Nausea and Vomiting

Excess type vomiting: acute onset, short duration, large volume turbid vomitus with strong odor, may accompany chills and fever; forceful pulse.

Differentiation

Symptoms

Formula

E x c e s s	Exterior wind-cold with cold dampness in the interior		acute onset, vomiting with undigested food, usually following a meal, chills and fever, headache, no thirst, poor appetite, floating and slippery pulse		Huo Xiang Zheng Qi San
	Damp-cold stagnation in the middle Jiao		nausea and vomiting, belching, acid regurgitation, distention and fullness in the epigastrium and abdomen, lack of ability to taste, poor appetite, heavy sensation in the limbs, loose stools or diarrhea; swollen tongue with thick, white greasy coat, slippery pulse		Ping Wei San
	Food stagnation		vomiting turbid food with foul order, usually after overeating, rotten-smelling belching, acid regurgitation, abdominal pain and distention which is relieved after vomiting, greasy tongue coating, slippery pulse		Bao He Wan
	Damp-phlegm in middle-jiao		frequent vomiting, happening mostly in the morning or evening	profuse thin phlegm, nausea recurs frequently, dizziness, palpitations, abdominal fullness, poor appetite, low energy, white greasy tongue coating, slippery pulse	Er Chen Tang modified
	Heat phlegm in the Stomach and Gallbladder			thick turbid phlegm, stifling sensation in chest, gnawing hunger, bitter taste in mouth, thirst, yellow greasy tongue coat; slippery and rapid pulse	Wen Dan Tang
	Liver attacking Spleen		nausea, vomiting with sour green watery food, acid regurgitation, belching, hypochondriac fullness and pain, usually induced or worsened by emotion or stress, red tongue and wiry pulse		Xiao Yao San modified or Si Ni San modified
	Constraint due to Qi stagnation		nausea or vomiting, belching, acid regurgitation, poor appetite, hypochondriac pain with focal distention, stifling sensation in the chest and abdomen, purple tongue with yellow greasy coating; wiry and rapid pulse		Yue Ju Wan
	Excess cold in the middle-Jiao with middle-Jiao Yang impairment		severe vomiting making one unable to eat, excruciating abdominal and epigastric pain which is aggravated by pressure, cold sensation in the abdomen, borborygmus, white moist tongue coating; wiry and tight or wiry and slow pulse		Da Jian Zhong Tang
	Water accumulation	with exterior syndrome	nausea, or vomiting, diarrhea possible, body heaviness, urinary difficulty, thirst with desire to drink, cough, slippery pulse	vomiting immediately after drinking water, or vomiting saliva, dizziness, headache, fever and chills, white moist coating; slippery and floating pulse	Wu Ling San
		with Yin deficiency
				insomnia, restlessness, red tongue with scanty coating; slippery and rapid pulse	Zhu Ling Tang

Nausea and Vomiting, cont.

Differentiation		Symptoms	Formula
D i s h a r m o n y	Ying-Wei disharmony	dry heaves, sweating with aversion to wind, slight chills and fever possible, headache, nasal congestion; thin white and moist tongue coating; floating, slightly weak pulse	Gui Zhi Tang
	Shao Yang syndrome	nausea and vomiting, heartburn, reduced appetite, dry throat, bitter or sour taste in the mouth, dizziness, irritability, sensation of fullness in the chest and hypochondria, alternating chills and fever; thin, white tongue coating, wiry pulse	Xiao Chai Hu Tang
	Stomach and Intestines disharmony	dry heaves or frank vomiting, borborygmus with diarrhea, reduced appetite, sensation of fullness and tightness in the epigastric area; thin, yellow and greasy tongue coating, wiry, rapid pulse	Ban Xia Xie Xin Tang

Deficiency type vomiting: chronic onset, long term duration, intermittent bouts, vomiting with small amount of clear vomitus, accompanied by fatigue, low energy, weak pulse.

D e f i c i e n c y	Spleen and Stomach deficiency	Qi	nausea and vomiting after overeating, intermittent attacks, vomiting with undigested food or thin fluid, poor appetite, abdominal pain which is relieved by pressure and warmth, low energy	weak pulse	Si Jun Zi Tang
		Yang		cold abdominal pain, weak deep and slow pulse	Li Zhong Tang
	Stomach deficiency with cold		vomiting immediately after eating, epigastric and abdomenal fullness and distention, or epigastric pain and discomfort, acid regurgitation with profuse saliva, poor appetite, fatigue, may have dizziness; pale tongue, weak or slow pulse		Wu Zhu Yu Tang
	Stomach deficiency with heat		nausea, vomiting, dry heaves or retching; hiccough, tender red tongue; weak and rapid pulse		Ju Pi Zhu Ru Tang
	Kidney Yang deficiency with cold		nausea or vomiting with undigested food, cold extremities, loose stools, aversion to cold, fatigue and desire to sleep, pale tongue with white moist coating; deep, slow and weak pulse		Si Ni Tang

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Nausea and Vomiting