Formulas · Text · Donguibogam 東醫寶鑑

The Vomiting Method

한글 토 · Pinyin Tu

Spring is the season for ejecting — the hardest of the three methods, and the one most nearly lost

吐

The first of the three great methods and the one the chapter says is hardest to use well. It opens with Zhongjing's rule that spring is the season for ejecting, likening it to breaking the ground so that what is pent up can rise, and then makes a complaint: sweating and purging have fixed rules, but ejecting does not, and physicians who read only the formula books have let the method go. The Neijing sentence it rests on is four graphs — what is high, let it overflow — and everything else follows from deciding whether the trouble sits high enough. What makes the chapter unusually practical is how much attention goes to management rather than to drugs. When to do it: early in the day, on an empty stomach, in clear weather, with a cloth bound round the waist. What to expect: dizziness so severe the patient must be warned, and the Book of Documents quoted to say that a medicine that does not make the head swim will not cure. How to help it along: a goose feather, a lump of sugar, hot pickle brine. How to stop it when it will not stop: musk, scallion, licorice, plain hot water — a different antidote for each class of drug. Who must never be given it: the frail, the elderly, anyone bleeding, and anyone whose account of themselves cannot be trusted. The chapter closes with sixteen simples and the倒倉 method, a three-day course of beef broth that is less a prescription than a regimen.

6.1 Spring Is the Season for Ejecting 春宜吐

6.1.1

Source원문

仲景大法, 春宜吐, 象萬物之耕耨科斫, 使陽氣之鬱者, 易達也. 《東垣》

Translation영역

Zhongjing's great rule: in spring, ejecting is the method. It takes after the ploughing and hoeing, the pruning and cutting back of the ten thousand things, so that the yang qi which is depressed may readily come through.

Clinical note임상 주석

The image is agricultural and exact: in spring the ground is broken so that what is waiting below can come up. Ejecting does the same for a yang qi that is pent in the chest. The three methods are keyed to the seasons throughout this volume — spring for ejecting, summer for sweating, autumn for purging — each going with the direction the qi is already taking.

Dongwon 東垣

6.2 Ejecting Is an Ancient Method 吐乃古法

6.2.1

Source원문

吐汗下三法, 乃上古高醫用之, 神妙莫測. 今庸下之流, 止看諸方, 不知治法. 不識源流, 不行聖人法, 去聖日遠, 可勝惜哉. 《綱目》

Translation영역

The three methods of ejecting, sweating and purging were used by the high physicians of antiquity, and their spirit-like subtlety could not be fathomed. Today the common sort look only at the formula books and do not know the methods of treatment. Not recognizing the source and the stream, not practising the method of the sages, they grow further from the sages by the day — how great a pity it is.

Clinical note임상 주석

止看諸方, 不知治法 — looking only at the formula books and not knowing the methods. The complaint is that a practitioner who knows prescriptions but not the three methods has the branches without the root. The chapter is defending a technique it sees falling out of use, which is why it gives so much space to how the procedure is conducted rather than to what is in the packet.

Gangmok 綱目

6.3 Where the Disease Is Above, Ejecting Is Indicated 病在上宜吐

6.3.1

Source원문

內經曰, 其高者, 因而越之. 越謂吐也.

Translation영역

The Neijing says: what is high, thereby overflow it. To overflow means to vomit.

Clinical note임상 주석

The four graphs the whole chapter rests on, and the gloss that ties them to this method. The principle is one of direction: what sits high goes out upward, and forcing it downward through the length of the body is the longer road. Gardenia's entry at 6.13.5 returns to this line to explain why a cold bitter medicine should cause vomiting at all.

Naegyeong 內經

6.4 Welling Medicines Are Hard to Use 涌劑難用

6.4.1

Source원문

涌謂吐也. 三法中惟涌劑爲難, 用汗下則一定法也. 故丹溪先生特註吐爲詳者, 恐人不深造其理, 徒蒼皇顚倒, 反有害於病者耳. 《丹心》

Translation영역

Welling means vomiting. Among the three methods only the welling medicines are difficult; in using sweating and purging there are fixed rules. Therefore Master Danxi annotated ejecting with particular fullness, fearing that people would not reach deep into its principle and would merely be thrown into haste and confusion, so doing harm to the patient instead.

Clinical note임상 주석

用汗下則一定法也 — sweating and purging have fixed rules. Ejecting does not, and that is the chapter's own account of why the method fell away. A purge announces itself when the bowel opens and a sweat when the skin damps; a vomit may not come at all, or may not stop. 蒼皇顚倒, haste and confusion, describes the practitioner rather than the patient.

Dansim 丹心

6.5 Ejecting Medicines 吐藥

6.5.1

Source원문

宜用瓜蔕散ㆍ獨聖散ㆍ稀涎散ㆍ豆參散ㆍ三聖散ㆍ二仙散ㆍ靑黛散ㆍ二神散ㆍ三仙散ㆍ四靈散ㆍ五玄散ㆍ六應散ㆍ不臥散ㆍ撩膈湯ㆍ梔豉湯ㆍ藜蘆散ㆍ雄黃散.

Translation영역

Melon Stalk Powder, Lone Sage Powder, Thin the Drool Powder, Bean and Sophora Powder, Three Sages Powder, Two Immortals Powder, Indigo Powder, Two Spirits Powder, Three Immortals Powder, Four Numina Powder, Five Mysteries Powder, Six Responses Powder, Not Lying Down Powder, Lift the Diaphragm Decoction, Gardenia and Fermented Soybean Decoction, Black False Hellebore Powder and Realgar Powder are used.

