BEFORE THE FIRST BITE / 第一口之前
Hypothetical Taylor: hungry, felt an urge to vomit before eating, no contents came up in the described episode. Request: “What needs checking, and how should I manage eating meanwhile?”
Describe: urge versus actual vomiting; before food/after something/waking you; approximate onset, other symptoms and actual medicines. Do not recreate symptoms or change medicine/food instructions yourself.
Blood/dark coffee-ground-like material in vomit or suspected poisoning -> emergency care. Sudden nausea with tight/heavy chest pain, spreading pain to arms/back/neck/jaw or shortness of breath -> emergency help.
Severe abdominal pain, headache OR stiff neck, vomiting longer than24hours, unable to keep ANY fluids down for12hours or more, or no urination for8hours or more -> immediate provider contact/medical care. These are source examples, not a complete triage algorithm or permission to wait with another urgent concern.
Recurrent nausea or no improvement in a few days -> medical advice. Optional notes do not delay a call. Existing clinical instructions stay in place.
Traditional upward stomach qi is a description in a vomiting lecture, not proof that pre-breakfast nausea is a cold pattern. No formula, dose or new regimen is supplied.
假设Taylor：饿了，第一口前想吐，这次没有吐出东西。请求：“需要检查什么，这期间怎样进食合适？”
说明想吐还是真吐、在进食前/某事之后/因此醒来，大约何时开始、其他症状和真实药物。不重演症状，不自行改药或随餐要求。
呕吐物带血或像咖啡渣的深色物质、怀疑中毒→急诊。突然恶心伴紧压沉重胸痛，向手臂背颈下颌扩散的疼痛，或呼吸困难→立即急救。
严重腹痛、头痛或颈僵；呕吐超过24小时；12小时或更久留不住任何液体；8小时或更久没有排尿→立即联系医疗人员或就医。资料例子不是完整急症算法，也不允许有其他紧急担忧时继续等待。
反复或几天不改善的恶心应医疗建议；可选记录不拖延电话，已有医嘱保留。
传统“胃气上逆”是在呕吐讲座中的描述，没有证明早餐前恶心是寒证。不提供方剂、剂量或新食谱。个人细节自行保存。