脉滑数为呕。代者霍乱。微滑者生。涩数者凶断。
呕吐者。饮食入胃而复逆出也。有声无物谓之哕。有物无声谓之吐。呕吐谓有声有物。
胃气
有所伤。中气不足所致也。有外感寒邪者。有内伤饮食者。有气逆者。三者俱以藿香正气散
加减治之。有胃热者。清胃保中汤。有胃寒者。附子理中汤。有呕哕痰涎者。加减二陈汤。
有水寒停胃者。茯苓半夏汤。有久病胃虚者。比和饮。医者宜审而治之也。
藿香正气散（方见霍乱） 治诸呕吐。照后加减。
一论外感寒邪呕吐者。（根据前方）
一论内伤饮食呕吐者。（根据前方）加砂仁八分。山楂二钱。神曲二钱。
一论有气逆呕吐者。（根据前方）加木香八分。砂仁八分。白豆蔻八分。
一论胃虚有热呕吐者。宜后方。
清胃保中汤
藿香（一钱） 白术（土炒一钱） 陈皮（八分） 半夏（姜炒八分） 砂仁（五分） 黄连（土炒
一钱
）白茯苓（三钱） 黄芩（土炒一钱） 栀子（姜炒二钱） 甘草（四分） 加枇杷叶（去毛一钱）
上锉一剂。生姜三片。长流水和黄泥搅澄清二盅。入药煮至一盅。稍冷服。气逆吐甚。
加伏龙肝一块。因气。加香附炒一钱。枳实麸炒八分。白术一钱。心烦不寐。加竹茹二钱。
酒伤脾胃。加干葛八分。天花粉三钱。白豆蔻八分。一论呕哕痰涎者。
加减二陈汤
陈皮（二钱） 半夏（姜炒二钱） 白茯苓（去皮三钱） 甘草（八分） 人参（二钱） 白术（
一钱五分） 竹茹（二钱） 砂仁（八分） 山栀（三钱） 麦门冬（去心一钱）
上锉一剂。生姜三片。枣一枚。水煎。徐徐温服。
一论水寒停胃作呕吐者。
茯苓半夏汤
白茯苓（去皮） 半夏（姜炒） 陈皮 苍术（米泔浸） 浓朴（姜炒各一钱） 砂仁（五分）
藿香（八分） 乌梅（一个） 干姜（炒三分） 甘草（三分）
上锉一剂。生姜三片。水煎。徐徐服。
一论阴症呕吐。或手足厥冷。腹痛。属虚寒。冷甚者。附子理中汤。（方见中寒门）
一论久病胃虚呕吐。月余不纳水谷。闻食即呕。闻药亦呕者。
比和饮
人参（一钱） 白术（一钱） 白茯苓（去皮一钱） 藿香（五分） 陈皮（五分） 砂仁（五分）
神曲（炒一钱） 甘草（炙三分）
上锉一剂。用陈仓米一合。顺流水二盅。煎沸泡伏龙肝。研细。搅浑澄清。取一钟。生
姜三片。枣二枚。同煎七分。稍冷服。别以陈仓米煎汤啜之。日进药二三服即止。
一论卒暴呕吐。虚弱困乏无力。及久病患呕吐。饮食入口即吐者。人参一两切片水煮。
徐徐而服之立止。
一治胃气冷。饮食即欲吐。白豆蔻五钱为末。以好酒一盏。微温调服。日三盏。
一治冷涎呕吐。阴症干呕。
吴茱萸（汤泡炒一钱半） 生姜（二片） 人参（三分） 大枣（五个）
上锉。水煎。食前服。
一治患呕吐。闻药即呕。百方不效。以伏龙肝为末。水丸。塞两鼻孔。却服对症药。遂
不再吐。如神。
一治热症呕吐。或憎寒发热口苦。小柴胡汤。多加生姜、人参。或加乌梅。
一治胃热而呕吐。欲知胃热。手足心皆热者是。
竹茹汤
半夏（姜汁炒二钱） 干葛（二钱） 青竹茹（四钱） 甘草（八分）
上锉。姜、枣煎服。或加前胡三分。
一治呕吐属热者。
黄连（姜炒一钱） 石膏（二钱火 ）
上为末。白滚水送下。
一治热吐不止。
栀子（炒黑） 朴硝（各等分）
上为末。每服二三茶匙。白滚水送下。
