嘉定钱远之，二十五岁，以鼓盆之戚，悲哀过度，不能食饭。又十余日，粥亦不能食，随食随吐，二便闭涩。
自谓必死，求诊于余。余曰∶脉按有力，非死证也。以酒蒸大黄，加桃仁、当归、砂仁、陈皮，蜜丸与服。凡五
服而下燥屎干血甚多，病若失矣。数日之间，能食倍常。（《必读》）
金针丸，治卒然呕吐，胸中痞闷，气不下行，此由饮食失宜，过伤胃气，胃气滞而不行，水谷不化，气逆则吐，
其脉沉疾而短滑。
巴豆 朱砂（等分）
上用白面糊和丸，如麻子大，遂旋用针穿一窍子，每服一丸，以针札定，于灯上烧少时，熟水下。（《鸡峰》）
呕家不以温药微利大便，则无由愈。养正丹或来复丹、黑锡丹之类（养正云云，原作此数药三字，今照上文录入）
皆有硫黄，能温利之。秘甚者，用加味感应丸。若先自溏利，是为虚寒，不宜用此。（《易简》）
呕吐家多大便秘结，虚冷者用灵砂或养正丹，温而利之。又苏合香丸用四分，感应丸用六分，夹研作细丸，
姜汁泡沸汤下，此亦温利。若大便热结，用蜜煮凝，捻作指铤，纳后部导之。（《直指》）
凡大肠燥结，呕吐不止，汤药不入，老人虚人多有此症，幽门不通，上冲于窍，以致呕吐泛满。须先以蜜煎导
其大便，通其幽门，然后服药则安，此要法也。（《危证简
便》）
镇坠方法 治吐，紫粉丸。
针砂醋浸一宿，辟去醋（按∶馆本云劈破），便带醋炒，直候铫子红色无烟乃止，候冷细研，更用醋团，
火烧洞赤，取起候冷，再研极细，面糊丸，如梧桐子大，每服四十丸，粥饮下。服讫，便啜一盏许粥，不吐已。
如未定，再服决定。小儿小丸之，随儿大小与之。此药极神异，然吐有多端，《良方》中有数法，皆累验者，
可参用之。（《苏沈》）
呕吐诸药不效，当借镇重之药以坠其逆气，宜姜苏汤下灵砂丹，须百粒作一服。俟药得效，却以养正丹、
半硫丸导之。（《要诀》）
杂治诸方 六味地黄丸，阴虚于下，令人多呕者，主此方，盐汤吞之。（《方考》）
呕吐诸药不效，再以鹅翎探吐积痰为愈。（《六要》）
凡呕吐，用芦管入鼻孔内，吹皂荚末少许，令嚏出即止。（《捷法》）
调摄法 痰 吐逆，忌甘滑等物。（《万安》引《保生信效方》）
嘉定人钱远之，二十五岁，因丧妻之痛，悲哀过度，导致无法进食米饭。又过了十多天，连粥也吃不下，吃多少吐多少，大小便闭塞不通。
他自认为必死无疑，来找我诊治。我说：“脉象按之有力，不是死证。”于是用酒蒸大黄，加入桃仁、当归、砂仁、陈皮，制成蜜丸让他服用。共服五剂后，排出大量燥屎和干血，病仿佛消失了一样。几天之内，食量加倍于常人。（出自《必读》）
金针丸，治疗突然发生的呕吐，胸中痞闷堵塞，气机不能下行。这是由于饮食不当，过度损伤胃气，导致胃气停滞不行，水谷不能消化，气机上逆而呕吐，其脉象沉疾而短滑。
以上药物用白面糊调和制成丸子，如麻子大小，随即用针穿一个小孔，每次服用一丸，用针固定好，在灯上烧一会儿，用熟水送下。（出自《鸡峰》）
呕吐患者如果不通过温性药物轻微通利大便，就没有痊愈的途径。养正丹或来复丹、黑锡丹之类（注：原文此处为“养正云云”，原稿为此三药名，现依上文录入），都含有硫黄，能够温补并通利。便秘严重的，使用加味感应丸。如果原本就有溏泄，这是虚寒证，不宜使用这些药物。（出自《易简》）
呕吐患者大多伴有便秘，属于虚冷的，使用灵砂或养正丹，以温性药物通利大便。另外，苏合香丸用四分，感应丸用六分，混合研成细丸，用姜汁泡沸水送下，这也是温通利下的方法。如果是大便热结，用蜂蜜煮至凝固，捏成指头大小的栓剂，纳入肛门导引通便。（出自《直指》）
凡是因大肠燥结导致呕吐不止，汤药无法进入体内的，老人和体虚之人多有此症。这是因为幽门不通，浊气上冲于口窍，导致呕吐泛酸胀满。必须先以蜜煎导法通便，疏通幽门，然后服药才能安定，这是关键的方法。（出自《危证简便》）
针砂用醋浸泡一夜，劈开去掉醋味（按：馆本注释为劈破），带着醋炒，直到铁锅变红且无烟为止，冷却后细细研磨，再用醋调和成团，火烧至通红，取出冷却，再研磨至极细，用面糊制成丸子，如梧桐子大小，每次服用四十丸，用米粥饮送下。服完后，再喝约一盏米的粥，呕吐即可停止。如果未完全稳定，再服用一次即可决定疗效。小儿则制作小丸，根据孩子的大小给予剂量。此药极为神异，然而呕吐原因有多种，《良方》中有几种方法，都是屡试有效的，可以参考使用。（出自《苏沈》）
呕吐诸药无效时，应当借助镇重的药物来降逆气，宜用姜苏汤送服灵砂丹，必须一百粒作为一次剂量。等到药效显现后，再用养正丹、半硫丸引导排泄。（出自《要诀》）
杂治各方 六味地黄丸，适用于下焦阴虚导致的多呕症状，主用此方，用盐汤吞服。（出自《方考》）
呕吐诸药无效时，再用鹅毛探喉催吐积痰，以此治愈。（出自《六要》）
凡呕吐，用芦管插入鼻孔内，吹入少许皂荚末，令患者打喷嚏即止。（出自《捷法》）
调摄方法 痰饮引起的呕吐逆气，忌食甘滑等食物。（出自《万安》，引用《保生信效方》）
Qian Yuanzhi, a resident of Jiading, aged twenty-five, suffered from excessive grief due to the death of his wife (gu盆之戚, mourning for a spouse). This led to an inability to eat rice. After more than ten days, he could not even consume porridge; whatever he ate was immediately vomited up, accompanied by constipation and difficulty in urination.
