仲景伤寒论，夫呕家有痈脓者，不可疗也，其呕脓尽自愈，若先呕后渴者，为欲解也，
先渴后呕者，为水停在心下，此属饮家。
呕家本渴，今反不渴者，以心下有支饮故也，此属支饮。（张仲景杂方此证当用小半夏
加茯苓汤方在支饮门中）
呕脉弱，小便复利，身有微热，见厥者难疗。四逆汤主之方。
甘草（二两炙） 附子（一枚） 干姜（一两半）
上三物 咀，以水三升，煮取一升二合，去滓，温分再服，强人用大附子一枚，干姜三
两。忌海藻菘菜猪肉。
又呕心下痞坚者，大半夏汤主之方。
半夏（三升洗） 人参（三两切） 白蜜（一升）
上三味，以泉水一斗二升，并蜜和扬之二百四十遍，煮药取二升半，温服一升，日再服
。忌羊肉饧。（本论治反胃支饮）
又干呕下利，黄芩汤主之方。
黄芩（三两） 人参（三两） 桂心（二两） 大枣（十二枚） 半夏（半升洗） 干
姜（三两）
上六味切，以水七升，煮取三升，温分三服。忌羊肉饧生葱。（出第十六卷中）
病源噫醋者，由上焦有停痰，脾胃有宿冷，故不能消谷，谷不消，胀满而气逆，所以好
噫而吞酸，气息酸臭也。（出第二十一卷中）
广济疗吐酸水，每食则变作醋水吐出，槟榔散方。
槟榔（十六分） 人参（六分） 茯苓（八分） 橘皮（六分） 荜茇（六分）
上五味捣筛为散，平晨空腹，取生姜五大两合皮捣，绞取汁，温内散方寸匕，搅调，顿
服之，日一服，渐加至一匕半，若利多减，以微通泄为度。忌酢物生冷油腻猪鱼等。
又疗常吐酸水，脾胃中冷，茯苓汤方。
茯苓（十二分） 橘皮（十二分） 白术（八分） 人参（六分） 桂心（六分） 甘
草（八分炙
）紫苏（十分） 生姜（十二分） 槟榔（七枚）
上九味切，以水九升，煮取二升半，绞去滓，分温三服，每服如人行七八里，未好瘥，
三两日更服一剂，老小取微利。忌生葱酢物桃李雀肉海藻菘菜。
又疗呕吐酸水结气筑心，白术散方。
白术（八分） 茯苓（八分） 吴茱萸（四分） 橘皮（六分） 荜茇（四分） 浓朴
（八分炙）
上九味捣筛为散，空腹煮姜枣汤服方寸匕，日二服，渐加至二匕半，觉热服少，饮食三
两口压之。忌酢物桃李雀肉等。
又疗心头结气连胸背痛，及吐酸水日夜不止，茯苓汤方。
茯苓（四两） 浓朴（四两炙） 橘皮（二两） 白术（二两） 生姜（十两）
上五味切，以水九升，煮取二升七合，绞去滓，分温三服，每服相去如人行七八里，
须利加槟榔末一两半，汤欲熟时纳之，甚安稳，三日服一剂，频服五六剂可则停。忌酢物桃
李雀肉等。（一方有吴茱萸人参各二两并出第一卷中）
延年疗食讫醋咽多噫，吴茱萸汤方。
吴茱萸（五合） 生姜（三两） 人参（二两） 大枣（十二枚）
上四味切，以水六升，煮取二升，绞去滓，分为三服，每服相去十里久。（肘后集验文
仲备急千金并同肘后分两小别）
又增损承气丸，疗胸胁支满，背上时有一答热则痛，腹胀多噫，醋咽气逆，两胁满，并
主之方。
前胡（七分） 枳实（七分炙） 桂心（五分） 干姜（五分） 吴茱萸（五分） 茯
苓（四分）
芍药（六分） 浓朴（十分炙） 橘皮（十分） 大黄（七分） 杏仁（七十枚去皮尖）
上十一味捣筛为末，纳杏仁脂中研调筛，度蜜和丸，每服食后少时，酒饮任性，初服七
丸如梧子，以气宣下泄为度。忌生葱大醋。（并出第十七卷中）
必效理中散，主食后吐酸水，食羹粥酪剧方。
干姜（二两） 食茱萸（二两）
上二味作散，酒服方寸匕，日三温服，勿冷服之，常醋水瘥。（千金同出第二卷中）
《伤寒论》中记载：凡是呕吐伴有痈脓的患者，不可强行止呕，待其呕吐出的脓液排尽后，病症自然痊愈。如果先出现呕吐随后感到口渴的，是病情即将解除的征兆；如果先感到口渴随后出现呕吐的，是因为水饮停滞在心下（胃脘部），这属于饮家（以水饮内停为主要特征的病证）。
呕吐患者本应感到口渴，现在反而不渴，是因为心下有支饮（水饮停留于胸膈之间）的缘故，这也属于支饮。（张仲景杂方中对此证应当使用小半夏加茯苓汤，该方剂收录在支饮门中。）
呕吐且脉象微弱，小便通畅，身体有轻微发热，并出现四肢厥冷的，难以治疗。主治方剂为四逆汤。
