〔《本》〕一味苍术丸 治呕吐清水如神。(方见吐酸湿条。)
〔仲〕茯苓饮 治心胸中有停痰宿水,自吐出水后,心胸间虚,气满,不能食。消痰气,令能食。
茯苓 人参 白术(各三两) 枳实(二两) 陈皮(五钱) 生姜(四两)
上六味,水六升,煮取一升八合,分温三服,如人行八九里进之。
〔丹〕盛兄两手麻弦,饮后呕清水。
神曲 苍术 香附(各五钱) 益元散(一两) 半夏(七钱半)
上为末,姜汁浸,蒸饼为丸。
〔仲〕渴欲饮水,水入则吐者,名曰水逆,五苓散主之。(方见伤寒。)
〔丹〕施卜,年四十,因灸艾火太多,病肠内下血粪,肚痛。今痛自止,善呕清水,食不下,宜清胃口之热。
黄芩(五分) 陈皮 地黄(各一钱) 白术(一钱半) 连翘(钱半) 甘草 茯苓(五分) 生姜(三片)
〔《千》〕治痰饮水吐无时节者,其源因冷冻饮料过度,遂令脾胃气羸,不能消于饮食,饮食入胃,则皆变成冷水,
反吐不停,皆赤石脂散主之。
赤石脂一斤,捣筛服方寸匕。酒饮时稍加至三匕服,尽一斤,终身不吐痰水。又不下痢,补五脏,令人肥
健。有人痰饮,服药不愈,用此方愈。
运气 呕吐清水有二∶
一曰湿。经云∶太阴之复,呕而密默,唾吐清液,治以甘热是也。
二曰寒。经云∶诸病水液,澄澈清冷,皆属于寒是也。
【《本草》】一味苍术丸:治疗呕吐清水,效果神奇。(方剂见“吐酸湿”条目。)
【张仲景】茯苓饮:治疗心胸部位有停聚的痰饮和宿水,患者自行吐出这些液体后,心胸感到空虚,气机壅满,无法进食。此方能消除痰气,使患者能够进食。
药材组成:茯苓、人参、白术(各三两),枳实(二两),陈皮(五钱),生姜(四两)。
制法与用法:以上六味药,加水六升,煎煮至剩余一升八合,分三次温服。服药时机如同人行走八九里路的时间间隔进行服用。
【朱丹溪】盛先生的双手脉象麻而弦,饮水后呕吐清水。
药材组成:神曲、苍术、香附(各五钱),益元散(一两),半夏(七钱半)。
制法与用法:以上药物研为细末,用姜汁浸泡,以蒸饼为粘合剂制成丸剂。
【张仲景】口渴想喝水,但水进入胃中即发生呕吐的,称为“水逆”,主治方剂为五苓散。(方剂见“伤寒”相关章节。)
【朱丹溪】施卜,四十岁,因为艾灸过多,导致肠道内便血且腹痛。现在腹痛已停止,但善于呕吐清水,饮食难下,适宜清泄胃中的热邪。
药材组成:黄芩(五分),陈皮、地黄(各一钱),白术(一钱半),连翘(一钱半),甘草、茯苓(各五分),生姜(三片)。
【《千金方》】治疗因痰饮引起、呕吐无固定时间的病症,其根源在于过度饮用冷冻饮料,导致脾胃之气虚弱,不能消化饮食。饮食进入胃中,都会变成冷水,反而不停呕吐,主治方剂为赤石脂散。
药材组成:赤石脂一斤,捣碎过筛,每次服用一方寸匕的量。若用酒送服,可稍加量至每次三匕服用。服完一斤药,终身不再呕吐痰水,也不会患痢疾,能补益五脏,使人肥壮健壮。有人患有痰饮病,服用其他药物无效,使用此方痊愈。
关于运气学说,呕吐清水有两种情况:
第一种是湿。经文说:“太阴经气复旺时,会出现呕吐且沉默不语,唾吐清液的情况,治疗应用甘热性质的药物。”指的就是这种情况。
第二种是寒。经文说:“各种疾病中的水液分泌物,如果清澈寒冷,都归属于寒证。”指的就是这种情况。
[Bencao] Yiwei Cangzhu Wan (Single-Ingredient Atractylodis Rhizoma Pill): Treats vomiting of clear fluid with miraculous effect. (Formula see "Vomiting Acid and Dampness" section.)
