脉寸口浮大，按之反涩，尺中亦微而涩，宿食也。
脉寸口如转索而紧，宿食也。
脉滑而数者，宿食也，当下之。
又浮而滑者，宿食也；脉沉，病若伤寒者，宿食留饮，当下之。
下利不欲食者，宿食。
脉短而滑酒病。脉浮而细滑者伤饮。
宿食状
千金云，胃中有辟食冷物则痛，不能食，有热物则欲食。
大腹有宿食，则寒凛如疟发热状；小腹有宿食，即暮发热，明旦复止。
又有云，病宿食则头痛、恶风增寒，心腹胀满下利，不欲食，吞酸噫气腐
气，或腹胀泄泻，及四肢浮肿。若胃实寒，食反留滞，其脉滑而数，宜下之愈；
若虚，其脉浮大，按之反涩，尺中亦微涩，宜温消之。
痰饮状
或咳、或喘、或呕、或泄、晕眩、 烦、悸忪、 KT 、寒热、疼痛、肿满、
挛癖、癃闭、痞膈、如风、如颠。
悬饮者 饮水留在胁下，咳唾引痛（治法当下）。
溢饮者 饮流于四肢，当汗不汗，身体疼痛（法当汗）。
支饮者 咳逆倚息、短气不得卧，其形如肿（随证汗下之）。
痰饮者 其人素盛今瘦，肠间漉漉有声（宜治湿从小便去之）。
留饮者 背寒如手大，或短气而渴，四肢历节疼，胁下痛引缺盆。
伏饮者 膈满喘咳，呕吐，发则寒热、腰背痛，目泪恶寒，振振然。
李论 饮食肠胃乃伤，复加之，则胃化迟难，故宿食饮留。
食者物也，有形之血也，因而饱食，筋脉横解肠为重，或呕、或吐、或下
利，甚则心胃大痛，犯其血也。宜分寒热轻重而治之。如初得，上部有脉，下部
无脉，其人当吐，不吐者死。宜瓜蒂散吐之。轻则内消宿食，缩砂、神曲是也；
重则除下，承气类也；寒则温之，半夏、干姜、山棱、莪术等也；热则寒之，大
黄、黄连、枳实、麦 等也。
饮者水也，无形之气也，因而大饮则气逆，形寒饮冷则伤肺，病则为咳、
满、水泄；重而为蓄积。轻者，宜取汗、利小便，使上下分消其湿，解醒汤、
五苓、半夏、术、壳之类是也；重者三花神 等也。又一云∶凡伤西瓜、冷水、
羊乳寒湿之物
白术（二钱） 川乌（二钱） 防己（一钱） 丁香 甘草（各五分）
凡伤羊肉、湿面湿热之物∶白术 连（一钱） 大黄（二钱） 甘草 以上二证，腹痛
白芍药（一钱）；心下痞加枳实；腹胀加浓朴；胸中不利加枳壳；胸中寒加陈皮；渴
者加茯苓；腹中闷加苍术；及体沉重加酲术。大抵伤冷物巴豆为君，伤热物大黄为君。
张论
饮食不消，分贫富而治之。富者乃膏粱太过，以致中脘停留，胀闭痞隔，
酸心，宜木香导饮丸主之。贫者饮食粗，动作劳，酒食伤之，以致心腹满闷，时
吐酸水，宜进食丸主之。又重者，证太阳伤寒，止脉沉，宜导饮丸治之。
又论留饮，蓄水而已，虽有四有五之说，止一证也。夫郁愤而不伸，则肝气
乘脾，脾气不濡，亦为留饮。肝主虑，久不决则饮气不行；脾主思，久则脾
结，亦为留饮。乘困饮水，脾胃失衰不能布散，亦为留饮。饮酒过多，胞经
不及渗泄，亦为留饮。渴饮冷水，乘快过多，逸而不动，亦为留饮。
夫水者，阴物也。但积水则生湿；停酒则发燥，久则成痰。在左胁同肥气；
在右胁同息贲。上入肺则喘；下入大肠则泻；入肾则涌水；在太阳为支饮。皆由
气逆得之。故湿在上者面浮目黄；在下者股膝肿满；在中者，支饮痞鬲痰逆。在
阳不去，久而化气；在阴不去，久而成形。宜治以导水如禹功，调以五苓、
葶苈、椒目逐水为全矣。
刘用槟榔丸 治伤之轻，饮食不化，心腹膨。
槟榔 木香（各一钱） 陈皮（八钱） 牵牛（头）
上醋糊丸，姜汤下二十丸。
雄黄丸 治伤之重，腹胁虚胀。
雄黄（一两另研） 巴豆（五钱生用）
丸治法同心痛条下。
瓜蒂散 吐心腹卒痛闷乱急剂。
瓜蒂 赤小豆（各三钱）
上为末，每一钱，温水下。
枳术丸 治伤食。
枳实（半两） 白术（一两）
□闷加曲 ；滞气加槟榔、木香、青皮；伤湿热加大黄、黄连、黄芩；
湿加萝卜子；热加连；伏湿痞闷加茯苓、泽泻；病后食伤加栀子粉湿面油腻加
豆粉半夏；伤冷硬加草豆蔻、棱、莪术；伤水加干姜；心胃痛加宿砂、丁香；
□□加人参半夏。
解酲汤 治伤酒。
白豆蔻 宿砂 生姜 葛花（各一半两） 木香（五分） 茯苓 陈皮（去白） 猪
苓（去皮） 人参 白术（各钱半） 青皮（三钱） 炒曲 泽泻（各三钱）
上为末，白汤下。
秘方 治胸中有物恶食。
