（附翻胃）
呕者有物在中。其所来之道远。故必呕而出也。吐者亦有物在中。其所来之道近。故一
吐而即出也。分而言之。微有不同。合而言之。同归于火。饮食痰涎停积不化。胃气一升。则涌
而出矣。其与翻胃相似。而实各有所属翻胃属寒。呕吐属热。惟其热也。故其出也。无定时
。或随食随吐。或食良久而后吐。随食随吐者。火邪急速不及入胃而即出。无呕吐之苦。无
挥咯之劳是即吐之谓也。食良久而后吐者。火犹稍缓。必入胃余时。委曲而出。酸苦万状。
伤神劳精。肠卷而腹急。是即呕之谓也。而所出之物。亦不甚尽惟翻也。则阴气下结。水谷
暂容。朝食则暮吐。暮食则朝吐。或朝食至午而吐。午时至暮而吐。其吐必尽所食日日如此
不少愆期。盖胃家受寒不能运化。自不容于不出。此翻胃与呕吐所以不同也。又有吞酸吐酸
者何也。盖饮食入胃。胃弱不能消。而又挟肝火。是以作酸。浮饮停蓄。变为酸痰。肝火升
即吐。肝火降即吞。其吞与吐。皆肝火升降之所为也。故治呕吐者。必治其热。治翻胃者。
必治其寒。治吞酸吐酸。必抑其肝。而后所投之药无不中矣。
（附翻胃）
呕吐是指胃中有实物。这些食物来自较远的消化道，所以必须通过呕吐排出。吐也是指胃中有实物。但这些食物来自较近的消化道，所以一吐就立即排出了。分开来说，二者有细微的不同；合起来说，都归结于火邪。饮食和痰涎停滞积聚无法消化，胃气上逆，就会涌出。这与翻胃相似，但实际上各有归属：翻胃属于寒证，呕吐属于热证。正因为是热证，所以呕吐没有固定的时间。有的随吃随吐，有的进食很久之后才吐。随吃随吐的，是因为火邪急迫迅速，食物来不及进入胃部就被吐出，没有呕吐的痛苦，也没有用力干呕的劳累，这就是“吐”的含义。进食很久之后才吐的，是因为火势稍缓，食物必须进入胃部停留一段时间后，才曲折地吐出，味道酸苦万分，损伤精神，耗损精气，肠道卷缩，腹部急迫，这就是“呕”的含义。而且吐出的东西也不完全干净。至于翻胃，则是阴气在下部结聚，水谷暂时容纳其中，早上吃的晚上吐，晚上吃的早上吐，或者早上吃的到中午吐，中午吃的到晚上吐。其吐出的必定是将所吃的所有食物全部吐出，每天如此，从不失期。这是因为胃家受寒，不能运化，自然容不下食物而不得不吐出。这就是翻胃与呕吐不同的原因。又有吞酸、吐酸是怎么回事呢？大概是因为饮食进入胃中，胃气虚弱不能消化，又夹杂肝火，所以产生酸味。浮饮停蓄，变为酸痰，肝火上升则吐酸，肝火下降则吞酸。这种吞和吐，都是肝火升降运动所致。所以治疗呕吐，必须清治其热；治疗翻胃，必须温治其寒；治疗吞酸吐酸，必须抑制肝火，这样所投用的药物才能无往不利。
关部脉象滑利，且大小不均匀的，必然出现呕吐逆乱。又说，呕吐没有其他原因，若是寸口脉紧、滑、数，提示轻微的血虚；若单见浮脉兼带芤象，则有瘀血。最忌讳的是脉象涩而弱。
(Attached: Fanwei / Regurgitation)
Ou (vomiting with sound and effort) refers to the presence of solid matter in the stomach. The path from which it comes is distant; therefore, it must be vomited out. Tu (vomiting without sound or great effort) also refers to the presence of matter in the stomach. However, the path from which it comes is near; thus, it is expelled immediately upon vomiting. Analyzed separately, there are slight differences; considered together, both are attributed to Fire pathogen. When food and phlegm-fluids stagnate and accumulate without being digested, Stomach Qi rebels upward, causing them to surge out. This resembles Fanwei (regurgitation), yet they have distinct etiologies: Fanwei belongs to Cold, while Ou/Tu belongs to Heat. Due to this Heat, the timing of expulsion is irregular. Some vomit immediately after eating; others vomit long after eating. Those who vomit immediately after eating do so because the Fire pathogen is rapid and urgent, preventing the food from entering the Stomach before being expelled. There is no suffering associated with retching, nor the labor of dry heaving; this is defined as Tu. Those who vomit long after eating do so because the Fire is slightly slower; the food must enter the Stomach and remain for some time before being expelled gradually. The taste is extremely sour and bitter, damaging the Shen (Spirit) and exhausting Jing (Essence), leading to contracted intestines and abdominal urgency; this is defined as Ou. Furthermore, the expelled matter is not always completely empty. In contrast, Fanwei involves Yin Qi binding downward, temporarily holding water and grain. Food eaten in the morning is vomited in the evening, and food eaten in the evening is vomited in the morning, or food eaten in the morning is vomited at noon, and food eaten at noon is vomited in the evening. The vomiting always expels all ingested food, occurring daily without fail. This is because the Stomach has suffered Cold and cannot transform and transport, making retention impossible and necessitating expulsion. This is why Fanwei differs from Ou/Tu.
What about Swallowing Acid (Tun Suan) and Vomiting Acid (Tu Suan)? Generally, when food enters the Stomach, weak Stomach Qi fails to digest it, compounded by Liver Fire, resulting in acidity. Floating fluids stagnate and transform into acidic phlegm. When Liver Fire ascends, acid is vomited; when Liver Fire descends, acid is swallowed. Both swallowing and vomiting are caused by the ascending and descending movements of Liver Fire. Therefore, treating Ou/Tu requires addressing the Heat; treating Fanwei requires addressing the Cold; and treating Swallowing/Vomiting Acid requires suppressing the Liver. Only then will the administered medicines hit the mark accurately.
A pulse at the Guan position that is slippery but uneven in magnitude indicates inevitable rebellious vomiting. It is also said that vomiting arises from no other cause than a Cun (inch) position pulse that is tight, slippery, and rapid; a slightly rapid pulse suggests mild Blood deficiency. A pulse that is floating alone with a Kou (cork-like) quality indicates blood stasis. The most contraindicated pulse qualities are choppy and weak.