甘草（二两，炙） 附子（一枚） 干姜（一两半）
以上三味药，切碎，用水三升，煮取一升二合，滤去药渣，分两次温服。体质强壮者可用大附子一枚，干姜三两。忌食海藻、菘菜（白菜类）、猪肉。
另外，呕吐且心下（胃脘部）痞塞坚硬者，主治方剂为大半夏汤。
半夏（三升，洗净） 人参（三两，切片） 白蜜（一升）
以上三味药，用泉水一斗二升，与蜂蜜混合搅拌二百四十遍，煎煮药物取二升半，温服一升，每日服用两次。忌食羊肉和饴糖。（本论用于治疗反胃和支饮。）
另外，干呕且伴有腹泻者，主治方剂为黄芩汤。
黄芩（三两） 人参（三两） 桂心（二两） 大枣（十二枚） 半夏（半升，洗净） 干姜（三两）
以上六味药切碎，用水七升，煮取三升，分三次温服。忌食羊肉、饴糖、生葱。（出自第十六卷。）
《诸病源候论》记载：嗳气吞酸的原因，是由于上焦有停痰，脾胃有宿冷，因此不能消化谷物。谷物不消化，导致胀满且气机上逆，所以经常嗳气并吞酸，呼出的气息带有酸臭味。（出自第二十一卷。）
《广济方》治疗吐酸水，每进食则变为醋水吐出，使用槟榔散。
槟榔（十六分） 人参（六分） 茯苓（八分） 橘皮（六分） 荜茇（六分）
以上五味药捣碎过筛制成散剂。清晨空腹时，取生姜五大两带皮捣烂，绞取汁液，将一方寸匕的药散加入姜汁中搅匀，一次性服下。每日服用一次，逐渐增加至一方寸半的量，如果腹泻次数多则减少用量，以大便微通泄为度。忌食醋类食物、生冷油腻及猪鱼肉等。
另外，治疗经常吐酸水，因脾胃虚冷所致，使用茯苓汤。
茯苓（十二分） 橘皮（十二分） 白术（八分） 人参（六分） 桂心（六分） 甘草（八分，炙） 紫苏（十分） 生姜（十二分） 槟榔（七枚）
以上九味药切碎，用水九升，煮取二升半，滤去药渣，分三次温服。每次服药间隔时间相当于人行走七八里的路程。若未痊愈，隔两三天再服一剂，老人小孩以微微通便为度。忌食生葱、醋类食物、桃李、雀肉、海藻、菘菜。
另外，治疗呕吐酸水、结气攻心，使用白术散。
白术（八分） 茯苓（八分） 吴茱萸（四分） 橘皮（六分） 荜茇（四分） 浓朴（八分，炙）
以上九味药捣碎过筛制成散剂。空腹时用姜枣汤送服一方寸匕的药散，每日两次，逐渐增加至二方寸半。感觉热时少服，饮食两三两口可压制症状。忌食醋类食物、桃李、雀肉等。
另外，治疗心头结气牵连胸背疼痛，以及日夜不停吐酸水，使用茯苓汤。
茯苓（四两） 浓朴（四两，炙） 橘皮（二两） 白术（二两） 生姜（十两）
以上五味药切碎，用水九升，煮取二升七合，滤去药渣，分三次温服。每次服药间隔时间相当于人行走七八里的路程。需要通便时加入一两半槟榔末，在汤药快要煮好时放入，效果非常安稳。每三日服一剂，频繁服用五六剂后即可停药。忌食醋类食物、桃李、雀肉等。（另一版本方中有吴茱萸、人参各二两，均出自第一卷。）
《延年方》治疗进食后醋咽感重、多嗳气，使用吴茱萸汤。
吴茱萸（五合） 生姜（三两） 人参（二两） 大枣（十二枚）
以上四味药切碎，用水六升，煮取二升，滤去药渣，分三次服用。每次服药间隔时间相当于行走十里路所需的时间。（《肘后备急方》、《集验方》、《文仲方》、《备急千金要方》与此相同，仅剂量略有差异。）
另外，增损承气丸，治疗胸胁支撑胀满，背部时常有一处发热则痛，腹胀多嗳气，醋咽气逆，两胁胀满，此方兼治上述诸症。
前胡（七分） 枳实（七分，炙） 桂心（五分） 干姜（五分） 吴茱萸（五分） 茯苓（四分） 芍药（六分） 浓朴（十分，炙） 橘皮（十分） 大黄（七分） 杏仁（七十枚，去皮尖）
以上十一味药捣碎过筛成末，纳入杏仁脂中研磨调匀过筛，用蜂蜜和成药丸。每次饭后稍顷服用，饮酒随意，初次服用七丸如梧桐子大小，以气机宣通下行排泄为度。忌食生葱和大醋。（均出自第十七卷。）
《必效方》理中散，主治食后吐酸水，食用羹粥酪浆后症状加重，使用此方。
干姜（二两） 食茱萸（二两）
以上两味药制成散剂，用酒送服一方寸匕，每日三次温服，不可冷服，常年的醋水呕吐可愈。（《千金要方》相同，出自第二卷。）
