伤寒发热无汗，呕不能食，而反汗出 然者，是转属阳明也。食谷欲呕者，属阳明也，吴茱萸汤主之。
得汤反剧者，属上焦也。腹痛欲呕吐者，黄连汤主之。（方论见腹痛。）
呕而发热者，小柴胡汤主之。发热微恶寒，肢节烦疼，微呕，心下支结，外症未去者，柴胡加桂枝汤主之。
论见发热。太阳病发热恶寒，身体痛，呕逆，脉紧者，名曰伤寒，麻黄汤症。（论见发热。）太阳与阳明合
病，不下利，但呕者，葛根加半夏汤主之。（《活人》云∶头疼身热痛，肌热目疼鼻干，脉浮而长是也。）
葛根加半夏汤
葛根（二钱） 麻黄 生姜（各一钱半） 甘草 芍药 桂枝（各一钱） 半夏（二钱） 大枣（二枚）
上 咀，以水一斗，先煎葛根、麻黄减二升，去白沫，纳诸药，煎服三升，温服一升，覆取微汗。
呕而往来寒热，胸胁苦满者，宜小柴胡。若兼下利者，乃太阳少阳合病，宜黄芩加半夏生姜汤。（论见
往来寒热及下利。）
太阳过经十余日，反二三下之，后四五日，柴胡症仍在者，先与小柴胡汤。呕不止，心下急，郁
郁微烦者，为末解也，与大柴胡汤下之愈。太阳病过经十余日，心下温温欲吐，而心中痛，大便反溏，腹微
满，郁郁微烦。先此时自极吐下者，与调胃承气汤。若不满者，不可与。但欲呕，胸中痛，微溏者，此非
柴胡症，以呕故知极吐下也。
〔《本》〕渴而饮水呕者，柴胡不中与也。（论见胁痛。）
先渴却呕者，为水停心下，此属饮家。（《活人》云∶赤茯苓汤主之。）先呕却渴者，此为欲解候也。
（《金匮》云∶呕思水者，少与之。）
呕而下利，有寒热者，为阳，宜黄芩汤、大柴胡汤。无热者，为阴，宜猪苓汤、真武汤。（并见呕利门。）
呕而脉弱，小便利，身热见厥者，难治，四逆汤主之。
呕而心烦，若汗吐下后者，栀子生姜豉汤。若未曾吐汗下后，兼咳而渴者，宜猪苓汤。（详见不得眠。）
呕多虽有阳明胃实，不可攻之。（论见胃实。）呕家有痈脓者，不可治，脓尽自愈。服桂枝呕者，酒
客病。（论见大法。）
伤寒病出现发热、无汗，伴有呕吐且不能进食，反而出现濈然汗出（连续不断出汗）的症状，这是病邪转属阳明经的表现。进食后想要呕吐的，属于阳明病，用吴茱萸汤主治。
服用吴茱萸汤后症状反而加重的，病位在上焦。腹痛且想要呕吐的，用黄连汤主治。（方剂论述见“腹痛”章节。）
呕吐且发热的，用小柴胡汤主治。发热且轻微恶寒，肢体关节烦扰疼痛，轻微呕吐，心下部有支撑结聚感，表证尚未解除的，用柴胡加桂枝汤主治。
（相关论述见“发热”章节。）太阳病出现发热、恶寒，身体疼痛，呕吐逆气，脉象紧的，称为伤寒，是麻黄汤证。（相关论述见“发热”章节。）太阳与阳明两经合病，不下利，只是呕吐的，用葛根加半夏汤主治。（《活人书》说：头痛、身热痛，肌肤发热、目疼鼻干，脉象浮而长的情况就是如此。）
葛根加半夏汤
葛根（二钱） 麻黄 生姜（各一钱半） 甘草 芍药 桂枝（各一钱） 半夏（二钱） 大枣（两枚）
以上药物切碎，用水一斗，先煎煮葛根、麻黄，减少二升水量，去掉表面的白沫，加入其余药物，煎取三升药液，每次温服一升，服药后覆盖衣被以取得微汗。
呕吐且寒热往来，胸胁部苦于胀满的，适宜用小柴胡汤。如果兼有下利的，这是太阳与少阳合病，适宜用黄芩加半夏生姜汤。（相关论述见“寒热往来”及“下利”章节。）
太阳病经过十余日，反而进行了二三次攻下治疗，之后又过了四五日，小柴胡汤证仍然存在的，先给予小柴胡汤。如果呕吐不止，心下部急迫，心中郁结轻微烦躁的，说明邪气未解，应给予大柴胡汤攻下即可痊愈。太阳病经过十余日，心下部温热想吐，心中疼痛，大便反而稀溏，腹部轻微胀满。在此之前曾经过剧烈的催吐或泻下治疗，应给予调胃承气汤。如果腹部没有胀满感的，不可给予此药。只想呕吐，胸部疼痛，大便轻微稀溏的，这不是小柴胡汤证，因为呕吐的缘故，可知此前曾经过剧烈的催吐或泻下治疗。
〔《本草纲目》引文〕口渴且饮水后呕吐的，不可给予小柴胡汤。（相关论述见“胁痛”章节。）
先感到口渴随后呕吐的，是因为水饮停聚在心下，这属于饮家范畴。（《活人书》说：用赤茯苓汤主治。）先呕吐随后感到口渴的，这是病情将要解除的征兆。（《金匮要略》说：呕吐想喝水的，少量给予饮用。）
呕吐且伴有下利，有寒热表现的，属于阳证，适宜用黄芩汤、大柴胡汤。没有发热的，属于阴证，适宜用猪苓汤、真武汤。（均见“呕利”门。）
呕吐且脉象微弱，小便通利，身体发热却四肢厥冷的，难以治疗，用四逆汤主治。
