〔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寒气偏盛，导致水谷运化失常所致。胃是水谷汇聚之所，若其气机不调，风冷之邪乘虚而入，寒邪与胃气相搏结，致使胃气上逆，从而引发呕吐。呕吐这一病症，并非仅仅由脾胃虚寒引起，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，有痰湿壅盛而呕吐的，也有血虚而呕吐的。医经说：“无阴则呕”，指的就是这种情况。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《局方》中的藿香正气散，配合生姜、大枣煎煮，待药液冷却后服用即可止吐。如果是痰湿壅盛引起的呕吐，适宜使用《局方》中的半夏汤、茯苓汤、二陈汤。如果是妊娠恶阻兼见呕吐者，可合用茯苓丸，自有专门的治疗方法。如果是血不归经（血虚失守）引起的呕吐，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，不在此处详述以免混淆。
【薛】东垣先生曾说：上述证候中，若有旧有的寒邪与新摄入的食物同时进入胃中，新旧邪气相互攻伐，气机并乱且逆乱，再次从胃中涌出，所以称为哕（呃逆）。他补充说：胃气因逆乱而导致哕。呕吐和哕，都归属于胃，只是根据气血多少的不同而有所区别。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：呕吐频繁时，即使有阳明证的证据，也千万不要使用泻下法。孙思邈说：经常呕吐的人应多服用生姜，因为它是治疗呕吐的圣药。气逆的病证必须用辛散的方法治疗，所以以生姜为主药。吐，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。哕，属于少阳经，少阳经多气少血，所以有声音但没有吐出物，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，或饮食积滞损伤脾胃，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，使用二陈汤、山栀、黄连、生姜。如果久病导致胃虚，呕吐且无法进食，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；有胃口有火兼有痰浊而呕吐的。如果像注船一样剧烈呕吐，口渴想喝水的就会死亡，饮用童便最为巧妙。前面的论述中说：血不归源而呕吐，使用十全大补汤，这确实是阐发了前人未曾阐发的理论，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，听到外面的言语不合心意，于是呕吐酸水，伴有内热、口渴，只喜欢喝冷水，脉象气口部大而无序，面色青赤，这是肝脾郁火所致。投药后，入口即吐。第三天吐出宿食，第七天吐出酸黄的胆汁样液体，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，放凉后喂服少许，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进半盏米汤，逐渐过渡到稀粥，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，伴有痰嗽、发热，又吃了湿面和冷茶，吞酸呕吐，绝食数日。误服了黄芩、黄连、青皮等药物，导致寒热加重、口干、流涎不止，闻到食物气味就呕吐。请我去诊治，我说：脾主涎，这是脾虚不能制约津液的表现。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，吃下一小块指甲大小的冬瓜，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加严重。再次邀请我去诊视，发现患者神气涣散，脉象微弱近乎消失，濒临死亡。只有眼珠还在转动，我说：寒邪淫溢于体内，应用辛热药物治疗，但此时药物已无法服下。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，趁热敷贴脐间。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，呕吐立即停止。两天后增加到十粒，各种症状稍退，但流涎不止，五天后逐渐服用前剂一二匙，胃气稍复，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】有一位三十五岁未生育的妇人，担心丈夫娶妾而产生抑郁，月经已经三个月没来了。她出现腹痛、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，痛苦反而加剧。每天下午1点到5点（未申时）发作寒热，腹中有肿块，像弹子大的有二三十个，翻腾作痛，活动时腹中有水声漉漉作响，痛极时呕吐酸水五六碗，吐完后肿块平息，寒热消退，疼痛也不再发作，第二天也是如此。又按疟疾治疗，病情反而加重。请我去诊脉，左手脉弦，尺脉涩，右手脉濡弱，重取则滑，尺脉同左。此时月经已经五月没来了。我说：这是郁证，哪有涩脉成孕的道理？如果是怀孕，之前的药应该有效。她丈夫也醒悟了。于是为她处方，用二陈汤加香附、山栀、抚芎、玄胡索、当归、红花等药物，服药后疼痛停止，连续服用四帖都有效，但停药则疼痛如故，调理一个月未能除根。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，郁而生木气亢盛，木气亢盛则克制脾土，脾受伤则不能运化精微物质生成气血，因此月经不来。肺金失去母脏（肝）的滋养，则肃降功能不行，木气无所畏惧而反侮其所不胜（肺），所以直冲犯清道而作呕吐，呕吐后诸证皆减，是因为木气升发而火势平息。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，水声也绝迹，七天不再发作。她丈夫高兴地说：怎么这么神速呢？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，是火盛激动水液，就像锅中汤滚泡浪沸腾一样。呕吐过多会进一步损伤肺金。所以用黄芪补益肺金作为君药，使其能够制约肝木；用柴胡疏泄肝气作为臣药，以升发胆火。经书说：木郁则达之，“达”是通达的意思。木性本应上升，既然郁结就不能上升，所以用柴胡升发胆肝的清气，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，以甘草缓急和中作为佐药。又说：木位之主，其泻以酸，用白芍药在脾中泻木作为臣药。病久生郁，郁久则生涎，用贝母、陈皮、枳实开郁逐涎作为使药。然后金得其正，木得其平，土得其安，因此病去而痊愈迅速。前方如果用山栀、黄连之类，都是降下的药物，火势正炽，岂能用区区寒凉药所能抑制呢？所以经书说：轻者正治，重则从其性而升之。凡是治病，一定要懂得这个道理。
益智子散 治疗妇人脾胃长久虚弱气弱，经常呕吐，完全不能进食，四肢无力。
益智仁（一两） 附子（炮制） 缩砂仁 丁香 厚朴 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，加生姜三片，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，用煎好的姜枣汤调服。
