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(Previous text omitted, continuing with the main text) It is the primary treatment for this condition.
[Annotation] The characters "Didang" are superfluous (erroneous additions).
[Commentary] Cold hernia (a disease characterized mainly by cold pain in the abdomen) causing abdominal pain, coldness of the limbs, numbness and insensibility of the hands and feet, and body pain, indicates a severe case of cold hernia. If moxibustion, acupuncture, and other medications fail to produce an effect, one should urgently administer Wutou Jian (Aconite Decoction) combined with five he (a unit of volume) of Guizhi Tang (Cinnamon Twig Decoction) to resolve the excessive cold in both the interior and exterior.
[Collected Commentaries] Xu Bin stated: The condition originates from cold hernia abdominal pain, progressing to cold extremities and numbness/insensibility of the hands and feet, indicating severe obstruction of Yang Qi; coupled with body pain, it shows that Ying Qi (Nutritive Qi) and Wei Qi (Defensive Qi) are disharmonious. At this point, if moxibustion, acupuncture, and other drugs cannot cure it, it is because whether attacking the exterior or the interior, the pathogenic factors resist and do not respond to treatment. Therefore, using Wutou (Radix Aconiti Lateralis Preparata) to attack cold as the main strategy, while combining the full dose of Guizhi Tang (Cinnamon Twig Decoction) to harmonize Ying and Wei Qi, is what is meant by treating seventy percent internally and thirty percent externally.

Formula for Wutou Guizhi Tang (Aconite and Cinnamon Twig Decoction)
Wutou (Radix Aconiti Lateralis Preparata)
Take the above single herb, add two jin (units of weight) of honey, decoct until reduced by half, remove the dregs, and mix the resulting liquid with five he of Guizhi Tang (Cinnamon Twig Decoction) to dissolve/mix, yielding one sheng (unit of volume). Initially take two he; if there is no response, take three he; if still no response, increase to five he. If the patient experiences a sensation resembling drunkenness, or vomits, it indicates the medicine has taken effect (hits the target).

[Formula Analysis] "Mixing with five he of Guizhi Tang (Cinnamon Twig Decoction)" refers to dissolving and mixing. "Yielding one sheng" means mixing five he of the honey decocted from Wutou with five he of Guizhi Tang (Cinnamon Twig Decoction) to yield one sheng. "No response" means ineffective; "again no response" means ineffective even after repeated dosing; "having a response" means effective. The sensation resembling drunkenness indicates that external cold is dissipating. Vomiting indicates that internal cold is being expelled, thus constituting hitting the target.

Question: How can one distinguish a patient suffering from Su Shi (retained undigested food)? The Master said: If the pulse at the Cun Kou (Inch Position) is floating and large, but feels choppy upon deep pressure, and the Chi Position (Cubit Position) is also slightly choppy, then one knows there is retained food, and Da Chengqi Tang (Major Order the Qi Decoction) should be used as the primary treatment.
[Annotation] The character "wei" (slight/faint) in "Chi position is slight and choppy" should be corrected to "da" (large), according to Shanghan Lun (Treatise on Cold Damage).
[Commentary] Su Shi disease (retained food disease) is equivalent to modern food stagnation injury, referring to food that remains undigested overnight. When a patient suffers from abdominal fullness and pain, how is it distinguished as caused by retained food? The pulse at the Cun Kou is floating and large; upon pressing, it feels large, choppy, and forceful. The Guan (Bar) and Chi positions exhibit the same. A pulse that is large, choppy, and forceful indicates excess syndrome with obstruction, hence knowing there is retained food. Purging method should be applied, and Da Chengqi Tang (Major Order the Qi Decoction) is suitable.

If the pulse is rapid and slippery, it indicates excess syndrome; this is due to retained food. Purging will lead to recovery; Da Chengqi Tang (Major Order the Qi Decoction) is suitable.
[Commentary] Abdominal fullness and pain accompanied by a rapid and slippery pulse indicate excess syndrome due to retained food; therefore, purging is indicated.
[Collected Commentaries] Li said: Slippery pulse indicates an abundance of water and grain qi. If slippery pulse is combined with rapid pulse, it means excess heat has entered the Stomach Fu organ. Thus, it is said: Retained food can be treated with purging.

Diarrhea accompanied by loss of appetite indicates retained food; purging is indicated, and Da Chengqi Tang (Major Order the Qi Decoction) is suitable.
[Commentary] Initial diarrhea with loss of appetite indicates food injury, characterized by aversion to food or lack of desire to eat; prolonged diarrhea with loss of appetite indicates Spleen injury leading to inability to eat. Now, initial diarrhea immediately accompanied by loss of appetite is due to retained food. Purging is indicated, and Da Chengqi Tang (Major Order the Qi Decoction) is undoubtedly suitable.
[Collected Commentaries] Shen Mingzong said: This is diarrhea caused by food injury. Sudden ingestion of excessive retained food stagnates in the Stomach, obstructing the mechanism of Qi ascent and descent. Water and grain fail to separate in the intestines and rush downward causing diarrhea. Because retained food stays in the Stomach, there is no desire to eat. One must attack and remove the retained food; once diarrhea stops and appetite returns, Da Chengqi Tang (Major Order the Qi Decoction) is suitable.

If retained food is located in the Upper Wan (upper part of the Stomach), emesis (vomiting) method should be used, and Gouti San (Thistle Powder) is suitable.
[Commentary] The Stomach is divided into Upper, Middle, and Lower Wan. For retained food in the Upper Wan, pain occurs in the diaphragm region accompanied by vomiting; emesis is applicable, purging is not. For retained food in the Middle Wan, pain occurs in the heart region accompanied by vomiting, or pain without vomiting; both emesis and purging may be applicable. For retained food in the Lower Wan, pain occurs above the umbilicus without vomiting; emesis is not applicable, purging is. Since the food is now in the Upper Wan, Gouti San (Thistle Powder) should be used to induce vomiting.

Formula for Gouti San (Thistle Powder)
Gouti (Fructus Momordicae, fried until yellow, one fen) Chixiaodou (Semen Phaseoli Rubri, boiled, one fen)
Grind the above two herbs into a powder. Boil Xiangchi (Fermented Soybean Mass) seven he to extract the juice. Mix one qianbi (unit of measure) of the powder into the juice and take warm. If vomiting does not occur, slightly increase the dose. Stop when vigorous vomiting is achieved. Do not administer to patients with blood loss or deficiency.

A pulse that is tight and changes like a turning rope indicates retained food.
[Commentary] "Turning rope irregularly" describes the shape of a Tight Pulse. Floating and tight pulse indicates Cold Damage; sinking and tight pulse indicates cold pain. Cold invading the Stomach region causes Grain Qi to fail to move, hence it is said: there is retained food.

Tight pulse, headache, wind-cold invasion, and undigested retained food in the abdomen (another version states: tight pulse at the Cun Kou).
[Commentary] Tight pulse with headache indicates external Wind-Cold damage; tight pulse with abdominal pain indicates internal injury from retained food.
[Collected Commentaries] Li said: Based on this pulse and symptoms, it resembles Cold Damage but is not Cold Damage, because the body does not ache and the waist/spine is not stiff. However, Tight pulses have distinctions: floating and tight indicates Cold Damage; sinking and tight indicates Food Injury. The Jiayi Jing (Classic of Eight Meridians) states: Excessively tight Renying pulse (on the left hand) indicates injury from cold; excessively tight Qikou pulse (on the right hand) indicates injury from food. Thus, cold and food injuries can be differentiated by the left and right hands. Therefore, one knows there is undigested retained food in the abdomen.