二陈汤加白术 山楂 川芎 苍术 神曲（炒）
□□□ 治留饮悬饮脉弦。又治脉伏，其人欲自利，难利，心下续筑
满，此为留饮欲去故也。
茯苓、桂术甘草汤 治心下有痰饮，胸胁肢满目眩。
大青龙汤 治溢饮体疼当发其汗。
麻黄（七钱半） 桂枝 甘草（各二钱） 杏仁 石膏（鸡子大） 半夏（续加）
泽泻汤 治心下有支饮，其人苦冒眩。支饮不得息，加葶苈大枣。
朴黄汤 治支饮胸满。
浓朴 大黄
二陈汤 小半夏汤 治呕家本渴，今反不渴，心下有支饮。治先渴却
呕，水停心下，属饮也，加茯苓。
五苓散 治瘦人脐下有悸，吐涎沫而颠眩，水也，亦治停痰宿水。
破钡丸 治五饮结为 瘕，支饮胸满吐逆，心痛大能散气。
以拨 胡椒 丁香 宿砂 青皮 乌梅 木香 蝎梢 巴豆（去油）
以青皮同巴豆，浆水渍一宿，漉出，同炒，青皮焦，去豆不用，渍浆
水淹乌梅肉，炊一熟饭，研细为膏，姜汤下五七丸。
控涎丹 治胃胸背手脚头项腰胯隐痛不忍，连筋骨牵钩痛，坐卧不
宁，时时走易。
甘遂 大戟 白芥子（真者） 糊为丸。
Pulse at the Cun Kou (radial artery) is floating and large, but pressing deeply reveals a choppy texture; the Chi pulse (distal radial artery) is also faint and choppy. This indicates retained food (food stagnation).
The pulse at the Cun Kou feels tight and forceful like a turning rope. This indicates retained food.
A slippery and rapid pulse indicates retained food; purgative treatment should be applied.
Additionally, a floating and slippery pulse indicates retained food; if the pulse is deep and the symptoms resemble Taiyang cold damage, this indicates retained food combined with fluid retention (accumulation of pathological fluids); purgative treatment should be applied.
Diarrhea accompanied by anorexia indicates retained food.
A short and slippery pulse indicates alcohol-induced pathology. A floating, fine, and slippery pulse indicates injury from drinking water/fluids.
Manifestations of Retained Food:
*Qianjin Fang* states that if cold substances are ingested into the stomach, pain occurs and eating is impossible; if hot substances are present, there is a desire to eat.
If retained food is in the large abdomen, chills resembling malaria and fever occur; if retained food is in the small abdomen, fever occurs in the evening and subsides by morning.
