伤食
伤食恶食分上下，次审寒热行吐泻；胸满（有物）噎嗳心
（口）腹疼，发热（胃有伏火，或似疟痢）皆因食不
化。
停于上脘，气壅痰盛者，宜吐。如伤冷食，腹胀气逆，噫气吞酸，恶心，欲吐不
吐，宜平胃散入盐少许探吐；如伤热物或酒面，发热，心口刺痛，停痰、停饮、伏火，宜二
陈汤加黄连、枳实探吐；伤重填塞胸中，下部无脉，体实年壮者，方敢瓜蒂散吐之；寻常饮
食过饱在膈，以手探吐为好。停宿中、下脘者，宜下以逐之。如伤冷物，腹胀满痛者，木香
见丸、丁香脾积丸、感应丸；如伤热物，
痞满者，
二黄丸；日晡潮热盛者，小承气汤；寒热两伤者，大黄备急丸、除原散；体弱者，下药兼补
，
保和丸。凡伤食，乃中焦血病，如牵牛猛烈伤气及一切峻攻，反伤胃气。又现有吐者，二陈
汤加砂仁、黄连、青皮、枳实；现有泻者，胃苓汤加山楂、麦芽，或三白汤，随时令寒暑
选用。如身受寒气，口又伤冷，初得便宜辛温理中，稍久郁而为热，当兼辛凉散之。
吐下未净消导之，
红丸子、枳术丸、保和丸、大安丸、平补枳术丸、单山楂丸。
吐下已虚补益借；
四君子汤、六君子汤、补中益气汤。
酒客分消与调中，
饮酒与水过者，宜上汗下渗，分消其湿，葛花解酲汤微汗即愈；渗剂，五苓散
、调中二陈汤。如久困于酒，或伤灰酒成积，腹痛，大便窘迫者，酒蒸黄连丸、香连丸。如
伤酒呕逆，眩晕，头痛如破者，补中益气去白术，加半夏、白芍、芩、柏、干葛、川芎；有
块者，更加莪术、木香。如善饮，每早长嗳不吐者，小调中汤最妙，一月三五次服之，亦
可为丸。如醉饱行房，以致蓄血，胃口时痛者，大调中汤，或八物汤加砂仁之类。有痛饮不
醉，忽糟粕出前窍，尿溺出后窍者，四物汤加海金砂、木香、槟榔、木通、桃仁，数服可安
。吃茶成癖者，星才丸。
忧思郁抑药嫌霸。
忧思伤脾，不思饮食者，清六丸加香附、炒黄连、白芍，姜汁蒸饼糊丸服；全不
食者，温胆汤神效；忧思兼伤食者，木香化滞汤。瘦倦气仰不食者，二炒苍柏散，加香附、
白芍、陈皮、半夏、黄连、扁柏等分，白术为君，姜汁面丸服；湿痰气滞不食者，三补丸加
苍术，倍香附。
积聚
五积六聚皆属脾，
经曰∶积聚、 瘕、痞满，皆太阴湿土之气。始因外感
、内伤、气郁，医误补而
留之以成积。积者，阴气，五脏所主，脉沉伏，或左或右，发有根，痛有常处。肝积左胁下
，曰肥气，言风气有余，而血随气不行也，令人胁痛 疟；心积脐上，曰伏梁，言如梁之横
架心下，令人烦心，乃火之郁也，忌热药与灸，又肠痈与此相似，但身股背肿，环脐而痛为
痈；脾积胃脘稍右，曰痞气，言阳气为湿所蓄也，令人黄胆倦怠，饮食不为肌肤，仍忌热
药；肺积右胁下，曰息贲，言喘息奔而上行也，令人咳嗽、肺痈；肾积发于小腹，或凑心下
，曰奔豚，言若豚之奔冲，上下无时也，令人喘逆骨痿，最为难治。诸积勿轻吐下，徒损真
气，积亦不去，奔豚尤不可吐。五积，古有五方，今增损五积丸更妙。聚者
，阳气，六腑所
成，脉沉结，或隐或见，发无根，痛无常处，散聚汤、七气汤、香棱丸、大阿魏丸、大安丸
加参。
左右中间移不移；
气不能作块成聚，块乃痰与食积、死血有形之物而成，积聚 瘕一也
。有积聚成
块，不能移动者，曰 ，言坚硬贞固也；或有或无，或上或下，
或左或右者，曰瘕，言假血
而成蠢动之形，且有活性。
左死血兮右气积，
治左破血为主，海石丸或当归龙荟丸料五钱，加桃仁、姜黄各一两，蜜丸。治
右调气，青皮汤、木香分气丸。有积者，消积正元散、红丸子、小阿魏丸，或当归龙荟丸
、保和丸，俱加鹁鸠屎。
当中痰结一团而；
中乃水谷出入之路，饮食、七情郁积成痰，石 丸、白芥丸。凡痞块
在皮里膜外，俱宜二陈汤加补气、行气药。
有余消导分新久，
积初为寒，宜辛温消导，大七气汤，乌白丸，大、小温中丸，退黄丸，阿魏撞气
丸；久则为热，宜辛寒推荡，木香槟榔丸、通玄二八丹、消块丸。通用纂积
丹、生漆膏。有
虫者，妙应丸。外治三圣膏、三棱煎、神效阿魏散。
不足平补是上医。
阳虚有积易治，惟阴虚难以峻补。痞积又忌滞药，止宜早服滋补药中，加鳖甲、
龟板、秋石丹；午服枳术丸、大安丸，或醋鳖丸善消融化为妙。若痞积滞冷贯脐，误为沉寒
痼冷，投以姜附热药，初服甚与病情相宜，久则痞积益甚，真气伤而阴血烁矣。俱硫、附固
不可服，如知、柏、门冬寒凉伤脾滞气，亦所不宜。古云∶衰其大半而止。又云∶养正积自
除。皆为虚损有积而言也。平补之外，更能断浓味，节色欲，戒暴怒，正思虑，庶乎万全。
蛊瘴 皆因饮食起居而得，故附
中蛊害人俗不妍，
据方书蛊有数种，皆妖昧变惑之气，其怪使然。人有造作而得之者，多取虫蛇之
类，以瓮盛之，使其自相啖食。其间一物独存者，则以酒肉祭之，取出放毒于酒肴中以害人
。毒发令人面目青黄，力乏身痛，唾吐鲜血，小便淋沥，大便脓血，唇口干燥，胸胁妨满，
腹痛如虫啮，又如虫行，病患所食之物，皆变化为虫，侵蚀脏腑，蚀尽则死。死则病气流注
，复染傍人。人死，则精魂反为其家，代力致富，不知有此事否？万病解毒丹、东坡雄矾丸
