秦子曰∶夫噎者，饮食在喉，不得下咽，噎住喉间；隔者，饮食稍能入咽，顷刻上逆吐
出。此火热煎熬，血液衰耗，胃脘干枯，其干在上，近喉之间，水饮可入，食物不进，名之
曰噎；其干在下，在胃之中，食虽暂下，才将入胃，不能下行，反而吐出，名之曰隔。噎隔
之症，纯热无寒，但有外感内伤之分，再无寒热之异。《内经》故曰∶三阳结而为隔。不比
膈气呕吐门，有寒有热者也。若肠结于下，胃反于上，更为甚矣。
【外感噎隔之症】向无饮食阻隔，忽尔内热唇焦，饮食不得下咽，下咽噎住不通，或
下咽而复吐出，烦热引饮，此外感噎隔之症也。
【外感噎隔之因】偶逢赫曦之令，或远行劳倦，时当大热，燥火烁人，津液内涸，而
噎隔之症作矣。
【外感噎隔之脉】右脉洪数，热在气；左脉洪数，热在血；两手洪数，气血皆热，两
手细数，血燥津竭。
【外感噎隔之治】宜清热生津，三因麦门冬汤、人参白虎汤；或冲竹沥、芦根汁。大
便闭
三因麦冬汤 通治津竭液干，呕吐隔食。
麦冬 知母 石膏 枇杷叶 葛根 山栀 黄芩 陈皮 甘草 竹茹
人参白虎汤
知母 石膏 粳米 人参 甘草 天花粉
三一承气汤 治便闭气壮者。
四顺饮 治便闭血枯者。
当归 白芍药 大黄 甘草
大柴胡汤 治便闭寒热气壮者。
柴胡 黄芩 广皮 半夏 甘草 大黄
柴胡饮子 治便闭寒热气弱者。
柴胡 黄芩 广皮 半夏 甘草 人参 大黄
Qin Zi said: The condition of "Ye" (dysphagia with obstruction) refers to food and drink getting stuck in the throat, unable to be swallowed, blocking the throat area; the condition of "Ge" (regurgitation/obstruction) refers to food and drink being able to barely enter the throat, but regurgitating upwards and vomiting out shortly after. This is caused by the simmering effect of fire-heat, leading to the depletion and consumption of blood, resulting in dryness of the stomach and duodenum. If the dryness is located in the upper part, near the throat, liquids can enter but solids cannot, this is named "Ye"; if the dryness is located in the lower part, within the stomach, although food may temporarily go down, as soon as it enters the stomach, it cannot proceed downward and is instead vomited back up, this is named "Ge". The symptoms of Ye and Ge are purely heat patterns without cold patterns; there is only a distinction between external contraction and internal injury, with no further differentiation of cold or heat. The *Neijing* states: "The binding of the three Yang meridians leads to Ge." This differs from the category of Qi stagnation in the diaphragm and vomiting, which includes both cold and heat patterns. If intestinal constipation occurs below and stomach reflux occurs above, the condition is even more severe.
[Symptoms of External Contraction Ye-Ge] The patient previously had no obstruction to eating and drinking, but suddenly experiences internal heat and dry, cracked lips, making it impossible to swallow food and drink. After swallowing, the food gets stuck and blocked, or is vomited out immediately after swallowing, accompanied by irritability, fever, and thirst for water. These are the symptoms of Ye-Ge caused by external contraction.
[Causes of External Contraction Ye-Ge] Occasionally encountering periods of intense heat, or suffering from fatigue due to long-distance travel, when the weather is extremely hot, dry-fire scorches the human body, causing the internal fluids to dry up, thereby triggering the Ye-Ge symptoms.
[Pulse of External Contraction Ye-Ge] A surging and rapid pulse on the right hand indicates heat in the Qi level; a surging and rapid pulse on the left hand indicates heat in the Blood level; surging and rapid pulses on both hands indicate heat in both Qi and Blood; fine and rapid pulses on both hands indicate dryness of Blood and exhaustion of fluids.
[Treatment of External Contraction Ye-Ge] One should employ methods to clear heat and generate fluids, using San Yin Mai Men Dong Tang (Three Causes Ophiopogon Decoction) or Ren Shen Bai Hu Tang (Ginseng White Tiger Decoction); or administer Zhu Li (Bamboo Sap) and Lu Gen Zhi (Reed Rhizome Juice). In cases of constipation:
San Yin Mai Dong Tang (Three Causes Ophiopogon Decoction) Universally treats vomiting and food obstruction due to fluid exhaustion and dryness.
Herbs: Ophiopogonis Radix (Maidong), Anemarrhenae Rhizoma (Zhimu), Gypsum Fibrosum (Shigao), Loquat Leaf (Pipaye), Puerariae Radix (Gegen), Gardeniae Fructus (Shanzhi), Scutellariae Radix (Huangqin), Citri Reticulatae Pericarpium (Chenpi), Glycyrrhizae Radix et Rhizoma (Gancao), Bamboo Viscum (Zhuru)
Ren Shen Bai Hu Tang (Ginseng White Tiger Decoction)
Herbs: Anemarrhenae Rhizoma (Zhimu), Gypsum Fibrosum (Shigao), Oryza Sativa (Jingmi), Ginseng Radix (Renshen), Glycyrrhizae Radix et Rhizoma (Gancao), Platycodonis Radix (Tianhuafen)
San Yi Cheng Qi Tang (Three-in-One Bowel-Purging Decoction) Treats constipation in patients with robust constitution.
Si Shun Yin (Four-Harmony Infusion) Treats constipation in patients with blood deficiency.
Herbs: Angelicae Sinensis Radix (Danggui), Paeoniae Radix Alba (Baishao), Rheomi Radix et Rhizoma (Dahuang), Glycyrrhizae Radix et Rhizoma (Gancao)
Da Chai Hu Tang (Major Bupleurum Decoction) Treats constipation with alternating chills and fever in patients with robust constitution.
Herbs: Bupleuri Radix (Chaihu), Scutellariae Radix (Huangqin), Citri Reticulatae Pericarpium (Guangpi), Pinelliae Rhizoma Preparatum (Banxia), Glycyrrhizae Radix et Rhizoma (Gancao), Rheomi Radix et Rhizoma (Dahuang)
Chai Hu Yin Zi (Bupleurum Infusion) Treats constipation with alternating chills and fever in patients with weak constitution.
Herbs: Bupleuri Radix (Chaihu), Scutellariae Radix (Huangqin), Citri Reticulatae Pericarpium (Guangpi), Pinelliae Rhizoma Preparatum (Banxia), Glycyrrhizae Radix et Rhizoma (Gancao), Ginseng Radix (Renshen), Rheomi Radix et Rhizoma (Dahuang)