Clinical note임상 주석

Seventeen formulas, and the section grades them openly by force. Bean and Sophora Powder and Four Numina Powder are marked 輕劑, light preparations; Five Mysteries Powder is marked 重劑, heavy. Three Sages Powder does all three methods at once. Melon stalk carries most of them, with black false hellebore root in the harsher ones. Two entries — Indigo Powder and Not Lying Down Powder — are not taken by mouth at all but blown or poured into the nose. **Most of these contain melon stalk, black false hellebore root or realgar, all toxic. Inducing vomiting is no longer recommended in poisoning and is dangerous where consciousness is impaired.**

Donguibogam · To

6.6 The Method of Bringing on Vomiting 取吐法

6.6.1

Source원문

須天氣淸明行之, 病急則不拘此法. 吐時, 宜辰卯二時. 內經曰, 平旦至日中, 天之陽, 陽中之陽也. 仲景大法, 春宜吐. 是天氣在上, 人氣亦在上, 一日之氣, 辰卯是其候也. 故宜早不宜夜, 先令病人隔夜不食. 《丹心》

Translation영역

It should be done when the weather is clear and bright; where the disease is urgent this rule does not bind. The time for ejecting should be the myo and jin hours. The Neijing says: from daybreak to midday is the yang of heaven, the yang within the yang. Zhongjing's great rule is that spring is the season for ejecting. This is the qi of heaven being above and the qi of man being above also, and within the qi of a single day the myo and jin hours are that season. Therefore early is fitting and night is not, and the patient is first made to go without food from the evening before.

Clinical note임상 주석

The reasoning runs by analogy — the morning is the spring of the day — but the practical content is sound: an empty stomach overnight, and the procedure done early with the whole day ahead to recover in. 病急則不拘此法 — where the disease is urgent this rule does not bind — is stated first, so the timing is a preference rather than a condition.

Dansim 丹心

6.6.2

Source원문

凡吐時, 先以布繫腰腹, 於無風處, 空心或半空心, 時得天氣淸朗爲好. 如風痰急病, 及傷食者, 不拘此例, 以吐爲度. 《入門》

Translation영역

Whenever ejecting, first bind a cloth round the waist and abdomen; do it in a place out of the wind, on an empty or half-empty stomach, and it is best when the weather is clear and bright. In urgent wind phlegm disease and in food damage this rule does not bind, and vomiting is the measure.

Clinical note임상 주석

先以布繫腰腹 — bind a cloth round the waist and abdomen — is the one piece of physical preparation the chapter gives, and it is sensible: abdominal support during forceful retching reduces strain. 於無風處, out of the wind, follows the same reasoning as elsewhere in the Bogam — a body opened by treatment is held to be open to contraction.

Immun 入門

6.6.3

Source원문

凡吐時, 能令人目翻, 吐時令閉雙目. 或不省人事, 則令人以手密掩之爲可. 《得效》

Translation영역

Whenever ejecting, it can make a person's eyes roll back; at the time of vomiting have them close both eyes. If they lose awareness, it is proper to have someone cover the eyes closely with a hand.

Clinical note임상 주석

目翻 — the eyes rolling back — is recorded as an expected effect and provided for. Closing or covering the eyes during violent retching is a small kindness and also keeps the patient from the disorientation of seeing the room move. That the source anticipates loss of awareness and says what to do about it tells how forceful these procedures were.

Deukhyo 得效

6.7 Methods for Helping the Vomiting Along 助吐法

6.7.1

Source원문

服吐藥療痰者, 以釵股或雞翎探引. 若不出, 以虀汁投之, 不吐再投. 且投且探, 無不出者. 吐至昏眩, 愼勿驚疑. 書曰, 若藥不瞑眩, 厥疾不瘳. 如發頭眩, 可飮氷水立解. 如無氷水, 新汲水亦可. 强者, 一二吐而安, 弱者, 可作三次吐之, 庶無損也. 吐之次日, 有頓復者, 有轉甚者, 盖引之而上未平也. 數日當再爲之. 如覺渴者, 氷水ㆍ新水ㆍ瓜梨涼物, 皆不禁. 惟禁食過飽硬物乾脯難化之物. 《子和》

Translation영역

Where an ejecting medicine has been taken to treat phlegm, probe and draw it out with a hairpin stem or a chicken feather. If nothing comes, give sour pickle brine; if there is no vomiting, give it again. Giving and probing by turns, there is nothing that will not come out. Should the vomiting reach the point of clouding and dizziness, take care not to be alarmed or to doubt. The Book of Documents says: if the medicine does not make the head swim, that disease will not be cured. Where dizziness of the head breaks out, iced water may be drunk and it resolves at once; if there is no iced water, newly drawn water will also do. The strong are at ease after one or two vomits; the weak may be made to vomit in three sittings, and there will be no harm. On the day after the vomiting, some recover at once and some grow worse — this is because what was drawn upward has not yet settled. After some days it should be done again. Where thirst is felt, iced water, fresh water, melon and pear and cooling things are none of them forbidden. Only eating to excess, hard things, dried meat and what is difficult to transform are forbidden.

Clinical note임상 주석

若藥不瞑眩, 厥疾不瘳 — if the medicine does not make the head swim, the disease will not be cured — is from the Book of Documents and is the sentence this whole tradition leans on. It licenses a violent reaction as evidence that the treatment is working. The passage is best read with 6.10 beside it. Zhang Congzheng's confidence here is matched there by a list of people who must never be given this, and the two together are the method's real shape. 有轉甚者 — some grow worse the next day — is recorded plainly rather than explained away, and the answer offered is to repeat the procedure. That is the part a modern reader should treat with most caution.