主之；或于足小趾尖处灸三壮，即有物出。酒饭得之，随酒饭出；肉菜得之，随肉菜出。凡
中蛊毒，不论年月远近，但煮鸡卵一枚，去壳，以银钗插入卵中，并入口中含一饭顷，取出
视之，钗卵俱黑，即为中毒。一法∶令患人唾津于水，沉则是蛊，浮则非也。又法∶口含大
豆，豆胀烂而皮脱者是蛊，否则亦非也。如出外，须用预知子置衣领中，遇毒则有声。凡中
蛊之人，用药已瘥，自后饮食永不得吃冷。若饮食带冷，则鬼气乘之，毒虫复生，竟不能救
。
更有挑生及毒泉。
岭南多有挑生毒者，乃挑毒于鱼肉菜果酒醋之中，以害于人。其候∶初觉胸腹作
痛，次则渐渐搅刺，满十日，则物生能动，行上胸痛，沉下腹痛。在上膈者，用胆矾末五分
，投入热茶内溶化，通口服之探吐；在下焦者，用郁金末二钱，米汤调服，泻下恶物，后以
四君子汤去甘草调之。如胁下忽肿，顷刻生痈。大如碗许者，用升麻末二钱，冷热水调，连
服，泻出如葱根，其肿即消。后以平胃散，兼进白粥调之。
江南溪涧中，有射工毒，或因雨潦逐水而入人家，含沙射人之影得之，寒热闷乱，头目俱痛
，亦如中尸，卒不能语。又有水毒虫，一名溪温。得之病同射工，但有烂疮为射工，无疮为
溪温。又有沙虱，细如疥虫，遇阴雨则行出草间，着人则入皮里，痛如针刺。是三者为病，
朝轻暮重，手足冷至肘膝，二三日腹中生虫，食人下部，脐中生疮，不痛不痒。急视下部，
有疮赤如截肉者，为阳毒，最急；如鲤鱼齿者，为阴毒，稍缓，要皆杀人不过二十日也。用
蒜擂浓汁，煎温洗之。是水毒身体当发赤斑，否则非也。当以他病调治，消水毒饮子主之。
瘴气寒温分内外，
东南两广，山峻水恶，地湿沤热。如春秋时月，外感霜毒，寒热胸满不食，此毒
从口鼻入也，宜清上热，解内毒，降气行痰，不宜发汗，平胃散加芩、连、升麻、柴胡、桔
梗、枳壳、木香、木通，姜煎服。如寒月外感风寒，气闭发热头痛，自汗如疟，南人气升，
或胸满痰壅，饮食不进，与北方只伤表而里自和者不同，宜解表清热，行痰降气，二陈汤加
柴胡、黄芩、苍术、羌活、川芎，水煎服，微汗即止。如内伤饮食得者，理脾却瘴汤、补中
益气汤、不换金正气散、枳术丸；虚甚或挟房劳者，一粒金丹；热者，柴苓汤、承气汤、三
黄汤合竹叶石膏汤，或三黄枳术丸。
不服水土（与）瘴同源。
平洋土坚水热，山谷土润水冷，俱以平胃散为主，随水土风气冷热加减。或变疟
、痢、黄胆、疮疖，俱于各类求之，然以扶脾胃为本。凡纵酒色及食鱼肉、时新菜果、笋
蕨生冷、糯饭烧酒及油炒酱爆、鸡鸭面食、过饥过饱、歇卧处有秽气、半夜失盖、早行沾
露
、空腹出外，皆能发瘴。仕宦商贾游外，俱宜节饮食，谨起居以防之。
饮食停滞导致的疾病，需根据症状发生在上焦还是下焦来区分，并进一步辨别寒热性质，观察是否出现呕吐或腹泻；若伴有胸脘胀满（感觉有物阻塞）、噎膈嗳气、心口及腹部疼痛，以及发热（因胃中有潜伏之火，或症状类似疟疾、痢疾），这些都是因为食物消化不良所致。
如果食物停滞在上脘（胃的上部），导致气机壅滞、痰湿盛者，适宜采用催吐法治疗。例如因食用生冷食物受伤，出现腹胀、气逆、打嗝吞酸、恶心、想吐却吐不出来的情况，宜用平胃散加入少许盐来探吐；如果是因食用热性食物或饮酒、面食过量，出现发热、心口刺痛、停痰、停饮、伏火等情况，宜用二陈汤加入黄连、枳实来探吐；如果伤势严重，食物填塞胸中，导致下部无脉象，且患者体质强壮、年富力强者，才敢使用瓜蒂散进行催吐；若是普通饮食过饱停留在膈间，用手探喉催吐即可。如果食物停滞在中脘、下脘，适宜采用泻下法以驱逐积滞。例如因食用生冷食物，出现腹胀满痛者，可用木香见丸、丁香脾积丸、感应丸；如果是因食用热性食物，出现痞满者，可用二黄丸；如果在申时（下午3-5点）潮热严重者，可用小承气汤；如果是寒热夹杂伤者，可用大黄备急丸、除原散；如果是体质虚弱者，应在泻下药中加入补益药，或使用保和丸。凡是伤食，属于中焦血分病变，如牵牛子药性猛烈会损伤正气，以及一切峻猛的攻下法，反而都会损伤胃气。如果目前已有呕吐症状，可用二陈汤加入砂仁、黄连、青皮、枳实；如果目前已有腹泻症状，可用胃苓汤加入山楂、麦芽，或者三白汤，根据季节的寒暑变化选用。如果身体感受寒气，口中又吃了生冷食物，初起时适宜用辛温药物调理中焦，时间久了郁结化为热，应当兼用辛凉药物疏散。
催吐和泻下后若未排净，需用消导法，可选用红丸子、枳术丸、保和丸、大安丸、平补枳术丸、单山楂丸。
催吐和泻下后若身体虚弱，则需借重补益法，可选用四君子汤、六君子汤、补中益气汤。
