《金匮要略》曰∶发汗令阳微，膈气虚，脉乃数。数为客热不能消，为胃中虚冷故也。
胃气无余，则朝食暮吐，为反胃。又云∶夫阳脉浮而涩，浮则为虚，涩则伤脾，脾伤则不磨
谷，而朝食而暮吐也。暮食而朝吐者，宿食不化，名曰反胃。王冰注云∶以晨食入胃，胃虚
不能克化，至暮胃气行里，与邪相搏，则食反出也。巢氏曰∶营卫俱虚，血气不足，停水积
饮，而在胃脘，即脏冷。脏冷则脾不磨而宿食不化，其气逆而成反胃也，则朝食暮吐，暮食
朝吐，甚则食已即吐。其脉紧而弦，紧为寒，弦为虚，虚寒相搏，故食已即吐，曰反胃。经
曰食不得入，是有火也，食入反出，是无火也。诸书论之详矣。夫反胃者，本乎胃食物所伤
，呕吐言胃口翻也，多因胃气先逆，饮酒过伤，或积风寒，或因忧思悒怏，或因蓄怒抑郁，
宿滞痼癖，积聚冷痰，动扰脾虚，胃弱不能消磨谷食，遂成此证。原其所自，女人得之，由
血气虚损，男子得之，多因下元冷惫。又因喜怒不常，惊恐无时，气与痰搏，升而不降，留
于咽嗌，则成膈噎。结于痰者，咯之不出，咽之不下，有大便秘少如羊屎者，名结肠反胃。
大抵翻胃未尝不由膈噎而起。《内经》谓阳结谓之膈，盖气之与神，并为阳也，逸则气神安
，劳则气神耗，气神俱扰，使阳气先结，阴气后乱，阴阳不和，脏腑生病，结于胸膈，则成
膈气，留于咽嗌，则成五噎。五膈治之不当，岁月因循，久则反胃。治法∶气虚者补其气，
血虚者养其血，调顺阴阳，化痰下气，阴阳平匀，气顺痰下，其证自平。王冰又云∶食痹者
，食已，心下痛阴阴然，不可忍也，吐出痛止，此胃气逆而不下行也。若脉软散，当病食痹
。又肺病传肝曰肝痹，膈痛出食者是也。《金匮要略》又有肝中寒、心中风、厥阴之为病，
三者皆以食入即吐，学人全在切脉用药。医者人之司命，可不谨乎？且如十膈气散，治冷
膈风膈气膈痰膈热膈忧膈悲膈喜膈水膈食膈，对其脉证，用之取效，用之不当，取祸非轻。
且翻胃不可峻用香燥之剂，治之不循次序，如抱薪救火。其脉浮缓者生，沉涩者逆，在乎审
察
《金匮要略》说：发汗导致阳气微弱，膈气虚弱，脉象因此变得数（快速）。脉数表现为客热（外来的或虚性的热邪），不能消化食物，这是因为胃中虚寒的缘故。
胃气不足，就会早晨吃晚上吐，这称为反胃（翻胃）。又说：阳脉浮而涩，浮脉表示虚证，涩脉表示脾脏受损，脾脏受损则无法磨化谷物，所以早晨吃晚上吐。晚上吃早晨吐的，是因为宿食不消化，名叫反胃。王冰注释说：因为早晨吃的食物进入胃中，胃气虚弱不能运化，到了傍晚胃气运行于里，与邪气相搏结，食物就会反出来。巢元方说：营气和卫气都虚弱，血和气都不足，停聚的水饮停留在胃脘，这就导致脏腑寒冷。脏腑寒冷则脾脏无法磨化食物，宿食不消化，气机上逆形成反胃，于是早晨吃晚上吐，晚上吃早晨吐，严重的甚至吃完就吐。脉象紧而弦，紧脉主寒，弦脉主虚，虚寒相互搏结，所以吃完就吐，这叫反胃。经书说：食物进不去，是有火邪；食物进去又吐出来，是没有火邪（指无阳气/命门之火）。各种书籍对此论述得很详细了。
所谓反胃，根本原因在于胃被食物所伤，呕吐是指胃口翻转，多因为胃气先上逆，饮酒过度损伤，或者积聚风寒，或者因为忧思抑郁，或者因为蓄积愤怒，导致宿食停滞、痼癖积聚、冷痰内停，扰动脾虚，胃弱不能消磨谷食，于是形成这种病症。推究其根源，女子患此病，多因气血虚损；男子患此病，多因下元（肾与命门）冷惫。再加上喜怒无常，惊恐不时，气与痰搏结，只升不降，停留在咽喉，就形成膈噎（噎膈）。结聚在痰的，咳不出来，咽不下去，有大便干结少如羊屎的，名叫结肠反胃。大抵翻胃未曾不是由膈噎发展而来的。《内经》说阳气结滞称为膈，盖气与神都属于阳，安逸则气神安宁，劳累则气神耗损，气神都被扰乱，使阳气先结滞，阴气后紊乱，阴阳不和，脏腑生病，结聚在胸膈，就形成膈气，留存在咽喉，就形成五噎。五膈治疗不当，岁月拖延，久了就会变成反胃。治疗方法：气虚的补益其气，血虚的滋养其血，调顺阴阳，化痰下气，阴阳平匀，气顺痰消，病症自然平息。
王冰又说：食痹者，吃完饭后，心下部隐隐作痛，难以忍受，吐出后疼痛停止，这是胃气上逆而不下行。如果脉象软散，应当是患食痹。另外肺病传变给肝叫肝痹，膈痛且进食后吐出的是这类病。《金匮要略》还有肝中寒、心中风、厥阴病这三种情况，都以食物入口即吐为特征，学习的人全在于仔细切脉和用药。医生是人的命运主宰，能不谨慎吗？况且像十膈气散，治疗冷膈、风膈、气膈、痰膈、热膈、忧膈、悲膈、喜膈、水膈、食膈，针对其脉证使用能取效，使用不当，招致的祸患也不轻。而且翻胃不可峻烈地使用香燥的药物，治疗如果不遵循次序，就像抱着柴草去救火一样危险。脉象浮缓的预后良好，沉涩的预后不良，关键在于审察清楚。
The *Jingui Yaolue* (Essential Prescriptions of the Golden Cabinet) states: Inducing sweating causes yang to become weak, and qi in the diaphragm to become deficient, resulting in a rapid pulse. A rapid pulse indicates exogenous heat or deficiency-heat that cannot digest food, which is due to cold deficiency in the stomach.
