🌿 Folk Prescriptions

【Syndrome Characteristics】
Vomiting presents various clinical characteristics: dry retching, silent vomiting, loud vomiting, or projectile vomiting; vomiting soon after eating, delayed vomiting, or vomiting without eating; vomiting newly ingested food, undigested old food, or saliva; vomitus varies in quantity. Vomiting often has triggers such as unpleasant odors, dietary indiscretion, emotional stress, or improper clothing for weather changes, all of which can provoke or worsen vomiting. Often accompanied by discomfort in the epigastrium, loss of appetite, acid regurgitation, and heartburn. Vomiting may occur occasionally but can also recur repeatedly. The syndrome characteristics vary based on differences in cold, heat, deficiency, and excess.
【Differentiation and Treatment】
1. Exterior Pathogen Invading the Stomach
Symptoms: sudden vomiting, acute onset, often accompanied by fever and chills, headache, body aches, chest tightness, poor appetite, white tongue coating, moist and slow pulse.
Treatment: release exterior pathogen, harmonize stomach, descend counterflow.
Formula: Huoxiang Zhengqi San. Ingredients: Agastache, Perilla, White芷 aromatic to transform turbidity, release exterior pathogen; Large Belly Peel, Magnolia Bark regulate qi and relieve fullness; White Atractylodes, Poria, Licorice strengthen spleen and dry dampness; Tangerine Peel, Pinellia harmonize stomach and descend counterflow. Together, they achieve the effect of releasing exterior pathogen and harmonizing stomach to stop vomiting. If wind-cold predominates, no sweating, add Schizonepeta, Saposhnikovia to dispel wind and scatter cold; if summer-dampness invades stomach, fever with sweating, use Xinjia Xiangru Yin to relieve summer heat and transform dampness; if foul air invades stomach, severe vomiting, swallow Jade Pivot Pill to dispel foulness and stop vomiting; if wind-heat invades stomach, headache, fever, use Yinqiao San without Platycodon to avoid upward dispersion, add Tangerine Peel, Bamboo Shreddings to clear heat and harmonize stomach; if food stagnation present, epigastric fullness, belching with sour smell, remove White Atractylodes, Licorice, add Shenqu, Chicken Gizzard, Radish Seed to eliminate accumulation and guide digestion; if summer-heat invades stomach, high fever, thirst, use Huanglian Jiedu Tang.
2. Food Stagnation
Symptoms: vomiting sour and rotten food, epigastric fullness, belching, poor appetite, worse after eating, relief after vomiting, loose or constipated stool with foul odor, thick greasy coating, slippery and forceful pulse.
Treatment: eliminate food stagnation, harmonize stomach, descend counterflow.
Formula: Baohe Wan. Ingredients: Shenqu, Hawthorn, Radish Seed eliminate food stagnation; Tangerine Peel, Pinellia, Poria harmonize stomach and descend counterflow; Forsythia clears accumulated heat. If stagnation turns to heat, abdominal distension and constipation, use Xiaochengqi Tang to purge bowels and clear heat, allowing turbid qi to descend and vomiting stops automatically; if food is vomited immediately, bad breath, dry mouth, stomach heat surging upward, use Zhu Ru Tang to clear stomach and descend counterflow; if ingesting spoiled or unclean food, abdominal pain with inability to vomit, use forced vomiting methods such as Burnt Salt Formula or Guati San to expel pathogen. Other options include Zhishi Daozhi Wan, Ji Shu Wan.
3. Phlegm-Dampness Retention
Symptoms: vomiting mostly clear phlegm or saliva, epigastric fullness, poor appetite, dizziness, palpitations, or vomiting with gurgling bowel sounds, white greasy coating, slippery pulse.
Treatment: warm and transform phlegm-dampness, harmonize stomach, descend counterflow.
Formula: Xiao Banxia Tang combined with Linggui Zhugan Tang. Ingredients: Fresh Ginger, Pinellia harmonize stomach and descend counterflow; Poria, Cinnamon Twig, White Atractylodes, Licorice warm spleen and transform dampness. If qi stagnation with abdominal pain, add Magnolia Bark, Citrus Husk to move qi and relieve fullness; if spleen function impaired, epigastric fullness, poor appetite, add Amomum, Cardamom, Atractylodes to open stomach and invigorate spleen; if phlegm-dampness obscures clear yang, dizziness and blurred vision, use Banxia Baizhu Tianma Tang; if phlegm-dampness transforms to heat, irritability, bitter taste, use Huanglian Wen Dan Tang to clear heat and resolve phlegm. Other options include Erchen Tang, Gan Sui Banxia Tang.
