按灵枢经脉篇云。足厥阴肝所生病者。胸满呕逆。夫木动必犯土。呕吐出于胃。而
致病之由在肝。胃病治肝。不拘伤寒杂症皆然。不可专以胃火胃寒为治。
邵评∶呕吐为胃气上逆。其胃气之所以上逆。因肝木犯胃所致。夫呕吐之因不
一。有胃阴亏者。有胃阳虚者。有胃火盛而热邪内结者。有胃中寒而浊阴干犯
者。有胃中有痰饮而气不下降者。虽有多因。总因肝火上升。乘虚犯胃。以木土
相仇。肝木克土。而顺乘阳明也。治呕吐者。当两和肝胃为法。
肝火犯胃 凡痞胀。食入即吐。并呕酸水。口渴舌黄。此肝火犯胃。恒因恼怒而得。
宜吴萸、川连、半夏、茯苓、浓朴、枳实、姜汁、竹茹之类主之。
邵评∶此方平肝火而和胃。最效。
胃火冲逆 凡阳明热病。舌苔燥黄。烦渴呕恶。脉来洪滑。米饮入口即呕。惟凉水
可纳者。宜白虎汤。重加活水芦根主之。
邵评∶此方清胃经火热。极效。
肝火冲逆 凡伤寒热盛之时。自觉气自左升。呕吐。勺水不纳。脉弦数。舌燥刺。或
呕吐酸苦黄水。此肝火上乘于胃。宜左金、半夏、陈皮、黑栀、（姜汁炒）茯苓、椒梅等。降之
泄之。或用姜汁炒川连。或用吴萸汤炒川连。治呕最验。
胃脘阳虚 凡食入呕吐。或纳少不变。脉细小而弦。或右脉弦大。脘中满痛。大便
欲解未通。此胃脘阳虚。肝木未亢。治宜专益胃阳。人参、半夏、茯苓、陈皮、干姜、吴萸主之。
胃气不降 夫脾主升。胃主降。若因怫怒动肝。肝木犯胃。胃阳受伤。不能传及小肠。变化失司。
大便不解。纳谷不饥。吞噫酸水。甚至胃底酿积之物。上涌为吐。此胃气不主下行故也。法当温胃阳
制肝逆为治。宜熟附、干姜、白芍、吴萸、枳实、炒白粳米主之。
邵评∶脾以上升为宜。胃以下行为顺。因怒动肝。肝逆乘胃。胃气不得下行。食不
变化。挟肝火上升而呕吐也。此与上条不同。上条只胃脘阳虚。无肝木乘侮。专
理胃阳为治。此则胃阳受伤。因怒而肝火上升犯胃。故吞噫酸水。酸为肝味也。
胃升不降。甚至胃底上泛。涌逆吐出。其胃阳之衰弱已极。肝木之亢逆莫制。几
有胃阳虚脱之变。急当温胃通阳。制肝降逆为治。
肝逆犯肺 凡病气自左升。腹中膨胀。呕吐涎沫酸苦黄水。则咳呛不已。此肝气
逆乘。过胃犯肺。法宜制肝和胃。须陈皮、半夏、茯苓、川椒、乌梅、萸汤炒川连。姜汁炙枇杷叶主之。
邵评∶气自左升者。肝气也。肝气升则为腹胀。犯胃上逆。则吐涎沫酸苦黄水。肝
挟相火。木火刑金。乘肺而作咳呛。已过胃而上升莫制矣。宜平肝和胃治之。
阴浊犯胃 有气从小腹上冲。为呕为胀。所吐皆黑绿苦水。此属下焦阴浊。冲逆
犯胃。厥阴秽气上逆也。宜川椒、乌梅、连制茱萸、茯苓、川楝子、（醋炒）小茴香、（盐水炒）黑
栀子（姜汁炒）等。以制肝逆。胃气虚者加人参。
邵评∶少腹为肝之部分。肝居下焦。其气上冲。则浊阴随之上逆。故呕而且胀。吐
出黑绿苦水。是胃底之浊水。被下焦之阴浊冲逆而上泛也。急当镇胃平肝。通阳泄浊治之。
肝络伏饮 凡气冲偏左。厥逆欲呕。呕尽方适。此伏饮在于肝络也。宜辛以通之。
淡吴萸、（盐水炒）半夏、茯苓、姜汁、旋复花、代赭石主之。
邵评∶肝主一身脉络。从左上冲者。肝气也。肝挟饮邪上逆。入于络中。则厥而呕吐。宜和肝宣络涤饮治之。
热邪内结 痞闷呕浊。不寐不饥。舌黄口渴。治宜苦辛泻心法。黄芩、川连、半夏、枳实、姜汁。
邵评∶热邪痞结阳明。治以苦辛开泄。
暑秽内结 吸入暑秽。先走募原。募原是胃络分布。故上逆而为呕吐。脘闷而痛。
寒热不解。舌黄而渴。宜泻心法。姜制川连、黄芩、半夏、枳实、藿梗、滑石、通草、郁金。
