有痰、有热、有虚，皆用生姜，随证用药。痰饮为患，而呕吐恶心者，二陈汤加丁香、乌梅、生姜七片，煎
服。戴云∶恶心者，无声无物、但心中欲吐不吐，欲呕不呕，虽曰恶心，非心经之病，皆在胃口上，宜用生姜，盖能
开胃豁痰故也。
翻胃即膈噎也，膈噎乃翻胃之渐发挥。详言之，大约有四∶有血虚、有气虚、有热、有痰。又有兼病者，血虚
者，脉必数而无力；气虚者，脉必缓而无力；血气俱虚者，口中多出沫，但见沫大出者必死；有热者，脉数而有
力；有痰者，脉滑数，二者可治。又曰∶翻胃脉，血虚，左手脉无力；气虚，右脉无力；有痰寸关沉，或伏而大。
血虚以四物为主，气虚以四君子为主，热以解毒为主，痰以二陈为主。必入童便、姜汁、竹沥、韭汁、牛羊乳。粪如
羊矢者，不治；年高者，虽不治，须用参、术，关防气虚、胃虚。有阴火上炎而翻胃者，作阴火治。有气结者，其
脉寸关沉而涩，宜开滞导气之药。有积血在内者，当消息以遂之。大便涩者，难治，常食兔肉则便利。翻胃病，
若痰实火盛之人，先以瓜蒂散吐之，后用大黄、皂角、黑牵牛、朴硝，为末糊丸，姜汤下十五丸。一方，治翻胃积
饮，通用益元散，以姜汁澄白脚为丸，时时服之。一方，以黄连、茱萸、炒贝母、栝蒌、陈皮、白术、枳实、牛转
草。但有咽下塞住不宽，项背转侧，欠伸不得，似乎膈噎之证，饮食不下，先有心疼，疼发一身尽黄，先以川芎、桔
梗、山栀、细茶、生姜齑汁，吐痰二碗，后用导痰汤加羌活、黄芩、红花，人壮者用此法。一老人翻胃，栝蒌、贝
母、白术、陈皮、吴茱萸、黄连、生甘草、人参、茯苓、枳
实。年少者，以四物汤清胃脘，血燥不润便，故涩，《格致余论》甚详。槟连丸治翻胃，或朝食而暮出者，或下咽
而吐者，或胃脘作痛者，或必得尽吐而爽者，或见食即吐者∶白术 黄连 砂仁 陈皮 半夏曲 神曲 蓬术（各一
两） 藿香 槟榔 青皮 丁香 麦 三棱 姜黄 良姜 白豆蔻 茯苓 桂花 连翘 山楂（各五钱） 川附（
半只） 吴茱萸（二钱） 上药末之，姜糊丸，每服七八十丸，姜汤或白汤下，日三服。一人年壮病翻，益元散加
陈皮、半夏、生姜、自然汁浸，晒干为末，竹沥甘蔗汁调服。一人但能食粥一匙，吃下，膈有一菜杂于其间，便连
粥俱不能下，鱼肉俱不可咽，止能食稀粥，其人起居如常，用凉膈散加桔梗。若面常觉发热，大便
结，此咽膈燥痰所碍，加白蜜饮之。治翻胃，未致于胃脘干槁者。一男子壮年，食后必吐出数口，隙不尽出，膈上时
作声，面色如平人，病不在脾胃，而在膈间。问其得病之由，乃因大怒未止辄吃面，即有此症。盖怒甚，则血郁于
上，积在膈间，有碍气之升降，津液因聚而为痰、为饮，与血相搏而动，故作声也。用二陈加香附、莱菔、韭汁服一
日，以瓜蒂散、酸浆吐之，再一日，又吐，痰中见血一盏，次日复吐，见血一钟乃愈。一中年人，中脘作痛，食已则
吐，面紫霜色，关脉涩涩，乃血病也，因跌仆后中脘即痛，投以生新推陈血剂，吐片血碗许而愈。一妇人因七情，咽
喉有核如绵，吐不出，咽不下，及两胁心口作痛，饮食少，胎已三月矣。用香附 砂仁 茯苓 陈皮（各二钱） 麦
冬浓朴 白术 人参 甘草（各五分） 枳壳 芍药 白豆蔻（各八分） 竹茹（二钱） 姜（五片）煎服。心痛
不止加草豆蔻。一人先因膈噎后食羊肉，前疾大作及咽酸，用二陈汤加苍术、白术、香
附、砂仁、枳壳、吴茱、黄连、神曲、生姜煎服，后里急后重
加木香、槟榔。痰气结核在咽间吐咯不出，此七情所致也。及痰火炎上，胸膈不宽，以二陈加香附、砂仁、栝蒌、
白术、浓朴、苏子、黄连、吴茱、枳壳、生姜煎服。头眩加前胡。因食欲过甚，遂成膈气，作死血治之，二陈加当
