大半夏汤 治痰症呕吐。
半夏（制，二升） 人参（三两，切）
上每四钱，姜七片，蜜少许，熟煎服。
小半夏茯苓汤 《金匮》云∶呕家用半夏以去其水，水去呕止。
半夏（一升） 生姜（半斤） 茯苓（四两）
上三味，以水七升，煮取一升半，分温再服。
《局方》二陈汤 治痰饮呕恶，头眩心悸。
陈皮 半夏（制，各三钱） 茯苓（二钱） 炙甘草（一钱）
水二盅，姜三片，食远服。
东垣云∶辛药生姜之类治呕吐，但治上焦气壅表实之病。若胃虚谷气不行，胸中痞塞而
呕吐
者，惟宜益胃，推扬谷气而已。故服小半夏汤不愈者，服大半夏汤立愈，此仲景心法也。
《本事》神术丸 治呕吐清水，亦治呕酸。（方见痰饮门。）
经云∶太阴之复，呕而密默，唾吐清液，治以苦热，是呕水属湿也。或一味苍术制炒为
丸服之。
丹溪云∶或问吞酸，《素问》明以为热，东垣又以为寒，何也？曰∶吐酸与酸不同，吐
酸是
吐出酸水如醋。平时津液随上升之气，郁而成积，成积既久，湿中生热，故从木化，遂作酸
味，非热而何？其有郁积之久，不能自涌而出，伏于肺胃之间，咯不得上，咽不得下。肌表
得风寒，则内热愈郁，而酸味刺心；肌表温暖，腠理开发，或得香热汤丸，津液得行，亦可
暂解
，非寒而何？《素问》言热者，言其本也，东垣言寒者，言其末也。但东垣不言外得风寒，
而作收气立说，欲泻肺金之实，又谓寒药不可治酸，而用安胃汤加二陈汤，俱犯丁香，且无
治热湿积郁之法，为未合经意。予尝论治吞酸，用黄连、茱萸各制炒，随时令迭为佐使，苍
术、茯苓为辅，汤浸蒸饼为小丸吞之，仍教以 食蔬果自养，则病自愈。
大半夏汤：治疗痰证引起的呕吐。
半夏（制过的，二升） 人参（三两，切片）
以上药材每次取四钱，加生姜七片、蜂蜜少许，煎煮至熟后服用。
小半夏茯苓汤：《金匮要略》中说：“对于呕吐患者使用半夏以去除体内的水饮，水饮去除了呕吐就会停止。”
半夏（一升） 生姜（半斤） 茯苓（四两）
以上三味药，用水七升，煮取一升半，分两次温服。
《局方》二陈汤：治疗痰饮引起的恶心呕吐、头晕目眩和心悸。
陈皮 半夏（制过的，各三钱） 茯苓（二钱） 炙甘草（一钱）
用水两盅，加生姜三片，在饭后较远的时候服用。
李东垣说：“用生姜等辛温药物来治疗呕吐，只是针对上焦气机壅滞、表实证的病症。如果是胃气虚弱导致谷气运行不畅，胸中痞塞不通而呕吐的患者，只适宜补益胃气，提升和发扬谷气罢了。所以服用小半夏汤没有痊愈的，服用大半夏汤立刻就能痊愈，这是张仲景的治疗心法。”
《本事方》神术丸：治疗呕吐清水，也治疗呕吐酸水。（方剂详情见痰饮门。）
《黄帝内经》说：“太阴经气复反时，会出现呕吐且沉默不语，吐出清稀液体，治疗应用苦热性质的药物，这说明呕吐清水属于湿邪所致。”或者单用一味苍术，经过炮制炒过后做成丸剂服用。
朱丹溪说：“有人问吞酸的问题，《素问》明确认为是热证，李东垣又认为是寒证，为什么呢？我说：吐酸与单纯的吞酸不同，吐酸是指吐出像醋一样的酸水。平时津液随着上升的气机，郁结而成积滞，积滞久了，湿气中生热，所以从木化火，于是产生酸味，这难道不是热证吗？那些有郁积很久，不能自行涌出，潜伏在肺胃之间的，咳不出来，咽不下去。如果肌表受到风寒侵袭，那么内热会更加郁结，酸味刺痛心脏；如果肌表温暖，腠理开泄，或者喝下香热的汤药丸剂，津液得以通行，也可以暂时缓解，这难道不是寒证吗？《素问》说热，是说的病本；李东垣说寒，是说的病标。但是李东垣没有提到外感风寒，而是从收敛之气立论，想要泻肺金的实证，又说寒药不可治酸，却使用安胃汤加上二陈汤，都含有丁香，而且没有治疗湿热积郁的方法，这与经典原意不合。我曾经论述治疗吞酸，用黄连、吴茱萸各制炒，根据时令交替作为佐使药，苍术、茯苓作为辅药，用汤浸泡蒸饼做成小丸吞服，仍然教导患者吃蔬菜水果来自我调养，那么病自然痊愈。”
Banxia Banxia Decoction (Pinellia and Ginseng Decoction): Treats vomiting caused by phlegm syndrome.