邵评∶暑秽自口鼻吸受。从上直行中道而走膜原。膜原者。脾与胃以膜相联。为
半表半里之界。暑热秽邪。结于膜原。而呕吐寒热。宜苦辛开泄治之。然惟舌黄可用泻心法。
又评∶舌白苔者。不宜陷胸、泻心。宜杏、蔻、桔、橘。苦辛开肺。如邪入膜原。舌苔粉白。
当用吴又可达原饮。舌黄腻浓者。非泻心不可。
湿热相蒸 胃中有火。脾家有湿。湿热相蒸。以致呕吐不纳。时饱时饥。渴不多饮。
舌苔微黄粘腻。此胃热蒸脾湿之验也。治宜寒热兼施。川连、干姜、茯苓、半夏、广皮、黄芩、泽泻、枳实、姜汁。
邵评∶脾湿胃热。蕴结中宫。格拒不开而作呕吐。治以和中开痞。清渗湿热为主。
痰饮兼寒 呕吐不渴。舌苔白滑。或兼咳嗽者。此痰饮兼寒邪也。二陈汤加桂枝、干姜、姜汁。
邵评∶寒饮内伏于胃。上升射肺。故呕吐咳嗽。寒邪有饮。则口不渴。白滑苔者。寒痰也。故用涤痰温散之法。
痰饮兼火 呕吐微渴。兼见咳嗽。舌苔淡红而鲜。或带微白者。此痰饮兼胃火也。
温胆汤加枇杷叶、（姜汁炙）黑栀子。（姜汁炒）
邵评∶和胃化痰。宣肺清热。此方极效。
胃中虚寒 纳谷不受。时呕涎沫。舌润不渴。右关濡软。六君子、加砂仁、干姜、呕涎
沫者。加益智仁摄之。吐痰饮者。加桂枝、姜皮和之。
邵评∶寒邪格拒不纳。有寒饮则呕涎沫。无热则舌润不渴。脉濡软。胃虚也。故用补中化痰而温散。
热伤胃津 暑热之邪不解。灼干胃中津液。舌红鲜泽。口渴。食入即呕。当戒腥油
腻物。二陈汤去甘草。加钗斛、姜汁炒竹茹。或温胆汤去枳实、甘草。加栀豉、金斛。
邵评∶湿热暑疫之邪。入于阳明。胃中津液受伤。而呕吐津亏。胃热则舌鲜红而
口渴。故以和胃生津化痰为治。
胃阴虚馁 如大汗后。胃中津液大虚。呕吐不纳。口渴。舌苔白嫩者。宜金水六君
煎。加麦冬、沙参。以和胃阴。
呕吐不已 此有升无降。宜镇逆法。 旋复花、代赭石、半夏、茯苓、会皮。虚者加人
参。
邵评∶胃不下行而上逆。气升呕吐。用镇逆降胃之法。极是。
按《灵枢·经脉篇》记载：足厥阴肝经所发生的疾病，包括胸满、呕吐逆气。木气（肝）变动必然侵犯土气（脾胃）。呕吐虽然表现于胃，但致病的根源在于肝。治疗胃病需兼顾治肝，无论是伤寒还是杂病，都是如此。不能仅仅针对胃火或胃寒进行治疗。
邵评注：呕吐是胃气上逆的表现。胃气之所以上逆，是因为肝木侵犯胃土所致。引起呕吐的原因不一，有因胃阴亏虚的，有因胃阳虚弱的，有因胃火旺盛且热邪内结的，有因胃中寒冷且浊阴之气干犯胃部的，有因胃中有痰饮导致气机不下降的。虽然原因众多，但总归是由于肝火上升，乘虚侵犯胃部，造成木土相克，肝木克制脾土，进而顺行侵犯阳明胃经。治疗呕吐，应当采用调和肝胃的方法。
肝火犯胃：凡是出现痞闷胀满、进食后立即呕吐、呕吐酸水、口渴、舌苔发黄的症状，这是肝火侵犯胃腑。通常因恼怒而引发。适宜用吴茱萸、黄连、半夏、茯苓、厚朴、枳实、姜汁、竹茹等药物为主治疗。
胃火冲逆：凡是阳明热病，舌苔干燥发黄，烦躁口渴、恶心呕吐，脉象洪大滑数，米汤入口即吐，只有凉水可以喝下的情况，适宜用白虎汤，并重加新鲜芦根为主治疗。
肝火冲逆：凡是伤寒热盛之时，自觉气从左侧上升，伴有呕吐，连一勺水都喝不下，脉象弦数，舌燥且有刺感，或者呕吐酸苦黄水，这是肝火上冲侵犯胃腑。适宜用左金丸、半夏、陈皮、黑栀子（姜汁炒）、茯苓、椒梅等药物。采取降泄的方法，或者使用姜汁炒黄连，或者用吴茱萸汤炒黄连，治疗呕吐最为灵验。
胃脘阳虚：凡是进食后呕吐，或者吃得少且不消化，脉象细小而弦，或者右脉弦大，胃脘部满痛，大便想解却未通畅，这是胃脘阳虚，肝木并未亢盛。治疗应当专门温补胃阳，用人参、半夏、茯苓、陈皮、干姜、吴茱萸为主治疗。