经常饮酒之人，需分消湿邪并调理中焦。饮酒过量或饮水过多者，适宜通过发汗和渗利小便的方法，分消体内湿气，葛花解酲汤可使其微汗而愈；渗湿剂可用五苓散、调中二陈汤。如果长期受酒困扰，或因饮用劣质酒形成积滞，出现腹痛、大便窘迫感，可用酒蒸黄连丸、香连丸。如果因饮酒导致呕吐逆乱、眩晕、头痛剧烈如破裂感，可用补中益气汤去掉白术，加入半夏、白芍、黄芩、黄柏、干葛、川芎；如果有肿块者，再加莪术、木香。如果善于饮酒，每天早晨长嗳气但不呕吐者，用小调中汤最为巧妙，每月服用三到五次，也可以制成丸药。如果醉酒后行房事，导致蓄血，胃口时常疼痛者，可用大调中汤，或者八物汤加入砂仁之类。如果有豪饮但不醉酒，突然从前阴排出糟粕样物质，从后阴排出尿液者，可用四物汤加入海金砂、木香、槟榔、木通、桃仁，服用几剂后可安定。吃茶成癖好者，可用星才丸。
忧思抑郁的药物不宜过于霸道。
忧思损伤脾气，导致不思饮食者，可用清六丸加入香附、炒黄连、白芍，用姜汁蒸饼糊作为丸剂服用；完全不吃东西者，温胆汤效果神效；忧思兼有伤食者，可用木香化滞汤。消瘦疲倦、气息短促不进食者，可用二炒苍柏散，加入香附、白芍、陈皮、半夏、黄连、扁柏等分，以白术为君药，用姜汁面做成丸剂服用；湿痰气滞导致不进食者，可用三补丸加入苍术，加倍使用香附。
积聚
五积和六聚都属于脾脏病变。
经典记载：积聚、瘕、痞满，都源于太阴湿土之气。起初是因为外感、内伤、气机郁结，医生误用补法而导致留滞形成积块。积，属于阴气，由五脏所主，脉象沉伏，或在左侧或在右侧，发病时有根基，疼痛位置固定。肝之积在左胁下，称为肥气，意思是风气有余，血液随气机运行不畅，使人胁痛、患疟疾；心之积在脐上，称为伏梁，意思是像横梁一样横架在心下，使人烦闷忧心，这是火气郁结所致，忌用热药和艾灸，另外肠痈与此相似，但身体大腿背部肿胀，环绕脐部疼痛的是痈；脾之积在胃脘稍右处，称为痞气，意思是阳气被湿气蓄积，使人黄疸、倦怠，饮食不能转化为肌肤营养，仍忌用热药；肺之积在右胁下，称为息贲，意思是喘息奔涌而上行，使人咳嗽、患肺痈；肾之积发于小腹，或冲至心下，称为奔豚，意思是像小猪奔跑冲撞一样，上下无常，使人喘逆、骨痿，最为难治。各种积块不要轻易使用吐下法，只会徒然损耗真气，积块也不会去除，奔豚尤其不可催吐。五积，古代有五方说法，现在增减后的五积丸更为奇妙。聚，属于阳气，由六腑形成，脉象沉结，或隐或现，发病时无根基，疼痛位置不固定，可用散聚汤、七气汤、香棱丸、大阿魏丸、大安丸加人参。
左右中间移动与否；
气不能结成块状形成聚，块状是由痰、食积、死血等有形之物形成的，积聚和瘕本质是一样的。有积聚形成块状，不能移动的，称为“积”，意思是坚硬稳固；或有或无，或上或下，或左或右，可以移动的，称为“瘕”，意思是假血而成，形态蠢动且具有活性。
左边多为死血，右边多为气积。
治疗左边的以破血为主，可用海石丸或当归龙荟丸料五钱，加入桃仁、姜黄各一两，蜜丸。治疗右边的以调气为主，可用青皮汤、木香分气丸。有积块的，可用消积正元散、红丸子、小阿魏丸，或当归龙荟丸、保和丸，均加入鹁鸠屎。
中间多为痰结一团。
中间是水谷出入的道路，饮食、七情郁积形成痰，可用石菖蒲丸、白芥丸。凡是痞块在皮里膜外，都适宜用二陈汤加入补气、行气药物。
有余之证需消导，需分辨新久。
积块初起为寒，适宜用辛温药物消导，可用大七气汤、乌白丸、大温中丸、小温中丸、退黄丸、阿魏撞气丸；日久则化为热，适宜用辛寒药物推荡，可用木香槟榔丸、通玄二八丹、消块丸。通用方有纂积丹、生漆膏。有虫者，可用妙应丸。外治法可用三圣膏、三棱煎、神效阿魏散。
不足之证需平补，这才是上医。
阳虚有积容易治疗，只有阴虚难以峻补。痞积又忌用滞涩药物，只宜早上服用滋补药中加入鳖甲、龟板、秋石丹；中午服用枳术丸、大安丸，或醋煮鳖丸，善于消融化为妙。如果痞积冷痛贯穿脐部，误认为是沉寒痼冷，投以姜附等热药，初服似乎与病情相符，久了则痞积更加严重，真气受伤，阴血枯竭。硫磺、附子绝对不可服用，如知母、黄柏、麦冬等寒凉药物会损伤脾胃、阻滞气机，也不适宜。古语说：“病势去其大半就停止。”又说：“培养正气，积块自然消除。”这都是针对虚损而有积块而言的。除了平补之外，更能断绝浓味饮食，节制色欲，戒除暴怒，端正思虑，这样才能万无一失。
蛊瘴
蛊瘴都是因为饮食起居不当而得病，所以附在此类之后。
民间中蛊害人的习俗并不美好。
据方书记载，蛊有好几种，都是妖媚迷惑人的气，其怪异如此。有人故意制造而得到它，多取虫蛇之类，装在瓮中，让它们互相吞噬。其中一种独自存活下来，就用酒肉祭祀它，取出后放入酒肴中以害人。中毒发作令人面目青黄，乏力身痛，唾吐鲜血，小便淋沥，大便脓血，唇口干燥，胸胁胀满，腹痛如虫咬，又如虫爬，病人所吃的食物，都变化为虫，侵蚀脏腑，蚀尽则死。死后病气流注，又会传染旁人。人死后，精魂反而成为他家的仆役，代为力致富，不知是否有此事？可用万病解毒丹、东坡雄矾丸主治；或者在足小趾尖处灸三壮，即有异物排出。从酒饭中得的毒，随酒饭排出；从肉菜中得的毒，随肉菜排出。凡是中蛊毒的人，不论年月远近，只要煮鸡蛋一枚，剥壳，用银钗插入蛋中，并入口中含一饭的时间，取出查看，钗和蛋都变黑，就是中毒。一种方法：让病人唾液吐入水中，下沉则是蛊，浮起则不是。又一种方法：口含大豆，豆膨胀腐烂而皮脱落的是蛊，否则也不是。如果外出，须用预知子放在衣领中，遇到毒则有声响。凡是中蛊的人，用药已经痊愈，此后饮食永远不能吃冷的。如果饮食带冷，则鬼气乘虚而入，毒虫复生，最终无法救治。
