论吐之原，难以概举，有冷吐。热吐、积吐、伤风嗽吐、伤乳吐。其吐则同，其证有
异。各述于后。冷吐乳片不消，多吐而少出，脉息沉微，面白眼慢，气缓神昏，额上汗出，
此因风寒入胃，或食生冷，或伤宿乳，胃虚不纳而出，宜温胃去风除宿冷，用当归散、水
煨姜、陈皮煎服，或间投冲和饮、理中汤及姜橘汤，定吐饮。如诸药不效，以参香饮治
之。热吐面赤唇红，吐次少而出多，乳片消而色黄，遍体热甚，或因暑气在胃，或食热
物，精神不慢，而多烦躁，此热吐也，宜解热毒，用大顺饮，温熟水空心调下，并五苓
散、小柴胡汤，并加姜汁缓服，及香薷散主之。误服热药，先投绿豆饮解之，次服止吐
之剂。积吐眼胞浮面微黄，足冷肚热，昼轻夜重，儿大者脉沉缓，此宿冷滞脾．故吐黄
酸水，或有清痰，脉实而滑为食积所伤，吐酸馊气，或宿食并出，儿小者 乳不化是也。
先用五苓散、姜汁，温汤调下和解，次以乌犀丸主之，最小者投三棱散、化癖丸。伤风
嗽吐，有热生风，有风生痰，痰结胸中，肺气不顺，连嗽不止，和痰吐出此为嗽吐。痰
壅而作，乃为实证，宜去风化痰，先投清肺饮，次小柴胡汤为治。若嗽久而肺虚，土不
生金，故面白唇燥，干嗽干呕而无痰，可温补为上，用茯苓浓朴汤。惺惺散、如意膏为
治。伤乳吐，才乳哺后即吐，或少停而吐，此因乳饮无度，脾气弱，不能运化，故有此证。
譬如小器盛物，满则溢，治法宜节乳，投三棱散。诸吐不止，大要节乳，徐徐用药调治
必安。节者撙节之义，一日但三次或五次，每以乳时，不可过饱，其吐自减，及间稀粥投
之，亦能和胃解吐。屡见不明此理，惟欲进药以求速效，动辄断乳二三日，致馁甚而胃
虚，啼声不已，反激他证。盖人以食为命，孩非乳不活；岂容全断其乳！然乳即血也，血
属阴，其性冷，吐多胃弱，故节之。医者切须知此，乳母亦宜服和气血、调脾胃等药。
论述呕吐的成因，难以一一列举，主要有冷吐、热吐、积吐、伤风咳嗽引起的呕吐、伤乳吐。它们的呕吐表现虽然相同，但伴随的症状却有所不同。以下分别叙述。
冷吐：乳汁片状不消化，呕吐次数多而吐出量少，脉象沉微，面色苍白，眼神迟缓，气息微弱，精神昏沉，额头出汗。这是由于风寒侵入胃中，或食用了生冷食物，或损伤了残留的乳汁，导致胃气虚弱无法容纳食物而溢出。治疗应当温补胃气、祛除风邪、消除宿寒，可使用当归散、水煨姜和陈皮煎汤服用，或者间歇性投喂冲和饮、理中汤及姜橘汤、定吐饮。如果上述药物无效，用参香饮治疗。
热吐：面色红赤，嘴唇红润，呕吐次数少而吐出量大，乳汁已消化且颜色发黄，全身发热严重。这可能是由于暑气滞留于胃，或食用了热性食物所致。患儿精神并不迟钝，反而多有烦躁不安，这属于热吐。治疗应当解除热毒，使用大顺饮，用温热的熟水在空腹时调服，并可配合五苓散、小柴胡汤，加入姜汁缓慢服用，以及香薷散主治。如果误服了热性药物，应先投喂绿豆饮以解其毒，随后再服用止吐的药物。
积吐：眼睑浮肿，面部微黄，脚冷肚子热，白天症状轻，晚上加重。年龄较大的儿童脉象沉缓，这是因为宿寒停滞在脾脏，所以呕吐出黄酸水，或有清稀痰液；若脉象实而滑，则是被食积所伤，呕吐出酸腐气味，或宿食一并吐出。年龄较小的儿童则是乳汁不化。治疗先用五苓散、姜汁，用温开水调下以和解，随后以乌犀丸为主治。年龄最小的患儿可投予三棱散、化癖丸。
伤风咳嗽引起的呕吐：有因热生风，有因风生痰，痰结聚于胸中，肺气不顺，连续咳嗽不止，混合着痰液一起吐出，这就是嗽吐。痰液壅盛而发作，属于实证，应当祛风化痰，先投喂清肺饮，其次用小柴胡汤治疗。如果咳嗽日久导致肺虚，土不生金（脾虚不能养肺），所以面色白、嘴唇干燥，干咳干呕而没有痰液，可以温补为上策，使用茯苓浓朴汤、惺惺散、如意膏治疗。
伤乳吐：刚喂奶后就呕吐，或少停片刻后呕吐。这是因为哺乳无节制，脾气虚弱，不能运化乳汁，所以出现这种症状。这就好比小容器盛物，满了就会溢出。治疗方法应当节制哺乳，投予三棱散。
各种呕吐不止，大原则是节制哺乳，慢慢用药调理，必定能安定。所谓“节”，就是撙节（节约、节制）的意思，一天只喂三次或五次，每次喂奶时，不要过饱，呕吐自然会减少，并且间歇性地喂些稀粥，也能调和胃气、缓解呕吐。多次见到不明白这个道理的人，只想通过进药来求取速效，动辄断绝哺乳两三天，导致孩子极度饥饿而胃气更虚，啼哭不止，反而激发其他病症。大概因为人以食物为生命根本，婴儿没有乳汁就无法存活，怎么容许完全断绝他们的乳汁呢！然而乳汁即血，血属阴，性质寒冷，呕吐过多会导致胃弱，所以要节制哺乳。医生务必知晓此理，乳母也应当服用调和气血、调理脾胃等药物。
The causes of vomiting are numerous and difficult to list comprehensively. They include Cold Vomiting, Heat Vomiting, Accumulation Vomiting, Vomiting due to Wind-Cold with Cough, and Milk Injury Vomiting. While the act of vomiting is similar, the accompanying symptoms differ. These are described below.