Jahwa 子和

6.7.2

Source원문

凡服吐藥, 不須盡劑. 服藥後, 約人行十里, 未吐, 以溫茶一鍾, 入香油數點投之, 良久, 以鵝翎探喉中, 徐徐牽引, 得吐卽止. 未吐則再投藥, 以吐爲度. 《丹心》

Translation영역

Whenever an ejecting medicine is taken, there is no need to finish the dose. After taking it, in about the time a person walks ten li, if there is no vomiting, give a cup of warm tea with a few drops of sesame oil in it; after a good while, probe the throat with a goose feather and draw gently, and when vomiting is obtained, stop. If there is no vomiting, give the medicine again, taking vomiting as the measure.

Clinical note임상 주석

約人行十里 — about the time a person walks ten li — is how the chapter measures an interval, and it is the tradition's usual way of naming a period of roughly an hour. 不須盡劑, no need to finish the dose, is the same titration the Purging chapter applies.

Dansim 丹心

6.7.3

Source원문

服藥如不吐, 含砂糖一塊, 涎出不損人. 皆自吐之法, 不用手探也. 《入門》

Translation영역

If the medicine has been taken and there is no vomiting, hold a lump of sugar in the mouth, and the drool comes without harming the person. These are all methods of vomiting of itself, without using the hand to probe.

Immun 入門

6.7.4

Source원문

凡用瓜蔕, 良久涎未出, 含砂糖一塊, 下咽卽涎出, 吐之. 《仲景》

Translation영역

Whenever melon stalk is used and after a good while no drool comes, hold a lump of sugar in the mouth; as it goes down the throat the drool comes and vomiting follows.

Junggyeong 仲景

6.7.5

Source원문

如服藥不吐, 熱虀水投之卽吐. 《丹心》

Translation영역

If the medicine has been taken and there is no vomiting, give hot pickle water and vomiting comes at once.

Dansim 丹心

6.7.6

Source원문

虛人宜少吐, 如藥力過時不吐者, 飮熱湯一升以助藥力. 若服藥過多者, 飮水解之. 《活人》

Translation영역

The depleted should vomit little. Where the medicine's force has passed its hour and there is no vomiting, drink 1 seung of hot decoction to help the medicine's force. Where too much medicine has been taken, drink water to resolve it.

Clinical note임상 주석

Six graded ways to bring on a vomit that has not come — a feather, sugar, sesame oil in tea, hot pickle water, hot decoction — and one to undo a dose that was too large. The chapter is as interested in controlling the method as in applying it. 虛人宜少吐, the depleted should vomit little, sits here rather than in the prohibitions, which is where a practitioner reading for technique will actually meet it.

Hwarinseo 活人

6.8 The Method of Pouring into the Nose 灌鼻法

6.8.1

Source원문

凡卒急病口噤, 無門下藥者, 如吐藥痰藥, 皆從鼻灌入, 下咽則便吐. 《子和》

Translation영역

Whenever in a sudden and urgent disease the jaw is clenched and there is no way to get medicine down, ejecting medicines and phlegm medicines alike are poured in through the nose; going down the throat, vomiting follows at once.

Clinical note임상 주석

The answer to a clenched jaw, and it is why this section exists. 口噤, the jaw locked, occurs in stroke, tetanus and seizure, and the chapter's other sections all assume a patient who can swallow. **Pouring liquid into the nose of an unconscious patient causes aspiration and is dangerous.**

Jahwa 子和

6.8.2

Source원문

欲吐風涎, 取皂角以漿水浸, 春秋四日, 夏二日, 冬七日, 揉去渣. 熬爲膏, 攤紙上陰乾. 用時以水化開, 灌入鼻內, 良久涎出爲效. 若吐多欲止之, 飮溫鹽湯一二口, 卽止. 《入門》

Translation영역

To eject wind drool, take gleditsia and steep it in fermented millet water — four days in spring and autumn, two in summer, seven in winter — then rub it and strain off the dregs. Reduce it to a paste, spread it on paper and dry it in the shade. When it is to be used, dissolve it in water and pour it into the nose; after a good while the drool comes, and that is the effect. If the vomiting is much and is to be stopped, drink one or two mouthfuls of warm salt decoction and it stops at once.

Clinical note임상 주석

A paste dried onto paper and kept, to be dissolved when needed — a prepared remedy for an emergency that leaves no time to compound anything. The seasonal steeping times follow the same logic as elsewhere: longest in winter when penetration is slow. The stopping instruction is given in the same breath as the method, which is characteristic of this chapter.

Immun 入門

6.9 Patterns for Which Ejecting May Be Used 可吐證

6.9.1

Source원문

傷寒初, 邪氣未傳裏, 瓜蔕散吐之.

Translation영역

At the beginning of cold damage, where the evil qi has not yet been transmitted to the interior, eject it with Melon Stalk Powder.

Bomyeongjip (保命集)

6.9.2

Source원문

傷寒初, 胸煩懊惱, 梔豉湯吐之.

Translation영역

At the beginning of cold damage, with vexation of the chest and anguish, eject it with Gardenia and Fermented Soybean Decoction.

Bomyeongjip (保命集)

6.9.3

Source원문

中風, 不省涎盛, 稀涎散吐之.

Translation영역

In wind stroke, with loss of awareness and drool abundant, eject it with Thin the Drool Powder.

Bomyeongjip (保命集)

6.9.4

Source원문

風頭痛, 若不吐涎, 久則瞽目. 瓜蔕散吐之.

Translation영역

In wind headache, if the drool is not ejected, in time the eyes go blind. Eject it with Melon Stalk Powder.

