〔丹〕一男子年六十二岁，平居不能顿食，常喜频食。一日忽觉咽膈壅塞，大便结粪如羊矢，三四日一见，
走动倦乏，与补气药则作痛。医见食少，则与快肠胃消导之药。予脉之，两手俱见涩脉似真脏，喜其人形瘦而
色紫黑，病见乎冬，却有生意。遂于四物汤加白术、陈皮煎取浓汤，研桃仁十二粒，再煎沸饮之。多食诸般血
以助药力。三十帖而知，至五十帖而大便润，七十帖而食进，百帖而愈。
浦江男子年六十，自来好色虚甚，去秋患吐病，或有作时，或有止时，腹结微渴。
地黄（一钱） 人参（半钱） 白术（一钱） 黄芩（三分） 川芎（三分） 芍药（一钱） 当归 陈皮（各五
分）
枳壳（半分） 甘草（炙，二分） 木通（三分）
杨淳三哥，大便秘涩，咽塞不通，人参散主之。（方见大便秘门。）
〔洁〕浓朴丸治饮食噎塞。（方见翻胃。）
〔丹〕东阳王仲延，咽膈间常觉有物闷闷，每食物必屈曲自膈而下，且梗涩作微痛，食亦减，他无所苦。
予脉之，右甚涩而关甚沉，左却和。予曰∶污血在胃脘之口，气因而郁为痰，此必食物所致，明以告我。彼不
自觉。予又曰∶汝去冬好食何物为多？曰∶我每日必单饮点剁酒三两杯逼寒气。为制一方，用生韭汁半盏，令
细呷之，每服半盏，一日三次，尽韭二斤而安。
治膈噎。马剥儿，即王瓜，烧存性。每一钱，用枣肉平胃散二钱，温酒调服，食即可下。然后随病源调理，
神效。（枣肉平胃散方见《局方》。）
〔世〕治噎。鸡谷袋不问多少，不可失包内物一粒，用泥固济，火 存性。用姜汁炒香附每个入半两，香
附末神曲为丸，姜汤送下。
治气噎，不下饮食。
枇杷叶（去毛，炙） 青皮（去穣） 陈皮（去白）
上等分为末。每服二钱，水一盏，生姜五片．同煎至六七分，温服，不计时候。
治膈气噎不下饮食。用陈皮去白，不拘多少，用大蒜研细和丸，如绿豆大。每服二十丸至三十丸，温米饮
下，食后，日三服。
〔《金匮玉函》〕五噎心膈，气滞烦闷，吐逆，不下食，芦根五两锉，水三大盏，煮二盏，去渣温服。
〔罗〕汉防已散 治五噎。
汉防己（五钱） 官桂（一两） 细辛（七钱半） 陈皮（去白，一两） 羚羊角（末） 紫苏（各七钱半） 杏
仁（汤洗，去皮尖，一两）
上为细末。每服三钱，生姜三片，水煎，日二。
〔《本》〕治五种积气及五噎，胸膈不快，停痰宿饮，缠金丹。
丁香 木香 沉香 槟榔 官桂 胡椒 砂（研） 白丁香（各一钱） 白豆蔻 飞矾（各一钱，
研） 马兜铃 南星 五灵脂 栝蒌根 半夏（各半两） 朱砂（三钱，留半为衣）
上为细末，入二味研药和勺，生姜汁煮糊丸，如桐子大。每服三丸，生姜汤下，或干嚼萝卜汤下。
治气食忧劳思虑，五噎膈气丸。
麦门冬 甘草（各五钱） 人参（四钱） 桂心 细辛 川椒 远志（去心，炒。各三钱） 附子 干姜（各二钱）
上为末，炼蜜丸，如鸡豆大。绵裹二丸含化，食后日三、夜三服。胸中当热，七日愈。
治气食忧劳思虑，五噎膈气丸。
半夏 桔梗（各一两） 肉桂 枳壳（各两半）
上细末，姜汁面糊丸，如桐子大。姜汤下三十丸，食后临卧服。
〔无择〕《广五行记》永徽中有僧惟则，病噎不能食，谓诸弟子曰∶吾死后便可开吾胸喉，视有何物。自
经而卒。弟子果开视胸中，得一物形似鱼而有两头，遍体皆肉鳞。弟子置碗中，跳跃不止，戏以诸味，皆随化
尽。时夏中盛蓝作淀，适有一僧，以淀置器中，此虫遂绕器中走，须臾化为水。此乃虫瘕，非五噎比。后人因
以蓝治噎，误矣。
〔子和〕沈丘王宰妻，病胸膈不利，口流涎沫，自言咽下胃中常有雷声，心间时作微痛，又复发昏。胸乳
之间，灸瘢如棋。化痰利膈等药，服之三载，病亦依然。其家知戴人痰药不损，来求之。一涌而出雪白虫一条，
长五六寸，有口鼻牙齿，走于涎中。病者恶而断之，中有白发一茎。此正与徐文伯所吐宫人发瘕一同，虫
出立安。
运气 噎皆属燥。经云∶阳明司天之政，民病咳嗌塞。又云∶阳明之胜，内余嗌塞，胸中不便，嗌塞而咳。
又云∶阳明司天清复，内余噎塞者是也。
上按运气，皆以嗌塞生于燥。嗌塞者，噎病也。丹溪皆以噎病生于血槁，血槁则燥矣。得病情合经旨者，
丹溪一人也。
〔禹锡〕头垢治噎，酸浆水煎膏用之，立愈。
〔《圣》〕治膈气，咽喉噎塞，饮食不下。用碓觜上细糠，蜜丸如弹子大。不时含一丸，咽津下。
〔孙〕治噎欲发时，衔鸬 鸟嘴遂下。《外台秘要》同。