Zhi Banxia (Prepared Pinelliae Rhizoma, two sheng) Renshen (Ginseng Radix et Rhizoma, three liang, sliced)
For each dose of four qian, add seven slices of fresh ginger and a small amount of honey, decoct until cooked, and take orally.
Xiaobanxia Fuling Tang (Minor Pinellia and Poria Decoction): The *Jingui Yaolue* states: "When treating vomiting, use Banxia to eliminate the retained water; once the water is eliminated, the vomiting stops."
Banxia (Pinelliae Rhizoma, one sheng) Shengjiang (Fresh Zingiberis Rhizoma, half jin) Fuling (Poria, four liang)
Take the above three ingredients, add seven sheng of water, boil to obtain one and a half sheng, divide into two doses, and take warm.
Erchen Tang (Two-Aged Decoction) from *Ju Fang*: Treats nausea and vomiting due to phlegm-fluid retention, dizziness, and palpitations.
Chenpi (Citri Reticulatae Pericarpium) Zhi Banxia (Prepared Pinelliae Rhizoma, three qian each) Fuling (Poria, two qian) Zhi Gancao (Honey-fried Glycyrrhizae Radix et Rhizoma, one qian)
Add two zhong of water and three slices of fresh ginger, take well after meals.
Li Dongyuan stated: "Using pungent herbs such as Shengjiang to treat vomiting only addresses conditions of qi stagnation in the upper jiao and exterior excess. For patients with deficiency of stomach qi leading to poor movement of grain qi, chest stuffiness, and vomiting, it is appropriate only to tonify the stomach and promote the rise and spread of grain qi. Therefore, if Xiaobanxia Tang fails to cure, Banxia Banxia Decoction will bring immediate relief; this is Zhang Zhongjing's core method."
Shenzhu Wan (Divine Efficacy Pill) from *Ben Shi Fang*: Treats vomiting of clear fluid and also vomiting of sour fluid. (See the Phlegm-Fluid section for the formula.)
The *Huangdi Neijing* states: "When the Taiyin meridian qi rebounds, there is vomiting accompanied by silence and spitting of clear fluids; treatment should employ bitter-hot herbs. This indicates that vomiting clear fluid belongs to dampness." Alternatively, use a single herb, Cangzhu (Atractylodis Rhizoma), processed and fried, made into pills for oral administration.
Zhu Danxi stated: "Someone asked about 'swallowing acid.' The *Suwen* clearly identifies it as heat, while Li Dongyuan identifies it as cold. Why? I say: Vomiting acid differs from merely swallowing acid; vomiting acid refers to expelling sour fluid like vinegar. Normally, body fluids follow the ascending qi, become stagnant and accumulate. After long-standing accumulation, heat arises within dampness, transforming according to Wood, thus producing an acidic taste. Is this not heat? In cases where accumulation has persisted for a long time without being able to surge out, lying latent between the lungs and stomach, unable to be coughed up or swallowed down. If the skin and muscles are exposed to wind-cold, the internal heat becomes more constrained, and the acidic taste pierces the heart; if the skin and muscles are warm, pores open, or fragrant hot decoctions/pills are taken allowing body fluids to circulate, temporary relief can be achieved. Is this not cold? When the *Suwen* speaks of heat, it refers to the root cause; when Li Dongyuan speaks of cold, he refers to the branch manifestation. However, Li Dongyuan did not mention external wind-cold but based his theory on the Qi-constricting phase, aiming to drain the excess of Lung Metal. He also claimed cold herbs cannot treat acidity, yet used Angwei Tang combined with Erchen Tang, both containing Dingxiang (Caryophylli Flos), lacking methods to treat heat-dampness accumulation, which does not align with the classic intent. I have discussed treating swallowing acid using Huanglian (Coptidis Rhizoma) and Zhuyu (Evodiae Fructus), both prepared and fried, alternating as assistant and guide herbs according to seasons, with Cangzhu and Fuling as auxiliary herbs, formed into small pills soaked in broth and steamed dough for swallowing. I also advised patients to nourish themselves with vegetables and fruits, so the disease would heal naturally."