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，煮至减半，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，竹茹鸡蛋大小一块，大枣一枚，煎至一盏，去渣温服。
许学士说：胃热的人手足心发热。政和年间，一位宗室亲属患伤寒，出汗后身体凉爽，几天后突然呕吐，药物和饮食都无法咽下。医生们都用丁香、藿香、滑石等药，咽下即吐。我说：这正是汗后余热留滞在胃脘，孙兆的竹茹汤正好对症。赶紧配药给他，立刻痊愈。
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，呕逆不能进食的方剂。
半夏（一升，真熊州产的，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，药即成。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，虽然觉得逐渐好转，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，适宜配制人参七味丸服用。
人参七味丸
人参 白术（各五两） 厚朴（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，也可与半夏丸交替服用。忌食桃、李、雀肉、生葱、生菜。
《补遗》治疗男子妇人一切呕吐。在五苓散中去掉桂枝，加入半夏末，分量与桂枝相同，每次服用一钱，用生姜自然汁调搜和匀如面团状，等候半个时辰左右，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 治疗一切呕吐不止。
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）
以上加水煎服。
[Da] When women experience vomiting, it is caused by pathogenic factors and cold in the Spleen and Stomach, leading to dysfunction in the digestion of food and fluids. The Stomach is the sea of water and grain; if its Qi mechanism is disordered, wind-cold pathogens may invade. Cold clashing with the Stomach causes Stomach Qi to rebel upward, resulting in vomiting. This disease of vomiting is not solely due to deficiency-cold of the Spleen and Stomach; there are also cases of vomiting due to Stomach heat, cases where the body of the Stomach is cold but the cardia (Stomach opening) is hot, cases due to excessive phlegm, and cases due to blood deficiency. The Classics state: "Without Yin, there is vomiting," referring to this situation. Therefore, medication cannot be applied uniformly. For vomiting due to Stomach cold, it is appropriate to use *Renshen Dingxiang San* (Ginseng and Clove Powder) or *Lizhong Wan* (Regulate the Middle Pill) from the *Jufang* (Prescriptions of the Bureau), as well as *Banxia Wan* (Pinellia Pill) and *Renshen Qiwei Wan* (Seven-Ingredient Ginseng Pill) by Xu Renze. For vomiting due to Stomach heat, it is appropriate to use *Xiao Chaihu Tang* (Minor Bupleurum Decoction), *Lugen Tang* (Reed Rhizome Decoction), *Zhuru Tang* (Bamboo Shavings Decoction), or *Huaihua San* (Sophora Flower Powder). For vomiting due to cold in the Stomach body and heat at the cardia, it is appropriate to use *Huoxiang Zhengqi San* (Agastache Powder to Rectify the Qi) from the *Jufang*, combined with decocted fresh ginger and jujubes, taken when cool to stop vomiting. For vomiting due to excessive phlegm, it is appropriate to use *Banxia Tang* (Pinellia Decoction), *Fuling Tang* (Poria Decoction), or *Erchen Tang* (Two-Aged Decoction) from the *Jufang*. For nausea and vomiting associated with pregnancy (*Ezu*), *Fuling Wan* (Poria Pill) can be used concurrently, which has its own specialized treatment. For vomiting due to blood failing to return to its source (blood deficiency and loss of containment), use *Shiquan Dabu Tang* (Comprehensive Great Tonifying Decoction—used for deficiency consumptive diseases in miscellaneous disorders), adding Chenpi (Tangerine Peel), Banxia (Pinellia), Huoxiang (Patchouli), fresh ginger, and jujubes, decocted and taken. For vomiting accompanied by *Hongxiangjiao* (Beriberi/Leg Qi), there is a specialized treatment, so it is not discussed here to avoid confusion.
