脉诀云滑脉居寸多呕逆 阳脉浮紧浮者胃气虚紧者寒在上二气相争其人即吐
脉诀云上部有脉下部无脉其人当死不吐者死
又曰呕而脉弱小便弗利身有微热厥者难治
胃中有热脉数而滑胃中有寒脉迟而滑
一胃中有痰作呕者宜 二陈汤加减用
一胃中有寒作呕者宜 治中汤加丁香 或养胃汤
一痰逆呕吐眩晕者宜 旋复花汤 茯苓半夏汤
一发热而呕者宜 柴胡竹茹汤
一食积作呕中脘痛者宜 香砂养胃汤
一胃寒作呕吐者宜 藿香散
一肝火逆上呕吐者宜 抑青丸
一病患胃虚呕吐者宜 丁香治中汤
一内伤饮食填塞胃气呕吐不已者宜用 藿香平胃散
一痰逆胸满呕吐者宜用 温胆汤
治胃中痰逆呕吐眩晕
旋复花 半夏 陈皮 干姜 人参 甘草 白术 槟榔
水二钟姜三片煎八分不拘时服
治脾胃虚弱身重有痰恶心欲吐此风邪羁绊于脾胃之中
白术 茯苓 半夏 神曲 陈皮 天麻 麦芽
姜三片煎服
治发热呕吐
柴胡 黄芩 半夏 人参 甘草 竹茹 陈皮
姜三片煎服
《脉诀》中说:滑脉出现在寸口部位,多伴有呕吐、气逆的症状。阳脉浮紧,其中“浮”表示胃气虚弱,“紧”表示寒邪在上部,两种气机相互争斗,病人就会发生呕吐。
《脉诀》又说:上部有脉搏而下部没有脉搏,病人应当死亡;如果不呕吐的,也会死亡。
又说:呕吐且脉象微弱,小便不通利,身体有轻微发热并出现四肢厥冷(手脚冰凉)的,属于难治之症。
一方:胃中有寒导致作呕的,适宜使用治中汤加丁香,或者使用养胃汤。
一方:痰气上逆导致呕吐、眩晕的,适宜使用旋复花汤或茯苓半夏汤。
一方:内伤饮食导致胃气壅塞、呕吐不止的,适宜使用藿香平胃散。
(以下方剂出处说明)
方见痰门:治疗胃中有痰导致的作呕。
方见中寒门:治疗胃寒脉沉而呕吐。
治疗胃中痰逆引起的呕吐、眩晕:
药材:旋复花、半夏、陈皮、干姜、人参、甘草、白术、槟榔。
用法:水两钟,生姜三片,煎至八分,不拘时间服用。
治疗脾胃虚弱、身体沉重、有痰、恶心欲吐,此乃风邪羁绊于脾胃之中:
药材:白术、茯苓、半夏、神曲、陈皮、天麻、麦芽。
用法:生姜三片,煎服。
治疗发热呕吐:
药材:柴胡、黄芩、半夏、人参、甘草、竹茹、陈皮。
用法:生姜三片,煎服。
治疗食积导致作呕、中脘疼痛:
药材:香附、砂仁、陈皮、半夏、甘草、草果、山楂、浓朴、神曲、官桂、苍术、藿香。
用法:生姜、大枣煎服。
The *Mai Jue* (Pulse Classic) states: When the Hua pulse (Slippery pulse) is found predominantly at the Cun position (inch position), it is often accompanied by vomiting and rebellious Qi. If the Yang pulse is floating and tight, "floating" indicates deficiency of Stomach Qi, while "tight" indicates Cold pathogen in the upper region. When these two Qi mechanisms contend with each other, the patient will vomit.
The *Mai Jue* further states: If there is a pulse at the upper part but no pulse at the lower part, the patient is destined to die; if they do not vomit, they will still die.
It also states: Vomiting accompanied by a weak pulse, difficulty in urination, slight fever, and Jue syndrome (cold extremities) constitutes a difficult-to-treat condition.
Heat in the Stomach presents with a Shuo pulse (Rapid pulse) that is slippery; Cold in the Stomach presents with a Chi pulse (Slow pulse) that is slippery.
Formula 1: For vomiting caused by Phlegm in the Stomach, Er Chen Tang (Two-Aged Decoction) should be used with modifications.
Formula 2: For vomiting caused by Cold in the Stomach, Zhi Zhong Tang (Regulate the Middle Decoction) with Ding Xiang (Clove) or Yang Wei Tang (Nourish the Stomach Decoction) should be used.
Formula 3: For vomiting and vertigo caused by rebellious Phlegm, Xuan Fu Hua Tang (Inula Flower Decoction) or Fu Ling Ban Xia Tang (Poria and Pinellia Decoction) should be used.
