Vomiting
AliasNausea and Vomiting
Traditional Chinese Medicine Definition
In traditional Chinese medicine, vomiting is referred to as "Hyperemesis gravidarum" (ě zǔ), which describes a pathological condition where the stomach loses its normal descending function, leading to qi reversal upwards, forcing stomach contents to be expelled from the mouth. According to the records in "Internal Medicine of Traditional Chinese Medicine," vomiting can be caused by factors such as external pathogenic invasion, irregular diet, emotional disorders, and weakness of the spleen and stomach. The disease primarily affects the stomach, and is closely related to the liver, spleen, and gallbladder.
Vomiting is a common gastrointestinal disorder in clinical practice of traditional Chinese medicine, with its core pathogenesis being the loss of the stomach's descending function and qi reversal upwards. Common triggers include improper diet, emotional fluctuations, and external invasion of the six pathogenic factors. In the process of differentiation, attention should be paid to the following key points:
1. Cold and heat, deficiency and excess: Patients with cold invasion of the stomach often present with vomiting of thin, watery sputum, with a preference for warmth and pressure. Those with heat invasion of the stomach tend to have vomit that is turbid, with bitter taste and dry mouth. The differentiation between deficiency and excess is reflected in the fact that those with food retention usually present with excess symptoms, while those with weakness of the spleen and stomach usually present with deficiency symptoms.
2. Accompanying symptoms: Patients with symptoms such as aversion to cold, fever, headache, and body ache usually have external pathogenic invasion of the stomach; those with belching, aversion to food, epigastric distension, and fullness usually have internal retention of food; and those with chest and hypochondriac distension, acid regurgitation, usually have liver qi invasion of the stomach.
Overall adjustment direction: In clinical practice of traditional Chinese medicine, the treatment of vomiting should adopt corresponding adjustment methods based on different patterns. For external pathogenic invasion of the stomach, it is advisable to disperse the pathogen, relieve the exterior, transform turbidity, and harmonize the stomach; for internal retention of food, it is advisable to eliminate food retention, harmonize the stomach, and reverse the qi; for internal obstruction of phlegm and dampness, it is advisable to resolve phlegm and dampness, harmonize the stomach, and reverse the qi; for liver qi invasion of the stomach, it is advisable to soothe the liver and regulate qi, harmonize the stomach, and reverse the qi. Traditional Chinese medicine believes that adjusting the spleen and stomach, and restoring the normal ascending and descending function of the stomach, is the key to treating vomiting.
Common Syndrome Types and Key Points of Differentiation
External evil affecting the stomach
Main Manifestations: Sudden vomiting, onset is acute, accompanied by aversion to cold, fever, and headache and body pain.
Management Approach: Expel evil and relieve the exterior, transform turbidity and harmonize the stomach
Food retention with internal stagnation
Main Manifestations: Vomiting of acid and foul substances, belching, loss of appetite, abdominal distension, feeling of relief after vomiting
Management Approach: Digestive and Stagnation Relief, Harmonize Spleen and Stabilize the Stomach
Phlegm and fluid retention syndrome
Main Manifestations: Vomiting clear fluid and phlegm, chest oppression, loss of appetite, dizziness, and palpitations
Management Approach: Warming Phlegm and Fluid, Harmonize Spleen and Stabilize the Stomach
Liver Qi attacking the Stomach Syndrome
Main Manifestations: Vomiting with acid regurgitation, frequent belching, chest and side pain
Management Approach: Relieve Liver Qi, Harmonize Spleen and Stabilize the Stomach
The above syndrome information is based on traditional Chinese medicine textbooks and clinical standards. Specific differentiation should be completed by a practicing traditional Chinese medicine physician in person.
Physician's Clinical Insights
Patients with vomiting often suffer from upward reversal of stomach qi. In treatment, it is necessary to harmonize the stomach and reverse the qi, while also paying attention to liver depression leading to fire.
— Li Mingjiu Traditional Chinese Medicine Practitioner
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This page is for the popular science of traditional Chinese medicine knowledge and does not constitute medical advice. Specific diagnosis should be completed by a licensed traditional Chinese medicine practitioner in person.
This article has been reviewed by licensed TCM physicians at Hangzhou Kezhentang TCM Clinic. It is for TCM popular science reference only and does not involve specific treatment plan recommendations.
References: Internal Medicine of TCM (13th Five-Year Plan Textbook), Diagnostic and Therapeutic Effectiveness Standards for TCM Diseases and Syndromes (ZY/T001.1-94), Classification and Codes of TCM Diseases and Syndromes (GB/T 15657-2021)