胃气不降：脾主升清，胃主降浊。如果因愤怒触动肝气，肝木侵犯胃腑，损伤胃阳，导致无法传导至小肠，气化功能失常，大便不通，不想进食，吞酸嗳气，甚至胃底积聚之物向上涌出成为呕吐，这是因为胃气不主下行所致。治疗方法应当温补胃阳、制约肝逆，适宜用熟附子、干姜、白芍、吴茱萸、枳实、炒白粳米为主治疗。
邵评注：脾气以上升为宜，胃气以下行为顺。因愤怒触动肝气，肝气逆乱乘犯胃腑，导致胃气不得下行，食物无法运化，挟带肝火上升而引起呕吐。这与上一条不同，上一条仅是胃脘阳虚，没有肝木乘侮的情况，专门调理胃阳即可；这一条则是胃阳受伤，因愤怒导致肝火上升侵犯胃腑，所以出现吞酸嗳气，酸味属于肝的味道。胃气只升不降，甚至胃底物质上泛，涌逆吐出，说明胃阳衰弱已极，肝木亢逆无法制约，几乎有胃阳虚脱的变化。急当温通胃阳，制约肝气、降逆止呕。
肝逆犯肺：凡是病势气自左侧上升，腹部膨胀，呕吐涎沫、酸苦黄水，导致咳嗽呛逆不止，这是肝气逆乱乘犯，经过胃脏侵犯肺脏。治疗方法宜制肝和胃，需用陈皮、半夏、茯苓、川椒、乌梅、吴茱萸汤炒黄连、姜汁炙枇杷叶为主治疗。
邵评注：气自左侧上升，是肝气的作用。肝气上升则导致腹胀，侵犯胃腑上逆，则呕吐涎沫、酸苦黄水。肝挟带相火，木火刑金，乘犯肺脏而引发咳嗽呛逆。这已经过了胃脏而上升无法制约。适宜平肝和胃治疗。
阴浊犯胃：有气从小腹上冲，导致呕吐和胀满，所吐出的都是黑绿色的苦水，这属于下焦阴浊之气，冲逆侵犯胃腑，是厥阴秽浊之气上逆。适宜用川椒、乌梅、制吴茱萸、茯苓、川楝子、醋炒小茴香、盐水炒黑栀子（姜汁炒）等药物，以制约肝逆。若胃气虚弱者加入人参。
邵评注：少腹是肝经分布的部分。肝居下焦，其气上冲，则浊阴随之上逆，所以既呕吐又胀满。吐出黑绿色苦水，是胃底的浊水被下焦的阴浊冲逆而上泛所致。急当镇胃平肝，通阳泄浊治疗。
肝络伏饮：凡是气冲偏向左侧，四肢厥冷欲呕，呕吐完后才感到舒适，这是伏饮停留在肝络之中。适宜用辛味药物以通利之。用淡吴茱萸、盐水炒半夏、茯苓、姜汁、旋复花、代赭石为主治疗。
邵评注：肝主管一身脉络，气从左上冲，是肝气的作用。肝挟带饮邪上逆，进入络脉，则出现厥冷和呕吐。适宜调和肝气、宣通络脉、涤除饮邪治疗。
热邪内结：痞闷、呕吐浊物，失眠、不想进食，舌苔黄、口渴。治疗适宜用苦辛泻心法。用黄芩、黄连、半夏、枳实、姜汁。
暑秽内结：吸入暑湿秽浊之气，先走窜募原。募原是胃络分布之处，所以上逆导致呕吐，胃脘闷痛，寒热不退，舌苔黄且口渴。适宜用泻心法。用姜制黄连、黄芩、半夏、枳实、藿梗、滑石、通草、郁金。
邵评注：暑湿秽浊之气从口鼻吸入，从上直行中道而走膜原。膜原是脾与胃以膜相连的地方，为半表半里的界限。暑热秽邪结于膜原，导致呕吐、寒热，适宜用苦辛开泄之法治疗。然而只有舌苔黄时才可用泻心法。
又评注：舌苔白者，不宜用陷胸汤、泻心汤，适宜用杏仁、蔻仁、桔梗、橘皮。苦辛开宣肺气。如果邪气入膜原，舌苔粉白，当用吴又可的达原饮。舌苔黄腻浓重者，非用泻心汤不可。
湿热相蒸：胃中有火，脾家有湿，湿热相互蒸腾，导致呕吐、不能进食，时而饱胀时而饥饿，口渴但不多饮，舌苔微黄粘腻，这是胃热蒸动脾湿的表现。治疗适宜寒热兼施。用黄连、干姜、茯苓、半夏、广陈皮、黄芩、泽泻、枳实、姜汁。
邵评注：脾湿胃热，蕴结于中焦，格拒不开而作呕吐。治疗以和中开痞、清渗湿热为主。
