经义
人以水谷为本，故人绝水谷则死。○食气入胃，散精于肝，淫气于筋。食气入胃，浊气归心，淫精于脉，
脉气流经，经气归于肺，肺朝百脉，输精于皮毛；毛脉合精，行气于元腑，腑精神明，留于四脏，气归于权衡。
饮入于胃，游溢精气，上输于脾，脾气
散精，上归于肺，通调水道，下输膀胱；水精四布，五经并行。○食入于阴，长气于阳。○饮食自倍，肠胃乃伤。
○水谷之邪气感，则害于六腑。○胃者，水谷之海，六腑之大源也。五味入口，藏于胃，以养五脏气。○五味
入胃，各归所喜。故酸先入肝，苦先入心，甘先入脾，辛先入肺，咸先入肾。久而增气，物化之常也。气增而久，
夭之由也。○肝色青，宜食甘，粳米、牛肉、枣、葵皆甘。心色赤，宜食酸，小豆、犬肉、李、韭皆酸。肺色
白，宜食苦，麦、羊肉、杏、薤皆苦。脾色黄，宜食咸，大豆、豕肉、栗、藿皆咸。肾色黑，宜食辛，黄黍、
鸡肉、桃、葱皆辛。辛散，酸收，甘缓，苦坚，咸软。毒药攻邪，五谷为养，五果为助，五畜为益，五菜为充，
气味合而服之，以补精益气。○辛走气，气病无多食辛；咸走血，血病无多食咸；苦走骨，骨病无多食苦；
甘走肉，肉病无多食甘；酸走筋，筋病无多食酸。○阴之所生，本在五味；阴之五宫，伤在五味。味过于酸，
肝气以津，脾气乃绝；味过于咸，大骨气劳，短肌，心气抑；味过于甘，心气喘满，色黑，肾气不衡；味过于
苦，脾气不濡，胃气乃浓；味过于辛，筋脉沮弛，精神乃央。○多食咸，则脉凝泣而变色；多食苦，则皮槁而
毛拔；多食辛，则筋急而爪枯；多食酸，则肉胝KT 而唇揭；多食甘，则骨痛而发落。（《素问》）
帝曰∶怯士之得酒，怒不避勇士者，何脏使然？少俞曰∶酒者，水谷之精，熟谷之液也；其气 悍，其入
于胃中则胃胀，气上逆满于胸中，肝浮胆横；当是之时，固比于勇士，气衰则悔，名曰酒悖也。（《灵枢》）
哲言
《经》云∶水谷之寒热感则害于六腑。又云∶阴气者，静则神藏，躁则消亡。饮食自倍，肠胃乃伤。此乃
浑言之也。分之为二∶饮也，食也。饮者水也，无形也。《经》又云∶因而大饮则气逆，形寒饮冷则伤肺。肺
病则为喘咳、为肿、为泻，轻则发
汗，利小便，使上下分消其湿；重而蓄积为满者，利下之。食者物也，有形也。《经》云∶因而饱食，筋脉
横解，肠 为痔。又云∶食伤太阴厥阴，气口大于人迎两三倍者，或呕吐、痞满，或下利肠 。治分寒热轻重，
轻则内消，重则除下，亦有宜吐者。《经》云∶在上者因而越之。然不可过剂，过则反伤脾胃。盖先因饮食自
伤，又加之以药过，脾胃复伤，气愈不化，食愈难消矣。（李东垣）
水谷入胃，其浊者为渣滓，下出幽门，达大小肠而为粪，出于谷道；其清者化而为气，上升于肺；其至清
而至精者，由肺灌溉乎四体，而为汗液津唾，助血脉，益气力，为生生不息之运用也；其清中之浊者，下入膀
胱而为尿，出于小便；其未入而在膀胱之外者，尚为浊气，既入而在膀胱之内者，即化为水也。（《医学正传》）
百谷入胃，虽酸、苦、甘、辛、咸、淡者，味必变酸，而酸为木味，谷初入胃，亦若春生故耳。吾见食入
顷而吐者必酸，再顷之必苦矣。苦是夏令，而味已二变矣。又再之必甘，是化成之天也。于兹时，清者为气、
为津、为液、为髓、为血，浊者为便、为溺，已判然于其间。得秋味辛散，则内外上下，各得其所。若不及秋
辛者，其溲如蜜，是失四变矣。若气血各归其道，是得冬藏，其味合咸；而汗，而血，而眵，而涕，而溲，皆
咸者，是五变其味，谷化成始成终者也。《经》谓仓廪之官，五味出焉者，此之谓乎。（卢不远）
伤饮
酒为水谷之液，血亦水谷之液；酒入中焦，必求同类，故直走血分。《经》曰∶饮酒者，卫气先行皮肤，
先充络脉，此之谓也。然血者神气也，血属阴而性和；酒者淫气也，酒属阳而性悍。凡酒入血分，血欲静而酒
动之，血欲藏而酒逐之，故饮酒者，身面皆赤，此入血之征，亦散血之征也。○酒本狂药，大损真阴，
惟少饮之，未必无益，多饮之，难免无伤，而耽饮之，则受其害者，十之八九焉。且凡人之禀赋，脏有阴阳，
而酒之性质，亦有阴阳。盖酒成于酿，其性则热，汁化于水，其质则寒。若阴虚者纵饮之，则质不足以滋阴，
而性偏动火，故热者愈热，而病为吐血、衄血、便血、尿血、喘嗽、躁烦、狂悖等证，此酒性伤阴而然也。若
阳虚者纵饮之，则性不足以扶阳，而质留为水，故寒者愈寒，而病为鼓胀、泄泻、腹痛、吞酸、少食、亡阳、
暴脱等证，此酒质伤阳而然也。故纵酒者，既能伤阴，尤能伤阳，害有如此。（张景岳）
夫酒者清冽之物，不随浊秽下行，惟喜渗入者也。渗入之区，先从胃入胆，胆为清净之腑，同气相求，
然胆之摄受无几；其次从胃入肠，膀胱渗之，化溺为多。逮至化溺，则所存者，酒之余质，其烈性，惟胆独当
之。每见善饮者，必浅斟缓酌，以俟腹中之渗，若连飞数觥，则倾囊而出耳。（喻嘉言）
酒者，五谷之津液，米曲之华英，虽能益人，亦能损人，何者？酒有大热大毒。大寒凝海，惟酒不冰，是
其热也；饮之易昏，易人本性，是其毒也。若避风寒，宣血脉，消邪气，引药势，无过于酒也。若醉饮过度，
盆倾斗量，毒瓦斯攻心，穿肠腐胁，神昏志谬，目不见人，此则丧生之本也。（《医方类聚》）
补编
酒者，大热有毒，气味俱阳，乃无形之物也。若伤之，止当发散，汗出则愈，其次莫如利小便，使上下
分消其湿。今治酒病，用酒症丸，及牵牛、大黄下之，是无形元气受病，反下有形阴血，乖误甚矣。（《兰室秘藏》）
治酒病，宜发汗。若利小便，炎焰不肯下行。故曰∶火郁则发之，以辛温散之，是从其体性也。是知利
小便，则湿去热不去。若动大便，尤为疏陋。盖大便者有形之物，酒者无形之物，从汗发之，是为近理，湿热
俱去。故治以苦温，发其火也；佐以苦寒，除其
湿也。○按酒之为物，气热而质湿，饮之而昏醉易狂者热也，宜以汗去之；既醒则热去而湿留，止宜利小便而
已。二者酌而用之，葛花解酲汤备矣。（王好古）
酒性虽热，体同于水。东垣乃谓饮者无形之物，此亦不能无疑；既待发汗利小便以去之，其可谓无形之
物乎？（朱丹溪）
《准绳》书中，载有人伤酒发热，治以补剂加葛根，犹不禁其散，极言鸡距子之妙。赵以德治酒病，用
鸡距子而愈，即此物也。苏州呼为“密六曲”，徽州呼为“金钩子”，九月有之。（《折肱漫录》）
伤食
食之欲也，思盐梅之状，则辄有所唾，而不能禁；见盘肴之盛，则若有所吞，而不能遏。饥思啖牛，渴
思饮海，故欲之于人也如贼，人之于欲也如战。（谭子）
食物有三化∶烹煮糜烂日火化，细嚼缓咽曰口化，蒸变传送曰胃化。（秦西水）
宜少毋食多，宜饥毋食饱，宜迟毋食速，宜热毋食冷，宜零毋食顿，宜软毋食硬。此六者，调理脾胃之
要法也。（《冯氏锦囊》）
恶食者，心下痞闷，见食恶食，甚则恶闻食臭。不能食者，心下不痞满，自不能食。饥不欲食者，心下
自不嗜食，若饥状。（《医阶辨证》）
冷食伤血，热食伤气，饱食伤胃，饥食伤脾；着气而食伤肝，食而着气伤脾；不意食而食伤脾，倍于常
而食伤肠胃。○人寤食而寐则否者何？人目张则卫气出外，目闭则卫气入内。卫气出外，主一身之动静云为，
而脏腑空虚，故须饮食以助之；卫气入内，则百骸皆逸，其气默行于脏腑，故不食。是以寤食而寐则否也。（《医参》）
食则易饥，非火也。盖脾胃以气为主，气属阳，脾胃之阳已虚，又被苦寒之药，以泻其阳，则阳愈虚，
而内空竭，须假谷气
以扶助之，故易饥而欲食，食亦不生饥肉也。《经》曰∶饮食自倍，肠胃乃伤。又曰∶饮食不为肌肤。其斯之
谓欤？（汪石山）
胃主受纳，脾司运化，故不食皆为中土受病。然胃之土，体阳而用阴；脾之土，体阴而用阳。胃实则痞满、
气胀，胃虚则饮食不甘；胃热则饥不能食，胃寒则胀满不食。○夫胃满则肠虚，肠满则胃虚，更实更虚，其气
乃居。若醉饱过度，或感风寒，或着气恼，以致填塞胸中，胃气不行，忽然厥逆昏迷，口不能言，肢不能举，
此名食厥。（《张氏医通》）
有胃气则生，无胃气则死。故诸病若能食者，势虽重尚可挽救；不能食者，势虽轻必致延剧。然有当禁食
与不当禁食之两途∶如伤寒邪传阳明，胃有燥热昏谵者；又如干霍乱之上下不通；或正值吐泻之际；或斑痧未
透于表；或瘟疫邪客膜原；或疟邪交战之时；或六淫之邪，充塞弥漫，呕恶痞胀；或伤食恶食等证，凡此禁其
谷食可也。其余诸证不食者，当责之胃阳虚、胃阴虚，或湿热阻气，或命门火衰。要知淡饮淡粥，人皆恶之；
或辛或咸，人所喜也。或其人素好之物，亦可酌而投之，以醒胃气，惟酸腻甜浊不可进。（《临证指南》）
补编
下利不欲食者，有宿食也，当下之。○宿食在上脘，当吐之，宜瓜蒂散。（《金匮》）
食在上者吐之。《经》曰∶上部有脉，下部无脉，其人当吐不吐者死。盖阳火之根，本于地下；阴水之源，
本于天上，故曰水出高源。食填闷乱，则两寸必盛；源塞流穷，则两尺自绝。吐去上焦之物，则金能生水，而
肝木发生之气，亦得畅达耳。○食在中者消之。食既下膈入胃，则不可吐，强吐之亦不能尽出；又不宜遽用下药，
下早则伤中气，而清纯冲和之气，并为之下陷矣。故杂病酒积，下早每作痞气，当健脾消导为主。○食在下者
