《易》曰∶蛊，坏极而有事也。人病蛊者，脾土败坏，身不即死，复有事也。事，犹病也。腹胀而硬，紫
筋浮
露，脐平如鼓，外劲内空，毋论能食不能食，总百无一生；若但浮大而软，则将成未成，是为胀满，犹可治也。
夫心、肺之病，其死也速；脾土之病，其死也迟。人见其迟也，而妄施汤药以治之，治之小愈，非真愈也，
苟延时日而已。善治者，于始萌之日，从其本原而治之，不使败坏成蛊，医之功也。若已成而复药之，总无济
矣。世有蛊证，余无治法，姑列其目，以俟能者。
隔，犹阻也。阻隔不通，不能纳谷，此三焦失职之病也。上焦出胃上口，主纳；中焦并胃中，主腐化；
下焦别回肠，主济泌。平人食谷，从上脘而直入中脘。上脘、中脘，即上焦、中焦。直入中脘，便腐化矣。
经云∶上焦如雾，中焦如沤，下焦如渎、为胃外釜底之然。若中、上二焦，火气衰微，上焦不能如雾之灌溉，
中焦不能如沤之腐化，便不能消谷，谷入反出矣。患此病者，百无一生，但有中上、中下之分，速死、迟死之
异。中上者，上焦、中焦不和也；中下者，下焦、中焦不和也。中下不和其死迟，中上不和其死速。然治得其
宜，速者可迟；治失其宜，迟者亦速矣。初患此病，医者每用辛香行气之药，谓能宽胸以开胃，讵知不能食者
真气虚也，真气既虚，岂可复行辛散以耗其气乎？既耗其气，元本不甚虚者，犹
可苟延；其元本虚者，数月之间，身命便不保矣。又初患此病，医者有用养血滋阴之药，谓开阑门而使之下，
可以不吐。若系中、下二焦，不相通贯，谷入中脘，下焦不相顺接，腐化有愆，仍从中脘而上逆，逆则吐，
此滋润下行之药，投之亦效；愈而复发，复投此药，便不效矣。初因下焦不得顺接，可以滋润下行；久则阴盛阳
虚，下焦生阳之气不能环复于上，下而不上，则不效矣；不效，必至身命不保矣。其中、上二焦，火气衰微，
初起或便用参、 、术、姜、桂、附等药，服之亦觉有效，药虽效而病不除，其后必疑温补之非，转服他药，
终归不治。天下岂有不食谷之人哉？经云∶得谷者昌，失谷者亡。善夫！
《易经》说：蛊，是指事物败坏到极点而引发事端。人患蛊病，是脾土功能败坏，身体没有立即死亡，而是出现了后续病变。“事”，就是指“病”。症状表现为腹部胀满且坚硬，青紫色的筋脉浮露于表面，肚脐平坦如鼓面，外表看似强劲内部却空虚，无论患者能否进食，总之都是百无一生；如果腹部只是膨大但按之柔软，则是即将形成或尚未完全形成的阶段，称为胀满，还可以治疗。
心、肺的疾病，死亡迅速；脾土的疾病，死亡缓慢。人们看到它死亡缓慢，就胡乱施用汤药来治疗，治疗后稍微好转，并非真正痊愈，只是拖延时日罢了。善于治疗的人，在病情刚萌芽时，就顺着根本原因进行治疗，不让其败坏成为蛊病，这是医生的功劳。如果已经形成蛊病再用药治疗，终究无济于事。世间虽有蛊证，我没有治疗方法，暂且列出其条目，以等待有能力的医者。
隔，就是阻隔的意思。气机阻隔不通，无法进食，这是三焦功能失职的疾病。上焦出于胃的上口，主要功能是受纳；中焦位于胃中，主要功能是腐熟消化；下焦分别回肠，主要功能是泌别清浊。正常人进食后，食物从上脘直接入中脘。上脘、中脘，对应上焦、中焦。食物直接进入中脘，就开始被腐熟消化了。医经说：上焦像雾露一样弥漫灌溉，中焦像沤渍一样腐熟消化，下焦像沟渠一样疏通排泄，这是因为胃外釜底（脾胃运化）的作用如此。如果中、上二焦的火气衰微，上焦不能像雾露那样灌溉，中焦不能像沤渍那样腐熟，就不能消化谷物，食物吃进去反而吐出来。患此病的人，百无一生，但有中上、中下之分，以及速死、迟死的区别。中上型，是上焦、中焦不和；中下型，是下焦、中焦不和。中下不和者死亡较慢，中上不和者死亡较快。然而如果治疗得当，速死者可以延缓；治疗失当，迟死者也会加速死亡。
起初患此病时，医生常用辛香行气的药物，认为能宽胸以开胃，岂不知不能进食是因为真气虚弱，真气既然已虚，怎么还能再用辛散药物耗损正气呢？一旦耗损正气，元气本不很虚的人，还可以勉强延续生命；元气本已虚的人，几个月之内性命就不保了。另外，起初患此病时，医生有用养血滋阴药物的，认为开通阑门使之下行，可以不呕吐。如果是中、下二焦不相通贯，食物进入中脘，下焦不相顺接，腐熟消化出现差错，仍然从中脘向上逆反，逆则呕吐，这种滋润下行的药物，投用也有效；但如果治愈后复发，再次投用此药，就不见效了。起初因为下焦不得顺接，可以用滋润下行法；时间久了则阴盛阳虚，下焦生发阳气不能循环回复于上，只下不上，就不见效了；无效，必然导致性命不保。其中、上二焦火气衰微的，初起或许直接用参、[白]术、姜、桂、附等药物，服用也觉得有效，药虽有效但病根未除，其后必定怀疑温补法的错误，转而服用其他药物，最终归于不治。天下哪有不吃谷物的人呢？医经说：能进食的就昌盛，不能进食的就灭亡。说得真好啊！
The *I Ching* (Book of Changes) states: "Gu" (Insect/Decay Disease) refers to a situation where things have deteriorated to the extreme, leading to complications. When humans suffer from Gu disease, it signifies the failure of Spleen Earth (the digestive system's transformative function). The body does not die immediately but experiences subsequent pathological events. Here, "event" implies "disease." Symptoms include abdominal distension that is hard and rigid, with purple veins floating on the surface, the umbilicus flattening like a drumhead, appearing firm externally but empty internally. Regardless of whether the patient can eat or not, there is essentially no chance of survival; however, if the abdomen is merely swollen and soft upon palpation, the condition is in the stage of forming or not yet fully formed, termed "distension and fullness," which is still treatable.