痰饮兼寒：呕吐但不口渴，舌苔白滑，或者兼有咳嗽，这是痰饮兼夹寒邪。用二陈汤加桂枝、干姜、姜汁。
邵评注：寒饮内伏于胃，上升射肺，所以呕吐咳嗽。有寒邪和有饮邪，则口不渴。白滑苔是寒痰的表现，所以用涤痰温散的方法。
痰饮兼火：呕吐伴轻微口渴，兼见咳嗽，舌苔淡红而鲜亮，或者带微白色，这是痰饮兼夹胃火。用温胆汤加枇杷叶（姜汁炙）、黑栀子（姜汁炒）。
胃中虚寒：受纳谷物困难，时常呕吐涎沫，舌润不渴，右关脉濡软。用六君子汤加砂仁、干姜；呕吐涎沫者，加益智仁以摄纳；吐痰饮者，加桂枝、姜皮以调和。
邵评注：寒邪格拒不纳食，有寒饮则呕吐涎沫，无热则舌润不渴，脉濡软，是胃虚的表现。所以用补中化痰而温散的方法。
热伤胃津：暑热之邪不解，灼烧干枯胃中津液，舌红鲜泽，口渴，食入即吐。应当戒除腥油腻食物。用二陈汤去甘草，加石斛、姜汁炒竹茹；或者用温胆汤去枳实、甘草，加栀子、豆豉、金斛。
邵评注：湿热暑疫之邪，进入阳明，胃中津液受伤，导致呕吐津亏。胃热则舌鲜红而口渴，所以以和胃生津化痰为治法。
胃阴虚馁：如大汗之后，胃中津液大虚，呕吐不纳食，口渴，舌苔白嫩，适宜用金水六君煎，加麦冬、沙参，以调和胃阴。
According to the *Ling Shu: Jing Mai* chapter, diseases occurring in the Foot Jueyin Liver meridian include chest fullness and vomiting with reverse qi. When Wood (Liver) moves, it inevitably invades Earth (Spleen/Stomach). Although vomiting manifests in the Stomach, the root cause of the disease lies in the Liver. Treating Stomach diseases requires addressing the Liver; this applies to both Shanghan (Cold Damage) and miscellaneous diseases. One should not treat solely based on Stomach Fire or Stomach Cold.
Shao's Commentary: Vomiting is the upward reversal of Stomach Qi. The reason Stomach Qi reverses upward is due to Liver Wood invading Stomach Earth. The causes of vomiting are diverse: there are cases of deficient Stomach Yin, deficient Stomach Yang, excessive Stomach Fire with internal binding of heat pathogens, cold in the Stomach with dryness of turbid Yin invading, and phlegm-fluids in the Stomach preventing Qi from descending. Although there