Clinical note임상 주석

久則瞽目 — in time the eyes go blind — is the reason given for treating a headache with an emetic, and it is the strongest claim in the list. What it may record is the association between severe recurrent headache and visual loss, which occurs in glaucoma and in giant cell arteritis. **Headache with visual disturbance requires urgent medical assessment.**

Bomyeongjip (保命集)

6.9.5

Source원문

頭風後有目疾, 半明可救. 防風散吐之.

Translation영역

Where an eye disease follows head wind and half the sight remains, it may be rescued. Eject it with Saposhnikovia Powder.

Bomyeongjip (保命集)

6.9.6

Source원문

暗風久不差, 鬱金散吐之.

Translation영역

In dark wind that has long not been cured, eject it with Turmeric Root Tuber Powder.

Bomyeongjip (保命集)

6.9.7

Source원문

陽癎久不愈, 未成痴呆, 稀涎散吐之.

Translation영역

In yang epilepsy long uncured, where dementia has not yet set in, eject it with Thin the Drool Powder.

Clinical note임상 주석

未成痴呆 — where dementia has not yet set in — marks a window for treatment and implies an observed course: long-standing seizures were seen to end in cognitive decline.

Bomyeongjip (保命集)

6.9.8

Source원문

陰癎, 三聖散吐之.

Translation영역

In yin epilepsy, eject it with Three Sages Powder.

Bomyeongjip (保命集)

6.9.9

Source원문

諸癎不省, 半生半熟湯吐之.

Translation영역

In all epilepsies with loss of awareness, eject it with Half Raw Half Cooked Decoction.

Bomyeongjip (保命集)

6.9.10

Source원문

多食生膾等物, 胸膈不快, 瓜蔕散吐之.

Translation영역

Where much raw sliced fish and the like has been eaten and the chest and diaphragm are not easy, eject it with Melon Stalk Powder.

Bomyeongjip (保命集)

6.9.11

Source원문

久患脇痛, 獨聖散, 加蝎梢半錢, 吐之.

Translation영역

In long-standing ribside pain, eject it with Lone Sage Powder with half a don of scorpion tail added.

Bomyeongjip (保命集)

6.9.12

Source원문

痎瘧久瘧, 常山散吐之. 雄黃散亦可.

Translation영역

In intermittent and long-standing malaria, eject it with Dichroa Powder; Realgar Powder will also serve.

Bomyeongjip (保命集)

6.9.13

Source원문

蛟龍病腹脹如鼓, 糖毬散吐之.

Translation영역

In dragon disease with the abdomen distended like a drum, eject it with Sugar Ball Powder.

Bomyeongjip (保命集)

6.9.14

Source원문

癲狂久不愈, 三聖散吐之, 後用承氣湯下之.

Translation영역

In mania and withdrawal long uncured, eject it with Three Sages Powder and afterwards purge with Order the Qi Decoction.

Clinical note임상 주석

Ejecting followed by purging, in that order, and the sequence is the school's standing approach to severe psychiatric disturbance: clear the chest first, then the bowel.

Bomyeongjip (保命集)

6.9.15

Source원문

諸厥不省, 三聖散, 鼻內灌之, 吐涎立效.

Translation영역

In all reversals with loss of awareness, pour Three Sages Powder into the nose, and ejecting the drool has effect at once.

Bomyeongjip (保命集)

6.9.16

Source원문

破傷風, 角弓反張, 三聖散吐之. 後用藥汗下之. 《保命》

Translation영역

In lockjaw with arched-back rigidity, eject it with Three Sages Powder, and afterwards use medicines to sweat and purge.

Clinical note임상 주석

Sixteen indications, and they range from a heavy meal of raw fish to tetanus. The unifying claim is that something sits high and can be brought up — phlegm, drool, food, or an evil qi that has not yet gone inward. 角弓反張, arched-back rigidity, is opisthotonos, and the Dampness chapter describes the same presentation at 3.8.8 as following a wound exposed to water. **Tetanus, status epilepticus and stroke are medical emergencies. Inducing vomiting in a patient with loss of awareness risks fatal aspiration.**

Bomyeongjip (保命集)

6.10 Patterns for Which Ejecting May Not Be Used 不可吐證

6.10.1

Source원문

病勢危劇, 老弱氣衰者, 不可吐.

Translation영역

Where the disease is grave and critical, and in the old and weak whose qi has declined, ejecting may not be used.

Jahwa 子和

6.10.2

Source원문

諸吐血ㆍ嘔血ㆍ咯血ㆍ唾血ㆍ嗽血ㆍ崩血ㆍ失血者, 皆不可吐.

Translation영역

In all who vomit blood, retch blood, hawk blood, spit blood, cough blood, flood blood or lose blood, ejecting may not be used.

Clinical note임상 주석

Seven kinds of bleeding named in a row so that none can be argued around. Forceful retching raises intrathoracic pressure and can tear the oesophagus or restart a bleed, and the prohibition is absolute.

Jahwa 子和

6.10.3

Source원문

病人無正性, 妄言妄從者, 不可吐.

Translation영역

Where the patient has no settled nature and speaks wildly and follows wildly, ejecting may not be used.

Clinical note임상 주석

A prohibition based on the patient's reliability rather than on their body. A procedure this forceful depends on the account they give of what they feel and on their doing what they are told, and where neither can be counted on the method is unsafe. That this is set down as a contraindication alongside bleeding and old age is worth noting.

Jahwa 子和

6.10.4

Source원문

主病者, 不辨邪正之說, 不可吐.

Translation영역

Where the one in charge of the case cannot distinguish sound counsel from false, ejecting may not be used.