4. Liver Qi Invading the Stomach
Symptoms: vomiting with sour regurgitation, frequent belching, distension and fullness in chest and hypochondrium, irritability, worsening with emotional stress, red edge of tongue, thin greasy coating, wiry pulse.
Treatment: soothe liver, regulate qi, harmonize stomach, stop vomiting.
Formula: Si Ni San combined with Banxia Houpu Tang. Ingredients: Bupleurum, Citrus Husk, White Peony soothe liver and regulate qi; Magnolia Bark, Perilla move qi and relieve depression; Pinellia, Poria, Fresh Ginger, Licorice harmonize stomach and descend counterflow to stop vomiting. If qi stagnation turns to fire, irritability, bitter taste, dry throat, combine Zuo Jin Wan to clear heat and stop vomiting; if qi stagnation with intestinal blockage, constipation, use Da Chaihu Tang to clear heat and purge bowels; if qi stagnation with blood stasis, stabbing pain in hypochondrium, use Ge Xia Zhu Yu Tang to activate blood and resolve stasis. Other options include Yueju Wan, Chaihu Shugan San.
5. Spleen-Stomach Deficiency
Symptoms: easily vomits after slight dietary indiscretion, intermittent episodes, poor appetite, difficulty digesting food, epigastric fullness, bland taste without thirst, pale complexion, fatigue, weakness, loose stools, pale tongue, thin white coating, weak and soft pulse.
Treatment: tonify qi and strengthen spleen, harmonize stomach, descend counterflow.
Formula: Xiangsha Liujunzi Tang. Ingredients: Ginseng, Poria, White Atractylodes, Licorice strengthen spleen and boost qi; Amomum, Aquilaria regulate qi and harmonize middle burner; Tangerine Peel, Pinellia harmonize stomach and descend counterflow. If spleen yang deficiency, cold limbs, add Aconite, Dried Ginger, or use Fu Zi Li Zhong Wan to warm and strengthen spleen; if stomach deficiency with counterflow, epigastric hardness, belching with food odor, use Xuan Fu Dai Zhe Tang to descend counterflow and stop vomiting. If middle qi severely deficient, shortness of breath, fatigue, use Bu Zhong Yi Qi Tang to tonify middle qi; if chronic illness affects kidney, kidney yang deficiency, soreness in waist and knees, cold limbs, sweating, use Fu Zi Li Zhong Tang with Cinnamon Twig, Evodia Fruit to warm and tonify spleen and kidney. Other options include Shen Ling Bai Zhu San, Qiwei Bai Zhu San.
6. Stomach Yin Deficiency
Symptoms: recurrent vomiting, small volume, or only spitting saliva, dry retching, dry mouth and sore throat, epigastric hunger-like discomfort without desire to eat, red tongue with little moisture, fine and rapid pulse.
Treatment: nourish stomach yin, descend counterflow, stop vomiting.
Formula: Mai Men Dong Tang. Ingredients: Ginseng, Ophiopogon, Rice, Licorice nourish stomach yin; Pinellia descends counterflow and stops vomiting. If yin deficiency is severe, five-palm heat, add Stonecrop, Tuberose, Anemarrhena to nourish yin and clear heat; if vomiting is severe, add Tangerine Peel, Bamboo Shreddings, Loquat Leaf; if yin deficiency with constipation, add Hemp Seed, Trichosanthes Seed, Honey to moisten intestines and relieve constipation. Other options include Yi Wei Tang, Zhu Ye Shi Gao Tang.
【Prognosis and Outcome】
In general, real syndromes have shorter duration, milder illness, easier to cure; deficiency syndromes and mixed deficiency-excess syndromes have longer duration, more severe illness, recurring episodes, harder to treat. If misdiagnosed or mistreated, real syndromes may turn into deficiency, mixed deficiency-excess, progressing from mild to severe. Long-term vomiting damages spleen and stomach, depletes source of nourishment, leading to complications. Therefore, vomiting should be timely diagnosed and treated to prevent damage to the foundation of life. Vomiting occurring during other diseases should also be taken seriously.
【Prevention and Care】
Avoid invasion by wind-cold, summer-heat, dampness, or foul air, avoid emotional stress, avoid eating pungent or foul foods, do not binge eat, avoid raw, cold, spicy, and stimulating foods. Patients with severe vomiting should rest in bed.