归、桃仁、香附、砂仁、白术、枳实、藿香、姜连，吐不止加丁香煎，临服加韭汁、姜汁、竹沥各少许，加牛乳尤佳。
一人痰火噎塞，胸膈不宽，二陈加紫苏、浓朴、香附、砂仁、姜连、木香、槟榔、白豆蔻、吴茱萸、生姜煎服。呕
吐胸膈疼，二陈加姜黄、香附、砂仁、丁香、藿香、白术、白豆蔻、枳壳、姜连∶心腹痛及咽酸去枳壳加吴茱萸，发热
去枳壳、吴茱，加甘葛、竹茹、枇杷叶、姜汁炒，热盛者，加连翘仁姜煎服。
凡因痰、热、虚引起的恶心，均可使用生姜，并根据具体证候配合其他药物。若因痰饮致病导致呕吐恶心，可用二陈汤加丁香、乌梅、生姜七片，煎服。戴元礼说：所谓恶心，是指没有声音也没有吐出物，只是心中想吐却吐不出来，想呕却呕不出来。虽然名为“恶心”，但这并非心经的病变，病位都在胃口之上，适宜用生姜，因为生姜能开胃豁痰的缘故。
翻胃就是膈噎，膈噎是翻胃的初期阶段。详细来说，大致有四种情况：血虚、气虚、热证、痰证。又有兼夹病症的情况。血虚者，脉象必然数而无力；气虚者，脉象必然缓而无力；气血俱虚者，口中多流出涎沫，只见涎沫大量涌出者必死无疑；有热者，脉象数而有力；有痰者，脉象滑数，这两种情况尚可治疗。又说：翻胃的脉象，血虚则左手脉无力；气虚则右脉无力；有痰则寸关部脉沉，或伏大而有力。血虚以四物汤为主方，气虚以四君子汤为主方，热证以解毒为主，痰证以二陈汤为主。必须加入童便、姜汁、竹沥、韭汁、牛羊乳。大便像羊屎一样干结的，属不治之症；年高者，虽然难治，也必须用人参、白术，以防气虚和胃虚。有因阴火上炎而导致翻胃的，按阴火证治疗。有气机郁结的，其脉象寸关部沉而涩，宜用开滞导气的药物。有瘀血积滞在体内的，应当斟酌病情予以疏导。大便干涩难解的，难治，常食兔肉可使大便通畅。翻胃病，若是痰实火盛之人，先用瓜蒂散催吐，后用大黄、皂角、黑牵牛、朴硝研末，用糊制成丸剂，姜汤送服十五丸。另一方，治疗翻胃积饮，通用益元散，用姜汁澄清后的沉淀部分为丸，时时服用。另一方，用黄连、吴茱萸、炒贝母、栝蒌、陈皮、白术、枳实、牛转草（注：疑为笔误或特定草药，此处保留原名）。如果有吞咽时堵塞不宽畅，项背转动困难，打哈欠伸懒腰都不舒服，似乎有膈噎的症状，饮食不下，先有心痛，疼痛发作时全身发黄，先用川芎、桔梗、山栀、细茶、生姜醋汁，催吐痰液两碗，后用导痰汤加羌活、黄芩、红花，身体壮实的人适用此法。一位老年翻胃患者，用栝蒌、贝母、白术、陈皮、吴茱萸、黄连、生甘草、人参、茯苓、枳实。年轻患者，用四物汤清胃脘，因血燥不能滋润肠道，所以大便干涩，《格致余论》中对此解释得很详细。槟连丸治疗翻胃，症状包括早晨吃晚上吐，或者刚咽下就吐，或者胃脘疼痛，或者必须全部吐出来才舒服，或者一见食物就吐：白术、黄连、砂仁、陈皮、半夏曲、神曲、蓬术（各一两）、藿香、槟榔、青皮、丁香、麦（注：疑为麦芽或麦冬，原文缺字，保留）、三棱、姜黄、良姜、白豆蔻、茯苓、桂花、连翘、山楂（各五钱）、川附子（半只）、吴茱萸（二钱）。将上述药物研成粉末，用姜糊做成丸剂，每次服用七八十丸，用姜汤或白开水送服，每日三次。一人年轻力壮患翻胃，用益元散加陈皮、半夏、生姜，用自然汁浸泡，晒干后研末，用竹沥和甘蔗汁调服。一人只能吃一勺粥，吃下去后，感觉胸膈间有一块菜混杂在其中，就连粥都下不去，鱼肉更不可咽，只能吃稀粥，其人起居如常，用凉膈散加桔梗。如果面部经常觉得发热，大便干结，这是咽膈燥痰阻碍所致，加白蜜饮用。这是治疗翻胃尚未发展到胃脘干枯萎缩阶段的方子。一男子壮年，饭后必吐出几口，但吐不尽，膈上时常发出声响，面色如常人，病不在脾胃，而在膈间。