🌿 Folk Prescriptions

【Symptom Characteristics】
Vomiting presents various clinical manifestations. It may be dry retching, silent vomiting, loud vomiting, or projectile vomiting; it may occur immediately after eating, reappear hours later, or happen without eating; it may expel newly ingested food, undigested old food, or saliva. The amount of vomitus varies. Vomiting often has triggers such as exposure to unusual odors, irregular diet, emotional stress, or improper clothing for weather changes—all of which can provoke or worsen vomiting. Accompanying symptoms commonly include epigastric fullness, loss of appetite, acid regurgitation, and discomfort. Although vomiting may occur occasionally, it can also recur repeatedly. Symptom characteristics vary depending on whether the condition is cold, heat, deficiency, or excess.
【Differentiation and Treatment】
1. Exterior Pathogens Invading the Stomach
Symptoms: Sudden vomiting, acute onset, often accompanied by fever, chills, headache, body aches, chest tightness, poor appetite, white tongue coating, and soft or slow pulse.
Treatment: Release exterior pathogens, harmonize the stomach, and descend rebellious qi.
Formula: Huoxiang Zhengqi San. Ingredients: Agastache, Perilla, and White芷 (White Atractylodes) are fragrant and transform turbidity, dispelling exterior pathogens; Large Belly Peel and Magnolia Bark regulate qi and eliminate fullness; White Atractylodes, Poria, and Licorice strengthen the spleen and dry dampness; Tangerine Peel, Pinellia, and others harmonize the stomach and descend rebellious qi. Together, they achieve the effect of releasing exterior pathogens and harmonizing the stomach to stop vomiting. If wind-cold predominates with no sweating, add Schizonepeta and Saposhnikovia to dispel wind and scatter cold; if summer-dampness invades the stomach with fever and sweating, use Xinjia Xiangru Yin to clear summer-heat and resolve dampness; if foul air invades the stomach with severe vomiting, swallow Yu Shu Dan to ward off foul air and stop vomiting; if wind-heat invades the stomach with headache and fever, use Yinqiao San without Platycodon to avoid ascending action, adding Tangerine Peel and Bamboo茹 (Bamboo Shreddings) to clear heat and harmonize the stomach; if food stagnation is present with epigastric distension and belching of sour food, remove White Atractylodes and Licorice, add Shenqu, Chicken Internal Gold, and Radish Seed to eliminate accumulation and guide digestion; if summer-heat invades the stomach with high fever and thirst, use Huanglian Jiedu Tang.
2. Food Stagnation
Symptoms: Vomiting with sour and foul smell, epigastric distension, belching, worsening after eating, temporary relief after vomiting, loose or constipated stools with foul odor, thick greasy tongue coating, and slippery, forceful pulse.
Treatment: Eliminate food stagnation, resolve accumulation, harmonize the stomach, and descend rebellious qi.
Formula: Baohe Wan. Ingredients: Shenqu, Hawthorn, and Radish Seed eliminate food stagnation; Tangerine Peel, Pinellia, and Poria harmonize the stomach and descend rebellious qi; Forsythia clears accumulated heat. If stagnation turns to heat with abdominal distension and constipation, use Xiao Chengqi Tang to purge the bowels and clear heat, allowing turbid qi to descend and stopping vomiting; if food is vomited immediately after ingestion, with bad breath and dry thirst due to stomach heat rising, use Zhu Ru Tang to clear stomach heat and descend rebellious qi; if unclean or spoiled food is accidentally ingested, causing abdominal pain and inability to vomit, use a guiding method such as Burnt Salt Formula or Guaiti San to induce vomiting and expel pathogens. Other formulas like Zhi Shi Dao Zhi Wan and Ji Shu Wan may also be used based on differentiation.
3. Phlegm-Dampness Retention
Symptoms: Vomiting mostly clear water or phlegm, epigastric fullness and oppression, poor appetite, dizziness, palpitations, or vomiting with rumbling in the intestines, white greasy tongue coating, and slippery pulse.
Treatment: Warm and transform phlegm-dampness, harmonize the stomach, and descend rebellious qi.
Formula: Xiao Banxia Tang combined with Linggui Zhugan Tang. Ingredients: Ginger and Pinellia harmonize the stomach and descend rebellious qi; Poria, Cinnamon Twig, White Atractylodes, and Licorice warm the spleen and transform dampness. If qi stagnation causes abdominal pain, add Magnolia Bark and Citrus Fruit Shell to move qi and relieve fullness; if spleen function is impaired with epigastric fullness and no appetite, add Amomum Seed, Cardamom, and Atractylodes to open the stomach and stimulate appetite; if phlegm-dampness obscures the clear yang causing dizziness and blurred vision, use Banxia Baizhu Tianma Tang; if phlegm-dampness transforms into heat with irritability and bitter taste, use Huanglian Wen Dan Tang to clear heat and resolve phlegm. Other formulas like Erchen Tang and GanSui Banxia Tang may also be used based on differentiation.