更有挑生毒及毒泉。
岭南地区多有挑生毒者，是将毒挑入鱼肉菜果酒醋之中，用来害人。其症状：起初觉得胸腹作痛，接着渐渐搅刺，满十日，则物体生长能动，上行胸痛，下行腹痛。在膈上的，用胆矾末五分，投入热茶内溶化，通口服下探吐；在下焦的，用郁金末二钱，米汤调服，泻下恶物，后用四君子汤去掉甘草调理。如果胁下突然肿胀，顷刻间生痈，大如碗许，用升麻末二钱，冷热水调匀，连服，泻出如葱根的东西，其肿即消。后用平胃散，兼进白粥调理。
江南溪涧中，有射工毒，有时因雨涝逐水进入人家，含沙射人之影而得病，寒热闷乱，头目俱痛，也像中尸厥，突然不能说话。又有水毒虫，一名溪温。得病同射工，但有烂疮的是射工，无疮的是溪温。又有沙虱，细如疥虫，遇阴雨则行出草间，附着人身上则进入皮里，痛如针刺。这三种致病因素，早晨轻晚上重，手足冷至肘膝，二三天后腹中生虫，食人下部，脐中生疮，不痛不痒。急视下部，有疮赤如截肉者，为阳毒，最急；如鲤鱼齿者，为阴毒，稍缓，都要杀人不过二十日。用蒜捣成浓汁，煎温洗之。这是水毒，身体应当发赤斑，否则不是。应当按其他病调治，消水毒饮子主治。
瘴气寒温需分内外。
东南两广地区，山峻水恶，地湿沤热。如在春秋时节，外感霜毒，寒热胸满不食，此毒从口鼻入也，适宜清上热，解内毒，降气行痰，不宜发汗，可用平胃散加入黄芩、黄连、升麻、柴胡、桔梗、枳壳、木香、木通，姜煎服。如在寒月外感风寒，气闭发热头痛，自汗如疟，南方人气上升，或胸满痰壅，饮食不进，与北方只伤表而里自和者不同，适宜解表清热，行痰降气，可用二陈汤加入柴胡、黄芩、苍术、羌活、川芎，水煎服，微汗即止。如果是内伤饮食得病，可用理脾却瘴汤、补中益气汤、不换金正气散、枳术丸；虚甚或挟房劳者，可用一粒金丹；热者，可用柴苓汤、承气汤、三黄汤合竹叶石膏汤，或三黄枳术丸。
不服水土与瘴同源。
平原土地坚实水温高，山谷土地湿润水冷，都以平胃散为主，随水土风气的冷热加减。或变为疟、痢、黄疸、疮疖，都在各类中求治，然而以扶护脾胃为本。凡是纵酒色及食鱼肉、时令新菜果、笋蕨生冷、糯饭烧酒及油炒酱爆、鸡鸭面食、过饥过饱、歇卧处有秽气、半夜失盖、早行沾露、空腹出外，都能引发瘴气。仕宦商贾游历在外，都适宜节制饮食，谨慎起居以防之。
Food Stagnation
Food stagnation diseases are differentiated by whether symptoms occur in the upper or lower jiao, and further assessed for cold or heat nature, observing for vomiting or diarrhea. If accompanied by chest and epigastric fullness (feeling of obstruction), dysphagia and belching, pain in the heart and abdomen, as well as fever (due to latent fire in the stomach, or symptoms resembling malaria or dysentery), these are all caused by indigestion of food.
If food stagnates in the upper jiao (upper part of the stomach), causing qi stagnation and abundant phlegm-dampness, emesis is appropriate. For example, if injured by cold food, presenting with abdominal distension, rebellious qi, hiccups with acid regurgitation, nausea, and a desire to vomit without success, use Pingwei San (Calm the Stomach Powder) with a small amount of salt to induce emesis; if injured by hot-natured food or excessive alcohol and wheat products, presenting with fever, stabbing pain in the heart