杜壬治安业坊阎家老妇人，患呕吐。请石秀才医，曰，胃冷而呕。下理中丸至百余丸，其病不愈。石疑之，
杜至，曰∶药病相投，何必多疑。石曰∶何故药相投，而病不愈？杜曰∶药力未及，更进五十丸必愈。果如其
言。石于是师法于杜。（《医学纲目》。）
王普侍郎病呕，饮食皆不得进，召孙兆治数日亦不愈。后复召杜，杜曰∶治呕愈呕，此胃风也。遂用川乌
一两，净洗去皮脐，不去尖，以浆一碗煮干，每个作两片，复用浆水一碗煮尽，更作四片，细嚼一片，以少温
水下。少顷，呕遂止，痛即少息。杜遂问曰∶寻常好吃何物？曰∶好吃甘甜之物。杜曰∶是甘甜乃膏梁之物，
积久成热，因而生风，非一朝一夕之故也。王服其说。（同上。）
毛公弼有一女，尝苦呕吐，求庞安常医，与之药曰∶呕吐疾易愈，但此女子能不嫁，则此病不作。若有娠
而呕作，不可为矣。公弼既还家，以其女嫁归沙溪张氏，年余而孕，果以呕疾死。（曾达臣《独醒杂志》。）
臧中立，毗陵人，客鄞，崇宁中，徽宗后病甚，中立应诏，以布衣麻履见。命之入诊，出问何证？中立对
曰∶脾脉极虚，殆呕泻之疾作楚。和药以进，且曰∶服此得睡为效。至夜半，果粥食，不一月获安。赐归，诏
出官帑，予地筑室南湖以居焉。（《宁波府志》。）
许学士政和中，治一宗人，病伤寒，得汗身凉数日，忽呕吐，药食不下。医用丁香、藿香、滑石等，下咽
即吐。许曰∶此证汗后余热留胃脘，正宜竹茹汤，用之即愈。
薛立斋治府庠沈姬文母，患脾虚中满，痰嗽发热，又食湿面冷茶，吞酸呕吐，绝食。误服芩、连、青皮等
药，益加寒热，口干流涎不收，闻食则呕，数日矣。迎治，曰∶脾主涎，以脾虚不能约制也。欲用人参安胃散，
惑于众论，以为胃经实火宿食，治之病日增剧。忽思冬瓜，食如指甲一块，顿发呕吐酸水不止，仍服前药愈剧。
复邀视之，则神脱脉绝濒死矣。惟目睛尚动，曰∶寒淫于内，治以辛热。然药不能下矣，急用盐、艾、附子炒
热熨脐腹，以散寒回阳。又令沈以口气补接母口之气，又以附子作饼热贴脐间。（救急妙法。）时许，神气少
苏，以参、术、附子为末，仍以是药加陈皮，煎膏为丸如粟米大，纳五七粒于口，随津液咽下即不呕。二日后
，加至十粒，诸病少退，口涎不止。五日后，渐服前剂一二匙，胃气少复，乃思粥饮，复投以参、术等药，
温补脾胃，五十余剂而后愈。（《明医杂着》、《妇人良方》。）
一人汤药入口即吐出，六脉洪大有力。此因地道不通，故气厥上行，而食物难入耳。不更衣已十余日，服
承气等汤俱不纳。曰∶秘结日久，涌逆势盛故也。止沸莫若抽薪，遂用蜜导，去燥粪数升，呕吐即止，调以养
血清火之剂而安。
章虚谷治一七十岁老人，数年前患疟，病根未除，每至夏秋则发。自去冬至丁亥春，忽病呕吐战振，筋脉
掣痛，愈后屡发，或见其小便黄赤，大便干少，面有红光，谓是肝郁化火，火逆犯作呕，胃阴不足，故小便黄
赤，大便干少也。章诊之，脉虚涩少神，舌苔白腐而浓，此中焦虚寒，浊阴聚胃也。以姜制半夏为君，佐参、
苓、附子、干姜、生姜、桂枝、芍药、乌梅、草果仁，一剂即甚效。继去乌梅加浓朴，连进十余剂，每剂附子
用至三钱，胃口开而病愈。
周慎斋治一人，饮食如常，每遇子时作吐，大便秘结。其人必苦虑忧思，脾气郁结，幽门不通。宜扶脾开
窍为主，遂以参、苓、白术，以苍术伴炒炙甘草各一钱，煮附子、乌药三分，水煎服愈。
周慎斋治一士，郁热呕吐，用竹茹、山栀各三钱，陈皮、茯苓各二钱，甘草一钱，煎成，加姜汁五匙，热
服而愈。（《大还》。）
陆养愚治李粮厅，因饭后劳攘，下午饮酒数杯，遂觉脐下小腹作痛，升至胃脘即呕，呕讫痛止。少顷，又
从下痛上，复呕，呕讫痛缓。自后痛呕益频，自疑中毒，以淡盐汤 汁探吐之，一无所出。医投以藿香正气散
不效。其脉浮按细数，稍重即伏，沉按甚坚，曰∶此饮食过饱，急遽所至。与润字丸百十颗，令以淡姜汤服之。
少顷，连泻数行而愈。
龚子才治梁太守女，患头晕呕吐，闻药即呕，诸医束手。令以伏龙肝为末，水丸，塞两鼻孔，用保中汤，
藿香梗、白术各一钱，陈皮、半夏、茯苓各八分，土炒黄连、土炒黄芩、姜汁炒山栀各一钱，砂仁三分，甘草
二分，生姜三片，以长流水入洁净泥土扰，沥取地浆水煎汤，探冷顿服而安。（《万病回春》。）
信陵府桂台殿下夫人善怒，怒即呕吐，胸膈不利，烦躁不宁，腹痛便秘，食下即吐，已八日，心慌喘急，
危甚。诊之，六脉虚微，此血虚胃弱，气郁痰火也。与二陈汤加姜连、酒芩、炒栀、当归、酒芍、香附、竹茹、
白术，入姜汁竹沥，二服而安。
张景岳治吴参军，因食蘑菇，至大吐大泻。医谓速宜解毒，以黄连、黑豆、桔梗、甘草、枳实之属连进，
而病益甚，胸腹大胀，气喘，水饮不入。延张诊，投以人参、白术、甘草、干姜、附子、茯苓之类。彼疑曰∶
腹胀气急，口干如此，安敢服此耶？阅日愈剧，再求治，与药如前，且疑且畏，含泪吞之，一剂而呕少止，二
剂而胀少衰。随大加熟地，以兼救其泻亡之阴。前后凡二十余剂，复元如故。盖蘑菇之为物，必产于深坑枯井，
或沉寒极阴之处，其得阴气最盛，故肥白且嫩也。今中其阴寒之毒，而复加黄连之寒，其解毒云何？兹用姜、
附以解其寒毒，人参、熟地以培其所伤之元气，此疾之所以愈也。
金氏少妇素任性，每多胸胁痛（肝火。）及呕吐等证，随调随愈。后于秋尽时，前证复作，而呕吐更甚，病
及两日，甚至厥脱不省。（肝火。）众谓汤饮不入，无策可施。一医云∶惟用独参汤，庶几万一。张诊之，其脉
乱数，且烦热躁扰，意非阳明之火，何以急剧若此。乃问其欲冷水否？彼点头，遂与以半钟，惟此不吐，且犹有不足之
状，乃复与一钟，觉稍安，因以太清饮投之。有谓此非伤寒，又值秋尽，能堪此乎？不与辩，及药下咽，即就
枕酣睡半日，不复呕矣。复以滋阴轻清等剂，调理而愈。大都呕吐多属胃寒，而复有火证若此者，（此病火
证极多，张偏于温补，故有此说。）经曰∶诸逆冲上，皆属于火，即此是也。（多属胃寒又是何说？）自后凡
见呕吐，其有声势涌猛，脉见洪数，症多烦热者，皆以此法愈之。（以多属胃寒及自后二字观之，张生平于
此误亦不少矣。盖此症良由肝火上逆，故暴急如此，而曰阳明之火，其孟浪可知。）
张路玉治曾余弟妇，患呕逆不食者月余，服宽膈理气二十余剂，几至绝粒，而痞胀异常。诊之，脉得虚大
而数，按仲景脉法云∶大则为虚。此胃中阳气大虚，而浊阴填塞于膈上也。因取连理汤方，用人参三钱服之，
四剂而痞止食进。后与异功散调理而康。
稽绍胸中有寒疾，每酒后苦唾，服葳蕤得愈。草似竹，取根、花、叶阴干。昔华佗入山，见仙人所服，以
告樊阿，服之寿百岁也。（《本草》。）
有妇人病吐逆，大小便不通，烦乱，四肢冷，渐无脉息，凡一日半。与大承气汤两剂，至夜半，渐得大便
通，脉渐生，翼日乃安。此关格之病，极难治，医者当谨慎也。经曰；关则吐逆，格则小便不通。如此，亦有
不得大便者。（《衍义》、《医说续编》。）
张子和治柏亭王论夫，本因丧子忧抑，不思饮食。医者不察，以为胃冷，去寒之剂尽用，病变呕逆而瘦。
求治于张，一再涌泄而愈。归家忘其禁忌，病复作，大小便俱秘，脐腹撮痛，呕吐不食，十日大小便不通，十
三日复问张。张令先食葵羹、波 菜、猪羊血，以润燥开结，次以导饮丸二百余粒，大下结粪。又令恣意饮冰
数升，继以搜风丸，桂苓白术散调之，食后服导饮丸三十余粒。不数日，前后皆通，痛止呕定。张临别，又留
润肠丸以防复结。又留涤肠散，大便秘则用之。凡服大黄、牵牛四十余日方瘳。论夫自叹曰∶向使又服向日热
药，已非今日人矣。一僧问张，云∶肠者，畅也。不畅，何以得愈？
按∶子和之医，大抵以此法行之耳。丹溪云∶凡病患欲吐者，切不可下之，逆故也。纵使二便后秘，可行
疏通，亦中病而止，然后养其气血，润其肠胃，庶乎标本之治。乃羸瘠之人，服大黄、牵牛四十余日方瘳，岂理
也哉！违圣人之法，以欺后世，恐非子和之笔也。孟子谓∶尽信书，不如无书。学人详之。（《医学续编》原评。）
薛立斋治一妇人，少作呕，口吐涎痰，面黄腹痛，月经不调，手足逆冷。此内外俱寒之证，遂以六君加附
子、木香，治之而愈。
