邪在表宜汗，在上焦宜吐，在中下宜下，此汗吐下三法也。若邪在上焦而反下之，则逆
其性
汗下
多矣。朱丹溪曰∶吐中就有发散之义。张子和曰∶诸汗法古方多用之。惟以吐发汗者，世罕
知之。
（仲景）
治卒中痰迷，涎潮壅盛，颠狂烦乱，人事昏沉，五痫痰壅；及火气上冲，喉不得息，食
填太阴，欲吐不出（痰壅上膈，火气上冲，食停上脘，并当用吐法）。伤寒如桂枝证，头不
痛、项不强，寸脉微浮，胸中痞硬，气上冲喉不得息者，胸有寒也，当吐之（汗出恶风，头
痛项强，为桂枝证，俱为邪在表；今无头痛项强，而脉微浮，胸痞硬，则不在表而未入里，
为邪在胸中，胸中与表相应，故宜吐）；亦治诸黄急黄（卒然发黄，心满气喘，命在须臾，
曰急黄。或服此
甜瓜蒂炒黄 赤小豆。共为末，熟水或酸齑水调下，量人虚实服之。吐时须令闭目，紧
束肚
血虚脉微者，俱不可服（非尺脉绝者，不宜便服此，恐损胃气。若止胸中窒塞闷乱，以物探
之，得吐即止。如探不出，方以此汤吐之。如头额两太阳痛者，令病患噙水一口，以此散一
字吹入鼻中，出黄水，即愈）。
此足太阳、阳明药也，胸中痰食与虚烦者不同，越以瓜蒂之苦，涌以赤小豆之酸，吐去
上焦有形之物，则木得舒畅，天地交而万物通矣。当吐而胃弱者，改用参芦（十剂曰∶燥可
去湿，
并宜此
也，脾
形之物
本方除赤豆，名独圣散∶治太阳中 （音谒，暑也），身重痛而脉微弱（夏月伤冷水，
水渍皮肤中，郁遏其外出之阳，反中入内，故身热重痛，以瓜蒂 去胸中之水，则皮中之水
自行）。本方除赤豆，加防风、藜芦，名三圣散（子和）。本方除赤豆，加郁金、韭汁，鹅翎
探吐，亦名三圣散∶治中风风痫，痰厥头痛。本方除赤豆，加全蝎五分∶吐风痰。本方加淡
豉，治伤寒烦闷（瓜蒂栀豉皆吐剂。要知瓜蒂吐痰食宿寒，栀豉吐虚烦客热，如未经汗下，
邪郁胸膈而痞满者，谓之实，宜瓜蒂散，此重剂也。已经汗吐下，邪乘虚客胸中而懊 者，
为虚烦，宜栀豉汤，此轻剂也。丹溪用瓜蒂、栀子、苦参、藜芦等剂累吐，许白云先生不透，
后以附子尖和浆水
邪气在体表适宜用发汗法，邪气在上焦适宜用涌吐法，邪气在中下焦适宜用泻下法，这就是汗、吐、下三种治法。如果邪气在上焦却反而使用泻下法，就会违背病势，导致误用汗法和下法的情况增多。朱丹溪说：涌吐法中蕴含着发散的意义。张子和说：古代方剂中多用发汗法。唯独以涌吐来发汗的方法，世人很少知道。
（张仲景）治疗中风痰迷心窍，涎沫上涌壅盛，癫狂烦乱，人事昏沉，五种痫证痰壅；以及火气上冲，咽喉呼吸不畅，饮食停滞太阴经，想吐却吐不出来（痰浊壅塞上膈，火气上冲，食物停在上脘，都应当使用涌吐法）。伤寒症见桂枝汤证，但头不痛、项不强，寸脉微浮，胸中痞塞坚硬，气上冲咽喉导致呼吸不畅的，这是胸中有寒饮，应当使用涌吐法（出汗怕风，头痛项强，是桂枝汤证，都属于邪气在表；现在没有头痛项强，而脉象微浮，胸中痞塞坚硬，说明邪气不在表也未入里，而是邪气在胸中，胸中与体表相应，所以适宜用涌吐法）；也治疗各种黄疸急黄（突然发黄，心腹胀满气喘，性命垂危，称为急黄。或者服用此方：甜瓜蒂炒黄，赤小豆。共研为末，用熟水或酸醋水调服，根据病人的虚实情况决定剂量。呕吐时要让病人闭目，紧紧束住肚子。血虚脉微的人，都不可服用（如果不是尺脉绝止者，不宜立即服用此药，恐怕损伤胃气。如果只是胸中窒塞闷乱，可以用物体探喉催吐，能吐出就停止。如果探不出，才用此汤涌吐。如果头额两侧太阳穴疼痛，让病人含一口水，将此散一字量吹入鼻中，流出黄水，即可痊愈）。