下之。如有食积，肠腹绞痛，手不可按者，不得不下。寒积用热药下
之，热积用寒药下之。（《证治准绳》）
凡水谷入胃，随阳道而上升，则化液化精；随阴道而下溜，只完水完谷。○脾气不健，水谷挟冷而填及
太阴，非真实可知。此处邪正分争扰攘，甚而拒关，则阴阳之往来于上下者，遂惊惶错乱，各抵关而奔还，势
使然也。乱实起于中焦，故乃抚其中焦，但求复我少火之阳，不必祛彼冷食之伤，以既伤在食，不可更伤以药，
此清净画一之治也。○食填太阴，抑遏少阳之气，碍其升路，则腹之胀痛，多连及胁。食填胃口，阻住膻中之
气，碍其降路，则腹之胀痛，多连及心。部署虽殊，总宜酌以卑监之土则温之，敦阜之土则平之。○五味入胃，
五脏皆争欲得之，所恃为之作陈平，而各归其所喜。攻使得长养于五脏者，胃肠之力也。胃肠一虚，即为失宰，
以致所喜非所得，所得非所喜，口中滋味，何由得美？稼穑既不作甘，又何由归形归化，以补精益气欤？所
以滋味一失，寒热辄生，以中气虚寒，阳从外徙，无有定处故也。意欲招回此阳，使得温里宣外，仍宰厥职，
则非理中不可。○脾虚不磨，由胃阳之不运也。凡阳虚者，诸阴皆得凑之，冷食之伤，阴邪内犯，而寒中也。
故散寒行滞，燥湿舒脾，可以兼施，要莫外于温者为是也。（程郊倩）
饮食虽入中焦，其变化精微，实赖少火上蒸。中年之后，大病之余，元阳亏损，不能熟腐水谷，因而衰
馁，易于停食，作痞作痛，为呕为泻，宜补火生土。譬之釜底加薪，水谷易熟也。（《玉机微义》）
虚人饮食所伤，及外感暴病新愈之后，当用六君子汤，理胃为主。内伤劳倦，及久病之后，当用补中益
气汤，理脾为主。理脾则百病不生，不理脾则诸病续起。○老人、虚人，易于伤食，或膨胀痞闷，或腹满作泻，
当消补兼施，宜常服资生丸。○伤食后，健脾须用枳术丸，合天行健之意。健者动也，内有枳实之动，能助脾
之消磨运动耳。（李东垣）
夫饥饿不饮食与饮食太过，虽皆失节，然必明其二者之分∶饥饿胃虚，此为不足；饮食停滞，此为有余。
惟其不足，故宜补益；惟其有余，故宜消导，人之盛衰不同也。又有物滞气伤，必须补益消导兼行者；亦有物
暂滞而气不甚伤，宜消导独行，不须补益者；亦有既停滞而复自化，不须消导，但当补益者。易老枳术丸，虽
曰消导，固有补益之意存乎其间。若有形之物，非枳术丸所能去，则备急丸之属推逐而去之。观此则知消导补
益之理矣。（朱丹溪）
当今方家，以平胃散出入增减，为调脾胃之准绳。盖平胃者，胃中高阜，则使平之，一平即止，不可过剂，
过剂则反成坎矣。而枳术丸尤甚，今人以此丸为补脾之药，朝服暮饵，更益橘、半、香、砂，则又甚矣。至若
山楂、神曲、麦芽，世常用之，山楂能化肉积，产妇儿枕痛者，煎服立化。不可轻用曲 者，以米与水在瓷缸
中，藉曲以酿成酒，藉 以酿成糖；人身脾胃非瓷缸比，原有化食之能，今食不化，其所能者病也，只补助
其能而自化。（《赵氏医贯》）
[Scriptural Principles]
Human beings rely on water and grain (diet) as the foundation of life; therefore, if a person is deprived of water and grain, they will die. ○ When food enters the stomach, its refined essence is dispersed to the Liver, nourishing the sinews; when food enters the stomach, its turbid essence returns to the Heart, permeating the vessels; vessel qi flows through the meridians, and meridian qi converges in the Lungs; the Lungs direct all vessels, distributing essence to the skin and hair; the essence of the skin and vessels combines, circulating qi through the six Fu organs; the Fu organs' spirit and brightness remain in the five Zang organs, and qi returns to a state of balance and coordination.
When drink enters the stomach, its floating and overflowing refined essence is transported upward to the Spleen; the Spleen disperses the essence, sending it upward to return to the Lungs; [the Lungs] regulate the water passages, transporting it downward to the Bladder; water essence distributes to all four directions, and the five channels run in parallel. ○ Food entering the Yin aspect promotes the growth of Yang qi. ○ If diet doubles in quantity, the intestines and stomach will be injured. ○ Pathogenic factors from water and grain, when invaded, will harm the six Fu organs. ○ The Stomach is the sea of water and grain, and the great source of the six Fu organs. The five flavors enter the mouth, are stored in the Stomach, and nourish the Qi of the five Zang organs. ○ After the five flavors enter the Stomach, each returns to its preferred organ. Thus, sourness first enters the Liver, bitterness first enters the Heart, sweetness first enters the Spleen, acridity first enters the Lungs, and saltiness first enters the the Kidneys. Long-term consumption increases the Qi of the corresponding organs, which is the normal law of transformation. However, if Qi increases excessively and persists for a long time, it becomes the cause of premature death. ○ The Liver's color is green, and it is suitable to eat sweet foods; rice, beef, dates, and okra are all sweet. The Heart's color is red, and it is suitable to eat sour foods; adzuki beans, dog meat, plums, and leeks are all sour. The Lungs' color is white, and it is suitable to eat bitter foods; wheat, mutton, apricots, and wild garlic are all bitter. The Spleen's color is yellow, and it is suitable to eat salty foods; soybeans, pork, chestnuts, and bean leaves are all