〔大〕夫妇人呕吐者，由脾胃有邪冷，谷气不理所为也，胃为水谷之海，其气不调
而有风冷乘之，冷搏于胃，胃气逆则令呕吐也。夫呕吐之疾，非特脾胃虚冷而呕吐也，亦
有胃热而呕者，亦有胃中冷，胃口热而吐者，亦有痰盛而呕者，亦有血弱而呕者。经云∶无
阴则呕是也。不可以一概用药。如胃冷而呕吐，宜用《局方》人参丁香散、理中丸，及
许仁则半夏丸、人参七味丸。如胃热而呕吐者，宜用小柴胡汤、芦根汤、竹茹汤、槐花
散。如胃中冷，胃口热而呕吐者，宜用《局方》藿香正气散，生姜、枣子煎，沉冷服即
止。如痰盛呕吐者，宜《局方》半夏汤、茯苓汤、二陈汤。如恶阻兼用茯苓丸，自有专
门。如血不归源而呕吐者，用十全大补（杂病虚劳。）加陈皮、半夏、藿香、姜、枣煎服。或有
香港脚而呕者，自有专门，不滥及。
〔薛〕东垣先生云∶前证内有故寒与新谷俱入于胃，新故真邪相攻，气并相逆，复
出于胃，故为哕，补手太阴，泻足少阴。又云∶胃因气逆为哕。夫呕、吐哕者，俱属于
胃，以其气血多少为异耳。如呕者，阳明也，阳明多血多气，故有声有物，血气俱病也。仲
景云∶呕多虽有阳明证，慎不可下。孙真人云∶呕家多服生姜，为呕家之圣药也。气逆
者必散之，故以生姜为主。吐者，太阳也，太阳多血少气，故有物无声，为血病也。有食
入则吐，以橘皮去白主之。哕者，少阳也，多气少血，故有声无物，乃气病也，以姜制半
夏为主。若脾胃虚弱，寒邪所客，饮食所伤者，用六君、丁香、藿香、生姜之类。若胃
中有热，膈上有痰，用二陈、山栀、黄连、生姜。若久病胃虚，呕而不纳谷者，用生姜、参、
术、黄 、香附之类。亦有痰膈中焦，食不得下者，有气逆而呕者，有气郁于胃口者，有
食滞于心肺之分而复出者，有胃口有火与痰而呕者。若注船大吐，渴饮水者即死，童便
饮之最妙。前论云∶血不归源而呕，用十全大补汤，诚发前人之未发，愚常用屡效。（此论
与王安道《溯洄集》所论少异，宜参看之。）先太宜人饮食后，闻外言忤意，呕吐酸水，内热
作渴，惟饮冷水，气口脉大而无伦，面色青赤，此肝脾郁火，投之以药，入口即吐。第
三日吐宿食，第七日吐酸黄水，十一日吐苦水，脉亦洪大，仍喜饮冷。以黄连煎汤冷冻饮料
少许，至二十日，加白术、茯苓，二十五日，加陈皮，三十七日加当归、炙草，至六十日
始进米饮半盏，渐进薄粥，调理得痊。府庠沈姬文母，患脾虚中满，痰嗽发热，又食
湿面冷茶，吞酸呕吐绝食，误服芩、连、青皮等药，益加寒热口干，流涎不收，闻食则
呕，数日矣。迎治，余曰∶脾主涎，此脾虚不能约制也。欲用人参安胃散，惑于众论，以
为胃经实火宿食治之，病日增剧。忽思冬瓜，食如指甲一块，顿发呕吐酸水不止，仍服前
药愈剧。复邀视之，则神脱脉绝濒死矣。惟目睛尚动，余曰∶寒淫于内，治以辛热，然
药不能下矣。急用盐、艾、附子炒热，熨脐腹以散寒回阳，又以口气补接母口之气，又
以附子作饼，热贴脐间。时许，神气少苏，以参、术、附子为末，仍以是药加陈皮煎膏为
丸，如粟米大，入五七粒于口，随津液咽下，即不呕。二日后加至十粒，诸病少退，其涎
不止，五日后渐服前剂一二匙，胃气少复，乃思粥饮。后投以参、术等药，温补脾胃，五
十余剂而愈。
〔孙〕一妇人三十五岁无子，恐夫娶外家致郁，经不行者三月矣。病腹痛恶心，诸医
皆云有孕，其夫亦粗知医，举家欣喜，治以安胎行气止痛之药，服三五十帖不效，痛苦
益甚。凡未申时发寒热，腹中有块，如弹子大者二三十枚，翻腾作痛，行动则水声漉漉，
痛极则吐酸水五六碗，吐尽则块息而寒热除，痛亦不作，明日亦然。又作疟治，转剧。召
予诊，左手弦，尺涩，右手濡弱，重取则滑，尺同左。时经已五月不行矣。予曰∶此郁病
也，岂有涩脉成孕之理，若然，则前药当效矣。其夫亦悟。乃为制方，以二陈加香附、山
栀、抚芎、玄胡、当归、红花之类，药进而痛止，连与四帖皆效，但药止则痛发如故，调
治一月不能除根。予因持脉案见先师黄古潭先生，先生乃谕予曰∶此郁火病也。其病起
于肝胆，盖肝主谋虑，胆主决断，谋不决则郁生，郁生则木盛，木盛则凌脾，脾伤则不
能运化精微而生气血，以故月水不来也。肺金失于母养，则降杀之令不行，木寡于畏而
侮所不胜，是以直冲犯清道以作吐也，吐后诸证皆减者，木升而火息也。为裁一方∶以
黄五钱，柴胡三钱，白芍药二钱，甘草一钱，陈皮、贝母、枳实各五分，姜三片，一
剂而寒热除，再剂而痛减吐止，水声亦绝，七日不发。其夫喜曰∶是何神速也。乃拉予复
请命于先生，先生曰∶夫寒热者，少阳胆也。吐酸者，厥阴肝也。痛而腹块翻腾者，火盛