It is also said that retained food disease presents with headache, aversion to wind with increased chills, abdominal distension and fullness, diarrhea, anorexia, acid regurgitation, belching with a putrid odor, abdominal distension with diarrhea, or edema of the four limbs. If the stomach is solid-cold causing food stagnation, the pulse is slippery and rapid; purgatives are suitable for cure. If it is a deficiency pattern, the pulse is floating and large, choppy upon pressure, and faint/choppy at the Chi position; warming and resolving methods are suitable.
Manifestations of Phlegm-Fluids:
Symptoms may include cough, asthma, vomiting, diarrhea, vertigo, irritability, palpitations, fright, alternating chills and fever, pain, swelling and fullness, tendon spasms and masses, strangury and urinary obstruction, chest/epigastric stuffiness, sensations resembling wind-stroke or mania.
Xuan Yin (Hanging Fluid): Water/fluid remains under the hypochondrium, causing pain upon coughing and spitting (Treatment: Purge).
Yi Yin (Overflowing Fluid): Fluid flows into the four limbs; sweating should occur but does not, causing body pain (Treatment: Induce sweating).
Zhi Yin (Supporting Fluid): Coughing with air hunger, leaning on objects to breathe, shortness of breath preventing lying flat, appearance resembling edema (Treatment: Sweat or purge according to syndrome).
Tan Yin (Phlegm-Fluid): The patient was formerly robust but is now emaciated; gurgling sounds are heard in the intestines (Treatment: Resolve dampness via urination).
Liu Yin (Stagnant Fluid): Cold sensation on the back the size of a hand, or shortness of breath with thirst, pain in the four limbs and joints, pain under the hypochondrium radiating to the Quren point.
Fu Yin (Hidden Fluid): Fullness in the diaphragm, wheezing, cough, vomiting; upon attack, chills and fever, lower back pain, tearing, aversion to cold, trembling.
Li Dongyuan’s Discussion: Diet injures the intestines and stomach; further aggravation leads to slow gastric transformation, resulting in retained food and fluid stagnation.
Food is tangible matter, belonging to tangible blood (here referring to tangible substances). Overeating causes tendons and vessels to relax and intestines to become heavy, leading to vomiting, eructation, or diarrhea. Severe cases cause severe heart and stomach pain, injuring blood and qi. Treatment must distinguish between cold and heat severity. In early stages, if the upper pulse exists but the lower pulse is absent, the patient should vomit; failure to vomit leads to death. Genti San (Thistle Powder) is suitable for inducing vomiting. For mild cases, internal resolution of retained food uses Sha Ren (Amomum Fruit) and Shen Qu (Medicated Leaven); for severe cases, downward expulsion uses Chengqi Tang formulas; for cold patterns, warming agents like Ban Xia (Pinellia Tuber), Gan Jiang (Dried Ginger), San Leng (Burreed Rhizome), and E Zhu (Curcuma Rhizome) are used; for heat patterns, cooling agents like Da Huang (Rhubarb Root), Huang Lian (Coptis Rhizome), Zhi Shi (Immature Bitter Orange), and Mai Dong (Ophiopogon Tuber) are used.
Drinking fluids involves intangible Qi. Excessive drinking causes Qi rebellion; cold exposure and cold drinks injure the Lung, causing cough, fullness, and watery diarrhea; severe cases lead to accumulation. Mild cases benefit from sweating and promoting urination to disperse dampness upward and downward, using Jie Cheng Tang (Resolve Intoxication Decoction), Wu Ling San (Five-Ingredient Powder with Poria), Ban Xia, Bai Zhu (Atractylodes Macrocephala Rhizome), and Zhi Ke (Bitter Orange). Severe cases use San Hua Shen You Wan (Three-Flower Divine Expulsion Pill). Another view: Injury from cold-damp substances like watermelon, cold water, or sheep milk can be treated with: Bai Zhu (2 qian), Chuan Wu (Aconite Root), Fang Ji (Stephania Root), Ding Xiang (Clove), and Gan Cao (Licorice Root) (each 0.5 qian).