Diseases of the Heart and Lungs lead to rapid death; diseases of Spleen Earth lead to slower death. Observing this slowness, people recklessly administer decoctions for treatment. Although the condition may slightly improve, it is not true recovery, but merely a prolongation of life. A skilled practitioner treats the root cause at the earliest萌芽 (germination/initial stage), preventing deterioration into Gu disease; this is the merit of the physician. If one attempts to treat after Gu has already formed, it is ultimately futile. Although Gu syndromes exist in the world, I have no treatment method for them. I list their categories here, awaiting capable practitioners.
"Ge" (Intestinal Obstruction/Regurgitation) means obstruction. It refers to blockage preventing the intake of food, a disease caused by the dysfunction of the Sanjiao (Triple Burner). The Upper Jiao emerges from the upper opening of the stomach and governs reception; the Middle Jiao resides within the stomach and governs rotting and ripening (digestion); the Lower Jiao separates the ileum and governs the separation of clear and turbid fluids. In healthy individuals, ingested food passes directly from the Upper Wan (Upper Stomach) to the Middle Wan (Middle Stomach). The Upper Wan and Middle Wan correspond to the Upper Jiao and Middle Jiao. Once entering the Middle Wan, digestion begins. The Classics state: The Upper Jiao is like mist (diffusing and irrigating); the Middle Jiao is like a fermenting vat (rotting and ripening); the Lower Jiao is like a ditch (draining and excreting). This is due to the function of the "outer furnace bottom" (Spleen and Stomach transformation). If the Fire Qi of the Middle and Upper Jiao declines, the Upper Jiao cannot irrigate like mist, and the Middle Jiao cannot digest like a fermenting vat. Consequently, grains cannot be digested, and food is regurgitated after ingestion. Patients suffering from this disease have virtually no chance of survival, though distinctions exist between Upper-Middle and Lower-Middle types, and between rapid and slow death. The Upper-Middle type involves disharmony between the Upper and Middle Jiao; the Lower-Middle type involves disharmony between the Lower and Middle Jiao. Death is slower in Lower-Middle disharmony and faster in Upper-Middle disharmony. However, if treatment is appropriate, rapid death can be delayed; if treatment is inappropriate, slow death can accelerate.
Initially, when suffering from this disease, physicians often use acrid-aromatic qi-moving herbs, believing they can broaden the chest to open the appetite. Little do they know that the inability to eat stems from deficiency of True Qi (Vital Energy). Since True Qi is deficient, how can one further deplete it with acrid-dispersing herbs? Once Qi is depleted, those with relatively robust Yuan Ben (Root Essence) may barely survive; those with deficient Yuan Ben will lose their lives within months. Furthermore, initially, some physicians use blood-nourishing and Yin-moistening herbs, claiming they open the Lanmen (Gate of the Ileum) to direct flow downward, thus stopping vomiting. If the pathology lies in the non-communication between the Middle and Lower Jiao, food enters the Middle Wan, but the Lower Jiao fails to connect smoothly, causing digestive errors and upward reversal from the Middle Wan, resulting in vomiting. In such cases, moistening and descending herbs may be effective. However, if the disease recurs after cure and these herbs are administered again, they become ineffective. Initially, because the Lower Jiao failed to connect smoothly, moistening and descending methods worked; over time, Yin becomes excessive and Yang deficient, so the generating Yang Qi of the Lower Jiao cannot circulate back upward. With flow only downward and not upward, the treatment fails, inevitably leading to death. For cases involving declining Fire Qi in the Upper and Middle Jiao, using Ginseng, [White] Atractylodes, Ginger, Cinnamon, and Aconite early on may seem effective. Although symptoms improve, the disease remains unrooted. Later, physicians doubt the efficacy of warming and tonifying methods and switch to other drugs, leading to untreatable conditions. How can there be anyone in the world who does not eat grains? The Classics say: "Those who obtain grain thrive; those who lose grain perish." How profound!