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Jingui Yaolue · Essentials from the Golden Cabinet
17. Vomiting, Hiccups and Diarrhea · Pulses, Signs and Treatment
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A vomiting patient with abscess pus must not have vomiting treated. Once pus is exhausted, recovery occurs of itself.
Vomiting before thirst means impending resolution. Thirst before vomiting means Water retained below Heart, a fluid disorder. A vomiting patient originally thirsty but now not thirsty instead has supporting fluids below Heart: supporting-fluid illness.
Question: A rapid pulse means heat that should consume grain and attract food. Why vomiting instead?
The Master replies: Induced sweating weakened yang and diaphragm qi. The resulting rapid pulse is visiting heat, unable to digest grain, because Stomach is deficient and cold.
Wiry pulse means deficiency and no surplus Stomach qi. Morning food vomited at evening becomes Stomach reversal. Cold was above, but the physician purged instead. Now the pulse is wiry, hence called deficiency.
Faint, rapid cunkou: faint means no qi, hence deficient nutritive qi, insufficient blood and cold within chest.
Floating, rough fuyang: floating means deficiency, rough Spleen injury. Injured Spleen cannot grind food. Morning food vomited at evening, evening food next morning, old grain undigested, is named Stomach reversal. Tight, rough pulse makes treatment difficult.
A patient wanting to vomit must not be purged.
Hiccups with full abdomen: inspect front and rear, determine which region is obstructed and free it for recovery.
Vomiting and chest fullness are governed by Zhuyu Tang.
Dry retching, saliva and foam, and headache are governed by Zhuyu Tang; its formula is referred to above.
Vomiting, bowel rumbling and focal blockage below Heart are governed by Banxia Xiexin Tang.
Dry retching and diarrhea are governed by Huangqin Jia Banxia Shengjiang Tang.
Vomiting in which grain cannot descend is governed by Xiao Banxia Tang, with formula under phlegm-fluids.
Vomiting with illness above the diaphragm, followed by desire for water, means resolution: give it promptly. Desire for water is then said to be governed by Zhuling San. Both supplied statements remain.
Vomiting with weak pulse, urine again free, slight bodily heat and reversal is difficult to treat. Sini Tang governs.
Vomiting with fever is governed by Xiao Chaihu Tang.
Stomach reversal with vomiting is governed by Da Banxia Tang. Thousand Gold says food cannot be received and is vomited upon entry; Outer Terrace specifies vomiting with hard focal blockage below Heart.
Vomiting immediately after food is governed by Dahuang Gancao Tang. The Outer Terrace formula also treats vomiting water.
Stomach reversal, vomiting and thirst desiring water are governed by Fuling Zexie Tang.
After vomiting, thirst with greedy water drinking is governed by Wenge Tang. It also governs slight wind, tight pulse and headache.
Dry retching, vomiting counterflow and saliva and foam are governed by Banxia Ganjiang San.
A chest sensation like panting yet not panting, vomiting yet not vomiting, hiccups yet not hiccups, with distress through Heart that is helplessly overwhelming, is governed by Shengjiang Banxia Tang.
Dry retching, hiccups or reversal of hands and feet are governed by Jupi Tang.
Hiccup counterflow is governed by Jupi Zhuru Tang.
Qi of the six bowels exhausted outwardly gives cold hands and feet, upward qi and contracted feet. Qi of the five viscera exhausted inwardly gives uncontrollable diarrhea; severe downward discharge gives numb hands and feet.
Diarrhea with deep, wiry pulse has downward heaviness. Large pulse means it will not yet stop; faint, weak, rapid pulse impending spontaneous cessation. Even with fever, the text denies death.
Diarrhea, reversely cold hands and feet and absent pulse, not warmed by moxa: if pulse does not return and slight panting occurs instead, death. Lesser Yin yielding to fuyang is favorable.
Diarrhea with slight heat, thirst and weak pulse now recovers spontaneously.
Diarrhea with rapid pulse, slight heat and sweat now recovers spontaneously. A tight pulse instead means unresolved illness.
Diarrhea with rapid pulse and thirst now recovers spontaneously. If not, pus and blood must be passed because heat is present.
Diarrhea with pulse instead wiry, fever and bodily sweat recovers spontaneously.
Qi-type diarrhea should be treated by promoting urine.
Diarrhea with cun pulse instead floating and rapid, chi naturally rough, must pass pus and blood.
Undigested-grain diarrhea must not have its exterior attacked. Sweat must bring distention and fullness.
Diarrhea with deep, slow pulse, slight facial red, slight bodily heat and undigested grain must cause oppressive clouding. Sweat resolves it. The patient must have slight heat because yang is worn upon the face while below is deficient.
After diarrhea, absent pulse and reversely cold hands and feet: if within a full day-and-night cycle pulse returns and extremities warm, survival; without pulse return, death according to the text.
Diarrhea with full, distended abdomen and bodily pain requires warming interior first, then attacking exterior. Sini Tang suits the former, Guizhi Tang the latter.
Diarrhea with all three pulse positions normal but hardness below Heart under pressure requires urgent purging. Dachengqi Tang is suitable.
Diarrhea with slow, slippery pulse is repletion, not yet about to cease. Urgently purge; Dachengqi Tang is suitable.
Diarrhea with pulse instead slippery has something to remove. Purging brings recovery; Dachengqi Tang is suitable.
Diarrhea recovered but returning at the corresponding year, month, day or hour has not been fully exhausted. Purge; Dachengqi Tang is suitable.
Diarrhea with delirious speech has dry stool. Xiao Chengqi Tang governs.
Diarrhea passing pus and blood is governed by Taohua Tang.
Heat diarrhea with downward heaviness is governed by Baitouweng Tang.
After diarrhea, further vexation with softness below Heart under pressure is deficient vexation. Zhizi Chi Tang governs.
Undigested-grain diarrhea, interior cold and exterior heat, sweat and reversal are governed by Tongmai Sini Tang.
Diarrhea with Lung pain is governed by Zishen Tang. Lung follows the supplied graph and is not silently changed to abdomen.
Qi-type diarrhea is governed by Helile San.
Helile San Formula
Helile 10 fruits.
Powder this ingredient, mix with gruel liquid and take at once.
Supplement: Xiao Chengqi Tang from Wings to Thousand Gold treats blocked stool, hiccups and repeated delirious speech.
Huangqin Tang from Outer Terrace treats dry retching and diarrhea.
Huangqin, Renshen and Ganjiang 3 liang each; Guizhi 1 liang; Dazao 12 fruits; Banxia half a sheng.
Boil the six ingredients in 7 sheng water to obtain 3 sheng. Divide into three warm doses.
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