〔《圣》〕治噎病。用野狼结喉骨曝干，杵末，入半钱于饭、饮内食之，妙。
〔《摘》〕五噎。吞酸多唾，呕吐不止∶天突（五分，留三呼，得气即泻三吸）。通关（在中脘旁各五分，
针入八分，左捻能进饮食，右捻能和脾胃。许氏云∶此穴一针四效，凡下针后，良久觉脾磨食、觉针动为一效。
次针破病根，腹中作声为二效。次觉流入膀胱为三效。又次觉气流行腰后骨空间为四效。）
〔《撮》〕治五噎∶ 中 中魁（中指大三节尖灸之，以口吹火灭。）
〔甄权〕噎塞膈气∶通谷
〔《明堂》〕五噎分治∶气噎， 中。忧噎，心 （灸。）食噎，乳根（乳左下一寸八分，灸。）劳噎，鬲 （灸）。
思噎，天府（灸）。
〔《集》〕五噎∶劳宫、中魁、中脘、三里、太阴、支沟、上脘（不已，再取后穴∶） 中、太白、下脘、右关、
脾、胃 。
〔仲〕寸口脉浮大，医反下之，此为大逆。浮即无血，大即为寒，寒气相搏，即为肠鸣。医不知，而反与
饮水，令汗大出，水得寒气，冷必相搏，其人即 。
〔《脉》〕寸口脉紧而芤 紧则为寒，芤则为虚，虚寒相搏，脉为阴结而迟，其人则噎。
[Case by Zhu Danxi] A sixty-two-year-old man, who usually could not eat a full meal at once, often preferred frequent small meals. One day, he suddenly felt a blockage in the throat and chest diaphragm, with dry stools resembling sheep dung, defecating only once every three to four days. He felt fatigued when walking, and taking Qi-tonifying herbs caused pain. Seeing his poor appetite, the physician prescribed herbs to promote gastrointestinal digestion and resolve stagnation. Upon palpating his pulse, I found both hands exhibiting a choppy pulse (Se Mai), resembling a true organ pulse (Zhen Zang Mai - a pulse indicating loss of stomach Qi). However, I noted that he was thin with a purplish-black complexion, the disease manifested in winter yet showed signs of vitality. Thus, I used Siwu Tang (Four Substances Decoction) added with Baizhu (Atractylodis Rhizoma) and Chenpi (Citri Reticulatae Pericarpium), decocted to obtain a concentrated liquid. Twelve Tao Ren (Persicae Semen) kernels were ground and added back to boil before drinking. He was advised to consume various blood-based foods to assist the medicinal power. After thirty doses, symptoms improved; after fifty doses, bowel movements became moist; after seventy doses, appetite increased; and after one hundred doses, he recovered.