salty. The Kidneys' color is black, and it is suitable to eat acrid foods; yellow millet, chicken, peaches, and scallions are all acrid. Acridity disperses, sourness astringes, sweetness moderates, bitterness hardens, and saltiness softens. Toxic drugs attack pathogens, five grains provide nourishment, five fruits assist, five meats benefit, and five vegetables fill. Consuming them with combined flavors supplements essence and benefits Qi. ○ Acridity moves Qi; in Qi diseases, do not consume much acridity. Saltiness moves Blood; in Blood diseases, do not consume much saltiness. Bitterness moves to the bones; in bone diseases, do not consume much bitterness. Sweetness moves to the flesh; in flesh diseases, do not consume much sweetness. Sourness moves to the sinews; in sinew diseases, do not consume much sourness. ○ The generation of Yin essence originates from the five flavors; the injury to the five palaces of Yin also comes from the five flavors. Excessive sourness causes Liver Qi to overflow and Spleen Qi to fail; excessive saltiness causes fatigue of the large bones, shortening of muscles, and suppression of Heart Qi; excessive sweetness causes Heart Qi panting and fullness, black complexion, and imbalance of Kidney Qi; excessive bitterness causes Spleen Qi to lack moisture and Stomach Qi to become thick; excessive acridity causes sinews and vessels to relax and deteriorate, and spirit to be damaged. ○ Excessive saltiness causes blood vessels to coagulate and change color; excessive bitterness causes dry skin and falling hair; excessive acridity causes tight sinews and withered nails; excessive sourness causes calloused flesh and everted lips; excessive sweetness causes bone pain and hair loss. (From *Su Wen*)
The Yellow Emperor asked: When a timid person drinks wine and becomes angry without avoiding brave warriors, which Zang organ causes this? Shao Yu replied: Wine is the essence of water and grain, the liquid of cooked grain; its Qi is fierce. When it enters the Stomach, it causes Stomach distension, and Qi rebels upward, filling the chest; the Liver floats and the Gallbladder spreads horizontally. At this time, one's momentum is indeed stronger than that of a brave warrior, but after the Qi declines, regret follows. This is called "wine rebellion" (Jiu Bei). (From *Ling Shu*)
[Philosophical Remarks]
The *Classic* states: Cold and heat from water and grain, when invaded, harm the six Fu organs. It also states: Yin Qi, when quiet, stores the spirit; when agitated, the spirit perishes. Doubling the diet injures the intestines and stomach. This is a general statement. Dividing it into two: Drink and Food. Drink is water, formless. The *Classic* further states: Drinking excessively causes Qi rebellion; cold form and cold drink injure the Lungs. Lung disease manifests as wheezing, coughing, edema, and diarrhea. Mild cases use sweating and diuresis to eliminate dampness from top to bottom; severe cases with accumulation and fullness use purgation. Food is substance, formed. The *Classic* states: Overeating leads to relaxed sinews and vessels, and hemorrhoids in the intestines. It also states: Food injuring the Taiyin and Jueyin meridians, where the Cun Kou pulse is two to three times larger than the Ren Ying pulse, or presenting with vomiting, stuffiness and fullness, or diarrhea and borborygmus. Treatment distinguishes between cold and heat and severity. Mild cases use internal resolution; severe cases use purgation; some are suitable for emesis. The *Classic* states: For pathogens above, use emesis to expel them. However, medication must not be overdosed; overdose will damage the Spleen and Stomach. Since the injury was originally caused by diet, adding excessive medication re-injures the Spleen and Stomach, making Qi transformation even more difficult and digestion harder. (Li Dongyuan)
