膈噎之症。内经止有三阳结谓之膈一句。子和从而释之。谓三阳者。大小
肠膀胱也。结则二阴不利。津液不行。故逆反而上。其言病机则得矣。而三
阳所以致结之故。则未始推及。至张鸡峰云是神思间病。惟内观静养。可
以却之。斯乃切中病情。盖此恙多由忧愁思虑。伤于心脾。血液不生。日渐
煎熬。肝火弥炽。肾水益枯。五脏之阴既竭。六腑之阳安得独足。于是槁在
上而为噎。槁在下而为膈。譬之江河阻塞。而饷道不通。有仰食不获而待
命矣。此时而浚其流。不若疏其源。然后水从天际而下。飞FS 立送。复循故
道也。故患膈噎者。欲嘘既槁之血液而复生之。莫若屏七情。绝嗜好。远帏
幕。心似已灰木。身如不系舟。奴枯禅老寂。而后静能胜动。水升火降。津液
渐行。庶出约有常。长享天命。谁谓治膈之大丹。不取诸身而足哉。舍此而
欲他求。惟有养血生津。开郁理气。佐以降火。或一法也。李绛兵部手集。用
人参三两取汁。入粟米鸡子白薤白。煮粥与啖。取其润滑而通阳明。最称
神效。至王太仆以食刹即出。食入反出。分有火无火之别。尤当参而调之。
毕竟此疾多得于忧患之人。而安逸者未尝有。则知药石之不胜病也。夏审矣。
地髓煎 治血枯便燥结。
生地黄(一斤) 鹿角胶(二两四钱) 生姜(八钱绞汁) 白蜜(二合) 酒(四合) 紫苏子(四钱酒研)
文武火煮地黄成膏。去滓。即以酒研苏子入煎。一二十沸下胶。胶化。下
姜汁蜜再煎。候稠。瓦器盛之。酒化下。
大半夏汤 治胃反呕吐痰盛者。
半夏(五钱) 人参(三钱) 白蜜(二钱)
水二钟。和蜜扬之百遍。煎服。
和胃汤
人参(一钱半) 黄连(六分土炒) 当归(一钱) 黄芩(七分土炒) 白芍药(一钱酒炒)
茯神(一钱) 石菖蒲(五分) 神曲(七分) 半夏(七分) 枳实(麸炒四分) 红花(三分) 苏子(一钱五分)
用陈壁土研细。搅入长流水。澄清煎药。入姜汁白蜜少许。童便一二匙和服。
The condition of Ge-Ye (Dysphagia and Esophageal Obstruction) is mentioned in the *Neijing* (Inner Canon of the Yellow Emperor) with only one sentence: "Jie of the Three Yangs is called Ge." Zhang Hezi (Zhang Congzheng, courtesy name Hezi) subsequently interpreted this. He stated that the "Three Yangs" refer to the Large Intestine, Small Intestine, and Bladder. When these are Jie (constrained/knotted), the Two Yin (anterior and posterior orifices) become obstructed, body fluids fail to circulate, causing Qi to rebel and ascend. While this explanation correctly addresses the pathogenesis, it fails to explore the root causes of why the Three Yangs become constrained. Later, Zhang Jimeng (Zhang Gao) claimed this was a disorder of the spirit and mind, curable only through introspection and quiet cultivation. This insight accurately hit the mark of the disease's nature. Generally, this ailment often arises from sorrow and excessive thinking, damaging the Heart and Spleen, leading to insufficient blood generation. Over time, this leads to internal simmering, causing Liver Fire to blaze fiercely and Kidney Water to dry up further. Once the Yin of the Five Zang organs is exhausted, how can the Yang of the Six Fu organs remain sufficient? Consequently, dryness above results in Ye (dysphagia/choking), and dryness below results in Ge (esophageal obstruction). It is like a river blocked, cutting off supply routes; those relying on food cannot eat and must wait for fate. At such times, dredging the downstream flow is inferior to clearing the source. Then, water falls from the sky, rushing down swiftly, returning to its old course. Therefore, for those suffering from Ge-Ye, if one wishes to restore dried-up blood, nothing is better than banishing the Seven Emotions (Joy, Anger, Worry, Pensiveness, Sadness, Fear, Fright), abandoning hobbies/desires, staying away from sensual pleasures, keeping the mind as still as dead ash and wood, and the body as unmoored as a boat, cultivating silence akin to a servant attending a Zen master. Only then can Stillness overcome Movement, Kidney Water rise, Heart Fire descend, and