噎塞反胃，总是血液衰耗，胃脘干槁，以致不能游溢
精气输脾，脾不散精归肺，气耗者难于下水，津伤者难于下食，津伤则噎，气耗则嗝，治者慎之。肺
之津液先竭，气不下顺，水饮可行，食物难入，名曰噎塞，其槁在上；食物可入，良久复出，名曰反胃，
其槁在下，皆谓之嗝。经所谓嗝则闭绝，多属气衰、血耗、火衰，张机峰以为神思间病。《内经》以为此
暴忧之疾。大抵气血亏损，复因悲思忧恚，则脾胃益伤，血液愈耗，气郁则生痰生火。故治嗝之法，
补气、养血、润燥、为本，降火、消痰、开郁、顺气为佐。须得病者慎自能养静，可保延年。若纵七情，
虽用药得当，终难挽回。其有属实者，或因瘀血，或因积痰，或因食滞，或因气郁，或因火、因虫，各随
见症而理之。方书论反胃，虽有属寒之条，然卒少见。必如《金匮》所云∶脾伤则食不磨，朝食暮吐，暮
食朝吐，宿谷不化者，正合《内经》澄澈清冷，皆属于寒，王太仆谓食久反出，是无火也之说，又必小便
清白为据，方可议投理中、八味之属。若不审辨，而概投香燥热药，适以速其亡也，可不慎诸。
参乳利嗝汤〔自制。〕嗝症主此加减。
人参〔补气，二、三钱。〕人乳〔养血，一杯，或用牛乳。〕麦冬〔润燥，五钱。〕
芦根汁〔降火。〕竹沥〔消痰，各一钱。〕郁金〔开郁，一钱。〕苏子〔三钱炒研。〕
橘红〔一钱。〕枇杷叶〔顺气。去毛、姜汁炙，四大片。〕白芍〔敛逆气，安脾胃。三钱，酒
妙。〕山楂〔行结气，消滞血，三钱。〕
此方补气、养血、润燥为主，佐以降火消痰，开郁顺气之剂，虚者宜之。
再造丹 嗝病不治之症，亦能挽回奏效。
川黄连〔二两，先同金银各二两，煎浓汁三碗。〕大田螺〔五十个，仰摆盘内，以黄连汁
挑点螺眼上，顷刻化成水，将绢滤收，同黄连、金银器煎至碗半。〕入煎萝卜子汁〔半碗，煎至碗
半。〕入菲菜汁〔半碗，煎至碗半。〕入侧柏叶汁〔半碗，煎至碗半。〕入梨汁〔一碗，
煎至碗半。〕入竹沥〔一碗，煎至碗半。〕入童便〔一碗，煎至碗半，取出金银器。〕入人
乳〔二碗，煎至一碗。〕入羊乳〔二碗，煎至一碗。〕入牛乳〔二碗，微火煎至成膏，取膏
入瓷罐内，封口埋土内一夜，以去火气，每用一酒杯，白汤下。极重者三服全愈，如汤水不能进者，将
膏挑置舌上，随津咽下，遂能饮食，只可食糜粥，一月后方可用饭。〕
昔人治反胃症愈后，只用人参〔五钱。〕陈皮〔一钱。〕黄米〔一两。〕作汤细啜，旬日后，方与
粥，恐仓廪未固，复致败坏耳。
此方清火消痰，祛瘀滋阴，养血润燥之剂，得之何氏家传效方，称其能回垂绝之症，以再造名之。
六味地黄汤〔见虚劳。〕治阴虚嗝症。
六味合竹如汤，加人乳 蔗浆 梨汁 青铅之属。〔癸水之精，色黑通肾，镇坠之剂。〕
此壮水、滋阴、润燥，求本之治也。《医贯》云∶经言三
阳结谓之嗝。三阳者，大、小肠，膀胱也。大、小肠主津液，膀胱藏津液，三阳热结，则津液燥竭，气
亦耗损，以致前后闭塞，下既不通，必反于上，直犯清空，上冲吸门喉咽，所以噎塞不下，纵稍能入，
反引动胃中之火，终必胃反而出也。然三阳之所以致结热，多由肾水干枯之故。盖肾主五液，司二便，
肾合膀胱也。此症男子年高色欲者常患之。老人天癸已竭，只有孤阳，当以养阴为主。褚氏所谓上病
疗下，须用六味丸料，大剂煎饮，久服可挽于十中、之一、二，又须宜远房帏，薄滋味也。若曰温胃，
胃本不寒。若用开郁香燥之品，适以助火。若下承气，苦寒损胃则津液愈竭。无如补阴，则焰光自灭，
世俗不明，余特详揭。
大黄 虫丸〔见虚劳。〕治胃脘停瘀成嗝，食下作痛。
宜去甘草。可用韭汁泛丸，一方用韭汁〔消瘀。〕牛乳〔养血润燥，〕二味和匀服。〔胃弱者勿用。〕
旋复代赭汤 治积饮成嗝，肥人宜之，并治呃逆。
旋复花〔味咸润下，能祛痰饮，一、二钱。煎成绢滤清服。〕代赭石〔性重坠下，能镇
逆气， 研细末，调服钱许。〕半夏〔治饮止呕，一、二钱。〕生姜汁〔开痰止呕，二、
三小匙。〕人参〔壮胃止呕。〕可加白蜜合参、半即大半夏汤。〕原方有甘、枣。〔呕家忌甘，去之。〕
人参利嗝丸〔自定义。〕治脾胃食滞成嗝，痞满不利，大便
燥结。
人参 白芍〔恐承气太峻，故用参，芍以监之。〕大黄〔通结，九制。〕枳实 浓朴
槟榔〔破滞，各等分。〕沉香〔降气减半。〕〔水泛为丸，每服钱许。白汤送下，一日三服。〕
沉香降气散〔见喘门。〕治气滞成嗝。
宜加甘蔗浆 芦根汁 梨汁 羚羊角〔降气逆，治噎塞。〕之属。
竹茹汤〔见伤寒。〕治胃中积热成嗝。
宜加黄连〔姜汁炒。〕大田螺汁〔皆至寒清胃，数大匙。〕童便〔恐有瘀凝，童便能降火
而行瘀。〕竹沥〔恐有痰滞，竹沥能除热而逐痰，各一杯。〕加金银器同煎。〔镇安逆气。〕
槟黄丸 万应丸〔俱见胃脘痛。〕治虫积成嗝。
此七方嗝症之属实者，随其所因，选而用之。
脉紧而涩难治。〔见贼克之脉也。〕年满六旬者难治。〔禀浓善守禁忌，尊信医药亦有生者。〕粪
如羊屎者不治。〔肠干小而不宽大者。〕口吐白沫者不治，皮肉干枯者不治。胸腹嘈痛、如刀割者死。
Yi (dysphagia) and Fanwei (regurgitation) are always caused by the depletion of blood and the dryness and withering of the stomach, leading to the inability to diffuse essence and qi to the Spleen, and the Spleen's failure to scatter essence to the Lung. When Qi is depleted, it is difficult to swallow water; when fluids are injured, it is difficult to swallow food. Injury to fluids results in Yi, while depletion of Qi results in Ge. Practitioners must be cautious regarding this. When the fluids of the