一男子食少胸满，手足逆冷，饮食畏寒，发热吐痰，时欲作呕，自用清气化痰之剂，脐腹愈胀，呼吸不利，
吐痰呕食，小便淋沥。又用五苓散之类，小便不利，诸证益甚。曰∶此脾土虚寒无火之证，故食入不消而反出，
非气膈所致逆。用八味丸、补中益气汤，加半夏、茯苓、姜、桂，旬日乃愈。
一妇人因劳役，发热倦怠，唾痰欲呕。或以为火证，用清热化痰等药，反大便不实，无气以动。此寒凉复
伤中气，形病俱虚，用参、 、术、草、麦冬、五味、陈皮、附子，治之而痊。后复劳，经水数日不止。众以
为附子之热所致，用四物、芩、连、槐花之类，凉而止之，前证愈甚，更加胸膈痞满，饮食日少。仍用前方去
门冬，更加茯苓、半夏、炮姜，数剂渐愈。又用当归芍药汤而经止。但四肢逆冷，饮食难化，不时大热，此命
门真火衰，脾土虚寒之假热也。用八味丸，半载而痊。又服六味丸，三载而生子。
宋理宗呕吐不止，召杨吉老治之，问用何方？曰∶辛热药也。帝曰∶服之不效。吉老奏曰∶热药冷服。药
成放井中良久，澄冷进服，一啜而吐止。（万密斋《幼科发挥》。）
立斋治一病，恶心少食，服解毒药愈呕。此胃气虚也，以六君子汤加生姜治之而安。戴氏元礼云∶如恶
心者，无声无物，欲吐不吐，欲呕不呕，虽曰恶心，非心经之病，皆在胃口上，宜用生姜，盖能开胸豁痰也。
施笠泽治邹翁，患呕吐，遍身疼，不能转侧。医为疗其呕吐矣，然眠食犹未安也。诊之曰∶风入于经，其
脉乃凝，留结不散，寒痰中停，四末不掉，三焦不行，亟疏其风，亟调其经，气和血平，转侧自能。先用苏合
丸以通其气，随用导痰汤加桂枝、沉香、白芍，一剂即熟睡，觉而展转自如。再用六君子加沉香，数剂而安。
马元仪治袁某，患小腹厥气上冲即吐，得饮则吐愈甚，诸治不效。诊之，两脉虚涩，右尺独见弦急，曰∶
人身中，清气本乎上，而反陷下，则为注为泄。浊气本乎下，而反逆上，则为呕吐。今病正在下而不在上也。
下焦之浊气上腾，则胸中之阳气不布，故饮入于胃，在上壅而不下达耳。经云∶云雾不清，则上应白露不下。
非地道下通，浊气何由而降？呕吐何由而止？以调胃承气汤一剂，下宿秽甚多，继培中气而愈。
张司马子妇，患胸中满结作痛，饮入则呕，涌出痰涎，多成五色，已数月。或主攻克，或主补虚，卒无一
效。至七月中，病转危迫。诊之，两关尺虚微少神，体倦神烦，胸中结痛，按之愈甚。此正气内伤，阴邪内结，
攻之则伤其正，补之则滞其邪，当以仲景脏结法治之。用黄连汤加桂枝，一剂呕吐顿除，再剂胸中满痛亦释。
次用理中汤加桂枝，数剂而安。
张景岳曰∶沈姓者业医，年近四旬，极劳碌，因 疝下坠，欲提上升，用盐汤吐法，遂吐不止，汤水不受，
如此一日夜，复大便下黑血一二碗，脉微如毛欲绝。此盖吐伤胃气，脾虚之极，兼以盐汤走血，血不能摄，从
便而下。令速用人参、姜、附等，以回垂绝之阳。忽一医至，曰∶诸逆冲上，皆属于火，大便下血，亦因火也。
尚堪参、附乎？宜速饮童便，则呕可愈，而血亦止矣。病者然之，及童便下咽，即呕极不堪而毙。
按∶疝下坠，本由肝木厥张，乃复激之上腾，致脾胃俱伤而下血，不死何俟。童便固非，即参、附亦
未为是也。
冯楚瞻治蒋公子，精神素弱，吐血阴亏，调理初愈，忽又梦遗，大吐不已，六脉沉微。曰∶梦遗俗名走阳
矣，大吐不止，阳亦伤矣。急以附子理中汤去甘草投之，到口即吐。又以白通之类，皆苦不受。沉困数日，上
不能入，下不能出。适有进西洋药酒一方，神治关格吐逆之证。方用红豆蔻去壳，肉蔻面裹煨，用粗纸包压去
油，白豆蔻、高良姜切片焙，肉桂去粗皮，公丁香各研细末五分，用上白糖霜四两，水一饭碗，入铜锅内煎化，
再入鸡子清二个，煎十余沸，入干烧酒一斤，离火置稳便处，将药末入锅内打匀，以火点着烧酒片刻，随即盖
锅，火灭用罗滤去渣，入瓷瓶内，冷水拔去火气饮之。内皆辛热纯阳之药，能破格阳之阴，又烧酒力猛辛烈，
直透丹田。令照方修治，饮之即不吐矣。遂以参、附峻补之药，陆续渐进，调理而痊。
杜壬为治安业坊阎家老妇人治疗呕吐。他请石秀才诊治，石秀才说：“这是胃寒引起的呕吐。”于是给予理中丸，服用了上百丸，但病情没有好转。石秀才对此感到怀疑。杜壬到来后说：“药证相符，何必多疑？”石秀才问：“为什么药证相符，病却不好？”杜壬说：“药力尚未达到病所，再进五十丸必定痊愈。”果然像他说的那样。石秀才因此拜杜壬为师。（出自《医学纲目》。）
王普侍郎患病呕吐，饮食都无法进入，召孙兆来治疗，几天也没有好转。后来再次召杜壬诊治，杜壬说：“越治呕得越厉害，这是胃风证。”于是用川乌一两，洗净去皮和脐部，不去尖头，用一碗浆水煮至干透，将每个川乌切成两片，再用一碗浆水煮尽，最后切成四片，细嚼一片，用少量温水送下。过了一会儿，呕吐停止，疼痛也稍缓解。杜壬于是问道：“平时喜欢吃什么食物？”回答说：“喜欢吃甘甜的食物。”杜壬说：“甘甜属于肥甘厚味之物，积久化热，因而生风，这不是一朝一夕形成的。”王普信服了他的说法。（同上。）
毛公弼有一个女儿，曾经苦于呕吐，求庞安常诊治。庞安常说：“呕吐之疾容易治愈，但这个女子如果不嫁人，这个病就不会发作。如果怀孕后呕吐发作，就无法救治了。”毛公弼回家后，将女儿嫁给沙溪张氏，一年多后怀孕，果然因为呕吐之疾去世。（曾达臣《独醒杂志》。）
臧中立是毗陵人，客居鄞县。崇宁年间，徽宗皇后病重，臧中立应诏入宫，以平民百姓穿着布衣麻鞋觐见。皇帝命他入内诊脉，出来后被问及是什么病症？臧中立回答说：“脾脉极度虚弱，大概是呕吐腹泻的疾病发作引起痛苦。”调和药物进献，并且说：“服用此药能睡着即为有效。”到了半夜，果然吃了粥食，不到一个月便康复。皇帝赏赐他回家，下诏拨出官库钱财，在南湖给他置地建房居住。（《宁波府志》。）
许学士在政和年间，治疗一位同宗族人，患伤寒，出汗后身体凉爽数日，突然呕吐，药食无法咽下。医生使用丁香、藿香、滑石等药，药一下咽就吐出来。许学士说：“这个证候是汗后余热留在胃脘，正适宜用竹茹汤，使用后立刻痊愈。”
薛立斋治疗府庠沈姬文的母亲，患有脾虚导致的中满，痰嗽发热，又吃了湿面和冷茶，出现吞酸呕吐，绝食。误服黄芩、黄连、青皮等药，更加重了寒热症状，口干流涎不止，闻到食物就呕吐，已经好几天了。请来薛立斋诊治，他说：“脾主涎，是因为脾虚不能制约津液。”想要用人参安胃散，但因受众人议论迷惑，认为这是胃经实火宿食，治疗后病情日益加重。忽然想吃冬瓜，吃了一块指甲大小的冬瓜，顿时引发呕吐酸水不止，仍然服用之前的药，病情更加严重。再次邀请诊治时，病人神气脱失，脉搏微弱接近死亡。只有眼珠还在转动，薛立斋说：“寒邪盛于内，应用辛热药物治疗。然而药已无法服下，急用盐、艾叶、附子炒热熨烫脐腹，以散寒回阳。又让沈某用口对口的方式补接母亲口中之气，又将附子做成饼状热贴脐间。（急救妙法。）”过了一会儿，神气稍微苏醒，将人参、白术、附子研成末，仍用这些药加陈皮，煎膏制成如粟米大的丸药，放五七粒在口中，随津液咽下就不再呕吐。两天后，加至十粒，各种病症稍退，但口水仍不止。五天后，逐渐服用前剂一二匙，胃气稍复，开始想喝粥饮，再投以人参、白术等药，温补脾胃，服用五十多剂后才痊愈。（《明医杂着》、《妇人良方》。）
有一人喝汤药入口即吐出，六脉洪大有力。这是因为地道（肠道）不通，所以气机厥逆上行，导致食物难以进入。已经十多天不大便，服用承气汤等药都不能接纳。薛立斋说：“便秘日久，涌吐之势强盛所致。”止沸不如抽薪，于是用蜜导通便，排出燥粪数升，呕吐随即停止，调养以养血清热之剂而安。
章虚谷治疗一位七十岁老人，几年前患疟疾，病根未除，每到夏秋季节就会发作。自去年冬至到丁亥年春，突然患病呕吐战栗震颤，筋脉抽搐疼痛，病愈后屡次复发，有时看到小便黄赤，大便干少，面部有红光，认为是肝郁化火，火气上逆犯胃作呕，胃阴不足，所以小便黄赤，大便干少。章虚谷诊察，脉象虚涩少神，舌苔白腐而浓，这是中焦虚寒，浊阴聚于胃所致。以姜制半夏为君药，佐以人参、茯苓、附子、干姜、生姜、桂枝、芍药、乌梅、草果仁，一剂就非常有效。随后去掉乌梅加浓朴，连续服用十余剂，每剂附子用到三钱，胃口打开而病愈。