Formula 4: For vomiting accompanied by fever, Chai Hu Zhu Ru Tang (Bupleurum and Bamboo Shavings Decoction) should be used.
Formula 5: For vomiting and pain in the Zhongwan point (CV12) caused by Food Stagnation, Xiang Sha Yang Wei Tang (Aucklandia and Amomum Decoction to Nourish the Stomach) should be used.
Formula 6: For vomiting caused by Cold in the Stomach, Huo Xiang San (Patchouli Powder) should be used.
Formula 7: For vomiting caused by Liver Fire rebelling upward, Yi Qing Wan (Suppress Blue Pill) should be used.
Formula 8: For patients suffering from vomiting due to Stomach deficiency, Ding Xiang Zhi Zhong Tang (Clove Regulate the Middle Decoction) should be used.
Formula 9: For vomiting that persists due to internal injury from diet causing obstruction of Stomach Qi, Huo Xiang Ping Wei San (Patchouli and Stabilize the Spleen Powder) should be used.
Formula 10: For chest fullness and vomiting caused by rebellious Phlegm, Wen Dan Tang (Warm the Gallbladder Decoction) should be used.
(Notes on Formula Sources)
See the "Phlegm Section": Treats vomiting caused by Phlegm in the Stomach.
See the "Internal Cold Section": Treats vomiting with a deep pulse caused by Cold in the Stomach.
Treatment for vomiting and vertigo caused by rebellious Phlegm in the Stomach:
Herbs: Inulae Flos (Xuan Fu Hua), Pinelliae Rhizoma Preparatum (Ban Xia), Citri Reticulatae Pericarpium (Chen Pi), Zingiberis Rhizoma (Gan Jiang), Ginseng Radix et Rhizoma (Ren Shen), Glycyrrhizae Radix et Rhizoma (Gan Cao), Atractylodis Macrocephalae Rhizoma (Bai Zhu), Arecae Semen (Bing Lang).
Preparation: Decoct with two units of water and three slices of fresh ginger until reduced to eight-tenths. Take at any time.
Treatment for heaviness of the body, Phlegm, nausea, and desire to vomit due to Spleen and Stomach weakness, where Wind Pathogen is entangled within the Spleen and Stomach:
Herbs: Atractylodis Macrocephalae Rhizoma (Bai Zhu), Poria (Fu Ling), Pinelliae Rhizoma Preparatum (Ban Xia), Massae Fermentatae Medicinalis (Shen Qu), Citri Reticulatae Pericarpium (Chen Pi), Gastrodiae Rhizoma (Tian Ma), Massae Fermentatae Medicinalis (Mai Ya).
Preparation: Decoct with three slices of fresh ginger and take.
Treatment for vomiting with fever:
Herbs: Bupleuri Radix (Chai Hu), Scutellariae Radix (Huang Qin), Pinelliae Rhizoma Preparatum (Ban Xia), Ginseng Radix et Rhizoma (Ren Shen), Glycyrrhizae Radix et Rhizoma (Gan Cao), Bambusae Caulis in Taenia (Zhu Ru), Citri Reticulatae Pericarpium (Chen Pi).
Preparation: Decoct with three slices of fresh ginger and take.
Treatment for vomiting and epigastric pain caused by Food Stagnation:
Herbs: Cyperi Rhizoma (Xiang Fu), Amomi Fructus Rotundus (Sha Ren), Citri Reticulatae Pericarpium (Chen Pi), Pinelliae Rhizoma Preparatum (Ban Xia), Glycyrrhizae Radix et Rhizoma (Gan Cao), Tsaoko Fructus (Cao Guo), Crataegi Fructus (Shan Zha), Magnoliae Officinalis Cortex (Nong Po/Mu Dan Pi - Note: Text says Nong Po, likely Mu Hou/Magnolia Bark), Massae Fermentatae Medicinalis (Shen Qu), Cinnamomi Cortex (Guan Gui), Atractylodis Rhizoma (Cang Zhu), Pogostemonis Herba (Huo Xiang).
Preparation: Decoct with fresh ginger and jujube fruits and take.
Treatment for vomiting caused by Cold in the Stomach:
Herbs: Pogostemonis Herba (Huo Xiang), Pinelliae Rhizoma Preparatum (Ban Xia), Citri Reticulatae Pericarpium (Chen Pi), Glycyrrhizae Radix et Rhizoma (Gan Cao), Atractylodis Rhizoma (Cang Zhu), Magnoliae Officinalis Cortex (Nong Po/Mu Hou), Platycodonis Radix (Jie Geng), Poria (Fu Ling).
Preparation: Decoct with fresh ginger and jujube fruits and take.