肠结最为紧要之证，恒于人性命有关。或因常常呕吐，或因多食生冷及硬物，或因怒后饱食，皆可
致肠结，其结多在十二指肠及小肠间，有结于幽门者。其证有腹疼者，有呕吐者，尤为难治。因投以开结
之药，不待药力施展而即吐出也。亦有病本不吐，因所服之药行至结处不能通过，转而上逆吐出者。是以治
此证者，当使服药不使吐出为第一要着。愚于此证吐之剧者，八九日间杓饮不存，曾用赭石细末五两，从中
又罗出极细者一两，将所余四两煎汤，送服极细者，其吐止而结亦遂开。若结证在极危急之
时，此方宜放胆用之。虽在孕妇恶阻呕吐者，亦可用之（赭石解参赭镇气汤后载
有数案可参观），有谓孕妇恶阻，无论如何呕吐，与性命无关者，乃阅历未到之言也。
有患此证急欲通下者，愚曾用赭石细末三两、芒硝五钱，煎汤送服甘遂细末钱半，服后两点半钟其结
即通下矣。后有医者得此方以治月余之肠结证，亦一剂而愈。后闻此医自患肠结，亦用此方煎汤先服一半，甘
遂亦送下一半，药力下行，结不能开，仍复吐出；继服其余一半，须臾仍然吐出，竟至不起。由此知用药一
道，过于放胆固多失事，若过于小心亦多误事也。况甘遂之性，无论服多服少，初次服之尚可不吐；若
连次服之，虽佐以赭石，亦必作吐。是以拙拟荡胸加甘遂汤，原用大剂大承气汤加赭石二两煎汤，送服甘遂
细末二钱。方下注云∶若服一剂不愈者，须隔三日方可再服。此固欲缓服以休养其正气，实亦防其连服致吐
也。至于赭石可如此多用者，以其原质为铁养化合，性甚和平，且善补血，不伤气分，虽多用于人无损也。
特是药局中赭石，必火 醋激然后轧细，如此制法，则养气不全，不如径用生者之为愈也。况其虽为石类，
与铁锈相近（铁锈亦铁养化合），即服生赭石细末，亦于人肠胃毫无伤损。若嫌上方中甘遂之性过猛烈者，
本书载有硝菔通结汤方，药性甚稳善，惟制此药时，略费手续。方后载有治验两则，后又遇此证多次，皆以
此方治愈。
肠结是极为紧要的病证，常常关系到人的性命。可能是因为经常呕吐，或者多吃生冷及坚硬的食物，或者在发怒后饱食，都可能导致肠结。其结滞多发生在十二指肠和小肠之间，也有结于幽门部位的。该病证有的表现为腹痛，有的表现为呕吐，尤其是伴有呕吐的更难治疗。因为服用开通结滞的药物，还没来得及药力发挥作用就被吐出来了。也有原本不呕吐的病人，因为所服用的药物运行到结滞处无法通过，反而上逆被吐出。因此，治疗此证，首要关键是让服药后不引起呕吐。
对于我遇到的呕吐剧烈的此类病人，八九天内连一点水都喝不下存不住，我曾使用赭石细末五两，从中筛选出极细的一两，将剩下的四两煎成汤剂，用这汤送服那一两极细的赭石粉，结果呕吐停止，结滞也随之开通。如果结滞证处于极度危急的时刻，这个方子应当大胆使用。即使是孕妇因恶阻（妊娠呕吐）而呕吐的人，也可以使用此方（关于赭石的解说参看“赭镇气汤”后的案例可供参考），有人说孕妇恶阻无论怎么呕吐都与性命无关，这是阅历不足的话。
有患此证急于通下的情况，我曾使用赭石细末三两、芒硝五钱，煎汤送服甘遂细末一钱半，服药后两个半小时，结滞就通下了。后来有位医生得到这个方子用来治疗持续一个多月的肠结证，也是一剂药就好了。后来听说这位医生自己患了肠结，也使用这个方子，先煎一半汤剂服用，甘遂也送服了一半，药力下行，但结滞未能开通，仍然呕吐；接着服用剩下的一半，片刻之后又呕吐出来，最终导致死亡。由此可知用药之道，过于大胆固然容易出错，但如果过于小心谨慎也往往耽误病情。况且甘遂的药性，无论服用多少，初次服用时通常不会引起呕吐；如果连续多次服用，即使配合赭石，也一定会引起呕吐。所以我拟定的“荡胸加甘遂汤”，原方是用大剂量的大承气汤加入二两赭石煎汤，送服甘遂细末二钱。方剂下方注明：如果服用一剂后未愈，必须间隔三天才可以再次服用。这固然是想通过延缓服药来休养病人的正气，实际上也是防止连续服药导致呕吐。至于赭石可以如此大量使用，是因为它的原质是氧化铁化合物，性质非常平和，且善于补血，不损伤气分，虽然大量使用对人也没有损害。只是药局中的赭石，必须经过火烧醋淬然后轧碎，这样的制法会导致氧化铁成分不全，不如直接使用生赭石更好。况且它虽然是石类，与铁锈相近（铁锈也是氧化铁化合物），即使用生赭石细末，也对人的肠胃毫无损伤。如果觉得上方中甘遂的药性过于猛烈，本书记载有“硝菔通结汤”方，药性很稳妥善良，只是制作此药时稍微麻烦一些。方后记载有两个治愈案例，后来又多次遇到此证，都是用此方治愈的。
Intestinal obstruction (Chang Jie) is a critical condition that often threatens life. It can be caused by frequent vomiting, excessive consumption of raw and cold or hard foods, or overeating after anger. The obstruction usually occurs between the duodenum and the small intestine, or sometimes at the pylorus. Symptoms may include abdominal pain or vomiting; cases with vomiting are particularly difficult to treat because the medication intended to resolve the obstruction is vomited out before it can take effect. In some cases where vomiting was not originally present, the ingested medicine reaches the site of obstruction, cannot pass through, and is forced back up, causing vomiting. Therefore, the primary goal in treating this condition is to ensure that the patient does not vomit after taking the medicine.
