bubble_chart Concept

Nausea is a symptom characterized by the urge to vomit but not being able to, and the inability to stop the sensation. Zhubing Yuanhou Lun. It is said that nausea refers to "a faint feeling in the heart with the desire to vomit, known as nausea." Jingyue Quanshu. The Miscellaneous Syndrome Treatise states: "Although it is called nausea, it is actually a disorder of appetite, not a heart disease."

bubble_chart Pattern Analysis

1. Stomach Cold︰Nausea may sometimes be accompanied by stomachache, or intermittent regurgitation of clear water and frothy saliva, with relief upon warmth and worsening of symptoms upon exposure to cold. Additionally, there may be symptoms such as reduced appetite, loose stool, shortage of qi, fatigue, a pale tongue, and a weak pulse. Stomach cold may arise from inherent middle energizer yang deficiency or from excessive consumption of cold and raw foods that damage stomach qi. The former presents with a prolonged course and obvious deficiency patterns, while the latter has a shorter duration and no clear signs of deficiency. Nausea is often accompanied by stomachache due to insufficient stomach yang and unresolved cold-dampness, leading to intermittent regurgitation of clear water and frothy saliva, with symptoms worsening upon cold exposure and alleviating with warmth. For those with middle energizer yang deficiency, symptoms such as reduced appetite, loose stool, shortage of qi, fatigue, a pale tongue, and a weak pulse may manifest. Treatment should focus on warming the middle and dissipating cold to direct qi downward. The formula Aconite Middle-Regulating Decoction or Evodia Decoction can be used with modifications.
2. Stomach Heat︰Nausea is sometimes accompanied by epigastric upset, acid swallow, fetid mouth odor, and may also present with dark urine, constipation, a yellow tongue coating, and a wiry or slippery pulse. Stomach heat nausea may arise from habitual indulgence in rich and greasy foods, leading to exuberant interior heat, or from common cold or summerheat, where external pathogens enter the interior, resulting in stomach heat qi counterflow nausea. This manifests as fetid mouth odor, acid swallow, dark urine, constipation, a yellow tongue coating, and a rapid pulse, among other heat pattern symptoms. For nausea due to exuberant interior heat, purgative decoction formulas with modifications can be used, while for nausea caused by summerheat entering the interior, Bamboo Leaf and Gypsum Decoction with modifications may be applied.
3. Stomach Yin Deficiency︰Nausea, or accompanied by severe vomiting, thirst with a desire to drink, or vomiting immediately after drinking water, inability to eat, shortness of breath, fatigue, a red tongue with scant coating, and a thready rapid pulse. Nausea is often accompanied by severe vomiting or occurs after severe vomiting, mostly due to Rebing late stage [third stage], or after major surgery, leading to severe deficiency of stomach yin, resulting in intense nausea and vomiting, inability to eat or drink, even vomiting immediately after drinking water, thirst, a red tongue, and a thready rapid pulse—all clear signs of stomach yin deficiency. Treatment should focus on nourishing stomach yin and descending rebellious qi. The formula used is Stomach-Tonifying Decoction combined with Tangerine Peel and Bamboo Shavings Decoction with modifications.
4. Liver-stomach Disharmony︰Nausea, or accompanied by vomiting, chest tightness, hypochondriac pain, bitter taste in the mouth, dry throat, poor appetite, or women with menstrual irregularities, thin yellow tongue coating, wiry and thin pulse. Liver-stomach disharmony is caused by liver qi stagnation and transverse invasion of the stomach, so it must be accompanied by symptoms of liver qi stagnation such as chest tightness, hypochondriac pain, bitter taste in the mouth, dry throat, and wiry pulse. The treatment should focus on soothing the liver and harmonizing the stomach, using Bupleurum and Calming Decoction, or Cold-Limbs Powder combined with Two Old Ingredients Decoction with modifications.
5. Food Stagnation︰Nausea with a desire to vomit, acid regurgitation, aversion to the smell of food, epigastric distension, loss of appetite, while the tongue and pulse are often normal. Food injury (dyspepsia) and nausea are caused by overeating damaging the stomach, leading to stomach qi failing to descend and rebelling upward, resulting in nausea. The treatment should focus on promoting digestion and removing food stagnation. Prescriptions such as Stomach-Calming Powder with Hawthorn and Medicated Leaven, or Immature Orange Fruit Stagnation-Removing Pill can be modified and applied.

"The causes of this syndrome include cold, food, phlegm-fluid retention, foul qi, fire pathogen, dampness damaging the stomach, or cold-damage diseases such as malaria and dysentery affecting the appetite. All of these can lead to it. If one wishes to examine it, one should observe the deficiency and excess, cold and heat, and that will suffice. For nausea caused by excess pathogen, it will cease once the pathogen is expelled, coming and going quickly. For nausea caused by deficiency-type pathogen, it will only be cured when the stomach qi is greatly restored." (Jingyue Quanshu．Miscellaneous Syndromes)

bubble_chart Documentation

1. Danxi Xinfa．Nausea: "Nausea can be caused by phlegm, heat, or deficiency, all of which can be treated with Fresh Ginger Rhizome, supplemented with assistant medicinal according to the symptoms. ...nausea, the urge to vomit but unable to, a feeling of unease in the heart, like someone afraid of boats, it is appropriate to use Major Pineilia Decoction, or Minor Pineilia Poria Decoction, or Middle-Regulating Decoction with Pineilia can also be used. Also, for nausea caused by heat in the stomach, using Two Old Ingredients Decoction with ginger juice stir-fried to yellow Coptis and Skullcap Root, one qian each, is most effective."
2. "Ming Yi Zhi Zhang": The term 'e' (惡) in nausea means fear or aversion, and should be pronounced as such. Nausea refers to the aversion to food and drink upon seeing them. If interpreted as the 'e' (惡) in good and evil, the meaning would not make sense." (Quoted from Zabing Guangyao)

bubble_chart Differentiation

Nausea and belching, retching (hiccup), hiccup, and vomiting are all common symptoms of spleen and stomach disorders. They should be clinically differentiated, and relevant discussions can be referred to in the respective sections.