周慎斋治疗一人，饮食正常，每逢子时发生呕吐，大便秘结。这个人一定苦于忧虑思虑，脾气郁结，幽门不通。宜以扶脾开窍为主，遂用人参、茯苓、白术，配合苍术伴炒炙甘草各一钱，煮附子、乌药三分，水煎服而愈。
周慎斋治疗一位读书人，郁热呕吐，用竹茹、山栀各三钱，陈皮、茯苓各二钱，甘草一钱，煎成后，加姜汁五匙，热服而愈。（《大还》。）
陆养愚治疗李粮厅，因为饭后劳碌，下午饮酒数杯，随即觉得脐下小腹作痛，痛感升至胃脘即呕吐，吐完痛止。一会儿，又从下往上痛，再次呕吐，吐完痛缓。此后痛呕更加频繁，自己怀疑中毒，用淡盐水探吐，一无所出。医生投以藿香正气散无效。其脉浮按细数，稍重即伏，沉按甚坚，陆养愚说：“这是饮食过饱，急遽所致。”给予润字丸一百多颗，令用淡姜汤送服。过了一会儿，连泻数次而愈。
龚子才治疗梁太守的女儿，患头晕呕吐，闻到药味就吐，众医束手无策。令用伏龙肝研末，水泛为丸，塞住两个鼻孔，用保中汤，藿香梗、白术各一钱，陈皮、半夏、茯苓各八分，土炒黄连、土炒黄芩、姜汁炒山栀各一钱，砂仁三分，甘草二分，生姜三片，用长流水加入洁净泥土搅拌，滤取地浆水煎汤，探冷顿服而安。（《万病回春》。）
信陵府桂台殿下夫人易怒，发怒即呕吐，胸膈不利，烦躁不宁，腹痛便秘，食下即吐，已经八天，心慌喘急，情况危急。诊察，六脉虚微，这是血虚胃弱，气郁痰火所致。给予二陈汤加姜连、酒芩、炒栀、当归、酒芍、香附、竹茹、白术，加入姜汁竹沥，两服而安。
张景岳治疗吴参军，因为吃蘑菇，导致大吐大泻。医生说速宜解毒，连续服用黄连、黑豆、桔梗、甘草、枳实等药，而病情更加严重，胸腹大胀，气喘，水饮不进。延请张景岳诊治，投以人参、白术、甘草、干姜、附子、茯苓之类。患者怀疑说：“腹胀气急，口干如此，怎敢服用这些药呢？”过了几天病情更重，再次求治，给药如前，患者半信半疑，含泪吞下，一剂后呕吐稍止，二剂后腹胀稍减。随后大量加入熟地黄，以兼救泻下亡失的阴液。前后共二十多剂，恢复如初。大概蘑菇这种物产，必产于深坑枯井，或沉寒极阴之处，它得到的阴气最盛，所以肥大洁白且嫩。现在中了它的阴寒毒，又加上黄连的寒性，所谓解毒有什么作用？这里用姜、附来解其寒毒，人参、熟地来培补所伤的元气，这就是疾病痊愈的原因。
金氏少妇平素任性，经常有胸胁痛（肝火）及呕吐等症状，随调随愈。后来在秋末时，前证复发，而呕吐更甚，病了两日，甚至出现厥脱不省人事。（肝火。）众人说汤药进不去，没有办法。一个医生说：“只有用独参汤，或许还有一线希望。”张景岳诊察，其脉乱数，且烦热躁扰，心想如果不是阳明之火，怎么会急剧到这种地步。于是问她想要冷水吗？她点头，于是给她半钟，唯独这个不吐，而且似乎还不够，于是又给一钟，感觉稍安，因此用太清饮投之。有人说这不是伤寒，又值秋末，能受得了吗？不予辩驳，等到药下咽，立即躺下酣睡半天，不再呕吐了。再用滋阴轻清等剂调理而愈。大多呕吐多属胃寒，而有火证像这样的，（这种病的火证极多，张景岳偏于温补，所以有此说法。）经曰：“诸逆冲上，皆属于火”，说的就是这种情况。（大多属胃寒又是什么说法？）自后凡是见到呕吐，其有声势涌猛，脉见洪数，症多烦热的，都用这种方法治愈。（从“多属胃寒”及“自后”二字来看，张景岳生平在此方面误解也不少。大概此症良由肝火上逆，所以暴急如此，而说是阳明之火，其鲁莽可知。）
张路玉治疗曾余弟媳，患呕逆不食月余，服用宽膈理气药二十多剂，几乎绝食，而痞胀异常。诊察，脉得虚大而数，按照仲景脉法说：“大则为虚。”这是胃中阳气大虚，而浊阴填塞于膈上。于是取连理汤方，用人参三钱服用，四剂后痞止食进。后与异功散调理而康。
稽绍胸中有寒疾，每次酒后苦唾，服用葳蕤得以痊愈。葳蕤草似竹，取根、花、叶阴干。昔日华佗入山，见仙人所服，告诉樊阿，服用它可活百岁。（《本草》。）
有妇人患吐逆，大小便不通，烦乱，四肢冷，渐渐无脉息，凡一日半。给予大承气汤两剂，到半夜，渐渐大便通，脉渐生，次日乃安。这是关格之病，极难治，医者应当谨慎。经曰：“关则吐逆，格则小便不通。”如此，也有不得大便的。（《衍义》、《医说续编》。）
张子和治疗柏亭王论的妻子，原本因为丧子忧郁，不思饮食。医生不察，以为是胃冷，用尽去寒之剂，病变为呕逆而消瘦。求治于张子和，经过一次涌吐泄下而愈。回家后忘记禁忌，病复发，大小便俱秘，脐腹撮痛，呕吐不食，十日大小便不通，十三日复问张子和。张子和令先食葵羹、菠菜、猪羊血，以润燥开结，次以导饮丸二百多粒，大下结粪。又令恣意饮冰数升，继以搜风丸，桂苓白术散调之，食后服导饮丸三十多粒。不数日，前后皆通，痛止呕定。张临别，又留润肠丸以防复结。又留涤肠散，大便秘则用之。凡服大黄、牵牛四十余日才瘳。王论夫自己感叹说：“假使又服用以前的热药，已经不是今天的人了。”一僧问张子和，说：“肠者，畅也。不畅，何以得愈？”
按语：张子和的医术，大致是用这种方法施行的。丹溪说：“凡病患欲吐者，切不可下之，逆故也。纵使二便后秘，可行疏通，亦中病而止，然后养其气血，润其肠胃，庶乎标本之治。”乃羸瘦之人，服大黄、牵牛四十余日才瘳，岂是道理哉！违背圣人之法，以欺后世，恐怕不是张子和的手笔。孟子说：“尽信书，不如无书。”学人详察。（《医学续编》原评。）
薛立斋治疗一妇人，年少时作呕，口吐涎痰，面黄腹痛，月经不调，手足逆冷。这是内外俱寒之证，遂以六君子汤加附子、木香，治之而愈。
一男子食少胸满，手足逆冷，饮食畏寒，发热吐痰，时欲作呕，自用清气化痰之剂，脐腹愈胀，呼吸不利，吐痰呕食，小便淋沥。又用五苓散之类，小便不利，诸证益甚。薛立斋说：“这是脾土虚寒无火之证，故食入不消而反出，非气膈所致逆。”用八味丸、补中益气汤，加半夏、茯苓、姜、桂，旬日乃愈。
一妇人因劳役，发热倦怠，唾痰欲呕。有人以为是火证，用清热化痰等药，反而大便不实，无气以动。这是寒凉复伤中气，形病俱虚，用参、 、术、草、麦冬、五味、陈皮、附子，治之而痊。后复劳，经水数日不止。众人以为是附子之热所致，用四物、芩、连、槐花之类，凉而止之，前证愈甚，更加胸膈痞满，饮食日少。仍用前方去门冬，更加茯苓、半夏、炮姜，数剂渐愈。又用当归芍药汤而经止。但四肢逆冷，饮食难化，不时大热，这是命门真火衰，脾土虚寒之假热也。用八味丸，半载而痊。又服六味丸，三载而生子。
宋理宗呕吐不止，召杨吉老诊治，问用什么方？杨吉老说：“辛热药也。”皇帝说：“服用不效。”杨吉老奏曰：“热药冷服。”药成放井中良久，澄清冷后进服，一啜而吐止。（万密斋《幼科发挥》。）
立斋治疗一病，恶心少食，服解毒药愈呕。这是胃气虚也，以六君子汤加生姜治之而安。戴氏元礼说：“如恶心者，无声无物，欲吐不吐，欲呕不呕，虽曰恶心，非心经之病，皆在胃口上，宜用生姜，盖能开胸豁痰也。”
施笠泽治疗邹翁，患呕吐，遍身疼，不能转侧。医生为他治疗呕吐，然而眠食犹未安。诊察说：“风入于经，其脉乃凝，留结不散，寒痰中停，四末不掉，三焦不行，亟疏其风，亟调其经，气和血平，转侧自能。”先用苏合丸以通其气，随用导痰汤加桂枝、沉香、白芍，一剂即熟睡，觉而展转自如。再用六君子加沉香，数剂而安。
马元仪治疗袁某，患小腹厥气上冲即吐，得饮则吐愈甚，诸治不效。诊察，两脉虚涩，右尺独见弦急，说：“人身中，清气本乎上，而反陷下，则为注为泄。浊气本乎下，而反逆上，则为呕吐。今病正在下而不在上也。下焦之浊气上腾，则胸中之阳气不布，故饮入于胃，在上壅而不下达耳。经云：‘云雾不清，则上应白露不下。’非地道下通，浊气何由而降？呕吐何由而止？”以调胃承气汤一剂，下宿秽甚多，继培中气而愈。
张司马之子妇，患胸中满结作痛，饮入则呕，涌出痰涎，多成五色，已数月。有人主张攻克，有人主张补虚，卒无一效。到七月中，病转危迫。诊察，两关尺虚微少神，体倦神烦，胸中结痛，按之愈甚。这是正气内伤，阴邪内结，攻之则伤其正，补之则滞其邪，当以仲景脏结法治之。用黄连汤加桂枝，一剂呕吐顿除，再剂胸中满痛亦释。次用理中汤加桂枝，数剂而安。
