呕家本渴, 渴为郤解, 今反不渴, 心下有支饮故也.
半夏一升 生姜半斤以水七升, 煮取一升半, 分温再服.
治卒呕吐, 心下痞, 膈间有水, 眩悸者.
半夏一升 生姜半斤 茯苓三两煎服如前.
治心胸中有痰饮宿水, 自吐出水, 复心胸间虚气满
不能食, 消痰气令能食.
茯苓三两 人参三两 白术三两 枳实二两 橘皮二两半 生姜四两
,右六味, 水六升, 煮取一升八合, 分三服. 如人行八九里, 再进之
.
【集注】赵良曰: 呕为痰饮动中, 涌而出之. 呕尽水当渴, 渴则可征
支饮之全去. 今反不渴, 是其饮尚留, 去之未尽也. 用半夏之辛温,
生姜之辛散, 散其欲出之饮, 则所留之邪自尽矣. 半夏, 生姜皆味辛
,可治膈上痰, 心下坚, 呕逆目眩. 然悸必心受水凌, 故加茯苓以去
水,伐肾邪安心神也. 后方加人参, 枳实, 橘皮, 此由上, 中二焦气
弱,水饮入胃, 脾不能输归于肺, 肺不能通调水道, 以致停积为痰为
宿水. 吐之则下气因而上逆, 虚与气结, 满不能食. 当补益中气, 以
人参, 白术为君; 茯苓逐宿水, 枳实破诸气为臣; 开脾胃, 宣扬上焦
,发散凝滞, 则陈皮, 生姜为使也. 其积饮既去, 而虚气塞满其中,
不能进食, 此证最多.
呕吐的人本来应该口渴，如果口渴了，说明病邪已经解除；现在反而不觉得口渴，这是因为心下有支饮（水饮停聚于心下）的缘故。
治疗突然呕吐，胃脘部痞塞不通，膈间有水气，伴有头晕、心悸症状的。
治疗心胸中有痰饮和陈旧的积水，患者自行吐出后，心胸间仍有虚气胀满，不能进食。此方能消除痰气，使患者能够进食。
茯苓三两，人参三两，白术三两，枳实二两，橘皮二两半，生姜四两。以上六味药，用水六升，煮取药液一升八合，分三次服用。如果在行走八九里的时间内，再进服一次。
【集注】赵良说：呕吐是因为痰饮扰动中焦，迫使水饮涌出。呕吐尽后，水饮应当感到口渴，口渴可以证明支饮已经完全去除。现在反而不渴，说明水饮仍然残留，没有被彻底清除。使用半夏的辛温之性，生姜的辛散之力，来发散那些想要排出的水饮，那么所残留的病邪自然就会全部消除。半夏和生姜都是味辛的药物，可以治疗膈上的痰饮、心下的坚结、呕吐逆气和目眩。但是心悸必然是因为心脏受到水气的凌犯，所以加入茯苓以去除水气，驱逐肾邪，安定心神。后面的方剂加入了人参、枳实、橘皮，这是因为上、中二焦的气虚弱，水饮进入胃中，脾不能将其输布归于肺，肺不能通调水道，导致停滞积聚成为痰和陈旧的水饮。通过催吐，下部的正气因而向上逆行，虚邪与气机郁结，导致胀满不能进食。应当补益中气，以人参、白术作为君药；茯苓驱逐陈旧的水饮，枳实破除各种气滞作为臣药；开通脾胃，宣发上焦，发散凝滞之气，则陈皮、生姜作为使药。当积存的饮邪已经去除，而虚气壅塞在胸中，导致不能进食，这种证候非常多见。
Patients who vomit should originally feel thirsty; if they feel thirsty, it indicates that the pathogenic factor has been resolved. Now, however, they do not feel thirsty, which is due to the presence of *Zhi Yin* (Branching Fluid Retention) below the heart.
Banxia (Pinelliae Rhizoma), 1 sheng; Shengjiang (Zingiberis Recens Rhizoma), 0.5 jin. Boil in 7 sheng of water until 1.5 sheng remains. Divide into two doses and take warm.
Treats sudden vomiting, epigastric fullness and obstruction (*Pi*), fluid retention between the diaphragm, dizziness (*Xuan*), and palpitations (*Ji*).
Banxia (Pinelliae Rhizoma), 1 sheng; Shengjiang (Zingiberis Recens Rhizoma), 0.5 jin; Fuling (Poria), 3 liang. Decoct and take as described above.
Treats phlegm-fluid retention and old stagnant water in the chest and heart region. After spontaneous vomiting expels the fluid, there remains a sensation of empty qi fullness in the chest and heart, accompanied by an inability to eat. This formula eliminates phlegm-qi and restores appetite.
Fuling (Poria), 3 liang; Renshen (Ginseng Radix et Rhizoma), 3 liang; Baizhu (Atractylodis Macrocephalae Rhizoma), 3 liang; Zhishi (Aurantii Fructus Immaturus), 2 liang; Chenpi (Citri Reticulatae Pericarpium), 2.5 liang; Shengjiang (Zingiberis Recens Rhizoma), 4 liang. The above six ingredients are boiled in 6 sheng of water until 1.8 sheng remains. Divide into three doses. If the patient can walk for the distance covered in eight or nine li, administer another dose.
[Ji Zhu] Zhao Liang stated: Vomiting occurs because phlegm-fluid disturbs the middle jiao, forcing it to surge out. Once the fluid is vomited out, thirst should follow; thirst serves as evidence that the *Zhi Yin* (Branching Fluid Retention) has been completely eliminated. The fact that there is no thirst now indicates that the fluid still remains and has not been fully cleared. Banxia’s pungent-warm nature and Shengjiang’s pungent-dispersing power are used to disperse the fluid that is attempting to exit, thereby eliminating any remaining pathogenic factors. Both Banxia (Pinelliae Rhizoma) and Shengjiang (Zingiberis Recens Rhizoma) are pungent in flavor and can treat phlegm above the diaphragm, hardness below the heart, vomiting with reflux, and dizziness. However, palpitations necessarily indicate that the Heart is being overwhelmed by water; therefore, Fuling (Poria) is added to remove water, drain kidney pathogens, and calm the spirit. The subsequent formula adds Renshen (Ginseng Radix et Rhizoma), Zhishi (Aurantii Fructus Immaturus), and Chenpi (Citri Reticulatae Pericarpium) because the Qi of the Upper and Middle Jiao is weak. When fluid enters the Stomach, the Spleen fails to transport it to the Lung, and the Lung fails to regulate the water passages, leading to stagnation and accumulation as phlegm and old water. Vomiting causes the descending Qi to rebel upward, resulting in the knotting of deficiency and Qi, causing fullness and an inability to eat. One must tonify the Middle Qi, using Renshen (Ginseng Radix et Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma) as Sovereign herbs; Fuling (Poria) drives out old water, and Zhishi (Aurantii Fructus Immaturus) breaks Qi stagnation as Minister herbs; Chenpi (Citri Reticulatae Pericarpium) and Shengjiang (Zingiberis Recens Rhizoma) open the Spleen and Stomach, promote the Upper Jiao, and disperse凝滞 (stagnation) as Envoy herbs. When accumulated fluid is removed but empty Qi obstructs the interior, preventing food intake, this pattern is very common.