Chen, male, 25 years old. After recovering from chronic diarrhea, he experienced vomiting again. The doctor believed it was due to deficiency and prescribed ginseng, atractylodes, amomum, and pinellia; then, suspecting heat, prescribed bamboo shavings, ophiopogon tuber, and reed rhizome. The random use of these medications was completely ineffective. His symptoms included mild fever, vomiting clear water, inability to retain ingested water, occasional rising qi, slight chest stuffiness, loss of taste, red and dry tongue tip, greasy coating, no thirst, deep yin pulse, and floating yang pulse. Reflecting on his condition, prolonged diarrhea led to spleen deficiency, causing water to stagnate in the stomach and rise with qi, resulting in vomiting. The inability to retain water was due to resistance from heat stagnation in the chest. This was a case of upper heat and middle deficiency, treated with Coptis Decoction from the "Treatise on Cold Damage Diseases." This formula uses ginger, cinnamon, ginseng, and licorice to warm and tonify the spleen and stomach, lower rising qi, clear chest heat with coptis rhizome, and stop vomiting with pinellia, making it an excellent remedy for complex cold and heat conditions. After taking the medicine, vomiting gradually ceased; with a second dose, all symptoms disappeared, and he was able to consume thin porridge. Later, he was treated with Wuwei Extraordinary Efficacy Powder and fresh ginger rhizome to warm the stomach and tonify qi, leading to a full recovery.