张景岳说：沈姓者业医，年近四旬，极劳碌，因疝气下坠，欲提上升，用盐汤吐法，遂吐不止，汤水不受，如此一日夜，复大便下黑血一二碗，脉微如毛欲绝。这大概是吐伤胃气，脾虚之极，兼以盐汤走血，血不能摄，从便而下。令速用人参、姜、附等，以回垂绝之阳。忽一医至，说：“诸逆冲上，皆属于火，大便下血，亦因火也。尚堪参、附乎？宜速饮童便，则呕可愈，而血亦止矣。”病者以为然，及童便下咽，即呕极不堪而毙。
按语：疝下坠，本由肝木厥张，乃复激之上腾，致脾胃俱伤而下血，不死何俟。童便固非，即参、附亦未为是也。
冯楚瞻治疗蒋公子，精神素弱，吐血阴亏，调理初愈，忽又梦遗，大吐不已，六脉沉微。说：“梦遗俗名走阳矣，大吐不止，阳亦伤矣。”急以附子理中汤去甘草投之，到口即吐。又以白通之类，皆苦不受。沉困数日，上不能入，下不能出。适有进西洋药酒一方，神治关格吐逆之证。方用红豆蔻去壳，肉蔻面裹煨，用粗纸包压去油，白豆蔻、高良姜切片焙，肉桂去粗皮，公丁香各研细末五分，用上白糖霜四两，水一饭碗，入铜锅内煎化，再入鸡子清二个，煎十余沸，入干烧酒一斤，离火置稳便处，将药末入锅内打匀，以火点着烧酒片刻，随即盖锅，火灭用罗滤去渣，入瓷瓶内，冷水拔去火气饮之。内皆辛热纯阳之药，能破格阳之阴，又烧酒力猛辛烈，直透丹田。令照方修治，饮之即不吐矣。遂以参、附峻补之药，陆续渐进，调理而痊。
Du Ren treated an elderly woman of the Yan family in Anye Fang for vomiting. He invited Scholar Shi to diagnose, who said, "This is vomiting caused by cold stomach." Li Zhong Wan (Cinnamon Twig and Poria Pill) was administered, over a hundred pills taken, but the illness did not improve. Scholar Shi suspected this. When Du Ren arrived, he said, "The medicine matches the syndrome; why doubt it?" Scholar Shi asked, "Why does the medicine match the syndrome, yet the illness does not improve?" Du Ren replied, "The medicinal power has not yet reached the disease site; administer another fifty pills, and it will surely heal." It turned out exactly as he said. Scholar Shi then took Du Ren as his teacher. (From *Medical Outline*.)
Vice Minister Wang Pu suffered from vomiting, unable to take any food or drink. Sun Zhao was summoned to treat him, but after several days, there was no improvement. Later, Du Ren was summoned again. Du Ren said, "The more you treat, the more severe the vomiting becomes; this is Wind in the Stomach." He used one liang of Chuanwu Rhizome (Aconiti Radix Lateralis Preparata), washed clean, peeled, and navel removed, but kept the tip. It was boiled in one bowl of grain water until dry. Each piece was cut into two slices, then boiled again in one bowl of grain water until exhausted, and finally cut into four slices. One slice was chewed finely and swallowed with a little warm water. After a short while, the vomiting stopped, and the pain subsided slightly. Du Ren then asked, "What do you usually like to eat?" The reply was, "I like sweet foods." Du Ren said, "Sweetness belongs to rich and greasy foods; accumulated over time, it generates heat and subsequently wind. This is not a matter of one day or night." Wang Pu accepted his explanation. (Ibid.)
Mao Gongbi had a daughter who suffered from vomiting and sought Pang Anchang's treatment. Pang Anchang said, "Vomiting diseases are easy to cure, but if this young woman does not marry, this illness will not recur. If she becomes pregnant and vomiting occurs, it cannot be saved." After returning home, Mao Gongbi married his daughter to the Zhang family in Shaxi. More than a year later, she became pregnant and indeed died from vomiting. (Zeng Dacheng's *Alone Awake Magazine*.)