A sixty-year-old man from Pujiang, who had always indulged in sexual activity leading to extreme deficiency, suffered from vomiting last autumn. The condition came and went intermittently, accompanied by abdominal stagnation and slight thirst.
Prescription: Dihuang (Rehmanniae Radix, 1 qian), Renshen (Ginseng Radix, 0.5 qian), Baizhu (Atractylodis Rhizoma, 1 qian), Huangqin (Scutellariae Radix, 0.3 qian), Chuanxiong (Ligustici Chuanxiong Rhizoma, 0.3 qian), Shaoyao (Paeoniae Radix, 1 qian), Danggui (Angelicae Sinensis Radix), Chenpi (Citri Reticulatae Pericarpium, each 0.5 fen), Zhike (Aurantii Fructus Immaturus, 0.5 fen), Gancao (Glycyrrhizae Radix et Rhizoma, roasted, 0.2 fen), Mutong (Akebiae Caulis, 0.3 fen).
Yang Chun's third brother suffered from constipation and dryness, with a blocked throat. He was treated with Renshen San (Ginseng Powder). (Formula see section on Constipation.)
[Li Dongyuan] Nongpo Wan (Magnolia Bark Pill) treats food dysphagia. (Formula see section on Fanwei/Regurgitation.)
[Case by Zhu Danxi] Wang Zhongyan from Dongyang often felt a sense of oppression in the throat and diaphragm. Every time he ate, food had to pass through a tortuous path below the diaphragm, causing slight pain and reduced intake, with no other discomfort. Palpating his pulse, I found the right hand very choppy and the Guan position very deep, while the left hand was harmonious. I said, "This is stagnant blood lodged at the entrance of the stomach, causing Qi stagnation and transformation into phlegm. This must be caused by food. Please tell me clearly." He was unaware. I asked again, "What did you eat most of last winter?" He replied, "I drank three or two cups of chopped wine daily to drive out cold qi." So I formulated a prescription using half a zhan of fresh Chinese chive juice, instructing him to sip it slowly, half a zhan per dose, three times a day. After consuming two jin of chives, he recovered.
Treatment for Ge Ye (Diaphragmatic Dysphagia). Ma Bo Er (Guarea thompsonii fruit, also known as Wang Gua), calcined until carbonized. One qian mixed with Er Rou Pingwei San (Jujube Flesh and Stomach-Ping Powder, 2 qian), taken with warm wine, allowing food to go down easily. Then regulate according to the disease source for miraculous effect. (Er Rou Pingwei San formula see *Ju Fang*).
[Popular Prescription] Treatment for Ye. Ji Nei Jin (Galli Gigerii Endothelium Corneum), regardless of quantity, ensuring no particle is lost inside the wrapping. Seal with mud and calcine. Stir-fry Xiangfu (Cyperi Rhizoma) with ginger juice, adding half a liang per piece. Mix Xiangfu powder with Shenqu (Medicated Leaven) to make pills, taken with ginger soup.
Treatment for Qi Ye (Qi-type Dysphagia), inability to eat or drink.
Prescription: Pipa Ye (Loquat Leaf, de-haired, roasted), Qingpi (Tangerine Peel, pith removed), Chenpi (Tangerine Peel, white part removed).
Grind equal parts into fine powder. Take 2 qian per dose with one cup of water and five slices of ginger, decoct to 60-70%, take warm, anytime.
Treatment for Ge Qi Ye (Diaphragmatic Qi Dysphagia), inability to eat or drink. Use Chenpi (white part removed), any amount, mix with finely crushed garlic to make pills the size of mung beans. Take 20-30 pills per dose with warm rice wash, after meals, three times daily.
[*Jin Gui Yu Han Jing*] Treats Wu Ye (Five Types of Dysphagia) with chest/diaphragm Qi stagnation, irritability, retching, and inability to eat. Lu Gen (Imperatae Rhizoma, 5 liang) cut up, decocted in three large cups of water to two cups, strain and take warm.
[Luo Tianyi] Han Fang Ji San (Stephania Tetrandra Powder) treats Wu Ye.