In the *Shanghan Lun* (Treatise on Cold Damage Diseases) by Zhang Zhongjing, it is recorded: For patients who vomit pus due to an abscess (Yong Nong), one should not forcibly stop the vomiting; once the pus is completely expelled, the condition will resolve spontaneously. If vomiting is followed by thirst, it indicates that the disease is about to resolve. If thirst precedes vomiting, it signifies water retention in the epigastrium (Xin Xia), which belongs to the category of "Yin Jia" (patients characterized by internal fluid retention).
Patients who vomit should naturally feel thirsty; if they do not feel thirsty now, it is because there is "Zhi Yin" (fluid retention in the chest and diaphragm) in the epigastrium, which also falls under the category of Zhi Yin. (For this syndrome, Zhang Zhongjing's miscellaneous formulas recommend using Xiao Banxia Jia Fuling Tang [Minor Pinellia Decoction with Added Poria], which is listed in the chapter on Zhi Yin.)
If a patient vomits, has a weak pulse, urination is free, the body has slight heat, and cold extremities are present, the condition is difficult to treat. It is primarily treated with Sini Tang [Counterflow Decoction].
Gancao (Licorice Root, 2 liang, processed with honey) Fuzi (Aconite Lateralis Radix Praeparata, 1 piece) Ganjiang (Dried Ginger, 1.5 liang)
The above three ingredients are crushed, boiled in 3 sheng of water until reduced to 1.2 sheng, filtered, and taken warm in two divided doses. For robust individuals, use a large Fuzi (1 piece) and Ganjiang (3 liang). Avoid consuming Haizao (Sargassum), Songcai (Chinese Cabbage), and pork.