Zang Zhongli, from Piling, was residing in Yin County. During the Chongning era, the Empress Dowager Huizong was critically ill. Zang Zhongli responded to the imperial summons, appearing in plain clothes and hemp shoes. He was ordered to enter and pulse-diagnose. Upon exiting, he was asked about the symptoms. Zang Zhongli replied, "The Spleen pulse is extremely deficient; it is likely that vomiting and diarrhea are causing suffering." He prepared medicine for her to take and added, "If sleeping after taking this medicine, it indicates efficacy." By midnight, she had eaten porridge, and within a month, she recovered. The Emperor granted him permission to return home and issued an edict to allocate treasury funds to buy land and build a house for him in South Lake. (*Ningbo Prefecture Gazetteer*.)
Scholar Xu, during the Zhenghe era, treated a clansman who had contracted Cold Damage (Shanghan). After sweating, his body felt cool for several days, when suddenly vomiting occurred, and medicine and food could not be retained. Physicians used Dingxiang (Clove), Huoxiang (Patchouli), and Huashi (Talcum), but the medicine was vomited immediately upon swallowing. Scholar Xu said, "This syndrome involves residual heat remaining in the epigastrium after sweating; it is precisely suitable for Zhuru Tang (Bamboo Shavings Decoction). Using it resulted in immediate recovery."
Xue Lizhai treated the mother of Shen Jiwen, a student at the local academy. She suffered from Spleen deficiency leading to abdominal fullness, phlegm-cough with fever, and after eating damp noodles and cold tea, experienced acid regurgitation, vomiting, and anorexia. Mistakenly taking Huangqin (Scutellaria Root), Huanglian (Coptis Rhizome), and Qingpi (Aurantii Fructus Immaturus Pericarpium), her chills and fever worsened, mouth became dry with uncontrolled salivation, and she vomited at the smell of food for several days. Xue Lizhai diagnosed: "The Spleen governs saliva; due to Spleen deficiency, it cannot control fluids." He intended to use Renshen Anwei San (Ginseng Stomach-Calming Powder), but was confused by public opinion, which believed it was Excess Fire and undigested food in the Stomach Meridian. Treatment made the condition worse. Suddenly desiring winter melon, she ate a piece the size of a fingernail, triggering uncontrollable vomiting of sour fluid. Taking previous medicines aggravated it. Upon re-examination, her spirit was depleted, and pulse was faint, near death. Only her eyeballs moved. Xue Lizhai said, "Cold invades internally; treat with acrid-hot herbs. However, medicine cannot be taken. Urgently use salt, Aiye (Mugwort Leaf), and Fuzi (Prepared Aconite Root) fried hot to moxa the umbilical abdomen to dissipate cold and restore Yang. Also have Shen breathe into his mother's mouth to replenish her Qi, and apply a hot cake of Fuzi to the umbilicus. (Emergency Wonderful Method)." After a while, her spirit revived slightly. Ginseng, Baizhu (Atractylodes Macrocephala Rhizome), and Fuzi were powdered, mixed with Chenpi (Citrus Reticulata Peel), decocted into a paste, and formed into pills the size of millet grains. Five or seven pills were placed in the mouth and swallowed with saliva, stopping vomiting. After two days, increased to ten pills; various symptoms receded, but salivation continued. After five days, gradually taking one or two spoons of the previous formula, Stomach Qi recovered slightly, craving porridge. Re-administering Ginseng and Baizhu to warm and tonify Spleen and Stomach, she healed after more than fifty doses. (*Mingyi Za Zhuo*, *Good Prescriptions for Women*.)