region, retained phlegm, retained fluid, and latent fire, use Erchen Tang (Two-Cured Decoction) added with Huanglian (Coptis Rhizome) and Zhishi (Immature Bitter Orange) to induce emesis; if the injury is severe, with food blocking the chest, absence of pulse in the lower body, and the patient is robust and young, only then dare one use Goudi San (Melon Pedicle Powder) to induce emesis; for ordinary overeating remaining in the diaphragm, manual induction of emesis is good. If food stagnates in the middle or lower jiao, purgation is appropriate to drive it out. For example, if injured by cold food, presenting with abdominal distension and painful fullness, use Muxiang Jian Wan (Aucklandia Pill), Dingxiang Pi Ji Wan (Clove Spleen Accumulation Pill), or Yinggan Wan (Responsive Pill); if injured by hot-natured food, presenting with stuffiness and fullness, use Erhuang Wan (Two-Yellows Pill); if tidal fever is severe at Shen hour (3-5 PM), use Xiao Chengqi Tang (Minor Order the Qi Decoction); if injured by both cold and heat, use Dahuang Beijii Wan (Rhubarb Emergency Pill) or Chuyuan San (Remove Origin Powder); if the constitution is weak, combine purgatives with tonics, or use Baohe Wan (Preserve Harmony Pill). All food stagnations belong to blood-level pathology in the middle jiao; drugs like Qianniu (Pharbitis Seed) are fierce and damage qi, and all harsh purgatives will instead damage stomach qi. If vomiting is currently present, use Erchen Tang added with Sharen (Amomum Fruit), Huanglian, Qingpi (Green Tangerina Peel), and Zhishi; if diarrhea is currently present, use Weiling Tang (Stomach and Five Decoction) added with Shanzha (Hawthorn Fruit) and Maiya (Sprouted Barley), or Sanbai Tang (Three Whites Decoction), selected according to seasonal cold or heat. If the body has contracted cold qi and consumed cold food, initially it is best to use acrid-warm herbs to regulate the middle; after a while, stagnation transforms into heat, so one should simultaneously use acrid-cool herbs to disperse.