一论大肠结燥。呕吐不止。汤药不入。老人虚人。多有此症。幽门不通。上冲窍门。呕
吐泛
满之症。法须先以蜜导煎。通其幽门。然后服药。盖人身之气。上下周流。下不通必宣其上
如前吐法是也。上不安必撤其下也。
藿香 浓朴（姜炒） 陈皮 白术（去芦炒） 白茯苓（去皮各一钱） 砂仁（炒五分） 枇
杷叶（擦去白毛三片） 甘草（三分） 生姜（一钱）
上锉。水煎服。
一治呕吐宿滞。脐腹痛甚。手足俱冷。脉微细。用附子理中汤一服。益甚。脉浮大。按
之而细。用参附汤一剂而愈。
一论阴虚于下。令人多呕者。乃诸阳气浮。无所根据从。故呕咳气喘。以六味地黄丸盐汤
送下。
一呕吐不食。腹痛后重。自用大黄等药一剂。腹痛益甚。自汗。发热昏愦。脉大。予用参、
术各一两。炙甘草、煨姜各三钱。升麻一钱。水煎服而苏。又用益气汤加炮姜。一剂而愈。
脉象滑数，主呕吐。脉象代（脉搏节律不齐，止有定数），主霍乱。脉微滑者，预后良好，可生。脉涩且数者，预后凶险，断为死证。
呕吐，是指饮食进入胃中，却又逆反而出。只有声音而没有实物吐出，称为哕（yuě，干呕）。只有实物吐出而没有声音，称为吐。既有声音又有实物吐出，称为呕吐。
这是由于胃气受到损伤，中气不足所导致的。有的是因为外感寒邪，有的是因为内伤饮食，有的是因为气机逆乱。这三种情况都可用藿香正气散加减来治疗。如果有胃热的，用清胃保中汤。如果有胃寒的，用附子理中汤。如果有呕吐、干呕并伴有痰涎的，用加减二陈汤。如果有水饮寒邪停滞在胃中的，用茯苓半夏汤。如果是因为久病导致胃虚的，用比和饮。医生应当仔细审察病因后进行治疗。
藿香正气散（方剂见霍乱章节）：治疗各种呕吐，按照后面的方法进行加减。
第二种论述：内伤饮食引起的呕吐。（依据前方）加砂仁八分，山楂二钱，神曲二钱。
第三种论述：气机逆乱引起的呕吐。（依据前方）加木香八分，砂仁八分，白豆蔻八分。
清胃保中汤
藿香（一钱） 白术（土炒一钱） 陈皮（八分） 半夏（姜炒八分） 砂仁（五分） 黄连（土炒一钱） 白茯苓（三钱） 黄芩（土炒一钱） 栀子（姜炒二钱） 甘草（四分）
若气逆呕吐严重，加伏龙肝一块；因气滞所致，加香附（炒）一钱，枳实（麸炒）八分，白术一钱；若心烦失眠，加竹茹二钱；若因饮酒损伤脾胃，加干葛八分，天花粉三钱，白豆蔻八分。
加减二陈汤
陈皮（二钱） 半夏（姜炒二钱） 白茯苓（去皮三钱） 甘草（八分） 人参（二钱） 白术（一钱五分） 竹茹（二钱） 砂仁（八分） 山栀（三钱） 麦门冬（去心一钱）
以上药材锉碎为一剂，加生姜三片，大枣一枚，用水煎煮，慢慢温服。
茯苓半夏汤
白茯苓（去皮） 半夏（姜炒） 陈皮 苍术（米泔水浸泡） 浓朴（姜炒，各一钱） 砂仁（五分） 藿香（八分） 乌梅（一个） 干姜（炒三分） 甘草（三分）
以上药材锉碎为一剂，加生姜三片，用水煎煮，慢慢服用。
第七种论述：阴症呕吐，或者手足厥冷，腹痛，属于虚寒证。寒冷严重的，用附子理中汤。（方剂见中寒门）
第八种论述：久病导致胃虚呕吐，一个多月不能进食进水，闻到食物就吐，闻到药味也吐的情况。
比和饮
人参（一钱） 白术（一钱） 白茯苓（去皮一钱） 藿香（五分） 陈皮（五分） 砂仁（五分） 神曲（炒一钱） 甘草（炙三分）