One patient vomited immediately after drinking herbal medicine; six pulses were surging and forceful. This was because the lower pathways were blocked, causing Qi rebellion upward, making food intake difficult. He had not defecated for over ten days, and Chengqi Tang (Gastro-Regulating Decoction) formulas were rejected. Xue Lizhai said, "Long-standing constipation leads to strong upward rushing momentum." To stop boiling, remove the firewood. Thus, honey suppositories were used to expel dry feces in large quantities; vomiting ceased. He was regulated with blood-nourishing and heat-clearing agents and recovered.
Zhang Xugu treated a seventy-year-old man who had malaria years prior, with the root cause unresolved, recurring every summer and autumn. From last winter through the spring of Dinghai, he suddenly suffered vomiting, tremors, and muscle spasms. Recurrences showed yellow-red urine and scant dry stool, with facial redness, attributed to Liver depression transforming into fire, with fire rebelling against the Stomach causing vomiting, and insufficient Stomach Yin. Zhang Xugu diagnosed: pulse was deficient, choppy, and lacking spirit; tongue coating was white, rotten, and thick. This indicated Middle Jiao deficiency-cold and turbid yin accumulating in the Stomach. He used Ginger-processed Banxia (Pinellia Tuber) as the sovereign herb, assisted by Renshen (Ginseng Root), Fuling (Poria), Fuzi (Prepared Aconite Root), Ganjiang (Dried Ginger), Shengjiang (Fresh Ginger), Guizhi (Cinnamon Twig), Shaoyao (Peony Root), Wumei (Mume Fruit), and Caoguoren (Areca Seed). One dose was very effective. Subsequently, Wumei was removed and Houpo (Magnolia Bark) added. Over ten doses were taken consecutively, using up to three qian of Fuzi per dose. The appetite opened, and the illness healed.
Zhou Shenzhai treated a man whose diet was normal, but who vomited specifically at Zi hour (11 PM - 1 AM), accompanied by constipation. The man suffered from worry and overthinking, causing Spleen Qi stagnation and blockage of the幽门 (Pylorus). Treatment should focus on supporting Spleen and opening orifices. He prescribed Renshen (Ginseng Root), Fuling (Poria), Baizhu (Atractylodes Macrocephala Rhizome), along with Cangzhu (Atractylodes Lancea Rhizome) stir-fried with Zhi Gancao (Honey-fried Licorice Root), each one qian, plus Fuzi (Prepared Aconite Root) and Wuyao (Lindera Root), three fen, decocted in water and taken orally, resulting in recovery.
Zhou Shenzhai treated a scholar with vomiting due to stagnant heat. He used Zhuru (Bamboo Shavings) and Shanzhi (Gardenia Fruit), each three qian; Chenpi (Citrus Reticulata Peel) and Fuling (Poria), each two qian; Gancao (Licorice Root), one qian. After decoction, five spoons of Jiangzhi (Ginger Juice) were added, taken hot, resulting in recovery. (*Da Huan*.)
Lu Yangyu treated Li Liangting. After labor following a meal and drinking several cups of wine in the afternoon, he felt pain in the lower abdomen below the navel rising to the epigastrium, followed by vomiting, with pain ceasing after vomiting. Shortly after, pain rose from below again, followed by vomiting, with relief after vomiting. Thereafter, pain and vomiting became more frequent. Suspecting poisoning, he induced vomiting with light salt water, yielding nothing. Physicians administered Huoxiang Zhengqi San (Patchouli and Magnolia Bark Powder) without effect. His pulse was fine and rapid on superficial pressure, hidden on moderate pressure, and firm on deep pressure. Lu Yangyu said, "This is due to overeating and sudden exertion." He gave Runzi Wan (Moistening Pill) one hundred pills, taken with light ginger soup. After a short while, several bowel movements occurred, and he recovered.
Gong Zicai treated the daughter of Governor Liang, who suffered from dizziness and vomiting, rejecting all medicine. Physicians were helpless. Gong instructed using Fulonggan (Dragon's House Earth) powdered, water-pilled, and inserted into both nostrils. He prescribed Baozhong Tang (Middle-Supporting Decoction): Huoxiang Geng (Patchouli Stem) and Baizhu (Atractylodes Macrocephala Rhizome), each one qian; Chenpi (Citrus Reticulata Peel), Banxia (Pinellia Tuber), and Fuling (Poria), each eight fen; Turmeric-soaked Huanglian (Coptis Rhizome), Turmeric-soaked Huangqin (Scutellaria Root), and Ginger-juice-stir-fried Shanzhi (Gardenia Fruit), each one qian; Sharen (Amomum Fruit), three fen; Gancao (Licorice Root), two fen; Shengjiang (Fresh Ginger), three slices. These were decocted in Di Jiang Shui (Earth Slurry Water) prepared by stirring clean soil in running river water and filtering. Taken cold in one dose, she recovered. (*Wan Bing Hui Chun*.)
The Lady of Prince Gui Tai of Xinling Prefecture was prone to anger, which triggered vomiting, chest oppression, irritability, abdominal pain, constipation, and immediate vomiting after eating for eight days. Her heart palpitated, and breathing was急促 (rapid), indicating critical danger. Pulse diagnosis revealed six pulses were weak and minute. This was Blood deficiency and weak Stomach, with Qi stagnation and Phlegm-Fire. He prescribed Erchen Tang (Two-Aged Decoction) modified with Jiang Lian (Ginger-Huanglian), Jiu Qin (Wine-Scutellaria), Chao Zhi (Stir-fried Gardenia), Danggui (Angelica Sinensis Root), Jiu Shao (Wine-Peony), Xiangfu (Cyperus Rhizome), Zhuru (Bamboo Shavings), and Baizhu (Atractylodes Macrocephala Rhizome), adding Jiangzhi (Ginger Juice) and Zhuli (Bamboo Sap). Two doses brought peace.