Prescription: Han Fangji (Stephaniae Tetrandrae Radix, 5 qian), Guanzi Gui (Cinnamomi Cortex, 1 liang), Xixin (Asari Radix et Rhizoma, 7.5 qian), Chenpi (Citri Reticulatae Pericarpium, white part removed, 1 liang), Lingyang Jiao (Saigae Tataricae Cornu, powdered), Zisu (Perillae Folium, each 7.5 qian), Xingren (Armeniacae Semen Amarum, washed in hot water, skin and tip removed, 1 liang).
Grind into fine powder. Take 3 qian per dose with three slices of ginger, decocted in water, twice daily.
[*Ben Cao*] Treats five types of accumulated Qi and Wu Ye, chest/diaphragm discomfort, retained phlegm and old fluid retention. Chan Jin Dan (Entangled Golden Pill).
Prescription: Dingxiang (Caryophylli Flos), Muxiang (Aucklandiae Radix), Chenxiang (Aquilariae Lignum Resinatum), Binglang (Arecae Semen), Guanzi Gui (Cinnamomi Cortex), Hujiao (Piperis Longi Fructus), Sha (Borneolum Syntheticum, ground), Baidingxiang (Vermisapis Faeces, each 1 qian), Bairdoukou (Cardamomi Fructus), Feifan (Alumen, each 1 qian, ground), Madouling (Aristolochiae Radix), Nanxing (Arisaematis Rhizoma), Wulingzhi (Trogopterori Faeces), Gualougen (Trichosanthis Radix), Banxia (Pinelliae Rhizoma, each half liang), Zhusha (Cinnabaris, 3 qian, half reserved for coating).
Grind into fine powder, mix the two ground ingredients, use ginger juice to make paste pills the size of paulownia seeds. Take 3 pills per dose with ginger soup, or chew dry with radish soup.
Treatment for Wu Ye Ge Qi (Five Types of Dysphagia and Diaphragmatic Qi) caused by Qi, Food, Worry, Labor, and Overthinking.
Prescription: Maimendong (Ophiopogonis Radix), Gancao (Glycyrrhizae Radix et Rhizoma, each 5 qian), Renshen (Ginseng Radix, 4 qian), Guixin (Cinnamomi Ramulus), Xixin (Asari Radix et Rhizoma), Chuanjiao (Zanthoxyli Pericarpium), Yuanzhi (Polygalae Radix, heart removed, roasted, each 3 qian), Fuzi (Aconiti Lateralis Radix Praeparata), Ganjiang (Zingiberis Rhizoma, each 2 qian).
Grind into powder, refine honey to make pills the size of chicken beans. Wrap two pills in silk and let dissolve in mouth. Take three times after meals and three times before bed. Chest should feel warm; cured in seven days.
Treatment for Wu Ye Ge Qi (Five Types of Dysphagia and Diaphragmatic Qi) caused by Qi, Food, Worry, Labor, and Overthinking.
Prescription: Banxia (Pinelliae Rhizoma), Jiegeng (Platycodonis Radix, each 1 liang), Rougui (Cinnamomi Cortex), Zhike (Aurantii Fructus Immaturus, each half liang).
Grind into fine powder, use ginger juice and flour paste to make pills the size of paulownia seeds. Take 30 pills with ginger soup, after meals and before bed.
[Wuze] *Guang Wu Xing Ji* records that during the Yonghui era, a monk named Weize suffered from dysphagia and could not eat. He told his disciples, "After my death, open my chest and throat to see what is there." He then hanged himself. The disciples indeed opened his chest and found an object resembling a fish with two heads, covered entirely in fleshy scales. Placed in a bowl, it jumped incessantly. When offered various flavors, it dissolved. In midsummer, when indigo was being made, a monk placed indigo dye in a vessel. The worm ran around the vessel and soon turned into water. This was a Chong Xia (Parasitic Mass), not comparable to Wu Ye. Later people mistakenly used indigo to treat dysphagia based on this.