激动其水，如锅中汤滚泡浪沸腾是也。吐多则肺金愈伤。故用黄 补肺金为君，使得以
制肝木，以柴胡泻肝为臣，以升发其胆火。经曰∶木郁则达之，达是通达之义。夫木性上
升者也，既郁则不升，故用柴胡升发胆肝之清气，使冲开其郁结以复其常。又曰∶过者
折之，以其畏也。所谓泻之，补肺制肝，正谓此也。又曰∶泄其肝者，缓其中，以甘草
缓中为佐。又曰∶木位之主，其泻以酸，以白芍药于脾中泻木为臣，病久生郁，郁久则
生涎，以贝母、陈皮、枳实开郁逐涎为裨使，然后金得其正，木得其平，土得其安，由是
病去而愈速。前方用山栀、黄连之类，皆降下之药，火势正炽，岂区区寒凉所能抑哉。故
经曰∶轻者正治，重则从其性而升之。但凡治病，要当识得此意。
益智子散 治妇人脾胃久虚气弱，多欲呕吐，全不下食，四肢无力。
益智（一两） 附子（炮） 缩砂仁 丁香 浓朴 黄 白术 白茯苓 陈皮 川芎 良
姜藿香叶 当归（各七钱半） 人参 桂心（各半两）
上 咀，每服三钱，姜三片，枣一枚，水一盏，煎至七分，去滓，无时温服。
丁香散 治妇人脏腑虚冷，脾胃气弱，食则呕吐，水谷不消。
丁香 白术 缩砂仁 草果仁 橘皮（各七钱半） 当归 白豆蔻 藿香叶
神曲 诃子皮 甘草（各半两） 人参（一两）
上为细末，每服二三钱，煎姜枣汤调下。
竹茹汤 治胃热呕吐。
干葛（三两） 半夏（汤洗七次，姜汁半盏，浆水一升，煮耗一半，取七钱半）
甘草（七钱半）
上 咀，每服五钱，水二盏，姜三片，竹茹鸡蛋大，枣子一枚，煎至一盏，去滓温服。
许学士云∶胃热者手足心热。政和中，一宗人病伤寒，得汗身凉，数日后忽呕吐，药
与饮食俱不下。医者皆用丁香、藿香、滑石等药，下咽即吐。予曰∶此正汗后饮热留胃
脘，孙兆竹茹汤正相当尔。亟治药与之，实时愈。
良方槐花散
皂荚 白矾 槐花（炒，令黄黑色） 甘草（各等分）
上为细末，白汤调下二钱。
许仁则半夏丸 疗积冷在胃，呕逆不下食方。
半夏（一升，真熊州者，洗去滑） 小麦曲（一升）
上捣半夏为散，以水搜面，丸如弹子大，以水煮令面熟，则是药成。初吞四五丸，日
二服，稍加至十四五丸，旋煮旋服，比觉病减，欲更合服亦佳。忌羊肉、饧。
又根据前半夏丸，虽觉渐损，然病根不除，欲多合前丸，又虑药毒不可久服，欲不服又
恐病滋蔓，宜合人参七味丸服之。
人参七味丸
人参 白术（各五两） 浓朴（炙） 细辛（各四两） 生姜（八两，末） 橘皮（三两）
桂心（二两）
上为细末，炼蜜丸如梧桐子大，饮下十丸，渐加至二十丸，与半夏丸间服亦可。忌
桃、李、雀肉、生葱、生菜。
《补遗》治男子妇人一切呕吐。五苓散内除桂，加半夏末如桂分两，每服一钱，以生
姜自然汁调搜和如面，候半时久，再以白沸汤一小盏，调开温服。（五苓散方，见伤寒准绳渴
门。）
青金丹 治一切呕吐不已。
硫黄（二钱） 水银（一钱）
入铫内慢火熬化，以木篦子拨炒成砂，再入乳钵研黑不见星，以姜汁糊丸如绿豆大，每
服二三十丸，米饮下。
人参安胃散 治脾胃虚热，呕吐泄泻，或饮食不入。
人参（一钱） 黄 （炒，二钱） 生甘草 炙甘草（各五分） 白芍药（七分） 白茯苓（四分）
陈皮（三分） 黄连（炒，二分）
上水煎服。
【大】妇女出现呕吐症状，是由于脾胃受邪气侵袭且伴有寒冷，导致饮食水谷的运化功能失常。胃是容纳水谷的器官，其气机运行不调，若有风冷之邪乘虚而入，寒气与胃气相搏结，导致胃气上逆，从而引发呕吐。呕吐这一病症，并非仅仅因为脾胃虚寒所致，也有因胃热而呕吐的，有胃中寒冷但胃口（贲门）发热而呕吐的，有痰湿盛重而呕吐的，也有血虚而呕吐的。医经说：“没有阴液制约就会发生呕吐”，就是这个道理。因此不能一概而论地用药。如果是胃寒引起的呕吐，适宜使用《太平惠民和剂局方》中的人参丁香散、理中丸，以及许仁则的半夏丸、人参七味丸。如果是胃热引起的呕吐，适宜使用小柴胡汤、芦根汤、竹茹汤、槐花散。如果是胃中寒冷而胃口发热引起的呕吐，适宜使用《太平惠民和剂局方》的藿香正气散，配合生姜、大枣煎煮，待药液冷却后服用即可止呕。如果是痰湿盛重引起的呕吐，适宜使用《太平惠民和剂局方》的半夏汤、茯苓汤、二陈汤。如果是妊娠恶阻兼见呕吐者，可合用茯苓丸，自有专门的治疗法度。如果是血不归经导致的呕吐，使用十全大补汤（用于杂病虚劳），加入陈皮、半夏、藿香、生姜、大枣煎服。如果有脚气病伴随呕吐者，自有专门治法，不在此处赘述。