Zhang Jingyue treated Military Commissioner Wu, who suffered massive vomiting and diarrhea after eating mushrooms. Physicians advised urgent detoxification, continuously administering Huanglian (Coptis Rhizome), Heidou (Black Soybean), Jiegeng (Platycodon Root), Gancao (Licorice Root), and Zhishi (Immature Bitter Orange), worsening the condition with abdominal distension, asthma, and inability to drink water. Zhang Jingyue prescribed Renshen (Ginseng Root), Baizhu (Atractylodes Macrocephala Rhizome), Gancao (Licorice Root), Ganjiang (Dried Ginger), Fuzi (Prepared Aconite Root), and Fuling (Poria). The patient doubted, saying, "With such abdominal distension, asthma, and dry mouth, how dare I take these?" Days passed, condition worsened. Seeking treatment again, given the same medicine, he swallowed it with tears, half-believing and half-fearing. One dose reduced vomiting; two doses reduced distension. Subsequently, large amounts of Shudi (Rehmannia Root Prepared) were added to rescue Yin lost through diarrhea. Over twenty doses restored health. Mushrooms grow in deep pits or dead wells, places of extreme cold and yin, absorbing maximum yin energy, hence plump, white, and tender. Contracting their yin-cold poison and adding cold Huanglian makes 'detoxification' meaningless. Here, Ginger and Aconite resolve cold poison; Ginseng and Rehmannia nourish damaged Yuan Qi. This is why the disease healed.
Young Madam Jin was usually capricious, often experiencing chest/hypochondriac pain (Liver Fire) and vomiting, resolving quickly with treatment. At the end of autumn, symptoms recurred, vomiting intensified. After two days, she fell into syncope and unconsciousness (Liver Fire). Physicians said oral medicine was impossible. One doctor suggested Dushen Tang (Single Ginseng Decoction) might work. Zhang Jingyue diagnosed: pulse was chaotic and rapid, with irritability and heat. He thought, if not Yangming Fire, why so acute? He asked if she desired cold water. She nodded. He gave half a cup; only this was not vomited, and she seemed unsatisfied. Another cup was given, bringing slight relief. Then Taqing Yin (Supreme Clarity Infusion) was administered. Some argued this was not Cold Damage and it was late autumn, questioning tolerance. Without debate, once the medicine entered the throat, she slept soundly for half a day, vomiting ceased. She was then regulated with Yin-nourishing and light-clearing agents and recovered. Most vomiting belongs to Stomach Cold, but fire syndromes exist like this. (This disease has many fire syndromes; Zhang Jingyue favors warming/tonifying, hence this comment.) The Classic says: "All rebellious upward movements belong to Fire," referring to this case. (What about 'mostly Stomach Cold'?) Since then, whenever seeing vomiting with violent momentum, surging-rapid pulse, and irritability/heat, this method cured them. (Judging by 'mostly Stomach Cold' and 'since then', Zhang Jingyue misunderstood this significantly here. Likely due to Liver Fire rebelling upward, causing sudden severity; calling it Yangming Fire shows recklessness.)
Zhang Luyu treated the sister-in-law of Zeng Yu, who suffered from vomiting and refusal to eat for over a month. Taking twenty-plus doses of broad-chest Qi-regulating herbs nearly starved her, causing abnormal bloating. Pulse was deficient, large, and rapid. According to Zhang Zhongjing's pulse methods: "Large indicates deficiency." This was great deficiency of Stomach Yang, with turbid yin filling the diaphragm. He used Lianli Tang (Connected Regulating Decoction) with three qian of Renshen (Ginseng Root). Four doses stopped bloating and allowed food intake. Yi Gong San (Extraordinary Power Powder) was used for convalescence.
Ji Shao had cold pathology in the chest, bitter saliva after alcohol, cured by Weirui (Polygonatum Rhizome). Resembling bamboo, roots, flowers, and leaves are dried in shade. Hua Tuo saw immortals using it in mountains and told Fan A; consuming it led to a lifespan of a hundred years. (*Ben Cao*.)
A woman suffered from vomiting/reversal, obstruction of urination and defecation, irritability, cold limbs, and gradual loss of pulse for a day and a half. Two doses of Da Chengqi Tang (Major Order the Qi Decoction) were given. By midnight, defecation gradually resumed, pulse returned, and she was safe the next day. This is Guan Ge (Obstruction and Refusal) disease, extremely difficult to treat; physicians must be cautious. The Classic says: "Guan implies vomiting/reversal; Ge implies urinary obstruction." In such cases, constipation may also occur. (*Yan Yi*, *Medical Sayings Continuation*.)
Zhang Zihe treated the wife of Wang Lun from Baiting. Originally depressed by losing a son, she lost appetite. Physicians failed to observe, assuming Cold Stomach, using all cold-dispelling agents. Condition changed to vomiting/reversal and emaciation. Seeking Zhang Zihe, she healed after one round of inducing vomiting and purging. Forgetting taboos at home, relapse occurred with constipation of both bowels, abdominal cramping, vomiting, and anorexia. Ten days without defecation/urination; thirteen days later, consulted Zhang Zihe again. Zhang Zihe ordered eating Kungeng (Okra Soup), spinach, and pig/sheep blood to moisten dryness and open knots, followed by Dao Yin Wan (Guiding Drink Pill) over two hundred pills to purge hard feces. Then allowed drinking ice in large quantities, followed by Sofeng Wan (Wind-Searching Pill), regulated with Guiling Baizhu San (Poria and Atractylodes Macrocephala Powder). Thirty-plus Dao Yin Wan pills taken after meals. Within days, both upper and lower passages cleared, pain stopped, vomiting settled. Before leaving, Zhang Zihe left Run Chang Wan (Intestine-Moistening Pill) to prevent recurrence and Di Chang San (Intestine-Cleansing Powder) for constipation. Taking Dahuang (Rhubarb Root) and Qianniu (Morning Glory Seed) for over forty days finally healed. Wang Lun sighed, "Had I taken those hot medicines before, I would not be alive today." A monk asked Zhang Zihe, "Chang means smooth/unobstructed. If not smooth, how can it heal?"
Commentary: Zhang Zihe's medical practice largely employed these methods. Danxi said: "For patients wanting to vomit, purgatives must absolutely not be used, as it goes against nature. Even if bowels/bladder are obstructed, clearing may be done, but stop once the pathogen is addressed, then nourish Qi/Blood and moisten intestines, achieving root-and-branch treatment." For a emaciated person to take Dahuang and Qianniu for forty days to heal—how is this reasonable? Violating Sage's laws to deceive posterity, this is likely not Zhang Zihe's writing. Mencius said: "To believe everything in books is better than having no books." Scholars should examine carefully. (*Medical Continuation* Original Commentary.)
Xue Lizhai treated a woman with occasional vomiting, spitting saliva/phlegm, sallow complexion, abdominal pain, irregular menstruation, and cold extremities. This was internal and external cold. He used Liu Jun Zi Tang (Six Gentlemen Decoction) plus Fuzi (Prepared Aconite Root) and Muxiang (Aucklandia Root), curing her.
A man with poor appetite, chest fullness, cold extremities, fear of cold food/drink, fever, phlegm expectoration, and occasional vomiting self-medicated with Qingqi Huatan (Clear Qi Transform Phlegm) agents, worsening abdominal distension, breathing difficulty, phlegm/vomit, and dribbling urination. Using Wuling San (Five-Ling Powder) worsened urinary difficulty and all symptoms. Xue Lizhai said: "This is Spleen Earth deficiency-cold without fire; thus food enters but is rejected, not Qi obstruction reversal." He used Bajun Wan (Eight-Treasure Pill) and Buzhong Yiqi Tang (Center-Supplementing Qi-Boosting Decoction), adding Banxia (Pinellia Tuber), Fuling (Poria), Shengjiang (Fresh Ginger), and Rougui (Cinnamon Bark). Recovery in ten days.