body fluids gradually circulate, allowing one to follow natural laws and enjoy longevity. Who says the great elixir for treating Ge-Ye does not come from within oneself? Abandoning this to seek elsewhere, one might only rely on nourishing Blood and generating fluids, relieving stagnation and regulating Qi, assisted by methods to descend Fire. This may be one approach. In the handwritten collection of Li Jiang, Minister of War, three taels of Renshen (Ginseng Radix et Rhizoma) juice were taken, mixed with millet, egg white, and Xiebai (Allii Macrostemonis Bulbus), and cooked into porridge for consumption. Its lubricating property was said to unblock the Yangming channel, achieving miraculous effects. As for Wang Taipu (Wang Bing), he distinguished between "food immediately vomited out" and "food eaten then regurgitated" based on the presence or absence of Fire, which deserves careful reference and adjustment. Ultimately, this disease mostly afflicts those burdened by worries and fears, while those living in leisure rarely suffer from it. Thus, we know that herbal medicines and acupuncture stones cannot always overcome the disease; the principle is clear.
Disui Jian (Earth Marrow Decoction): Treats constipation due to Blood Dryness.
Sheng Dihuang (Rehmanniae Radix Recens, 1 jin), Lujiao Jiao (Colla Cornus Cervi, 2 liang 4 qian), Shengjiang (Zingiberis Rhizoma Recens, 8 qian, juiced), Baimi (Mell, 2 he), Jiu (Vinum, 4 he), Zisuzi (Perillae Fructus, 4 qian, ground with wine).
Boil Sheng Dihuang over mild and strong fire until it becomes a paste. Remove dregs. Add the wine-ground Zisuzi and continue boiling for 10-20 boils. Add Lujiao Jiao; once melted, add Shengjiang juice and Baimi. Boil again until thick. Store in a ceramic vessel. Take by dissolving in wine.
Banxiexia Tang (Major Pinellia Decoction): Treats Wei Fan (Stomantic Regurgitation/Vomiting) with abundant Phlegm-Dampness.
Banxia (Pinelliae Rhizoma, 5 qian), Renshen (Ginseng Radix et Rhizoma, 3 qian), Baimi (Mell, 2 qian).
Use two zhong of water. Mix with honey and stir vigorously one hundred times. Decoct and take orally.
Hewei Tang (Harmonize Stomach Decoction)
Renshen (Ginseng Radix et Rhizoma, 1.5 qian), Huanglian (Coptidis Rhizoma, 6 fen, soil-fried), Danggui (Angelicae Sinensis Radix, 1 qian), Huangqin (Scutellariae Radix, 7 fen, soil-fried), Baishao (Paeoniae Radix Alba, 1 qian, wine-fried), Fushen (Poria cum Radice, 1 qian), Shichangpu (Acori Tatarinowii Rhizoma, 5 fen), Shenqu (Massa Medicata Fermentata, 7 fen), Banxia (Pinelliae Rhizoma, 7 fen), Zhishi (Aurantii Fructus Immaturus, 4 fen, bran-fried), Honghua (Carthami Flos, 3 fen), Suzi (Perillae Fructus, 1.5 qian).
Grind Chenbitu (Old Wall Earth) finely, mix with running water, clarify, and use the clarified water to decoct the herbs. Add a small amount of Shengjiang juice and Baimi. Take orally mixed with 1-2 spoons of Tongbian (Child's Urine).