After emesis and purgation, if digestion is not complete, use digestive methods: Hongwanzi (Red Pill), Zhizhu Wan (Atractylodes and Immature Bitter Orange Pill), Baohe Wan, Daan Wan (Great Peace Pill), Pingbu Zhizhu Wan (Neutralizing Atractylodes and Immature Bitter Orange Pill), or Dan Shanzha Wan (Single Hawthorn Pill).
After emesis and purgation, if deficiency exists, rely on tonification: Sijunzi Tang (Four Gentlemen Decoction), Liujunzi Tang (Six Gentlemen Decoction), Buzhong Yiqi Tang (Tonify the Middle and Augment the Qi Decoction).
For habitual drinkers, separate and eliminate dampness while regulating the middle. Those who drink excessively or consume too much water should induce sweating and promote urination to separate and eliminate dampness; Gegua Jieying Tang (Pueraria Flower Decoction to Relieve Intoxication) cures with mild sweating; for diuretic agents, use Wuling San (Five-Ingredient Powder with Poria) or Tiaozhong Erchen Tang (Regulate Middle Two-Cured Decoction). If long-term alcohol confinement occurs, or accumulation forms from inferior wine, presenting with abdominal pain and urgent defecation, use Jiu Zheng Huanglian Wan (Wine-Steamed Coptis Pill) or Xianglian Wan (Costus and Coptis Pill). If alcohol injury causes vomiting and rebellion, vertigo, and headache as if breaking, use Buzhong Yiqi Tang removing Baizhu, added with Banxia (Pinellia Tuber), Shaoyao (Peony Root), Huangqin (Scutellaria Root), Huangbai (Phellodendron Bark), Ge Gen (Kudzu Root), and Chuanxiong (Sichuan Lovage Rhizome); if masses exist, add Ezhu (Curcuma Zedoary Rhizome) and Muxiang (Vladimiria Root). If one enjoys drinking, experiencing long belching every morning without vomiting, Xiaotiaozhong Tang (Minor Regulate Middle Decoction) is best, taken three to five times a month, or made into pills. If sexual intercourse after drunkenness leads to blood stasis and occasional stomach pain, use Datiaozhong Tang (Major Regulate Middle Decoction) or Babatu Tang (Eight Substances Decoction) added with Sharen. If heavy drinking without intoxication suddenly results in feces-like matter exiting the anterior orifice and urine exiting the posterior orifice, use Siwu Tang (Four Substances Decoction) added with Haijinsha (Lygodium Spore), Muxiang, Binglang (Areca Seed), Mutong (Akebia Stem), and Taoren (Peach Kernel); several doses can bring peace. Tea addiction is treated with Xingcai Wan.
Medicines for worry, thought, and depression should not be overly harsh.
Worry and thought damage the spleen, leading to loss of appetite; use Qingliu Wan (Clear Six Pill) added with Xiangfu (Cyperus Rhizome), fried Huanglian, and Shaoyao, formed into pills with ginger juice and steamed biscuit paste; for total anorexia, Wendan Tang (Warm Gallbladder Decoction) is miraculous; for worry/thought combined with food stagnation, use Muxiang Huazhi Tang (Aucklandia Transform Stagnation Decoction). For those who are thin, fatigued, breathless, and not eating, use Erchao Cangbai San (Double-Fried Atractylodes and Phellodendron Powder) added with Xiangfu, Shaoyao, Chenpi (Aged Tangerina Peel), Banxia, Huanglian, Bianbo (Flattened Biota Seed) in equal parts, with Baizhu as the sovereign herb, formed into pills with ginger juice and flour; for damp-phlegm and qi stagnation causing anorexia, use Sanbu Wan (Three Tonify Pill) added with Cangzhu (Atractylodes Rhizome), doubling the amount of Xiangfu.
Accumulations and Masses
Five Accumulations and Six Gatherings all belong to the spleen.
The classics state: Accumulations (Ji), Gatherings (Ju), Pin (Distention), and Man (Fullness) all stem from the qi of Taiyin damp-earth. Initially due to external contraction, internal injury, or qi stagnation, mistaken tonification by physicians leaves them to form accumulations. Ji (Accumulation) is yin qi, governed by the five zang organs, with a deep and hidden pulse, located left or right, having a root upon onset, and pain in a fixed location. Liver accumulation under the left hypochondrium is called Feiqi (Fat Qi), meaning excess wind qi and blood failing to move with qi, causing hypochondriac pain and malaria; Heart accumulation above the umbilicus is called Fuliang (Hidden Beam), meaning like a beam橫ly placed under the heart, causing vexation, which is fire stagnation; hot herbs and moxibustion are contraindicated. Intestinal abscess is similar but presents with swelling of thighs, back, and pain around the umbilicus. Spleen accumulation slightly to the right of the epigastrium is called Piqi (Pi Qi), meaning yang qi accumulated by dampness, causing jaundice, fatigue, and food failing to nourish flesh; hot herbs are still contraindicated. Lung accumulation under the right hypochondrium is called Xiben (Gasp), meaning gasping and rushing upward, causing cough and lung abscess. Kidney accumulation originating in the lower abdomen or rushing to the heart is called Bentun (Running Piglet), meaning rushing up and down unpredictably like a piglet, causing panting and bone萎 (withering), most difficult to treat. Do not lightly use emesis or purgation for various accumulations; it only depletes true qi and does not remove the accumulation; Bentun especially must not be emetic. The ancient Five Accumulations have five formulas; the modified Wujii Wan (Five Accumulations Pill) today is better. Ju (Gathering) is yang qi, formed by the six fu organs, with a deep and knotted pulse, appearing and disappearing, having no root, and pain in variable locations; use Sanju Tang (Disperse Gathering Decoction), Qi Qi Tang (Seven Qi Decoction), Xiangleng Wan (Aucklandia Prismatic Pill), Daawei Wan (Great Asafoetida Pill), or Daan Wan added with Ren Shen (Ginseng Root).