are many causes, they generally stem from Liver Fire rising and invading the Stomach when deficiency exists, causing Wood and Earth to conflict, with Liver Wood overacting on Spleen Earth, and subsequently affecting the Yangming Stomach channel. To treat vomiting, one should employ methods to harmonize the Liver and Stomach.
**Liver Fire Invading the Stomach**: Symptoms such as epigastric stuffiness and distension, immediate vomiting after eating, vomiting sour water, thirst, and a yellow tongue coating indicate Liver Fire invading the Stomach. This often arises from anger. It is appropriate to use herbs such as Evodiae Fructus (Wuzhuyu), Coptidis Rhizoma (Chuanlian), Pinelliae Tuber (Banxia), Poria (Fuling), Magnoliae Officinalis Cortex (Houpo), Immature Bitter Orange (Zhishi), Ginger Juice (Jiangzhi), and Bamboo Shavings (Zhuru).
Shao's Commentary: This formula pacifies Liver Fire and harmonizes the Stomach, being most effective.
**Stomach Fire Rushing Upward**: In Yangming Heat diseases, if the tongue coating is dry and yellow, accompanied by irritability, thirst, nausea, and vomiting, with a surging and slippery pulse, and even rice water is vomited immediately upon entry while only cool water can be retained, Baihu Tang (White Tiger Decoction) should be used, heavily supplemented with fresh Reed Rhizome (Lugen).
Shao's Commentary: This formula clears Heat-Fire from the Stomach meridian, being extremely effective.