[Xue] Mr. Dongyuan stated: In the aforementioned conditions, if old cold pathogens and newly ingested food enter the Stomach together, the new and old pathogens attack each other, causing Qi to conflict and rebel, emerging again from the Stomach, thus forming *Yue* (hiccups/regurgitation). He further stated: The Stomach forms *Yue* due to rebellious Qi. Vomiting, spitting, and *Yue* all belong to the Stomach, differing only according to the abundance or scarcity of Qi and Blood. Vomiting belongs to the Yangming channel; Yangming has abundant Qi and Blood, so there is both sound and material expelled, indicating that both Qi and Blood are diseased. Zhang Zhongjing said: "When there is much vomiting, even if there are Yangming signs, one must be cautious and absolutely avoid purgation." Sun Simiao said: "Those who vomit frequently should take fresh ginger often, as it is the holy medicine for vomiting." Rebellious Qi must be dispersed; therefore, fresh ginger is the primary herb. Spitting (expelling without sound) belongs to the Taiyang channel; Taiyang has abundant Blood but scarce Qi, so there is material expelled but no sound, indicating a Blood disease. For immediate vomiting after eating, *Chenpi* (Tangerine Peel, white part removed) is used as the primary herb. *Yue* (hiccups/regurgitation with sound but no material) belongs to the Shaoyang channel; Shaoyang has abundant Qi but scarce Blood, so there is sound but no material expelled, indicating a Qi disease, treated primarily with ginger-processed Banxia. If the Spleen and Stomach are weak, with cold pathogens lodging or dietary injury, use *Liujunzi Tang* (Six-Gentlemen Decoction), Dingxiang (Clove), Huoxiang (Patchouli), fresh ginger, etc. If there is heat in the Stomach and phlegm above the diaphragm, use *Erchen Tang* (Two-Aged Decoction), Shanzhi (Gardenia), Huanglian (Coptis), fresh ginger. If chronic illness leads to Stomach deficiency, with vomiting and inability to accept food, use fresh ginger, Renshen (Ginseng), Baizhu (Atractylodes), Huangqi (Astragalus), Xiangfu (Cyperus), etc. There are also cases of phlegm obstruction in the middle Jiao preventing food descent, cases of Qi rebellion causing vomiting, cases of Qi stagnation at the cardia, cases of food stasis between the Heart and Lungs regurgitating upward, and cases of fire and phlegm at the cardia causing vomiting. If vomiting is severe like pouring water, and the patient is thirsty and desires water, death ensues; drinking child's urine is most excellent. The previous discussion stated: For vomiting due to blood failing to return to its source, use *Shiquan Dabu Tang*; this truly expounds upon what predecessors had not yet revealed. I have used this method frequently with success. (This discussion differs slightly from Wang Andao's *Suhui Ji*; reference is advised.) My late mother, after eating, heard external words that displeased 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 indicated Liver-Spleen constrained fire. Medication administered 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 Huanglian (Coptis) decoction, cooled, was given. By the twentieth day, Baizhu (Atractylodes) and Fuling (Poria) were added; on the twenty-fifth day, Chenpi (Tangerine Peel); on the thirty-seventh day, Danggui (Angelica) and Zhi Gancao (Honey-fried Licorice). By the sixtieth day, she could consume half a cup of rice drink, gradually advancing to thin congee, and recovered through regulation. Shen Jiwen, a student of the local academy, had a mother suffering from Spleen deficiency with central fullness, phlegm-cough, and fever. After eating wet noodles and cold tea, she experienced acid regurgitation, vomiting, and anorexia. She