这是足太阳、阳明经的药物。胸中的痰食与虚烦不同，用瓜蒂的苦味涌吐，用赤小豆的酸味催吐，吐出上焦有形的病邪，那么肝木得以舒畅，天地之气相交而万物通畅。应当涌吐但胃气虚弱的人，改用参芦（《十剂》说：燥可去湿，……都适宜用此法，脾……有形的病邪）。本方除去赤小豆，名为独圣散：治疗中暑（音谒，即暑邪），身体沉重疼痛而脉微弱（夏季受冷水伤害，水渍浸皮肤之中，郁遏其外出的阳气，反而内侵，所以身体发热沉重疼痛，用瓜蒂去除胸中之水，则皮中之水自行消散）。本方除去赤小豆，加防风、藜芦，名为三圣散（张子和创制）。本方除去赤小豆，加郁金、韭菜汁，用鹅毛探喉催吐，也叫三圣散：治疗中风风痫，痰厥头痛。本方除去赤小豆，加全蝎五分：治疗风痰。本方加淡豆豉，治疗伤寒烦闷（瓜蒂和栀豉都是涌吐剂。要知道瓜蒂吐除痰食宿寒，栀豉吐除虚烦客热，如未经过汗、吐、下法，邪气郁结胸膈而痞满的，称为实证，适宜用瓜蒂散，这是重剂。已经经过汗、吐、下法，邪气乘虚客居胸中而心中懊恼的，为虚烦，适宜用栀豉汤，这是轻剂。丹溪用瓜蒂、栀子、苦参、藜芦等药剂多次催吐，许白云先生未能透发，后来用附子尖和浆水……）
When pathogenic factors are in the exterior, sweating (Diaphoresis) is appropriate; when they are in the Upper Jiao (Upper Burner), emesis (Emetic therapy) is appropriate; when they are in the Middle and Lower Jiao, purgation (Purgative therapy) is appropriate. These are the three methods of sweating, emesis, and purgation. If pathogenic factors are in the Upper Jiao but purgation is used instead, it will go against the nature of the disease, leading to excessive or incorrect use of sweating and purgation methods. Zhu Danxi said: "Emesis contains the meaning of dispersion." Zhang Hezi said: "Ancient formulas mostly used sweating methods. However, the method of using emesis to induce sweating is rarely known by the world."