Clinical note임상 주석

The one contraindication in these chapters that is about the practitioner. If the person directing the treatment cannot tell good advice from bad, the method is not to be attempted — which is a plain acknowledgement that this technique is dangerous in unsteady hands.

Jahwa 子和

6.10.5

Source원문

性行剛暴, 好怒憙淫之人, 不可吐. 《子和》

Translation영역

In a person whose nature and conduct are hard and violent, given to anger and fond of excess, ejecting may not be used.

Jahwa 子和

6.10.6

Source원문

諸亡血, 及諸虛家, 皆不可吐. 《入門》

Translation영역

In all who have lost blood and in all the depleted, ejecting may not be used.

Clinical note임상 주석

Six prohibitions, and only two are about a disease. The rest concern the patient's age, strength, temperament and truthfulness, and the practitioner's judgement. Read against 6.7, where a violent reaction is welcomed as proof the medicine is working, this section is what keeps the method from being reckless. The two belong together.

Immun 入門

6.11 Where the Pulse Is Not Seen in the Lower Position, Ejecting Is Indicated 下部脉不見宜吐

6.11.1

Source원문

內經曰, 上部有脉, 下部無脉, 其人當吐, 不吐者死. 何謂下部無脉. 此爲木鬱也. 瓜蔕散吐之.

Translation영역

The Neijing says: where there is a pulse in the upper position and none in the lower, that person should vomit, and one who does not vomit dies. What does it mean that there is no pulse in the lower position? This is wood depression. Eject it with Melon Stalk Powder.

Clinical note임상 주석

The passage the Internal Damage chapter cites at 1.37.1, given here with its explanation. 不吐者死 — one who does not vomit dies — is meant literally. **A pulse present at the wrist and absent at the cubit describes circulatory failure. This is a medical emergency, and inducing vomiting in such a patient is dangerous.**

Naegyeong 內經

6.11.2

Source원문

解曰, 盛食塡塞於胸中, 兩寸脉當主事, 兩尺脉不見, 其理安在. 盖胸中者, 肺也, 肺者, 手太陰金也. 金主殺伐, 金能克木. 故肝木生發之氣, 伏於地下, 非木鬱而何. 吐去上焦陰土之物, 木得舒暢, 則鬱結去矣. 此乃天地交而萬物通也. 《東垣》

Translation영역

The explanation says: where heavy food stuffs and blocks the chest, the two inch pulses take charge and the two cubit pulses are not seen — where does the principle of this lie? The chest is the lung, and the lung is the hand greater yin metal. Metal governs killing and cutting down, and metal can restrain wood. Therefore the engendering and effusing qi of the liver wood lies hidden below the ground — and if this is not wood depression, what is it? Eject what is of the yin earth in the upper burner, and the wood obtains ease and expansion, and the depressed bind is gone. This is heaven and earth intercoursing so that the ten thousand things pass through.

Clinical note임상 주석

Dongwon reads an absent cubit pulse as the liver's rising qi being pressed down by the lung, which is pressed down in turn by food stuffing the chest. Remove the food and the whole column opens. 天地交而萬物通 is the Yi's hexagram of peace, the reverse of the stagnation hexagram the Wasting Thirst chapter invokes at 4.7. Both chapters use the same figure for a body in which above and below have stopped communicating.

Dongwon 東垣

6.12 Methods for Stopping the Vomiting 止吐法

6.12.1

Source원문

服瓜蔕, 吐不止. 煎麝香湯解之, 下咽立止.

Translation영역

Where melon stalk has been taken and the vomiting does not stop, decoct musk and give it to resolve it; as it goes down the throat it stops at once.

Clinical note임상 주석

The antidote is keyed to the drug, and the pairing has a history: the entry at 6.13.1 records that melons would not set fruit within ten li of a household whose women all wore musk, and takes this as proof that musk resolves melon toxin. **Musk is CITES Appendix I and prohibited in trade.**

Jahwa 子和

6.12.2

Source원문

服藜蘆吐不止, 葱白湯解之.

Translation영역

Where black false hellebore root has been taken and the vomiting does not stop, resolve it with scallion white decoction.

Jahwa 子和

6.12.3

Source원문

服石藥吐不止, 以甘草ㆍ貫衆湯解之.

Translation영역

Where a mineral medicine has been taken and the vomiting does not stop, resolve it with licorice and dryopteris decoction.

Jahwa 子和

6.12.4

Source원문

服諸草木吐不止, 以麝香湯解之.

Translation영역

Where any plant or tree medicine has been taken and the vomiting does not stop, resolve it with musk decoction.

Jahwa 子和

6.12.5

Source원문

丁香ㆍ甘草ㆍ白水, 總解諸藥吐. 《子和》

Translation영역

Clove, licorice and plain water resolve the vomiting from all medicines generally.

Jahwa 子和

6.12.6

Source원문

甘草, 總解諸藥吐不止.

Translation영역

Licorice resolves generally where the vomiting from any medicine does not stop.

Dansim 丹心

6.12.7

Source원문

白湯亦總解. 《丹心》

Translation영역

Plain hot water also resolves generally.