mistakenly took Qin (Scutellaria), Lian (Coptis), and Qingpi (Aurantium peel), which exacerbated her chills, fever, dry mouth, uncontrollable salivation, and vomiting upon smelling food. Upon consultation, I said: "The Spleen controls saliva; this is Spleen deficiency failing to constrain fluids." I intended to use *Renshen Anwei San* (Ginseng Powder to Pacify the Stomach), but was swayed by public opinion to treat it as Stomach excess fire and food stasis. The condition worsened daily. Suddenly desiring winter melon, she ate a piece the size of a fingernail, triggering continuous violent vomiting of sour fluid. Continuing the previous medicines made it worse. Upon re-examination, her spirit was depleted, pulse was faint and near extinction, and she was near death. Only her eyeballs moved. I said: "Cold pervades the interior; it should be treated with acrid-hot herbs, but medicine cannot be retained." Urgently, salt, Aiye (Mugwort leaf), and Fuzi (Aconite) were stir-fried hot and applied to the umbilicus and abdomen to scatter cold and restore Yang. I also breathed air into her mouth to supplement her Qi, and applied a hot cake of Fuzi to the umbilicus. After about an hour, her spirit slightly revived. Renshen (Ginseng), Baizhu (Atractylodes), and Fuzi (Aconite) were powdered, mixed with Chenpi (Tangerine Peel) paste, and formed into pills the size of millet grains. Five to seven grains were placed in the mouth and swallowed with saliva, stopping the vomiting immediately. After two days, the dose increased to ten grains, and symptoms receded slightly, though salivation continued. After five days, one or two spoonfuls of the previous decoction were gradually taken, restoring some Stomach Qi, and she began craving congee drink. Subsequently, Renshen (Ginseng) and Baizhu (Atractylodes) were used to warm and tonify the Spleen and Stomach. After more than fifty doses, she recovered.
[Sun] A thirty-five-year-old woman, barren, feared her husband taking another wife, leading to depression. Her menses had ceased for three months. She suffered abdominal pain and nausea. All physicians claimed she was pregnant. Her husband, knowing some medicine, rejoiced and treated her with fetal-calming, Qi-regulating, and pain-relieving herbs. After thirty to fifty doses with no effect, her suffering intensified. Every afternoon (Wei-Shen hours), she experienced chills and fever. Abdominal masses, like quail eggs, 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. Treated as malaria, the condition worsened. Upon my pulse diagnosis, the left hand was wiry with a choppy Chi position; the right hand was soggy and weak, but deep pressure revealed slippery pulses, similar to the left. Menses had been absent for five months. I said: "This is a constraint disorder. 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) plus Xiangfu (Cyperus), Shanzhi (Gardenia), Fuxiong (Ligusticum), Yuanhu (Corydalis), Danggui (Angelica), Honghua (Safflower), etc. Pain ceased with administration. Four consecutive doses were effective, but pain returned 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 constrained fire disorder originating in the Liver and Gallbladder. The Liver governs planning; the Gallbladder governs decision-making. Lack of resolution leads to constraint. Constraint generates Wood hyperactivity. Wood hyperactivity overacts on Earth (Spleen). Spleen injury fails to transform fine essences into Qi and Blood, hence amenorrhea. Lung Metal loses nourishment from its mother (Wood), so descending functions fail. Wood, lacking fear, insults its conqueror (Metal), rushing up to disturb the clear orifices, causing vomiting. Symptoms reduce after vomiting because Wood