【薛】东垣先生曾说：上述证候中有旧有的寒邪与新摄入的食物同时进入胃中，新旧邪气相互攻冲，气机并逆而上，从胃中复出，所以称为呃逆（哕），治疗应补益手太阴肺经，泻足少阴肾经。又说：胃因气机上逆而导致呃逆。呕吐、吐物、呃逆这三种症状，都归属于胃，只是根据气血多少的不同而有差异。如呕吐，属于阳明经，阳明经多血多气，所以既有声音又有吐出物，是血和气都受病的表现。张仲景说：呕吐频繁者，即使有阳明证，也千万不可使用下法。孙思邈说：经常呕吐的人应多服用生姜，因为生姜是治疗呕吐的圣药。气机上逆的必须用发散的方法，所以以生姜为主药。吐物，属于太阳经，太阳经多血少气，所以只有吐出物而没有声音，这是血分受病。有进食后立即呕吐的，以橘皮（去白）为主药治疗。呃逆，属于少阳经，少阳经多气少血，所以只有声音而没有吐出物，这是气分受病，以姜制半夏为主药治疗。如果脾胃虚弱，寒邪客居体内，或因饮食损伤，可使用六君子汤、丁香、藿香、生姜等药物。如果胃中有热，膈上有痰，可使用二陈汤、山栀、黄连、生姜。如果久病导致胃虚，呕吐且不能纳食，可使用生姜、人参、白术、黄芪、香附等药物。也有痰阻中焦，食物无法下咽的；有气机上逆而呕吐的；有气郁结在胃口的；有食滞在心肺之间而反出的；有胃口有火兼有痰而呕吐的。如果像注船一样剧烈呕吐，口渴想喝水的就会死亡，此时饮用童便最为妙效。前面的论述中提到：血不归经而呕吐，使用十全大补汤，这确实是阐发了前人的未发之论，我常用此法且屡获疗效。（此论点与王安道《溯洄集》中的论述略有不同，应当参考对照。）我的先母在饭后，听到外面的言语违背心意，导致呕吐酸水，内热发作且口渴，只喝冷水，气口脉象大而无序，面色青赤，这是肝脾郁火所致，投药后入口即吐。到了第三天吐出宿食，第七天吐出酸黄的苦水，第十一天吐出苦水，脉象依然洪大，仍然喜欢喝冷水。用黄连煎汤，放凉后让患者少量饮用，到了第二十天，加入白术、茯苓，第二十五天加入陈皮，第三十七天加入当归、炙甘草，到了第六十天才开始能喝半盏米汤，逐渐过渡到稀薄粥食，经过调理得以痊愈。府庠沈姬文的母亲，患有脾虚导致的中满，痰嗽发热，又吃了湿面和冷茶，吞酸呕吐绝食，误服黄芩、黄连、青皮等药物，更加加重了寒热口干、流涎不止的症状，闻到食物气味就呕吐，已经好几天了。请我去诊治，我说：脾主涎，这是脾虚不能约束津液的表现。本想用人参安胃散，但因众人议论纷纷，认为应按胃经实火和宿食来治疗，结果病情日益加重。忽然想吃冬瓜，吃了一块指甲大小的冬瓜，顿时引发剧烈呕吐酸水不止，继续服用之前的药物使病情更剧。再次邀请我去诊视时，患者神气涣散，脉象微弱近乎死亡。只有眼珠还在转动，我说：寒邪淫溢于内，应用辛热药物治疗，然而药物已经无法下咽了。急忙用盐、艾叶、附子炒热，熨烫脐腹部以散寒回阳，又用口气对接母亲的口鼻之气，又用附子做成饼，热贴于脐间。约一个时辰后，神气稍微恢复，将人参、白术、附子研为末，仍用这些药加陈皮煎膏制成丸药，如粟米大小，每次放入五至七粒在口中，随津液咽下，呕吐即止。两天后增加到十粒，各种病症稍退，但流涎不止，五天后逐渐服用前剂一二匙，胃气稍微恢复，开始想喝粥饮。后来投以人参、白术等药，温补脾胃，服用五十多剂后痊愈。
【孙】一位三十五岁无子的妇人，担心丈夫娶外室而致气郁，月经已经三个月没来了。患病腹痛恶心，众医生都说是有孕，她的丈夫也略懂医术，全家欣喜，用安胎行气止痛的药物进行治疗，服了三五十帖无效，痛苦反而更加严重。每逢未时和申时发作寒热，腹中有肿块，像弹子大的有二三十枚，翻腾作痛，行动时腹部有水声漉漉作响，痛极时呕吐酸水五六碗，吐尽后肿块平息，寒热消除，疼痛也不再发作，第二天也是如此。又按疟疾治疗，病情反而加剧。召我去诊脉，左手脉弦，尺脉涩，右手脉濡弱，重取则滑，尺脉同左手。此时月经已五月不行。我说：这是郁证，哪有涩脉成孕的道理？如果真是怀孕，前面的药应该有效。她的丈夫也醒悟了。于是为她制方，用二陈汤加香附、山栀、抚芎、玄胡、当归、红花等药物，服药后疼痛停止，连续服用四帖都有效，但停药则疼痛复发如故，调理一个月不能除根。我拿着脉案去拜见恩师黄古潭先生，先生教导我说：这是郁火病。病起于肝胆，肝主谋虑，胆主决断，谋而未决则生郁，郁而生则木气旺盛，木旺则克制脾土，脾受伤则不能运化精微而生生气血，因此月经不来。肺金失去母脏（肝）的滋养，则肃降的功能不行，木气无所畏惧而侮所不胜（肺），所以直冲犯清道而作呕吐，呕吐后诸症皆减，是因为木气升发而火气平息。为此裁制一方：用黄芪五钱，柴胡三钱，白芍药二钱，甘草一钱，陈皮、贝母、枳实各五分，生姜三片，一剂后寒热消除，两剂后疼痛减轻呕吐停止，水声也绝，七天不再发作。丈夫高兴地说：为何如此神速？