（见痰饮中）
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呕吐而病在膈上，后思水者解，急与之，思水者，猪苓散主之。
【注】
此详申上条饮呕，以明其治也。呕吐病后，则伤膈上津液，若思水者，急与饮之，不
复呕吐者，是病去胃和自解也。思水者，与饮之而仍呕吐者，是病未除而有水饮也。
主之猪芩散者，利水以止呕吐也。
【集注】
程林曰：上章言先呕□渴，此为欲解；今呕吐而病在膈上，后思水者解，亦与上证不
殊，故急与之以和胃。然思水之人，又有得水而贪饮，则胃中热少不能消水，更与人
作病，故思水者，用猪苓散以散水饮。
魏荔彤曰：呕吐而病在膈上，后思水者，欲解之征也，即论中所言，先呕后渴，此为
欲解之义也。急与之，呕吐后伤津液，水入而津液可复也。若夫未曾呕吐即思水者，
即论中所言，先渴□呕之证也，是为水停心下，应治其支饮，而渴方愈也。主以猪苓
散，利水补土，以治湿邪者，治渴而即以治上逆之呕吐也。
猪苓 茯苓 白术各等分
右三味，杵为散，饮服方寸匕，日三服。
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呕而发热者，小柴胡汤主之。
【注】
呕而腹满是有里也，主之大柴胡汤，攻里以止呕也；今呕而发热，是有表也，主之小
柴胡汤，和表以止呕也。
【集注】
程林曰：经曰：呕而发热者，柴胡汤证具。夫呕家未有发热者，以发热属半表半里，
故与小柴胡汤以和之。
李□曰：伤寒发热者为表证，然邪欲侵里，里气拒而不纳，则逆而作呕，此半表半里
证也。小柴胡为治半表半里，和解之剂。
（参见痰饮篇）
呕吐且病位在上膈，之后想喝水的，是病情将解的表现，应迅速给予饮水；若仍想喝水的，用猪苓散主治。
【注释】
此处详细阐述上一条关于饮邪致呕的内容，以明确其治疗方法。呕吐病后，会损伤上膈的津液，如果患者想喝水，应立即给予饮水，不再呕吐的，说明病邪已去，胃气调和，自然痊愈。如果患者想喝水，给水喝后仍然呕吐的，说明病邪未除，体内仍有水饮停留。使用猪苓散主治，是为了利水以止住呕吐。
【集注】
程林说：上一章说先呕吐后口渴，这是想要痊愈的迹象；现在呕吐且病位在上膈，之后想喝水的，也是将要痊愈，这与上述证候没有不同，所以迅速给予饮水以调和胃气。然而，想喝水的人，如果有得到水后贪饮的情况，那么胃中热气少而不能消化水液，反而让人产生新的病痛，所以对于想喝水的人，用猪苓散来消散水饮。
魏荔彤说：呕吐且病位在上膈，之后想喝水的，是想要痊愈的征兆，也就是《伤寒论》中所说的，先呕吐后口渴，这是想要痊愈的含义。迅速给予饮水，是因为呕吐后伤了津液，水进入后津液可以恢复。至于还没有呕吐就想喝水的，就是《伤寒论》中所说的，先口渴后呕吐的证候，这是水停在心下，应该治疗支饮，口渴才会痊愈。主治用猪苓散，利水补脾土，以治疗湿邪，治疗口渴的同时也就治好了上逆的呕吐。
猪苓、茯苓、白术各等分
以上三味药，捣碎成散剂，用米汤送服一方寸匕，每日服用三次。
@@@
【注释】
呕吐且腹部胀满是里有实邪，主治用大柴胡汤，攻逐里实以止住呕吐；现在呕吐且发热，是有表邪，主治用小柴胡汤，和解表里以止住呕吐。
【集注】
程林说：经典中说：呕吐且发热的，柴胡汤的证候具备。凡是呕吐的患者没有不发热的，因为发热属于半表半里证，所以给予小柴胡汤来调和它。
李□说：伤寒发热属于表证，然而邪气想要侵入里部，里气拒绝而不接纳，于是逆乱而作呕，这是半表半里证。小柴胡汤是治疗半表半里、和解的方剂。
(See the section on Phlegm-Fluids)
Vomiting with the pathology located above the diaphragm, followed by a desire for water, indicates that the disease is resolving; in such cases, provide water promptly. If the patient continues to desire water, Zhu Ling San (Polyporus Powder) is the primary treatment.