Movement in the left, right, and center;
Qi cannot form blocks or gatherings; blocks are formed by有形 (formative) substances like phlegm, food stagnation, and dead blood. Ji, Ju, and Xia are essentially one. Accumulations that form blocks and cannot move are called "Ji" (Accumulation), meaning hard and firm; those that appear and disappear, move up and down, left and right, are called "Xia" (Mass), meaning formed by false blood, with moving shapes and activity.
Left is dead blood, right is qi accumulation.
Treating the left focuses on breaking blood: use Haishi Wan (Calcium Carbonate Pill) or Danggui Longhui Wan (Angelica and Scutellaria Pill) base 5 qian, added with Tao Ren (Peach Kernel) and Jianghuang (Turmeric Rhizome) 1 liang each, honey-pill. Treating the right focuses on regulating qi: use Qingpi Tang (Green Tangerina Peel Decoction) or Muxiang Fenqi Wan (Aucklandia Separating Qi Pill). For existing accumulations, use Xiaoji Zhengyuan San (Eliminate Accumulation Correct Origin Powder), Hongwanzi, Xiaoawei Wan (Little Asafoetida Pill), or Danggui Longhui Wan, Baohe Wan, all added with Bobojiu Shi (Pigeon Droppings).
Center is phlegm knotting in one mass.
The center is the pathway for food and water; dietary and emotional stagnation forms phlegm; use Shichangpu Wan (Acorus Pill) or Baijie Wan (White Mustard Seed Pill). Any Pi (distention) masses in the subcutaneous or membranous layers should use Erchen Tang added with qi-tonifying and qi-moving herbs.
Excess requires digestion, distinguishing new and old.
New accumulations are cold; use acrid-warm digestion: Da Qi Qi Tang (Great Seven Qi Decoction), Wu Bai Wan (Black and White Pill), Da Wen Zhong Wan (Great Warm Middle Pill), Xiao Wen Zhong Wan, Tuihuang Wan (Retreat Jaundice Pill),awei Zhuangqi Wan (Asafoetida Striking Qi Pill). Old accumulations become heat; use acrid-cold pushing: Muxiang Binglang Wan (Aucklandia and Areca Pill), Tongxuan Erba Dan (Penetrating Mystery Two-Eight Elixir), Xiaokuai Wan (Reduce Mass Pill). General formulas include Zuanji Dan (Gather Accumulation Elixir) and Shengqi Gao (Raw Lacquer Ointment). For worms, use Miaoying Wan. External treatments: Sansheng Gao (Three Sages Ointment), Sanleng Jian (Polygonatum Decoction), Shenxiaoawei San (Miraculous Asafoetida Powder).
Deficiency requires neutral tonification; this is the superior physician.
Yang deficiency with accumulation is easy to treat; yin deficiency is difficult to tonify harshly. Pi accumulations also avoid cloying herbs; best to take tonics early in the day added with Biejia (Turtle Shell), Guiban (Tortoise Plastron), Qiushi Dan (Mineral Salt Elixir); take Zhizhu Wan, Daan Wan, or Cu Bie Wan (Vinegar Turtle Pill) at noon, which excellently dissolve and transform. If Pi accumulation cold pain penetrates the umbilicus, mistakenly diagnosed as chronic cold, using Ginger and Aconite hot herbs may seem suitable initially, but later worsens the accumulation, damaging true qi and scorching yin blood. Liu Huang (Sulfur) and Fu Zi (Prepared Aconite Root) must absolutely not be used; Zhi Mu (Anemarrhena Rhizome), Huang Bai, and Dong Quai (Ophiopogon Tuber) are cold and damage spleen/stagnate qi, also unsuitable. Ancient saying: "Stop when half the disease is gone." Another: "Nourish righteousness, and the accumulation removes itself." These refer to deficiency with accumulation. Besides neutral tonification, cut rich flavors, restrain lust, guard against rage, correct thoughts, for ultimate safety.
Gu Poison and Miasma
Gu poison and miasma are acquired through diet and lifestyle, hence attached here.
Folk customs of Gu poisoning are not elegant.