For patients with severe vomiting due to this condition, who had been unable to retain even a spoonful of liquid for eight or nine days, I once used five taels of fine Ochre powder (Heshi). From this, I sifted out one tael of the finest particles. The remaining four taels were decocted into a soup, which was then used to administer the one tael of finest Ochre powder. This stopped the vomiting and resolved the obstruction. In extremely critical cases of intestinal obstruction, this formula should be used boldly. Even for pregnant women suffering from hyperemesis gravidarum (Ezu), this can be applied (see the case studies following the description of Zhenqi Tang with Ochre for reference). Some claim that vomiting during pregnancy, regardless of severity, is irrelevant to life; this is a statement born of insufficient experience.
In cases where rapid purgation is urgently needed, I once used three taels of fine Ochre powder and five qian of Mangxiao (Mirabilite), decocted in water, to administer one and a half qian of fine Kansui powder (Gansui). Half an hour and a half after ingestion, the obstruction was relieved. Later, another physician used this formula to treat a case of intestinal obstruction lasting over a month and achieved a cure with a single dose. Subsequently, I learned that this same physician suffered from intestinal obstruction himself and used this formula: he first took half the decoction and administered half the Gansui powder. Although the medicinal force moved downward, the obstruction did not resolve, and he vomited again. He then took the remaining half, but vomited immediately afterward, leading to his death. This illustrates that while being too bold in prescribing can lead to errors, being overly cautious can also cause missed opportunities. Furthermore, regarding the nature of Gansui, whether taken in large or small amounts, it typically does not induce vomiting upon the first administration. However, if taken repeatedly, even when combined with Ochre, it will inevitably cause vomiting.
Therefore, my formulated "Dangxiong Decoction with Added Gansui" uses a large dose of Dachengqi Tang (Major Order the Qi Decoction) with two taels of Ochre decocted together, to administer two qian of fine Gansui powder. A note below the formula states: "If one dose is ineffective, wait three days before administering again." This is intended not only to allow time for the body's healthy qi to recover by spacing out doses, but also to prevent vomiting caused by continuous administration. Ochre can be used in such large quantities because its original composition is iron oxide, which has a very mild nature, nourishes blood, does not damage qi, and is harmless even in large doses. However, Ochre sold in pharmacies is often calcined with vinegar and crushed; this processing method compromises its chemical integrity. It is better to use raw Ochre directly. Although it is a mineral similar to rust (which is also iron oxide), using raw fine Ochre powder causes no harm to the gastrointestinal tract. If one finds the potency of Gansui in the above formula too harsh, the book records another formula, Xiaofu Tongjie Tang (Radish and Mirabilite Obstruction-Resolving Decoction), which has a stable and gentle nature, though its preparation is slightly more laborious. Two successful case reports follow this formula, and I have successfully treated multiple subsequent cases of this condition using it.