以上药材锉碎为一剂，用陈仓米一合，顺流水二盅，煎沸后浸泡伏龙肝，研细，搅浑后澄清，取一钟药液，加生姜三片，大枣二枚，同煎至七分满，稍冷后服用。另外再用陈仓米煎汤饮用。每天服药二三次即可停止呕吐。
第九种论述：突然暴发的呕吐，身体虚弱困乏无力，以及久病患者呕吐，饮食入口即吐出的情况。用人参一两切片，用水煮，慢慢服用，立即可止。
第十种治疗：胃气寒冷，饮食后立即想吐。用白豆蔻五钱研为末，用好酒一盏，微温调服，每天三次，每次一盏。
第十一种治疗：冷涎呕吐，阴症干呕。
吴茱萸（汤泡炒一钱半） 生姜（二片） 人参（三分） 大枣（五个）
以上药材锉碎，用水煎煮，饭前服用。
第十二种治疗：患有呕吐，闻到药味就吐，百方无效。用伏龙肝研为末，用水泛丸，塞住两个鼻孔，然后再服用对症的药物，于是就不再呕吐，效果如神。
第十三种治疗：热症呕吐，或者憎寒发热、口苦。用小柴胡汤，多加生姜、人参，或者加乌梅。
第十四种治疗：胃热而呕吐。要知道是否是胃热，看手心脚心是否都发热即可判断。
竹茹汤
半夏（姜汁炒二钱） 干葛（二钱） 青竹茹（四钱） 甘草（八分）
以上药材锉碎，加姜、枣煎服。或者加前胡三分。
第十五种治疗：呕吐属于热证的。
黄连（姜炒一钱） 石膏（二钱火煅）
以上研为末，用白开水送服。
第十六种治疗：热吐不止。
栀子（炒黑） 朴硝（各等分）
以上研为末，每次服用二三茶匙，用白开水送服。
第十七种论述：大肠结燥，呕吐不止，汤药无法进入。老人和体虚的人，多有此症。幽门不通，气机上冲窍门，出现呕吐泛满的症状。治疗方法必须先以蜜导煎（蜂蜜制剂通便），通其幽门，然后才能服药。因为人身之气，上下周流，下边不通必须宣通上边，就像前面说的吐法一样。上边不安宁必须撤除下边的阻滞。
藿香 浓朴（姜炒） 陈皮 白术（去芦炒） 白茯苓（去皮，各一钱） 砂仁（炒五分） 枇杷叶（擦去白毛三片） 甘草（三分） 生姜（一钱）
以上药材锉碎，用水煎服。
第十八种治疗：呕吐宿食停滞，脐腹疼痛剧烈，手足俱冷，脉象微细。用附子理中汤一服，病情反而加重。脉象浮大，按之却细，用参附汤一剂而痊愈。
第十九种论述：阴虚于下，导致人经常呕吐的。这是诸阳气上浮，无所依附遵循，所以出现呕吐、咳嗽、气喘。用六味地黄丸，盐汤送服。
第二十种治疗：呕吐不食，腹痛后重。患者自行服用大黄等药物一剂，腹痛更加严重，自汗，发热昏愦，脉大。我用参、术各一两，炙甘草、煨姜各三钱，升麻一钱，用水煎服，病人苏醒。后来又用益气汤加炮姜，一剂而痊愈。
A slippery and rapid pulse indicates vomiting. A choppy or intermittent pulse (Dai Mai) indicates Huoluan (Cholera-like disease with sudden vomiting and diarrhea). A slightly slippery pulse suggests a favorable prognosis (survival). A choppy and rapid pulse indicates an ominous prognosis (death).