Injury from warm-damp substances like mutton or wet dough: Bai Zhu, Huang Lian (1 qian), Da Huang (2 qian), Gan Cao. For abdominal pain, add Bai Shao Yao (White Peony Root, 1 qian); for epigastric stuffiness, add Zhi Shi; for abdominal distension, add Hou Po (Magnolia Bark); for chest discomfort, add Zhi Ke; for chest cold, add Chen Pi (Tangerine Peel); for thirst, add Fu Ling (Poria); for abdominal heaviness, add Cang Zhu (Atractylodes Lancea Rhizome); for general heaviness, add fried Bai Zhu. Generally, for cold injuries, Ba Dou (Croton Seed) is the sovereign herb; for heat injuries, Da Huang is the sovereign herb.
Zhang Yuansu’s Discussion:
Indigestion is treated differently based on wealth. The wealthy suffer from excessive rich foods, causing stagnation in the Zhong Wan (Middle Epigastrium), distension, obstruction, stuffiness, and acid reflux; Mu Xiang Dao Yin Wan (Costus Guiding Drink Pill) is indicated. The poor consume coarse food and labor hard, suffering alcohol and food injury causing abdominal fullness and frequent acid regurgitation; Jin Shi Wan (Advance Food Pill) is indicated. Severe cases presenting as Taiyang cold damage with only a deep pulse are treated with Dao Yin Wan.
Regarding stagnant fluid, although there are theories of Four and Five Fluids, it is essentially one syndrome. Depression and frustration cause Liver Qi to invade the Spleen, leading to Spleen Qi deficiency and stagnant fluid. The Liver governs planning; prolonged indecision stops fluid Qi. The Spleen governs thought; prolonged thinking causes Spleen knotting and stagnant fluid. Drinking while fatigued, when Spleen/Stomach are weak and cannot distribute fluids, causes stagnant fluid. Excessive drinking prevents Bladder meridians from excreting, causing stagnant fluid. Drinking cold water excessively while active, followed by inactivity, causes stagnant fluid.
Water is Yin pathogen. Accumulated water generates dampness; stored wine generates dryness, eventually transforming into phlegm. In the left hypochondrium, it resembles Fei Qi (Fat Qi); in the right hypochondrium, it resembles Xi Ben (Breathing Burden). Ascending to the Lung causes wheezing; descending to the Large Intestine causes diarrhea; entering the Kidney causes Yong Shui (Surging Water); in the Taiyang channel, it is Zhi Yin. All result from Qi rebellion. Dampness above causes facial edema and yellow eyes; below causes thigh/knee swelling; in the middle causes Zhi Yin, stuffiness, and phlegm reversal. If Yang pathogen persists, it transforms into Qi over time; if Yin pathogen persists, it forms physical masses. Treatment should guide water like Yu Gong San, regulating with Wu Ling San, Ting Li Zi (Descurainia Seed), and Jiao Mu (Sichuan Pepper Seed) to expel water.
Liu Wansu’s Bing Lang Wan: Treats mild injury, indigestion, and abdominal distension.
Bing Lang (Areca Seed), Mu Xiang (Costus Root) (each 1 qian), Chen Pi (Tangerine Peel, 8 qian), Qian Niu (Morning Glory Seed, head powder).
Make pills with vinegar paste, take 20 pills with ginger decoction.
Xiong Huang Wan: Treats severe injury, empty distension of abdomen and hypochondrium.
Xiong Huang (Realgar, 1 liang, separately ground), Ba Dou (Croton Seed, 5 qian, raw).
Pill preparation follows the method under Heart Pain section.
Genti San: Emergency emetic for sudden heart/abdominal pain and confusion.
Genti (Thistle Fruit), Chi Xiao Dou (Red Adzuki Bean) (each 3 qian).
Powder, take 1 qian with warm water.
Zhi Zhu Wan: Treats food injury.
Zhi Shi (Immature Bitter Orange, 0.5 liang), Bai Zhu (1 liang).
