huo Shen Dan (Fire-Nourishing Divine Elixir). After ingestion, drink water to assist the medicinal action (or prevent rejection); one dose alleviates symptoms, two doses further alleviate them, ten doses result in recovery, and thirty doses ensure complete cure. Vomiting caused by Yin-pathogens arises from accumulation over a long period. Without substantial tonification, Yin cannot generate and Yang cannot transform. Some seek rapid effects by adding three qian of Ren Shen (Ginseng Root) to the formula, which may reduce efficacy by two-tenths compared to the original, but ultimately it is not as exquisite as the original prescription. Since this is a pure Yin disease, there is no need to borrow Yang-tonifying herbs; moreover, Bai Zhu (Atractylodes Macrocephala Rhizome) in the original formula is already a Yang herb. Why add unnecessary Ren Shen? People do not realize the severity of their illness and only seek quick recovery; they might change to my formula or seek other treatments, which may inadvertently cause harm.

Yin Huo Zhi Tu Tang (Fire-Guiding Vomiting-Stop Decoction)
Huang Lian (Coptidis Rhizoma, 1 qian), Fu Ling (Poria, 1 liang), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 5 qian), Chen Pi (Citri Reticulatae Pericarpium, 1 qian), Shen Qu (Massa Medicata Fermentata, 1 qian), Mai Dong (Ophiopogonis Radix, 1 qian), Ren Shen (Ginseng Radix et Rhizoma, 2 qian), Sha Ren (Amomi Fructus Rotundus, 1 grain), Huo Xiang (Agastaches Herba, 5 fen), Sheng Jiang (Zingiberis Rhizoma Recens, 3 slices). Decoct in water and take orally.

Ji Huo Shen Dan (Fire-Nourishing Divine Elixir)
Rou Gui (Cinnamomi Cortex, 3 qian), Shu Di Huang (Rehmanniae Radix Praeparata, 1 liang), Shan Yu Rou (Corni Fructus, 5 qian), Wu Wei Zi (Schisandrae Chinensis Fructus, 2 qian), Fu Ling (Poria, 5 qian), Shan Yao (Dioscoreae Rhizoma, 1 liang), Rou Dou Kou (Myristicae Semen, 2 pieces), Bai Zhu (Atractylodis Macrocephalae Rhizoma, 1 liang), Qian Shi (Euryales Semen, 5 qian). Decoct in water and take orally.