呕吐且心烦，如果是经过发汗、催吐或泻下治疗后的，用栀子生姜豉汤。如果未曾经过吐、汗、下治疗，兼有咳嗽且口渴的，适宜用猪苓汤。（详见“不得眠”章节。）
呕吐频繁，即使有阳明胃实证的证据，也不可用攻下法。（相关论述见“胃实”章节。）患有呕吐且有痈脓的，不可强行止呕治疗，待脓液排尽后自然痊愈。服用桂枝汤后出现呕吐的，是酒客（长期饮酒者）的病。（相关论述见“大法”章节。）
In Taiyang disease (Taiyang syndrome), if there is fever, absence of sweating, vomiting with inability to eat, and instead a continuous sweating (Ji Ran Han Chu), this indicates the pathogen has transferred to the Yangming channel. If one desires to vomit after eating grain, it belongs to Yangming disease, which is primarily treated with Wuzhuyu Tang (Evodia Decoction).
If symptoms worsen after taking the decoction, the pathology lies in the Upper Jiao (Upper Burner). For abdominal pain accompanied by the desire to vomit, Huanglian Tang (Coptis Decoction) is the primary treatment. (For formula discussion, see "Abdominal Pain".)
For vomiting accompanied by fever, Xiaochaihu Tang (Minor Bupleurum Decoction) is the primary treatment. For fever with slight aversion to cold, vexing pain in the limbs and joints, slight vomiting, a sensation of support and accumulation under the heart (Xin Xia Zhi Jie), and unresolving exterior symptoms, Chaihu Jia Guizhi Tang (Bupleurum plus Cinnamon Twig Decoction) is the primary treatment.
(For related discussion, see "Fever".) In Taiyang disease, if there is fever, aversion to cold, body pain, vomiting and reverse qi, and a tight pulse, it is named Cold Damage (Shanghan), representing the Mahuang Tang (Ephedra Decoction) pattern. (For related discussion, see "Fever".) In combined disease of Taiyang and Yangming channels, if there is no diarrhea but only vomiting, Gegen Jia Banxia Tang (Kudzu plus Pinellia Decoction) is the primary treatment. (The *Huo Ren* text states: Headache, body heat and pain, skin heat, eye pain, nasal dryness, and a floating and long pulse are indicative.)