For chest stuffiness, add Shen Qu; for Qi stagnation, add Bing Lang, Mu Xiang, Qing Pi (Green Tangerine Peel); for damp-heat injury, add Da Huang, Huang Lian, Huang Qin (Scutellaria Root); for dampness, add Luo Bo Zi (Radish Seed); for heat, add Huang Lian; for hidden dampness/stuffiness, add Fu Ling, Ze Xie (Alisma Rhizome); for post-illness food injury, add Zhi Zi (Gardenia Fruit) powder; for oily/wet dough injury, add Dou Fen (Bean Starch), Ban Xia; for cold/hard food injury, add Cao Dou Kou (Grass Cardamom), Leng, E Zhu; for water injury, add Gan Jiang; for heart/stomach pain, add Su Sha (Sand Amomum), Ding Xiang; [missing characters] add Ren Shen (Ginseng Root), Ban Xia.
Jie Cheng Tang: Treats alcohol intoxication.
Bai Dou Kou (White Cardamom), Su Sha, Sheng Jiang (Fresh Ginger), Ge Hua (Kudzu Flower) (each 0.5 liang), Mu Xiang (0.5 qian), Fu Ling, Chen Pi (de-white), Zhu Ling (Polyporus), Ren Shen, Bai Zhu (each 1.5 qian), Qing Pi (3 qian), Chao Qu (Fried Medicated Leaven), Ze Xie (each 3 qian).
Powder, take with boiling water.
Secret Recipe: Treats foreign body sensation in chest and anorexia.
Er Chen Tang (Two-Aged Decoction) plus Bai Zhu, Shan Zha (Hawthorn Fruit), Chuan Xiong (Sichuan Lovage Rhizome), Cang Zhu, Shen Qu (fried).
[Missing Characters]: Treats Liu Yin and Xuan Yin with wiry pulse. Also treats hidden pulse where the patient desires spontaneous diarrhea but finds it difficult, with continuous pounding/fullness in the epigastrium; this indicates stagnant fluid attempting to exit.
Fu Ling Gui Zhu Gan Cao Tang: Treats phlegm-fluid in the heart region, causing chest/hypochondriac/limb/eye vertigo.
Da Qing Long Tang: Treats Yi Yin with body pain, requiring sweating.
Ma Huang (7.5 qian), Gui Zhi (Cinnamon Twig), Gan Cao (each 2 qian), Xing Ren (Apricot Seed), Shi Gao (Gypsum, egg-sized), Ban Xia (add later).
Ze Xie Tang: Treats Zhi Yin in the heart region, causing severe vertigo/dizziness. For Zhi Yin causing breathing difficulty, add Ting Li Zi and Da Zao (Jujube).
Pu Huang Tang: Treats Zhi Yin with chest fullness.
Hou Po, Da Huang.
Er Chen Tang, Xiao Ban Xia Tang: Treats patients who usually thirst after vomiting but now do not, indicating Zhi Yin in the heart region. Treats initial thirst followed by vomiting due to water stopping in the heart region (fluid pathogen); add Fu Ling.
Wu Ling San: Treats thin individuals with palpitations below the umbilicus, salivation, and dizziness due to water pathogen; also treats retained phlegm and old water.
Po Bei Wan (Likely typo for Po Kuai Wan or similar): Treats five fluids结 (knotting) into masses, Zhi Yin with chest fullness/vomiting, heart pain; disperses Qi.
[Yi Bo - likely missing herb name], Hu Jiao (Pepper), Ding Xiang, Su Sha, Qing Pi, Wu Mei (Mume Fruit), Mu Xiang, Xie Shao (Scorpion Tail), Ba Dou (de-oiled).
Soak Qing Pi with Ba Dou in fermented grain water overnight, drain, stir-fry together until Qing Pi is scorched, discard Ba Dou. Soak Wu Mei meat in fermented grain water, steam with cooked rice, grind to paste, take 5-7 pills with ginger decoction.
Kong Xian Dan: Treats hidden pain in stomach, chest, back, hands, feet, head, neck, waist, and hips that is unbearable, radiating to bones/tendons, restlessness, migrating pain.
Gan Suan (Euphorbia Root), Da Ji (Spurge Root), Bai Jie Zi (Mustard Seed, authentic), make pills with paste.