Vomiting refers to food entering the stomach but being regurgitated backward. Vomitus without sound is called Yue (dry heaving). Regurgitation of matter without sound is called Tu (vomiting). When both sound and matter are present, it is referred to as Ou Tu (vomiting).
This condition arises from damage to Stomach Qi and insufficiency of Middle Qi. It may be caused by external contraction of Cold pathogenic factors, internal injury from diet, or rebellion of Qi. These three types can all be treated with modifications of Huoxiang Zhengqi San (Agastache Powder to Rectify the Qi). If there is Heat in the Stomach, Qingwei Baozhong Tang (Stomach-Clearing and Middle-Protecting Decoction) is used. If there is Cold in the Stomach, Fuzi Lizhong Tang (Aconite Pill to Regulate the Middle) is used. If there is vomiting or dry heaving with phlegm-fluids, Jiajian Erchen Tang (Modified Two-Aged Phlegm Decoction) is used. If there is retention of cold fluids in the Stomach, Fuling Banxia Tang (Poria and Pinellia Decoction) is used. If the Stomach is deficient due to prolonged illness, Bihe Yin (Harmonizing Drink) is used. The physician should carefully examine the syndrome before treating.
Huoxiang Zhengqi San (Formula see Huoluan chapter): Treats various types of vomiting; follow the modifications below.
First discussion: Vomiting due to external contraction of Cold pathogenic factors. (Based on the above formula)
Second discussion: Vomiting due to internal injury from diet. (Based on the above formula) Add Amomi Fructus (Sharen) 8 fen, Crataegi Fructus (Shanzha) 2 qian, Medicated Leaven (Shenqu) 2 qian.
Third discussion: Vomiting due to rebellious Qi. (Based on the above formula) Add Aquilariae Lignum Resinatum (Muxiang) 8 fen, Amomi Fructus (Sharen) 8 fen, Tsaoko Cardamomi Fructus (Baidoukou) 8 fen.
Fourth discussion: Vomiting due to Stomach deficiency with Heat. Use the following formula.
Qingwei Baozhong Tang (Stomach-Clearing and Middle-Protecting Decoction)
Agasteghis Herba (Huoxiang) 1 qian
Atractylodis Rhizoma (Baizhu), stir-fried with earth 1 qian
Citri Reticulatae Pericarpium (Chenpi) 8 fen
Pinelliae Rhizoma (Banxia), stir-fried with ginger juice 8 fen
Amomi Fructus (Sharen) 5 fen
Coptidis Rhizoma (Huanglian), stir-fried with earth 1 qian
Poria (Fuling) 3 qian
Scutellariae Radix (Huangqin), stir-fried with earth 1 qian
Gardeniae Fructus (Zhizi), stir-fried with ginger juice 2 qian
Glycyrrhizae Radix et Rhizoma (Gancao) 4 fen
If Qi rebellion causes severe vomiting, add Longgu (Fulonggan/Hearth Earth) one piece.
If caused by Qi stagnation, add Cyperi Rhizoma (Xiangfu), stir-fried 1 qian, Zizyphi Fructus (Zhishi), bran-stir-fried 8 fen, Atractylodis Rhizoma (Baizhu) 1 qian.
If there is mental restlessness and insomnia, add Bambusae Folium (Zhuru) 2 qian.
If damaged by alcohol affecting the Spleen and Stomach, add Puerariae Radix (Gegen) 8 fen, Trichosanthis Radix (Tianhuafen) 3 qian, Tsaoko Cardamomi Fructus (Baidoukou) 8 fen.
Fifth discussion: Vomiting and dry heaving with phlegm-fluids.