When stomach qi is insufficient, one eats in the morning and vomits in the evening, known as Fanwei (Reversal Stomach / Regurgitation). It further states: If the yang pulse is floating and choppy, floating indicates deficiency, and choppy indicates injury to the spleen. When the spleen is injured, it fails to grind grains, leading to vomiting in the evening after eating in the morning. Vomiting in the morning after eating in the evening occurs because retained food is not digested; this is named Fanwei. Wang Bing commented: Because food eaten in the morning enters the stomach, but the stomach qi is too weak to transform it, by evening when stomach qi moves inward, it clashes with pathogenic factors, causing the food to be regurgitated. Chao Yuanfang stated: When Ying (nutritive) and Wei (defensive) qi are both deficient, and blood and qi are insufficient, stagnant water and accumulated fluids remain in the epigastrium, leading to coldness of the zang organs. Coldness of the zang organs prevents the spleen from grinding food, so retained food is not digested; qi rebels upward forming Fanwei, resulting in vomiting in the evening after eating in the morning, and vomiting in the morning after eating in the evening. In severe cases, vomiting occurs immediately after eating. The pulse is tight and wiry; tight indicates cold, and wiry indicates deficiency. The combination of deficiency and cold causes vomiting immediately after eating, called Fanwei. Classics state: Food cannot enter due to fire (heat); food enters and comes back out due to lack of fire (lack of yang/mingmen fire). Various texts discuss this in detail.
Fanwei fundamentally stems from damage to the stomach by food. "Ou" (vomiting) refers to the reversal of the stomach opening. It is often caused by initial rebellion of stomach qi, excessive alcohol consumption, accumulation of wind-cold, sorrowful thoughts and depression, pent-up anger, retention of undigested food, chronic masses, accumulation of cold-phlegm, which disturb spleen deficiency and weaken the stomach's ability to digest grains, thus forming this syndrome. Tracing its origin, women suffering from this condition do so due to deficiency and depletion of blood and qi; men suffer from it mostly due to cold exhaustion of the lower yuan (kidneys and mingmen). Additionally, irregular emotions like anger and joy, and frequent fright, cause qi and phlegm to bind together, ascending without descending, remaining in the throat, forming Ge Ye (Dysphagia). Phlegm binding results in inability to expectorate or swallow, accompanied by dry stools resembling sheep dung, named Jielong Fanwei (Colon-Colligation Fanwei). Generally, Fanwei arises from Ge Ye. The *Neijing* states that yang obstruction is called Ge. Qi and spirit belong to yang; leisure keeps them peaceful, while labor depletes them. Disturbance of qi and spirit causes yang to obstruct first, followed by yin chaos. Yin-yang disharmony leads to organ disease. Obstruction in the chest and diaphragm forms Geqi (Diaphragm Qi), while retention in the throat forms Wuye (Five Dysphagias). Improper treatment of Wuge, prolonged over time, eventually becomes Fanwei. Treatment methods: Tonify qi for qi deficiency; nourish blood for blood deficiency; regulate yin and yang; resolve phlegm and direct qi downward. When yin and yang are balanced, qi flows smoothly, and phlegm descends, the syndrome resolves naturally.
Wang Bing also stated: In Shibì (Food Bi Syndrome), pain occurs in the epigastrium after eating, dull and unbearable, ceasing only after vomiting. This is due to rebellious stomach qi failing to descend. If the pulse is soft and scattered, it indicates Shibì. Furthermore, lung disease transmitting to the liver is called Ganbi (Liver Bi), characterized by diaphragmatic pain and vomiting after eating. The *Jingui Yaolue* also mentions Liver Cold, Heart Wind, and Jueyin disease, all presenting with immediate vomiting upon eating. Practitioners must rely entirely on precise pulse diagnosis and appropriate medication. Physicians hold the fate of people; can they not be cautious? For instance, Shige Qisan (Ten Diaphragms Qi Powder) treats Cold Diaphragm, Wind Diaphragm, Qi Diaphragm, Phlegm Diaphragm, Heat Diaphragm, Sorrow Diaphragm, Grief Diaphragm, Joy Diaphragm, Water Diaphragm, and Food Diaphragm. Used correctly according to pulse and symptoms, it yields efficacy; used incorrectly, it brings grave harm. Moreover, Fanwei should not be treated harshly with aromatic and drying agents. Treating without following proper order is like adding fuel to a fire. A floating and moderate pulse indicates a favorable prognosis; a deep and choppy pulse indicates an adverse prognosis. Careful examination is essential.