[Zhang Zhongjing] Fuling Yin (Poria Decoction): Treats retention of phlegm-fluid and old water in the chest and heart region. After the patient vomits out this fluid, the chest feels empty, Qi is full/stagnant, and food cannot be consumed. This formula eliminates phlegm-Qi and restores appetite.
Ingredients: Fuling (Poria), Renshen (Ginseng), Baizhu (Atractylodis Macrocephalae Rhizoma) (each 3 liang), Zhishi (Immature Bitter Orange), Chenpi (Citri Reticulatae Pericarpium) (2 liang), Chenpi (Citri Reticulatae Pericarpium) (5 qian), Shengjiang (Fresh Ginger) (4 liang).
Preparation and Administration: The above six ingredients are boiled in 6 sheng of water until reduced to 1.8 sheng. Divide into three warm doses. Administer at intervals equivalent to a person walking for eight or nine li.
[Zhu Danxi] Brother Sheng's pulses on both hands were numb and wiry; he vomited clear fluid after drinking.
Ingredients: Shenqu (Massa Medicata Fermentata), Cangzhu (Atractylodis Rhizoma), Xiangfu (Cyperi Rhizoma) (each 5 qian), Yiyuan San (Yunnan Powder), Banxia (Pinelliae Rhizoma) (7.5 qian).
Preparation and Administration: Grind into powder, soak in ginger juice, and form pills using steamed wheat cake as binder.
[Zhang Zhongjing] When thirst drives one to drink water, but the water is immediately vomited upon entry, this is named Shuini (Water Reversal). Wuling San (Five-Ingredient Poria Powder) is the primary treatment. (Formula see "Shanghan" section.)
[Zhu Danxi] Shi Bu, aged forty, suffered from intestinal bleeding and abdominal pain due to excessive moxibustion. The pain has now ceased, but he frequently vomits clear fluid and cannot eat. It is appropriate to clear heat from the stomach.
Ingredients: Huangqin (Scutellariae Radix) (5 fen), Chenpi (Citri Reticulatae Pericarpium), Dihuang (Rehmanniae Radix Praeparata) (each 1 qian), Baizhu (Atractylodis Macrocephalae Rhizoma) (1.5 qian), Lianqiao (Forsythiae Fructus) (1.5 qian), Gancao (Glycyrrhizae Radix et Rhizoma), Fuling (Poria) (each 5 fen), Shengjiang (Fresh Ginger) (3 slices).
[Qianjin Fang] Treats intermittent vomiting caused by phlegm-fluid. The root cause is excessive consumption of cold drinks, which weakens Spleen and Stomach Qi, impairing digestion. Food entering the stomach transforms into cold water, leading to continuous vomiting. Chishizhi San (Red Halloysite Powder) is the primary treatment.
Ingredients: Chishizhi (Halloysitum Rubrum) 1 jin, pounded and sifted. Take one cun-bi (square-inch spoonful) per dose. If taken with wine, increase slightly to three cun-bi per dose. Upon completing one jin, vomiting of phlegm-fluid will cease for life, dysentery will not occur, the Five Zang organs will be tonified, and the body will become robust and healthy. There was a case of phlegm-fluid disease unresponsive to other medicines, which was cured by this formula.
Regarding Yunqi (Six Qi and Five Movements theory), vomiting of clear fluid arises from two patterns:
First, Dampness. The Classic states: "When Taiyin undergoes reversal [of pathogenic influence], there is vomiting, muteness, and spitting of clear fluid; treat with sweet-hot substances." This refers to the aforementioned condition.
Second, Cold. The Classic states: "All pathological fluids that are clear, transparent, and cold belong to Cold." This refers to the aforementioned condition.