Library

There is a distinction between true and false vomiting. Since vomiting has already occurred, how can there be a distinction between true and false? The reason for this distinction lies in the fact that many vomiting cases are accompanied by other symptoms. If the vomiting is the true manifestation (the root cause), then the accompanying symptoms are false manifestations; if the vomiting is a false manifestation, then the accompanying symptoms represent the true condition. Therefore, it is essential to distinguish them clearly.

For instance, in Taiyang disease (Exterior Syndrome of the Taiyang channel) presenting with vomiting, the Taiyang disease is the true condition, while the vomiting is a false manifestation. If one merely stops the vomiting without addressing the cold pathogen, the cold syndrome will not be cured. Similarly, in Fanwei (Regurgitation/Gastric Outlet Obstruction), the vomiting stems from a true deficiency of the Lower Yuan (Kidney Yang/Mingmen Fire). If one treats only the vomiting without addressing the underlying deficiency, the vomiting cannot be stopped. This explains why vomiting symptoms have true and false distinctions.

Generally speaking, true vomiting is rare, whereas false vomiting is common. True vomiting usually results from stomach pathology itself; treating the stomach promptly alleviates the symptoms. In such cases, the patient feels nauseous suddenly, which is not a chronic condition nor caused by fire pathogens or wind pathogens. The formula used is Erchen Tang (Two-Cured Decoction) added with aromatic and sandalwood-type herbs and Pingwei San (Calm the Stomach Powder). One dose can achieve success, making treatment quite easy, as it addresses the true nature of the vomiting.

Regarding false vomiting, one must observe the patient's condition, differentiate deficiency and excess, examine daily habits, and inspect the moisture or dryness of the mouth and tongue. Then, based on formulas for treating Taiyang disease, Fanwei, etc., modifications should be made according to the specific pathology to effectively stop the vomiting. Otherwise, failure may ensue. I do not provide fixed formulas for false vomiting because the causes are diverse, and a single formula cannot apply universally.

Why are diarrhea symptoms also divided into true and false? Does diarrhea truly have such a distinction? This is because diarrhea is invariably accompanied by pathogenic factors. Diarrhea caused by pathogens differs significantly from diarrhea caused by deficiency. Thus, I categorize and discuss them separately. Diarrhea due to Yin deficiency is true diarrhea; previously, formulas for tonifying Spleen Yin and warming Mingmen Fire were provided, so no new formula is established here. However, diarrhea accompanied by pathogens is false diarrhea. One should not use antidiarrheal drugs simply because diarrhea is present. Such cases typically involve abdominal pain that occurs in paroxysms. This "pathogenic diarrhea" differs from "deficiency diarrhea," which involves pain without paroxysmal intensity. Pathogenic diarrhea is characterized by tenesmus (urgent need to defecate with little output), whereas deficiency diarrhea does not present this way. Differentiating based on these signs is most accurate. The previous discussion on diarrhea established formulas but only addressed diarrhea accompanied by fire, neglecting diarrhea accompanied by pathogens. Diarrhea accompanied by pathogens is essentially diarrhea accompanied by wind, and there is also diarrhea accompanied by toxins. These all belong to false diarrhea and must be understood. I now prescribe a formula effective for both wind-diarrhea and toxin-diarrhea, named Hui Zhu Dan (Filth-Expelling Pill). This formula expels filth while simultaneously dispelling wind, clears fire-toxins, and promotes the excretion of turbid fluids through urine, while clearing substances exit via stool. This achieves a balance where both the healthy Qi and pathogens are appropriately managed. How to distinguish between wind-diarrhea and toxin-diarrhea? Wind-diarrhea presents with tenesmus and a buzzing sound in the anus. Toxin-diarrhea presents with stools resembling glue or lacquer, dark black like leaking roof water. Distinguishing by these characteristics is generally accurate, though careful clinical observation is required.

Hui Zhu Dan (Filth-Expelling Pill)
Dahuang (Rhei Radix et Rhizoma) (3 qian) Cheqianzi (Plantaginis Semen) (5 qian) Danggui (Angelicae Sinensis Radix) (5 qian) Gancao (Glycyrrhizae Radix et Rhizoma) (2 qian) Binglang (Arecae Semen) (2 qian) Zhiqiao (Aurantii Fructus Immaturus) (1 qian) Luoboziz (Brassicae Semens) (1 qian) Taoren (Persicae Semen) (20 grains) Zhizi (Gardeniae Fructus) (2 qian) Chaihu (Bupleuri Radix) (2 qian) Decoct in water and take orally.