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Most times, if you don’t feel like eating, experience nausea and/or feel like vomiting, something must be irritating your upper gastrointestinal tract enough for your body to react in such a manner. If you’re in a balanced condition (i.e. immune system not slow acting, but also not over-reacting), then it must be something wrong with the food. In such a case, your well-balanced body is probably just taking care of itself reacting in such a manner. You can help by drinking water to flush out the bad stuff, and if you really must, eating herbs or downing pills to help your body along. That’s where these two herbal decoctions come into the picture.

橘皮竹茹汤
橘皮竹茹汤 is probably the formula to begin with. It is neutral in nature and mild in action. Recommended in the classics for use after a big illness, probably (my take on this) to build up your immune system while mitigating the upward acting symptoms of nausea and vomitting. It is hence also useful as a herb combination that treats vomiting associated with morning sickness.

Hence, a formula like 橘皮竹茹汤 may be suitable in cases of food poisoning, but is more appropriate for cases where the body is already weak. The stomach in this case may also be weak and unable to take food most healthy people can handle. In this instance, you can think of such food as overly strong for the weak person, in the same way food that causes poisoning is overly strong for the healthy person. The treatment principle includes:

1. building up the body with the emphasis on spleen qi (using 生姜、大枣 to 和中 while adding 人参、甘草 to 扶正)
2. facilitating qi movement (橘皮)
3. getting rid of stagnant phlegm that is warm/hot in nature (竹茹)

旋覆代赭汤

This decoction is stronger than the one above. Let’s see why by looking at what it does:

1. building up the body with the emphasis on spleen qi (using 生姜、大枣 to 和中 while adding 人参、甘草 to 扶正)
2. strongly moving qi in a downward direction (旋覆花、代赭石、半夏)

We see here the obvious similiarity shared by both decoctions - the emphasis on building spleen qi.

The difference is on how it regulates the qi mechanism in the body. 旋覆花 and 半夏 both clear phlegm while moving qi downward (against the upward movement characterized by the action of vomitting. Research has been done showing that 半夏 inhibits vomiting by inhibit the vomiting center of the central nervous system. 代赭石 is (please note) used in small quantity here because it is a mineral (yes, a rock called haematite) that is able to suppress the central nervous system.

So it does seem that the herbs used here to regulate qi and clear phlegm are stronger than those used in 橘皮竹茹汤. Indeed, downward action seems to be the emphasis. One observes that this decoction probably interferes with your nervous system in an allopathic manner the way most pharmaceutical drugs do. That said, the inclusion of the four builders of spleen qi are probably there to mitigate any allopathic damage done.