[Annotation]
This passage elaborates on the preceding clause regarding vomiting caused by fluid retention, clarifying its treatment. After vomiting, the fluids of the upper diaphragm are damaged. If the patient desires water, providing it immediately will result in the cessation of vomiting if the pathogen has departed and the Stomach Qi has harmonized, leading to natural recovery. However, if the patient desires water but continues to vomit after drinking, it indicates that the pathogen remains and fluid retention persists. Zhu Ling San (Polyporus Powder) is prescribed to promote urination and stop vomiting.
[Collected Annotations]
Cheng Lin stated: The previous chapter mentioned that vomiting followed by thirst indicates an impending resolution. Similarly, vomiting with pathology above the diaphragm followed by a desire for water also signifies resolution, consistent with the aforementioned syndrome. Therefore, water should be provided promptly to harmonize the Stomach. However, patients desiring water may drink greedily once they obtain it. If the Stomach lacks sufficient heat to transform the ingested water, it may lead to new pathological conditions. Thus, for those desiring water, Zhu Ling San (Polyporus Powder) is used to dissipate fluid retention.
Wei Litong stated: Vomiting with pathology above the diaphragm followed by a desire for water is a sign of impending resolution, aligning with the principle in the Treatise on Cold Damage that "vomiting followed by thirst indicates resolution." Promptly providing water replenishes the fluids damaged by vomiting. Conversely, if a patient desires water before vomiting occurs, it corresponds to the syndrome of "thirst followed by vomiting," indicating fluid retention in the epigastrium. This requires treating Branch Fluids (Zhi Yin), after which the thirst will resolve. Zhu Ling San (Polyporus Powder) promotes urination and strengthens the Spleen Earth to treat dampness; by addressing the thirst, it simultaneously treats the upward rebellious vomiting.
Zhu Ling (Polyporus), Fu Ling (Poria), Bai Zhu (Atractylodis Macrocephalae Rhizoma) in equal parts.
These three herbs are pulverized into a powder. Take one fangcun bi (a square-inch measure) with warm water, administered three times daily.
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Vomiting accompanied by fever is primarily treated with Xiao Chai Hu Tang (Minor Bupleurum Decoction).
[Annotation]
Vomiting accompanied by abdominal fullness indicates interior excess; Da Chai Hu Tang (Major Bupleurum Decoction) is prescribed to purge the interior and stop vomiting. In contrast, vomiting accompanied by fever indicates exterior involvement; Xiao Chai Hu Tang (Minor Bupleurum Decoction) is prescribed to harmonize the exterior and interior and stop vomiting.
[Collected Annotations]
Cheng Lin stated: The Classics state: "Vomiting with fever indicates that the Chai Hu Tang syndrome is present." Typically, patients who vomit do not necessarily have fever; however, since fever belongs to the Shaoyang (Half-Exterior, Half-Interior) stage, Xiao Chai Hu Tang (Minor Bupleurum Decoction) is given to harmonize the condition.
Li [Name Missing] stated: Fever in cold damage is a Exterior Syndrome. However, when pathogens attempt to invade the Interior, the Interior Qi rejects them, causing rebellion and vomiting. This constitutes a Half-Exterior, Half-Interior syndrome. Xiao Chai Hu Tang (Minor Bupleurum Decoction) is a formula for treating Half-Exterior, Half-Interior syndromes through harmonization.