According to medical texts, there are several types of Gu, all bewitching and confusing qi, strangely so. Some create it deliberately, collecting insects and snakes in a jar to let them eat each other. The sole survivor is sacrificed with wine and meat, then put into food/drink to harm people. Poison onset causes blue-yellow face, weakness, body pain, spitting fresh blood, dribbling urine, pus-blood stool, dry lips/mouth, chest/hypochondriac fullness, abdominal pain like insect bites or crawling. Food eaten turns into insects, eroding viscera; death follows erosion. After death, disease qi flows and infects others. Dead souls serve families for wealth; whether true is unknown. Treat with Wanbing Jiedu Dan (Ten Thousand Disease Detoxifying Elixir) or Dongpo Xiongfan Wan (Dongpo Realgar Alum Pill); or moxa three grains on the tip of the little toe, expelling objects. Poison from wine/rice exits with them; from meat/veg, exits with them. For any Gu poisoning, regardless of time, boil one egg, peel, insert silver needle, hold in mouth for a meal time, remove; black needle/egg indicates poisoning. Method: spit saliva into water; sinking is Gu, floating is not. Method: hold soybean in mouth; swollen/rotten/shed skin is Gu, otherwise not. When traveling, keep Yuzhizi (Premonition Seed) in collar; sounds when poisoned. After Gu poisoning heals, never eat cold food again. Cold food allows ghost qi to enter,毒虫 (poison insects) regenerate, incurable.
There are also "Tiao Sheng" (Lifting Life) poisons and toxic springs.
Lingnan has many "Tiao Sheng" poisoners, injecting poison into fish, meat, vegetables, fruits, wine, vinegar to harm people. Symptoms: initial chest/abdominal pain, gradually stabbing, after ten days object grows and moves, upper chest pain, lower abdominal pain. In upper diaphragm, use Danfan (Alum) powder 5 fen, dissolved in hot tea, drunk to induce emesis; in lower jiao, use Yujin (Curcuma Aromatica Rhizome) powder 2 qian, mixed with rice soup, purging evil matter, then regulate with Sijunzi Tang removing Gancao (Licorice Root). If sudden hypochondriac swelling, abscess forming instantly like a bowl, use Shengma (Cimicifuga Rhizome) powder 2 qian, mixed with cold/hot water, taken continuously, purging onion-root-like matter, swelling subsides. Then use Pingwei San, advance white porridge.
In Jiangnan streams, there is She Gong (Shooting Worker) poison, entering homes via rain/flood, shooting sand at shadows causing chills/heat, confusion, head/eye pain, similar to corpse possession, sudden muteness. There is also Water Poison Insect, named Xiwen (Stream Warmth). Same disease as She Gong, but with rotting ulcers is She Gong, without ulcers is Xiwen. There is also Shali (Sand Louse), fine as scabies mites, emerging in grass during rain, entering skin, stinging pain. These three cause morning light/evening heavy disease, cold hands/feet to elbows/knees, worms in abdomen after 2-3 days eating lower body, ulcers at umbilicus, painless/itchless. Urgently check lower body: red ulcer like cut meat is Yang Du (Yang Poison), most urgent; like carp teeth is Yin Du (Yin Poison), slower; all kill within 20 days. Wash with crushed garlic thick juice, warm decoction. This is water poison, body should have red spots, otherwise not. Treat as other diseases, Xiao Shuidu Yinzi (Eliminate Water Poison Drink)主治 (main treatment).
Miasma cold/heat differentiate internal/external.
Southeast Guangdong/Guangxi, steep mountains, bad waters, damp/steamy earth. In spring/autumn, external frost poison causes chills/heat, chest fullness, anorexia; poison enters mouth/nose, clear upper heat, resolve internal toxin, descend qi, move phlegm; do not induce sweat. Use Pingwei San added with Huangqin, Huanglian, Shengma, Chaihu, Jiegeng (Platycodon Root), Zhike (Bitter Orange Peel), Muxiang, Mutong, decocted with ginger. In cold months, external wind-cold causes qi closure, fever/headache, spontaneous sweating like malaria, southern person's qi rising, or chest fullness/phlegm obstruction, anorexia; different from north where only exterior is injured and interior harmonizes; resolve exterior, clear heat, move phlegm, descend qi. Use Erchen Tang added with Chaihu, Huangqin, Cangzhu, Qianghuo (Notopterygium Rhizome), Chuanxiong, water decocted, mild sweat stops. If internal injury from diet, use Lipi Quezhang Tang (Regulate Spleen Remove Miasma Decoction), Buzhong Yiqi Tang, Buhuanjin Zhengqi San (Non-Exchanging Metal Upright Qi Powder), Zhizhu Wan; severe deficiency or with sexual exhaustion, use Yili Jin Dan (One Grain Golden Elixir); heat, use Chai Ling Tang (Bupleurum and Poria Decoction), Chengqi Tang, Sanhuang Tang (Three Yellows Decoction) combined with Zhuye Shigao Tang (Bamboo Leaf and Gypsum Decoction), or Sanhuang Zhizhu Wan.
Acclimatization failure shares origin with miasma.
Flatlands have firm soil/hot water, valleys have moist soil/cold water; all use Pingwei San as main, adjusting for soil/wind/cold/heat. Or transforming into malaria, dysentery, jaundice, sores/boils, seek in respective categories, but focus on supporting spleen/stomach. Indulgence in alcohol/lust, eating fish/meat, seasonal fruits/veg, bamboo shoots/fiddleheads raw, sticky rice/spiced wine, oil-fried/sauce-braised, chicken/duck/wheat noodles, hunger/fullness extremes, sleeping in foul air, uncovering at midnight, walking dew-covered early, empty stomach going out, all can trigger miasma. Officials/merchants traveling should regulate diet, caution routine to prevent.