**Liver Fire Rushing Upward**: During the phase of intense heat in Shanghan, if one feels Qi rising from the left side, accompanied by vomiting, inability to retain even a spoonful of water, a wiry and rapid pulse, a dry and prickly tongue, or vomiting of sour, bitter, and yellow fluids, this indicates Liver Fire ascending to invade the Stomach. Zuojin Wan (Left Metal Pill), Banxia, Chenpi, Gardeniae Fructus (Heizhi, stir-fried with ginger juice), Fuling, and Zhaomei (Pepper Plum) are suitable. Employ descending and purging methods, or use Chuanlian stir-fried with ginger juice, or Chuanlian stir-fried with Wuzhuyu Tang decoction. These are highly verified for treating vomiting.
**Deficiency-Cold of the Epigastrium**: If vomiting occurs after eating, or food intake is low and undigested, with a fine and wiry pulse, or a wiry and large right pulse, epigastric fullness and pain, and a sensation of needing to defecate but failing to do so, this indicates Deficiency-Cold of the Epigastrium without hyperactive Liver Wood. Treatment should focus specifically on tonifying Stomach Yang, using Ginseng Radix et Rhizoma (Renshen), Banxia, Fuling, Chenpi, Zingiberis Rhizoma (Ganjiang), and Evodiae Fructus (Wuzhuyu).
**Failure of Stomach Qi to Descend**: The Spleen governs ascending, and the Stomach governs descending. If anger stirs Liver Qi, causing Liver Wood to invade the Stomach and damage Stomach Yang, transmission to the Small Intestine fails, and transformation and transportation are disrupted. This leads to constipation, lack of appetite, belching with sour taste, and even the upsurge of accumulated matter in the stomach fundus resulting in vomiting. This is because Stomach Qi fails to descend. The method should be to warm Stomach Yang and restrain Liver rebellion, using Prepared Aconite Lateralis Radix (Shufu), Ganjiang, Paeoniae Radix Alba (Baishao), Wuzhuyu, Zhishi, and stir-fried Oryza Sativa Semen (Baijingmi).
Shao's Commentary: Spleen Qi should ascend, and Stomach Qi should descend smoothly. Anger stirs Liver Qi, which rebels and attacks the Stomach, preventing Stomach Qi from descending. Food fails to transform, carrying Liver Fire upward, causing vomiting. This differs from the previous section; the previous case was merely Epigastric Yang Deficiency without Liver Wood overacting, treated by regulating Stomach Yang alone. This case involves damaged Stomach Yang where anger causes Liver Fire to rise and invade the Stomach, leading to sour belching (sourness is the flavor of the Liver). With Stomach Qi rising but not descending, and fundus contents flooding upward, Stomach Yang is extremely weak, and Liver Wood rebellion is unchecked, approaching a state of Stomach Yang collapse. Urgent treatment is required to warm and unblock Stomach Yang, restrain Liver, and descend rebellion.
**Liver Rebellion Invading the Lung**: If Qi rises from the left, abdominal distension occurs, and vomiting of saliva, sour/bitter/yellow fluids leads to incessant coughing and wheezing, this is Liver Qi rebelling and attacking, passing through the Stomach to invade the Lung. The method should restrain the Liver and harmonize the Stomach, using Chenpi, Banxia, Fuling, Zanthoxyli Fructus (Chuanjiao), Mume Fructus (Wumei), Chuanlian stir-fried with Wuzhuyu Tang, and Loquat Leaf (Pipaye) roasted with ginger juice.
Shao's Commentary: Qi rising from the left is Liver Qi. Rising Liver Qi causes abdominal distension; invading the Stomach and reversing upward causes vomiting of saliva and sour/bitter/yellow fluids. The Liver carries Ministerial Fire, and Wood-Fire insults Metal, attacking the Lung to cause coughing. This has passed the Stomach and risen uncontrollably. Pacify the Liver and harmonize the Stomach.