Clinical note임상 주석

A table of antidotes arranged by class of drug — musk for melon stalk and for plant medicines, scallion for black false hellebore, licorice and dryopteris for minerals — with licorice and plain hot water as the general remedies. That the chapter supplies this before its list of simples says what it thinks of its own method. A practitioner giving these drugs is expected to know how to stop them first. **Persistent vomiting causes dehydration and electrolyte loss and can tear the oesophagus. It is a medical matter rather than one for household remedies.**

Dansim 丹心

6.13 Simple Medicinals 單方

6.13.1

Source원문

瓜蔕主食諸苽果, 病在胸膈中者, 皆吐下之. 又吐痰涎塞咽喉不下, 宜用瓜蔕散. 《本草》

Translation영역

Melon stalk (瓜蔕): Governs the eating of any melons and fruits where the disease lies in the chest and diaphragm, ejecting or purging it all. It also ejects phlegm drool blocking the throat so that nothing goes down; Melon Stalk Powder is used.

Boncho 本草

6.13.2

Source원문

瓜蔕唐宰相王鐸, 爲會昌節度使, 姬妾數百, 皆帶蘭麝, 所過十里之外, 瓜蓏皆不實. 足見麝香能解瓜毒. 《醫說》

Translation영역

Melon stalk (瓜蔕), note: Wang Duo, minister of the Tang and military governor of Huichang, had several hundred concubines who all wore orchid and musk; for ten li beyond wherever they passed, the melons and gourds bore no fruit. This sufficiently shows that musk can resolve melon toxin.

Clinical note임상 주석

An anecdote offered as evidence, and it is the reasoning behind the antidote at 6.12.1. The observation — that melons failed to set fruit where musk was worn — is unlikely to have been made as reported, but the inference drawn from it became standing practice.

Uiseol 醫說

6.13.3

Source원문

藜蘆大吐上膈風涎, 暗風, 癎病. 上有藜蘆散是也. 《本草》

Translation영역

Black false hellebore root (藜蘆): Greatly ejects wind drool above the diaphragm, and treats dark wind and epilepsy. Black False Hellebore Powder above is this.

Clinical note임상 주석

**Black false hellebore root is toxic, causing cardiac arrhythmia and severe hypotension. Deaths are on record.**

Boncho 本草

6.13.4

Source원문

苦參能吐人. 若熱結胸, 用此爲末, 醋湯調二錢服卽吐. 《本草》

Translation영역

Sophora root (苦參): Can make a person vomit. Where heat has bound in the chest, powder it and take 2 don stirred into vinegar decoction, and vomiting follows.

Boncho 本草

6.13.5

Source원문

苦瓠令人吐. 取切煮食之. 勿多服有毒. 《本草》

Translation영역

Bitter gourd (苦瓠): Makes a person vomit. Slice it, boil and eat. Do not take much of it — it has toxin.

Boncho 本草

6.13.6

Source원문

梔子能吐. 胸膈煩燥, 作湯服, 吐之. 《子和》凡用梔子湯, 非吐人之藥, 以其燥熱鬱結之甚, 而以藥頓攻之不能開通, 故用此發達鬱結, 令氣通宣行而已. 山梔, 無豉吐不宣. 《入門》

Translation영역

Gardenia (梔子): Can eject. Where the chest and diaphragm are vexed and agitated, make a decoction and take it, and it ejects. Gardenia Decoction is not a medicine that makes a person vomit; it is that the dryness and heat are bound up so severely that attacking them at once with medicines cannot open them through, and so this is used to effuse and reach the depressed bind, making the qi pass through and diffuse — no more than that. With mountain gardenia, without fermented soybean the ejecting does not diffuse.

Clinical note임상 주석

非吐人之藥 — not a medicine that makes a person vomit. The section says plainly that gardenia is not an emetic and that the vomiting is a consequence of opening what was bound, not the aim. 無豉吐不宣, without fermented soybean the ejecting does not diffuse, explains why the two are always paired.

Immun 入門

6.13.7

Source원문

松蘿煮湯, 可爲吐藥. 能吐胸中客熱痰涎. 《本草》

Translation영역

Usnea (松蘿): Boiled into a decoction it may serve as an ejecting medicine. It can eject visiting heat and phlegm drool in the chest.

Boncho 本草

6.13.8

Source원문

柳枝皮 主痰熱在胸, 可爲吐湯. 《本草》

Translation영역

Willow twig bark (柳枝皮): Governs phlegm heat lying in the chest and may serve as an ejecting decoction.

Boncho 本草

6.13.9

Source원문

人參蘆頭 能吐人. 凡防風ㆍ桔梗等之蘆頭, 皆氣脉上行, 故煮湯服, 皆能發吐. 最宜虛人. 《丹心》

Translation영역

Ginseng neck (人參蘆頭): Can make a person vomit. In general the necks of saposhnikovia, platycodon and the like all have their qi and vessels running upward, and so boiled into a decoction and taken they can all bring on vomiting. It is most fitting for the depleted.

Clinical note임상 주석

最宜虛人 — most fitting for the depleted — and this is the one emetic in the chapter offered for a weak patient. The prohibitions at 6.10 exclude the depleted from the method generally, so this is the exception that proves the rule. The principle stated — that the neck of any root sends its qi upward — is why these are removed before the root is used to supplement.

Dansim 丹心

6.13.10

Source원문

白礬吐痰, 却水故也. 上有稀涎散, 是也. 《本草》

Translation영역

Alum (白礬): Ejects phlegm, because it drives off water. Thin the Drool Powder above is this.

Boncho 本草

6.13.11

Source원문

赤小豆 末能吐人. 傷寒飮冷, 見食則啘, 取末二錢, 酸漿水調服探吐. 《子和》

Translation영역

Adzuki bean (赤小豆): The powder can make a person vomit. In cold damage where cold drink has been taken and the sight of food brings retching, take 2 don of the powder stirred into sour fermented millet water and probe to induce vomiting.