ascends and Fire subsides." I formulated a prescription: Huangqi (Astragalus) 5 qian, Chaihu (Bupleurum) 3 qian, Baishao (White Peony Root) 2 qian, Gancao (Licorice) 1 qian, Chenpi (Tangerine Peel), Beimu (Fritillaria), Zhishi (Immature Bitter Orange) each 0.5 qian, Fresh Ginger 3 slices. After one dose, chills/fever ceased; after two doses, pain reduced, vomiting stopped, and water sounds disappeared. No recurrence for seven days. Her husband rejoiced: "How miraculous!" He urged me to consult the Master again. The Master said: "Chills and fever belong to Shaoyang Gallbladder. Sour vomiting belongs to Jueyin Liver. Painful abdominal masses churning is fire agitating water, like boiling soup in a pot. Excessive vomiting injures Lung Metal further. Thus, Huangqi (Astragalus) tonifies Lung Metal as the Sovereign herb to control Liver Wood. Chaihu (Bupleurum) drains Liver as the Minister herb to ascend Gallbladder Fire. The Classics say: 'For Wood constraint, achieve unimpeded flow.' 'Unimpeded' means thorough penetration. Wood nature tends to ascend; since constrained, it cannot, so Chaihu ascends the clear Qi of Gallbladder and Liver, breaking the constraint to restore normalcy. It also says: 'For excess, subdue it via its fear.' Draining refers to tonifying Lung to control Liver. It also says: 'To drain the Liver, soothe its center,' using Gancao (Licorice) to soothe the center as the Assistant. It also says: 'For the main treatment of Wood positions, use sour to drain.' Baishao (White Peony Root) drains Wood within the Spleen as the Minister. Chronic illness creates constraint; long-standing constraint generates phlegm. Beimu (Fritillaria), Chenpi (Tangerine Peel), and Zhishi (Immature Bitter Orange) open constraint and drive out phlegm as the Envoy. Then Metal is correct, Wood is balanced, Earth is peaceful, leading to rapid recovery. Previous formulas using Shanzhi (Gardenia) or Huanglian (Coptis) are descending herbs. With raging fire, how can slight cold herbs suppress it? Thus, the Classics say: 'For mild cases, treat directly; for heavy cases, follow its nature and ascend.' In treating any disease, one must understand this principle."
*Yizhi Zi San* (Alpinia Oxyphylla Powder) treats women with long-standing Spleen-Stomach deficiency and weak Qi, frequent vomiting, complete anorexia, and limb weakness.
Yizhiren (Alpinia Oxyphylla Fruit) (1 liang), Fuzi (Prepared Aconite), Suosharen (Amomum Fructus), Dingxiang (Caryophylli Flos), Houpo (Magnoliae Officinalis Cortex), Huangqi (Astragali Radix), Baizhu (Atractylodis Macrocephalae Rhizoma), Baifuling (Poria Cum Mycelium), Chenpi (Citri Reticulatae Pericarpium), Chuanxiong (Ligustici Chuanxiong Rhizoma), Liangjiang (Alpiniae Katsumadai Rhizoma), Huoxiangye (Agastaches Pallidae Folium), Danggui (Angelicae Sinensis Radix) (each 7.5 qian), Renshen (Ginseng Radix et Rhizoma), Guixin (Cinnamomi Ramulus) (each 0.5 liang).
Crush the herbs. Take 3 qian per dose, with 3 slices of fresh 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 viscera deficiency-cold, weak Spleen-Stomach Qi, vomiting after eating, and indigestion of food and fluids.
Dingxiang (Caryophylli Flos), Baizhu (Atractylodis Macrocephalae Rhizoma), Suosharen (Amomum Fructus), Caoguoren (Tsaoko Fructus), Juapi (Citri Reticulatae Pericarpium) (each 7.5 qian), Danggui (Angelicae Sinensis Radix), Baidoukou (Amomi Rotundus Fructus), Huoxiangye (Agastaches Pallidae Folium), Shenqu (Massa Medicata Fermentata), Hezipi (Terminaliae Chebulae Pericarpium), Gancao (Glycyrrhizae Radix et Rhizoma) (each 0.5 liang), Renshen (Ginseng Radix et Rhizoma) (1 liang).
Grind into fine powder. Take 2-3 qian per dose,調 with decocted ginger-jujube water.