When water and grain enter the Stomach, the turbid part becomes dregs, exits through the pylorus, reaches the large and small intestines to become feces, and exits via the anus; the clear part transforms into Qi, rising to the Lungs; the clearest and most refined part, irrigated by the Lungs to the four limbs, becomes sweat, fluid, saliva, assisting the blood vessels and benefiting strength, constituting the endless operation of life; the turbid part within the clear descends into the Bladder to become urine, exiting via the urethra; what has not entered and remains outside the Bladder is still turbid Qi, while what has entered inside the Bladder transforms into water. (*Yi Xue Zheng Zhuan*)
Various grains entering the Stomach, although initially sour, bitter, sweet, acrid, salty, and bland, eventually transform into sourness, as sour belongs to Wood. Just as grains enter the Stomum, it is like spring generation. I have seen food vomited shortly after eating is necessarily sour; after another interval, it becomes bitter. Bitter corresponds to summer, and the flavor has changed twice. After another interval, it becomes sweet, representing the heaven of transformation. At this time, the clear part becomes Qi, Jin, Ye, Marrow, and Blood; the turbid part becomes stool and urine, clearly distinguished. Receiving the autumn acrid dispersal, everything inside and outside, above and below, finds its place. If lacking autumn acridity, urine will be like honey, losing the fourth transformation. If Qi and Blood each return to their paths, this is winter storage, and the flavor harmonizes with saltiness; sweat, blood, eye discharge, nasal mucus, and urine are all salty. This is the fifth flavor transformation, completing the beginning and end of grain transformation. The *Classic* says the official of granaries (Spleen/Stomach) produces the five flavors; this is what is meant. (Lu Buyuan)
[Alcohol Injury]
Wine is the liquid of water and grain, and blood is also the liquid of water and grain; wine entering the Middle Jiao seeks its kind, thus going directly to the Blood level. The *Classic* says: Those who drink wine, Wei Qi first travels through the skin, first filling the collaterals; this is what is meant. However, blood is the spirit and Qi; blood belongs to Yin and is gentle in nature. Wine is licentious Qi; wine belongs to Yang and is fierce in nature. Whenever wine enters the Blood level, Blood desires stillness but Wine agitates it; Blood desires storage but Wine pursues it. Therefore, drinkers have red bodies and faces; this is the sign of wine entering Blood, and also the sign of dispersing Blood. ○ Wine is essentially a drug of madness, severely damaging True Yin. Only drinking moderately may have benefits; drinking excessively inevitably causes harm; indulging in drinking results in harm nine or ten times out of ten. Moreover, everyone's constitution has Yin and Yang in the Zang organs, and wine's nature also has Yin and Yang. Wine is formed by fermentation; its nature is hot, but its juice transforms from water, so its quality is cold. If a Yin-deficient person indulges in drinking, the quality cannot nourish Yin, but the nature偏 (deviates) to move Fire, so heat becomes hotter, leading to hematemesis, epistaxis, hematochezia, hematuria, wheezing/cough, irritability, and madness. This is due to wine nature damaging Yin. If a Yang-deficient person indulges in drinking, the nature cannot support Yang, but the quality remains as water-dampness, so cold becomes colder, leading to drum distension, diarrhea, abdominal pain, acid regurgitation, anorexia, Yang collapse, and sudden collapse. This is due to wine quality damaging Yang. Thus, indulging in wine damages both Yin and Yang, causing such great harm. (Zhang Jingyue)