询问其得病原因，是因为大怒未止时就吃面条，于是出现此症。大概是因为愤怒过度，血液郁结于上部，积聚在膈间，阻碍了气的升降，津液因此聚集成痰、成饮，与血相搏动而发声，所以发出声响。用二陈汤加香附、莱菔、韭汁服用一天，再用瓜蒂散、酸浆水催吐，又过一天，再次催吐，痰中带血一盏，次日再吐，见血一钟后才痊愈。一中年人，中脘作痛，进食后即吐，面色呈紫霜色，关脉涩涩，这是血病，因跌仆后中脘即痛，投以生新推陈的血分药剂，吐出一碗左右血块而愈。一妇人因七情内伤，咽喉有核状物如棉絮，吐不出，咽不下，以及两胁心口作痛，饮食减少，胎孕已三个月。用香附、砂仁、茯苓、陈皮（各二钱）、麦冬、浓朴、白术、人参、甘草（各五分）、枳壳、芍药、白豆蔻（各八分）、竹茹（二钱）、生姜（五片）煎服。心痛不止加草豆蔻。一人先前因膈噎，后来吃了羊肉，旧病大作且伴有咽酸，用二陈汤加苍术、白术、香附、砂仁、枳壳、吴茱萸、黄连、神曲、生姜煎服，后来出现里急后重，加木香、槟榔。痰气结核在咽喉间，吐咯不出，这是七情所致。以及痰火炎上，胸膈不宽，用二陈汤加香附、砂仁、栝蒌、白术、浓朴、苏子、黄连、吴茱萸、枳壳、生姜煎服。头眩加前胡。因食欲过甚，遂成膈气，按死血（瘀血）治疗，用二陈汤加当归、桃仁、香附、砂仁、白术、枳实、藿香、姜连，吐不止加丁香煎，临服时加韭汁、姜汁、竹沥各少许，加牛乳尤其好。一人痰火噎塞，胸膈不宽，用二陈汤加紫苏、浓朴、香附、砂仁、姜连、木香、槟榔、白豆蔻、吴茱萸、生姜煎服。呕吐胸膈疼，用二陈汤加姜黄、香附、砂仁、丁香、藿香、白术、白豆蔻、枳壳、姜连；心腹痛及咽酸去枳壳加吴茱萸，发热去枳壳、吴茱，加甘葛、竹茹、枇杷叶（姜汁炒），热盛者，加连翘仁姜煎服。
For nausea caused by phlegm, heat, or deficiency, ginger can be used in all cases, with additional herbs selected according to the specific syndrome. If vomiting and nausea are caused by fluid retention (Tan Yin), Er Chen Tang (Two-Cured Decoction) should be added with Dingxiang (Caryophylli Flos), Wumei (Mume Fructus), and seven slices of Shengjiang (Zingiberis Rhizoma Recens), then decocted and taken orally. Dai Yun stated: "Nausea" refers to a sensation where there is no sound nor any vomitus expelled, but rather a feeling of wanting to vomit without actually doing so. Although termed "nausea," it is not a disease of the Heart Meridian; the pathology lies above the stomach opening. Ginger is appropriate here because it opens the stomach and resolves phlegm.
