子坚玉体清和。从来无病。迩因外感之余。益以饥饱内伤。遂至胸膈不快。胃中隐隐作痛。有时得食则
已。有时得食反加。大便甚艰。小水不畅。右关之脉。乍弦乍迟。不相调适。有似锢疾之象。用药得当。驱之
无难。若岁久日增。后来必为大患。大意人身胃中之脉。从头而走于足者也。胃中之气。一从小肠而达于膀
胱。一从小肠而达于大肠者也。夫下行之气。浊气也。以失调之故。而令浊气乱于胸中。干其清道。因是窒塞
不舒。其始本于病时。胃中津液。为邪火所烁。至今津液未充。火势内蕴。
易于上燎。所以得食以压其火则安。然邪火炽则正气消。若食
饮稍过。则气不能运转其食。而痛亦增。是火不除则气不复。气不复则胃中清浊混乱。不肯下行。而痛终不
免也。病属胃之下脘。而所以然之故。全在胃之中脘。盖中者。上下四旁之枢机。中脘之气旺盛有余。必驱下
脘之气入于大小肠。从前后二阴而出。惟其不足。所以反受下脘之浊气而挠指也。夫至人之息以踵。
呼之于根。吸之于蒂者也。以浊气上干之故。究竟吸入之气。艰于归根。且以痛之故。而令周身之气。凝滞不
行。亦非细故也。为订降火生津下气止痛一方。以为常用之药。尚有进者。在先收摄肾气。不使外出。然后
浊气之源清。而膀胱得吸引上中二焦之气以下行。想明哲知所务矣。
胡卣臣先生曰。言一病即知其处。既知其处矣。又知其上下正反之
因。犹珠玉之光。积而成照。非有意映重渊连赤极也。
Lu Zijian’s constitution is clear and harmonious, and he has never been ill. Recently, following an external contraction, compounded by internal injury due to irregular eating (hunger and fullness), he developed discomfort in the chest and diaphragm, with a dull pain in the stomach. Sometimes the pain subsides after eating; sometimes it worsens after eating. Stool is very difficult to pass, and urination is obstructed. The pulse at the right Guan position is alternately wiry and slow, lacking coordination, resembling the presentation of a entrenched disease. If medicated appropriately, dispelling the pathogen is not difficult. However, if the condition persists for years and increases daily, it will inevitably lead to major complications later.
The general principle is: the meridian of the stomach in the human body runs from the head down to the feet. The Qi of the stomach reaches the bladder via the small intestine, and also reaches the large intestine via the small intestine. The Qi that descends is turbid Qi. Due to disharmony, this turbid Qi becomes chaotic in the chest, interfering with the pathways of clear Qi, resulting in obstruction and discomfort. Initially, during the illness, the fluids of the stomach were scorched by pathogenic fire, and since then, the fluids have not yet replenished. The fire smolders internally, making it prone to flare upwards. Therefore, eating suppresses the fire, bringing relief. However, when pathogenic fire is excessive, healthy Qi diminishes. If food intake is slightly excessive, Qi cannot transform the food, and pain increases. This indicates that unless the fire is eliminated, Qi cannot recover; unless Qi recovers, the clear and turbid elements in the stomach remain confused, refusing to descend, so pain remains inevitable.
The pathology resides in the lower Wan (lower part) of the stomach, but the reason for this lies entirely in the middle Wan (middle part) of the stomach. The "Middle" serves as the pivot for the upper, lower, front, and back. When the Qi of the Middle Wan is abundant and vigorous, it necessarily drives the Qi of the Lower Wan into the large and small intestines, exiting through the anterior and posterior orifices. Precisely because the Qi of the Middle Wan is insufficient, it is instead disturbed by the turbid Qi of the Lower Wan (manifesting as abnormal pulse characteristics). The perfected person breathes using the heels; exhalation originates from the root, inhalation from the tip. Due to the interference of turbid Qi rising, the inhaled Qi ultimately struggles to return to its root. Furthermore, due to the pain, the Qi of the entire body becomes stagnant and fails to circulate, which is no trivial matter.
Therefore, a prescription for descending fire, generating fluids, directing Qi downward, and relieving pain has been formulated for regular use. There is further advice: first, gather and secure Kidney Qi, preventing it from leaking outward. Then, the source of turbid Qi will be cleared, and the Bladder will be able to attract the Qi of the Upper and Middle Jiao to descend. It is assumed that the wise will know what to prioritize.
Mr. Hu Youchen stated: "Discussing one disease reveals its location; having known the location, one also understands the causes of the upper/lower and correct/reverse aspects. This is like the light of pearls and jade accumulating to form illumination, not intentionally attempting to reflect upon the deep abyss or the extreme red."