Wine is a clear and cool substance, not descending with turbidity, but preferring to penetrate. The area of penetration starts from the Stomach entering the Gallbladder; the Gallbladder is a pure and clear Fu organ, seeking similar Qi, but the Gallbladder's capacity is small; next, from the Stomach entering the Intestines, the Bladder penetrates, transforming mostly into urine. Once transformed into urine, what remains is the residual quality of wine, whose烈性 (fierce nature) is borne solely by the Gallbladder. I often see good drinkers sipping slowly to wait for abdominal penetration; if they gulp several cups in succession, the wine pours out like an empty bag. (Yu Jiayan)
Wine is the fluid of five grains, the flower of rice and yeast; although it can benefit people, it can also harm them. Why? Wine has great heat and great toxicity. In great cold that freezes the sea, only wine does not freeze; this is its heat. Drinking easily causes dizziness and alters one's true nature; this is its toxicity. To avoid wind and cold, promote blood circulation, eliminate pathogens, and guide medicinal potency, nothing surpasses wine. But if drunk to excess, measured in basins and dou, toxic vapors attack the heart, corroding intestines and ribs, causing confusion and delirium, blindness, this is the root of death. (*Yi Fang Lei Ju*)
[Supplement]
Wine is greatly hot and toxic, with flavors belonging entirely to Yang, and is a formless entity. If injured by wine, one should only disperse; sweating cures it. Next best is promoting urination to eliminate dampness from top to bottom. Currently, treating wine disease with Jiu Zheng Wan, or using Qian Niu (Pharbitis Seed) and Da Huang (Rhubarb) to purge, treats formless Yuan Qi illness but wrongly purges formed Yin Blood; this is a grave error. (*Lan Shi Mi Cang*)
Treating wine disease should involve sweating. If promoting urination, the flame of fire refuses to go down. Thus it is said: Fire郁 (stagnation) should be dispersed; use acrid-warm herbs to disperse, following its nature. Knowing this, promoting urination removes dampness but not heat. Moving the bowels is even more crude. Bowel movements are formed substances; wine is a formless substance. Dispersing via sweat is reasonable, eliminating both dampness and heat. Thus treat with bitter-warm to disperse fire; assist with bitter-cold to remove dampness. ○ Regarding wine: Qi is hot, quality is damp. Dizziness and drunkenness from drinking are due to heat; use sweat to remove it. After waking, heat is gone but dampness remains; only promote urination. Use both appropriately; Ge Hua Jie Cheng Tang is complete. (Wang Haogu)
Although wine nature is hot, its body is like water. Li Dongyuan said drinkers are formless entities; this is doubtful. If it needs sweating and diuresis to remove, how can it be called formless? (Zhu Danxi)
The book *Zhun Sheng* records a case of alcohol-induced fever treated with tonics plus Ge Gen (Kudzu Root), yet dispersion was not stopped, highly praising the efficacy of Ji Ju Zi (Caltrop Fruit). Zhao Yi De cured wine disease with Ji Ju Zi, which is this plant. Called "Mi Liu Qu" in Suzhou, "Jin Gou Zi" in Huizhou, available in September. (*Zhe Gong Man Lu*)
[Food Injury]