Cold Vomiting: Undigested milk curds appear in vomit; there is frequent vomiting but small volume expelled. The pulse is deep and faint (Chen Wei). The complexion is pale, eyes are sluggish, breath is weak, spirit is lethargic, and sweat appears on the forehead. This is caused by Wind-Cold invading the Stomach, consumption of raw/cold foods, or damage from retained old milk, leading to a deficiency of Stomach Qi that fails to retain food. Treatment should warm the Stomach, dispel Wind, and eliminate cold stagnation. Use Danggui San (Angelica Powder), water-boiled Ginger (Shui Wei Jiang), and Chenpi (Tangerine Peel) decocted for administration. Alternatively, intermittently administer Chonghe Yin (Harmonizing Drink), Lizhong Tang (Regulate the Middle Decoction), Jiangju Tang (Ginger and Citrus Decoction), or Dingtu Yin (Vomiting-Stopping Drink). If these remedies fail, use Shenxiang Yin (Ginseng and Aquilaria Drink).
Heat Vomiting: The face is red, lips are crimson. There are few episodes of vomiting but large volumes expelled. The milk has digested and turned yellow. The whole body feels very hot. This may be due to Summerheat-Qi lingering in the Stomach or consumption of hot-natured foods. The child’s spirit is not dull but rather irritable and restless. This is Heat Vomiting. Treatment should resolve heat toxicity. Use Dashun Yin (Great Harmony Drink), administered with warm boiled water on an empty stomach. It can also be combined with Wuling San (Five-Ingredient Powder with Poria), Xiaochaihu Tang (Minor Bupleurum Decoction), taken slowly with Ginger Juice, or treated primarily with Xiangru San (Elsholtzia Powder). If hot medicines were mistakenly administered, first give Moudou Yin (Mung Bean Drink) to detoxify, followed by anti-emetic agents.
Accumulation Vomiting: Eyelids are puffy, facial complexion is slightly yellow. Feet are cold while the abdomen is hot. Symptoms are lighter during the day and heavier at night. In older children, the pulse is deep and slow (Chen Huan), indicating cold stagnation in the Spleen, resulting in vomiting of yellow, sour fluid or clear phlegm. If the pulse is excess and slippery (Shi Hua), it indicates injury from food accumulation, with vomiting of sour/foul odor or undigested food. In younger children, it manifests as undigested milk. Initially, use Wuling San (Five-Ingredient Powder with Poria) and Ginger Juice, mixed with warm water to harmonize. Subsequently, treat primarily with Wuxi Wan (Black Rhinoceros Horn Pill). For the youngest infants, administer Sanleng San (Curcuma Longa Powder) or Huapi Wan (Mass-Dissolving Pill).
Vomiting due to Wind-Cold with Cough: Heat may generate Wind, or Wind may generate Phlegm. Phlegm knots in the chest, causing Lung Qi to flow irregularly. Continuous coughing leads to vomiting mixed with phlegm; this is called Cough-Vomiting. When Phlegm is obstructive and acute, it is an Excess pattern. Treatment should dispel Wind and transform Phlegm. First administer Qingfei Yin (Lung-Clearing Drink), followed by Xiaochaihu Tang (Minor Bupleurum Decoction). If chronic cough leads to Lung Deficiency, where Earth (Spleen) fails to generate Metal (Lung), the face becomes pale and lips dry. With dry cough and dry retching without phlegm, warming and tonification is superior. Use Fuling Nongpu Tang (Poria and Magnolia Bark Decoction), Xingxing San (Awakening Powder), or Ruyi Gao (As-Desired Ointment).
Milk Injury Vomiting: Vomiting occurs immediately after feeding or after a short pause. This is due to unregulated breastfeeding, weak Spleen Qi, and inability to transport and transform milk. It is like a small vessel overflowing when full. Treatment requires regulating milk intake and administering Sanleng San (Curcuma Longa Powder).
For all types of persistent vomiting, the general principle is to regulate breastfeeding and gradually medicate to restore stability. "Regulating" implies moderation: feed only three to five times a day. Avoid overfeeding during each session; vomiting will naturally decrease. Intermittent feeding of thin rice gruel can also harmonize the Stomach and stop vomiting. Many who do not understand this principle seek rapid results through medication, often stopping breastfeeding for two or three days. This leads to severe hunger and further Stomach deficiency, causing incessant crying and triggering other pathologies. Food is life for humans, and infants cannot survive without milk; thus, complete cessation is inadvisable. Milk is blood; blood belongs to Yin and is cold in nature. Excessive vomiting weakens the Stomach, hence the need for regulation. Physicians must understand this. Nursing mothers should also take herbs to harmonize Qi and Blood and regulate the Spleen and Stomach.