4. Liver Qi Invading the Stomach
Symptoms: Vomiting with acid reflux, frequent belching, chest and flank distension, irritability, worse with emotional distress, red edges of the tongue, thin greasy coating, and wiry pulse.
Treatment: Soothe the liver, regulate qi, harmonize the stomach, and stop vomiting.
Formula: Sini San combined with Banxia Houpu Tang. Ingredients: Bupleurum, Citrus Fruit Shell, and White Peony soothe the liver and regulate qi; Magnolia Bark and Perilla move qi and relieve depression; Pinellia, Poria, Ginger, and Licorice harmonize the stomach and descend rebellious qi. If liver qi transforms into fire with irritability, bitter taste, and dry throat, combine Zuo Jin Wan to clear heat and stop vomiting; if qi stagnation causes intestinal obstruction with constipation, use Da Chaihu Tang to clear heat and purge the bowels; if qi stagnation leads to blood stasis with stabbing pain in the flanks, use Gexia Zhuyu Tang to activate blood and resolve stasis. Other formulas like Yueju Wan and Chaihu Shugan San may also be used based on differentiation.
5. Spleen-Stomach Deficiency
Symptoms: Vomiting easily triggered by minor dietary indiscretion, intermittent episodes, poor appetite, difficulty digesting food, epigastric fullness, bland taste without thirst, pale complexion, lack of vitality, fatigue, loose stools, pale tongue, thin white coating, and weak, soft pulse.
Treatment: Tonify qi and strengthen the spleen, harmonize the stomach, and descend rebellious qi.
Formula: Xiangsha Liujunzi Tang. Ingredients: Ginseng, Poria, White Atractylodes, and Licorice strengthen the spleen and tonify qi; Amomum Seed and Sandalwood regulate qi and harmonize the middle burner; Tangerine Peel and Pinellia harmonize the stomach and descend rebellious qi. If spleen yang is deficient with cold limbs and aversion to cold, add Aconite and Dry Ginger, or use Fuzi Lizhong Wan to warm and strengthen the spleen; if stomach deficiency leads to rebellious qi with a hard sensation in the epigastrium and sour belching, use Xuanfu Dai Zhe Tang to descend rebellious qi and stop vomiting. If central qi is severely depleted with fatigue and lack of energy, use Bu Zhong Yi Qi Tang to tonify central qi; if chronic illness affects the kidney with deficiency of kidney yang, causing lower back and knee soreness, cold limbs, and sweating, use Fuzi Lizhong Tang with Cinnamon Twig and Evodia to warm and tonify the spleen and kidney. Other formulas like Shenling Baizhu San and Qiwu Bai Zhu San may also be used based on differentiation.
6. Stomach Yin Deficiency
Symptoms: Recurrent vomiting, but small volume, or only spitting saliva, dry retching, dry mouth and throat, epigastric hunger without desire to eat, red tongue with little moisture, and fine, rapid pulse.
Treatment: Nourish stomach yin, descend rebellious qi, and stop vomiting.
Formula: Mai Men Dong Tang. Ingredients: Ginseng, Ophiopogon, Rice, and Licorice nourish stomach yin; Pinellia descends rebellious qi and stops vomiting. If yin deficiency is severe with five-palm heat, add Stonehemp, Gypsum, and Zhimu to nourish yin and clear heat; if vomiting is severe, add Tangerine Peel, Bamboo Shreddings, and Loquat Leaf; if yin deficiency leads to constipation, add Hemp Seed, Trichosanthes Seed, and Honey to moisten the intestines and promote bowel movements. Other formulas like Yiw Wei Tang and Zhu Ye Shi Gao Tang may also be used based on differentiation.
【Prognosis and Outcome】
In general, real syndromes have shorter duration and milder conditions, making them easier to cure. Deficiency syndromes and mixed deficiency-excess syndromes have longer courses, more severe conditions, recurrent episodes, and are harder to treat. If mismanaged or improperly treated, real syndromes may turn into deficiency syndromes, mixed deficiency-excess syndromes, or progress from mild to severe. Long-standing vomiting damages the spleen and stomach, impairing the source of transformation, making complications likely. Therefore, vomiting should be timely diagnosed and treated to prevent damage to the body’s foundation. When vomiting occurs in other diseases, it should also be taken seriously.
【Prevention and Care】
Avoid exposure to wind, cold, summer-heat, dampness, or foul air; avoid emotional stress; avoid eating raw, foul-smelling foods; avoid overeating or binge eating; avoid raw, cold, spicy, and pungent foods. Patients with severe vomiting should rest in bed.