Fan Wei (Reversal Stomach / Vomiting due to obstruction) is synonymous with Ge Ye (Diaphragmatic Obstruction); Ge Ye is the initial stage of Fan Wei. In detail, there are approximately four types: Blood Deficiency, Qi Deficiency, Heat, and Phlegm. There are also combined syndromes. In Blood Deficiency, the pulse is rapid yet forceless. In Qi Deficiency, the pulse is slow yet forceless. In combined Qi and Blood Deficiency, excessive saliva flows from the mouth; if large amounts of saliva are seen spurting out, death is inevitable. In Heat syndromes, the pulse is rapid and forceful. In Phlegm syndromes, the pulse is slippery and rapid; these two conditions are treatable. It is further stated that regarding the pulse in Fan Wei: Blood Deficiency manifests as a forceless pulse on the left side; Qi Deficiency manifests as a forceless pulse on the right side; Phlegm manifests as a deep pulse at the Cun and Guan positions, or a hidden yet large pulse. For Blood Deficiency, Si Wu Tang (Four-Substance Decoction) is the primary formula. For Qi Deficiency, Si Jun Zi Tang (Four-Gentlemen Decoction) is primary. For Heat, detoxification is the main approach. For Phlegm, Er Chen Tang is primary. These formulas must be supplemented with Tong Bian (Child's Urine), Jiang Zhi (Ginger Juice), Zhu Li (Bamboo Sap), Jiu Zhi (Chinese Chive Juice), and cattle/sheep milk. If feces resemble sheep droppings, the condition is untreatable. In elderly patients, although difficult to treat, Renshen (Ginseng Radix et Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma) must be used to prevent Qi and Stomach deficiency. If Fan Wei is caused by Yin Fire flaring upward, it should be treated as a Yin Fire syndrome. If caused by Qi stagnation, the pulse at Cun and Guan is deep and choppy; herbs that open stagnation and guide Qi should be used. If there is accumulated blood stasis internally, the condition should be assessed and guided accordingly. If stool is dry and difficult to pass, the prognosis is poor; frequent consumption of rabbit meat may facilitate bowel movement. For Fan Wei in patients with excess phlegm and abundant fire, first induce vomiting using Gua Di San (Melon Sepal Powder), followed by a pill made from Dahuang (Rhei Radix et Rhizoma), Zaojiao (Gleditsiae Sinensis Spina), Hei Qian Niu (Pharbitidis Semen Nigrum), and Puxiao (Natrii Sulfas), powdered and bound with paste, taken with ginger water (15 pills). Another prescription for Fan Wei with accumulated fluids uses Yi Yuan San (Benefit the Origin Powder) universally, formed into pills using the clarified sediment of ginger juice, taken frequently. Another prescription uses Huanglian (Coptidis Rhizoma), Zhuyu (Evodiae Fructus), fried Beimu (Fritillariae Bulbus), Gualou (Trichosanthis Fructus), Chenpi (Citri Reticulatae Pericarpium), Baizhu, Zhishi (Aurantii Fructus Immaturus), and Niuzhuancao. If there is a sensation of blockage upon swallowing, difficulty turning the neck and back, inability to stretch or yawn comfortably, resembling Ge Ye, with inability to eat and prior heart pain accompanied by generalized jaundice during pain episodes, first induce vomiting of two bowls of phlegm using Chuanxiong (Ligustici Chuanxiong Rhizoma), Jiegeng (Platycodonis Radix), Shanzhi (Gardeniae Fructus), fine tea, and vinegar made from fresh ginger. Then use Dao Tan Tang (Guide Out Phlegm Decoction) added with Qianghuo (Notopterygii Rhizoma et Radix), Huangqin (Scutellariae Radix), and Honghua (Carthami Flos); this method is suitable for robust individuals. An elderly patient with Fan Wei was treated with Gualou, Beimu, Baizhu, Chenpi, Zhuyu, Huanglian, Sheng Gancao (Raw Glycyrrhizae Radix et Rhizoma), Renshen, Fuling (Poria), and Zhishi. Younger patients should use Si Wu Tang to clear the stomach cavity; blood dryness fails to moisten the intestines, causing constipation, as detailed in *Ge Zhi Yu Lun* (Supplements to the Investigation of Things). Bin Lian Wan (Areca and Coptis Pill) treats Fan Wei characterized by eating in the morning and vomiting in the evening, vomiting immediately after swallowing, epigastric pain, relief only after complete vomiting, or vomiting upon seeing food: Baizhu, Huanglian, Sharen (Amomi Fructus Rotundus), Chenpi, Banxia Qu (Pinelliae Fermentatum), Shenqu (Massae Medicatae Fermentatae), Pengzhu (Curcumae Longae Rhizoma) (each 1 liang), Huoxiang (Agastaches Herba), Binglang (Arecae Semen), Qingpi (Citri Reticulatae Pericarpium Viride), Dingxiang, Mai (likely Maidong or Maiya, text unclear), Sanleng (Sparganii Rhizoma), Jianghuang (Curcumae Longae Rhizoma), Liangjiang (Alpiniae Officinarum