(Zhang Zhongjing) Treats sudden stroke with phlegm confusing the mind, surging saliva and phlegm obstructing heavily, mania and restlessness, unconsciousness, five types of epilepsy with phlegm obstruction; as well as flaming heat rushing upward, inability to breathe through the throat, food filling the Taiyin channel, wanting to vomit but unable to do so (Phlegm-heat obstructing the upper diaphragm, flaming heat rushing upward, food stagnating in the upper stomach all require emetic therapy). In typhoid fever presenting with Guizhi Tang syndrome (Cinnamon Twig Decoction pattern), if there is no headache or stiffness of the neck, but the cun pulse is slightly floating, the chest feels痞 (stuffy and hard), and qi rushes up to the throat causing breathing difficulty, this indicates cold-fluid retention in the chest, and emesis should be used (Sweating, aversion to wind, headache, and neck stiffness constitute the Guizhi Tang syndrome, indicating pathogenic factors in the exterior; now, without headache and neck stiffness, but with a slightly floating pulse and stuffy/hard chest, the pathogen is neither in the exterior nor entered the interior, but resides in the chest. The chest corresponds to the exterior, hence emesis is appropriate); it also treats various types of jaundice and acute jaundice (Sudden onset of yellowing, chest fullness and panting, life in imminent danger, called acute jaundice. Or administer this formula: Tianhuadi (Melon Pedicle) stir-fried until yellow, Xiaohudou (Adzuki Bean). Grind into powder, take with warm water or sour vinegar water, dosage adjusted according to the patient's deficiency or excess. During vomiting, the patient must keep eyes closed and bind the abdomen tightly. Patients with blood deficiency and faint pulse must not take this (Unless the chi pulse is absent/extinct, do not take this immediately as it may damage stomach qi. If only experiencing chest oppression and restlessness, induce vomiting by probing the throat with an object; stop once vomiting occurs. If probing fails, then use this decoction for emesis. If pain occurs in the forehead and temples, have the patient hold a mouthful of water, blow one 'zi' amount of this powder into the nose, discharge of yellow fluid indicates cure).
This is a medicine for the Foot-Taiyang and Foot-Yangming channels. Phlegm-food stagnation in the chest differs from deficiency-heat irritability. Using the bitterness of Gengti (Melon Pedicle) to surge upwards, and the sourness of Chixiaodou (Adzuki Bean) to induce vomiting, expelling有形 (form/material) pathogens from the Upper Jiao allows Wood Qi to flow freely, Heaven and Earth interact, and all things proceed smoothly. For those who need emesis but have weak stomach qi, substitute with Shenlu (Ginseng Stalk). (*Shi Ji* states: "Dryness can remove dampness... [text fragment] ...are suitable for this, Spleen... [text fragment] form/pathogens"). Removing Chixiaodou from this formula yields Dusheng San (Single Holy Powder): treats Sunzhong (Heatstroke/Summerheat), characterized by heavy body pain and faint pulse (In summer, injury from cold water causes moisture to penetrate the skin, suppressing outward-flowing Yang, which turns inward, causing fever, heaviness, and pain. Using Gengti to remove water from the chest allows water in the skin to dissipate naturally). Removing Chixiaodou from this formula and adding Fangfeng (Saposhnikovia Root) and Lilü (Veratrum Root) yields Sansheng San (Three Holy Powders) (created by Zhang Hezi). Removing Chixiaodou from this formula and adding Yujin (Curcuma Tuber) and Jiuzhi (Leek Juice), inducing vomiting with a goose feather, is also named Sansheng San: treats wind-stroke and wind-epilepsy, phlegm-jue headache. Removing Chixiaodou from this formula and adding Quanxie (Scorpion) 5 fen: treats wind-phlegm. Adding Danshi (Light Fermented Soybean) to this formula treats typhoid restlessness (Both Gengti and Zhichi-Danshi are emetics. Note that Gengti expels phlegm, food stagnation, and retained cold; Zhichi-Danshi expels deficiency-heat irritability. If no sweating, emesis, or purgation has been performed, and pathogens are stagnant in the chest-diaphragm causing fullness/stuffiness, it is called Excess, suitable for Gengti San, which is a heavy agent. If sweating, emesis, or purgation has already been performed, and pathogens invade the chest due to deficiency causing mental vexation/retention, it is called Deficiency-Irritability, suitable for Zhichi Tang, which is a light agent. Danxi used Gengti, Zhizi, Kushen, Lilü etc. repeatedly to induce vomiting, but Mr. Xu Baiyun could not achieve thorough expulsion, later using Fuzi Jian (Aconite Tip) mixed with Jiangshui (Fermented Rice Water)... )