于是拉着我再去请教先生，先生说：寒热往来，属于少阳胆经。呕吐酸水，属于厥阴肝经。腹痛且腹中肿块翻腾，是火盛激动其水，如同锅中汤滚泡浪沸腾一般。呕吐多则肺金更伤。所以用黄芪补肺金为君药，使其能够制约肝木，用柴胡泻肝为臣药，以升发胆火。医经说：木郁则达之，“达”是通达的意思。木性本上升，既然郁结则不能上升，所以用柴胡升发胆肝的清气，使其冲开郁结以恢复常态。又说：过者折之，以其畏也。所谓泻之，补肺制肝，正是这个意思。又说：泄其肝者，缓其中，以甘草缓中为佐药。又说：木位之主，其泻以酸，以白芍药于脾中泻木为臣药。病久生郁，郁久则生涎，以贝母、陈皮、枳实开郁逐涎为使药。然后金得其正，木得其平，土得其安，因此病去而痊愈迅速。前方用山栀、黄连之类，都是降下的药物，火势正炽，岂是区区寒凉所能抑制的呢？所以医经说：轻者正治，重则从其性而升之。凡是治病，要懂得这个道理。
益智子散 治疗妇人脾胃长久虚弱气弱，多欲呕吐，完全不能进食，四肢无力。
益智仁（一两） 附子（炮制） 缩砂仁 丁香 浓朴 黄芪 白术 白茯苓 陈皮 川芎 良姜 藿香叶 当归（各七钱半） 人参 桂心（各半两）
以上药材切碎，每次服用三钱，生姜三片，大枣一枚，水一盏，煎至七分，去渣，随时温服。
丁香散 治疗妇人脏腑虚冷，脾胃气弱，进食则呕吐，水谷不消化。
丁香 白术 缩砂仁 草果仁 橘皮（各七钱半） 当归 白豆蔻 藿香叶 神曲 诃子皮 甘草（各半两） 人参（一两）
以上研为细末，每次服用二三钱，用姜枣汤调服。
竹茹汤 治疗胃热呕吐。
干葛（三两） 半夏（汤洗七次，姜汁半盏，浆水一升，煮耗一半，取七钱半） 甘草（七钱半）
以上切碎，每次服用五钱，水二盏，生姜三片，竹茹鸡蛋大小，大枣一枚，煎至一盏，去渣温服。
许学士说：胃热者手足心热。政和年间，有一位宗族亲属患伤寒，出汗后身体凉爽，数日后突然呕吐，药物和饮食都无法下咽。医生们都用丁香、藿香、滑石等药，咽下即吐。我说：这正是汗后余热留于胃脘，孙兆的竹茹汤正好对症。急忙配药给他，随即痊愈。
良方槐花散
皂荚 白矾 槐花（炒至黄黑色） 甘草（各等分）
以上研为细末，用开水调服二钱。
许仁则半夏丸 治疗积冷在胃，呕逆不下食方。
半夏（一升，真熊州产者，洗去滑腻） 小麦曲（一升）
以上捣半夏为散，用水调和面粉，丸如弹子大，用水煮至面熟，则是药成。初服四五丸，每日两次，稍加至十四五丸，边煮边服，等到感觉病减，想再配制服用也很好。忌食羊肉、饴糖。
又根据前半夏丸，虽然感觉逐渐减轻，但病根未除，想多配制前丸，又担心药毒不可久服，不服又怕病情蔓延，适宜合用人参七味丸服用。
人参七味丸
人参 白术（各五两） 浓朴（炙） 细辛（各四两） 生姜（八两，末） 橘皮（三两） 桂心（二两）
以上研为细末，炼蜜丸如梧桐子大，饮水送下十丸，渐加至二十丸，与半夏丸交替服用也可以。忌桃、李、雀肉、生葱、生菜。
《补遗》治疗男子妇人一切呕吐。在五苓散中除去桂枝，加入半夏末如桂枝的分量，每次服用一钱，用生姜自然汁调搜和匀如面团状，等候半个时辰，再用一小盏白沸汤，调开温服。（五苓散方，见《伤寒准绳·渴门》。）
青金丹 治疗一切呕吐不已。
硫黄（二钱） 水银（一钱）
放入铫内慢火熬化，用木篦子拨炒成砂，再入乳钵研黑不见星，用姜汁糊丸如绿豆大，每次服用二三十丸，米饮送下。
人参安胃散 治疗脾胃虚热，呕吐泄泻，或饮食不入。
人参（一钱） 黄芪（炒，二钱） 生甘草 炙甘草（各五分） 白芍药（七分） 白茯苓（四分） 陈皮（三分） 黄连（炒，二分）
以上用水煎服。
[Da] When women experience vomiting, it is caused by pathogenic factors and cold in the Spleen and Stomach, leading to dysfunction in the digestion and absorption of food and fluids. The Stomach is the sea of water and grain; when its Qi mechanism is disordered, wind-cold pathogens may invade. Cold clashing with Stomach Qi causes Stomach Qi to rebel upward, resulting in vomiting. Vomiting is