Furthermore, for vomiting accompanied by hardness and fullness in the epigastrium, the primary formula is Dabanxia Tang [Major Pinellia Decoction].
Banxia (Pinelliae Rhizoma, 3 sheng, washed) Renshen (Ginseng Radix, 3 liang, sliced) Baimi (White Honey, 1 sheng)
The above three ingredients are mixed with 12 dou of spring water and honey, stirred 240 times, then decocted to obtain 2.5 sheng. Take 1 sheng warm, twice daily. Avoid mutton and Yitang (Malt Sugar). (This section treats Fanwei [reverse regurgitation] and Zhi Yin.)
Additionally, for dry heaving accompanied by diarrhea, the primary formula is Huangqin Tang [Scutellaria Decoction].
Huangqin (Scutellariae Radix, 3 liang) Renshen (Ginseng Radix, 3 liang) Guixin (Cinnamon Twig, 2 liang) Dazao (Jujubae Fructus, 12 pieces) Banxia (Pinelliae Rhizoma, 0.5 sheng, washed) Ganjiang (Dried Ginger, 3 liang)
The above six ingredients are cut, decocted in 7 sheng of water until reduced to 3 sheng, and taken warm in three divided doses. Avoid mutton, Yitang, and raw scallions. (From Volume 16.)
According to the *Zhubing Yuanhou Lun* (Source Book of All Categories of Diseases and Etiologies): The cause of yiqi (belching) and tun suan (acid regurgitation) lies in retained phlegm in the upper jiao and lingering cold in the spleen and stomach, leading to an inability to digest grains. Undigested grains cause distension and rebellious qi, resulting in frequent belching and acid regurgitation, with sour-smelling breath. (From Volume 21.)
The *Guangji Fang* treats vomiting acidic water, where food turns into acidic water upon eating, using Binglang San [Areca Seed Powder].
Binglang (Arecae Semen, 16 fen) Renshen (Ginseng Radix, 6 fen) Fuling (Poria, 8 fen) Jupi (Citri Reticulatae Pericarpium, 6 fen) Bibai (Long Pepper Fruit, 6 fen)
The above five ingredients are ground into powder. In the morning on an empty stomach, take 5 liang of fresh ginger (with skin), crush and juice it. Mix one fangcunbi (a square-inch measure) of the powder into the ginger juice, stir well, and take at once. Take once daily, gradually increasing to 1.5 fangcunbi. If diarrhea occurs frequently, reduce the dose; aim for mild laxation. Avoid vinegar, raw/cold/greasy foods, pork, and fish.
Furthermore, to treat chronic vomiting of acidic water due to spleen-stomach cold, use Fuling Tang [Poria Decoction].
Fuling (Poria, 12 fen) Jupi (Citri Reticulatae Pericarpium, 12 fen) Baizhu (Atractylodis Macrocephalae Rhizoma, 8 fen) Renshen (Ginseng Radix, 6 fen) Guixin (Cinnamon Twig, 6 fen) Gancao (Licorice Root, 8 fen, processed) Zisu (Perillae Folium, 10 fen) Shengjiang (Fresh Ginger, 12 fen) Binglang (Arecae Semen, 7 pieces)
The above nine ingredients are cut, decocted in 9 sheng of water until reduced to 2.5 sheng, filtered, and taken warm in three divided doses. Space each dose by the time it takes to walk 7-8 li. If not cured, administer another dose after 2-3 days. For elderly and children, aim for mild laxation. Avoid raw scallions, vinegar, peaches, plums, sparrow meat, seaweed, and Chinese cabbage.
Furthermore, to treat vomiting of acidic water and qi stagnation attacking the heart, use Baizhu San [Atractylodes Powder].
