（附梅 气）
噎者咽喉噎塞而不通。饮或可下。食则难食也。膈者。胃口隔截而不受。虽饮食暂下。
少顷
复吐。而不能容也。求其所以致病之由。要皆忧郁不开。思虑太过。忿怨不伸。或惊恐时值
。变故屡遭。汲汲遑遑。无安宁之日。以致内气并结于上焦。而噎膈之症斯成矣。此皆处于
逆境者然耳。至于素享富贵之人。亦有是症者何哉。必因浓味所伤。酒色过度。虚火用事。
真阴消铄。以至血液干枯。顽痰胶固。结于咽喉之处。则成噎结。于胃口之处。则成膈。又
有不因酒色而得者。亦当以血枯痰腻。及气郁治之。但审其所得之由。及观其所
禀之浓薄。方可用药。如瘦人多火。其血亦干。亦有因火而生痰者。肥人多湿。其痰易结。
亦有因湿而生滞者。穷困之人多忧郁。经营之人多思虑。不得志之人多慎怨。遭变故之人多
惊恐。好酒之人多痰火。好色之人多积血。嗜味之人多宿食。使气之人多恼怒。当细审而治
之。不可以一端求也。又有所谓鼠噎者。见人即不食。背人即私食之。乃食鼠残中毒所致。
又岂可用一例治之乎。凡治此症。以开郁消痰。顺气润血为主斯。得窍妙矣。
(Attached: Plum Pit Qi)
Yi (choking sensation) refers to a feeling of blockage in the throat where food cannot pass. Drinking may sometimes go down, but eating is difficult. Ge (diaphragmatic obstruction) refers to the stomach area being blocked and unable to receive food. Although food may temporarily go down, it is vomited up after a short while and cannot be retained. To investigate the cause of this disease, it is generally due to unresolved depression, excessive worry, unexpressed resentment, or frequent encounters with frightening changes and misfortunes, leading to a state of constant anxiety without peace. This causes internal Qi to knot together in the Upper Jiao (Upper Burner), resulting in Yi-Ge syndrome. This typically occurs in those living in adverse circumstances. But why do people who have always enjoyed wealth and nobility also suffer from this? It must be due to injury from rich and heavy flavors, excess in alcohol and sexual activity, causing deficient fire to flare up, consuming and depleting True Yin, leading to dryness of blood and stubborn phlegm solidifying. When this knots in the throat, it becomes Yi-jie (choking knot); when it knots in the stomach opening, it becomes Ge (obstruction). Even for those not caused by alcohol or lust, treatment should still focus on dry blood, sticky phlegm, and Qi stagnation. However, one must carefully examine the cause of the illness and observe whether the patient's constitution is lean or plump before prescribing medication. For instance, lean people tend to have more fire, and their blood is also dry; there are cases where phlegm is generated by fire. Plump people tend to have more dampness, and their phlegm easily knots; there are cases where stagnation is generated by dampness. Poor people often suffer from depression, business-oriented people from excessive thinking, frustrated people from resentment, those encountering changes from fright, wine lovers from phlegm-fire, lustful people from accumulated blood, flavor-lovers from retained food, and irritable people from anger. Treatment must be carefully assessed based on these factors and cannot rely on a single approach. There is also what is called "Rat Yi," where the patient refuses to eat in front of others but eats secretly when alone, caused by poisoning from eating rat leftovers. How can such cases be treated with a uniform method? In treating this syndrome, the main principles are to relieve depression, resolve phlegm, regulate Qi, and nourish blood. Only then can the essence of treatment be achieved.
In cases of Qi deficiency, the pulse is necessarily slow and weak. In cases of Blood deficiency, the pulse is necessarily rapid and weak. In cases of Phlegm, the Cun and Guan positions are deep and slippery. In cases of Qi stagnation, the Cun and Guan positions are deep and choppy/stagnant.