The desire for food: thinking of the shape of salt and plum causes salivation uncontrollably; seeing abundant dishes makes one feel like swallowing uncontrollably. Hungry, one wants to eat beef; thirsty, one wants to drink the sea. Thus desire is like a thief to humans, and humans are like warriors against desire. (Tan Zi)
Food has three transformations: cooking until soft is Fire Transformation; chewing slowly is Mouth Transformation; steaming and transporting is Stomach Transformation. (Qin Xishui)
Prefer less over more; prefer eating when hungry over eating when full; prefer slow eating over fast eating; prefer hot over cold; prefer small frequent meals over large single meals; prefer soft over hard. These six points are key methods for regulating Spleen and Stomach. (*Feng Shi Jin Nang*)
Those who dislike eating have epigastric stuffiness and fullness, dislike seeing food, and in severe cases dislike the smell of food. Those who cannot eat have no epigastric fullness but simply cannot eat. Those who are hungry but do not want to eat have no desire in the epigastrium, appearing hungry. (*Yi Jie Bian Zheng*)
Cold food injures Blood; hot food injures Qi; overeating injures the Stomach; eating while hungry injures the Spleen; eating while angry injures the Liver; getting angry while eating injures the Spleen; unexpected eating injures the Spleen; doubling usual intake injures the intestines and stomach. ○ Why do people eat when awake and not when asleep? When eyes are open, Wei Qi goes out; when closed, Wei Qi goes in. When Wei Qi goes out, it governs movement and action of the whole body, leaving Zang-Fu empty, requiring food to assist; when Wei Qi goes in, all bones rest, and Qi silently circulates in Zang-Fu, hence no eating. Thus, eating when awake and not when asleep. (*Yi Can*)
Easily becoming hungry after eating is not due to Fire. Spleen and Stomach are dominated by Qi; Qi belongs to Yang. If Spleen-Stomach Yang is already deficient, and bitter-cold medicines drain Yang, Yang becomes more deficient, and the interior empties, requiring Grain Qi to assist, hence easy hunger and desire to eat, though eating does not generate flesh. The *Classic* says: Doubling diet injures intestines and stomach. It also says: Diet does not become flesh. This is what is meant. (Wang Shishan)
Stomach receives and holds; Spleen transports and transforms; thus anorexia is always a disease of the Central Earth (Spleen/Stomach). However, Stomach Earth is Yang in body and Yin in function; Spleen Earth is Yin in body and Yang in function. Stomach excess causes stuffiness and distension; Stomach deficiency makes food tasteless. Stomach heat causes hunger but inability to eat; Stomach cold causes distension and inability to eat. ○ Full Stomach means empty Intestines; full Intestines mean empty Stomach; alternating excess and emptiness allows Qi to reside. If overeating/drinking, or catching wind-cold, or emotional anger causes blockage in the chest, Stomach Qi fails to move, suddenly leading to syncope, coma, inability to speak, and inability to move limbs; this is named Food Syncope (Shi Jue). (*Zhang Shi Yi Tong*)
Having Stomach Qi means life; lacking Stomach Qi means death. Thus, in all diseases, if the patient can eat, even if severe, it can be saved; if unable to eat, even if mild, it will worsen. However, there are indications for fasting and non-fasting. For example, in Shanghan transmitting to Yangming with dry-heat, confusion, and delirium; or Gan Huoluan (dry cholera) with upper/lower blockage; or during vomiting/diarrhea; or when macules/rashes have not erupted; or plague pathogens in Mo Yuan; or Malaria pathogen battle; or six excess pathogens filling and diffusing, causing vomiting, nausea, stuffiness, and distension; or food injury and aversion to food; in these cases, withholding grain/food is appropriate. For other diseases where patients cannot eat, blame Stomach Yang deficiency, Stomach Yin deficiency, damp-heat blocking Qi, or Mingmen Fire decline. Know that light drinks and light porridge are disliked by all; spicy or salty foods are liked. Or familiar foods of the person can be given酌情 (appropriately) to awaken Stomach Qi; only sour, greasy, sweet, and turbid foods should be avoided. (*Lin Zheng Zhi Nan*)