not solely due to deficiency-cold of the Spleen and Stomach; there are also cases caused by Stomach heat, cases where the middle Jiao (Stomach body) is cold but the upper orifice (cardia/pylorus area) is hot, cases dominated by phlegm-dampness, and cases due to blood deficiency. The Classics state: "Absence of Yin leads to vomiting." Therefore, medication cannot be applied uniformly. For vomiting due to Stomach cold, one should use *Renshen Dingxiang San* (Ginseng and Clove Powder) or *Lizhong Wan* (Regulate the Middle Pill) from the *Taiping Huimin Heji Jufang*, as well as *Banxia Wan* (Pinellia Pill) or *Renshen Qiwei Wan* (Seven-Ingredient Ginseng Pill) by Xu Renze. For vomiting due to Stomach heat, *Xiaochaihu Tang* (Minor Bupleurum Decoction), *Lugen Tang* (Reed Rhizome Decoction), *Zhuru Tang* (Bamboo Shavings Decoction), or *Huaihua San* (Sophora Flower Powder) are suitable. For vomiting due to cold in the Stomach body and heat at the orifice, *Huoxiang Zhengqi San* (Patchouli and Qi-Regulating Powder) from the *Heji Jufang*, decocted with fresh ginger and jujube, taken cold, will stop the vomiting. For vomiting due to excessive phlegm, *Banxia Tang* (Pinellia Decoction), *Fuling Tang* (Poria Decoction), or *Erchen Tang* (Two-Aged Decoction) from the *Heji Jufang* are appropriate. For nausea and vomiting during pregnancy (*Ezu*), *Fuling Wan* (Poria Pill) can be used concurrently, following specific protocols. For vomiting due to blood failing to return to its vessels, use *Shiquan Dabu Tang* (Comprehensive Great Tonifying Decoction, indicated for deficiency-consumption in miscellaneous diseases) added with Chenpi (Tangerine Peel), Banxia (Pinellia), Huoxiang (Patchouli), ginger, and jujube. Cases of vomiting associated with *Jiaogixing* (Beriberi/Leg Swelling) have their own specialized treatments and are not discussed here.