Lung first exhaust, and Qi fails to descend smoothly, water and drinks may pass, but food is difficult to enter, named Yi (dysphagia), where the withering is located in the upper part. When food can enter but is vomited out after a long time, named Fanwei (regurgitation), where the withering is located in the lower part. Both are referred to as Ge (epiglottis obstruction). The *Classic* states that "Ge leads to closure and interruption," mostly belonging to Qi deficiency, blood depletion, and fire deficiency. Zhang Jifeng considers it a disease of the spirit and mind. The *Inner Classic* regards it as a sudden illness caused by extreme sorrow. Generally, when Qi and Blood are deficient, compounded by sadness, worry, anger, and resentment, the Spleen and Stomach are further damaged, blood is more depleted, Qi stagnation generates phlegm and fire. Therefore, the treatment method for Ge syndrome takes tonifying Qi, nourishing Blood, and moistening dryness as the root, while descending fire, resolving phlegm, opening depression, and regulating Qi as auxiliaries. It is necessary for the patient to carefully cultivate themselves and maintain tranquility to ensure longevity. If one indulges in the Seven Emotions, even if the medication is appropriate, it will ultimately be difficult to reverse the condition. For those with excess patterns, whether due to blood stasis, accumulated phlegm, food retention, Qi stagnation, fire, or parasites, each should be treated according to the presenting symptoms. Formulas discuss Fanwei, although there are clauses attributing it to cold, sudden onset is rare. One must follow what is said in the *Jin Gui Yao Lue*: "If the Spleen is injured, food is not ground; morning food is vomited in the evening, evening food is vomited in the morning, undigested grain remains." This perfectly matches the *Inner Classic*'s statement: "Clear and cold substances all belong to cold." Wang Bing stated that food being vomited after a long time indicates a lack of Fire. Furthermore, clear and white urine must be present as evidence before considering administering formulas such as Lizhong Tang (Regulate the Middle Decoction) or Bawei Wan (Eight-Ingredient Pill). If not carefully differentiated, and aromatic, drying, and hot medicines are indiscriminately administered, it will only hasten death. Can one not be cautious?
Shenru Ligé Tang (Ginseng and Human Milk Decoction for Unblocking Ge) [Self-made] is the main formula for Ge syndrome, to be modified according to conditions.