Rhizoma), Baidoukou (Cardamomi Fructus), Fuling, Guihua (Osmanthi Flos), Lianqiao (Forsythiae Fructus), Shanzha (Crataegi Fructus) (each 5 qian), Chuan Fu (Semi Aconiti Lateralis Radix Praeparata), Zhuyu (2 qian). Grind these into powder, bind with ginger paste into pills. Take 70–80 pills per dose with ginger water or plain water, three times daily. A young, robust man with Fan Wei was treated with Yi Yuan San added with Chenpi, Banxia, and Shengjiang, soaked in natural juices, dried, powdered, and taken mixed with Zhuli and Sugarcane Juice. A patient who could only swallow one spoonful of porridge, feeling a piece of vegetable stuck in the diaphragm preventing further ingestion, unable to swallow fish or meat, subsisting only on thin porridge, with normal daily activities, was treated with Liang Ge San (Cool the Diaphragm Powder) added with Jiegeng. If the face often feels hot and stool is constipated, this indicates dry phlegm obstructing the throat and diaphragm; add Bai Mi (Honey) to drink. This treats Fan Wei before the stomach cavity becomes dry and atrophic. A young man would vomit several mouthfuls after eating, though not completely, with sounds emanating from the diaphragm; his complexion was normal. The pathology was not in the Spleen or Stomach but in the diaphragm. Inquiry revealed he ate noodles while still angry. Severe anger causes blood to stagnate upward, accumulating in the diaphragm, hindering the ascending and descending of Qi. Fluids gather into phlegm and fluids, which contend with blood, causing noise. After taking Er Chen Tang added with Xiangfu (Cyperi Rhizoma), Laifu (Radish Seed), and Jiu Zhi for one day, he was induced to vomit using Gua Di San and sour plum water. On the second day, another vomiting episode occurred, expelling a cup of bloody phlegm. On the third day, another cup of blood was expelled, after which he recovered. A middle-aged man suffered epigastric pain and vomiting after eating, with a purplish-frost complexion and a choppy Guan pulse, indicating a blood disorder following a fall. He was administered a blood-regulating formula promoting new generation and eliminating old stasis, vomiting about a bowl of blood before recovering. A woman suffered from seven emotions affecting her health, feeling a cotton-like mass in the throat that could neither be spat out nor swallowed, along with pain in the hypochondrium and epigastrium, reduced appetite, and a pregnancy of three months. She was treated with Xiangfu, Sharen, Fuling, Chenpi (each 2 qian), Maidong (Ophiopogonis Radix), Nongpo (Magnoliae Officinalis Cortex), Baizhu, Renshen, Gancao (each 5 fen), Zhike (Aurantii Fructus), Shaoyao (Paeoniae Radix Alba), Baidoukou (each 8 fen), Zhuru (Bambusae Caulis in Taeniae, 2 qian), and Shengjiang (5 slices) decocted. If heart pain persists, add Caodoukou (Alpiniae Katsumadai Semen). A patient previously suffering from Ge Ye ate mutton, exacerbating the condition and causing acid regurgitation. He was treated with Er Chen Tang added with Cangzhu (Atractylodis Rhizoma), Baizhu, Xiangfu, Sharen, Zhike, Zhuyu, Huanglian, Shenqu, and Shengjiang decocted. Later, when tenesmus developed, Muxiang (Aucklandiae Radix) and Binglang were added. Phlegm-Qi nodules in the throat that cannot be expectorated are caused by the seven emotions. When Phlegm-Fire flares upward causing chest and diaphragm discomfort, Er Chen Tang is added with Xiangfu, Sharen, Gualou, Baizhu, Nongpo, Suzi (Perillae Fructus), Huanglian, Zhuyu, Zhike, and Shengjiang decocted. Add Qianhu (Peucedani Radix) for dizziness. Excessive appetite leading to Diaphragmatic Qi should be treated as fixed blood stasis: Er Chen Tang added with Danggui (Angelicae Sinensis Radix), Taoren (Persicae Semen), Xiangfu, Sharen, Baizhu, Zhishi, Huoxiang, Jianglian (Coptis stir-fried with ginger), Dingxiang if vomiting persists. Before administration, add small amounts of Jiu Zhi, Jiang Zhi, and Zhuli; adding cow milk is especially beneficial. A patient with Phlegm-Fire obstruction and chest discomfort was treated with Er Chen Tang added with Zisu (Perillae Folium), Nongpo, Xiangfu, Sharen, Jianglian, Muxiang, Binglang, Baidoukou, Zhuyu, and Shengjiang decocted. For vomiting with chest/diaphragm pain, Er Chen Tang is added with Jianghuang, Xiangfu, Sharen, Dingxiang, Huoxiang, Baizhu, Baidoukou, Zhike, and Jianglian. For heart/abdominal pain and acid regurgitation, remove Zhike and add Zhuyu. For fever, remove Zhike and Zhuyu, add Gan Ge (Puerariae Radix), Zhuru, Pipaye (Loquat Leaf stir-fried with ginger). For severe heat, add Lianqiao Ren (Forsythiae Semen) stir-fried with ginger.