**Yin Turbidity Invading the Stomach**: If Qi rushes upward from the lower abdomen causing vomiting and distension, and the vomitus is black-green bitter fluid, this belongs to Lower Jiao Yin Turbidity rushing up to invade the Stomach, representing Jueyin foul Qi reversing upward. Use Zanthoxyli Fructus, Wumei, Processed Evodiae Fructus (Zhi Zhuyu), Fuling, Toosendan Fructus (Chuanlianzi), stir-fried Cuminum Cyminum Seed (Xiaohuixiang with vinegar), and stir-fried Gardeniae Fructus (Heizhi with salt water and ginger juice) to restrain Liver rebellion. Add Ginseng if Stomach Qi is deficient.
Shao's Commentary: The lower abdomen is part of the Liver's domain. The Liver resides in the Lower Jiao; its Qi rushing upward causes turbid Yin to reverse upward, resulting in vomiting and distension. Vomiting black-green bitter fluid indicates turbid water from the stomach fundus being flushed up by Lower Jiao Yin Turbidity. Urgently calm the Stomach, pacify the Liver, unblock Yang, and drain turbidity.
**Hidden Fluids in Liver Collaterals**: If Qi rushes to the left, extremities are cold and one desires to vomit, feeling comfortable only after vomiting, this indicates hidden fluids residing in the Liver collaterals. Use acrid substances to unblock them. Use mild Evodiae Fructus (Dan Wuzhuyu), stir-fried Banxia, Fuling, Jiangzhi, Inulae Flos (Xuanfuhua), and Haematitum (Daizheshi).
Shao's Commentary: The Liver governs the body's collaterals. Qi rushing up from the left is Liver Qi. Liver carrying fluid pathogens reverses upward into the collaterals, causing coldness and vomiting. Harmonize the Liver, open the collaterals, and eliminate fluids.
**Internal Binding of Heat Pathogens**: Epigastric stuffiness, vomiting of turbid matter, insomnia, lack of appetite, yellow tongue coating, and thirst. Treat with the Acrid-Bitter Heart-Purging method. Use Scutellariae Radix (Huangqin), Coptidis Rhizoma (Chuanlian), Banxia, Zhishi, and Jiangzhi.
Shao's Commentary: Heat pathogens bind in Yangming; treat with Acrid-Bitter opening and draining.
**Internal Binding of Summer-Heat Filth**: Inhalation of summer-heat filth first travels to the Mouyuan (Membrane Source). The Mouyuan is where Stomach collaterals distribute, so it reverses upward causing vomiting, epigastric stuffiness and pain, unresolved chills and fever, yellow tongue coating, and thirst. Use the Xixin Fa (Heart-Purging Method). Use ginger-processed Coptidis Rhizoma, Huangqin, Banxia, Zhishi, Agastache Herba (Huogeng), Talcum (Huashi), Akebia Caulis (Tongcao), and Curcumae Longae Rhizoma (Yujin).
Shao's Commentary: Summer-heat filth enters via mouth and nose, traveling straight down the middle path to the Membrane Source. The Membrane Source is the boundary between exterior and interior where the Spleen and Stomach connect via membranes. Summer-heat filth binds here, causing vomiting, chills, and fever. Treat with Acrid-Bitter opening and draining. However, the Xixin Fa is only applicable when the tongue coating is yellow.
Additional Commentary: If the tongue coating is white, Xianxiong Tang (Chest-Sinking Decoction) and Xixin Fa are contraindicated; use Apricot Kernel (Xingren), Amomum Fruit (Kouren), Platycodon Root (Jiegeng), and Tangerine Peel (Jupi) to open the Lung with Acrid-Bitter methods. If pathogens enter the Membrane Source and the coating is powdery white, use Wu Youke's Daoyin Yin (Origin-Reaching Decoction). If the coating is yellow, greasy, and thick, the Xixin Fa is indispensable.
**Steaming of Damp-Heat**: Fire in the Stomach and Dampness in the Spleen steam each other, causing vomiting, anorexia, alternating satiety and hunger, thirst with little desire to drink, and a slightly yellow, sticky tongue coating. This verifies Stomach Heat steaming Spleen Dampness. Treat with simultaneous Cold and Hot methods. Use Chuanlian, Ganjiang, Fuling, Banxia, Guangpi, Huangqin, Alisma Rhizoma (Zexie), Zhishi, and Jiangzhi.