Renshen (Ginseng Root) [Tonifies Qi, 2-3 qian] Renru (Human Milk) [Nourishes Blood, 1 cup, or cow milk] Maidong (Ophiopogon Tuber) [Moistens dryness, 5 qian] Lugenzhi (Reed Rhizome Juice) [Descends fire] Zhuli (Bamboo Sap) [Resolves phlegm, 1 qian each] Yujin (Curcuma Tuber) [Opens depression, 1 qian] Suzi (Perilla Seed) [3 qian, stir-fried and crushed] Juhong (Exocarpium Citri Reticulatae Viride) [1 qian] Pipaye (Loquat Leaf) [Regulates Qi. Remove hairs, process with ginger juice, 4 large slices] Baishao (White Peony Root) [Astringes rebellious Qi, calms Spleen and Stomach. 3 qian, processed with wine] Shanzha (Hawthorn Fruit) [Moves stagnant Qi, resolves blood stasis, 3 qian]
This formula primarily tonifies Qi, nourishes Blood, and moistens dryness, assisted by agents that descend fire, resolve phlegm, open depression, and regulate Qi. It is suitable for deficiency patterns.
Zaizao Dan (Recreation Pill) Even for Ge disease, considered an incurable condition, it can still achieve a cure.
Chuanlianhuang (Coptis Rhizome) [2 liang, first decocted together with 2 liang each of gold and silver vessels into 3 bowls of concentrated decoction] Datianluo (Fresh Water Snail) [50 pieces, placed upside down in a dish, pointed with Coptis decoction on the snail's eyes, instantly turning into water, filtered through silk cloth, then decocted together with Coptis and gold/silver vessels until half a bowl remains] Add Luobozizi zhi (Radish Seed Juice) [half a bowl, decocted until half a bowl remains] Add Jiucai zhi (Chinese Chive Juice) [half a bowl, decocted until half a bowl remains] Add Cibaiye zhi (Biota Tops Juice) [half a bowl, decocted until half a bowl remains] Add Lizhi (Pear Juice) [one bowl, decocted until half a bowl remains] Add Zhuli (Bamboo Sap) [one bowl, decocted until half a bowl remains] Add Tongbian (Child's Urine) [one bowl, decocted until half a bowl remains, remove gold/silver vessels] Add Renru (Human Milk) [two bowls, decocted until one bowl remains] Add Yangru (Sheep Milk) [two bowls, decocted until one bowl remains] Add Niuru (Cow Milk) [two bowls, simmered over low heat until becoming a paste. Take the paste, put it in a porcelain jar, seal it, and bury it in the earth overnight to remove fire energy. Use one wine glass per dose, taken with warm water. In extremely severe cases, three doses result in complete recovery. If even liquids cannot be swallowed, place the paste on the tongue and swallow with saliva, enabling the patient to eat. Only porridge can be eaten initially; rice can be introduced after one month.]
In the past, after curing Fanwei, people would only use Renshen (Ginseng Root) [5 qian], Chenpi (Tangerine Peel) [1 qian], and Huangmi (Yellow Millet) [1 liang] to make a decoction and sip it slowly. After ten days, congee was given, fearing that the Granary (Spleen/Stomach) was not yet solid, which might lead to relapse.
This formula is an agent that clears fire, resolves phlegm, dispels stasis, nourishes Yin, nourishes Blood, and moistens dryness. Obtained from the He family's hereditary effective prescription, it is called "Recreation" because it is claimed to rescue critical conditions.
Liuyi Dihuang Tang (Six-Ingredient Rehmannia Pill) [See Xu Lao] Treats Yin-deficiency Ge syndrome.
Liuyi He Zhu Ru Tang (Six-Ingredient Combined Bamboo-like Decoction), added with Renru (Human Milk), Zhejiang (Sugarcane Juice), Lizhi (Pear Juice), Qingqian (Lead Carbonate), etc. [Essence of Gui Water, black color connects to Kidney, belongs to heavy-settling agents]
This is a treatment that strengthens Water, nourishes Yin, and moistens dryness, seeking the root. The *Yi Guan* says: The Classics state that "Three Yang knotting is called Ge." Three Yang refers to the Large Intestine, Small Intestine, and Bladder. Large and Small Intestines govern fluids, Bladder stores fluids. Heat knotting in Three Yang causes fluid exhaustion and Qi depletion, leading to blockage of front and back. Since the bottom does not flow freely, it must rebound upwards, directly attacking the Clear Realm, rushing up to the Xi Men (Inhaling Gate) and throat, causing Yi obstruction. Even if slightly able to enter, it triggers fire in the Stomach, eventually resulting in gastric regurgitation. However, the reason for heat knotting in Three Yang is mostly due to the dryness of Kidney Water. The Kidney governs five fluids and controls urination and defecation, and pairs with the Bladder. This syndrome is often suffered by elderly men who indulge in sexual activity. Elderly people have exhausted Tian Gui (Heavenly Water/Menstrual Essence equivalent in men), possessing only isolated Yang, so they should focus on nourishing Yin. As Chu Shi said, treating upper diseases by addressing the lower, one must use Liuyi Wan ingredients, decocted in large doses and drunk for a long time. It can save one or two out of ten cases. One must also avoid sexual intercourse and consume bland flavors. If one says warm the Stomach, the Stomach is originally not cold. Using aromatic and drying agents to open depression will only assist fire. Using Chengqi Tang (Major Order the Qi Decoction) with bitter-cold herbs damages the Stomach, causing further fluid exhaustion. There is no better way than tonifying Yin, so the flame naturally extinguishes. The secular world does not understand this, so I specifically reveal it in detail.
