《宣明五气篇》曰∶五气所病，心为噫。
《脉解篇》曰∶太阴所谓上走心为噫者，阴盛而上走于阳明，阳明络属心，故曰上走心
为噫也。
《经脉篇》曰∶足太阴病，则舌本强，食则呕，胃脘痛，腹胀善噫，得后与气，则快然
如衰。
《口问篇》曰∶人之噫者，何气使然？曰∶寒气客于胃，厥逆从下上散，复出于胃，故
为噫。
《阴阳别论》曰∶二阳一阴发病，主惊骇、背痛、善噫、善欠，名曰风厥。
《痹论》曰∶心痹者，脉不通，烦则心下鼓，暴上气而喘，嗌干善噫。
《三部九候论》曰∶若有七诊之病，其脉候亦败者死矣，必发哕噫。
《至真要大论》曰∶岁厥阴在泉，风淫所胜，民病膈咽不通，食则呕，腹胀善噫，得后
与气，则快然如衰，身体皆重。太阳司天，寒淫所胜，民病胸胁胃脘不安，面赤目黄，善噫
嗌干，甚则色 ，渴而欲饮，病本于心。少阴之复，燠热内作，外为浮肿，为哕噫。
《四时刺逆从论》曰∶刺五脏，中心一日死，其动为噫。
《诊要经终论》曰∶太阴终者，腹胀闭不得息，善噫善呕。
（《内经》无恶心之说，凡呕吐证即其类也。经义详见本门，共三条）
恶心证，胃口泛逆，兀兀不宁之病。凡恶心欲吐，口必流涎，咽之不下，愈咽愈恶，而
呕吐继之，亦有不呕吐而时见恶心者，然此虽曰恶心，而实胃口之病，非心病也。此证之因
，则有寒，有食，有痰饮，有秽气，有火邪，有阴湿伤胃，或伤寒疟痢诸邪之在胃口者，皆
得有之，若欲察之，但当察其虚实寒热则尽之矣。盖实邪恶心者，邪去则止，其来速，其去
亦速；虚邪恶心者，必得胃气大复，其病方愈。且此证惟虚寒者十居八九，即有实邪呕恶者
，亦必其脾气不健，不能运化而然。此所以凡治恶心者，必当知其实中有虚，勿得妄行攻击
，而胃气不可罔顾也。
一、虚寒恶心，其证最多，若非猝暴而常见，或形气不足之辈，悉以胃气弱也。故凡治
此者，多宜以温补为主。若脾胃微虚生痰，或兼吞酸嗳腐，咳嗽恶心者，宜六君子汤。若脾
肾虚寒，痰滞咳嗽而恶心者，金水六君煎。若脾胃虚寒，或太阴自利腹痛，呕吐恶心者，温
胃饮，或理中汤、圣术煎。若脾肾虚寒，上下不能营运，或胀满，或呕吐，或伤寒阴证，寒
邪深入三阴，而恶心呕吐不止者，理阴煎或温胃饮。
一、实邪恶心，以一时邪滞犯胃，得吐则滞去，滞去则恶心自解。若有余邪，如法治之
。若恶心多痰，及风寒咳嗽，或伤生冷，或饮酒过多，脾胃不和者，二陈汤或橘皮半夏汤。
若脾胃多滞，或寒湿伤脾恶心者，平胃散。若胃寒多滞，或伤生冷，或寒痰不清，吞酸胀满
恶心者，和胃饮或和胃二陈煎。若受秽浊寒邪，胀满腹痛恶心者，调气平胃散。若感冒暑热
，火盛烦躁恶心者，仲景竹叶石膏汤。若中药毒或诸毒而恶心者，速宜于诸毒门求法治之。
《脉解篇》说：太阴经所说的“气上走于心而致嗳气”，是因为阴气过盛而上行侵犯阳明经，阳明的络脉归属并联系心脏，所以称为气上走于心而致嗳气。
《经脉篇》说：足太阴脾经发病，就会出现舌根僵硬，进食后呕吐，胃脘疼痛，腹部胀满且容易嗳气，大小便通畅或排气后，症状就会减轻而感到舒适。
《口问篇》说：人为什么会嗳气？是什么气导致的呢？回答说：寒气客居在胃中，厥逆之气从下向上散漫，再出于胃，所以产生嗳气。
《阴阳别论》说：二阳（阳明）与一阴（厥阴）同时发病，主要症状为惊恐、背痛、容易嗳气、容易呵欠，这种病名叫风厥。
《痹论》说：心痹病患者，血脉不通畅，心烦时感觉心下悸动如鼓，突然气逆上冲而喘息，咽喉干燥且容易嗳气。
《三部九候论》说：如果有七种诊察到的危重病症，其脉象也败坏的话，就会死亡，必定会出现呃逆和嗳气。
《至真要大论》说：岁运厥阴风木在泉，风气淫胜，百姓患病表现为膈部和咽部不通畅，进食则呕吐，腹部胀满且容易嗳气，大小便通畅或排气后，症状就会减轻而感到舒适，身体沉重。太阳寒水司天，寒气淫胜，百姓患病表现为胸胁和胃脘部不安，面色发红，眼睛发黄，容易嗳气且咽喉干燥，严重时面色晦暗发黑，口渴想喝水，病本在于心。少阴君火复气，体内燠热内生，外部出现浮肿，并伴有呃逆和嗳气。
《四时刺逆从论》说：针刺五脏，如果误中心脏，一天后死亡，其动的征象是嗳气。
《诊要经终论》说：太阴经气终结时，腹部胀满闭塞不能呼吸，容易嗳气和呕吐。
（《内经》中没有“恶心”这一说法，凡是呕吐的证候都属于此类。经文义理详见本门，共三条）
恶心证，是指胃口泛逆、心中兀兀然不宁的病证。凡是恶心欲吐的人，口中必然流涎，吞不下去，越吞咽越觉得恶心，随后引发呕吐；也有不呕吐但时常感到恶心的情况。然而这虽然叫作恶心，实际上是胃口的病，而不是心脏的病。此证的成因，有寒邪、食积、痰饮、秽浊之气、火邪、阴湿损伤胃腑，或者伤寒、疟疾、痢疾等邪气停留在胃口的，都会导致此病。若要辨别，只要考察其虚实寒热即可穷尽病因。实邪引起的恶心，邪气去除则停止，发病迅速，痊愈也快；虚邪引起的恶心，必须等到胃气大幅恢复，疾病才能痊愈。而且此证中虚寒者占十之八九，即使是有实邪导致的呕恶，也一定是因为脾气不健，不能运化所致。因此，凡治疗恶心者，必须知道实证中夹杂虚证，不要妄用攻伐之法，而不可不顾护胃气。
一、虚寒型恶心，这种情况最多见，如果不是突然暴发而是经常见到，或者是形体元气不足的人，都是因为胃气虚弱。所以治疗这类患者，多适宜以温补为主。如果是脾胃轻微虚弱生痰，或者兼有吞酸、嗳腐、咳嗽、恶心的，宜用六君子汤。如果是脾肾虚寒，痰滞咳嗽且恶心的，用金水六君煎。如果是脾胃虚寒，或者太阴自利腹痛、呕吐恶心的，用温胃饮，或者理中汤、圣术煎。如果是脾肾虚寒，上下不能营运，或者出现胀满，或者呕吐，或者伤寒阴证，寒邪深入三阴经，而恶心呕吐不止的，用理阴煎或温胃饮。