*Zhuru Tang* (Bamboo Shavings Decoction) treats Stomach heat vomiting.
Gange (Puerariae Lobatae Radix) (3 liang), Banxia (Pinelliae Rhizoma) (washed 7 times in hot water, mixed with 0.5 zhan of ginger juice and 1 sheng of fermented grain water, boiled until volume halves, take 7.5 qian), Gancao (Glycyrrhizae Radix et Rhizoma) (7.5 qian).
Crush. Take 5 qian per dose, with 2 sheng of water, 3 slices of fresh 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 (Clove), Huoxiang (Patchouli), Huashi (Talcum), etc., but everything was vomited immediately. I said: "This is exactly residual heat after sweating lingering in the Stomach cavity. Sun Zhao's *Zhuru Tang* is precisely indicated." I urgently prepared the medicine, and he recovered instantly.
*Liangfang Huaihua San* (Good Prescriptions Sophora Flower Powder)
Zaojiao (Gleditsiae Sinensis Spina), Baifan (Alumen), Huaihua (Sophorae Flos) (stir-fried until yellow-black), Gancao (Glycyrrhizae Radix et Rhizoma) (equal parts).
Grind into fine powder. Take 2 qian,調 with boiling water.
*Xu Renze Banxia Wan* (Xu Renze Pinellia Pill) treats accumulation of cold in the Stomach, rebellious vomiting, and inability to eat.
Banxia (Pinelliae Rhizoma) (1 sheng, genuine from Xiongzhou, washed to remove slime), Xiaomaiqu (Triticum Vulgare Fermentatum) (1 sheng).
Pound Banxia into powder. Mix with water and flour, form pills the size of quail eggs. Boil in water until the flour is cooked; the medicine is ready. Initially swallow 4-5 pills, twice daily. Gradually increase to 14-15 pills. Cook and take immediately. When symptoms improve, preparing more is good. Avoid mutton and maltose.
Furthermore, based on the first half of the Banxia Pill formula, although gradual improvement occurs, the root cause remains. Wanting to prepare more of the previous pill, but fearing long-term toxicity, yet fearing non-treatment will let the disease spread, it is suitable to take *Renshen Qiwei Wan* (Seven-Ingredient Ginseng Pill).
*Renshen Qiwei Wan* (Seven-Ingredient Ginseng Pill)
Renshen (Ginseng Radix et Rhizoma), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 5 liang), Houpo (Magnoliae Officinalis Cortex) (roasted), Xixin (Asari Radix et Rhizoma) (each 4 liang), Shengjiang (Zingiberis Recens Rhizoma) (8 liang, powdered), Juapi (Citri Reticulatae Pericarpium) (3 liang), Guixin (Cinnamomi Ramulus) (2 liang).
Grind into fine powder. Form honey pills the size of sophora seeds. Take 10 pills with water, gradually increasing to 20 pills. Can also 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 Poria Powder), add Banxia powder in equal amount to 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, stir, and take warm. (See *Wuling San* formula in *Shanghan Zhunsheng* under Thirst section.)
*Qingjin Dan* (Green Gold Pill) treats persistent vomiting of all types.
Liuhuang (Sulfur) (2 qian), Shuiyin (Mercurius) (1 qian).
Slowly melt in a crucible. Stir-fry with a wooden spatula until granular. Grind in a mortar until black and stars are invisible. Form pills the size of mung beans with ginger juice paste. Take 20-30 pills per dose with rice drink.
*Renshen Anwei San* (Ginseng Powder to Pacify the Stomach) treats Spleen-Stomach deficiency-heat, vomiting, diarrhea, or inability to ingest food.
Renshen (Ginseng Radix et Rhizoma) (1 qian), Huangqi (Astragali Radix) (roasted, 2 qian), Sheng Gancao (Raw Licorice), Zhi Gancao (Honey-fried Licorice) (each 0.5 qian), Baishao (Paeoniae Radix Alba) (0.7 qian), Baifuling (Poria Cum Mycelium) (0.4 qian), Chenpi (Citri Reticulatae Pericarpium) (0.3 qian), Huanglian (Coptidis Rhizoma) (roasted, 0.2 qian).
Decoct in water and take.