Dahuang Zhechong Wan (Rhubarb and Ground Beetle Pill) [See Xu Lao] Treats Ge syndrome formed by blood stasis stagnating in the epigastrium, causing pain upon eating.
Gancao (Licorice Root) should be removed. One can use Jiuzhi (Chinese Chive Juice) to coat the pills. One prescription uses Jiuzhi [Resolves stasis] and Niuru (Cow Milk) [Nourishes Blood and moistens dryness], mixed evenly and taken. [Do not use for weak Stomachs]
Xuanfu Daizhe Tang (Inula and Hematite Decoction) Treats Ge syndrome formed by accumulated fluids, suitable for obese individuals, and also treats hiccup.
Xuanfuhua (Inula Flower) [Salty taste, moistens and descends, can dispel phlegm-fluids, 1-2 qian. Decoct, filter through silk cloth, and take the clear liquid] Daizheshi (Magnetitum) [Heavy and sinking nature, can suppress rebellious Qi, finely powdered, taken mixed with water, approx. 1 qian] Banxia (Pinellia Tuber) [Treats fluid retention and stops vomiting, 1-2 qian] Shengjiangzhi (Fresh Ginger Juice) [Opens phlegm and stops vomiting, 2-3 small spoons] Renshen (Ginseng Root) [Strengthens Stomach and stops vomiting] Can add Baimi (White Honey) combined with Renshen and Banxia, i.e., Dabanxia Tang (Major Pinellia Decoction). The original formula has Gancao (Licorice Root) and Dazao (Jujube). [Vomit patients avoid sweet taste, remove them]
Shenren Ligé Wan (Ginseng Pill for Unblocking Ge) [Custom-defined] Treats Ge syndrome formed by food retention in Spleen and Stomach, with fullness and discomfort, and dry constipation.
Renshen (Ginseng Root), Baishao (White Peony Root) [Fearing Chengqi Tang is too harsh, thus using Ginseng and White Peony to monitor it] Dahuang (Rhubarb Root) [Unblocks accumulation, nine-processed] Zhishi (Immature Bitter Orange), Houpo (Magnolia Bark), Binglang (Areca Seed) [Breaks stagnation, equal parts] Chenxiang (Aquilaria Wood) [Reduces dosage by half for descending Qi] [Water-coated pills, take approx. 1 qian per dose, with warm water, three times a day]
Chenxiang Jiangqi San (Aquilaria Powder for Descending Qi) [See Chuan Men] Treats Ge syndrome formed by Qi stagnation.
Should add Zhejiang (Sugarcane Juice), Lugenzhi (Reed Rhizome Juice), Lizhi (Pear Juice), Lingyangjiao (Saiga Antelope Horn) [Descends rebellious Qi, treats dysphagia], etc.
Zhuru Tang (Bamboo Sheath Decoction) [See Shang Han] Treats Ge syndrome formed by accumulated heat in the Stomach.
Should add Huanglian (Coptis Rhizome) [Processed with ginger juice], Datianluo zhi (Fresh Water Snail Juice) [Both are extremely cold, clear Stomach, several large spoons], Tongbian (Child's Urine) [Fearing blood stasis coagulation, Child's Urine can descend fire and move stasis], Zhuli (Bamboo Sap) [Fearing phlegm stagnation, Bamboo Sap can clear heat and expel phlegm, 1 cup each]. Decoct together with gold and silver vessels. [Settle rebellious Qi]
Binghuang Wan (Betel Nut and Rhubarb Pill), Wanying Wan (Universal Pill) [Both see Wei Wan Tong] Treats Ge syndrome formed by parasite accumulation.
These seven formulas are for Ge syndrome with excess patterns, selected and used according to their specific causes.
Pulse tight and choppy is difficult to treat. [See Ze Ke Pulse] Age sixty or above is difficult to treat. [Those with strong constitution who observe taboos and respect medicine may survive] Stool like sheep dung is untreatable. [Intestines are dry, small, and not wide] Vomiting white foam is untreatable, dry skin and flesh is untreatable. Chest and abdomen burning pain, feeling like knife cutting, indicates death.