Believing himself destined to die, he sought my consultation. I stated, "The pulse is forceful upon palpation; this is not a fatal condition." I prescribed a honeyed pill made from Rhubarb (Da Huang) steamed with wine, added with Peach Kernel (Tao Ren), Angelica Sinensis (Dang Gui), Amomum (Sha Ren), and Tangerine Peel (Chen Pi). He took five doses, after which a large amount of dry feces and stagnant blood were discharged, and the illness seemed to vanish. Within a few days, his appetite doubled that of normal times. (From *Bixu*)
Jinzhen Wan (Golden Needle Pill) treats sudden vomiting, chest oppression and stuffiness, and failure of Qi to descend. This is caused by improper diet, which excessively damages Stomach Qi, leading to stagnation and failure of movement, resulting in the failure to transform food and fluids, and rebellious Qi causing vomiting. The pulse is deep, rapid, short, and slippery.
Croton Seed (Badou) and Cinnabar (Zhusha) in equal parts.
Mix the above with wheat paste to form pills the size of hemp seeds. Immediately pierce a hole through each with a needle. Take one pill per dose, secure it with a needle, heat it briefly over a lamp, and swallow with warm water. (From *Jifeng*)
For patients with vomiting, if the bowels are not slightly unblocked using warming herbs, there is no way to recover. Formulas such as Yangzheng Dan (Nourishing Righteousness Pill), Laifu Dan (Restoring Revival Pill), or Heixi Dan (Black Tin Pill)—note: original text says "Yangzheng yunyun", here recorded as these three drugs based on context—all contain Sulfur (Huangqi), which can warm and unblock. For severe constipation, use Jiawei Yinggan Wan (Modified Induction Pill). If the patient already has loose stools, this indicates deficiency-cold, and these formulas should not be used. (From *Yijian*)
Patients with vomiting often have constipation. For those with deficiency-cold, use Lingsha (Refined Mercury) or Yangzheng Dan to warm and unblock the bowels. Alternatively, mix Suhe Xiang Wan (Styrax Pill) [4 fen] and Yinggan Wan [6 fen], grind into fine pills, and take with ginger juice prepared in boiling water; this also warms and unblocks. If the constipation is due to heat accumulation, prepare a suppository by boiling honey until solid, shaping it like a finger, and inserting it into the anus to guide evacuation. (From *Zhizhi*)
Whenever dryness and accumulation in the Large Intestine cause persistent vomiting where liquids cannot be retained, especially in the elderly and the deficient, this occurs because the pylorus is blocked, allowing turbid Qi to rush upward to the orifices, causing vomiting and fullness. One must first use honey suppositories to unblock the bowels and open the pylorus; only then can medication be taken to stabilize the condition. This is a crucial method. (From *Weizheng Jianbian*)
Methods of Sedation and Descending: To treat vomiting, use Zifen Wan (Purple Powder Pill).
Immerse Ferri Pulvis (Zhen Sha) in vinegar overnight. Split it open (Note: Gu edition notes "split") and stir-fry with the vinegar remaining until the crucible turns red and smoke ceases. Cool and grind finely. Re-form into a mass with vinegar, fire-burn until red-hot, cool, and grind extremely fine. Mix with wheat paste to form pills the size of Sophora seeds. Take forty pills per dose with gruel. After ingestion, drink about one cup of gruel to stop vomiting. If not fully stabilized, administer another dose to ensure efficacy. For children, make smaller pills and adjust dosage according to age. This medicine is miraculous. However, since vomiting has various causes, refer to several methods in *Liangfang* which have proven effective repeatedly. (From *Su Shen*)
When all other remedies for vomiting fail, resort to heavy sedatives to descend rebellious Qi. Administer Lingsha Dan (Mercury Pill) with Jiangsu Tang (Ginger and Perilla Decoction); the dose must be one hundred pills. Once the effect is achieved, follow up with Yangzheng Dan or Banshu Wan (Half Croton Pill) to guide evacuation. (From *Yaojue*)
Miscellaneous Prescriptions: Liuwei Dihuang Wan (Six-Ingredient Rehmannia Pill) is indicated for frequent vomiting caused by Yin deficiency in the lower jiao. Swallow with salted water. (From *Fangkao*)
If all medicines for vomiting are ineffective, induce vomiting again using a goose feather to remove accumulated phlegm, which leads to cure. (From *Liuyao*)
For any case of vomiting, insert a reed tube into the nostril and blow a small amount of Gleditsia Sinensis powder (Zao Jia Mo) into it. Inducing sneezing will stop the vomiting. (From *Jiefai*)
Regulation Methods: For vomiting and regurgitation due to Phlegm, avoid sweet and slippery foods. (From *Wan'an*, citing *Baosheng Xinxiaofang*)