Gegen Jia Banxia Tang (Kudzu plus Pinellia Decoction)
Gegen Radix Puerariae Lobatae (2 qian)
Mahuang Herba Ephedrae (1.5 qian)
Shengjiang Rhizoma Zingiberis Recens (1.5 qian)
Gancao Radix Glycyrrhizae (1 qian)
Shaoyao Radix Paeoniae Alba (1 qian)
Guizhi Ramulus Cinnamomi (1 qian)
Banxia Rhizoma Pinelliae Preparatum (2 qian)
Dazao Fructus Jujubae (2 pieces)
Cut the herbs into small pieces. Use one dou of water. First decoct Gegen and Mahuang until the volume reduces by two sheng. Remove the white foam on the surface. Add the remaining herbs. Decoct to obtain three sheng of liquid. Take one sheng warm. Cover with blankets to induce slight sweating.
For vomiting accompanied by alternating chills and fever, and bitter fullness in the chest and hypochondrium, Xiaochaihu Tang (Minor Bupleurum Decoction) is appropriate. If accompanied by diarrhea, this is a combined disease of Taiyang and Shaoyang channels, and Huangqin Jia Banxia Shengjiang Tang (Scutellaria plus Pinellia and Fresh Ginger Decoction) is appropriate. (For related discussion, see "Alternating Chills and Fever" and "Diarrhea".)
After Taiyang disease has passed for more than ten days, if improper purgative treatments were performed two or three times, and after another four or five days, the Xiaochaihu Tang pattern persists, administer Xiaochaihu Tang first. If vomiting continues incessantly, there is urgency in the epigastrium, and mild depression and vexation, the pathogenic factor remains unresolved; Da Chaihu Tang (Major Bupleurum Decoction) should be administered to purge the pathogen for recovery. After Taiyang disease has passed for more than ten days, if there is a warm sensation in the epigastrium with desire to vomit, pain in the heart region, loose stools, and mild abdominal fullness with mild depression and vexation: if prior to this time, extreme emetic or purgative treatments were used, Tiaowei Chengqi Tang (Regulating the Stomach and Directing Downward Decoction) should be given. If there is no fullness, do not give it. If there is only desire to vomit, pain in the chest, and slightly loose stools, this is not the Xiaochaihu Tang pattern; due to vomiting, it is known that extreme emetic or purgative treatments were previously used.
[From *Bencao*] If thirsty and drinking water leads to vomiting, Xiaochaihu Tang (Minor Bupleurum Decoction) should not be given. (For related discussion, see "Hypochondriac Pain".)
If thirst precedes vomiting, it is due to fluid retention in the epigastrium; this belongs to the category of Fluid Retention disorders (Yin Jia). (*Huo Ren* states: Chi Fuling Tang (Red Poria Decoction) is the primary treatment.) If vomiting precedes thirst, this is a sign that the condition is about to resolve. (*Jinkui* states: For those who vomit and desire water, give it in small amounts.)
For vomiting accompanied by diarrhea, if there are chills and fever, it is a Yang pattern, suitable for Huangqin Tang (Scutellaria Decoction) or Da Chaihu Tang (Major Bupleurum Decoction). If there is no fever, it is a Yin pattern, suitable for Zhuling Tang (Polyporus Decoction) or Zhenwu Tang (True Warrior Decoction). (See "Vomiting and Diarrhea" section.)
For vomiting with a weak pulse, free urination, body heat with cold extremities, the prognosis is difficult; Sini Tang (Recovery from Collapse Decoction) is the primary treatment.
For vomiting with mental restlessness, if this occurs after sweating, vomiting, or purging, Zhizi Shengjiang Chi Tang (Gardenia, Fresh Ginger, and Fermented Soybean Decoction) is indicated. If there has been no prior vomiting, sweating, or purging, and cough with thirst is present, Zhuling Tang (Polyporus Decoction) is appropriate. (See "Insomnia" section.)
Even if there are signs of Yangming Stomach Excess (Wei Shi) with frequent vomiting, purgative methods must not be used. (For related discussion, see "Stomach Excess".) For patients with vomiting due to abscess pus, do not treat the vomiting directly; self-healing will occur once the pus is exhausted. Vomiting after taking Guizhi Tang (Cinnamon Twig Decoction) indicates a condition specific to wine drinkers (Jiu Ke). (For related discussion, see "General Principles".)