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Chapter Eighteen Emetic Formulae

The emetic formulae are mainly composed of vomiting-inducing herbs. They have the effects of pouring out phlegm, retained food, and poisonous materials and arc uscd to treat phlegm syncope, food retention and food poisoning. They all per tam to the emetic therapy of the eight therapies.
Thc cmetic formulae arc mainly to pour out phlegm, retained food and poi sonous materials in throat, chest and epigastrium hy means of vomiting. They are indicated to apuplexia, phlegm syneope, food retention, food syocope, throal block age, acute jaundice, dry cholera and food poisoning. The commonly used herbs for composing emetic formulae are muskmelon pedieel, veratrum, table salt, and so on. The representative formulae are Muskmelon Pedicel Powder and Emetic Salt Solution.
The drastic effect of emetic formulae is easy to injure the stomaeh-qi. So it should he stopped as soon as the effect is showed. It should also be cautious to apply them to the senile, weak, pregnant or postpartum patients. If vomiting is unceasing after taking emetic deeoetion, small amount of ginger juice or cold porridge or cold water can stop it. If they cannot stop it yet, it should be dealt with different methods according to different deeoction. For example, unceasing vomiting caused by taking Muskmelon Pedicel Powder can be relieved by taking 0. 03
0. 06g musk or 0. 3-O. 6g clove powder. If it is due to taking Emergency Phlegm Diluting Powder, then licorice and basket fern deeoetion can stop it. Besides, other formulae.for harmonizing the stomach to lower the rebellious qi can also be used to relieye the unceasing vomiting. But if the vomiting is not induced after taking deeoctioo, other assistant methods, such as stimulating the throat by ginger or feather ,or frequent swallow of hot water, should be applied. Whenever vomiting is induced, patient should avoid wind to prevent from exogenous attack. Meanwhile, proper diet such as porridge is necessary to nurture the spleen and stomach. Fatty and indigestible food are prohibited to preventing from re injury of the stomachqi.
Muskmelon Pedicel Powder
gad di san
SOURCE:Treatise on Clod-Attack
339
INGREDIENTS:
Muskmelon pedieel ig
Red bean ig
DIRECTIONS:Grind the above herbs into fine powder. Take it with prepared soybean 9g deeoet ion. If vomiting is not induced after taking it, applying clean feather to stimulate the throat for vomiting.
EFFECT:Fooring out phlegm and retained food.
INDICATIONS: stagnation of phlegm and retained food in the chest and epigastrium manifested by stuffiness and hardness of chest, severe vexation, shortness of breath with gas pushing up to the chest, slight floating pulse on the “con” portion.
ANALYSTS OF FORMIJLA:This is a key formula for emetic therapy. Being bilter flavor, muskmelon pedicel ads as the main herb to poor out phlegm and retained food. Because mosknelon pedicel possesses toxicity and easily injures the stomach-qi, red bean and prepared soybean arc used together to protect the stomach-qi. Meanwhile, prepared soybean can dispel evil from the chest as well as helping muskmelon pedicel pour not evils. They together act as the ad] avant and dispatcher herbs.
If the retained food stays in the intestines rather than cpigastrium, or phlegm is not located in the chest, or patient is deficient, this formula is prohibited.
ASSOCIATED FORMULA:
Three Sages Powder (san shèng san) , (Confucian Duties to Their Parents)
Ledehopriella root 9g, muskmelon pedicel 9g, veratrum 0. 3--3g
Grind the above herbs into coarse granules arid decoct them in water for oral administration. Take it slowly till vomiting is induced. Or give the decbctioa by nosal feeding. Effect: pouring nut wind-phlegm. Indications: closure syndrome of apoplexia manifested hy aphasia, suffocative vexation, wry mouth and eyes, or uncansciousness, lockjaw, floating, slippery anti forceful pulse. It cauld also be applied to epilepsy due to turbid phlegm obstructing in the chest or to syndrome due to food puisuning at the cpigastrium.
NOTES: The emetic effect of Three Sages Powder is stronger than thet of Muskmelon Pedicel Powder. The former is special for pouring oat wind—phlegm and mainly applied to apoplexia and epilepsy doe to phlegm retention; while the latter is good at pouring out phlegm and retaind food and mainly applied to stuff mess and hardness of the chest, shortness of breath with gas pushing up to the
340
chest due to stagnation of phlegm aod retaioed food in the chest.
Emergency Phlegm-Diluting Powder
jià JI xi xidn san
SOURCE: The General Collection for Holy Relief
INGREDIENTS:
Chinese honeylocust fruit 15g
Dehydrated slum 30g
DIRECTIONS:Grind the ahove two herbs into extremely ‘fine powder. Take 0. 5—3 gram of this powder with warm water each time.
EFFECT:Indueing vomiting to opeu the orifice.
INDICATIONS: Closure syndrome of apoplexia due ro exuheraot phlegm in the throat characterized by stridor uneonsciousuess, or sudden syncope, or wry mouth, slippery and forceful pulse. Also, obstruction of respirtory pathways.
ANALYSIS OF FORMULA: Having pungent flavor for opeoniog the orifice and salt flavor fur softening hardness, Chinese hooeyloeost fruit is good at eliminating greasy phlegm. Being sour and hitter flavors to induce vomiting, dehydrated alum can resolve the obstinate phlegm. The combination of these two herbs has the effects of diluting phlegm and inducing it out from mouth slowly.
This is a formula for emergency aad only suitable to the excessive syndrome. Ii is eontraindicated to apuplexia of collapse type and syndrome of yaog floating due to yin exhaustion with phlegm retention.
Emetic Salt Solution
ydn tang tan fang
SOURCE:Essential Formolae Worth A Thousand Gold for Eniergeney
iNGREDIENT:
Table salt
IDRECTIONS:Dissolve the table salt in saturated saline, 200 ml of this liquid is taken each time. Afterward, stimulating the throat to induce vomiting.
EFFCT:Pouring out retained food.
INDICATIONS:Food retention or dry cholera with the feeling of vomiting or diarrhea hot not real vonuting and diarrhea, vexation with stuffy of chest.
ANALYSIS OF FORMULA:This is a mild formula for common sue. The extremely salt flavor of the saline liquid can arouse vomiting along with which the
341

retained food will he poored oot so as to recover the normal fonctional activity of qi.
It can also be applied to food syncope doe to food retention in the stomach, or qi syncope due to extreme stagnation of the liver qi.
In Summary
There are totally 3 emetic formulae. Muskmelon Pedicel Powder has the strongest effect of inducing vomiting and it is mainly suitable to phlegm retention in the chest or food retention in epigastrium marked by stuffiness and hardness of the chest and epigastrium, shortness of hreath with gas poshing up to the chcst. Emergency Phlegm-Dilating Powder has weaker effect of inducing vomiting and it is mainly applied to the closure syndrome of apoplexia due to exuberant phlegm obstructing the flow of qi. Emetic Salt Solution is mild and mainly used to treat dry cholera manifested by abdominal pain with the feeling of vomiting or diarrhea hut not real vomiting and diarrhea. In addition, it can also be used against food re tention, food syneppe and qi syncope.

 



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