[Case by Zhang Hezi] The wife of Wang Zai, magistrate of Shenqiu, suffered from chest/diaphragm obstruction, salivation, claiming thunderous sounds in the stomach upon swallowing, occasional mild heart pain, and fainting. Her chest and breasts were marked with moxibustion scars like chess pieces. She took phlegm-resolving and diaphragm-clearing medicines for three years with no improvement. Her family knew that Dai Ren's (Zhang Hezi's courtesy name) phlegm medicines did not harm the healthy Qi, so they sought his help. He induced vomiting, expelling a snow-white worm, five to six cun long, with mouth, nose, and teeth, crawling in the saliva. The patient disgustedly cut it, finding a single white hair inside. This was exactly like the Hair Xia (Hair Mass) vomited by Xu Wenbo from a palace maid. Once the worm was expelled, she was immediately at peace.
Physiological Factors (Yunqi) All cases of Ye belong to Dryness. The classics state: "When Yangming governs the heaven, the people suffer from cough and throat obstruction." Again: "When Yangming prevails, there is excess internal throat obstruction, chest discomfort, throat obstruction with cough." Again: "When Yangming governs the heaven and clarity returns, internal excess causes throat obstruction."
Based on the above analysis of physiological factors, all throat obstructions arise from Dryness. Throat obstruction is Ye disease. Danxi believed all Ye diseases arose from Blood Desiccation; desiccated blood leads to dryness. Among them, only Danxi matched the classic principles with the actual condition.
[Yuxi] Head scurf treats Ye disease. Decoct in sour spring water to make a paste, apply/use for immediate cure.
[*Sheng Ji Zong Lu*] Treats Ge Qi, throat obstruction, inability to eat or drink. Use fine bran from the pestle head, make honey pills the size of bullet shots. Hold one pill in mouth occasionally, swallow saliva to guide it down.
[Sun Simiao] When Ye disease is about to onset, hold an cormorant's beak in the mouth, then swallow. Same view in *Waitai Miyao*.
[*Sheng Ji Zong Lu*] Treats Ye disease. Sun-dry the laryngeal bone of a wild wolf, grind to powder. Take half a qian mixed with rice or drink, excellent effect.
[*Zisheng Jing*] Wu Ye. Acid regurgitation with excessive saliva, continuous vomiting: Tiantu (ST22, insert 0.5 cun, retain needle for three breaths, upon obtaining De Qi, reduce needle for three breaths). Tongguan (0.5 cun lateral to Zhongwan, insert 0.8 cun. Twisting left promotes eating; twisting right harmonizes spleen and stomach. Xu says: This point has four effects from one insertion. First, after some time, feeling the spleen grinding food and feeling the needle move. Second, piercing the root of the disease, hearing sounds in the abdomen. Third, feeling flow into the bladder. Fourth, feeling Qi circulate in the space behind the lumbar bones.)
[*Yixue Rumeng*] Treats Wu Ye: Zhongkui (Moxibustion on the tip of the third joint of the middle finger, extinguish fire by blowing.)
[Zhen Quan] Ye Se Ge Qi: Tonggu (KI10).
[*Mingtang*] Differentiated treatment for Wu Ye: Qi Ye, Zhongwan (CV12). You Ye, Xinshu (BL15, moxa). Shi Ye, Rugen (ST18, 1.8 cun below nipple, moxa). Lao Ye, Ge Shu (BL17, moxa). Si Ye, Tianfu (LU3, moxa).
[*Zhenjiu Ju Ying*] Wu Ye: Laogong (PC8), Zhongkui, Zhongwan (CV12), Sanli (ST36), Taiyin (SP6?), Zhigou (SJ6), Shangwan (CV13). If not cured, take subsequent points: Zhong, Taibai (SP3), Xiawan (CV10), Youguan, Pishu (BL20), Weishu (BL21).
[Zhang Zhongjing] Cun Kou pulse floating and large. If the physician incorrectly uses purgation, this is a great error. Floating indicates lack of blood; large indicates cold. Cold Qi combats, resulting in borborygmus. The physician, unaware, gives water, causing profuse sweating. Water meets cold Qi, cold combats, resulting in Pi syndrome (fullness/stagnation).
[*Mai Jing*] Cun Kou pulse tight and hollow. Tight indicates cold; hollow indicates deficiency. Deficiency and cold combat, the pulse becomes Yin knot and slow, the person suffers from Ye.