[Xue] Master Dongyuan stated: In the aforementioned conditions, old cold pathogens and newly ingested food enter the Stomach together. The new and old pathogens attack each other, causing Qi to rebel and exit from the Stomach, resulting in hiccups (*Yue*). Treatment involves tonifying the Hand-Taiyin Lung Meridian and draining the Foot-Shaoyin Kidney Meridian. He also said: Hiccups result from rebellious Stomach Qi. Vomiting, spitting, and hiccups all belong to the Stomach, differing only in the quantity of Qi and Blood involved. Vomiting belongs to the Yangming channel, which has abundant Qi and Blood; thus, it presents with both sound and material, indicating disease in both Qi and Blood. Zhang Zhongjing said: "In frequent vomiting, even if Yangming symptoms exist, one must strictly avoid purgatives." Sun Simiao said: "Those who vomit often should take fresh ginger, as it is the holy medicine for vomiting." Rebellious Qi must be dispersed, so fresh ginger is the primary herb. Spitting (without sound) belongs to the Taiyang channel, which has abundant Blood but little Qi; thus, it presents with material but no sound, indicating Blood disease. For immediate vomiting after eating, Chennopii (Citrus Peel, white part removed) is the primary herb. Hiccups belong to the Shaoyang channel, which has abundant Qi but little Blood; thus, it presents with sound but no material, indicating Qi disease. Jiang-processed Banxia is the primary herb. If the Spleen and Stomach are weak, invaded by cold pathogens, or damaged by diet, use *Liujunzi Tang* (Six-Gentlemen Decoction), Dingxiang (Clove), Huoxiang (Patchouli), ginger, etc. If there is heat in the Stomach and phlegm above the diaphragm, use *Erchen Tang* (Two-Aged Decoction), Shanzhi (Gardenia), Huanglian (Coptis), and ginger. If chronic illness leads to Stomach deficiency, with vomiting and inability to retain food, use ginger, Renshen (Ginseng), Baizhu (Atractylodes), Huangqi (Astragalus), Xiangfu (Cyperus), etc. There are also cases of phlegm obstruction in the middle Jiao preventing food intake, rebellious Qi causing vomiting, Qi stagnation at the Stomach orifice, food retention between the Heart and Lungs causing regurgitation, and fire-phlegm at the Stomach orifice causing vomiting. If vomiting is profuse like a pouring ship, accompanied by thirst for water, death ensues; drinking child's urine is most effective. The previous discussion mentioned using *Shiquan Dabu Tang* for vomiting due to blood failing to return to its vessels, which indeed elucidates insights previously unexpressed. I have used this method frequently with success. (This discussion differs slightly from Wang Andao's *Suhui Ji*; comparison is recommended.) My late mother, after eating, heard words that offended her, leading to vomiting of sour fluid, internal heat, thirst, and a preference for cold water. Her Qi-kou pulse was large and chaotic, and her complexion was greenish-red. This was Liver-Spleen depressed fire. Medication entered the mouth but was immediately vomited. On the third day, she vomited undigested food; on the seventh day, sour-yellow fluid; on the eleventh day, bitter fluid. The pulse remained surging and large, and she still preferred cold drinks. A small amount of cooled Huanglian (Coptis) decoction was given. By the twentieth day, Baizhu (Atractylodes) and Fuling (Poria) were added. By the twenty-fifth day, Chenpi (Tangerine Peel) was added. By the thirty-seventh day, Danggui (Angelica) and Zhi Gancao (Honey-fried Licorice) were added. By the sixtieth day, she could consume half a cup of rice drink, gradually advancing to thin congee, and recovered through regulation. The mother of Shen Jiwen, a government student, suffered from Spleen deficiency causing abdominal fullness, phlegm-cough, and fever. After eating wet noodles and cold tea, she experienced acid regurgitation, vomiting, and anorexia. She mistakenly took Huangqin (Scutellaria), Huanglian (Coptis), and Qingpi (Aurantium Peel), worsening her chills, fever, dry mouth, and uncontrollable salivation. She vomited upon smelling food for several days. Upon consultation, I stated: "The Spleen controls saliva; this is Spleen deficiency failing to constrain fluids." I intended to use *Renshen Anwei San* (Ginseng Stomach-Calming Powder), but was swayed by others' opinions to treat it as Stomach meridian excess-fire and food retention. The condition worsened daily. Suddenly craving winter melon, she ate a piece the size of a fingernail, triggering incessant vomiting of sour fluid. Continuing the previous medication exacerbated the condition. Upon re-examination, her spirit was depleted, and her pulse was faint, nearing death. Only her eyeballs moved. I stated: "Cold flooding internally requires acrid-hot treatment, but medicine cannot be retained." I urgently applied salt, Aiye (Mugwort Leaf), and Fuzi (Aconite Root) heated and pressed to the umbilical-abdominal region to dissipate cold and restore Yang. I also used breath-to-mouth resuscitation and applied a hot Fuzi cake to the navel. After about an hour, her spirit slightly revived. I powdered Renshen (Ginseng), Baizhu (Atractylodes), and Fuzi (Aconite Root), mixed with Chenpi (Tangerine Peel) paste into pills the size of millet grains. Placing five to seven pills in the mouth allowed them to be swallowed with saliva, stopping vomiting. After two days, the dose increased to ten pills, and symptoms subsided somewhat, though salivation persisted. After five days, gradually taking one or two spoons of the previous decoction restored some Stomach Qi, and she desired congee. Subsequently, tonifying the Spleen and Stomach with Renshen and Baizhu for over fifty doses led to recovery.