Jiajian Erchen Tang (Modified Two-Aged Phlegm Decoction)
Citri Reticulatae Pericarpium (Chenpi) 2 qian
Pinelliae Rhizoma (Banxia), stir-fried with ginger juice 2 qian
Poria (Fuling), peeled 3 qian
Glycyrrhizae Radix et Rhizoma (Gancao) 8 fen
Panacis Ginseng Radix (Renshen) 2 qian
Atractylodis Rhizoma (Baizhu) 1 qian 5 fen
Bambusae Folium (Zhuru) 2 qian
Amomi Fructus (Sharen) 8 fen
Gardeniae Fructus (Shanzhi) 3 qian
Ophiopogonis Radix (Maimendong), heart removed 1 qian
Decoct these ingredients as one dose with three slices of Zingiberis Rhizoma Recens (Shengjiang) and one date. Simmer in water and take warm slowly.
Sixth discussion: Vomiting caused by retention of cold fluids in the Stomach.
Fuling Banxia Tang (Poria and Pinellia Decoction)
Poria (Fuling), peeled
Pinelliae Rhizoma (Banxia), stir-fried with ginger juice
Citri Reticulatae Pericarpium (Chenpi)
Atractylodis Macrocephalae Rhizoma (Cangzhu), soaked in rice wash water
Magnoliae Officinalis Cortex (N Houpo), stir-fried with ginger juice, each 1 qian
Amomi Fructus (Sharen) 5 fen
Agasteghis Herba (Huoxiang) 8 fen
Pruni Mume Fructus (Wumei) one
Zingiberis Rhizoma (Ganjiang), stir-fried 3 fen
Glycyrrhizae Radix et Rhizoma (Gancao) 3 fen
Decoct these ingredients as one dose with three slices of Zingiberis Rhizoma Recens (Shengjiang) in water. Take slowly.
Seventh discussion: Yin syndrome vomiting, or cold extremities, abdominal pain, belonging to deficiency-cold. For severe cold, use Fuzi Lizhong Tang (Aconite Pill to Regulate the Middle). (See Zhonghan Men for formula).
Eighth discussion: Vomiting due to Stomach deficiency from prolonged illness, unable to retain water or grain for over a month, vomiting upon smelling food, and even vomiting upon smelling medicine.
Bihe Yin (Harmonizing Drink)
Panacis Ginseng Radix (Renshen) 1 qian
Atractylodis Rhizoma (Baizhu) 1 qian
Poria (Fuling), peeled 1 qian
Agasteghis Herba (Huoxiang) 5 fen
Citri Reticulatae Pericarpium (Chenpi) 5 fen
Amomi Fructus (Sharen) 5 fen
Medicated Leaven (Shenqu), stir-fried 1 qian
Glycyrrhizae Radix et Rhizoma (Gancao), honey-fried 3 fen
Decoct these ingredients as one dose using one he of aged rice (Chencangmi) and two zhong of flowing water. Boil, soak Longgu (Fulonggan/Hearth Earth), grind fine, mix until turbid then clarify, take one zhong of the liquid. Add three slices of Zingiberis Rhizoma Recens (Shengjiang) and two dates. Simmer together to seven-tenths volume. Take when slightly cool. Additionally, drink soup made from aged rice. Taking the medicine two or three times a day will stop the vomiting.
Ninth discussion: Sudden violent vomiting, physical weakness and exhaustion, and vomiting in chronic patients where food is vomited immediately upon entry. Take Panacis Ginseng Radix (Renshen) one liang, sliced, boiled in water, and taken slowly. It stops immediately.
Tenth treatment: Cold Stomach Qi causing immediate desire to vomit after eating. Grind Amomi Fructus (Baidoukou) five qian into powder. Mix with one cup of good wine, warm slightly, and take orally. Three cups per day.
Eleventh treatment: Cold saliva vomiting, Yin syndrome dry heaving.
Evodiae Fructus (Wuzhuyu), soaked in water and stir-fried 1 qian 5 fen
Zingiberis Rhizoma Recens (Shengjiang) two slices
Panacis Ginseng Radix (Renshen) 3 fen
Jujubae Fructus (Dazao) five pieces
Decoct these ingredients in water and take before meals.
Twelfth treatment: Patient suffers from vomiting, vomits upon smelling medicine, and hundred remedies fail. Grind Longgu (Fulonggan/Hearth Earth) into powder, make pills with water, and plug both nostrils. Then take the appropriate medicine. Vomiting ceases thereafter, with miraculous effect.