Shao's Commentary: Spleen Dampness and Stomach Heat accumulate in the Middle Jiao, blocking and refusing to open, causing vomiting. Treat by harmonizing the center, resolving stuffiness, and clearing/drainage of Damp-Heat.
**Phlegm-Fluids Accompanied by Cold**: Vomiting without thirst, white and slippery tongue coating, possibly with coughing. This is Phlegm-Fluids combined with Cold pathogens. Use Erchen Tang (Two-Aged Decoction) plus Guizhi Tang (Cinnamon Twig Decoction) components (Guizhi), Ganjiang, and Jiangzhi.
Shao's Commentary: Cold fluids hide in the Stomach, rising to shoot into the Lung, causing vomiting and coughing. With Cold pathogens and fluids, there is no thirst. A white-slippery coating indicates Cold Phlegm. Therefore, use methods to eliminate phlegm and disperse cold.
**Phlegm-Fluids Accompanied by Fire**: Vomiting with slight thirst, accompanied by coughing, pale red and bright tongue coating, or slightly white. This is Phlegm-Fluids combined with Stomach Fire. Use Wendan Tang (Warm the Gallbladder Decoction) plus Pipaye (roasted with ginger juice) and Heizhi (stir-fried with ginger juice).
Shao's Commentary: Harmonize the Stomach, resolve phlegm, ventilate the Lung, and clear Heat. This formula is extremely effective.
**Deficiency-Cold in the Stomach**: Inability to receive food, occasional vomiting of saliva, moist tongue without thirst, soft and soggy right Guan pulse. Use Liujunzi Tang (Six-Gentlemen Decoction) plus Amomi Fructus (Sharen) and Ganjiang. For vomiting saliva, add Alpinia Oxyphylla Fructus (Yizhiren) to secure. For vomiting phlegm-fluids, add Guizhi and Zingiberis Pericarpium (Jiangpi) to harmonize.
Shao's Commentary: Cold pathogens block and refuse intake; with cold fluids, saliva is vomited. Without heat, the tongue is moist and there is no thirst. A soft pulse indicates Stomach deficiency. Therefore, tonify the center, resolve phlegm, and disperse cold.
**Heat Damaging Stomach Fluids**: Unresolved summer-heat pathogens scorch and dry Stomach fluids, resulting in a bright red tongue, thirst, and immediate vomiting after eating. Avoid greasy and oily foods. Use Erchen Tang minus Licorice Root (Gancao), plus Dendrobii Caulis (Chahu/Dendrobium) and stir-fried Zhuru. Alternatively, use Wendan Tang minus Zhishi and Gancao, plus Gardeniae Fructus (Zhizi) and Fermented Soybean (Chidouchi) and Jinhu.
Shao's Commentary: Damp-heat and summer-plague pathogens enter Yangming, damaging Stomach fluids, leading to vomiting and fluid depletion. Stomach Heat causes a bright red tongue and thirst. Therefore, treat by harmonizing the Stomach, generating fluids, and resolving phlegm.
**Deficiency of Stomach Yin**: After profuse sweating, if Stomach fluids are greatly depleted, causing vomiting, anorexia, thirst, and a tender white tongue coating, use Jinshui Liu Jun Jian (Golden Water Six-Gentlemen Decoction) plus Ophiopogonis Radix (Maidong) and Glehniae Radix (Shashen) to harmonize Stomach Yin.
**Incessant Vomiting**: This is rising without descending. Use the Suppressing Rebellion Method. Use Xuanfuhua, Daizheshi, Banxia, Fuling, and Chenpi. Add Renshen for deficiency.
Shao's Commentary: Stomach Qi does not descend but reverses upward; Qi rises causing vomiting. Using methods to suppress rebellion and descend Stomach Qi is very correct.