[Sun] A thirty-five-year-old woman without children feared her husband would take another wife, leading to Qi depression. Her menses had ceased for three months. She suffered from abdominal pain and nausea. All physicians diagnosed pregnancy. Her husband, knowing some medicine, rejoiced and administered fetal-calming, Qi-regulating, and pain-relieving herbs. After thirty to fifty doses, there was no effect, and suffering increased. Every Wei and Shen hours (1:00 PM - 5:00 PM), she experienced chills and fever. Abdominal masses, like marbles, numbering twenty to thirty, churned painfully. Movement produced gurgling water sounds. Extreme pain caused vomiting of five to six bowls of sour fluid. After vomiting, the masses subsided, chills/fever ceased, and pain stopped, repeating the next day. Treating it as malaria worsened the condition. Upon my pulse diagnosis, the left hand was wiry with a choppy Chi position; the right hand was soggy and weak, becoming slippery upon heavy pressure, with the Chi position matching the left. Menses had been absent for five months. I stated: "This is a depression syndrome. How can a choppy pulse indicate pregnancy? If it were pregnancy, the previous medicines would have worked." Her husband realized his error. I prescribed *Erchen Tang* (Two-Aged Decoction) added with Xiangfu (Cyperus), Shanzhi (Gardenia), Fuxiong (Ligusticum), Yuanhu (Corydalis), Danggui (Angelica), Honghua (Safflower). Pain ceased upon administration. Four doses were effective, but pain recurred upon cessation. One month of regulation failed to cure the root. Taking the pulse records to my master, Mr. Huang Gutan, he instructed me: "This is a depressed-fire syndrome originating in the Liver and Gallbladder. The Liver governs planning; the Gallbladder governs decision-making. Lack of resolution leads to depression. Depression causes Wood to flourish. Flourishing Wood insults the Spleen. Spleen injury prevents transformation of essence and generation of Qi and Blood, hence amenorrhea. Lung Metal loses nourishment from its mother (Liver), losing its descending function. Wood, lacking fear, insults what it cannot overcome (Metal), rushing up to disturb the clear orifices, causing vomiting. Symptoms subside after vomiting because Wood rises and Fire extinguishes." I formulated a prescription: Huangqi (Astragalus) 5 qian, Chaihu (Bupleurum) 3 qian, Baishao (White Peony) 2 qian, Gancao (Licorice) 1 qian, Chenpi (Tangerine Peel), Beimu (Fritillaria), Zhishi (Immature Bitter Orange) each 0.5 qian, Ginger 3 slices. After one dose, chills/fever ceased. After two doses, pain decreased, vomiting stopped, and water sounds disappeared. No recurrence for seven days. The husband exclaimed: "How miraculous!" He urged me to consult the Master again. The Master said: "Chills and fever belong to the Shaoyang Gallbladder. Sour vomiting belongs to the Jueyin Liver. Abdominal pain and churning masses indicate fire stirring water, like boiling soup. Frequent vomiting injures Lung Metal further. Thus, Huangqi tonifies Lung Metal as the Sovereign herb to control Liver Wood. Chaihu drains Liver Wood as the Minister herb to ascend Gallbladder Fire. The Classics say: 'For Wood depression, achieve flow.' Flow means unblocking. Wood naturally ascends; depression prevents this. Chaihu ascends the clear Qi of Gallbladder and Liver, breaking depression to restore normalcy. It also says: 'Excess is reduced by what it fears.' Draining refers to tonifying Lung to control Liver. It also says: 'To drain the Liver, soothe its center,' using Gancao to soothe the center as the Assistant. It also says: 'For the main aspect of Wood, drain with sour,' using Baishao to drain Wood within the Spleen as the Minister. Chronic illness generates depression; long-term depression generates phlegm. Beimu, Chenpi, and Zhishi open depression and expel phlegm as the Envoy. Then Metal is correct, Wood is balanced, Earth is secure, leading to rapid recovery. Previous formulas used Shanzhi and Huanglian, which are descending herbs. With blazing fire, how can slight cold suppress it? Thus, the Classics say: 'Light cases are treated directly; heavy cases follow their nature and ascend.' Understanding this principle is essential in treating diseases."
*Yizhi Zi San* (Alpinia Oxyphylla Powder) treats women with chronic Spleen-Stomach deficiency and weak Qi, frequent vomiting, complete anorexia, and limb weakness.
Ingredients: Yizhiren (Alpinia Oxyphylla Fruit) 1 liang, Fuzi (Processed Aconite Root), Suosharen (Amomum Fruit), Dingxiang (Clove), Nongpo (Magnolia Bark), Huangqi (Astragalus Root), Baizhu (Atractylodes Macrocephala Rhizome), Bai Fuling (Poria), Chenpi (Tangerine Peel), Chuanxiong (Ligusticum Chuanxiong Rhizome), Liangjiang (Galangal Rhizome), Huoxiangye (Patchouli Leaf), Danggui (Angelica Sinensis Root) [each 7.5 qian]; Renshen (Ginseng Root), Guixin (Cinnamon Twig) [each 0.5 liang].
Preparation: Coarsely crush. Take 3 qian per dose, with 3 slices of ginger and 1 jujube, in 1 sheng of water, decoct to 0.7 sheng. Strain and take warm at any time.
*Dingxiang San* (Clove Powder) treats women with deficiency-cold of the Zang-Fu, weak Spleen-Stomach Qi, vomiting after eating, and indigestion of food and fluids.