Baizhu (Atractylodis Macrocephalae Rhizoma, 8 fen) Fuling (Poria, 8 fen) Wuzhuyu (Evodiae Fructus, 4 fen) Jupi (Citri Reticulatae Pericarpium, 6 fen) Bibai (Long Pepper Fruit, 4 fen) Nongpo (Magnoliae Officinalis Cortex, 8 fen, processed)
The above nine ingredients are ground into powder. Take one fangcunbi with ginger-date soup on an empty stomach, twice daily. Gradually increase to 2.5 fangcunbi. If feeling hot, take less; eating a few mouthfuls can suppress symptoms. Avoid vinegar, peaches, plums, and sparrow meat.
Furthermore, to treat qi stagnation in the heart radiating to chest and back pain, and ceaseless day-and-night vomiting of acidic water, use Fuling Tang [Poria Decoction].
Fuling (Poria, 4 liang) Nongpo (Magnoliae Officinalis Cortex, 4 liang, processed) Jupi (Citri Reticulatae Pericarpium, 2 liang) Baizhu (Atractylodis Macrocephalae Rhizoma, 2 liang) Shengjiang (Fresh Ginger, 10 liang)
The above five ingredients are cut, decocted in 9 sheng of water until reduced to 2.7 sheng, filtered, and taken warm in three divided doses. Space each dose by the time it takes to walk 7-8 li. To promote bowel movement, add 1.5 liang of Binglang powder when the decoction is nearly ready; this is very safe. Take one dose every three days. Frequent administration of 5-6 doses may allow discontinuation. Avoid vinegar, peaches, plums, and sparrow meat. (Another version includes Wuzhuyu and Renshen, 2 liang each; all from Volume 1.)
The *Yannian Fang* treats postprandial acidic sensation and excessive belching using Wuzhuyu Tang [Evodia Decoction].
Wuzhuyu (Evodiae Fructus, 5 he) Shengjiang (Fresh Ginger, 3 liang) Renshen (Ginseng Radix, 2 liang) Dazao (Jujubae Fructus, 12 pieces)
The above four ingredients are cut, decocted in 6 sheng of water until reduced to 2 sheng, filtered, and taken in three divided doses. Space each dose by the time it takes to walk 10 li. (*Zhouhou Beiji Fang*, *Jiyi Fang*, *Wenzhong Fang*, *Beiji Qianjin Yaofang* agree, with slight dosage variations.)
Additionally, Zengsun Chengqi Wan [Modified Chengqi Pills] treats flank fullness, occasional heat-induced pain on the back, abdominal distension with excessive belching, acidic regurgitation with rebellious qi, and bilateral flank fullness.
Qianhu (Peucedani Radix, 7 fen) Zhishi (Aurantii Fructus Immaturus, 7 fen, processed) Guixin (Cinnamon Twig, 5 fen) Ganjiang (Dried Ginger, 5 fen) Wuzhuyu (Evodiae Fructus, 5 fen) Fuling (Poria, 4 fen) Shaoyao (Paeoniae Radix Alba, 6 fen) Nongpo (Magnoliae Officinalis Cortex, 10 fen, processed) Jupi (Citri Reticulatae Pericarpium, 10 fen) Dahuang (Rhei Radix et Rhizoma, 7 fen) Xingren (Armeniacae Semen Amarum, 70 pieces, peeled and de-husked)
The above eleven ingredients are ground into powder, mixed with almond fat, refined, sifted, and bound with honey into pills. Take shortly after meals, with wine as desired. Initial dose: 7 pills the size of a wutong seed. Stop when qi flows downward and excretion occurs. Avoid raw scallions and strong vinegar. (All from Volume 17.)
The *Bixiao Fang* Lizhong San [Regulate the Middle Powder] treats vomiting of acidic water after meals, worsening with soups, porridges, and dairy.
Ganjiang (Dried Ginger, 2 liang) Shizhuyu (Zanthoxyli Fructus Edulis, 2 liang)
The above two ingredients are made into powder. Take one fangcunbi with wine, three times daily, warm. Do not take cold. Chronic acidic vomiting will heal. (*Qianjin Yaofang* agrees; from Volume 2.)