第十五章．治呕吐方

Chapter 15. herbs for vomiting

1．镇逆汤

1. Zhen Ni Tang (Zhen here means to suppress, and to stop, in Chinese; Ni means reverse)

治呕吐，因胃气上逆，胆火上冲者。
This formula is used to suppress vomit that is caused by reversed Stomach Qi or reversed Gall Bladder Fire.

生赭石（六钱，细轧） 青黛（二钱） 清半夏（三钱） 生杭芍（四钱） 龙胆草（三钱） 吴茱萸（一钱）生姜（二钱） 野台参（二钱）

Daizheshi 18 gram (grind), Qingdai 6 gram, Banxia 9 gram, Baishao 12 gram, Longdancao 9 gram, Wuzhuyu 3 gram, Fresh ginger 6 gram, wild Taishen 6 gram.

2．薯蓣半夏粥

2. Shuyu Banxia Zhou (Shuyu is the name of a herb; Banxia: the name of a herb; Zhou here means soup in Chinese)

 治胃气上逆，冲气上冲，以致呕吐不止，闻药气则呕吐益甚，诸药皆不能下咽者。
This formula is used for continuous vomiting due to Stomach Qi rushing up reversely. The Chong Qi rushes up. The person have more vomit upon smelling the herbal smell and so much so that the person could not have anything swallowed.

生山药（一两，轧细） 清半夏（一两）
Shanyao 30 gram (grind), Banxia 30 gram.

上二味，先将半夏用微温之水淘洗数次，不使分毫有矾味。用煮菜小锅（勿用药瓶）煎取清汤约两杯半，去渣调入山药细末，再煎两三沸，其粥即成，和白沙糖食之。若上焦有热者，以柿霜代沙糖，凉者用粥送服干姜细末半钱许。
Wash the Banxia with warm water for several times until there is no any smell of vitriol. Use the dish cooking pot (do not use the herbal pot) to cook the Banxia for about 650 ml. Add the Shanyao powder in, continue the cook for two to three boiling. The soup is ready to eat. Add some white sugar to eat. If there is Fire in the Upper Jiao, use the Shishuangbing to replace the sugar. If the body feels cold in the Upper Jiao, drink some Ganjiang (dried ginger) powder with the herbal soup. 

吐后口舌干燥，思饮水者热也。吐后口舌湿润，不思饮水者凉也。若呕吐既久，伤其津液，虽有凉者亦可作渴，又当细审其脉，滑疾为热，弦迟为凉。滑而无力，为上盛下虚，上则热而下或凉。弦而有力，为冲胃气逆，脉似热却非真热。又当问其所饮食者，消化与否，所呕吐者，改味与否，细心询问体验，自能辨其凉热虚实不误也。
After vomit, if the person feels dry mouth and throat, and wishes to drink water, it suggests the condition belongs to Fire; if after vomiting, he has wet tongue, and has no desire to drink, it suggests a cold condition. However, if the vomit has been there for a long time to cause loss of liquid in the body, the person will also feel thirsty in a cold condition. In this case, check the pulse carefully. If the pulse feels slippery and frequent, it is Hot; if it is string and late, it is cold. If it is slippery but weak, it suggests Upper-sthenic but Lower-asthenic condition, and the Upper-Hot and Lower-cold condition. String and strong, it is reverse of Chong Qi and Stomach Qi. If the pulse feels as hot but not really hot, it is needed to ask about the diet, the digestion, the odor of vomited stuff, etc., to distinguish the Hot and Cold condition.

从来呕吐之证，多因胃气冲气，并而上逆。半夏为降胃安冲之主药，故《金匮》治呕吐，有大小半夏汤。
Generally speaking, the vomit is in most cases caused by the up-reverse of the Stomach Qi and Chong Qi together. Herb Banxia is the main herb to reverse the reversed Stomach Qi and the Chong Qi, so that there are Da Banxia Tang and Xiao Banxia Tang in the book 《Jin Kui》.

特是呕者，最忌矾味，而今之坊间鬻者，虽清半夏亦有矾，故必将矾味洗净，而后以治呕吐，不至同于抱薪救火也。其多用至一两者，诚以半夏味本辛辣，因坊间治法太过，辣味全消，又经数次淘洗，其力愈减，必额外多用之，始能成降逆止呕之功也。而必与山药作粥者，凡呕吐之人，饮汤则易吐，食粥则借其稠粘留滞之力，可以略存胃腑，以待药力之施行。且山药，在上大能补肺生津，则多用半夏，不虑其燥，在下大能补肾敛冲，则冲气得养，自安其位。且与半夏皆无药味，故用于呕吐甚剧，不能服药者尤宜也。

It should be specifically pointed out that, the person with vomit hates and dislike the vitriol taste and smell. Currently in the market, even the so called pure Banxia contains the vitriol, which must be washed off completely, to prevent further more vomit due to the vitriol. The amount of the Banxia was used up to 30 gram, for the reason that, the process of the Banxia in the herbal shop depleted off its spicy taste; and that, the more washing further more removed its spicy. It has to be used in a large amount, so as to keep its power in vomit-stopping function. To make it as soup with Shanyao, is for the reason that the person with vomit is easy to vomit after drink water-solution. The Shanyao soup is sticky, so to hold the healing effect of the Banxia longer time in stomach. In addition, the Shanyao could supply more liquid to the body and nourish the lung, so can prevent the possible dryness side effect from the Banxia. The Shanyao can also nourish the Kidney to restrain the Qi back to the Kidney. When the Chong Qi is nourished, it would stay in its original place in the body, no longer rushing up to push the Stomach Qi up. The Shanyao is calm, has no herbal taste, so it is as the Banxia, suitable to the person with strong vomit.

有因“胆倒”而呕吐不止者，《续名医类案》载：许宣治一儿十岁，从戏台倒跌而下，呕吐苦水，绿如菜汁。许曰：此“胆倒”也，胆汁倾尽则死矣。方用温胆汤，加枣仁、代赭石，正其胆腑。可名正胆汤，一服吐止。按：此证甚奇异，附载于此，以备参考。

There is a clinic condition, in which the vomit is due to “reverse of Gall Bladder”. In the book《Xu Ming Yi Lei An》, there is a case as such. Dr. Xuxuan treated a child, who was 10 years of old. The child vomited bitter water, which had color as green as vegetable juice. Dr. Xu said: this is “reverse of Gall Bladder”. After the gall bladder juice is vomited completely, the person would die. He used herbal formula Wen Dan Tang, with addition of Suanzaoren, Daizheshi to re-localize the gall bladder. The formula should be termed as Zhen Dan Tang (note: Zhen here means to re-localize; to put in normal or correct position; Dan here means gall bladder in Chinese). One dose stopped the vomit. Comments: this case is very mysterious, so it is cited here for a reference.