Ingredients: Dingxiang (Clove), Baizhu (Atractylodes Macrocephala Rhizome), Suosharen (Amomum Fruit), Caoguoren (Tsaoko Cardamom Seed), Ju Pi (Tangerine Peel) [each 7.5 qian]; Danggui (Angelica Sinensis Root), Baidoukou (White Cardamom Seed), Huoxiangye (Patchouli Leaf), Shenqu (Medicated Leaven), Hezipi (Persimmon Sepal), Gancao (Licorice Root) [each 0.5 liang]; Renshen (Ginseng Root) 1 liang.
Preparation: Grind to fine powder. Take 2-3 qian per dose, mixed with ginger-jujube decoction.
*Zhuru Tang* (Bamboo Shavings Decoction) treats Stomach heat vomiting.
Ingredients: Gange (Kudzu Root) 3 liang; Banxia (Pinellia Tuber) washed seven times in boiling water, with 0.5 zhan of ginger juice and 1 sheng of fermented grain water, boiled until half evaporated, retaining 7.5 qian; Gancao (Licorice Root) 7.5 qian.
Preparation: Coarsely crush. Take 5 qian per dose, with 2 sheng of water, 3 slices of ginger, bamboo shavings the size of an egg, and 1 jujube. Decoct to 1 sheng. Strain and take warm.
Scholar Xu stated: Those with Stomach heat have hot palms and soles. During the Zhenghe era, a clan relative suffered from Shanghan (Cold Damage). After sweating, his body cooled, but days later he suddenly vomited, unable to retain medicine or food. Physicians used Dingxiang, Huoxiang, and Shihuang (Talcum), but vomiting occurred immediately upon swallowing. I stated: "This is residual heat remaining in the Stomach after sweating. Sun Zhao's Zhuru Tang is precisely indicated." I prepared the medicine, and he recovered instantly.
*Liangfang Huaihua San* (Good Formula Sophora Flower Powder)
Ingredients: Saojiao (Gleditsia Sinensis Fruit), Baifan (Alum), Huaihua (Sophora Flower, stir-fried until yellow-black), Gancao (Licorice Root) [equal parts].
Preparation: Grind to fine powder. Mix with hot water and take 2 qian.
*Xu Xueshi Banxia Wan* (Scholar Xu's Pinellia Pill) treats accumulation of cold in the Stomach, retching, and inability to eat.
Ingredients: Banxia (Pinellia Tuber, 1 sheng, authentic Xiongzhou variety, washed to remove slipperiness); Xiaomaiqu (Wheat Medicated Leaven, 1 sheng).
Preparation: Pound Banxia into powder. Mix with water and dough. Form pills the size of marbles. Boil in water until the dough is cooked. Initial dose: 4-5 pills, twice daily. Gradually increase to 14-15 pills. Cook and take immediately. Condition improves. Avoid mutton and maltose.
Furthermore, regarding the earlier Banxia Wan: although symptoms gradually improved, the root cause remained. To prepare more pills raised concerns about long-term toxicity. To abstain raised fears of disease progression. It is advisable to combine with *Renshen Qiwei Wan*.
*Renshen Qiwei Wan* (Seven-Ingredient Ginseng Pill)
Ingredients: Renshen (Ginseng Root), Baizhu (Atractylodes Macrocephala Rhizome) [each 5 liang]; Nongpo (Magnolia Bark, honey-fried), Xixin (Asarum Root) [each 4 liang]; Shengjiang (Fresh Ginger, minced) 8 liang; Ju Pi (Tangerine Peel) 3 liang; Guixin (Cinnamon Twig) 2 liang.
Preparation: Grind to fine powder. Mix with refined honey to form pills the size of paulownia seeds. Take 10 pills with water, gradually increasing to 20 pills. Can be alternated with Banxia Wan. Avoid peaches, plums, sparrow meat, raw scallions, and raw vegetables.
*Supplement* treats all vomiting in men and women. Remove Guizhi (Cinnamon Twig) from *Wuling San* (Five-Ingredient Powder with Poria), add Banxia powder equal to the amount of Guizhi. Take 1 qian per dose. Mix with fresh ginger juice to form a dough-like consistency. Wait half an hour. Then mix with a small cup of boiling water and take warm. (See *Wuling San* formula in *Shanghan Zhunsheng* under Thirst section.)
*Qingjin Dan* (Green Golden Pill) treats persistent vomiting of all types.
Ingredients: Liuhuang (Sulfur) 2 qian; Shuiyin (Mercury) 1 qian.
Preparation: Slowly melt in a crucible. Stir-fry with a wooden spatula until granular. Grind in a mortar until black and no stars visible. Use ginger juice paste to form pills the size of mung beans. Take 20-30 pills with rice drink.
*Renshen Anwei San* (Ginseng Stomach-Calming Powder) treats deficiency-heat of Spleen-Stomach, vomiting with diarrhea, or inability to ingest food.
Ingredients: Renshen (Ginseng Root) 1 qian; Huangqi (Astragalus Root, fried) 2 qian; Sheng Gancao (Raw Licorice Root), Zhi Gancao (Honey-fried Licorice Root) [each 0.5 qian]; Baishao (White Peony Root) 0.7 qian; Bai Fuling (Poria) 0.4 qian; Chenpi (Tangerine Peel) 0.3 qian; Huanglian (Coptis Rhizome, fried) 0.2 qian.
Preparation: Decoct in water and take.