Thirteenth treatment: Heat syndrome vomiting, or aversion to cold with fever and bitter taste. Use Xiaochaihu Tang (Minor Bupleurum Decoction), adding more Zingiberis Rhizoma Recens (Shengjiang) and Panacis Ginseng Radix (Renshen), or add Pruni Mume Fructus (Wumei).
Fourteenth treatment: Vomiting due to Stomach Heat. To know if it is Stomach Heat, check if the palms and soles are hot.
Zhuru Tang (Bamboo Shavings Decoction)
Pinelliae Rhizoma (Banxia), stir-fried with ginger juice 2 qian
Puerariae Radix (Gegen) 2 qian
Bambusae Folium (Qingzhuru) 4 qian
Glycyrrhizae Radix et Rhizoma (Gancao) 8 fen
Decoct with ginger and dates. Or add Peucedani Radix (Qianhu) 3 fen.
Fifteenth treatment: Vomiting belonging to heat syndrome.
Coptidis Rhizoma (Huanglian), stir-fried with ginger juice 1 qian
Gypsum Fibrosum (Shigao), calcined 2 qian
Grind into powder and take with plain boiled water.
Sixteenth treatment: Unstopping heat vomiting.
Gardeniae Fructus (Zhizi), charred black
Natrii Sulfas (Pu Xiao), equal parts
Grind into powder. Take two or three tea spoons each time, with plain boiled water.
Seventeenth discussion: Dryness and constipation of the Large Intestine, unstopping vomiting, inability to take decoctions. This symptom is common in the elderly and the weak. The pylorus is blocked, Qi rebels upward through the opening, causing vomiting and fullness. The method requires first using Honey Suppository Decoction (Midao Jian) to unblock the pylorus, then administer medicine. Because the Qi of the human body circulates up and down; if the lower part is not unblocked, the upper part must be vented, just like the vomiting method mentioned earlier. If the upper part is unsettled, the lower part must be cleared.
Agasteghis Herba (Huoxiang)
Magnoliae Officinalis Cortex (N Houpo), stir-fried with ginger juice
Citri Reticulatae Pericarpium (Chenpi)
Atractylodis Rhizoma (Baizhu), de-rhizome and stir-fried
Poria (Fuling), peeled, each 1 qian
Amomi Fructus (Sharen), stir-fried 5 fen
Loquat Leaf (Pipaye), wiped to remove white hairs three leaves
Glycyrrhizae Radix et Rhizoma (Gancao) 3 fen
Zingiberis Rhizoma Recens (Shengjiang) 1 qian
Decoct in water and take.
Eighteenth treatment: Vomiting with retained stagnant food, severe umbilical and abdominal pain, cold extremities, faint and thin pulse. Use Fuzi Lizhong Tang (Aconite Pill to Regulate the Middle) for one dose; the condition worsens. If the pulse is floating and large but fine upon pressure, use Shenfu Tang (Ginseng and Aconite Decoction) for one dose, and the patient recovers.
Nineteenth discussion: Yin deficiency in the lower jiao causing frequent vomiting. This is due to Yang Qi floating upwards without foundation, leading to vomiting, coughing, and wheezing. Take Liuwei Dihuang Wan (Six-Ingredient Pill with Rehmannia), delivered with salt water.
Twentieth treatment: Vomiting and anorexia, abdominal pain with tenesmus. The patient self-administered Dahuang (Rhubarb) etc., one dose, resulting in worsened abdominal pain, spontaneous sweating, fever, confusion, and a large pulse. I administered Panacis Ginseng Radix (Renshen) and Atractylodis Rhizoma (Baizhu) each one liang, Glycyrrhizae Radix et Rhizoma (Gancao) honey-fried and Zingiberis Rhizoma (Jiang) baked each three qian, Cimicifugae Rhizoma (Shengma) one qian, decocted in water. The patient regained consciousness. Later, Yiqi Tang (Qi-Boosting Decoction) with Paojiang (Baked Ginger) was used for one dose, and the patient recovered.