A woman, due to overwork, had fever, fatigue, phlegm expectoration, and urge to vomit. Others considered it Fire, using heat-clearing/phlegm-transforming drugs, causing loose stools and lack of Qi movement. This was cold-cooling injuring Middle Qi, with form and disease both deficient. Using Renshen (Ginseng Root), [missing character], Baizhu (Atractylodes Macrocephala Rhizome), Gancao (Licorice Root), Maidong (Ophiopogon Tuber), Wuweizi (Schisandra Berry), Chenpi (Citrus Reticulata Peel), and Fuzi (Prepared Aconite Root) cured her. Later, overwork caused prolonged menstruation. Others attributed it to Fuzi's heat, using Siwu Tang (Four Substance Decoction), Huangqin (Scutellaria Root), Huanglian (Coptis Rhizome), and Huaihua (Sophora Flower) to cool and stop bleeding, worsening previous symptoms and adding chest oppression and decreased appetite. Using previous formula minus Maidong, adding Fuling (Poring) and Banxia (Pinellia Tuber), and Paojiang (Roasted Ginger), she improved over several doses. Danggui Shaoyao San (Angelica and Peony Powder) stopped menstruation. But cold extremities, indigestion, and intermittent high fever indicated Mingmen True Fire decline and Spleen Earth deficiency-cold false heat. Bajun Wan (Eight-Treasure Pill) cured her in half a year. Liuwei Wan (Six-Ingredient Pill) allowed conception after three years.
Emperor Lizong of Song suffered incessant vomiting. Yang Jilao was summoned. Asked for the prescription, Yang said: "Acrid-hot medicine." The Emperor said: "Ineffective." Yang reported: "Hot medicine taken cold." The decoction was placed in a well for a long time, clarified and cooled before administration. One sip stopped vomiting. (Wan Mizhai's *Pediatric Development*.)
Lizhai treated a case of nausea and poor appetite, where detoxifying drugs worsened vomiting. This was Stomach Qi deficiency. Liu Jun Zi Tang (Six Gentlemen Decoction) with Shengjiang (Fresh Ginger) brought peace. Dai Yuanli said: "Regarding nausea: silent, no substance, wanting to vomit but not, wanting to retch but not. Though called nausea, it is not a Heart Meridian disease, but located at the Stomach gate. Use Shengjiang (Fresh Ginger), as it opens the chest and resolves phlegm."
Shi Lizze treated Old Man Zou with vomiting, body pain, and inability to turn. Doctors treated vomiting, but sleep and appetite remained unsettled. Diagnosis: Wind entered meridians, congealing pulse, lingering unresolved. Cold-phlegm stagnates in center, extremities limp, Triple Burner stagnant. Urgently disperse Wind, regulate meridians. When Qi harmonizes and Blood calms, turning becomes natural. First, Suhexiang Wan (White Musk Pill) to unblock Qi. Then, Daotan Tang (Phlegm-Guiding Decoction) plus Guizhi (Cinnamon Twig), Chenxiang (Agarwood), and Shaoyao (Peony Root). One dose led to deep sleep, waking with free movement. Then Liu Jun Zi Tang (Six Gentlemen Decoction) plus Chenxiang (Agarwood). Several doses brought peace.
Ma Yuanyi treated Mr. Yuan, who vomited when Qi rebelled upward from lower abdomen, worse with drinking. Treatments failed. Pulse: both sides deficient/choppy; Right Chi (Kidney) string-taut and rapid. Ma said: "In the body, Clear Qi naturally rises; sinking causes diarrhea/leakage. Turbid Qi naturally rises from below; reversing upward causes vomiting. Now the disease is in the Lower Jiao, not Upper. Turbid Qi from Lower Jiao ascending blocks Upper Jiao Yang distribution. Thus, drink entering Stomach stagnates above, failing to descend. Classic says: 'If clouds/mist are unclear, White Dew does not descend.' Unless Lower Pathways connect downward, how can Turbid Qi descend? How can vomiting stop?" One dose of Tiaowei Chengqi Tang (Stomach-Regulating Gastro-Regulating Decoction) expelled much old filth. Subsequent tonification of Middle Qi led to recovery.
Grand Marshal Zhang's daughter-in-law suffered chest fullness/knotting pain, vomiting upon drinking, spurting phlegm-saliva of five colors for months. Some advocated attacking/purging; others advocated tonifying deficiency. None worked. By mid-July, condition became critical. Pulse: Guan and Chi positions deficient/minute/lacking spirit. Fatigue, irritability, chest knotting pain worsening on pressure. This was internal injury to Righteous Qi, internal knotting of Yin Evil. Attacking injures Righteous Qi; tonifying stagnates Evil. Treat according to Zhang Zhongjing's Zangjie (Organ Knotting) method. Huanglian Tang (Coptis Decoction) plus Guizhi (Cinnamon Twig). One dose stopped vomiting; two doses resolved chest fullness/pain. Next, Lizhong Tang (Middle-Regulating Decoction) plus Guizhi (Cinnamon Twig). Several doses brought peace.
Zhang Jingyue stated: A physician named Shen, nearly forty, overworked, suffered hernia descent. Attempting to lift it using Salt Soup Vomiting Method, he vomited incessantly, rejecting all liquids for a day and night. Then passed one or two bowls of black blood in stool. Pulse was faint as hair, near extinction. This was vomiting injuring Stomach Qi, extreme Spleen deficiency, combined with Salt Soup moving Blood, causing uncontrolled bleeding from bowels. Ordered immediate Renshen (Ginseng Root), Jiang (Ginger), and Fuzi (Prepared Aconite Root) to restore dying Yang. Suddenly, a physician arrived, saying: "All rebellious upward movements belong to Fire; lower bleeding is also due to Fire. Can Renshen/Fuzi be tolerated? Quickly drink Child Urine (Tongbian); vomiting will stop, and bleeding will cease." The patient agreed. Upon swallowing Child Urine, vomiting became unbearable, and he died.
Commentary: Hernia descent originates from Liver Wood rebellion,激 (provoking) upward, injuring Spleen/Stomach and causing lower bleeding. Death was inevitable. Child Urine was certainly wrong; even Renshen/Fuzi were not entirely correct either.
Feng Chuzhan treated Young Master Jiang, constitutionally weak spirit, hematemesis with Yin deficiency, just recovering from regulation, suddenly suffered nocturnal emission (Zouyang), continuous massive vomiting, six pulses sunken/minute. Feng said: "Nocturnal emission is vulgarly called 'Walking Yang'; continuous massive vomiting injures Yang too." Urgently administered Fuzi Lizhong Tang (Aconite and Middle-Regulating Decoction) minus Gancao (Licorice Root). Vomited immediately upon entry. Bai Tong Tang (White Pass Decoction) type also rejected bitterly. Confined for days, unable to ingest or excrete. Fortunately, a Western Medicine Wine prescription appeared, miraculous for Guan Ge (Obstruction/Refusal) vomiting. Formula: Hong Doukou (Red Cardamom Shell Removed), Roukou (Nutmeg wrapped in dough baked), pressed with coarse paper to remove oil; Bai Doukou (White Cardamom), Gaoliangjiang (Galangal Root) sliced roasted; Rougui (Cinnamon Bark) scraped; Gong Dingxiang (Male Clove) each powdered five fen. Mix with four liang of White Rock Sugar, one rice bowl water, melt in copper pot. Add two egg whites, boil ten times. Add one jin Dry Liquor, remove from fire, place stably. Stir powder into pot, ignite liquor briefly, cover pot immediately. Filter residue with sieve, store in porcelain bottle, cool in cold water to remove fire qi before drinking. Contains purely acrid-hot Pure Yang herbs, breaking Ge Yang Yin. Liquor is fierce/acrid, penetrating directly to Dantian. Followed prescription; drinking stopped vomiting. Then gradually advanced Renshen/Fuzi strong tonics, regulating to recovery.