[Supplement]
Diarrhea with loss of appetite indicates retained food; purgation is indicated. ○ Retained food in the Upper Jiao requires emesis; Gua Di San (Melon Peduncle Powder) is suitable. (*Jin Gui Yao Lue*)
Food in the upper part uses emesis. The *Classic* says: Pulse present above, absent below; if the person should vomit but does not, they die. Because the root of Yang Fire is underground; the source of Yin Water is heavenly; thus "Water comes from high source." Food blockage causes fullness/confusion, making both Cun pulses strong; source blocked, flow exhausted, making both Chi pulses vanish. Vomiting upper Jiao substances allows Metal to generate Water, and Liver Wood generating Qi to flow freely. ○ Food in the middle part uses resolution. Once food passes the diaphragm into the Stomach, it cannot be vomited; forced vomiting won't expel all; nor should purgatives be used hastily; early purgation injures Middle Qi, and pure/harmonious Qi sinks with it. Thus, miscellaneous diseases with wine accumulation, if purged too early, often become Pi Qi (stuffiness masses); focus on strengthening Spleen and resolving stagnation. ○ Food in the lower part uses purgation. If food accumulation causes colic and abdominal pain, unpressable, purgation is necessary. Cold accumulation uses warm purgatives; heat accumulation uses cold purgatives. (*Zheng Zhi Zhun Sheng*)
Whenever water and grain enter the Stomach, ascending via Yang Dao transforms into fluid and essence; descending via Yin Dao remains as complete water and complete grain. ○ If Spleen Qi is not robust, water and grain carrying cold fill the Taiyin; this is not truly known. Here, evil and righteous Qi struggle and disturb; if rejecting the gate, the interaction of Yin and Yang above and below becomes panicked and chaotic, rushing back at the gates, driven by circumstances. Chaos actually arises in the Middle Jiao; thus soothe the Middle Jiao, seeking only to restore my Shao Huo (Ministerial Fire) Yang; do not need to dispel the cold food injury, because since it is injured by food, do not injure further with medicine; this is the treatment of purity and unity. ○ Food filling Taiyin suppresses Shaoyang Qi, hindering its ascent, causing abdominal distension/pain often extending to hypochondrium. Food filling Stomach opening blocks Tan Zhong Qi, hindering its descent, causing abdominal distension/pain often extending to the heart. Although deployment differs, generally use Bei Jian Earth to warm, Dun Fu Earth to level. ○ Five flavors entering the Stomach, all five Zang organs compete to obtain them; relying on the Spleen/Stomach as mediators to return each to its preference. What nourishes the five Zang organs is the power of intestines and stomach. If intestines/stomach are deficient, the master is lost, so what is preferred is not obtained, and what is obtained is not preferred; how can taste be sweet? If Spleen/Stomach do not produce sweetness, how can forms transform to supplement essence and benefit Qi? Thus, once taste is lost, cold/heat arise easily, because Middle Qi is deficient and cold, Yang shifts outward without fixed location. Intent to召回 (recall) this Yang to warm interior and disseminate exterior, resuming its duty, requires Li Zhong Tang. ○ Spleen deficiency failing to grind is due to Stomach Yang failing to transport. All Yang-deficient persons allow Yin to gather; cold food injury, Yin evil invading internally, causes Cold Middle. Thus, dispersing cold, moving stagnation, drying dampness, and relaxing Spleen can be combined; primarily warming is correct. (Cheng Jiaoqian)