一、实邪型恶心，是由于一时邪气阻滞犯胃，通过呕吐使邪滞去除，邪滞去除则恶心自然解除。如果有余留的邪气，按上述方法治疗。如果恶心多痰，以及风寒咳嗽，或者伤于生冷，或者饮酒过多，导致脾胃不和的，用二陈汤或橘皮半夏汤。如果脾胃多有停滞，或者寒湿伤脾导致恶心的，用平胃散。如果胃寒多有停滞，或者伤于生冷，或者寒痰不清，伴有吞酸、胀满、恶心的，用和胃饮或和胃二陈煎。如果感受秽浊寒邪，出现胀满、腹痛、恶心的，用调气平胃散。如果感冒暑热，火盛烦躁导致恶心的，用张仲景的竹叶石膏汤。如果因中药毒或其他毒物导致恶心的，应速在其他毒物门类中寻求治疗方法。
The *Xuanming Wuqi Pian* (Chapter on Five Qi and Their Pathological Manifestations) states: Among the diseases caused by the five qi, the Heart corresponds to belching.
The *Maijie Pian* (Chapter on Pulse Resolution) states: What Taiyin refers to as "qi moving upward to the Heart causing belching" occurs because yin qi is excessive and moves upward to invade the Yangming channel. Since the collaterals of Yangming connect to and belong to the Heart, it is said that qi moves upward to the Heart causing belching.
The *Jingmai Pian* (Chapter on Meridian Channels) states: When the Foot-Taiyin Spleen channel is diseased, the root of the tongue becomes stiff, vomiting occurs after eating, epigastric pain arises, abdominal distension occurs with frequent belching, and upon defecation or passage of flatus, one feels relieved as symptoms subside.
The *Kouwen Pian* (Chapter on Questions Concerning the Mouth) asks: Why do people belch? What qi causes this? The answer is: Cold qi lodges in the Stomach, rebellious qi rises from below and scatters upward, then emerges from the Stomach, thus causing belching.
The *Yinyang Bie Lun* (Treatise on Differences Between Yin and Yang) states: When Er-Yang (Yangming) and Yi-Yin (Jueyin) are involved in disease onset, the main symptoms include fright, back pain, frequent belching, and frequent yawning; this condition is named Fengjue (Wind-Jue).
The *Bi Lun* (Treatise on Bi Syndrome) states: In Xinbi (Heart Bi), blood vessels are obstructed. When vexation occurs, there is palpitation in the lower chest like drumbeating; sudden upward rushing of qi leads to panting, dry throat, and frequent belching.
The *Sanbu Jiuhou Lun* (Treatise on Three Regions and Nine Palpations) states: If there are seven types of critical illnesses and the pulse conditions are also deteriorated, death will ensue, inevitably accompanied by hiccups and belching.