Jahwa 子和

6.13.12

Source원문

蘿蔔子 能吐食積痰. 取子五合(炒擂), 和漿水濾汁, 入油與蜜少許, 旋旋溫服. 《丹心》

Translation영역

Radish seed (蘿蔔子): Can eject food accumulation and phlegm. Take 5 hop of the seed, stir-fried and ground, mix with fermented millet water and strain the liquor, add a little oil and honey, and take warm a little at a time.

Dansim 丹心

6.13.13

Source원문

鰕汁能吐人. 又吐風痰. 取鰕(帶殼) 半斤, 入醬ㆍ薑ㆍ葱等料物, 煮汁. 先吃鰕後飮汁, 以物探吐之. 《丹心》

Translation영역

Shrimp broth (鰕汁): Can make a person vomit, and also ejects wind phlegm. Take half a geun of shrimp in their shells, put in soybean paste, ginger, scallion and such seasonings, and boil the liquor. Eat the shrimp first and then drink the liquor, and probe with something to induce vomiting.

Clinical note임상 주석

A dish rather than a drug — shrimp boiled with soybean paste, ginger and scallion, eaten and then brought up. The chapter includes it because shellfish reliably provokes retching in those it disagrees with.

Dansim 丹心

6.13.14

Source원문

茶能吐人. 取茗煎湯多飮, 探吐之. 《本草》

Translation영역

Tea (茶): Can make a person vomit. Take tea leaves, decoct them and drink much, and probe to induce vomiting.

Boncho 本草

6.13.15

Source원문

半生半熟湯 卽百沸湯, 與新汲水各一椀, 相和飮之, 卽吐. 名曰陰陽湯. 《本草》

Translation영역

Half raw half cooked decoction (半生半熟湯): That is, one bowl of much-boiled water and one of newly drawn water, mixed together and drunk, and vomiting follows at once. It is called Yin and Yang Decoction.

Clinical note임상 주석

The same preparation the Internal Damage chapter gives at 1.37.1 under its other name, where salt is added. Cold water and boiled water in equal parts, and the name records what it is held to be.

Boncho 本草

6.13.16

Source원문

逆流水 凡欲吐, 取逆流水, 調藥服之卽吐. 《丹心》

Translation영역

Counterflowing water (逆流水): Whenever ejecting is wanted, take counterflowing water, stir the medicine into it and take, and vomiting follows at once.

Clinical note임상 주석

Water that runs backward, used to make the stomach run backward. The reasoning is by correspondence and the chapter offers no other, but the entry shows how far the principle of direction was carried in this method.

Dansim 丹心

6.13.17

Source원문

鹽湯能吐. 詳見霍亂. 《本草》

Translation영역

Salt decoction (鹽湯): Can eject. Treated in fuller detail in the Sudden Turmoil chapter.

Clinical note임상 주석

**A large salt dose can itself be fatal. Inducing vomiting is no longer recommended in poisoning.**

Boncho 本草

6.14 The Method of Overturning the Granary 倒倉法

6.14.1

Source원문

腸胃爲市, 無物不有, 而穀爲最多, 故謂之倉也. 倒者, 傾去舊積而滌濯, 使之潔淨也. 人之飮食, 寧無過傷. 停痰瘀血, 日積月深, 中宮不淸矣, 土德不和矣. 誠於中, 形於外, 發爲癱瘓, 爲勞瘵, 爲蠱脹, 爲癲疾, 爲無名奇病. 先哲製爲萬病元ㆍ溫白元等劑, 攻補兼施, 非不工巧, 然不若倒倉之爲便捷也. 黃牡牛肥肉二十斤或十五斤, 取長流水, 於大鍋內煮爛. 水耗則添熱湯, 不可用冷水. 以肉爛成渣, 融入湯中爲液爲度, 綿濾去滓取汁. 再入鍋中, 文武火熬至琥珀色則成矣.

Translation영역

The intestines and stomach are a marketplace: there is nothing that is not there, and grain is the most plentiful, and so they are called a granary. To overturn is to tip out the old accumulation and wash it clean. In a person's eating and drinking, how should there be no excess and damage? Standing phlegm and static blood accumulate by the day and deepen by the month; the central palace is not clear and the virtue of earth is not harmonious. What is real within takes form without, and breaks out as paralysis, as taxation consumption, as gu distension, as withdrawal disease, as nameless strange diseases. The former worthies made the Ten Thousand Diseases Pill and the Warm White Pill and such preparations, attacking and supplementing together — not that these are unskilful, but they are not as convenient and quick as overturning the granary. Take 20 geun of the fat flesh of a yellow bull, or 15 geun, and boil it soft in long-flowing water in a great pot. As the water is consumed add hot water — cold water must not be used. Boil until the flesh has fallen apart into dregs and melted into the broth as a liquid; strain it through silk, discard the residue and take the liquor. Put it back in the pot and reduce over a moderate then strong fire until it reaches an amber colour, and it is done.

Clinical note임상 주석

Not a prescription but a regimen, and the chapter gives it the last word. Fifteen or twenty geun of beef reduced to an amber broth, taken until the patient vomits, purges, and finally passes what the method is meant to clear. 倒倉, overturning the granary, is Danxi's own coinage and his argument is that a slow course of attacking-and-supplementing pills does less than emptying the storehouse once. 不可用冷水 — cold water must not be used — is the one technical caution in the preparation, and it is about the broth rather than the patient: adding cold water to a long reduction stops the collagen breaking down.

Dansim 丹心

6.14.2

Source원문

未行此法前一月, 不可近婦人, 行此法後半年, 不可近婦人, 三年勿喫牛肉. 如性急好色, 不守禁忌者, 不可行此法也. 《丹心》

Translation영역

For a month before this method is carried out, one must not approach women; for half a year after carrying it out, one must not approach women; and for three years one must not eat beef. Where a person is hasty by nature and fond of sensual excess and will not keep the prohibitions, this method must not be carried out.