Although diet enters the Middle Jiao, its transformation into refined essence relies on Shao Huo steaming upward. After middle age, or after major illness, Yuan Yang is depleted, unable to cook/rotten water and grain, leading to decline, easy food retention, forming Pi masses and pain, vomiting and diarrhea; suitable to tonify Fire to generate Earth. Like adding fire to the stove, water and grain cook easily. (*Yu Ji Wei Yi*)
For deficient persons injured by diet, or newly recovered from acute external contraction, use Liu Jun Zi Tang (Six Gentlemen Decoction), focusing on regulating Stomach. For internal injury from fatigue, or after chronic illness, use Bu Zhong Yi Qi Tang (Tonify the Middle and Augment the Qi Decoction), focusing on regulating Spleen. Regulating Spleen prevents hundred diseases; failing to regulate Spleen leads to continuous diseases. ○ Elderly and deficient persons easily suffer food injury, or distension/stuffiness, or abdominal fullness/diarrhea; combine resolving and tonifying, regularly服用 (take) Zi Sheng Wan. ○ After food injury, strengthening Spleen requires Zhi Zhu Wan (Immature Bitter Orange and Atractylodes Pill), incorporating the meaning of Tian Xing Jian (Heavenly Movement Strength). Jian means movement; containing Zhi Shi (Immature Bitter Orange) movement assists Spleen's digestion and motion. (Li Dongyuan)
Hunger/not eating and overeating are both irregularities, but distinguish them: Hunger/Stomach deficiency is insufficiency; Food stagnation is excess. Because insufficiency, tonification is suitable; because excess, resolution is suitable; human prosperity/decline differs. Some have material stagnation and Qi injury, requiring combined tonification and resolution; some have temporary material stagnation with slight Qi injury, requiring resolution alone without tonification; some have stagnation that self-resolves, requiring no resolution, only tonification. Yi Lao's Zhi Zhu Wan, though called resolution, contains intent of tonification. If formed substances cannot be removed by Zhi Zhu Wan, then Bei Ji Wan type pushes them out. Observing this reveals the principles of resolution and tonification. (Zhu Danxi)
Current physicians use Ping Wei San (Calm the Stomach Powder) with modifications as the standard for regulating Spleen/Stomach. "Ping" (Calm) means flattening the high mounds in the Stomach; flatten once and stop, do not overdose; overdose creates depression. Zhi Zhu Wan is especially problematic; moderns use it as a Spleen-tonifying pill, taking morning and evening, adding Chen Pi (Tangerine Peel), Ban Xia (Pinellia), Xiang Fu (Cyperus), and Sha Ren (Amomum); this is even worse. As for Shan Zha (Hawthorn), Shen Qu (Medicated Leaven), and Mai Ya (Malt), commonly used by world: Shan Zha resolves meat accumulation; for postpartum childbed pain decoction, it dissolves immediately. Do not lightly use Shen Qu; rice and water in porcelain jars use Qu to brew wine, use Qu to brew sugar; human Spleen/Stomach are not porcelain jars, originally having the ability to digest food; now food not digested, the ability is diseased; only assist the ability and it self-digests. (*Zhao Shi Yi Guan*)