The *Zhihen Yao Da Lun* (Great Treatise on the Most Essential Truths) states: When Jueyin Wind-Wood governs the Earthly Branches, wind excess prevails, and the people suffer from obstruction in the diaphragm and pharynx, vomiting after eating, abdominal distension with frequent belching, relief upon defecation or flatus, and heaviness of the body. When Taiyang Cold-Water governs the Heavenly Stem, cold excess prevails, and the people suffer from discomfort in the chest, hypochondrium, and epigastrium, red face, yellow eyes, frequent belching, dry throat; in severe cases, dark complexion, thirst, and desire to drink, with the disease root lying in the Heart. When Shaoyin Fire experiences a return (rebound), internal heat arises, external edema appears, along with hiccups and belching.
The *Sishi Cini Cong Lun* (Treatise on Following or Opposing Needling According to Seasons) states: When needling the Zang organs, if the Heart is punctured, death occurs within one day, and the sign of movement is belching.
The *Zhunao Jingzhong Lun* (Treatise on Key Points for Meridian Termination) states: When Taiyin qi terminates, abdominal distension and closure prevent breathing, accompanied by frequent belching and vomiting.
(The *Neijing* does not mention "nausea"; all vomiting syndromes belong to this category. Detailed scriptural meanings are found in this section, totaling three entries.)
Nausea syndrome refers to the rebellion of stomach qi and a feeling of unsettled restlessness in the epigastrium. Whenever nausea with the urge to vomit occurs, saliva flows in the mouth, cannot be swallowed, and swallowing exacerbates the nausea, leading subsequently to vomiting. There are also cases where vomiting does not occur but nausea is intermittent. Although called nausea, this is actually a disorder of the Stomach, not the Heart. The causes of this syndrome include cold, food stagnation, phlegm-fluid retention, foul odors, fire pathogens, damp-cold injuring the Stomach, or pathogens such as cold damage, malaria, and dysentery residing in the Stomach. To investigate, one need only examine deficiency/excess and cold/heat. For nausea caused by excess pathogens, cessation occurs once the pathogen is expelled; onset is rapid, and recovery is swift. For nausea caused by deficiency pathogens, recovery requires significant restoration of Stomach qi. Moreover, eight or nine out of ten cases are deficiency-cold. Even when nausea is due to excess pathogens, it is invariably because Spleen qi is weak and fails to transform and transport. Therefore, treating nausea requires recognizing deficiency within excess and avoiding reckless attacking methods, while never neglecting the protection of Stomach qi.
1. Deficiency-Cold Nausea: This is the most common type. If it is not acute/sudden but chronic, or occurs in individuals with insufficient form and qi, it is due to weak Stomach qi. Treatment should primarily focus on warming and tonifying. If mild Spleen-Stomach deficiency generates phlegm, or if accompanied by acid regurgitation, belching of rotten food, cough, and nausea, Liu Junzi Tang (Six Gentlemen Decoction) is suitable. If Spleen and Kidney deficiency-cold cause phlegm stagnation, cough, and nausea, Jinshui Liujun Jian (Golden Water Six Gentlemen Decoction) is indicated. If Spleen-Stomach deficiency-cold causes spontaneous diarrhea, abdominal pain, vomiting, and nausea associated with Taiyin, Wenyin Yin (Warming Stomach Decoction), Lizhong Tang (Regulate the Middle Decoction), or Shengzhu Jian (Holy Atractylodes Decoction) may be used. If Spleen and Kidney deficiency-cold impair upper and lower circulation, causing distension, vomiting, or persistent nausea/vomiting due to Cold Damage Yin syndromes with deep penetration into the Three Yin channels, Liyin Jian (Nourishing Yin Decoction) or Wenyin Yin (Warming Stomach Decoction) are appropriate.
2. Excess Pathogen Nausea: Caused by temporary pathogenic stagnation invading the Stomach; vomiting expels the stagnation, resolving the nausea. If residual pathogens remain, treat according to the method above. If nausea involves much phlegm, wind-cold cough, injury from raw/cold foods, or excessive alcohol consumption leading to Spleen-Stomach disharmony, Erchen Tang (Two Old Decoction) or Chupi Banxia Tang (Tangerine Peel and Pinellia Decoction) are suitable. If Spleen-Stomach has much stagnation, or cold-dampness injures the Spleen causing nausea, Pingwei San (Level the Stomach Powder) is indicated. If Stomach cold with much stagnation, injury from raw/cold foods, unclear cold-phlegm, acid regurgitation, distension, and nausea occur, Hewei Yin (Harmonize Stomach Decoction) or Hewei Erchen Jian (Harmonize Stomach Two Old Decoction) are used. If foul turbid cold pathogens cause distension, abdominal pain, and nausea, Tiaoqi Pingwei San (Regulate Qi Level the Stomach Powder) is indicated. If summerheat-heat contraction with fire excess causes vexation and nausea, Zhongjing's Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction by Zhang Zhongjing) is used. If nausea results from Chinese herbal toxicity or other poisons, seek treatment methods in the respective toxicology sections immediately.