Clinical note임상 주석

The restrictions are longer than the treatment by a wide margin — a month before, six months after, and three years without beef. Where the patient will not keep them the method is refused outright. That refusal echoes 6.10.5, where a hard and intemperate nature is itself a contraindication. Danxi is making the same judgement: a procedure this demanding is only safe in someone who will follow through.

Dansim 丹心

6.14.3

Source원문

疝病黃病久者, 倒倉法皆好. 《丹心》

Translation영역

In long-standing mounting disease and yellow disease, the method of overturning the granary is good in both.

Dansim 丹心

6.14.2 In Overturning the Granary the Distress Must Be Borne 倒倉須忍煩惱

6.14.2.1

Source원문

大槪中間飮七八鍾時, 藥力經涉經絡骨節, 搜逐宿垢, 正邪寧不牴牾. 悉有急悶, 似痛似痛, 自有惡況, 此皆好消息. 邪不勝正, 將就擒耳, 尤須寧耐忍受. 又於欲吐未吐, 欲泄未泄交作, 皆有惱括意思, 皆歡喜樂受, 一以靜處之. 此等有太半日景象, 不先說知, 使方寸瞭然, 鮮有不張皇者矣. 《丹心》

Translation영역

Broadly, when seven or eight cups have been drunk, the medicine's force passes through the channels and network vessels and the bones and joints, searching out and driving off the old filth — how should the right and the evil not collide? There is urgent oppression throughout, something like pain and something like pain again, and of itself an ill condition; and all of this is good news. The evil not prevailing over the right, it is about to be taken captive — and all the more must one be patient and bear it. And when the wish to vomit that does not come and the wish to purge that does not come alternate, there is in all of it a sense of torment; let it all be received with gladness and taken calmly, and met throughout with stillness. Such a state of things lasts the better part of a day, and unless it is explained beforehand so that the heart is clear about it, there are few who are not thrown into alarm.

Clinical note임상 주석

The section exists to be read to the patient. 不先說知, 使方寸瞭然, 鮮有不張皇者 — unless it is explained beforehand so that the heart is clear, few are not thrown into alarm — makes informing the patient part of the procedure rather than a courtesy. What is described is the better part of a day of urgent oppression, something like pain, and the alternating urge to vomit and to purge that will not complete. Danxi tells the patient in advance that this is expected and asks them to meet it calmly. 皆好消息, all of this is good news, is the interpretation offered — though a modern reader will note that it is also what a dangerous reaction feels like, and 6.10's prohibitions are what keep the two apart.

Dansim 丹心

6.14.3 The Meaning of Overturning the Granary 倒倉之義

6.14.3.1

Source원문

倒倉者, 傾倒倉廩之陳腐也. 脾胃與大小腸有食積痰飮, 爲腹痛, 痞癖, 食瘧, 黃疸, 痞滿, 惡心, 噫氣, 呑酸等證, 行之無不應手獲效. 其餘一應氣血虛損, 與反胃, 嗝噎, 鼓脹, 勞瘵, 大風, 眞病已成, 及肥白氣虛之人, 脉虛軟無力者, 切不可輕試也. 《正傳》

Translation영역

Overturning the granary means tipping out what is stale and rotten in the storehouse. Where the spleen and stomach and the large and small intestines have food accumulation and phlegm rheum, becoming abdominal pain, glomus and aggregation, food malaria, jaundice, glomus fullness, nausea, belching, acid swallowing and the like, carrying it out there is nothing that does not answer the hand and obtain its effect. But for all the rest — vacuity detriment of qi and blood, stomach reflux, dysphagia and blockage, drum distension, taxation consumption, great wind, any true disease already formed, and those who are stout and pale with vacuous qi whose pulse is vacuous, soft and without strength — it must on no account be lightly attempted.

Clinical note임상 주석

The Jeongjeon draws the line the preceding sections leave open: this method is for accumulation, and for nothing else. What it excludes is telling, because Danxi's own passage at 6.14.1 offers the method for paralysis, taxation consumption, gu distension and withdrawal disease. 眞病已成, a true disease already formed, is the phrase that separates them — where the illness is established in the tissue rather than sitting as accumulation in the gut, emptying the storehouse does nothing and costs much. 肥白氣虛之人, 脉虛軟無力者 — stout and pale with vacuous qi, the pulse soft and without strength — is the same constitution the Internal Damage chapter assigns to damp phlegm at 1.19.3, and here it is a contraindication.

Jeongjeon 正傳

6.15 Rosy Sky Paste 霞天膏

6.15.1

Source원문

卽倒倉法之藥也. 詳見霞天膏.

Translation영역

That is, the medicine of the method of overturning the granary. Treated in fuller detail under Rosy Sky Paste.

Clinical note임상 주석

The reduced beef broth of 6.14 has its own name, and the chapter gives it a section so that a reader meeting the name elsewhere can find it. Amber when reduced, which is where the name comes from.

Donguibogam · To

About this translation 凡例

Base text: Donguibogam (東醫寶鑑, 1613 first edition), Miscellaneous Disorders, Volume 1, The Vomiting Method chapter. The Chinese text is collated against the public-domain Wikisource transcription and a printed edition; original character forms (脉, 人參) are retained. Terminology follows Wiseman & Feng, A Practical Dictionary of Chinese Medicine. Translation and clinical notes are original to this site. — Eui Young (Justin) Chung, L.Ac., Dipl. O.M.